Policy Holder’s Manual - Private Car Package
Bajaj Allianz General Insurance Company Ltd.
Regd. Off. : GE Plaza, Airport Road, Yerwada, Pune - 411 006. Tel. (91-20) 66026666, Fax (91-20) 66026667
Website : www.bajajallianz.co.in
1-800-22-5858 -( Toll Free) - BSNL / MTNL Land Line
1-800-102-5858 -( Toll Free) - Bharti / Airtel
30305858
OR SMS US AT 9860685858 “ MOTOR CLAIM” YOU WILL GET A CALL
Help Line No. :
Insurance is subject matter of solicitation
CONTENTS
1. Contact Details for Claim Intimation 02
2. Bagic 24 X 7 Spot Assistance 03
3. Chapter 1 -
Prevention is Better than cure 04
4. Chapter 2 -
Claim Guidelines 12
5. Chapter 3 -
Terms and Condition 16
6. Chapter 4 -
Renewal of Insurance Policy 18
7. Annexure I -
Motor Insurance Claim Form
8. Annexure II -
Private Car Insurance - Proposal Form
9. Annexure III -
Private Car Insurance - Policy Schedule 37
10. Annexure IV -
India Motor Tariff - Endorsements Private Car 45
11. Annexure V -
List of Insurance Ombudsmen 55
12. Annexure VI -
For Status of your claim or any other help call
your nearest office 58
Important Details
Period of Insurance From To
Complete Policy Number
Name of the Insured
Contact number of Insured
Vehicle type & Model
Engine No.
Chassis No.
Dear Customer
Seasons Greeting !!!
At the outset, please accept our sincere thanks for choosing of Bajaj Allianz General Insurance Co. Ltd. as your insurer. It has been our
constant endeavor to bring the best products and services in the industry to our valued customers backed by the highest claim
settlement rate. As a result Bajaj Allianz have been rated IAAA by ICRA Ltd on claim payability 2006. Therefore you can be rest assured
of an unmatched Bajaj Allianz care & protection at all times in your motoring.
Policy Holder's Manual is one such proactive effort in this direction to provide valuable inputs in order to minimize incidents affecting
your personal as well as vehicle safety. The manual also covers the process and requirements needed to speed up the settlement of
claims in the event an unfortunate accident or loss.
Our call center is accessible round the clock and throughout the year for an early help and support to our customers. Should you
require any assistance or guidance on the spot of accident even during odd hours e.g. towing, medical etc. , please do not hesitate to
ask call center for unique Bajaj Allianz 24 X 7 Spot Assistance .
Our unique PRE-PAID Claim Settlement facilty will provide you freedom to choose your own garage and get the vehicle repaired at
your own convenient time without getting in to the usual long process. All you have to do is contact, our call center or local office and
ask for Bajaj Allianz Drive In Centre
Vehicle thefts are on the rise in many part of country particularly in major cities. As per Police reports, thefts usually happen out of
misuse of original keys after the same is misplaced or copied. We therefore, suggest you to take extra care in protecting your vehicle
keys and avoid handing over keys to strangers including unscrupulous parking lot attendants valets in valet parking and garages.
Also it is advisable to fit antitheft device / engine immoblizer, over and above the Original Equipment supplied locking system. We
at Bajaj Allianz have made special arrangement with the suppliers of such antitheft devices in the major cities to supply and fit these
devices with lucrative discounted price. You may contact our local office for the same.
Happy Motoring.
Vijay Kumar
VP Motor
DISCLAIMER : Contents of this manual shall not alter, amend, modify or any other way affect the terms and conditions of the insurance policy
issued. In case of any discrepancy or conflict between the contents in the manual and terms & conditions of the policy issued, the terms &
conditions of the said in the policy shall prevail
01
Contact Details for Claim Intimation
Claim intimation & registration
Call us at
1-800-22-5858 -( Toll Free) - BSNL / MTNL Land Line only
OR
1-800-102-5858 -( Toll Free) - Bharti / Airtel
OR
30305858
OR
Or SMS at 9860685858 " MOTOR CLAIM" We will call you back
OR
Send a e-mail to "[email protected]"
Please obtain claim registration number ( It is useful for future reference)
Claim Status Information
Please make sure to provide your mobile number to
Bajaj Allianz Call Centre while registering claim for follow up reasons.
- On allotment of surveyor you will receive SMS giving details of surveyor.
- On approval of claim you will receive SMS giving approved amount
- For all any query contact nearest Bajaj Allianz office ( refer list of BAGIC offices)
BAGIC 24 X 7 SPOT ASSISTANCE
PREPAID SETTLEMENT AT BAJAJ ALLIANZ DRIVE IN CENTRES
Bajaj Allianz had ensured that its customers are guided and supported at every stage in case any unfortunate accident
takes place, Our BAGIC 24 X 7 Spot assistance is always there round the clock to assist and guide in following areas
lMedical assistance.
lDrop to nearest taxi/bus/ railway station.
lLegal assistance.
lTowing to workshop/shifting to a safe location.
lSpot surveying.
lProviding claim form and guidance
Please note : The above assistance is limited to providing necessary guidance and advice in selected cities only .
Bajaj Allianz will not be responsible or involved in monetary assistance or transactions what so ever and bills needs
to be settled by you.
Incase of minor losses / damages e.g. windshield damage, bumper damage,fender damage etc. special
arrangements made for valued customers at 53 cities.
You just need to drive in any of these Bajaj Allianz Drive in Centres .Loss survey , settlement etc. will be done with in
no time and payment can be made before you choose repairer. You are at your liberty to shop & repair vehicle at
your convenience. After repair you should show the vehicle for reinspection.
For more details and appointment you may contact call centre or nearest Bajaj Alllianz office.
Please don't remove the Vehicle from the
spot of accident without consulting us.
The address, phone numbers, fax numbers are subject to change without prior notice
02 03
Prevention is Better than Cure
Protect Your Car From Theft
lAlways Keep Your Vehicle Locked and Keys at Safe Place
The majority of vehicles stealing takes place while vehicles are left unlocked and often the keys are left in the
ignition. Even if you leave vehicle for a moment or more, make sure that the vehicle is properly locked and the
keys are with you. NEVER leave your vehicle with the engine running. This is an open invitation to thieves.
lDo not Hand Over Keys Strangers
Please remember that keys can be duplicated in no time. Therefore refrain from giving keys to any unknown
parking lot attend / garaging person / valet parking. These instances are mis-utilized by vehicle lifters. Many
such links are unearthed.
l Put Anti Theft Device in Addition to Original Equipment supplied Lock
Most of the cars carry mechanical steering cum ignition lock as standard fitment. Over the period the keys and
key barrel were out and keys become ineffective. In addition there is always possibility of duplication of keys,
therefore it is safer to put additional anti theft device which cuts off fuel and electrical circuit. In certain cities
we have made a special provision with the suppliers of such devices at a special rate. You may contact nearest
office for more information.
lKey Misplacement
Sufficient care must be taken to replace key and lock set or put additional safety measures.
lPark in Well-Lit and Busy Areas
Studies suggest the most of the theft take place when vehicle is parked in unprotected areas in night time.
Make sure your vehicle is parked in safe and protected area, this reduces the chance of vehicle lifting.
lFit a suitable Anti theft device / Engine immmobilizer
Suitable Immobilizer/ secret Ignition or fuel cut off switch in your car saves it from theft menace. Contact
Bajaj Allianz staff at the nearest office for Identifying anti-theft devices suitable for your car, assistance fitment
and for information on available discounts under promotional schemes, our staff at the nearest office.
Crumple zones protect the occupants in case of frontal impact.
Side impact bars in doors protect side impact.
Three stage protective bumpers protect the vehicle from impacts.
Non-jamming doors facilitate easy evacuation of occupants from vehicle in emergency.
ABS – braking system provide stability and direction control even in hard braking in slippery surfaces.
Traction system provide optimum gripping and stability on all kinds of road surfaces.
Air bag prevent occupant dash against vehicle interiors and avoid serious injuries.If used along with seat
belts.
Seat belts with pre-tensioners provide secured position even in case of accident.
Head restraints are extensions of the car’s seats that limit head movement during impact from rear side and
reduce the probability of neck injury.
Collapsible steering to absorb impact and protects the driver from being trapped between the steering wheel
and seat, during a collision.
Laminate / shatter proof glass avoid injuries generated by broken sharp glass pieces.
Automatic dimming rear view mirrors facilitate night driving.
Tyres provide directional control and provide effective braking, make sure that the tyres with enough tread
depth are fitted in the vehicle
Check your vehicle’s safety features:
Safe Driving:
Chapter 1
04 05
Fasten your seat belts:
Buckling up your safety belt may be the single most dramatic move you can make to reduce your health risks by
50% as seat belt restrain body movement in the event of front collision. Please ensure that seat belts are in
proper condition and seat back rest is in upright condition for effectiveness.
Head Restraints:
Head restraints are extensions of the car seats that limit head movement during impact from rear side and
reduce the probability of neck injury. Ensure height of head restraint is appropriately adjusted in acordance
with height and position of your head before.
Air Bags:
Airbags are meant to protect face and upper part of the body during major impacts from hitting any object e.g.
windshiled , steering wheel car interior directly. Ensure that seat belts are fastened.
Brakes :
Check braking system effectiveness of your vehicle before you start your journey by few repeat brake
applications. Generally braking is less effective on wet roads and loose soil.
Tyres :
Check tyre pressure and condition before going for drive. Ensure these are in good condition as per
manufacturer’s recomendations. Excessive tyre pressure reduce tyre-road contact area and hence reduce
braking efficiency. Similarly worn out tyres substantially reduces road grip at endanger while negotiating
sharp turns and high speed manuvouring.
Windshield Glass :
While driving on road with loose pebbles do not follow closely any other vehicle , as chances of loose stones or
pebbles caught in tyres of other vehicle can hit the windshield.
Never Drink and Drive :
Young people in particular are at high risk for auto accidents. Alcohol is the major cause of fatal car crashes
caused by human error. People are killed on the road every day because they or others had alcohol-impaired
judgment or reflexes. Drunk driving results in hundreds of thousands of injuries including lifetime disability
from brain damage, paralysis, blindness, amputated or deformed limbs.
If you are taking any medications, be sure to read and obey the warning labels. If the label says the medication
causes drowsiness or not to drive-heed the warning and don’t drive. The warnings are there for a reason.
Consult with your doctor or pharmacist if you have any questions or to ask about medications for your
condition that don’t cause drowsiness.
Freshen Up & recharge Yourself :
Make sure you that you are fresh and charged enough after good last night sleep before you go for drive.
Avoid Driving Alone :
Avoid driving alone especially for long drives
Plan in Advance
Plan sufficiently in advance to avoid excessive speeding and stress driving.
Keep Your Eyes On The Road
Avoid taking your eyes off the road by eliminating any possible distractions ahead of time. Before setting out
on a drive, be sure that important items are within easy reach, i.e. directions and
maps, sunglasses, etc. Reduce to a minimum possibly dangerous diversions of
06 07
your attention from the tasks of safe driving such as c h a n g i n g t a p e s o r
compact discs and always pull over to a safe place to use your cellular telephone
Maintain Distance
Maintain adequate gap with vehicles ahead and running behind your vehicle to avoid panic braking. Driver
should vary the speed of the vehicle
.
Precautions While Turning
Put on turning indicators sufficiently in advance to enable vehicles approaching and following vehicle to
reduce their speed. Decision to take turn must be followed by rear view
mirrors.
Courteous driving is a key to reducing traffic crashes.
Yield the right-of-way at intersections.
Do not weave in and out of traffic.
A yellow light means to SLOW DOWN and be prepared to STOP.
Many crashes occur due to people rushing to “beat” the yellow light.
ALWAYS obey school zone speed limits and stop for school buses with flashing lights
Avoid driving while speaking on cell phone..
Give the right of way to emergency vehicles.
Prepare yourself for night driving
Traffic death rates are three times greater at night than during the day, yet many of us are unaware of night
driving’s special hazards or don’t know effective ways to deal with them.
Driving Etiquettes
Night Driving
Driving at night is more dangerous than during the day. One of the obvious reasons is reduced visibility
resulting into excessive fatigue and stress
As per governement statistics , people returning from long hour parties are generally intoxicated, hence
extra care has to be taken for own and other’s driving as well.
Make frequent stops for light snacks and exercise. If you’re too tired to drive, stop and get rest.
Effective planning and check up of vehicle is necessary it minimizes risk in night driving.
Most of the accident occur due to poor intensity and incorrect direction of head lamps beam. With aging of
the vehicle head lamp reflectors become dull and reduced reflection of light beam. Hence regular
maintenance checks and replacement required if necessary.
Keep your headlights on low beams when following another vehicle so you don’t blind the driver ahead of you
or light reflecting in the mirror of the vehicle ahead.
Never venture to drive through water when flow above tyre centerline. The engine, electrical and electronics
components may get seriously damaged if attempts are made to cross through deep waters.
while passing though low level water logged area use lowest gear and high acceleration to prevent blocking
of exhaust gases coming out of engine.
In case the vehicle is flooded while it is parked e.g. basement parking, do not try to crank/ push start the
engine. Even one attempt can cause serious damage to engine. Consult the expert technician for check and
necessary rectifications.
While traveling in rain – Check wiper motor & blade, brakes, windshield glass, steering, tyres etc. most
effected items for proper functioning. Avoid rash driving with harsh braking.
Tips for Driving in Rain and Water logged Area
Save Your Vehicle from fire
08 09
Generally modern days vehicles are considered to be safe, However chances of fire cannot be ruled out due to various
reasons . Few important tips are mentioned below:
l Avoid any contact of electrical appliance and mobile phone in case there is any fuel / fumes leakage.
l Ensure that fuel lines are properly maintained and not tampered. All MPFI vehicle run with high fuel pressure
thus any attempt to remove fuel by cutting or removing pipe can be dangerous.
lEnsure high tension cords are well maintained and free from cracks and spark leakage.
l Ensure that the vehicle is parked at a properly clean and paved place and free from attack of rats and insects.
Rats has tendency to damage fuel pipes and high tension cord as well. Donot ever park running vehicle on the
flammable materials e.g papers, wood, plastics etc. as catalytic converter is very hot for some time even after
engine is switched off.
lDo not run the vehicle in idle for long time e.g. waiting with AC on for incomming passengers. This can result
overheating of catalytic converter.
l Do not fit any electrical and electronics accessories without proper guidance of an expert.
lEnsure recommended size battery is fitted in your vehicle. Abnormal sized battery can cause short circuit with
hood and other parts.
l Do not keep any flammable substance e.g gas cylinder , perfume bottle , air freshner while vehicle is parked in
Sun as the temperature raises steeply can cause fire hazard.
Emergency handling kit:
Your Policy holder manual.
Owner’s Manual of the vehicle manufacturer.
First Aid Kit with Duct Tape.
Flash Light, Reflective Triangles, Portable radio and spare batteries.
Emergency Kit
Spare tyre in good condition
Tool Kit with screw drivers, recommended wrenches, pliers, tire pressure gauge , jack & jack rod, jumper
cables
Documents as per government regulations:
Proof of valid certificate of registration
Proof of valid certificate of insurance
Proof of payment of tax .
Permit · P.U.C certificate
Driving license
any other document as notified by Government from time to time.
10 11
Claim Guidelines
A. In case of an accident
1 Park the vehicle safely -
2a. Intimate Us -
2b. Inform Following details to Call Centre -
3 Shift the vehicle to Repair Shop
Shift the vehicle safely to the side of the road to avoid further damage or and intimate Bajaj Allianz General
Insurance call centre for further advice. Please donot remove the damaged vehicle without recommendations
from the spot. As we may carry out spot inspection to verify the cause , circumstances , responsibility and
admissible loss.
Intimate the call centre for seek advice
1-800-22-5858 -( Toll Free) - BSNL / MTNL Land Line, 1-800-102-5858 -( Toll Free) - Bharti / Airtel
020 - 30305858 Or SMS at 9860685858 “ MOTOR CLAIM” We will call you.
Send a e-mail to “[email protected]”
You get a claim registration number (It is useful for future reference)
Complete policy number
Name of the insured ( vehicle owner)
Name of the driver
Insured’s ( vehicle owner’s) contact number
Place of accident
Vehicle registration Number
Vehicle type & Model
Brief description of the accident
Date and time of the accident
Where the vehicle is lying currently.
Other details asked by call centre
a Avail special services ( limited cities only) - Ask call centre for details Complementary towing / pick up of the
damaged vehicle by towing agency
Preferred / tie up garages for timely quality repair , cash less facility and value added services
b. It is advantageous to repair your vehicle at Bajaj allianz Preferred Workshops ( Refer page No.14)
Filled claim form with contact numbers, mobile number and e mail id.( given in booklet).
Proof of insurance - policy / cover note
Copy of registration book , tax receipt ( please furnish original for verification)
Copy of motor driving licence with original of the person driving the vehicle at the time of accident.
Police panchanama / FIR ( in case of third party property damage / death / bodily injury)
Estimate of repair from the repairer.
Surveyor will inspect the vehicle at workshop. It is advisable to be present in workshop during surveyor’s visit.
Provide requisite documents to surveyor as above Information about the approved claim amount and
deductions through CAC sheet ( Claim amount confirmation) will be made available to the garage before
delivery date of the vehicle . You may ask for the same from the repairer.
Incase of vehicle is being repaired at Bajaj Allianz Preferred workshop, the payment will be made directly to the
garage and you are required to pay only the difference as per bill if any.
For all garages other than preferred garages, you are required to settle the bill with the workshop and submit bills
along with the documents to the nearest Bajaj Allianz office for reimbursement as per surveyor’s report.
You are advised to contact nearest Bajaj Allianz office in case of any claim related query not call centre. List of
offices with address , contact person name and telephone numbers are provided at annexure - 1
6 Submit bill to the surveyor or nearest Bajaj allianz office
7 Reimbursement will take approximately 7 days / 30 days (for net of loss) from the date of submit of final bill -
provided all documents are in order and with in policy purview.
4 Hand over documents to surveyor / garage.
5 Cooperate with Bajaj Allianz during following activities carried out
Chapter 2
12 13
B. In case of injury to third party / damage to property
C. In case of theft
Assist the injured person and shift to the nearest hospital.
Report the matter to the nearest police station and obtain a copy of FIR.
Donot make any promises or offer compensation to any third party who may be involved in the accident on behalf
of Bajaj Allianz . Such promises are not binding on Bajaj Allianz
Inform third party injury or damage to Bajaj Allianz General Insurance Company Limited.
Report the claim to call centre with in 24 hours of the theft.
File FIR with in 24 hours and obtain a copy.
Bajaj Allianz may depute an investigator to verify facts and collect necessary documents as mentioned in the
claim form.
If the claim is admissible then Bajaj Allianz office may require documents for transferring the rights of the vehicle
in the name of the company . You may get in touch with nearest office for details.
The process may take a minimum of 3 months if all the requirements are met and documents are in order
including not traceable report from court / police.
Advantages of Bajaj Allianz Preferred Workshop (BAPW)
S.N. Features Bajaj Allianz Preferred Workshop Other Garages
1 Repair Cost Low High : Due to unnecessary part
replacement.
2 Repair Quality Good quality
6 months warranty on repair No warranty
Depend on contractors.
3 Time taken for repair Low: Due to low volume & better High: Due to poor supervision.
supervision by owner himself
4 Response to query / No follow up required ,prompt Poor Accountability.
Follow up response.
5 Survey Fast Survey ,no follow up needed Delay in survey , Customer to follow up
6 Cost difference to be borne Low: little difference between High : Large difference between bill
customer. billed amount and claim amount amount and claim amount, due to
higher depreciation component.
7 Depreciation Low : Due high labour content High : due to higher part content
than parts
8 Tow in facility Free of cost within municipal limits Customer to pay
9 Free pick up & drop Available free of cost * Charged to Customer
10 Value added services For Periodical Maintenance jobs
1. 30% discount on labour charges. 1. No discount offered.
2. 5% discount on parts (Maruti vehicles) 2. No discount offered.
3. Free pick up & drop.* 3. Not guaranteed
For Accidental Repairs
1. Cashless settlement. 1. Not guaranteed
2. Free of Cost fuel additives. 2. Not guaranteed
3. Complementary washing, 3. Not guaranteed
cleaning & polishing
For nearest BAPW call our call Center
*subject to terms and conditions
14 15
Terms and Conditions
A. What is not covered
=Loss or damage where the premium has not been credited to Bajaj Allianz General Insurance Company Ltd.
account due to any reason whatsoever.
=Loss or damage caused due to mechanical and electrical breakdown , including manufacturing defect.
=Loss or damage as a result of improper usage or operational error by the driver.
=Depreciation on the repair bill as per age of vehicle as stated in the policy.
=Loss due to deductions on account of depreciation on parts made of plastic / nylon / rubber etc. under 50% / 30%
category as per guidelines of the IRDA.
=All deductibles as mentioned in the policy schedule , including the excess clause.
=Loss or damage which is not intimated in time I.e maximum within 72 hours of loss.
=Towing charges if service is provided or offered by Bajaj Allianz but not accepted by customer due to any reason
whatsoever.
=Loss or damaged where an opportunity is not given to our representative to survey or investigate, including speot
inspection.
=Loss or damage in case the vehicle is not registered permanently.
=Minor scratches, fading , wear and tear requiring touch up or minor repair under rutine maintenance.
=Loss or damage to the vehicle when driven by a person without valid permanent driving licence.
=Loss or damage to vehicle when used in violation of Motor Vehicle Act 1988 of India.
=Loss or damaged to vehicle which has been altered / modified without approval of RTO / manufacturer’s
recommendations.
=Loss or damage to vehicle when driven in violation of manufacurer’s guidelines such as , number of occupants /
over loading and other guidelines stated in the user manual.
=Extension of loss / addition of damage over and above the initial damage as a result of negligence on the part of
owner while towing / transportation / loading-unloading / handling of damaged vehicle.
=Loss of damage to engine unit due to hydrostatic lock, oil leakage and oil starvation , leakage of coolant
Any other charges over nad above the recommendation of the surveyor, including damages not related to the
cause of loss.
=Loss to vehicle when used for any other purpose other than specified in the policy “ Limitation as to use” Loss or
damage in case of non disclosure of actual facts and circumstances related to accident, including the clause of
details of the third party vehicle.
=Amount deductible under the excess clause as specified in the policy.
=Deduction of salvage / scrap value up to 5% of total value of parts.
=In case you prefer the workshop of your choice then Bajaj Allianz General insurance Company Limited cannot
assure special benefits such as cash less settlement, quality repair, maximising compensation and other benefits
decided by company or the preferred garages from time to time.
=Make sure to register FIR with the local police station in case of theft loss, major loss , damage to third party
property , third party physical injury.
=Any changes in the vehicle particulars mentioned in the policy schedule including ownership chassis , engine,
other particules, purpose of usage, modification / alternation in the machine involving change in risk must be
immediately intimated to the nearest Bajaj Allianz Office. Make sure that the changes are endorsed in the policy
schedule at the office.
=In case you have migrated to any other city in India , you may contact the nearest office for change in address
other service ( list of offices attached.)
=In case of the payment of premium is paid by cheque , please make sure that the amount has been credited to
bajaj Allianz General insurance Company Limited bank account.
B. Important Things to Remember :
Chapter 3
16 17
Renewal of Insurance Policy
nEvery motor policy should be renewed before expiry date and time. Failure to do so can lead to unnecessarily
burden incase any mishappening takes place. You may loose no claim bonus.
nBajaj Allianz has made necessary arrangements to send automatic reminders to all its policy holders to remind
renewal of policy.
nBajaj Allianz office or its agent may also contact you in person, by telephonic reminder or by renewal notice before
one month of expiry of policy.
nYou may send demand draft / cheque along with the renewal notice received from our company or agent. If the
notice is not received contact our call center or agent for the same.
nYou may log into our web site https://www.bajajallianz.co
Select Buy Online – Motor / Bike
nFeed the inputs for computation of premium.
Pay the premium on line by credit card.
nVisit / Call any of Bajaj Allianz insurance agent / office for detailed discussion and renew.
nYou must to fill up fresh proposal form in case followings
=In case there is gap in renewal of policy with respect to previous policy pre-inspection by designated Bajaj
Allianz officers is required
=In case owners ship of vehicle is transferred.
=In case vehicle configuration is altered / modified e.g fitment of CNG / LPG kit and / or any modification
done in vehicle or vehicle systems.
=In case any changes in vehicle usage pattern changed e.g. person driving , used by employees , used by
family members, paid driver.
=In case alteration required in optional personal accidental coverage.
=In case fitment/removal of accessories, antitheft devices etc.
Chapter 4
18
1. Important Instructions :
2. Policy Holder Details
a. Claim form is to be filled in capital letter & signed by the insured.
b. Please do not leave any column unanswered.
c. All facts and Statements must be factual not influenced or biased in any form.
d. The damaged vehicle must be parked at safe place to avoid any subsequent loss/theft. Company will not be
responsible for the same.
e. Please read carefully the attached list of documents required to speed up processing of your claim.
Policy No. : Cover Note No. :
Period of Insurance : From To :
Name of the Insured : Phone Off. :
Gender : Male / Female Date of Birth :
Address (Please note - If the Claim is approved, the Claim payment Cheque shall be dispatched at the address mentioned herein)
PIN : E mail :
Phone Res. : Mobile
MOTOR INSURANCE CLAIM FORM
THE ISSUE OF THIS FORM IS NOT TO BE TAKEN AS AN ADMISSION OF LIABILTY
3. Vehicle Details
4. Loss Details (Accident / Theft)
Registration No. : Make : Date of 1st Registration :
Chassis No. : Engine No. : Date of Transfer (if applicable) :
Type of Fuel : Colour of Vehicle :
Date : Time : Speed :
Exact Place Where loss occured :
Place to which the vehicle was heading for before accident :
Purpose for which vehicle was being used at the time of accident :
Nature of goods carried at the time of accident (Commercial Vehicle )
Number of people travelling and in what capacity at time of accident :
Is it reported to the Police ? YES / NO
Name of the Police Station : Gen. Diary/Crime No/FIR No. :
ANNEXURE I
ANNEXURE I ANNEXURE I
Yes / No
Express Way
National Highway
State Highways
City roads
Town/Village roads
Private roads
Yes / No
Business/office
Pleasure
Domestic
Social
MILEAGE at the time of accident.
Location of Accident
5. Statement of how the Accident / Theft Occured :
6. Give a rough sketch describing the road map & position of the vehicle at the time of accident.
9. Third Party Property Damage (include other vehicle involved)
Purpose of travel at the time of accident
7. Driver Details
ANNEXURE I ANNEXURE I
Declaration
1. I/We the above named, do hereby, to the best of my/our knowledge and belief, warrant the truth of the foregoing statements in every
respect and agree that if I have made any false or fraudulent statement of there be any suppression or concealment, the policy shall be
cancelled and the claim shall be forfeited.
2. I/We have received a list of documents with this claim Form and have understood all the requirement to be fulfilled for administration
of this claim and the Company shall not be held responsible for any delay in settlement of claim due to non-fulfilment of requirements
including the documents as mentioned above.
3. I/We agree to provide additional information to the Company, if required.
Name : Signature of insured : Date :
List of Documents required for claim settlement
(To be submitted to the nearby Bajaj Allianz office)
Claim for accidental damages:
1. Proof of insurance - Policy / Covernote copy
2. Copy of Registration Book, Tax Receipt [Please furnish original for verification]
3. Copy of Motor Driving Licence [with original] of the person driving the vehicle at the material time
4. Police Panchanama/FIR ( In case of Third Party property damage /Death / Body Injury)
5. Estimate for repairs from the repairer where the vehicle is to be repaired
6. Repair Bills and payment receipts after the job is completed
7. Claims Discharge Cum Satisfaction Voucher signed across a Revenue Stamp [format attached below]
Claim for theft cases:
1. Original Policy document
2. Original Registration Book/Certificate and Tax Payment Receipt
3. Previous insurance details - Policy No, insuring Office/Company, period of insurance
4. All the sets of keys/Service Booklet/Warranty Card
5. Police Panchanama/ FIR and Final Investigation Report
6. Acknowledged copy of letter addressed to RTO intimating theft and making vehicle "NON-USE"
7. Form 28, 29 and 30 signed by the insured and Form 35 signed by the Financer, as
the case may be, undated and blank
8. Letter of Subrogation
9. Consent towards agreed claim settlement value from you and Financer
10. NOC of the Financer if claim is to be settled in your favour
11. Blank and undated "Vakalatnama"
12. Claim Discharge Voucher signed across a Revenue Stamp [format attached below]
Additional documents in specific claims shall be intimated separately.
13. Additional documents in specific claims shall be intimated separately.
ANNEXURE I ANNEXURE I
PRIVATE CAR INSURANCE – PROPOSAL FORM
ABOUT YOU
1. Please answer all the questions in BLOCK letters.
2. If you require additional space please use space for additional information on reverse.
3. Failure to disclose material facts which an insurer would regard as likely to influence the acceptance and assessment of
your proposal can lead to your policy being rendered void. If in doubt as to whether certain facts are relevant, please include
the same.
1. Name in Full
2. Date of Birth 3. Sex Male / Female
4. Telephone No.: Mobile:
Office: Residence:
5. Address
PIN Code:
6. E-mail address
ANNEXURE II
ANNEXURE I ANNEXURE II
7. Occupation and Designation
Govt Employee Defence Personnel Public Sector official
Pvt Sector Official Business Self Employed (give details)
Others (give details)
8. Office / Business address
PIN Code:
9. Have you been previously insured in respect this vehicle? Yes / No
10. If Yes, are you entitled for No Claim Discount from
your previous insurer? If Yes NCB percentage
and No. of years without any claim.
11. Please give name of your previous insurer
12. Previous insurance policy no. and policy period
13. Are you member of Automobile Association of India?
If yes, give details of membership
Full Name Occupation
Relationship
with
Proposer
Date of
Birth
DD/MM/YY
No. of
years
driving
Suffering from any
disease / infirmity
(please see note below)
ABOUT THE DRIVERS
The vehicle to be driven by: 1. You the Insured only
2. You and Your Spouse
3. You, Your Spouse and any other person named below
Please give details of main drivers / Named drivers referred above:
Note: Please mention whether the person suffer from Diabetes, epilepsy, heart condition or any other disease or infirmity
(including uncorrected defective vision or a hearing or mental defect) that could affect his/her ability to drive
Have You or any of the above drivers:
1. Been prosecuted or convicted for any offence or any prosecution pending? Yes / No
2. Had motor insurance refused, had a policy cancelled or had any special conditions
imposed by any motor insurer? Yes / No
3. Had any loss, accident or claim during the last 3 years in connection with any motor vehicle? Yes / No
If you have answered Yes to any of questions above please give details
ANNEXURE II ANNEXURE II
12. Seating capacity including driver
13. Fuel used Petrol / Diesel / CNG / LPG / Electric / Any other (Please give details)
14. Kilometer reading as on date
15. Average Monthly use ………..km
16. Will the vehicle be let out on hire?
17. Whether use of vehicle limited to own premises?
18. Will the vehicle generally used on Yes No
Express Way
National Highways
State Highways
City Roads
Town/Village Roads
Private Roads
Please indicate more than one above also if used
19. Is the vehicle in good state of repair? Yes / No
20. If NO, give details
ABOUT THE MOTOR VEHICLE TO BE INSURED
1. Registration no. and date of registration of the vehicle
Date of Regn:
2. Registering authority & Location
If the vehicle is generally used in a place other than
the place of registration, please indicate the place
where it is generally used.
3. Is the vehicle registered as Private Car / Commercial Vehicle
4. Year of Manufacture
5. Engine No. & Chasis No.
6. Registration No.
7. Make
8. Model
9. Type of Body
10. Cubic Capacity
11. Colour
ANNEXURE II ANNEXURE II
21. Do you use tubeless tyres? Yes / No
22. Is the vehicle Company maintained? Yes / No
23. Is the vehicle fitted with anti-theft device? Yes / No
24. If Yes, please give:
· Manufacturer & type of device
· Whether approved by Automobile Research Institute, Pune? Yes / No
25. Where the vehicle will be parked Inside locked garage Inside covered, unlocked garage
during the night? Inside compound, in open On Public Road
Others (please give details)
26. Whether any modification or conversion has been done in the vehicle from the maker’s standard specification
and/or does it have any extras?
If Yes, please give details Yes / No
27. Do You have a second family car available? If Yes, please give details
ABOUT THE INSURANCE COVER REQUIRED
1. Type of cover required? Package cover
Third Party Liability only
Any other – Please explain
2. Do you wish to limit Third Party Property Damage cover to
the statutory limit of Rs.6000/-? Yes / No
3. Do you wish to opt for legal liability to:
a. Paid Driver Yes / No
b. Other employees Yes / No
(If Yes, No. of persons………….)
4. Do you wish to opt for Personal accident cover for
named persons? If Yes please give the name of the person
(other than insured or paid driver/cleaner)
5. Do you wish to cover Personal Accident cover for Yes / No
unnamed passengers? If Yes, sum insured per person: Rs………
6. What is the deductible you wish to opt for? Minimum (as per tariff)
Rs.2,500/- + Minimum Deductible
Rs.5,000/- + Minimum Deductible
Rs.7,500/- + Minimum Deductible
Rs.15,000/- + Minimum Deductible
ANNEXURE II ANNEXURE II
7. Insured Declared Value (IDV)
IDV of the vehicle to be fixed on the basis of manufacturer’s listed selling price of the brand and model as the vehicle
proposed for insurance at the time of taking policy adjusted for depreciation as per table below:
Age of the vehicle % of depreciation
for fixing IDV
Not Exceeding 6 months 5%
Exceeding 6 months but not exceeding 1 year 15%
Exceeding 1 year but not exceeding 2 years 20%
Exceeding 2 year but not exceeding 3 years 30%
Exceeding 3 year but not exceeding 4 years 40%
Exceeding 4 year but not exceeding 5 years 50%
For vehicles more than 5 years old, please talk to the insurer for fixing IDV
8. Is their any Hypothecation / Hire Purchase /
Lease interest to be noted in the policy?
If Yes, give the details of the party.
9. Whether geographical area extension to the
following countries required?
Bangladesh, Bhutan, Maldives, Nepal, Pakistan , Srilanka
If Yes, indicate which countries?
10. Period of Insurance required From _______________ to _______________
(a) For the vehicle:
(b) *Non-Electrical accessories:
(c) *Electrical Accessories
(d) CNG/LPG kit
*Please give details of the accessories
PREVIOUS INSURANCE HISTORY FOR THE VEHICLE
1. Date of purchase of the vehicle by the Proposer
2. Was it new at the time of purchase?
3. Past insurance history of the vehicle
(i) Name of the insurer
(ii) Policy No.
(iii) Period of insurance
(iv) Type of cover
(v) *NCB if earning
(vi) Details of claims for last 3 years
*For granting NCB, appropriate documentary evidence to be submitted.
I/We hereby declare and warrant that the above statements are true and complete in all respects and that there is no other information which
is relevant to my application for insurance that has not been disclosed to you. I agree that this proposal and the declarations shall be the basis
of the contract between me and Bajaj Allianz and I/We agree to accept a policy, subject to the conditions prescribed by Bajaj Allianz.
Place :
Date : Signature of the Proposer
ANNEXURE II ANNEXURE II
SECTION 41 OF INSURANCE ACT, 1938
No person shall allow or offer to allow either directly or indirectly as an inducement to any person to take out or renew or
continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of whole or part of the
commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or
continuing a policy accept any rebate except such rebate as may be allowed in accordance with the published prospectuses or
tables of the Insurer.
Any person making default in complying with the provisions of this section shall be punishable with fine, which may extend to
Five Hundred Rupees.
Bajaj Allianz General Insurance Company Limited
Important notice*
1. In the event of a claim ,please make sure to call our 24 hours Call Center directly
- to get your claim registered in our records and the claim number issued for future reference.
- to know about the claim process and the necessary requirements for faster settlement of claim.
- to know the approved garage where vehicle is to be taken for quality repair , cashless settlement and other
value added services
Improper communication can lead to delay in settlement or repudiation of claim :
2. Please refer to the Claim Guide copy supplied by your agent for more details on claim settlement process, requirements
and the Bajaj Allianz Preferred Workshops list . In case you have'nt received ,please contact our nearest office or the
agent.
3. Should you decide on garage of your choice , company cannot assure the services such as cash less settlement facility ,
quality of job , avoid excess or wrong billing by the garage .
To contact please dial toll free number :
or email at :
*Conditions apply
1-800-22-5858 -( Toll Free) - BSNL / MTNL Land Line only or 1-800-102-5858 -
( Toll Free) - Bharti / Airtel or 30305858 [email protected]
ANNEXURE III
ANNEXURE II
37
PRIVATE CAR PACKAGE POLICY
Whereas the Insured by a proposal and declaration dated as stated in the Schedule which shall be the basis of this contract and is deemed to be incorporated herein has applied to
Bajaj Allianz General Insurance Company Limited (hereinafter referred to as “Company”) for the Insurance hereinafter contained and has paid the premium mentioned in the
schedule as consideration for such insurance in respect of accidental, loss or damage occurring during the Period of Insurance.
NOW THIS POLICY WITNESSETH that subject to the Terms, Exceptions, and Conditions contained herein or endorsed or expressed hereon.
1. The Company will indemnify the Insured against loss or damage to the Motor Car insured hereunder and/or its accessories whilst thereon;
i. by fire explosion self ignition or lightning;
ii. by burglary housebreaking or theft;
iii. by Riot and Strike;
iv. by Earthquake (Fire and Shock Damage);
v. by Flood Typhoon Hurricane Storm Tempest Inundation Cyclone hailstorm Frost;
vi. by accidental external means;
vii. by malicious act;
viii. by terrorist activity;
ix. whilst in transit by road rail inland waterway lift elevator or air
x. by landslide/rockslide
Subject to a deduction for depreciation at the rates mentioned below in respect of parts replaced :
1. For all rubber, nylon, plastic parts, tyre, battery & air bags 50%
2. For fibre glass components 30 %
3. For all parts made of glass Nil
4. Rate of depreciation for all other parts including wooden parts will be as per the following schedule
AGE OF VEHICLE % OF DEPRECIATION
Not exceeding 6 months....................................... Nil
Exceeding 6 months but not exceeding 1 year .... 5%
Exceeding 1 year but not exceeding 2 years.... 10%
SECTION I - LOSS OR DAMAGE TO THE VEHICLE INSURED
Exceeding 2 years but not exceeding 3 years... 15%
Exceeding 3 years but not exceeding 4 years.. 25%
Exceeding 4 years but not exceeding 5 years..... 35%
Exceeding 5 years but not exceeding 10 years... 40%
Exceeding 10 years................................................... 50%
2 The Company shall not be liable to make any payment in respect of :
a. consequential loss depreciation wear and tear mechanical or electrical breakdown failures or breakages
b. damage to tyres and tubes unless the vehicle is damaged at the same time when the liability of the Company is limited to 50% of cost of replacement; and
c. Any accidental loss or damage suffered whilst the Insured or any person driving the vehicle with the knowledge and consent of the Insured is under the influence of
intoxicating liquor or drugs.
3 In the event of the vehicle being disabled by reason of loss or damage covered under this Policy the company will bear the reasonable cost of protection and removal to
the nearest repairer and redelivery to the Insured but not exceeding in all Rs.1500/- in respect of any one accident.
The Insured may authorise the repair of the vehicle necessitated by damage for which the Company may be liable under this Policy provided that:
a. the estimated cost of such repair including replacements does not exceed Rs. 500/-
b. the Company is furnished forthwith a detailed estimate of the cost of repairs and
c. the Insured shall give the Company every assistance to see that such repair is necessary and the charges are reasonable.
The insured declared value (IDV) of the vehicle will be deemed to be the ‘ SUM INSURED’ for the purpose of this policy which is fixed to the commencement of each policy period
for the insured vehicle.
The IDV of the vehicle ( and accessories if any fitted in the vehicle ) is to be fixed on the basis of the manufacturer’s listed selling price of the brand and model as the vehicle insured
at the commencement of insurance / renewal and adjusted for depreciation ( as per schedule below ).
The schedule of age wise depreciation as shown below is applicable for the purpose of Total loss / Constructive Total Loss (TL / CTL) claims only.
AGE OF VEHICLE % OF DEPRECIATION FOR FIXING IDV
Not exceeding 6 months.........................................5%
Exceeding 6 months but not exceeding 1 year ....15%
Exceeding 1 year but not exceeding 2 years......20%
Exceeding 2 years but not exceeding 3 years.....30%
Exceeding 3 years but not exceeding 4 years.....40%
SUM INSURED - INSURED’S DECLARED VALUE (IDV)
38 39
40 41
Exceeding 4 years but not exceeding 5 years.....50%
IDV of vehicles beyond 5 years of age and of obsolete models of the vehicles (i.e. Models which the manufacturers have discontinued to manufacture) is to be determined on the
basis of understanding between the insurer and the insured.
IDV shall be treated as the ‘ Market Value’ throughout the policy period without any further depreciation for the purpose of Total Loss (TL) / Constructive Total Loss (CTL) claims.
The insured vehicle shall be treated as a CTL if the aggregate cost of retrieval and / or repair of the vehicle, subject to terms and conditions of the policy, exceeds 75% of the IDV of
the vehicle.
1. Subject to the Limits of Liability as laid down in the Schedule hereto, the Company, will indemnify the Insured in the event of an accident caused by or arising out of the
vehicle, against all sums which the Insured shall become legally liable to pay in respect of :
i) death of or bodily injury to any person including occupants carried in the vehicle (provided such occupants are not carried for hire or reward) but except so far as it is
necessary to meet the requirements of Motor Vehicles Act the Company shall not be liable where such death or injury arises out of and in the course of the
employment of such person by the insured.
ii) damage to property other than property belonging to the Insured or held in trust or in the custody or control of the Insured.
2. The Company will pay all costs and expenses incurred with its written consent.
3. In terms of and subject to the limitations of the indemnity granted by this section to the Insured the Company will indemnify any driver who is driving the vehicle on the
insured's order or with insured's permission provided that such driver shall as though he were the Insured observe fulfil and be subject to the terms exceptions and
conditions of this Policy in so far as they can apply.
4. In the event of the death of any person entitled to indemnity under this Policy the Company will in respect of the liability incurred by such person indemnify his/her personal
representatives in the terms of and subject to the limitations of this Policy provided that such personal representatives shall as though he/she was the Insured observe fulfil
and be subject to the terms exceptions and conditions of this Policy in so far as they can apply.
5. The Company may at its own option (A) arrange for representation at any Inquest or Fatal Inquiry in respect of any death which may be the subject of indemnity under this
policy and (B) undertake the defence of proceedings in any Court of Law in respect of any act or alleged offence causing or relating to any event which may be the subject to
the indemnity under this Section.
Nothing in this Policy or any endorsement hereon shall affect the right of any person indemnified by this Policy or any other person to recover an amount under or by virtue of the
provision of the Motor Vehicles Act.
But the Insured shall repay to the Company all sums paid by the Company, which the Company would not have been liable to pay, but for the said provisions.
In the event of any accident involving indemnity to more than one person any limitation by the terms of this policy and/or of any Endorsement thereon of the amount of any
indemnity shall apply to the aggregate amount of indemnity to all persons indemnified and such indemnity shall apply in priority to the insured.
SECTION II - LIABILITY TO THIRD PARTIES
AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY
APPLICATION OF LIMITS OF INDEMNITY
SECTION III - PERSONAL ACCIDENT COVER
FOR OWNER - DRIVER
1 The Company undertakes to pay compensation as per the following scale for bodily injury / death sustained by the owner - driver of the vehicle, in direct connection
with the vehicle insured or whilst driving or mounting into / dismounting from the vehicle insured or whilst traveling in it as a co-driver, caused by violent accidental
external and visible means which independent of any other cause shall within six calendar months of such injury result in :
Nature of injury Scale of compensation
(I) Death .................................................... 100%
(II) Loss of two limbs or sight of two eyes or one limb and sight of one eye.......................... 100%
(III) Loss of one limb or sight of one eye.............. 50%
(IV) Permanent total disablement from injuries other than named above. .................. 100%
Provided always that
A) compensation shall be payable under only one of the items(i) to (iv) above in respect of the owner - driver arising out of any occurrence and the total liability
of the insurer shall not in the aggregate exceed the sum of Rs 2. Lakhs during any one period of insurance.
B) no compensation shall be payable in respect of death or bodily injury directly or indirectly wholly or in part arising or resulting from or traceable to (1)
Intentional self injury suicide or attempted suicide physical defect or infirmity or (2) an accident happening whilst such person is under the influence of
intoxicating liquor or drugs.
C) Such compensation shall be payable directly to the insured or to his/her legal representatives whose receipt shall be the full discharge in respect of the injury to
the insured.
2) This cover is subject to
(a) the owner-driver is the registered owner of the vehicle insured herein;
(b ) The owner driver is the insured named in this policy.
(c) the owner-driver holds an effective driving license, in accordance with the provisions of Rule 3 of the central Motor Vehicles Rules, 1989, at the time of the
accident.
(Applicable to all Sections of the Policy)
The Company shall not be liable under this Policy in respect of:
1. Any accidental loss damage and/or liability caused sustained or incurred outside the Geographical Area.
2. Any claim arising out of any contractual liability.
3. Any accidental loss damage and/or liability caused sustained or incurred whilst the vehicle insured herein is
a. being used otherwise than in accordance with the limitations as to Use or
b. being driven by or is for the purpose of being driven by him/her in the charge of any person other than a driver as stated in the drivers clause.
GENERAL EXCEPTIONS
42 43
4. a. Any accidental loss or damage to any property whatsoever or any loss or expense whatsoever resulting or arising therefrom or any consequential loss.
b. Any liability of whatsoever nature directly or indirectly caused by or contributed to by or arising from ionising radiations or contamination by radioactivity from
any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel. For the purpose of this exception combustion shall include any self-sustaining
process of nuclear fission.
5. Any accidental loss damage or liability directly or indirectly caused by or contributed to by or arising from nuclear weapons material.
6. Any accidental loss damage and/or liability directly or indirectly or proximately or remotely occasioned by contributed to / by or traceable to or arising out of or in
connection with War, Invasion, the Act of foreign enemies, hostilities or Warlike operations (whether before or after declaration of war) Civil War, Mutiny Rebellion,
Military or usurped power or by any direct or indirect consequences of any of the said occurrences and in the event of any claim hereunder the Insured shall prove that
the accidental loss damage and/or liability arose independently of and was in no way connected with or occasioned by or contributed to by or traceable to any of the
said occurrences or any consequences thereof and in default of such proof the Company shall not be liable to make any payment in respect of such a claim.
The Company shall not be liable for each and every under Section -I (loss of damage to vehicle insured) of this policy in respect of the deductible stated in the schedule.
This policy and the Schedule shall be read together and any word or expression to which a specific meaning has been attached in any part of this Policy or of the Schedule shall bear
the same meaning wherever it may appear.
1. Notice shall be given in writing to the Company immediately upon the occurrence of any accidental loss or damage in the event of any claim and thereafter the Insured
shall give all such information and assistance as the Company shall require. Every letter claim writ summons and/or process or a copy thereof shall be forwarded to the
Company immediately on receipt by the Insured. Notice shall also be given in writing to the Company immediately the Insured shall have knowledge of any impending
Prosecution Inquest or Fatal Inquiry in respect of any occurrence, which may give rise to a claim under this Policy. In case of theft or criminal act which may be the
subject of a claim under this Policy the Insured shall give immediate notice to the Police and co-operate with the Company in securing the conviction of the offender.
2. No admission, offer, promise, payment, or indemnity shall be made or given by or on behalf of the Insured without the written consent of the Company which shall be
entitled if it so desires to take over and conduct in the name of the Insured the defence or settlement of any claim or to prosecute in the name of the Insured for its own
benefit any claim for indemnity or otherwise and shall have full discretion in the conduct of any proceedings or in the settlement of any claim and the Insured shall give
all such information and assistance as the Company may require.
3. The Company may at its own option repair reinstate or replace the vehicle or part thereof and/or its accessories or may pay in cash the amount of the loss or damage and
the liability of the Company shall not exceed
a) For total loss / Constructive total loss of the vehicle the Insured’s Declared Value (IDV) of the vehicle (including accessories thereon ) as specified in the
schedule as the value of the wreck
b) For partial losses i.e. Losses other than total loss / constructive total loss of the vehicle - actual and reasonable cost of repair and / or replacement of parts lost or
damaged subject to depreciation as per limits specified.
4. The Insured shall take all reasonable steps to safeguard the vehicle from loss or damage and to maintain it in efficient condition and the Company shall have at all times
free and full access to examine the vehicle or any part thereof or any driver or employee of the Insured. In the event of any accident or breakdown the vehicle shall not be
left unattended without proper precautions being taken to prevent further damage or loss and if the vehicle be driven before the necessary repairs are effected any
extension of the damage or any further damage to the vehicle shall be entirely at the insured's own risk.
DEDUCTIBLE
CONDITIONS
5. The Company may cancel the policy by sending seven days notice by recorded delivery to the insured at the insured’s last known address and in such event will return to
the insured the premium paid less the pro rata portion thereof for the period the policy has been in force or the policy may be cancelled at any time by the insured on
seven days’ notice by recorded delivery and provided no claim has arisen during the currency of the policy, the insured shall be entitled to a return of premium less
premium at the company’s Short Period rates for the period the policy has been in force. Return of the premium by the company will be subject to retention of the
minimum premium of Rs.100/- (or Rs. 25/- in respect of vehicles specificially designed / modified for use by blind / handicapped/mentally challenged persons).
Where the ownership of the vehicle is transferred, the policy cannot be cancelled unless evidence that the vehicle is insured elsewhere is produced.
6. If at the time any claim arises under this Policy there is any other existing insurance covering the same loss, damage or liability, the Company shall not be liable to pay or
contribute more than its rateable proportion of the loss damage compensation cost or expenses.
7. If any dispute or difference shall arise as to the quantum to be paid under this policy (liability being otherwise admitted) such difference shall independently of all other
questions be referred to the decision of a sole arbitrator to be appointed in writing by the parties to the dispute or if they cannot agree upon a single arbitrator within 30
days of any party invoking arbitration, the same shall be referred to a panel of three arbitrators, comprising of two arbitrators, one to be appointed by each of the parties
to the dispute/difference and a third arbitrator to be appointed by such two arbitrators who shall act as the presiding arbitrator and Arbitration shall be conducted
under and in accordance with the provisions of the Arbitration and Conciliation Act, 1996.
It is clearly agreed and understood that no difference or dispute shall be referable to arbitration as herein before provided, if the Company has disputed or not accepted
liability under or in respect of this policy.
It is hereby expressly stipulated and declared that it shall be a condition precedent to any right of action or suit upon this policy that the award by such
arbitrator/arbitrators of the amount of the loss or damage shall be first obtained.
It is also hereby further expressly agreed and declared that if the company shall disclaim liability to the insured for any claim hereunder, and such claim shall not within
12 calender months from the date of such disclaimer have been the subject matter of a suit in a court of law then the claims shall for all purpose be deemed to have been
abandoned and shall not thereafter be recoverable hereunder.
8. The due observance and fulfillment of the terms conditions and endorsement of this Policy in so far as they relate to anything to be done or complied with by the Insured
and the truth of the statements and answers in the said proposal shall be conditions precedent to any liability of the Company to make any payment under this Policy.
9. In the event of the death of the sole Insured, this policy will not immediately lapse but will remain valid for a period of three months from the date of the death of Insured
or until the expiry of this policy (whichever is earlier). During the said period legal heirs of the Insured to whom the custody and use of the Motor Vehicle passes may
apply to have this Policy transferred to his / her / their names or obtain a new insurance policy for the Motor Vehicle.
Where such legal heirs wish to apply for a transfer of this policy or obtain a new policy for the Vehicle such heir(s) should make an application to the company
accordingly within the aforesaid period. All such applications should be accompanied by :
a. Death certificate in relation to the insured
b. Proof of title to the Vehicle
c. Original Policy
The Company reserves its rights to abide by any order of the court in regard to declaration about the legal heir / heiress and ownership of the vehicle and the nominee
will not have any right to dispute such order of the Court.
44 45
INDIA MOTOR TARIFF - ENDORSEMENTS PRIVATE CAR
IMT. 1. Extension of Geographical Area
In consideration of the payment of an additional premium of Rs 500/- it is hereby understood and agreed that notwithstanding anything contained in this Policy to
the contrary the Geographical Area in this Policy shall from the . . . ./ . . . ./ . . . . to the . … ./. . . /. . . . (both days inclusive) be deemed to include *
It is further specifically understood and agreed that such geographical extension excludes cover for damage to the vehicle insured / injury to its occupants / third
party liability in respect of the vehicle insured during sea voyage / air passage for the purpose of ferrying the vehicle insured to the extended geographical area.
Subject otherwise to the terms exceptions conditions and limitations of this Policy.
NOTE :- Insert Nepal/ Sri Lanka/ Maldives/ Bhutan/ Pakistan/Bangladesh as the case may be.
IMT.2. AGREED VALUE CLAUSE (APPLICABLE ONLY TO VINTAGE CARS)
It is hereby declared and agreed that in case of TOTAL LOSS/CONSTRUCTIVE TOTAL LOSS of the Vintage Car insured hereunder due to a peril insured against, the
amount payable will be the Insured’s Declared Value (IDV) of the vehicle as mentioned in the Policy without deduction of any depreciation.
It is further declared and agreed that in case of partial loss to the vehicle, depreciation on parts replaced will be as stated in Section I of the Policy.
Subject otherwise to the terms exceptions conditions and limitations of this Policy.
IMT. 5 HIRE PURCHASE AGREEMENT
It is hereby understood and agreed that ……...................................................................................................….. (hereinafter referred to as the Owners) are the Owners
of the vehicle insured and that the vehicle insured is subject of an Hire Purchase Agreement made between the Owners on the one part and the insured on the
other part and it is further understood and agreed that the Owners are interested in any monies which but for this Endorsement would be payable to the
insured under this policy in respect of such loss or damage to the vehicle insured as cannot be made good by repair and / or replacement of parts and such
monies shall be paid to the Owners as long as they are the Owners of the vehicle insured and their receipt shall be a full and final discharge to the insurer in
respect of such loss or damage.
It is further declared and agreed that for the purpose of the Personal Accident Cover for the owner-driver granted under this policy, the insured named in the
policy will continue to be deemed as the owner-driver subject to compliance of provisions of the policy relating to this cover.
Save as by this Endorsement expressly agreed nothing herein shall modify or affect the rights and liabilities of the insured or the insurer respectively under or in
connection with this Policy.
Subject otherwise to the terms exceptions conditions and limitations of this policy.
IMT.6. LEASE AGREEMENT
It is hereby understood and agreed that ……............................................… (hereinafter referred to as the Lessors) are the Owners of the vehicle insured and that
the vehicle insured is the subject of a Lease Agreement made between the Lessor on the one part and the insured on the other part and it is further understood
and agreed that the Lessors are interested in any monies which but for this Endorsement would be payable to the insured under this policy in respect of such
ANNEXURE IV
46 47
loss or damage to the vehicle insured as cannot be made good by repair and / or replacement of parts and such monies shall be paid to the Lessors as long as they
are the Owners of the vehicle insured and their receipt shall be a full and final discharge to the insurer in respect of such loss or damage. It is also understood and
agreed that notwithstanding any provision in the Leasing Agreement to the contrary, this policy is issued to the insured namely
…………............................................. as the principal party and not as agent or trustee and nothing herein contained shall be construed as constituting the insured
an agent or trustee for the Lessors or as an assignment (whether legal or equitable) by the insured to the Lessors, of his rights benefits and claims under this
policy and further nothing herein shall be construed as creating or vesting any right in the Owner/Lessor to sue the insurer in any capacity whatsoever for any
alleged breach of its obligations hereunder.
It is further declared and agreed that for the purpose of the Personal Accident Cover for the owner-driver granted under this policy, the insured named in the
policy will continue to be deemed as the owner-driver subject to compliance of provisions of the policy relating to this cover.
Save as by this Endorsement expressly agreed nothing herein shall modify or affect the rights and liabilities of the insured or the insurer respectively under or in
connection with this Policy.
Subject otherwise to the terms exceptions conditions and limitations of this policy.
IMT.7. Vehicles subject to Hypothecation Agreement
It is hereby declared and agreed that the vehicle insured is pledged to / hypothecated with …............................ ..............................…………….. (hereinafter referred
to as the “Pledgee”) and it is further understood and agreed that the Pledgee is interested in any monies which but for this Endorsement would be payable to the
insured under this policy in respect of such loss or damage to the vehicle insured as cannot be made good by repair and / or replacement of parts and such
monies shall be paid to the Pledgee as long as they are the Pledgee of the vehicle insured and their receipt shall be a full and final discharge to the insurer in
respect of such loss or damage.
It is further declared and agreed that for the purpose of the Personal Accident Cover for the owner-driver granted under this policy, the insured named in the
policy will continue to be deemed as the owner-driver subject to compliance of provisions of the policy relating to this cover.
Save as by this Endorsement expressly agreed that nothing herein shall modify or affect the rights or liabilities of the Insured or the Insurer respectively under or in
connection with this Policy or any term, provision or condition thereof.
Subject otherwise to the terms exceptions conditions and limitations of this policy.
IMT. 8. DISCOUNT FOR MEMBERSHIP OF RECOGNISED AUTOMOBILE ASSOCIATIONS
It is hereby understood and agreed that in consideration of insured’s membership of ………………** a discount in premium of Rs. ……….* is allowed to the insured
hereunder from …./…../…...
It is further understood and agreed that if the insured ceases to be a member of the above mentioned association during the currency of this Policy the insured
shall immediately notify the insurer accordingly and refund to the insurer a proportionate amount of the discount allowed on this account for the unexpired
period of the cover.
Subject otherwise to the terms exceptions conditions and limitations of the policy
* For full policy period, the full tariff discount to be inserted. For mid-term membership, prorata proportion of the tariff discount for the unexpired policy period
is to be inserted.
** Insert name of the concerned Automobile Association.
IMT.9. DISCOUNT FOR VINTAGE CARS (Applicable to Private Cars only)
It is hereby understood and agreed that in consideration of the insured car having been certified as a Vintage Car by the Vintage and Classic Car Club of India, a
discount of Rs. ……….* is allowed to the insured from …./…../……
Subject otherwise to the terms exceptions conditions and limitations of the policy
*Amount calculated as per tariff provision is to be inserted. For mid-term certification as Vintage Car pro-rata proportion of tariff discount for the unexpired period
is to be inserted.
IMT.10. INSTALLATION OF ANTI-THEFT DEVICE ( Not applicable to Motor Trade Policies)
In consideration of certification by …………………* that an Anti-Theft device approved by Automobile Research Association of India (ARAI), Pune has been
installed in the vehicle insured herein a premium discount of Rs…………** is hereby allowed to the insured.
It is hereby understood and agreed that the insured shall ensure at all times that this Anti-theft device installed in the vehicle insured is maintained in efficient
condition till the expiry of this policy.
Subject otherwise to the terms, exceptions, conditions and limitations of the policy
* The name of the certifying Automobile Association is to be inserted.
** Premium discount calculated as per tariff provision is to be inserted. For mid-term certification of installation of Anti Theft device pro-rata proportion of tariff
discount for the unexpired period is to be inserted.
IMT.12. DISCOUNT FOR SPECIALLY DESIGNED/MODIFIED VEHICLES FOR THE BLIND, HANDICAPPED AND MENTALLY CHALLENGED PERSONS.
Notwithstanding anything to the contrary contained in the policy it is hereby understood and agreed that the vehicle insured being specially designed /modified
for use of blind, handicapped and mentally challenged persons and suitable endorsement to this effect having been incorporated in the Registration Book by the
Registering Authority, a discount of 50% on the Own Damage premium for the vehicle insured is hereby allowed to the insured.
Subject otherwise to the terms exceptions conditions and limitations of the policy.
IMT.13 . USE OF VEHICLE WITHIN INSURED’S OWN PREMISES
(Applicable to all classes except as otherwise provided in the tariff )
It is hereby understood and agreed that the insurer shall not be liable in respect of the vehicle insured while the vehicle is being used elsewhere than in the
insured’s premises except where the vehicle is specifically required for a mission to fight a fire.
For the purposes of this endorsement ‘Use confined to own premises’ shall mean use only on insured’s premises to which public have no general right of access.
IMT 15. PERSONAL ACCIDENT COVER TO THE INSURED OR ANY NAMED PERSON OTHER THAN PAID DRIVER OR CLEANER
In consideration of the payment of an additional premium it is hereby agreed and understood that the Company undertakes to pay compensation on the scale
provided below for bodily injury as hereinafter defined sustained by the insured person in direct connection with the vehicle insured or whilst mounting and
dismounting from or traveling in vehicle insured and caused by violent accidental external and visible means which independently of any other cause shall within
six calendar months of the occurrence of such injury result in:-
Details of Injury Scale of Compensation
i) Death .................................................................................................................................... 100%
ii) Loss of two limbs or sight of two eyes or one limb and sight of one eye.......................................... 100%
iii) Loss of one limb or sight of one eye........................................................................ 50%
iv) Permanent Total Disablement from injuries other than named above ................................................ 100%
Provided always that
(1) compensation shall be payable under only one of the items (i) to (iv) above in respect of any such person arising out of any one occurrence and total
liability of the insurer shall not in the aggregate exceed the sum of Rs.....….................... .............................* during any one period of insurance in respect
of any such person.
(2) no compensation shall be payable in respect of death or injury directly or indirectly wholly or in part arising or resulting from or traceable to (a)
intentional self injury suicide or attempted suicide physical defect or infirmity or (b) an accident happening whilst such person is under the influence of
intoxicating liquor or drugs.
(3) such compensation shall be payable only with the approval of the insured named in the policy and directly to the injured person or his/her legal
representative(s) whose receipt shall be a full discharge in respect of the injury of such person.
Subject otherwise to the terms exceptions conditions and limitations of this policy.
* The Capital Sum Insured (CSI) per passenger is to be inserted.
IMT.16. PERSONAL ACCIDENT TO UNNAMED PASSENGERS OTHER THAN INSURED AND THE PAID DRIVER AND CLEANER
In consideration of the payment of an additional premium it is hereby understood and agreed that the insurer undertakes to pay compensation on the scale
provided below for bodily injuries hereinafter defined sustained by any passenger other than the insured and/or the paid driver attendant or cleaner and/or a
person in the employ of the insured coming within the scope of the Workmen’s Compensation Act, 1923 and subsequent amendments of the said Act and
engaged in and upon the service of the insured at the time such injury is sustained whilst mounting into, dismounting from or traveling in the insured motor car
and caused by violent, accidental, external and visible means which independently of any other cause shall within three calendar months of the occurrence of
such injury result in :
Details of Injury Scale of Compensation
i) Death 100%
ii) Loss of two limbs or sight of two eyes or one limb and sight of one eye 100%
iii) Loss of one limb or sight of one eye 50%
iv) Permanent Total Disablement from injuries other than named above 100%
Provided always that: -
(1) compensation shall be payable under only one of the items (i) to (iv) above in respect of any such person arising out of any one occurrence and total liability of the
insurer shall not in the aggregate exceed the sum of Rs.................................... ...................................................* during any one period of insurance in respect of any
such person.
(2) no compensation shall be payable in respect of death or injury directly or indirectly wholly or in part arising or resulting from or traceable to (a) intentional self
injury suicide or attempted suicide physical defect or infirmity or (b) an accident happening whilst such person is under the influence of intoxicating liquor or
drugs.
(3) such compensation shall be payable only with the approval of the insured named in the policy and directly to the injured person or his/her legal representative(s)
whose receipt shall be a full discharge in respect of the injury of such person.
(4) not more than 4 ‘’ the number of persons stated in the schedule’’ are in the vehicle insured at the time of occurrence of such injury.
Subject otherwise to the terms exceptions conditions and limitations of this policy.
* The Capital Sum Insured (CSI) per passenger is to be inserted.
** The registered sitting capacity of the vehicle insured is to be inserted.
IMT 17. PERSONAL ACCIDENT COVER TO PAID DRIVERS, CLEANERS AND CONDUCTORS : (Applicable to all classes of vehicles)
In consideration of the payment of an additional premium, it is hereby understood and agreed that the insurer undertakes to pay compensation on the scale
provided below for bodily injury as hereinafter defined sustained by the paid driver/cleaner/conductor in the employ of the insured in direct connection with the
vehicle insured whilst mounting into dismounting from or traveling in the insured vehicle and caused by violent accidental external and visible means which
independently of any other cause shall within six calendar months of the occurrence of such injury result in :-
Details of Injury Scale of Compensation
i) Death 100%
ii) Loss of two limbs or sight of two eyes or one limb and sight of one eye 100%
iii) Loss of one limb or sight of one eye 50%
iv) Permanent Total Disablement from injuries other than named above 100%
Provided always that
(1) compensation shall be payable under only one of the items (i) to (iv) above in respect of any such person arising out of any one occurrence and total liability of the
insurer shall not in the aggregate exceed the sum of Rs........................................................................................…..* during any one period of insurance in respect of
any such person.
(2) no compensation shall be payable in respect of death or injury directly or indirectly wholly or in part arising or resulting from or traceable to (a) intentional self
injury suicide or attempted suicide physical defect or infirmity or (b) an accident happening whilst such person is under the influence of intoxicating liquor or
drugs.
(3) such compensation shall be payable only with the approval of the insured named in the policy and directly to the injured person or his/her legal representative(s)
whose receipt shall be a full discharge in respect of the injury of such person.
Subject otherwise to the terms exceptions conditions and limitations of this policy.
* The Capital Sum Insured (CSI) per person is to be inserted.
IMT.19. COVER FOR VEHICLES IMPORTED WITHOUT CUSTOMS DUTY
Notwithstanding anything to the contrary contained in this policy it is hereby understood and agreed that in the event of loss or damage to the vehicle insured
and/or its accessories necessitating the supply of a part not obtainable from stocks held in the country in which the vehicle insured is held for repair or in the event
of the insurer exercising the option under 500/1000 * to pay in cash the amount of the loss or damage the liability of the insurer in respect of any such part shall be
limited to :-
(a) (i) the price quoted in the latest catalogue or the price list issued by the Manufacturer or his Agent for the country in which the vehicle insured is held for repair
48 49
50 51
less depreciation applicable;
OR
(ii) if no such catalogue or price list exists the price list obtaining at the Manufacturer’s Works plus the reasonable cost of transport otherwise than by air to the
country in which the vehicle insured is held for repair and the amount of the relative import duty less depreciation applicable under the Policy; and
(b) the reasonable cost of fitting such parts.
Subject otherwise to the terms conditions limitations and exceptions of this Policy.
* Insert ‘Condition 3’ in the case of the Private Car and Motorsied Two Wheeler Policies and ‘Condition 4’ in the case of Commercial Vehicles Policy.
IMT.20. REDUCTION IN THE LIMIT OF LIABILITY FOR PROPERTY DAMAGE
It is hereby understood and agreed that notwithstanding anything to the contrary contained in the policy the insurers liability is limited to Rs. 6000/- (Rupees six
thousand only) for damage to property other than the property belonging to the insured or held in trust or in custody or control of the insured
In consideration of this reduction in the limit of liability a reduction in premium of Rs 100/- is hereby made to the insured .
Subject otherwise to the terms conditions limitations and exceptions of the policy.
IMT.22. COMPULSORY DEDUCTIBLE
Notwithstanding anything to the contrary contained in the policy it is hereby understood and agreed that the insured shall bear under Section 1 of the policy in
respect of each and every event (including event giving rise to a total loss/constructive total loss) the first Rs.500/1000* (or any less expenditure which may be
incurred) of any expenditure for which provision has been made under this policy and/or of any expenditure by the insurer in the exercise of his discretion under
Condition no 3** of this policy .
If the expenditure incurred by the insurer shall include any amount for which the insured is responsible hereunder such amount shall be repaid by the insured to
the insurer forthwith.
For the purpose of this Endorsement the expression “event” shall mean an event or series of events arising out of one cause in connection with the vehicle insured
in respect of which indemnity is provided under this policy.
Subject otherwise to the terms conditions limitations and exceptions of this Policy.
* (i) to insert amount as appropriate to the class of vehicle insured as per GR.40 of the tariff.
(ii) in respect of a vehicle rated under the Tariff for Private Car and in respect of a motorised two wheeler not carrying passengers for hire or reward, if any
deductible in addition to the compulsory deductible provided in this endorsement is voluntarily borne by the insured, the sum representing the aggregate of
the compulsory and the voluntary deductibles is to be inserted.
IMT 22A. VOLUNTARY DEDUCTIBLE (For private cars/motorized two wheelers other than for hire or reward)
It is by declared and agreed that the insured having opted a voluntary deductible of Rs. …………* a reduction in premium of Rs. …….** under Section 1 of the policy is
hereby allowed.
In consideration of the above, it is hereby understood and agreed that the insured shall bear under Section 1 of the policy in respect of each and every event (including
event giving rise to a total loss/constructive total loss ) the first Rs.……..*** (or any less expenditure which may be incurred) of any expenditure for which provision has
been made under this policy and/or of any expenditure by the insurer in the exercise of his discretion under Condition no 3 of this policy .
If the expenditure incurred by the insurer shall include any amount for which the insured is responsible hereunder such amount shall be repaid by the insured to the
insurer forthwith.
For the purpose of this Endorsement the expression “event” shall mean an event or series of events arising out of one cause in connection with the vehicle insured in
respect of which indemnity is provided under this policy.
Subject otherwise to the terms conditions limitations and exceptions of this Policy.
* To insert voluntary deductible amount opted by the insured under tariff for Private car / tariff for motorised two wheeler.
** To insert appropriate amount relating to the voluntary deductible opted as per the provision of tariff for Private car / tariff for motorised two wheelers.
*** To insert aggregate amount of voluntary deductible opted and the compulsory deductible applicable to the vehicle insured as in G.R. 40.
# To insert policy condition No. 3 of the tariff for private car / tariff for motorised two wheelers.
IMT.24. ELECTRICAL / ELECTRONIC FITTINGS
(Items fitted in the vehicle but not included in the manufacturer’s listed selling price of the vehicle – Package Policy only)
In consideration of the payment of additional premium of Rs………, notwithstanding anything to the contrary contained in the policy it is hereby understood and
agreed that the insurer will indemnify the insured against loss of or damage to such electrical and/or electronic fitting(s) as specified in the schedule whilst
it/these is/are fitted in or on the vehicle insured where such loss or damage is occasioned by any of the perils mentioned in Section.1 of the policy.
The insurer shall, however, not be liable for loss of or damage to such fitting(s) caused by/as a result of mechanical or electrical breakdown.
Provided always that the liability of the insurer hereunder shall not exceed the Insured’s Declared Value (IDV) of the item.
Subject otherwise to the terms conditions limitations and exceptions of this Policy.
IMT.25. CNG/LPG KIT IN BI-FUEL SYSTEM (Own Damage cover for the kit )
In consideration of the payment of premium of Rs……………* notwithstanding anything to the contrary contained in the policy it is hereby understood and agreed
that the insurer will indemnify the insured in terms conditions limitations and exceptions of Section 1 of the policy against loss and/or damage to the CNG/LPG kit
fitted in the vehicle insured arising from an accidental loss or damage to the vehicle insured, subject to the limit of the Insured’s Declared Value of the CNG/LPG kit
specified in the Schedule of the policy.
Subject otherwise to the terms conditions limitations and exceptions of this Policy.
* To insert sum arrived at in terms of G.R.42.
IMT. 28. LEGAL LIABILITY TO PAID DRIVER AND/OR CONDUCTOR AND/OR CLEANER EMPLOYED IN CONNECTION WITH THE OPERATION OF INSURED VEHICLE
(For all Classes of vehicles.)
In consideration of an additional premium of Rs. 25/- notwithstanding anything to the contrary contained in the policy it is hereby understood and agreed that
52 53
the insurer shall indemnify the insured against the insured’s legal liability under the Workmen’s Compensation Act, 1923 , the Fatal Accidents Act, 1855 or at
Common Law and subsequent amendments of these Acts prior to the date of this Endorsement in respect of personal injury to any paid driver and/or conductor
and/or cleaner whilst engaged in the service of the insured in such occupation in connection with the vehicle insured herein and will in addition be responsible
for all costs and expenses incurred with its written consent.
Provided always that
(1) this Endorsement does not indemnify the insured in respect of any liability in cases where the insured holds or subsequently effects with any insurer or group of
insurers a Policy of Insurance in respect of liability as herein defined for insured’s general employees;
(2) the insured shall take reasonable precautions to prevent accidents and shall comply with all statutory obligations;
(3) the insured shall keep record of the name of each paid driver conductor cleaner or persons employed in loading and/or unloading and the amount of wages and
salaries and other earnings paid to such employees and shall at all times allow the insurer to inspect such records on demand.( This condition does not apply for
Private Cars/ Motorisedtwo wheelers not used for hire or reward.)
(4) in the event of the Policy being cancelled at the request of the insured no refund of the premium paid in respect of this Endorsement will be allowed.
Subject otherwise to the terms conditions limitations and exceptions of the Policy except so far as necessary to meet the requirements of the Motor Vehicles Act,
1988.
*In case of Private cars/ motorised two wheelers (not used for hire or reward) delete this para.
IMT. 29. LEGAL LIABILITY TO EMPLOYEES OF THE INSURED OTHER THAN PAID DRIVER AND/OR CONDUCTOR AND/OR CLEANER WHO MAY BE TRAVELLING
OR DRIVING IN THE EMPLOYER’S CAR
In consideration of the payment of an additional premium @ Rs.25/- per employee insured notwithstanding anything to the contrary contained in the policy it is
hereby understood and agreed that the insurer will indemnify the insured against the insured’s liability at Common Law and Statutory Liability under the Fatal
Accidents Act, 1855 for compensation (including legal costs of any claimant) for death of or bodily injury to any employee (other than paid drivers) of the within
named insured being carried in or upon or entering in or getting on to or alighting from or driving the vehicle insured.
Provided that in the event of an accident whilst the vehicle insured is carrying more than ....................................................* employees of the insured
(including the driver) the insured shall repay to the insurer a rateable proportion of the total amount payable by the insurer by the reason of this endorsement in
respect of accident in connection with such vehicle insured.
Subject otherwise to the terms, conditions limitations and exceptions of this Policy.
NB. * To insert the number of employees for which the premium has been paid.
IMT. 30. TRAILERS.
In consideration of the payment of an additional premium it is hereby understood and agreed that the indemnity granted by this policy shall extend to apply to the
Trailer (Registration No.......................................................................)”
Provided always that -
* (a) the IDV of such Trailer shall be deemed not to exceed …...............................................................……* *
(b) the term “Trailer” shall not include its contents or anything contained thereon.
(c) such indemnity shall not apply in respect of death or bodily injury to any person being conveyed by the said Trailer otherwise than by reason of or in
pursuance of a contract ...........................................................................of employment.
Subject otherwise to the terms, conditions limitations and exceptions of this Policy.
* Delete in the case of Liability to the public Risks only policies.
** Insert value of trailer as declared at inception of insurance or any renewal thereof.
IMT.32. ACCIDENTS TO SOLDIERS /SAILORS/ AIRMEN EMPLOYED AS DRIVERS
In consideration of the payment of an additional premium of Rs 100/-* it is hereby understood and agreed that in the event of any Soldier/Sailor/Airman
employed by the insured to drive the vehicle insured being injured or killed whilst so employed, this policy will extend to relieve the insured of his liability to
indemnify Ministry of Defence under the respective Regulations.
Subject otherwise to the terms, conditions limitations and exceptions of this Policy.
* This additional premium is flat and irrespective of period of insurance but not.( This condition does not apply for Private Cars/ Motorisedtwo wheelers not used
for hire or reward.) exceeding 12 months. Any extension of the policy period beyond 12 months will call for payment of further additional premium under this
endorsement .
List of Insurance Ombudsmen
AHMEDABAD
2nd Flr.,
Shree Jayshree Ambica Chambers,
Near C.U.Shah College ,
5, Nayvug Colony, Ashram Road,
AHMEDABAD - 380 014
BHOPAL
st
1 Floor, 117, Zone-II,
(Above D.M. Motors
Pvt. Ltd.)
Maharana Pratap Nagar,
BHOPAL - 462 011
BHUBANESWAR
62, Forest Park,
BHUBANESWAR - 751 009
CHANDIGARH
S.C.O. No. 101,102&103,
2nd Floor, Batra Building
Sector 17-D,
CHANDIGARH - 160 017
CHENNAI ##
Fatima Akhtar Court, 4th Flr., 453
(old 312 ) Anna Salai, Teynampet,
CHENNAI -600 018
Office of the Ombudsman
Contact Details Areas of Jurisdiction
(O) 7546150
Fax:079-7546142
E-mail: [email protected]
(O) 2578100, 2578102, 2578103
Fax:0755-2578103
E-mail:[email protected]
(O) 2535220 Fax:0674-2531607
Email :[email protected];
(O) 706196
EPBX: 0172-706468
Fax: 0172-708274
(O) 24333678, 24333668, 24335284
Fax: 044-24333664
E-mail ad: [email protected]
Gujarat, UT of Dadra & Nagar
Haveli, Daman and Diu
Madhya Pradesh & Chhattisgarh
Orissa
Punjab, Haryana, Himachal
Pradesh, Jammu & Kashmir, UT of
Chandigarh
Tamil Nadu, UT–Pondicherry Town
and Karaikal (which are part of UT
of Pondicherry)
ANNEXURE V
55
56 57
DELHI
st
2/2 A, 1 Floor, Universal Insurance
Bldg. Asaf Ali Road,
NEW DELHI – 110 002
GUWAHATI
Aquarius,
Bhaskar Nagar,
R. G. Baruah Rd.
GUWAHATI - 781 021
HYDERABAD
Door No. 6-2-46, ‘Moin Court’,
Flat No. 101, 1st Floor, Lane
Opp.Saleem Function
A. C. Guards, Lakdi-Ka-pool,
HYDERABAD - 500 004.
KOCHI
nd
2 Flr., CC 27/2603
Pulinat Building
Opp. Cochin Shipyard,
M.G. Road,
ERNAKULAM - 682 015
KOLKATA
North British Bldg.
29, N. S. Road, 3rd Flr.,
KOLKATA -700 001.
(O) 23239611
Fax: 011-23230858
insombudsmandel@netcracker.com
(O) 2413525
EPBX: 0361-2415430
Fax: 0361-2414051
(O) 5504122, 5504123
Fax:040/23376599
E-mail : [email protected]
(O)2373334,2350959
Fax:0484-2373336
E-mail: [email protected]
(O) 22212666 / 22212669
Fax: 033-22212668
Delhi & Rajashthan
Assam, Meghalaya, Manipur,
Mizoram, Arunachal Pradesh,
Nagaland and Tripura
Andhra Pradesh, Karnataka and
UT of Yanam – a part of the UT of
Pondicherry
Kerala, UT of (a) Lakshadweep,
(b) Mahe – a part of UT of
Pondicherry
West Bengal, Bihar, Jharkhand
and UT of Andeman & Nicobar
Islands, Sikkim
LUCKNOW
Chintel’s House, 1st Flr.,
16, Station Road,
LUCKNOW - 226 001
MUMBAI
3rd Flr., Jeevan Seva
Annexe (Above MTNL)
S. V. Rd., Santa Cruz (W)
MUMBAI - 400 054
(O) 2635486, 2635490,2635489
Fax:0522-2636755
E-mail: [email protected]
(O)26106928
EPBX: 022-6106889
Fax: 022-26106052, 26106980
Email: [email protected] /
Uttar Pradesh and Uttaranchal
Maharashtra, Goa
Note : Address and contact number of Governing Body of Insurance Council:
Secretary General
Governing Body of Insurance Council
Jeevan Seva Annexe
3rd Floor (Above MTNL)
S.V. Road, Santacruz (W)
Mumbai - 400 054
Tel. No. : 022 - 610 6889
Fax No. : 022 - 6106980, 610 6052
E-mail ID: [email protected]
The address, phone numbers, fax numbers are subject to change without prior notice
For Status of your claim or any other help call your nearest office :
WEST
Ahmedabad Region
204 & 206, 2nd Flr, Time Square Building,Nr. Prisma Complex,
C.G. Road, Ellisbridge, Ahmedabad - 380006
Tel. No. 079 - 26408006 / 8305
Fax No. 079 - 26408009, 26561263
Baroda Region
2nd Flr., Gokulesh 2, B/H Standard Charted Bank
R.C. Dutt Road, Alkapur, Vadodara - 390007
Tel. 0265 - 2310471, 6617800, 2310320
Fax No. 0265 - 6621984
Bhopal Branch
41-G - 10, 1st Floor, Shivaji Nagar,
Opp. Shivaji Petrol Pump, Bhopal
Tel. No. 0755 - 4203388, 4203399, 4271796
Fax No. 0755 - 2556801
Prabhadevi Branch
952 / 954, Appasaheb Marathe Marg,
Prabhadevi , Mumbai - 400025
Tel. No. 9522 - 56628666 Fax No. 9522- 56628621
Mumbai Prabhadevi Branch
DGP House, 88 - C, Old Prabhadevi - Mumbai - 25
Tel. No. 9522- 55527777 Fax No. 9522 - 5552788 / 99
Mumbai Ghatkopar East
Unit No. 401, 4th Floor, Nr. Shopper’s Stop,
M.G. Road, Ghatkopar (East) Mumbai - 89
Tel. No. 9522 - 55031856 / 57/ 59/ 60
Fax No. 9522 - 55031858
Andheri (East ) Branch
Jaisingh Business Centre, 4th Floor,
Sahar Road, Andheri East, Mumbai - 400099
Tel. No. 022- 56480175 / 76/ 77/ 78
Fax No. 022 - 56480179
Thane Branch
Suraj Arcade, 1st Flr., Next to Deodhar Hospital
Gokhale Road, Thane (W) - 400602
Tel. No. 022 - 56208265 / 6/ 67/ 68/ 69
Fax No. 022 - 67921515
Vashi Branch
Office No. 101 & 116, Persipolis Premises,
Plot No. 74, Sector 17, Vashi, Navi Mumbai - 3
Tel. No. 022 - 55910224/25/27/28/29, 56733661
Fax No. 022 - 55910226
Nagpur Branch
219 - 221, 3rd Floor, Sriram Tower,
Kingsway, Sadar - Nagpur - 440001
Tel. No. 0712 - 6630152 / 53/ 54/ 55/ 56
Fax No. 0712 - 6616700
Rajkot Branch
601 - 2, 606 Prasham, 6th Floor, Beside Dharam Cinema,
Kasturba Gandhi Rd., Rajkot - 1
Tel. No. 0281 - 5526163 / 64/ 60 Fax No. 0281 - 5526162
Surat Branch
25 - 28, upper Ground Floor, Megh Mayur Plaza,
Athwalines, Parlepoint, Surat Dumas Road, Surat - 395007
Tel. No. 0261 - 2256682, 2210663, 2210754
Fax No. 0261 -.2256681
CENTRAL
Aurangabad Branch
2nd Flr., Rajendra Bhavan, Next to LIC Bldg.
Adalat Road, Aurangabad - 55
Tel. No. 0240 - 6623990 / 6624416 Fax No. 0240 - 2324254
Panji - Goa Branch
3 C & D, Sesa Ghor, 20, Patto Plaza
EDC, Complex, Panji - Goa - 403001
Tel. No. 0832 - 2438710 / 711 Fax No. 0832 - 2437810
Indore Branch
4th Floor, Commerce House, 7 Race Course Road,
Opp. Gangur Sweets, Indore
Tel. No. 0731 - 4065790 / / 4068734
Fax No. 0731 - 4068626
Nasik Branch
Office No: 9, 1st Floor, Unity Plaza, Mumbai Naka,
(Suryojit Circle) above AT & T World, Nasik - 422006
Tel. No. 0253 - 2504014 / 2502115 Fax No. 0253 - 2504074
Pune Region
4th Floor, Vardhman Complex, 7, Loves Chowk,
Shankar Sheth Road, Pune 411042
Tel. No. 020 26400100 Fax No. 020 - 26400111
Raipur Bramch
Shiv Mohan, Vidhan Sabha Road, Pandri Raipur- 492001
Tel. No. 0771 - 4061470 Fax. No. 0771 - 4061471
NORTH
Chandigarh Branch
SCO - 139- 140, 1st Floor, Sector - 8-C, Chandigarh - 18
Tel. No. 0172 - 5072964 / 65 Fax No. 0172 - 5079493
Delhi Region
C- 31/32, 1st & 2nd Flr. Connaught Place, New Delhi - 110011
Tel. No. 011 - 55308800, 23415422 Fax No. 011 - 41490511
4266000
Delhi West
201 - 201A, 2nd Flr., Itl Twin Tower
Netaji Subhash Place, Pitampura - 110088
Tel. No. 011 - 42470810 / 16, 42470818
Fax No. 011 - 27351068
Noida Region
A-3, 3rd Floor, Sector 4, Noida - Uttar Pradesh
Tel. No.- 0120 - 4322971 / 2/ 4/ 5/ 6
Fax No. 0120 - 4322976
Gurgaon Region
3rd Floor, JMD Regent Plaza, Sikanderpur
Mehrauli, Gurgaon (Haryana) - 122002
Tel. No. 0124 - 4064501/ 4/ 5, 4064931/ 32/ 33
Fax No. 0124 - 4064503
Ludhiana Branch
SCO - 147, Feroz Gandhi Market,
Ludhiana - 141001
Tel. No. 0161 - 5019129, 5026488, 5057509
Fax No. 0161 - 5057508
Jaipur Branch
O-12-A, 2nd Floor, Ashoka Marg,
C-Scheme - Jaipur - 302001
Tel. No. 0141 - 5104609 / 2375429 Fax No. 0141 - 2375648
Jaladhar Branch
2nd Floor, Satnam Complex, BMC Chowk,
G.T. Road, Jalandhar 144001
Tel. No. 0181 - 5089590 / 2231873 / 8 Fax No. 0181 - 5089589
Jammu Branch
C/o Jammu & Kashmir Bank, Zonal Office,
Railhead Complex, Panama Chowk, Jammu Tawi - 1800012
Tel. No. 0191 - 2471663, 2477653, 2471424
Fax No. 0191 - 2471554
ANNEXURE VI
58 59
60 61
Srinagar Branch
C/o Jammu & Kashmir Bank Ltd.,
Corporate Head Quarters M.A Road, Srinagar 190001.
Tel. No. 0194 - 2471025 / 2482897
Kanpur Branch
11/9, Silver Line, Opp. Elgin Mills Retail Shop,
Civil Lines, Kanpur - 208001
Tel. No. 0512- 2530780 / 81 Fax No. 0512 - 2530529
Lucknow Branch
4, Shanajaf Road, Hazratjang, Lucknow - 226001
Tel. No. 0522 - 2200553 / 4 Fax No. 0522 - 2200552
EAST
Kolkata Region
Macmet House, 10-BOC, Ganguli Sarani,
Lee Road, Kolkatta - 700020
Tel. No. 033 - 30580688 / 689 Fax No. 033 - 22817500
Kolkata Region
57, Chowrange Road, Horizon Bldg, 2nd Floor, Kolkata - 71.
Tel. No. 033 - 40034298, 20034299
Guwahati Branch
2 B, 2nd Floor, Centre Point, G.S. road,
Opp. Bora Service Station - Guwahati - 781007
Tel. No. 0361 - 2463330/1, 2460088 Fax No. 0361 - 2460089
Hyderabad Region
608 & 609, 6th Floor, 2nd Block,
White House, Begumpet, hyderabad
Tel. No. 040 - 55680002 / 3, 6888 Fax No. 040 - 55680001
Ranchi Branch
504, Mahabir Towers, Opp. Church Complex,
Main Road - Ranchi 1
Tel. No. 0651 - 2331886, 2330722 Fax No. 0651 - 2331709
Vishakapatnam Branch
3-B, Balajii Mangalgiri Chambers,
VIP Road, CBM Compound, Vishakapatnam - 16
Tel. No. 0891- 2740570, 5563434, 5564767/ 662
Fax No. 0891- 5563828
Siliguri Branch
City Plaza, 4th Floor, 2nd Mile Sevoke Road, Siliguri - 734401
Tel. No. 0353 - 2640342 / 43 Fax No. 0353 - 2216574
Bangalore Region
105 - A, 1st Floor, 136, Residency Road,
Cears Plaza, Bangalore- 25
Tel. No. 080 - 22075156 / 7/ 8 , 22297612 / 3
Fax No. 080 - 22075166, 22075188
Mysore Branch
No. 363, Sri Hari Complex, Seetha Vilas Road, Mysore - 570024
Tel. No. 0821 - 2424370 / 2424390 Fax No. 0821 - 2424380
Bhubaneshwar Branch
Ground Floor, Prasanti, 168 - B, Bapujinagar,
Janpath - Bhubaneshwar - 751009
Tel. No. 0674- 2535316/ 2535391 Fax No. 0674 - 2535316
Chennai Branch
No. 25/26, Prince Towes, 4th Floor,
College Road, Nangambakkam, Chennai - 6
Tel. No. 044 - 283311115/ 8, 28311822 / 4, 43904400
Fax No. 044 - 28311826
Cochin Branch
3rd Flr. Finance Tower, Kaloor, Ernakulam - 682017, Cochin.
Tel. No. 0484 - 5533176 / 186, 2400267 / 68
Fax No. 0484 - 2401001
Prevention is better than cure. Act before it is late to
protect your vehicle from theft.
Most cars are stolen by duplicating the original key, while they are left with
unknown / unscrupulours car mechanics, parking lot attendants, cleaners and
drivers, in good faith.
It takes little time for these thieves to duplicate the keys and steal the cars as they
have access to the car identity, your address, place of parking in connivance with the
unscrupulous elements.
Therefore take adequate precautions and get additional anti theft device fitted. For
more information get in touch with the nearest Bajaj Allianz General Insurance
Company Limited Office or Call Centre.
Coimbatore Branch
Door No. 11, Office No. 6, People’s Park
3rd Flr., Govt’s Art College Road, Coimbatore
Tel. No. 0422 - 5537557 / 4392345 ( 3 lines)
Fax. No. 0422 - 4392195
Hubli Branch
Vivekanand Corner, Desai Cross Club Rd., Hubli - 580029
Tel. No. 0836 - 4253333 / 666 , 2357120 / 6120
Fax No. 0836 - 2357121
Madurai Branch
1st Floor, KMA - Complex 12-G, Ram Nagar
By Pass Road, Madurai - 625010
Tel. No. 0452 - 4352442 / 4352443 Fax No. 0452 - 4352444
Trivandrum Branch
TC 28 / 2222 (5), Anugraha, 2nd Floor, M.G. Road,
Pazhavangadi, Trivandrum - 695023
Tel. No. 0471- 2467790 / 91 / 98 Fax No. 0471 - 2467793
Calicut Branch
5th Floor, M’sons Arcade, Cheeroty Road, Calicut - 673001.
Tel. No. 495 - 5570288
Agra Branch
38/4, Shop No. 4, 3rd Floor, Friend’s Centre,
Sanjay Place, Agra - 282004
Dehradun Branch
Shop No. 204, 2nd Floor, Chanakya Towers
52, Dila Ram Bazar, Raipur Road, Dehradu - 248001
Mangalore Branch
107 Crystal Arc,Balmatta Road
Mangalore 575 001
Ph:0824-4266733/44
Fax:0824-4266755
The address, phone numbers, fax numbers are subject to change without prior notice
