CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED

Registered Office: 2nd Floor, “DARE House”, 2, N.S.C. Bose Road, Chennai – 600 001.
Toll free: 1800-208-5544, T: +91 (0) 44 4044 5400, F: +91 (0) 44 4044 5550
E: customercare@[Link] ; website: [Link]
IRDA Regn. No. 123; PAN AABCC6633K CIN U66030TN2001PLC047977

Policy Number : 3407/00239750/000/00

Dear Customer,

Greetings & welcome to Chola MS family! We express our heartfelt gratitude for choosing us as your trusted
insurance partner.

In line with our brand promise T3 - Trust, Transparency aided by Technology, we take this opportunity to
communicate an important information as mandated by the Insurance Regulatory & Development Authority of
India (IRDAI) on the Customer Information Sheet (CIS)"
It is essential for a policyholder to understand the critical terms and conditions of the policy that has been
bought/renewed. With this objective in mind, we have devised a simple CIS. This will be provided to all the
policyholders in English. If you so desire, we will provide in the local language for your better understanding.

We hereby enclose two separate documents; Policy Schedule and the Customer Information Sheet with this
covering letter. Documents will comprehensively outline policy coverage, limits, list of exclusions, waiting periods
and procedure to follow during claims.

Upon receipt of the CIS, request you to make a note of all the key particulars and acknowledge the same to us.
This is mandatory. As receipt of acknowledgement or In case of any discrepancy in the CIS, we have enabled
the following modes for your communication with us.
- Email us at customercare@[Link]
- Visit our website [Link]
- Scan the QR code or download the Chola MS Customer App on the Play store / App Store
- Through post / courier at the address mentioned below
Manager, Customer Care, Chola MS General Insurance Company Limited.
Hari Nivas Towers First Floor, #163, Thambu Chetty Street, Parry's Corner, Chennai - 600 001

Its always important to declare the exact material information when it comes to buying insurance policy. Any
misrepresentation or non-disclosure may affect the claims settlement / continuity of the policy in the immediate to
long term.

At Chola MS, our constant endeavour is to improve our processes and services. As a patron, we value your
feedback and do share yours too.

At all times, we #pledgetoprotect.

Warm Regards,

For Cholamandalam MS General Insurance Company Limited

Authorised Signatory
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number
1. Product Name Chola Standalone Own Damage Policy for Private Car
2. Unique
Identification
Number (UIN) IRDAN123RP0002V01201920
allotted by
IRDAI
3. Policy Number 3407/00239750/000/00
4. Structure

Loss or damage to the vehicle insured: Indemnity with deduction for depreciation

5. Interest This is a standalone Own damage cover which offers insurance coverage to As per
Insured Private Cars mentioned in the Policy Schedule bearing the following details: - Policy
Schedule
cum
Year of certificate
Regn. No. Make Model Variant manufacturi of
ng Insurance
AP40CT5854 MARUTI DZIRE VXI 2024
SUZUKI

6. Sum Insured / • Own Damage – Sum Insured (IDV): (as specified in the Policy Sum
Motor Insured Schedule) Insured –
Declared Insured’s
Value Scope Loss or damage to the vehicle insured Declared
Insured Declared Value (IDV) Scope: Value
The IDV of the insured vehicle and any accessories is set based on the (IDV)
manufacturer’s listed selling price of the insured vehicle's brand and model
at the inception of the policy or at renewal. Insured Declared Value gets
adjusted each year as per the depreciation table specified in the policy.
During the policy period, the IDV serves as the Market Value for Total Loss
(TL), Constructive Total Loss (CTL), or Cash loss claims without further
depreciation. Insured vehicle will be declared a CTL if the total cost of
retrieval or repair exceeds 75% of the IDV, in line with the policy terms and
conditions.

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

1 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number
7 Policy The Company will indemnify the insured against loss or damage to the vehicle Loss or
Coverage insured hereunder and / or its accessories whilst thereon damage
i. by fire explosion self ignition or lightning ; to the
ii. by burglary housebreaking or theft ; vehicle
iii. by riot and strike; insured
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.

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

2 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number
8. Add-on Add-on covers that are applicable for Section I of the policy are listed below https:
Covers which will enhance the terms of coverage. These Add-on are purchased by //www.
insured on payment of additional premium. Kindly refer to our website chola
[Link] for detailed wording of these Add-on covers: insuranc
[Link]/
down
loads
Name of the Add- Sum limits/limits of
Description of coverage
on Cover Chola MS

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

3 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number
9. Loss 1. Compulsory deductible:- As per
Participation As specified in the Policy Schedule Policy
Schedule
2. Depreciation
Depreciation is decrease in value of the insured vehicle with time due to
age and wear & [Link] depreciation table applicable for Partial loss.
Rate of depreciation for replacement of parts for partial loss claims:-
1. For all rubber / nylon / plastic parts, SECTION
tyres and tubes, batteries and air bags. 50% I – Loss
of
2. For fibre glass components 30% or
3. For all parts made of glass Nil damage
4. Rate of depreciation for all other parts including wooden parts will be as to the
per the following schedule vehicle
insured
AGE OF VEHICLE % OF DEPRECIATION
Not exceeding 6 months Nil
Exceeding 6 months but not
5%
exceeding 1 year
Exceeding 1 year but not
10%
exceeding 2 years
Exceeding 2 years but not
15%
exceeding 3 years
Exceeding 3 years but not
25%
exceeding 4 years
Exceeding 4 years but not
35%
exceeding 5 years
Exceeding 5 year but not
40%
exceeding 10 years
Exceeding 10 years 50%

5. Rate of Depreciation for Painting: In the case of painting, the depreciation

rate of 50% shall be applied only on the material cost of total painting
charges. In case of a consolidated bill for painting charges,the material
component shall be considered as 25% of total painting charges for the
purpose of applying the depreciation.
The Company will not apply depreciation for Non-OEM (Original Equipment
Manufacturer) / Non-OES (Original Equipment Supplier) parts that are used in
repairs of Insured Vehicle following a loss.

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

4 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number
10 Exclusions Loss of
Section I - Loss or damage to the vehicle insured or
The Company shall not be liable to make any payment in respect of damage
(a) consequential loss, depreciation, wear and tear,mechanical or electrical to the
breakdown,failures or breakages, vehicle
(b) damage to tyres and tubes unless the vehicle Insured is damaged at the insured
same time in which case the liability of the company shall be limited to 50% of
the 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 General
influence of intoxicating liquor or drugs. Excepti
ons

any accidental loss or 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 Driver's Clause.

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

5 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number

4. (i) Any accidental loss or damage to any property whatsoever or any loss or
expense whatsoever resulting or arising there from or any consequential loss

(ii) 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 or 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 consequence of any of the said occurrences
and in the event of any claim hereunder the insured shall prove that the
accidental loss damageand/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 occurrencesor 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.

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) Use in connection with motor trade.

1. As per Sec 147 of MV Act issued policy the premium received only to
an extent of liability fixed by IRDA /Central Govt
[Link] 150
(2) (b) that the policy is void on the ground that it was obtained by, non
disclosure of any material fact or by representation of any fact which
was, false in some material particular;

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

6 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number

i. Or
ii.(c) that there is non-receipt of premium as required under section 64VB of the
Insurance Act, 1938.
[Link] Application for compensation shall be entertained unless it is made within 6
Months from the date of occurrence of the Accident.
[Link] Sum shall be payable by an Insurer in case a person driving the vehicle
does not have a valid driving license or is under the influence of Alcohol or Drug.

11 Special Warranty:-
conditions and 1. It is hereby warranted the coverage under this Policy commences only
warranties (if from the Risk Start time and Date as mentioned in the Policy Schedule.
any) No Liability shall attach under this Policy in respect of any Accident/Loss
prior to the time and date of commencement of Period of Insurance. If this
policy is preceded by break-in insurance, it is expressly agreed and
understood that there will be no liability for any loss or damage that has
occurred prior to the date of commencement mentioned in the schedule.
conditions
Special conditions:
1. 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 –If a damaged
Motor vehicle is assessed as being unrepairable and hence a
wreck ie., `total loss’ or write off, we will grant the insured the option
to retain wreck and accept a `cash loss’ settlement (being the IDV
less the assessed value of salvage based on competitive quotes
procured by the Insurer including any submitted by or through the
insured).
Basis of Loss settlement: Indemnity

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

7 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number
b. For partial losses, i.e. Losses other than Total Loss/Constructive
Total Loss of the vehicle -actual and reasonable costs of repair
and/or replacement of parts lost/damaged subject to depreciation
as per limitsspecified. However, we will not apply depreciation on
Non-OEM (Original Equipment Manufacturer)/Non-OES
(Original Equipment Supplier) parts that are used in repairs of
Motor vehicle following a loss. The insured will not be burdened
with disposal of salvage and will be paid the claim amount. It will be
the responsibility of the insurer to collect the salvage from the
customer .
Basis of Loss settlement: Indemnity
Salvage: As per the guidelines specified by IRDAI
2. 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 [Link] 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.

3. The policy may be cancelled at any time by the insured for any reason by
informing the Company The Company can cancel the policy only on the
grounds of established fraud, vehicle shall be entirelyat the insured’s
own risk. by sending seven days notice by recorded delivery to the insured
at insured last known address. In the event of cancellation,the
Company will
4. Refund proportionate premium for unexpired policy period, provided there
is no claim (s) made during the policy period.

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

8 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number
5. However under no circumstances, the company can cancel the Motor
Third Party Liability Section except in case of double insurance
or Total Loss of the insured vehicle.
a. In the event of cancellation due to double insurance, the refund
of premium (OD+TP) will be as follows provided there is no claim:-
If double insurance 100% refund in the policy
(both policies) is with commencing later (Risk start date (RSD) is
1.
Chola MS later)

2. If double insurance •100% refund under Chola

where MS policy if policy is commencing
one policy is with later (RSD is later)
Chola MS
• If Chola MS policy is commencing earlier
(RSD) and is requested to be cancelled,
premium will be refunded proportionately
for the unexpired policy period

b. In the event of a 'cash-loss settlement' for Total Loss of the insured

vehicle, the insurer is entitled to cancel the Own Damage insurance
effective the date of [Link] the insurer can cancel the
statutory Motor Third Party Liability Insurance Policy after requiring
the Policyholder to either cancel the road registration of the wreck
and submit documentary evidence in original thereof or alternatively
evidence in original a statutory Motor ThirdParty liability insurance
policy covering the wreck effective the date of damage.

6. Multiple policies involving Bank or other lending or financing entity

If at the time of occurrence of an event that gives rise to any claim under
this policy, if it is found that there is more than one Insurance Policy
issued to the insured covering the same insured vehicle, the insurer will
not apply Contribution clause.
7. The due observance and fulfillment of the terms, conditions and
endorsements 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.

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

9 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number

8. 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 heir(s) of
the insured to whom the custody and use of the Motor Vehicle passes
may apply to have this Policy transferred to the name(s) of the heir(s) or
obtain a new insurance policy for the Motor Vehicle.

Where such legal heir(s) desire(s) to apply for 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 respect of the insured

b) Proof of title to the vehicle
c) Original Policy.

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

10 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number
12. Admissibility of 1.
Admissibility of Claim:-
Claim
A claim under the Motor Insurance policy becomes admissible if
• The loss or damage to the vehicle insured is due to accidental
collision, or due to natural disasters as mentioned in Section-I or
theft or Fire.
• The policy of insurance is in force at the time of accident
• The driver at the time of accident is not under the influence of
drugs/alcohol and holds a valid driving license.
• The insured vehicle is driven in within the specified geographical
limits.
• Complying all other requirements in accordance with the Motor
Vehicle Act 1988 and as amended 2019.
• There shall be no breach of policy terms and conditions.

2. Denial of claims:
We have mentioned below few instances in consequence of which a
claim may be denied under the policy.
a) Claims arising as a result of gross negligence will be rejected.
Some examples are as follows:-
• Keys Left in the vehicle
• Theft due to giving Lift to unknown persons
• No precautionary measure to Safeguard the vehicle when left
abandoned / un attended by insured / driver / users of
vehicle at the time of theft loss.
• Driver/employees willful act (sec-406)
b) If Fraudulent means are adopted for settlement of claim.
c) If the vehicle insured is used for Commercial purpose
d) If the insured/driver / user does not hold a valid and effective
driving license at the time of the accident and is disqualified from
holding or obtaining such a license.
e) If the vehicle is driven before the necessary repairs are effected.
Any extension of the damage or any further damage to the
vehicle insured will be entirely at the insured's own risk.
f) Cause of loss is not covered under the standard policy
conditions. E.g. Mechanical failure / Wear & Tear / Rusted /
Corrosions / accumulated / multiple scratches & damages /
cosmetic loss / damages. For E-vehicles- Insured vehicle
should run min kms as per the OEM guidelines for claiming
battery damages/failures.
Claim calculation process giving an example for Own damage of the insured vehicle
All claims shall be settled as per policy terms & conditions

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

11 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number
13. Policy Servicing
Policy Servicing: For queries related to policy / claim servicing, please
- Claim
Intimation and contact us at our Toll free number 1800 208 5544 or write to us at
Processing customercare@[Link].
Claim Intimation can be given by insured : -
• in writing by post to the below mentioned address or
Cholamandalam MS General Insurance Company Limited, Hari
Nivas Towers, Thambu Chetty Street, Chennai – 600 001.
• by mail to [Link]@[Link] or
• by clicking web link @ [Link] or
• contact our toll free number @1800 208 5544

Details of OD Claims procedure (Processing)

Cashless:

1. List of claim Documents to be submitted by the insured: -

1. Claim Form detailing the damage of the insured vehicle
2. Driving license
3. Fitness
4. FIR
5. Un traced report
6. Fire brigade report
7. Post Mortem Report
8. Repair / replacement bill
9. Any other documents directly related to claim settlement
3.
10. Accident details including the names of the injured person if
applicable

2. Insurer appoints the Surveyor and obtains the survey report.

Cashless Settlement:
1. If the vehicle is repaired at the network garages with whom Chola
MS had tied up PAN India, the insured need not pay the amount for
repairs from his pocket excluding depreciation, non-accident related portion
repair and policy excess as applicable.

2. Re-inspection is to be done to ensure whether repairs are duly completed

and certify road worthy conditions.
3. The insurance claim amount will be paid by Chola MS directly to the
network garage.

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

12 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number
Reimbursement:
Sl. No.1,2,3 mentioned in cashless will be applicable
4. If the vehicle is repaired at a workshop/garage which is recommended by
the insured and not in the network garage list of the insurer, the cost of
repairs will be borne by the insured.
5. Re-inspection is to be done to ensure whether repairs are duly completed
and certify road worthy conditions.
6. The Claim amount will be reimbursed to insured through NEFT transfer.

TAT (Turnaround time for settlement of claim)

Initial Survey Within 24 hours from the time of

intimation of claim to Chola MS
Obtaining Survey report by Within 15 days of allocation
Chola MS
Approval /Rejection of Claim With 7 days from the date of receipt of
after receiving first/addendum Survey Report with all relevant claim
survey report documents.

Escalation Matrix
Please contact us at our Toll free number 1800 208 5544 or write to us at
customercare@[Link].

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

13 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number
14. Grievance If You have a grievance about any matter relating to the Policy, or Our decision
Redressal on any matter, or the claim,You can address Your grievance as follows:
and
Policyholders 1. Our Grievance Redressal Officer
Protection You can send Your grievance in writing by post or email to Our Grievance
Redressal Officer at the following address or call our Toll Free @1800 208
5544:

Courier/Post : Manager, Grievance Cell,

Cholamandalam MS General Insurance Company
Limited, Hari Nivas Towers First Floor, #163,Thambu
Chetty Street, Parry's Corner, Chennai - 600 001.
E-Mail : customercare@[Link]

You may also approach the grievance cell at any of the company’s branches
with the details of grievance. If You are not satisfied with the redressal of
grievance through one of the above methods, You may contact the
grievance officer at GRO@[Link]. For details of
grievance officer, kindly refer the link [Link].

2. Insurance Ombudsman
If You are still not satisfied with the redressal of grievance through above
methods,You may also approach the office of Insurance Ombudsman of the
respective area/region for redressal of grievance as per Insurance
Ombudsman Rules [Link] of the offices of the Insurance
Ombudsman are available at IRDAI website [Link] or General
Insurance Councilwebsite [Link]
or on company website [Link]. Grievance may also
be lodged at IRDAI Integrated Grievance Management system [Link]
[Link]/igms-complaint-logging.

3. Consumer Affairs Department of IRDAI

a. In case if the grievance is not resolved within 15 days or if You are
unhappy with the resolution You can approach the Grievance
Redressal Cell of the Consumer Affairs Department of IRDAI by
calling Toll Free Number 155255 (or) 1800 4254 732 or sending an
e-mail to complaints@[Link]. You can also make use of IRDAI's
online portal – Bima Bharosa Portal by registering Your complaint at igms.
[Link].

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

14 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number
b. You can send a letter to IRDAI with Your complaint on a Complaint
Registration Form available by clicking here. You must fill and send the
Complaint Registration Form along with any documents by post or courier to
General Manager, Insurance Regulatory and Development Authority of India
(IRDAI), Consumer Affairs Department - Grievance Redressal Cell, [Link].115/1,
Financial District, Nanakramguda, Gachibowli, Hyderabad - 500032

c. You can also visit the portal [Link] for more details.

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

15 of 16
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001. Toll Free: 1800 208 5544
T: +91 (0) 44 4044 5400 | F: +91 (0) 44 4044 5550 | E: customercare@[Link] | website: [Link]
IRDAI Regn. No.123 | PAN: AABCC6633K | CIN: U66030TN2001PLC047977 | REACH US THROUGH WHATSAPP

CUSTOMER INFORMATION SHEET

This document provides only key information about your policy.
Please refer to the policy document for detail terms and conditions.
Policy/
SI Description Clause
Title
NO (Please refer to applicable Policy Clause Number in next column) Number
15. Obligations of • Insured to disclose all material information (such as Details about the Vehicle -
Policyholder Registration No., Make, Model, Variant, Year of manufacturing, Engine No.,
Chassis No., place of registration, Financier and nominee details, add-on
covers required) at time of filling the proposal form.

• In case of any change / modification / addition to the already declared

information the same should be brought to the notice of the insurer immediately

• Non-disclosure of material information may affect the claim settlement.

• NCB under this Policy is based on representation regarding NCB and absence
of claim under the previous [Link] the information be found incorrect or false
in any aspect, this Policy shall be void ab initio and no benefit shall be payable
by the company.

• This policy has been issued upon declaration by the Insured that a valid
Pollution Under Control (PUC) Certificate is held on the date of commencement
of the Policy. The insured undertakes to renew and maintain
a valid and effective PUC and/or fitness Certificate, as applicable, during
the subsistence of the Policy

Declaration by the Policyholder:

I have read the above and confirm having noted the details.
Place:
Date: (Signature of the Policyholder)

Note:
i. In case of any conflict, the terms and conditions mentioned in the policy document shall prevail.

Refer our website for Policy Wording and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS CHOLA to 56677 | Visit [Link] | Email customercare@[Link]
Disclaimer: The Company may contact you for matters related to your policy or to provide details of products & services offered.
To opt out from the facility,please register under Do Not Call section on our website.

16 of 16
Cholamandalam MS General Insurance Company Limited

Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001.
Toll Free: 1800 208 5544 | Ph: 044 4044 5400 | Fax: 044 4044 5500 |
E-mail: customercare@[Link] | [Link]
PAN AABCC6633K CIN: U66030TN2001PLC047977 IRDAI Regn. No.123

Policy Schedule cum Certificate of Insurance

Chola Standalone Own Damage Policy for Private Car UIN IRDAN123RP0002V01201920
Policy cum Certificate Number 3407/00239750/000/00 Period of Insurance: From 16:44 hrs. on 18/06/2025 To: Midnight of 17/06/2026
Name & Communication Address: Registration Address:
THOPUGUNTA JAGADEESH 2-7-63 PARCHURI VEEDHI NELLORE,NAWAB PET MYPADU ROAD SRI
POTTI SRIRAMULU NELLORE,
2-7-63 PARCHURI VEEDHI NELLORE,NAWAB PET MYPADU ROAD SRI GUNDLAPALEM B.O,NELLORE,ANDHRA PRADESH, PIN - 524002
POTTI SRIRAMULU NELLORE, Mobile: 9398886184 Landline: Mail:thopukuntajagadeesh@[Link]
GUNDLAPALEM B.O,NELLORE,ANDHRA PRADESH, PIN - 524002
Business/ Profession: Individual
Customer ID 190000025377493 EIA Date of Registration 14/06/2024 Place of Registration ELURU1
GSTIN Geographical Area India
Financier Name BAJAJ FINANCE LTD Financier Address
Nominee Name LEGAL HEIR Nominee Relationship Brother
PARTICULARS OF VEHICLE INSURED

Registration Mark AP40CT5854 Engine Number K12NN1077766 Chassis Number MA3CZFB3SRD885046

Type of Body SEDAN Vehicle Colour Licensed Carrying Capacity 5

Make MARUTI SUZUKI Model DZIRE Variant VXI Year of Mfg 2024 Cubic Capacity 1197

Fuel used PETROL Total Seating Capacity including Driver 5 Contract No

Non-Electrical
For Vehicle 6,00,000 0
IDV (Insured's Accessories
Declared Value) in
Electrical/Electronic
Rupees (Rs.)
Accessories 0.00 Value of CNG/ LPG kit 0.00 Total Value 6,00,000

Details of Motor Third Party Insurance Policy covering the vehicle insured under this Policy

Name of Insurer BAJAJ ALIANZ Policy Number OG-25-9910-1825- Start Date 10/06/2024 End Date 09/06/2027
The coverage hereunder is only for Own Damage of the vehicle insured under this policy. No other liability in connection with the vehicle
including Third party liability for Personal injury / Property damage is payable under this Policy.

PREMIUM COMPUTATION TABLE

Sum Insured Premium Sum Insured Time Premium

A. OWN DAMAGE (Rs.) IMT B. ADD-ON COVER (Rs.) Options Excess
(Rs.) (Rs.)
Basic - OD 6,00,000.00 19,146.00 Total Premium (B) 0.00
TOTAL PREMIUM (A+B) 8308
Total Own Damage Premium 19,146.00
CGST(0%) .00
Bonus Discount(20%) 3,829.00
SGST(0%) .00
Experience Based Discount 7,659.00 IGST(18%) 1,495.00
Sub Total(Discounts) 11,488.00 TOTAL AMOUNT Rs. 9,803.00

Total 11,488.00
TOTAL PREMIUM (A) 8,308.00

Refer our Website for the Policy/Add-on wording and the Ombudsman list. For claims Assistance Contact Toll Free:1800 208 5544SMS CHOLA to 56677|
Visit [Link] | Email customercare@[Link] Disclaimer: The Company may contact you for matters related to your policy or to provide details
of products & services offered. To opt out from the facility, please register under Do Not Call section on our website.
Cholamandalam MS General Insurance Company Limited

Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001.
Toll Free: 1800 208 5544 | Ph: 044 4044 5400 | Fax: 044 4044 5500 |
E-mail: customercare@[Link] | [Link]
PAN AABCC6633K CIN: U66030TN2001PLC047977 IRDAI Regn. No.123

Policy Schedule cum Certificate of Insurance

Chola Standalone Own Damage Policy for Private Car UIN IRDAN123RP0002V01201920
E-Invoice Declaration: "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 (E-Invoice), we are not required to prepare an invoice in terms of the provisions of the said sub-rule and also as per Notification
No. 13/2020-CT dated 21-03-2020". This policy schedule shall be in lieu of Tax Invoice and hence no separate GST invoice required in compliance with Rule 54(2) of
CGST Rules, 2017.

Consolidated Stamp Duty Paid Vide G.O. Rt No.166, Commercial Taxes and Registration (j1) Department,Tamil Nadu dated 13/06/2025
Subject to I.M.T. Endt. Nos. and Memorandum:22
Compulsory deductible under Section 1 Rs. 1000

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.
1. As per Sec 147 of MV Act issued policy the premium received only to an extent of liability fixed by IRDA/Central Govt
2. Sec 150 (2) (b) that the policy is void on the ground that it was obtained by, nondisclosure of any material fact or by representation of any fact which was,
false in some material particular;
i. Or
ii. (c) that there is non-receipt of premium as required under section 64VB of, the Insurance Act, 1938.
3. No Application for compensation shall be entertained unless it is made within 6 Months from the date of occurrence of the Accident
4. No Sum shall be payable by an Insurer incase a person driving the vehicle does not have a valid driving license or is under the influence of Alcohol or
Drug.
DRIVER CLAUSE: Any person including insured:Provided that a person driving holds an effective driving license at the time of the accident and is not
disqualified from holding or obtaining such a license. Provided also that the person holding an effective Learners license may also drive the vehicle and that
such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989 as amended from to time.
Warranties: It is hereby warranted that the coverage under this Policy commences only from the Risk Start time and Date as mentioned
in the Policy schedule. No Liability shall attach under this Policy in respect of any Accident/Loss prior to the time and date of commencement of Period
of Insurance. If this policy is preceded by break-in insurance, it is expressly agreed and understood that there will be no liability for any loss or damage that
has occurred prior to the date of commencement mentioned in the [Link] under this policy is subject to realisation of premium cheque(s).
In case of dishonor of cheque(s), no separate intimation will be given and the policy stands cancelled from inception.

No Claim Bonus: The insured is entitled for a No Claim Bonus (NCB) on the own damage section of the policy, if no claim is made or pending during the
preceding year - 20 % No Clam is made or pending during the Preceding Two consecutive years- 25 % No claim is made or pending during the Preceding
Three consecutive years-35 % No claim is made or pending during Preceding Four consecutive years-45 % No claim is made or pending during the
Preceding Five consecutive years-50%. No Claim Bonus will only be allowed provided the policy is renewed within 90 days of the expiry date of the previous
[Link] that NCB under this Policy is based on representation regarding NCB and absence of claim under the previous Policy. If the information be
found incorrect or false in any aspect, this Policy shall be void ab initio and no benefit shall be payable by the company.
PUC: This policy has been issued upon declaration by the Insured that a valid Pollution Under Control (PUC) Certificate is held on the date of
commencement of the Policy. The insured undertakes to renew and maintain a valid and effective PUC and/or fitness Certificate, as applicable, during the
subsistence of the Policy.

NOTE:The Policy Schedule CUM Certificate of Insurance is an important document issued based on your [Link] request you to verify the details
and ensure that everything is in order. In case of any discrepancies, please contact us within 15 days from the date of issuance of policy.
Grievance Clause: For resolution of any query or grievance, you may contact the respective branch office of the Company or may call 1800 208 5544 or
may write an email to customercare@[Link] you are not satisfied with the response of the office, you may email to Grievance Officer at
GRO@[Link] the event of unsatisfactory response from the Grievance Officer, you may, subject to vested jurisdiction, approach the
Insurance Ombudsman for the redressal of [Link] of the offices of the Insurance Ombudsman are available at IRDAI website [Link] or
General Insurance Council [Link] or on company website [Link].
Intermediary Name: GIRNAR INSURANCE BROKERS Code: 2008441380600097 Contact No.: 7551196989
Business Location: HYDERABAD - BRANCH

GST Invoice No. 2025063600138221 GSTIN: 36AABCC6633K1ZK SAC Code: 997134 SAC Description:Motor vehicle insurance services
Place: CHENNAI Date: 19/06/2025 for Cholamandalam MS General Insurance Company Limited

Receipt No. 1093875224 Receipt Date: 19/06/2025

Signature Not Verified

Signed by: DS CHOLAMANDALAM MS GENERAL
INSURANCE COMPANY LIMITED 4
Reason: KANCHIPURAM SRIDHAR HARISH
Location: Chennai
19-06-2025 10:33:13
Duly Constituted Attorney(s)

Refer our Website for the Policy/Add-on wording and the Ombudsman list. For claims Assistance Contact Toll Free:1800 208 5544SMS CHOLA to 56677|
Visit [Link] | Email customercare@[Link] Disclaimer: The Company may contact you for matters related to your policy or to provide details
of products & services offered. To opt out from the facility, please register under Do Not Call section on our website.
Cholamandalam MS General Insurance Company Limited

Registered Office: 2nd Floor, "Dare House" No.2, NSC Bose Road, Chennai - 600 001.
Toll Free: 1800 208 5544 | Ph: 044 4044 5400 | Fax: 044 4044 5500 |
E-mail: customercare@[Link] | [Link]
PAN AABCC6633K CIN: U66030TN2001PLC047977 IRDAI Regn. No.123

Policy Schedule cum Certificate of Insurance

Chola Standalone Own Damage Policy for Private Car UIN IRDAN123RP0002V01201920
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 the Motor Vehicles Act, 1988.
In the event of a claim under Compulsory personal accident cover (CPA), the intimation of the claim to the Insurer shall be within 30 days of its occurrence.
Important notice as per tariff: 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 as
amended from time to time is recoverable from the insured. See the clause headed ''AVOIDANCE OF CERTAIN TERMS wider AND RIGHT OF
RECOVERY''. For legal interpretation, English Version will hold good.
For Claims: please call 1800-208-5544 or mail to customercare@[Link]. or visit our website [Link].

Whether tax is payable under reverse charge basis - No

Refer our Website for the Policy/Add-on wording and the Ombudsman list. For claims Assistance Contact Toll Free:1800 208 5544SMS CHOLA to 56677|
Visit [Link] | Email customercare@[Link] Disclaimer: The Company may contact you for matters related to your policy or to provide details
of products & services offered. To opt out from the facility, please register under Do Not Call section on our website.
 Policy Schedule cum Certificate of Insurance
Chola Compulsory Personal Accident (Owner-Driver) under Motor Insurance Policies
UIN IRDAN123RP0086V02201819
Policy Number 3407/00239750/000/00
A INSURED DETAILS
Name of the Insured Gender Age Date of Birth Nominee Name Nominee Relationship
Mr. THOPUGUNTA Male 28 14/05/1997 LEGAL HEIR Brother
Period of Insurance From 16:44 hrs. on 18/06/2025 To Midnight of 17/06/2026

A SUMINSURED DETAILS

Sum Insured: Rs.15,00,000 (Rupees Fifteen lakhs only)

Nature of injury Scale of compensation

(i) Death 100% of Sum Insured
(i) Loss of two limbs or sight of two eyes or one limb and sight of one eye 100% of Sum Insured
(iii) Loss of one limb or sight of one eye 50% of Sum Insured
iv) Permanent total disablement from injuries other than named above 100% of Sum Insured
Provided always that:
The compensation shall be payable under only one of the items (i) to (iv) above in respect of the Insured arising out of any one occurrence and the total
liability of the insurer shall not in the aggregate exceed the sum of Rs.15 lakhs (Rupees Fifteen Lakhs only) during any one period of insurance.

C. VEHICLE DETAILS
Vehicle Make [Link] [Link] [Link]
MARUTI SUZUKI AP40CT5854 K12NN1077766 MA3CZFB3SRD885046
D. PREMIUM DETAILS
Premium Rs. 650.00
CGST (0%) Rs. 0.00
SGST (0%) Rs. 0.00
IGST (18%) Rs. 117.00
Total Premium Rs. 767.00
The registered Owner in person is entitled to the Compulsory PA cover where he/she holds an effective driving license.
Coverage under this policy will extend to all the vehicles owned by the Owner-driver under the same Policy. In other words,the cover under this Policy
would be valid when the owner-driver drives any of the vehicles he / she owns
Grievance Clause: For resolution of any query or grievance, you may contact the respective branch office of the Company or may call1800 208 5544
or may write an email to customercare@[Link] you are not satisfied with the response of the office,you may email to Grievance
Officer at GRO@[Link]. In the event of unsatisfactory response from the Grievance Officer,you 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
[Link] or General Insurance Council [Link] or on company website [Link].
Intermediary Name:GIRNAR INSURANCE BROKERS Intermediary
PRIVATE Code:
LIMITED
2008441380600097 Contact No.: 7551196989
Business Location:HYDERABAD - BRANCH

GST Invoice No. : 2025063600138221 GSTIN: 36AABCC6633K1ZK SAC Code: 997133 SAC Description: Motor vehicle insurance services

Receipt Number and Date 1093875224 19/06/2025

In WITNESS WHEREOF, this Policy of Insurance has been signed on 19/06/2025 for Cholamandalam MS General Insurance Company Limited

Place : NELLORE Signature Not Verified

Signed by: DS CHOLAMANDALAM MS GENERAL
INSURANCE COMPANY LIMITED 4
Reason: KANCHIPURAM SRIDHAR HARISH
Location: Chennai
19-06-2025 10:33:13
Duly Constituted Attorney(s)

Refer our Website for the Policy/Add-on wording and the Ombudsman list. For claims Assistance Contact Toll Free:1800 208 5544SMS CHOLA to 56677|
Visit [Link] | Email customercare@[Link] Disclaimer: The Company may contact you for matters related to your policy or to provide details
of products & services offered. To opt out from the facility, please register under Do Not Call section on our website.