REF.No.

RN01531099611 Client Id - 5008446280 Date 15/05/2015

Mr.SIDHARTH NAHAR Registration Address

4 GULMARG COLONY 4 GULMARG COLONY
NEAR SAKET NEAR SAKET
Indore Indore, 452001
Indore, 452001 Indore
Indore MADHYA PRADESH
MADHYA PRADESH

Ref: Renewal of Motor Policy No. 0153109961 Package

Dear Mr.SIDHARTH NAHAR,

We thank you for choosing Tata AIG for your insurance needs. We wish to remind you that your Policy expires on midnight of 14/07/2015. The
premium on renewal is Rs.110,039.76/-.
The renewal details of your vehicle as mentioned below are based on the following and as per current regulations:
Ø The premium quoted is based on the claims experience under the current policy 70 days prior to expiry.
Ø In case any claim is reported subsequently, No Claim Bonus allowed would be withdrawn and the renewal premium may be subject to loading.
Ø The IDV (Valueof Insurance) of vehicles less than 5 years old is based on the provisions of the India Motor Tariff and the IDV of vehicles that are
obsolete or more than 5 years old has been taken as per the market value.
We request you to sign the renewal notice and return the same along with your payment instructions before the expiry of the policy to avoid inspection for
policy to start afresh. Kindly satisfy yourself with all the details of the vehicle as provided below.
Please call on our 24-Hour Toll Free Helpline 1-800-119966 if you wish to pay by credit card.(*Conditions Apply) You can also call us for availing
our free cheque pick-up facility or for any query on our toll free number or any of our local offices at the contact numbers provided over-leaf.
Alternatively, you can send us an e-mail to customersupport@tata-aig.com.
We look forward to continue serving your General Insurance needs.
Thanking You.
Yours Truly

Atri Chakraborty
National Head - Operations & Systems

VEHICLE DETAILS
Registration Number MP09NS9999 Registration City INDORE
Engine Number 1146660 Registration Date 12/07/2012
Chassis Number A753102 Seating Capacity 5
Make & Model MERCEDES BENZ E-350 CDI Financing Institution N/A
Cubic Capacity 2987 Year of Manufacture 2011
Vehicle IDV/ Accessories IDV 36,00,000 / 0 Coverage Package

If any of the above mentioned vehicle details are incorrect/missing, please provide us with the correct details in the space provided on 2nd page.
RENEWAL DETAILS CHANGES
Coverage Package
Vehicle Value 36,00,000
Value of Electrical Accessories 0
Value of CNG Kit 0
Premium
Third Party(including PD, if opted) 4,931
Own Damage 72,209
Driver 50
PA Coverage for Owner-Driver 100
Key Replacement 265
Emergency Transport/Hotel Exp 110
Loss of Personal belonging 110
Depreciation reimbursement 20,160

RE09 App No. ASN66272765 0001803002 Wip No 001931935G

 Bonus / Imposed Excess 0% / 0
Home Secure(Privilege)/Personal Accident N/A
Amount Payable (Rs.) 1,10,040
(Including Service Tax)
#<<40,00,000>> / #<<No Bonus/Loading>> / # <<93,039>> / # <<0%>> Service Tax Registration No :

RE09 App No. ASN66272765 0001803002 Wip No 001931935G

 REF.No. RN01531099611
CHANGES PROPOSED ON RENEWAL
Following are the details of non-built Electronic / Non-Electronic accessories which I have installed and desire coverage in the Renewal
Policy.
Item Music System AC Others
Make & Serial No
Year of Purchase
Value(Rs.)
Other Additions/Deletions Required -

My Correct/Missing Vehicle Details are as Under.

Registration Number Registration City
Engine Number Registration Date
Chassis Number Seating Capacity
Make & Model Financing Institution
Cubic Capacity Year of Manufacture
Please attach RC book copy for changes to be made in vehicle details and a Letter from Financier for change in financier details.
My Changed Communication Address and Telephone Nos. are as mentioned below.

Address: Residence Telephone Numbers:

Office Telephone Numbers:
Mobile Number:
Email Id:
PIN:
My payment details are as follows:
Cheque/DD No : Date :
Name of Bank : Branch :
Please write your cheque in favour of Tata AIG General Insurance Company Limited and call us at our 24-hour Toll Free Helpline
1800119966 OR below mentioned nearest Branch phone numbers to avail of our free pick up of the renewal premium or in case you have
any query.
City STD Code 24 hr Toll-numbers Branch office ( 9:00 am to 6:00 pm Monday to Friday)
Mumbai 022 66939500
Delhi 011 66603500 43021000
Bangalore 080 66500001 66272829
Chennai 044 66841050 28255960 / 66220222
Hyderabad 040 66629882 66625300/01/02
Ahmedabad 079 66610201 66610920/21/22/23/24/25
Pune 020 66014156 6601 1111 Ext-138
Kolkata 033 22895063/64506374
Chandigarh 0172 4685000
Guwahati 0361 2462339/2462343
Jaipur 0141 5103146 / 2361995
Jamshedpur 0657 2487231 / 2487454
Baroda 0265 6622011/ 6643742/43
I acknowledge receiving renewal notice in respect of my motor policy and agree to renew the said policy for one calendar year as per
details provided herein.

I hereby declare that the information provided above is true and correct.
Date :

Place : Signature of the Insured

You have insured your car, now protect your home with Tata AIG's Homesecure and your family
with the Car Owner's Personal Accident Policy. As a privileged customer of Tata AIG, we offer you
HomeSecure for as little as Rs.2.65* per day and the Personal Accident policy for as little as
Rs. 3.65* per day!
* Conditions apply. For further information, please call the 24 hour Toll Free Helpline on 1800-119966

RE09 App No. ASN66272765 0001803002 Wip No 001931935G

REF.No.RN01531099611
Client ID 5008446280
Mr.SIDHARTH NAHAR
4 GULMARG COLONY
NEAR SAKET
Indore
Indore MADHYA PRADESH
Indore 452001
 Policy Number 0153109961
Policy Expiry Date 14/07/2015
Renewal Premium in Rs.(inclusive of taxes) 110,039.76

Auto Insurance Renewal Slip

Please fill this slip and call us on 1-800-11-99-66(Toll Free from MTNL/BSNL landlines) and we will have it picked up.
Yes! I would like to renew my car insurance as per details given below!
Please attach the RC book copy for changes to be made in vehicle details and a Letter from Financier details.
Existing New Existing New
Registration Number MP09NS9999 Registration City INDORE
Engine Number 1146660 Registration Date 12/07/2012
Chassis Number A753102 Seating Capacity 5
Make & Model MERCEDES BENZ E-350 CDI Financing Institution N/A
Cubic Capacity 2987 Year of Manufacture 2011
Vehi/Accesssory IDV Rs. 36,00,000 / 0 Imposed Excess Rs. 0
Please check your contact details for accuracy and completeness, and update if required
My New Address:

Contact Number: Mobile Number: email id:

Following are the details of non-built in accessories which I have installed and desire coverage in the Renewal Policies.
Item Music System AC Others
Make & Serial No
Year of Purchase
Value(Rs)
Other Additions/Deletions Required
Service Tax Reg No.: 0153109961 0001803002 RN01531099611