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    59424276

    Uploaded by

    anshi
    This document is a renewal notice from Universal Sompo General Insurance Co. Ltd. for a motor vehicle insurance policy held by Amit Kumar Sharma for a goods carrying vehicle. The policy is due for renewal on February 9, 2020. The notice provides the insured's details, policy number, vehicle details, premium breakdown, and a signature line for the insured to renew the policy with the same terms and conditions.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    59424276

    Uploaded by

    anshi
    101 views2 pages
    This document is a renewal notice from Universal Sompo General Insurance Co. Ltd. for a motor vehicle insurance policy held by Amit Kumar Sharma for a goods carrying vehicle. The policy is due for renewal on February 9, 2020. The notice provides the insured's details, policy number, vehicle details, premium breakdown, and a signature line for the insured to renew the policy with the same terms and conditions.

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    This document is a renewal notice from Universal Sompo General Insurance Co. Ltd. for a motor vehicle insurance policy held by Amit Kumar Sharma for a goods carrying vehicle. The policy is due for renewal on February 9, 2020. The notice provides the insured's details, policy number, vehicle details, premium breakdown, and a signature line for the insured to renew the policy with the same terms and conditions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    101 views2 pages

    59424276

    Uploaded by

    anshi
    This document is a renewal notice from Universal Sompo General Insurance Co. Ltd. for a motor vehicle insurance policy held by Amit Kumar Sharma for a goods carrying vehicle. The policy is due for renewal on February 9, 2020. The notice provides the insured's details, policy number, vehicle details, premium breakdown, and a signature line for the insured to renew the policy with the same terms and conditions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    (A joi nt venture between Al l ahabad Bank, Sompo Japan Ni pponkoa Insurance Inc.

    , Indi an Overseas Bank, Karnataka Bank and Dabur Investments)

    29/11/2019 USGI LOCATION: DEHRADUN BRANCH OFFICE


    AMIT KUMAR SHARMA MARKETING OFFICIAL: ASHU BANSAL
    S/O KRISHAN LAL SHARMA
    INTERMEDIARY CODE: 201187327952
    207 SUBHASH NAGAR GANDHI COLONY
    352 INTERMEDIARY NAME: D2C INSURANCE BROKING PVT. LT
    352 247001 INTERMEDIARY BRANCH: DEHRADUN BRANCH OFFICE
    65
    LOAN A/C:
    MOBILE NO: 9992446444

    *2315/59424276/00/000*
    Subject: RENEWAL NOTICE FOR MOTOR - GOODS CARRYING VEHICLE
    Dear Sir/ Madam, Policy No- 2315/59424276/00/000 USGI/POSWEB/0198395/00/000

    We wish to inform you that your captioned Policy is falling due for renewal on: 09/02/2020
    The details of the risk covered in the above Policy is given over leaf.

    The Premium Payable for the renewal, given overleaf may be remitted to us by Cheque / DD before the expiry of this
    Policy to maintain continuity of your insurance.

    The renewal coverage is based on your current claim status, which may alter in case of any claim lodged on us before expiry of
    the current Policy.

    The premium cited overleaf will be subject to review in event of a claim lodged after the date of issuance of this Renewal Notice.

    Thanking you for placing your trust and confidence in Universal Sompo General Insurance Co. Ltd. and assuring you of our best
    attention at all times.

    In case of any query or clarification contact our executive / your insurance agent or our call centre.

    This is computer generated letter and does not require signature

    Renew the Policy with same terms and conditions.

    Payment Details as under:

    Cheque/ Demand Draft Number (Drawn on Universal Sompo General Insurance Co.Ltd.):
    Dated

    Drawn on Bank:

    For Amount: Rs
    You may place online payment link request to us on epay@universalsompo.com or call us at our call centre.
    My Mobile / Telephone Number is :
    My PAN Card Number is :
    My G.S.T Number is :

    Note: The premium instrument may be handed over with this Renewal Notice to Our Branch Office/Bancassurance
    Advisor/Branch Manager of Bank (only Allahabad Bank/Indian Overseas Bank/Karnataka Bank) your Insurance Broker/
    Agent. You may alternatively courier the premium instrument and Renewal Notive duly signed to the following address:

    Universal Sompo General Insurance Co. Ltd. (Renewal Section)


    Plot No: EL 94, T. T. C. Industrial Area,
    Mahape, Navi Mumbai - 400710
    OR
    For any changes/ corrections in the policy and/ or to discuss the rates/ terms/ conditions/ coverage before renewing the Policy
    to know about other products offered by Universal Sompo General Insurance Co. Ltd. Please contact us at our Call Centre.

    Signature of the Insured Policy No:- 2315/59424276/00/000

    Toll Free Number: 1 – 800 –224030 or 1 – 800 – 2004030


    Landline Number: (022) - 27639800 or (022) - 39133700 (Local Charges Apply)
    Fax Number: (022) 39171419 E-mail Address: renewalcontactus@universalsompo.com or contactclaims@universalsompo.com

    IRDAI Registration No. 134 UIN NO. IRDA/USG/22/2008-09/LR/01


    (A joi nt venture between Al l ahabad Bank, Sompo Japan Ni pponkoa Insurance Inc., Indi an Overseas Bank, Karnataka Bank and Dabur Investments)

    POLICY NUMBER 2315/59424276/00/000 NAME AMIT KUMAR SHARMA POL END DATE 09/02/2020
    PRODUCT MOTOR - GOODS CARRYING VEHICLE
    VEHICLESUBCLASS: A1.D PUBLIC CARRIERS OTHER THAN 3 WHEELERS EXC 20000KG NOT EXC 40000KG
    PARTICULARS OF VEHICLE INSURED

    REGISTRATION CHASSIS ENGINE MAKE MODEL YOM BODY GVW ZONE NCB %
    NUMBER NUMBER NUMBER TYPE (Kgs)

    UP-12-AT-9321 527120 010853 EICHER MOTORS 30.25 FE 2014 OPEN 28000 C 20


    TRAILER TYPE NUMBER OF TRAILERS 0.00
    INSURED'S DECLARED VALUE (Rs.)

    BASE VALUE TRAILER NON ELEC ACCESSORIES ELEC ACCESSORIES FIBER TANK CNG/LPG IDV

    950,000.00 0.00 0.00 0.00 0.00 0.00 950,000.00


    FINANCIAL INTEREST: :

    PREMIUM COMPUTATION (Rs.)


    BASIC OWN DAMAGE PREMIUM 21,135.00
    TOTAL OWN DAMAGE (INCL. ACCESSORIES AND EXTENSIONS) AFTER LOADING/DISCOUNT 4,961.00
    IMT 23 3,170.00
    NO CLAIM BONUS -992.00
    TOTAL OWN DAMAGE AFTER NCB 3,969.00
    BASIC THIRD PARTY 43,037.00
    PERSONAL ACCIDENT: OWNER-DRIVER ( CPA) * 225.00
    LEGAL LIABILITY: PAID DRIVER 50.00
    LEGAL LIABILITY: CELANER/CONDUCTOR/COOLIES 100.00
    TOTAL LIABILITY PREMIUM 375.00
    NET PREMIUM 47,381.00
    GST** 5,946.00
    RENEWAL PREMIUM 53,327.00

    *As per IRDAI circular No IRDAI/NL/CIR/MOTP/200/2018 dated 11/12/2018 if you choose to opt for the CPA cover as part of Liability policy or the Package policy it exists
    today, you can continue to do so by paying the premium mentioned in this renewal notice. If you want to choose to take stand-alone CPA policy, the CPA cover offered in this
    renewal notice shall be deleted on production of proof of such stand-alone CPA Policy or proof of having Individual Personal Accident Policy having Sum Insured of Rs 15,00,000/-
    and above covering death and PTD Risk effective as on date.

    **12% G.S.T on Basic Third Party Component and 18% G.S.T. on Own Damage Component.
    Note:- Kindly submit your a valid PUC Certificate along with premium on renewal of the insurance policy.

    Please provide the below details mandatorily


    NOMINEE NAME: RELATION WITH INSURED:

    VEHICLE REG. NO: ENGINE NO: CHASSIS NO:

    PUC NO: PUC CENTRE: PUC EXPIRY DATE:

    NCB DECLARATION LETTER (To be field by the Insured)

    I/We declare that the rate of NCB claimed by me/us is ____% during renewal of above mentioned policy number and that no claim has arisen in the expiring Policy during period from
    _______________ to _______________.
    I/We undertake that if this declaration is found to be incorrect submitted documents are fake all benefits under the policy will stand forfeited.
    Yours faithfully, Name................................
    Insured Signature..............
    Note: This renewal notice contains two pages
    Place.................................

    --
    Scan this QR Code to Pay your renewal premium. S
    2
    3
    1
    5
    Premium Payable Rs.53327/-

    Toll Free Number: 1 – 800 –224030 or 1 – 800 – 2004030


    Landline Number: (022) - 27639800 or (022) - 39133700 (Local Charges Apply)
    Fax Number: (022) 39171419 E-mail Address: renewalcontactus@universalsompo.com or contactclaims@universalsompo.com

    IRDAI Registration No. 134 UIN NO. IRDA/USG/22/2008-09/LR/01

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