HDFC ERGO General Insurance Company Limited

Certificate of Insurance cum Policy Schedule 2302205821966400000

Standalone Motor Own Damage Cover - Private Car

2302205821966400000

Vehicle Details Policy Details

MR GUNADEVAN C Make MARUTI Policy No. 2302 2058 2196 6400 000
Communication Address: Model ALTO-K10 LXI Period of From 27 Dec, 2023 00:01 hrs
S/O SH. CHANDRASEKARAN, QUATER NO.B-2, SEWA Registration No HP-47-A-1244 Insurance To 26 Dec, 2024 23:59
VIHAR OLONY KHAIRI, PO KHAIRI, TEH DALHOUSIE, DISTT RTO CHAMBA Issuance Date 31/10/2023
CHAM BA Bhunad CHAMBA 176325 CHAMBA Chassis No. MA3SFM61SNL130818 Invoice No. 205821966400000
HIMACHAL PRADESH - 176325 Tel. 99XXXXXXX1
Cubic Capacity /Watts 998 Seats 5 Customer Id 101594049444
Year of Manufacture 2022 Body Type HATCHBACK
Engine No. 1087171 EIA No. Not provided
Odometer reading:
Payment Details : Fund Transfer

Policy Year Policy Period For the Vehicle (`) Trailer (`) Non Electrical Acc. (`) Electrical Acc. (`) CNG/LPG Kit (`) Total IDV (`)
Year 1 From 27/12/2023 To 26/12/2024 385558 0 3939 0 0 389497
Own Damage Policy Period
From Date & Time 27/12/2023 00:01 hrs To Date & Time 26/12/2024 Midnight
Note: Bundled policy wordings and Liability only policy wording will be applicable for the respective policy durations mentioned above
Premium Details (`)
Own Damage Premium(a) (`) Liability Premium(b) (`)
Basic Own Damage 5156 Total Premium (a+b) 7988
Non-Electrical Accessories 53 Integrated Tax 18% 1438
Total Basic Premium 5209
Less: Anti-Theft Device - OD others 789
Less: No Claim Bonus (20%) 1016
Total - Less 1805
Add on Coverages
Zero Depreciation IRDAN125RP0001V01201920/A0014V01201920 2337
Emergency Assistance Cover IRDAN125RP0001V01201920/A0013V01201920 50
Engine and Gear box Protection IRDAN125RP0001V01201920/A0006V01201920 701
Cost of Consumable Items IRDAN125RP0001V01201920/A0007V01201920 467
Return to Invoice - - (IRDAN125RP0001V01201920/A0010V02202324) 779
Emergency Assistance Wider IRDAN125RP0001V01201920/A0014V01201920 250
Total - Add on 4584
Net Own Damage Premium (a) 7988 Total Premium 9426
Geographical Area India Compulsory Deductible (IMT-22) 1,000 Voluntary Deductible 0
Previous Policy No. 13195239 Valid 27/12/2022 to 26/12/2023 of IFFCO TOKIO GENERAL INSURANCE CO. LTD. NCB 0%
Policy Holder declare that no claim has been made in the previous year policy. If declaration found incorrect, benefits under the present policy in respect of own damage section will stand forfeited.
Compulsory
Leased PA cover for
Agreement owner driver has not been
(IMT-6)/Hypothecated provided
(IMT-7) to the insured basis his/her declaration of not holding an effective driving license Or having Alternate PA / Stand alone CPA policy with minimum sum
with
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. Persons or Class of Persons entitled to drive: Any person including the 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 learner's license may also drive the vehicle and
that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989. Limits of Liability 1. 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 Vehicles Act, 1988. 2. Under Section II - 1(ii) of the policy -Damage to Third Party Property- ` 750000 3. P. A. Cover under Section III for Owner - Driver(CSI): `
NA Terms, Conditions & Exclusions: As per the Indian Motor Tariff. A personal copy of the same is available free of cost on request and the same is also available at our website.

I / We hereby certify that the policy to which the certificate relates as well as the certificate of insurance are issued in accordance with the provision of chapter X, XI of M. [Link] [Link] stamp duty of Rs. 0.5/-
paid vide Order No:(LOA/ENF-1/CSD/64/2024-25/ Validity Period Dt. 15/10/2024 to Dt. 31/12/2028, OW No. 4742 Dt 04/10/2024 GRN NO. MH007778466202425M,Dt. 10/09/2024, SBI Bank & DEFACE No.
0005045616202425,Dt. 03/10/2024) a s prescribed b y Government of Maharashtra Notification No. Mudrank 2017/C.R.97/M-1, Dt.09/01/2018. I / We hereby declare that though our aggregate turnover in any
preceding financial year from 2017-18 onwards i s 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 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 is recoverable from the Insured. See the clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY". Disclaimer: The Policy
shall be void from inception if the premium in full i s not realised b y the company. In the event of misrepresentation, fraud or non-disclosure of material fact, the Company reserves the right to cancel the Policy.
Please note that the insured vehicle was pre-inspected and a report was prepared accordingly. The existing damages to the vehicle as mentioned in the report shall not be paid by the Company. The policy is issued
basis the information provided by you, which is available with the company. In case of discrepancy or non recording of relevant information in the policy, the insured is requested to bring the same to the notice of the
company within 15 days.
“Please note that your communication address i s treated a s the address for underwriting purposes, which i s generally address where you would be currently and temporarily residing, and is different from your
permanent address. Details alongwith the proof for your permanent address is provided either from reference of C-KYC Registry and/or on Aadhaar. Any submission for change in address is treated as change in
communication address. Please go to the self-help page or your nearest branch if case you intend to change the ‘permanent address’ provided.”
GST for this invoice is not payable under reverse charge basis.
Important Notice - The policy coverages is only for Own Damage and Third Party Liability in connection to vehicle is not covered in the policy.
Active TP Policy No: 13195239 Valid From 27/12/2022 to 26/12/2025 of IFFCOTOKIO

Branch :1st floor,109,south block,bahu plaza,jammu- jammu

For Claim/Policy related queries Please Contact us at 022 6158 2020 / 022 6234 6234 or Visit Help Section on [Link] for policy copy/tax certificate/make changes/register and track claims.
Goods & Services Tax Registration No: 01AABCL5045N1ZM HSN Code 997134

HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN :IRDAN125RP0001V01201920. Policy Issuing/ Customer Happiness Center: D 301, 3rd Floor,
CIN : U66030MH2007PLC177117. Registered & Corporate Office: HDFC ERGO General Insurance Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078.
Company Limited – 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri (East), Mumbai – 400 059. Customer Service No : 022 6158 2020 / 022 6234 6234 | [Link]
HDFC ERGO General Insurance Company Limited
Certificate of Insurance cum Policy Schedule 2302205821966400000

Standalone Motor Own Damage Cover - Private Car

2302205821966400000

Broker Name : MARUTI SUZUKI INSURANCE BROKING PVT LTD For HDFC ERGO General Insurance Company Ltd
Broker Code : 201499374460 Tel No. : 91-11-46781101

Duly Constituted Attorney

Scan the code for Instant Policy Info, Register/Track Claim, Renewal and Modifications in policy.

"For detailed policy terms and conditions please visit our website [Link]

HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN :IRDAN125RP0001V01201920. Policy Issuing/ Customer Happiness Center: D 301, 3rd Floor,
CIN : U66030MH2007PLC177117. Registered & Corporate Office: HDFC ERGO General Insurance Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078.
Company Limited – 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri (East), Mumbai – 400 059. Customer Service No : 022 6158 2020 / 022 6234 6234 | [Link]
HDFC ERGO General Insurance Company Limited
2302205821966400000

Proposal Form cum Transcript Letter For Standalone Motor Own Damage Cover - Private Car

Vehicle Details Proposal Details

Make MARUTI Proposal No. 202310310007661
Model ALTO-K10 LXI Period of From 27 Dec, 2023 00:01 hrs
Registration No HP-47-A-1244 Insurance To 26 Dec, 2024 23:59
RTO CHAMBA Issuance Date 31 Oct 2023
2302205821966400000
Chassis No. MA3SFM61SNL130818 Invoice No. 205821966400000
MR GUNADEVAN C Cubic Capacity Customer Id 101594049444
998 Seats 5
S/O SH. CHANDRASEKARAN, QUATER NO.B-2, SEWA VIHAR
OLONY KHAIRI, PO KHAIRI, TEH DALHOUSIE, DISTT CHAM BA Year of Manufacture 2022 Body Type HATCHBACK
Bhunad CHAMBA 176325 CHAMBA - 176325 Engine No. 1087171
HIMACHAL PRADESH - Tel. 99XXXXXXX1
Odometer reading:
Payment Details : Fund Transfer

Policy Year Policy Period For the Vehicle (`) Trailer (`) Non Electrical Acc. (`) Electrical Acc. (`) CNG/LPG Kit (`) Total IDV (`)
Year 1 From 27/12/2023 To 26/12/2024 385558 0 3939 0 0 389497
Own Damage Policy Period
From Date & Time 27/12/2023 00:01 hrs To Date & Time 26/12/2024 Midnight

Note: Bundled policy wordings and Liability only policy wording will be applicable for the respective policy durations mentioned above
Premium Details (`)
Own Damage Premium(a) (`) Liability Premium(b) (`)
Basic Own Damage 5156 Total Premium (a+b) 7988
Non-Electrical Accessories 53 Integrated Tax 18% 1438
Total Basic Premium 5209
Less: Anti-Theft Device - OD others 789
Less: No Claim Bonus (20%) 1016
Total - Less 1805
Add on Coverages
Zero Depreciation IRDAN125RP0001V01201920/A0014V01201920 2337
Emergency Assistance Cover IRDAN125RP0001V01201920/A0013V01201920 50
Engine and Gear box Protection IRDAN125RP0001V01201920/A0006V01201920 701
Cost of Consumable Items IRDAN125RP0001V01201920/A0007V01201920 467
Return to Invoice - - (IRDAN125RP0001V01201920/A0010V02202324) 779
Emergency Assistance Wider IRDAN125RP0001V01201920/A0014V01201920 250
Total - Add on 4584
Net Own Damage Premium (a) 7988 Total Premium 9426
Geographical Area India Compulsory Deductible (IMT-22) 1,000 Voluntary Deductible (IMT-22A) 0
Previous Policy No. 13195239 Valid 27/12/2022 to 26/12/2023 of IFFCO TOKIO GENERAL INSURANCE CO. LTD. NCB 0%
Policy Holder declare that no claim has been made in the previous year policy. If declaration found incorrect, benefits under the present policy in respect of own damage section will stand forfeited.
Compulsory
Leased PA cover
Broker Agreement
Name for owner driver has
(IMT-6)/Hypothecated
: MARUTI SUZUKI not been provided
(IMT-7)
INSURANCE to the insured
with
BROKING PVT basis
LTD his/her
Brokerdeclaration
Code :of201499374460
not holding an effective
Tel No. driving license Or having Alternate PA / Stand alone CPA policy with minimum sum
: 91-11-46781101
Anti rebate clause
Prohibition of Rebates (Section 41 of Insurance Act, 1938 as amended) : 1. No person shall allow o r offer to allow, either directly or indirectly, as an inducement to any person to take out or renew or
continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any
person taking out or renewing or continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectuses or tables of the insurer: provided that acceptance by an
insurance agent of commission in connection with a policy of life insurance taken out by himself on his own life shall not be deemed to be acceptance of a rebate of premium within the meaning of this sub-section if
at the time of such acceptance the insurance agent satisfies the prescribed conditions establishing that he is a bona fide insurance agent employed by the insurer.
2. Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakh rupees..

Terms and Conditions

I hereby declare that the Insured Person(s) listed in Proposal Form will abide to the following T&C:
1 ) I/We hereby declare that the statements made by me/us are true to the best of my / our knowledge and belief and I/we hereby agree that this declaration shall form the basis of the contract between me/us and
HDFC ERGO General Insurance Company Limited.
2) I/We also declare that, if any additions or alterations are carried out after the submission of this proposal form, then the same would be conveyed to the insurers immediately.
3) I/We also shall endeavor to procure the renewal notice and pass on the same to HDFC ERGO General Insurance immediately upon the receipt of such renewal notice.
4 ) Any person who, knowingly and with intent to defraud the Insurance Company o r other persons, files a proposal for insurance containing any false information, o r conceals for the purpose of misleading,
information concerning any fact material thereto, commits a fraudulent act which will render the policy voidable at the Company's sole discretion and result in a denial of insurance benefits.
GSTIN :- Motor(Comprehensive and TP):For policy issued in the name of corporate entity (proprietor, HUF, partnership, private company etc), GSTIN is printed on the policy, basis the details provided during policy
issuance. For any subsequent changes or addition (i.e. if GSTIN not entered at the time of policy issuance ) on policy schedule, changes shall be carried out through fresh policy issuance with prospective effect.
5) I understand the Proposal No. 202310310007661 is issued to me basis on above information.
6) It has been declared by you that you are not a Politically Exposed Person and the source of funds to purchase this policy are from salary/business income.
Transcript Declaration : In case disagreement or objection or any other changes with respect to information and contents mentioned herein above,please contact our toll free number and register your objections /
changes / disagreement to the conte nt of this transcript or you may also send us email or written correspondence at the following details within a period of 15 days from date of your receipt of this transcript along.

HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN :IRDAN125RP0001V01201920. Policy Issuing/ Customer Happiness Center: D 301, 3rd Floor,
CIN : U66030MH2007PLC177117. Registered & Corporate Office: HDFC ERGO General Insurance Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078.
Company Limited – 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri (East), Mumbai – 400 059. Customer Service No : 022 6158 2020 / 022 6234 6234 | [Link]
 HDFC ERGO General Insurance Company Limited

2302205821966400000

CUSTOMER INFORMATION SHEET/KNOW YOUR POLICY

This document provides only key information about your policy. Please refer to the policy document for detailed terms and
conditions.

Policy
[Link] Title Description (Please refer to applicable Policy Clause Number in next column) Clause
Number
1 Product Name Standalone Motor Own Damage Cover - Private Car
Unique Identification
2 Number (UIN) allotted by UIN NO: IRDAN125RP0001V01201920
IRDAI
Section I-
3 Structure Section I: indemnity basis Sum
Insured –
Insured’s
Declared
Value
(Idv)
4 Interests Insured Motor Vehicle
Sum Insured / Motor Refer
5 Insured Declared Value Section I: 5156 policy
Scope schedule

6 Policy Coverage Covers the Private Cars against:

Section I: Loss of or Damage to the Vehicle Insured
The Company will indemnify the insured against loss or damage to the vehicle
insured hereunder and/or its accessories whilst thereon
i. by fire explosion self ignition or lightning;
ii. by burglary housebreaking or theft;
iii. by riot and strike;
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.

HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN :IRDAN125RP0001V01201920. Policy Issuing/ Customer Happiness Center: D 301, 3rd Floor,
CIN : U66030MH2007PLC177117. Registered & Corporate Office: HDFC ERGO General Insurance Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078.
Company Limited – 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri (East), Mumbai – 400 059. Customer Service No : 022 6158 2020 / 022 6234 6234 | [Link]
 HDFC ERGO General Insurance Company Limited

2302205821966400000

7 Add-on Cover Emergency Assistance 50,Zero Depreciation - Claim 2337,Cost of Consumables Refer
467,Return to Invoice 779,Engine and GearBox Protector 701,Emergency policy
Assistance Wider 250 schedule
8 Loss Participation Workshop Generates the invoice basis the assessment given by the surveyor.
- For Cashless Settlement, Insured pays his share of liability to the Workshop which
includes - Compulsary deductible (As per the policy schedule) and Voluntary
deductible (IMT22A), if opted as per the chosen slab and takes delivery of the
vehicle.
- For Reimbursement Settlement, Insured pays the entire invoice amount to
Garage Workshop, HDFC ERGO will reimburse its share of liability minus the
Compulsary and voluntary deductible(if applicable) to Insured's account.
General
9 Exclusions The Company shall not be liable under this Policy in respect of: Exception
s
Section I:
1. 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;
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
3. any accidental loss or damage or liability directly or indirectly caused by or
contributed to by or arising from nuclear weapons material.
4. 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 war like
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 damage and/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
occurrences or 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.
Section II:
[Link] accidental loss damage and/or liability caused sustained or incurred whilst the
vehicle insured herein is TP
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 Drivers Clause
As per policy schedule Refer
Special Conditions and
10 policy
Warranties (if any)
schedule

HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN :IRDAN125RP0001V01201920. Policy Issuing/ Customer Happiness Center: D 301, 3rd Floor,
CIN : U66030MH2007PLC177117. Registered & Corporate Office: HDFC ERGO General Insurance Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078.
Company Limited – 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri (East), Mumbai – 400 059. Customer Service No : 022 6158 2020 / 022 6234 6234 | [Link]
 HDFC ERGO General Insurance Company Limited

2302205821966400000

11 Admissibility of Claim Following are the key parameters leading to admissibility or denial of claims:
-Loss will be admissible only if occured from insured perils mentioned in policy
wordings.
- Report the Loss to Insurance Company without any delay.
- Duty of care & loss minimization post accident.
- Avoid willful Negligence and self-damage to insured vehicle.
- Ensure vehicle is in best running condition
- Drive the vehicle responsibly
- Not to use the vehicle for any other purposes other than what is the vehicle is
registered for.
- Take additonal coverage before planning to take vehicle outside the defined
geographical areas.
Include a sample claim calculation process for retail products
1. Assessed amount by the surveyor is billed in the final invoice.
2. Surveyor processes the bill and calculates the amount payable by Inurance
Company (Sample Calculation Sheet)
3. Parts in bills are categorized as per replacement, repair, labour and paint and
applicable depreciation as per the Indian Motor Tariff is applied.(Parts Depreciation
Sheet)
4. Deductibles as per the policy are deducted from the summary and policy
benefit(Zero Depreciation, Consumables, Return to Invoice, etc) is added and final
Insurance Company payable is calculated.
GENERAL EXCEPTIONS (Applicable to all sections of the Policy) The Company
shall not be liable under this Policy in respect of
1. 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
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
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 war like
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 damage and/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
occurrences or 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.
12 Policy Servicing - Claim [Link] time for claim settlement including escalation matrix] Input
Intimation and from
Processing Claims
Team

HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN :IRDAN125RP0001V01201920. Policy Issuing/ Customer Happiness Center: D 301, 3rd Floor,
CIN : U66030MH2007PLC177117. Registered & Corporate Office: HDFC ERGO General Insurance Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078.
Company Limited – 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri (East), Mumbai – 400 059. Customer Service No : 022 6158 2020 / 022 6234 6234 | [Link]
 HDFC ERGO General Insurance Company Limited

2302205821966400000

As per PPHI guidelines on our website

[Link]
2. a) Surveyor appointment- 72 hours
Pendency letters- 7 days
Interim survey report- 15 days
Final survey report- 30 days
Additional survey report- 15 days
Settlement post survey report- 30 days
b) Customer Escalation Matrix
Level 1 In case the Complainant has not received a response or is not satisfied with
the response / resolution given / offered, then the Customer can write to: The
Complaints & Grievance Cell HDFC ERGO General Insurance Company Limited
D-301, 3rd Floor, Eastern Business District (Magnet Mall), LBS Marg, Bhandup
(West), Mumbai – 400078, Maharashtra e-mail: grievance@[Link]
• Level 2 In case the Complainant has not received a response or is not satisfied with
the response / resolution given / offered by the C&G cell, then the Customer can
write to the Chief Grievance Officer of the Company at the following address The
Chief Grievance Officer HDFC ERGO General Insurance Company Limited D-301,
3rd Floor, Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West),
Mumbai – 400078, Maharashtra e-mail: cgo@[Link]
• Level 3 Office of The Insurance Ombudsman
Grievanc
Grievance Redressal and If You have a grievance about any matter relating to the Policy, or Our decision on e
13
Policyholders Protection any matter, or the claim, You can address Your grievance as follows: Redress
al
1. Our Grievance Redressal Officer
If you have a grievance that you wish us to redress, you may contact us with the
details of your grievance through:
• Call Centre - 022 6158 2020 / 022 6234 6234
• Emails – grievance@[Link]
• Contact Details for Senior Citizens: 022 6158 2026 | Email ID:
seniorcitizen@[Link] Designated Grievance Officer in each branch.
• Company Website – [Link]
• Courier - Any of our Branch office or corporate office
You may also approach the Complaint & Grievance (C&G) Redressal Cell at any
of our branches with the details of your grievance during our working hours from
Monday to Friday.
If you are not satisfied with our redressal of your grievance through one of the
above methods, you may contact our Head of Customer Service at
The Complaint & Grievance Redressal Cell , HDFC ERGO General Insurance
The Company Ltd.
D-301,3rd Floor, Eastern Business District (Magnet Mall), LBS Marg, Bhandup
(West), Mumbai – 400078, Maharashtra
In case you are not satisfied with the response / resolution given / offered by the
C&G cell, then you can write to the Chief Grievance Officer of the Company at
the following address
To the Chief Grievance Officer
HDFC ERGO General Insurance The Company Limited
D-301, 3rd Floor, Eastern Business District (Magnet Mall), LBS Marg, Bhandup
(West), Mumbai - 400078, Maharashtra
e-mail: cgo@[Link]
HDFC ERGO General Insurance The Company Limited

HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN :IRDAN125RP0001V01201920. Policy Issuing/ Customer Happiness Center: D 301, 3rd Floor,
CIN : U66030MH2007PLC177117. Registered & Corporate Office: HDFC ERGO General Insurance Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078.
Company Limited – 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri (East), Mumbai – 400 059. Customer Service No : 022 6158 2020 / 022 6234 6234 | [Link]
 HDFC ERGO General Insurance Company Limited

2302205821966400000

Grievance may also be lodged at IRDAI Integrated Grievance Management

System- [Link]
You may also approach the nearest Insurance Ombudsman for resolution, if your
grievance is not redressed by the Company. The contact details of Ombudsman
offices are below if your grievance pertains to:
• Insurance claim that has been rejected or dispute of a claim on legal
construction of the policy
• Delay in settlement of claim
• Dispute with regard to premium
• Non-receipt of your insurance document
You may also refer Our website [Link]
[Link]/customer-care/[Link] for detailed grievance
redressal procedure.
Obligations of the • To disclose all information correctly sought by the insurer at time of filling the
14
Policyholder proposal form
• In case of any change / modification / addition to the already declared information
the same shall be brought to the notice of the Insurer immediately
• Disclosure of material information may affect the claim settlement.

Declaration by the Policyholder;

I have read the above and confirm having noted the details.

Place:
Date:
(Signature of the Policyholder)

Note:
i. Insurer shall provide web-link where the product related documents including the Customer Information sheet are available on the w
ii. In case of any conflict, the terms and conditions mentioned in the policy document shall prevail.
iii. Insurer to take confirmation of the Policyholder regarding receiving of the Customer Information Sheet.

HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN :IRDAN125RP0001V01201920. Policy Issuing/ Customer Happiness Center: D 301, 3rd Floor,
CIN : U66030MH2007PLC177117. Registered & Corporate Office: HDFC ERGO General Insurance Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078.
Company Limited – 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri (East), Mumbai – 400 059. Customer Service No : 022 6158 2020 / 022 6234 6234 | [Link]