Future Generali India Insurance Company Limited.
Servicing Office : 2nd Floor, R.D.Enclave, Christianbasti, G.S.Road, GUWAHATI, ASSAM (State Code:18) -781005
Future Secure Private Car Package Policy UIN --IRDAN132RP0001V05201213
Certificate Cum Policy Schedule (FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
PAN :AABCF0191R GSTIN: 18AABCF0191R1Z8 CIN :U66030MH2006PLC165287 IRDAI Reg:132
Policy No: 132/02/11/0126/MTP/3410106536 Proposal No. & Date: HIIB13314394, 10-JAN-2025
Policy Issued On: 13-JAN-2025 11:57 HRS Previous Policy No.: OG-24-9910-1801-00191783
Insured Name: MR. INDRAJIT BARUAH Previous Insurer: Bajaj Allianz General Insurance Company Limited.
Period of Own Damage : 17-JAN-2025 (00:00) To 16-JAN-2026 (1 YEAR)
VILL- UPARHALI,KHAKHAPARA, P/O- BIJOY NAGAR, P/S-
Period of Liability Cover: 17-JAN-2025 (00:00) To 16-JAN-2026 (1 YEAR)
Insured Address: PALASBARI,PH-7085625698, GUWAHATI , ASSAM (State Code:18) -
781122 Period of Compulsory 17-JAN-2025 (00:00) To 16-JAN-2026 (1 YEAR)
Personal Accident Cover:
Customer Type PAN GSTIN Name Age (Yr.) Relation
Customer Details Nominee Details
INDIVIDUAL XXXXX8142M NA MR MAHESH BARUAH 67 FATHER
Vehicle Details
Make Model Variant Cubic Capacity Manufacturing Year Seating capacity
HYUNDAI NEW I20 (IB) I20 MAGNA EXECUTIVE VTVT 1197 2018 5
Body Type Registration No. RTO Hypothecation/Lease* Fuel Type VIN/Chassis No.
HATCHBACK AS 01 DX 9395 KAMRUP NO PETROL MALBM51BLJM646345
Vehicle IDV Electrical Accessories Non-Electrical Accessories BI Fuel Kit Total IDV Engine No
267,398 0 0 0 267,398 G4LAJM157704
Own Damage Premium (A) Amount(INR) Liability Premium (B) Amount(INR)
Basic Own Damage Premium Basic Third Party Liability Premium 3,416
Vehicle 2,689 Bi-Fuel Kit 0
Non-Elec. Accessories (IMT-24) 0 Geographical Area Extension (IMT-1) 0
Elec. Accessories (IMT-24) 0 Sub Total (Third Party Liability) 3,416
Bi-Fuel Kit (IMT-25) 0 Personal Accident (PA) Cover
Geographical Area Extension (IMT-1) 0 Compulsory PA Cover for Owner Driver Rs 1500000 (IMT-15) 330
IMT 23 Premium 0 PA Cover for 0 Unnamed Passengers Rs 0 Each (IMT-16) 0
Sub Total (Basic Premium) 2,689 PA cover for Paid Driver of Rs 2 Lac (IMT-17) 0
Discount/Deductibles Sub Total PA Cover 330
Voluntary Deductibles (0) (IMT-22A) 0 Legal Liability
Anti Theft Device (IMT-10) 0 Paid Driver (IMT-28) 0
AA Membership (IMT-8) 0 Employees (for 0 persons) (IMT-29) 0
No Claim Bonus (20%) 538 Sub Total (Legal Liability) 0
Handicapped Discount (IMT-12) 0 Net Liability Premium (B) 3,746
Sub Total (Deductibles) 538 Total Premium (A+B) 9,641
Total Own Damage Premium 2,151 SGST(9%) 868
Add On Coverages ( ZD ) 3744 CGST(9%) 868
Net Own Damage Premium (A) 5,895 Gross Premium Paid 11,377
Add-on Cover Opted in the Policy:
Notes: 1. Consolidated Stamp Duty Paid To State Exchequer
2.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, 3.Geographical Area Ext. extended to (IMT-1): NA
during the subsistence of the Policy.
5.The policy is subject to compulsory deductible of INR 1000
4. Policy issuance is subject to realization of cheque if premium is paid by cheque (IMT-22) & Voluntary Deductible of INR 0
6. This policy is to be read in conjunction with the Policy /Add-on wordings T&C available on the insurer website http://www.futuregenerali.in
*Hypothecation Details: Payment Mode: Online
Limitations as to use:The policy covers use of the vehicle for any purpose other than (1) Hire or Reward (2) Carriage of goods (other than samples or personal luggage) (3) Organized racing (4) Pace
making (5) Speed testing (6) Reliability trials (7) Any purpose in connection with motor trade.
Driver's Clause: Any person including the insured: Provided that the person driving holds an effective driving license at the time of the accident and is not disqualified from holding or obtaining such
license. Provided also that the person holding an effective learners license may also drive the vehicle & that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
Limits of Liability Clause: Under Section II-1(i) of the policy-Death of or bodily injury: Such amount as is necessary to meet the requirements of the Motor Vehicle Act 1988.Under Section II-1 (ii) of
the policy-Damage to third party property is INR 7.5 Lakhs, PA Cover Under Section III for Owner-Driver is INR 15 Lakhs.
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(s) - 20%, preceding
two consecutive years - 25%, preceding three consecutive years - 35%, preceding four consecutive years - 45%, preceding five consecutive years - 50% of NCB on OD Premium.
NCB is allowed provided the policy is renewed within 90 days of the expiry date of the previous policy.
Declaration on Tax Invoice 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.
Important Notice: The insured is not indemnified if the vehicle is used or driven otherwise than in accordance with the schedule. Any payment made by the company by reasons 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 & RIGHT
OF RECOVERY" For legal interruption, English version will hold good.
Grievance Clause: For resolution of any query or grievance, Insured may check Grievance redressal policy at https://general.futuregenerali.in/customer-service/grievance-redressal or connect with the
respective servicing office of insurance company. In the event of unsatisfactory response,he/she may approach the insurance ombudsman for the redressal of grievance at www.irdai.gov.in or on website
of General Insurance Council: www.gicouncil.in
HSN/SAC : 997134, Description of Service : Motor Vehicle Insurance Services, Place of Supply : ASSAM(State Code : 18), Insurer Invoice Number : 132/02/11/0126/
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 XI of Motor Vehicle Act, 1988.
Insurance Broker Name : Hyundai India Insurance Broking Pvt. Ltd. For & On Behalf of
Corporate Office:16th Floor, Building No. 9A, DLF Cybercity, Phase III, Gurugram, Scan for Renewal Future Generali India Insurance Company Limited.
Haryana 122001 (Valid from 90 Days Prior to
Expiry)
Broker Code: 822 (Valid UPTO:30/05/2025) MISP NAME-FROSTEES INDIA PVT LTD
CIN No.: U67200HR2021PTC098982 MISP CODE-HIIB-MHY-0193
GST: 06AAGCH0310P1ZP DP NAME-MOUSUMI BARUAH
Email ID: connect@hiib.in
Contact No: 0124-6833000
Authorized Signatory
For Claims, Policy Servicing & Renewal, Kindly contact (MUKESH HYUNDAI) at +91-7099025900
