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PolicyNumber
Cover Note No.
*
Engine No. last 5 digits
Chassis No. last 5 digits
Registration No.
I read and accept the terms of renewal of policy with break-in insurance
Terms & Conditions
Customer Type :
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Corporate
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(
MH
12
CA
1275
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Previous Year Vehicle Registration No :
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Previous Policy Expiry Date :
Available in Previous Policy.
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Claim Made in Expiring Policy :
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No Claim Bonus (NCB %) in Expiring Policy :
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20%
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45%
50%
55%
65%
Available in Previous Policy
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Additional Covers and Add discounts
Additional Covers
Value of Electrical Accessories (in Rs.) :
If electrical and or electronic items fitted...
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Value of Non Electrical Accessories (in Rs.) :
Any Non electrical/ Non electronic equip...
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CNG/ LPG Kit Attached :
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In case of vehicles fitted with bi-fuel sys...
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Type of fitted - Inbuilt / Externally Fitted :
Inbuilt
Externally fitted
Value of CNG/ LPG kit (in Rs.) :
Personal Accident Cover for Un-named Passengers :
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200000
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180000
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160000
150000
140000
130000
120000
110000
100000
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80000
70000
60000
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40000
30000
20000
10000
Sum Insured is applicable for each pers...
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Legal liability to Paid Driver :
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Optional Cover for a Paid Driver...
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Voluntary Deductible (in Rs.) :
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5000
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15000
Insured may opt for higher deductible...
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Is Anti Theft Device Installed :
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ARAI stands for Automotive Research...
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Are you a Member of Automobile Association :
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A member of any of the following...
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Premium details (including all taxes as applicable)
Current Showroom Price :
Rs.
Insured Declared Value (IDV) of Car :
Rs.
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Enter Your IDV :
Note :
The original IDV is
You can increase or decrease the Vehicle IDV between -10% to +20% and the range is
Add-on covers
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'Yes'
to add value to your Policy &
Get Benefited
Nil Depreciation cover :
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No
Nil Depreciation cover on Rubber & Plastic parts...
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NCB Retention cover :
Yes
No
NCB Retention...
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Your Car Premium (in Rs.) :
Would you like to buy
Personal Accident Cover
of Rs.10,00,000 for the Car Owner?
Yes
No
Optional Personal Accident Cover Premium :
Total Premium :Rs.
Offer for You :
Payment of
Rs.
can be made in 6
EMI
of Rs.
each month (Applicable only on ICICI Bank,and HDFC Credit Cards without any extra charges). At Payment Page you can Opt
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