NISSAN RENAULT FINANCIAL SERVICES INDIA

MR. LAXMI CHAND PAMNANI

MOTI LAL PAMNANI , 47/ NEW SARAKANDA JABRAD
PARA PAMNANI VIHAR , , BILASPUR ,
CHHATTISGARH-495001

We thank you for purchasing your online policy from our portal.

Your Vehicle Insurance Policy number 993192423110016106 through your preferred Insurance Partner Reliance General
Insurance Co.Ltd. has been successfully generated and it is attached for your reference.

In case of any queries or assistance, please call us on our Helpline No 1-800-315-4444 or write to us at
[email protected]

We thank you for choosing NRFSI and take pride in having you as our customer.

Assuring you of our best services at all times.

Warm Regards,
Team Nissan Renault Financial Services India (P) Ltd.

Disclaimer:
Pursuant to sec 64VB of the Insurance Act 1938 , your policy will only be effective after the Insurer has received the premium for the policy in cleared funds
In case of dishonor of the premium cheque , your policy is automatically cancelled ab initio ( i.e. from the beginning)
For legal interpretation , English version will prevail . The attached certificate cum schedule is to be read with the policy wordings terms and conditions governing the
coverage , which can be downloaded from the Insurer's web site:www.reliancegeneral.co.in

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Nissan Renault Financial Services India Pvt. Ltd
IRDA License No. CA0604; Category of License : Corporate Agent
(Composite)
 Reliance General Insurance Co.Ltd.
RELIANCE - PACKAGE POLICY - CERTIFICATE CUM POLICY SCHEDULE CUM RECEIPT
IRDAI Registration No. 103
(FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
Servicing Office of Insurer: 5th floor, national corporate park office no.516, GE road, Raipur, Chatthisgarh Raipur,
RAIPUR , CHHATTISGARH-492099 State Code-22
PAN: AABCR6747B GSTIN: 22AABCR6747B1ZQ CIN NO : U66602MH2000PLC128300

Policy No. & Policy Issued On 993192423110016106 , 14 Nov 2024 5:49PM Proposal No. & Date PDGPROD15148194, 14 Nov 2024
Period of Own Damage
Insured Name MR. LAXMI CHAND PAMNANI 19 Nov 2024 12:00AM to 18 Nov 2025 11:59PM (Midnight)
Cover
Period of Compulsory 19 Nov 2024 12:00AM to 18 Nov 2025 11:59PM
Period of Liability Cover : 19-Nov-2024 to 18-Nov-2025 (Midnight)
PA Cover (Midnight)1Yr.
MOTI LAL PAMNANI , 47/ NEW SARAKANDA JABRAD
Previous Own Damage
Insured Add. PARA PAMNANI VIHAR , , BILASPUR , P0024200001/4101/506378
Policy No .
CHHATTISGARH-495001
Previous Own Damage
MAGMA HDI General Insurance Co.Ltd.
Insurer
Nominee Name HEMANT PAMNANI Age 45 Relation SPOUSE

Make Model Variant Cubic Capacity/GVW Seating capacity

RENAULT LODGY dCi Stepway RXL - JSRGWB 1461 8
Vehicle Type Vehicle Sub Class Carrier Type Fuel Type Engine No. Chassis No./VIN
PRIVATE MUV Diesel E054043 MEEJSRGWBH8001094
Manufacturing Year RTO Registration No. Registration Date CNG/LPG Kit
2017 BILASPUR CG 10 AJ 2007 16 Oct 2017 0
Vehicle IDV Non-Elec. Accessories IDV Elec. Accessories IDV Total IDV
270000 0 0 270,000.00
Schedule of Premium (Amount in Rs.)
Own Damage Premium (A)
Basic Premium Deductibles
Vehicle 4,977 Voluntary Deductibles (0) (IMT-22A) 0
Non-Elec. Accessories 0 Anti Theft Device (IMT-10) 0
Elec. Accessories (IMT-24) 0 AA Membership (IMT-8) 0
CNG/LPG Kit (IMT - 25) 0 No Claim Bonus (25%) 1,245
Sub Total (Basic Premium) 4,977 Handicap Discount(IMT-12) 0
Geographical Area Extension (IMT-1) 0 Sub Total (Deductibles) 1,245
Lamp,Tyre Mudguards (IMT - 23) 0
Add On (Consumables ,Zero Depreciation) 4996
Sub Total-Addition 9,973 Net Own Damage Premium (A) 8,728

Liability Premium (B)

Basic Third Party Liability (including TPPD) 3,416 PA Cover (10000 per person) for Driver(1) (IMT-17) 5
Third Party Liability For Bi-Fuel Kit 0 PA Cover (10000 Per Person) for 8 Unnamed Persons(IMT-16) 40
Legal liability to Driver (0) (IMT - 28) 0
Legal liability to Employee (0) (IMT - 29) 0 Third Party Liability Geographical Area Extension 0
PA Cover For Owner Driver (IMT-15) 675 Net Liability Premium (B) 4136
Total Premium (A+B) 12,864
CGST(9.00%) 1158
SGST(9.00%) 1158
Gross Premium Paid 15,180
Note: 1.Policy issuance is subject to realization of cheque/UTR NO 2.Consolidated Stamp duty Paid vide Letter of Authorisation “NO LOA/ENF-1/CSD/62/2024-25/(Validity Period Dt.01/10/2024 to
Dt.01/12/2025)/4634 Date 25-09-2024” at General Stamp Office, Mumbai. ** Not Applicable for the State of Jammu & Kashmir 3.The policy is subject to compulsory deductible of Rs.1000 (IMT-22) 4. Geographical Area-
India *Subject to IMT Endt. Nos.& Memorandum:,16,17,22 5.Add-on : Zero Depreciation UIN: IRDAN103RP0010V02100001/A0006V01201314, Consumables UIN: IRDAN103RP0010V02100001/A0007V02201314
Financier Details: ----NA----
Registered and Corporate address Office : 6th Floor, Oberoi Commerz, International Business Park, Oberoi Garden City, Off. Western Express Highway, Goregaon (E) MUMBAI-
400063 Paid number: 022 4890 3009 An ISO 9001:2015 Certified Company
Payment Mode: Dealer’s Cheque/ DD Addon Cover(s) : 1.- If opted, the benefits and exclusions applicable as per insurance company's rules & regulations.
Limitations as to use: The Policy covers use of the vehicle for any purpose other than:a)Hire or Reward b)Carriage of goods (other than samples or personal luggage) c)Organized racing d)Pace making e)Speed testing
f)Reliability Trials g)Any purpose in connection with Motor Trade.
Driver’s Clause: Any person including the Insured: Provided that a person driving holds a valid driving license at the time of the accident and is not disqualified from holding of such a license. Provided that the person
holding a valid Learner's License may drive the vehicle and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules,1989
Limits of Liabilty Clause: Under Section III of the policy - PA cover for owner driver CSI 1500000.0/- (a) Under Section II (1)(i) of the Policy-Death of or bodily injury to any person so far as it is necessary to meet the
requirements of the Motor Vehicle Act, 1988. (b) Under Section II (1)(ii) of the Policy-Damage to property other than property belonging to the insured or held in trust or in the custody of control of the insured up to the limits
specified- (TPPD 1 Sum Insured - 7,50,000/.).
Grievance Clause: For resolution of any query or grievance, Insured may contact the respective branch office of the Company or may call at 022-48903009 or may write an email at [email protected]. In
case the insured is not satisfied with the response of the office, insured may contact the Nodal Grievance Officer of the Company at [email protected]. In the event of unsatisfactory response from the Nodal
Grievance Officer, insured may email to Head Grievance Officer at [email protected]. In the event of unsatisfactory response from the Head Grievance Officer, he/she may, subject to vested jurisdiction,
approach the Insurance Ombudsman for the redressal of grievance. Details of the offices of the Insurance Ombudsman are available at IRDAI website www.irda.gov.in or on company website www.reliancegeneral.co.in or on
www.gbic.co.in . The insured may also contact the following office of the Insurance Ombudsman within whose territorial jurisdiction the branch or office of the Company is located. For Ombudsman address refer
www.reliancegeneral.co.in.
The NCB provided is on Basic OD Premium excluding Add-on wherever applicable. The policy wording with detailed terms, conditions and exclusions are available on our website www.reliancegeneral.co.in
*No Claim Bonus is subject to no claim on the previous policy. Benefits under the policy stands forfeited if claim is/was made in previous policy
No Claim Bonus will be allowed, provided the policy is renewed within 90 days of the expiry of the previous policy
The policy has been issued based on the information provided by you and the policy is not valid if any of the information provided is incorrect. Subject otherwise to the terms, conditions and exclusions of the RELIANCE
PRIVATE CAR - PACKAGE POLICY - CERTIFICATE CUM POLICY SCHEDULE . In witness whereof this Policy has been signed at chhattisgarh on policy tax invoice date in lieu of Proposal/Cover note No. as
mentioned in the policy
This document shall be treated as a Tax Invoice as per Rule 9(2) of the Goods and Services Tax Invoice Rules
Updating Registration Number of vehicles within 15 days of policy inception is MANDATORY as per IRDA. Kindly provide the same to your Agent/Our Call center/Policy issuing Branch (Applicable for policies booked
without Registration No of vehicles).
In the unfortunate event of a claim, please call quoting your Policy No. on 022-48903009 (paid number) or (022) 48903009 and register your claim immediately within 7days from the date of loss
Trade Logo displayed above belongs to Anil Dhirubhai Ambani Ventures Private Limited and used by Reliance General Insurance Company Limited under License
'It is hereby declared and agreed that all pre-existing damages to the vehicle having occurred prior to the commencement of cover are excluded from the scope of the policy'
Statutory Provisions:'As per Section 146 of the Motor Vehicle Act, 1988 it is mandatory to have your vehicle insured against third party risk.As per Section 196 of the Motor Vehicle Act, 1988 driving an uninsured vehicle is
punishable with fine or Rs. 2000 and/or imprisonment up to 3 months for the first offence and fine of Rs. 4000 and/or imprisonment up to 3 months for the second offence.'
Important Notice: The insured is not indemnified, if the vehicle is used or driven otherwise than in accordance with this Schedule. Any payment made by the Company by reason of wider terms appearing in the
Certificate in order to comply with the Motor Vehicle Act, 1988 is recoverable from the insured. See the clause headed “AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY”. For legal interpretation,
English version will hold good.
Warranted that the insured named herein/owner of the vehicle holds a valid Pollution Under Control (PUC) Certificate and/or valid fitness certificate, as applicable, on the date of commencement of the Policy and undertakes
to renew and maintain a valid and effective PUC and/or fitness Certificate, as applicable, during the subsistence of the Policy. Further, the Company reserves the right to take appropriate action in case of any discrepancy in
the PUC or fitness certificate.
I/we hereby certify that the Policy to which this Certificate relates as well as this Certificate of Insurance are issued in accordance with the provisions of Chapter X and Chapter XI of Motor Vehicle Act, 1988

HSN/SAC : 997134 Description of Service: Motor vehicle Insurance Place of Supply : CHHATTISGARH(State Code : 22) Invoice Number : Y111424034356
We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the aggregate turnover notified under sub-rule (4) of rule 48, we are not required to prepare an invoice
in terms of the provisions of the said sub-rule
Corporate Agent : Nissan Renault Financial Services India Scan QR Code to view the policy For & On Behalf of Reliance General Insurance Co.Ltd.
Pvt. Ltd.
Address : VBC Solitaire, 5th Floor, 47 & 49 Bazullah Road, T.
Nagar, Chennai - 600017 Corporate Agent (Composite),
IRDAI License no. :CA0604 (Valid Till : 21-10-2027)
MISP Name : MAHADEVA CARS PRIVATE LIMITED
VYAPAR VIHAR SQUARE MURARKA COMPLEX ,
BILASPUR, CHHATTISGARH
Pan : AAHCM8217F
DP Name : MANISH KUMAR SAHU DP Code :
DPDNRBIJA06111

FOR RENEWAL / CLAIMS ASSISTANCE Please contact Ins.Co.& Dealer VYAPAR VIHAR SQUARE MURARKA COMPLEX , BILASPUR , CHHATTISGARH- 495001 Contact No. :
8359017000