prem. calc

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G A T E W A Y

PREMIUM AUTO CALUCULATION

VERSION 5.5 (DE-TARIFF SPECIAL)

Developed By :

N. SATEESH KUMAR Executive Operations, Vizag

G A T E W A YPREMIUM AUTO CALCULATION (DE - TARIFF SPECIAL)

TWO WHEELERS

FOUR WHEELERS

COMMERCIAL VEHICLES(Buses etc.,)

CONSTRUCTION EQUIPMENTS

TRACTORS

COMMERCIAL VEHICLES(Passenger & Good Carrier)

FIRE INSURANCE

FIRE LONG TERM

SHOP KEEPERS

HOUSE KEEPERS

OFFICE PACKAGE

MOTOR DEALERS

PERSONAL GUARD

HEALTH GUARD

HOSPITAL CASH

WORKMEN COMPENSATION

MOTOR TRADE ROAD RISK

TRAVEL COMPANION

OWNERSHIP TRANSFER

MOTOR TRADE ROAD TRANSIT

PRODUCT NAMEPRODUCT NAME

STAND ALONE TP PREMIUMS

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TOMr. N. Satish,Visakhapatnam

QUOTATION FOR TWO WHEELER

Thank You,For Bajaj Allianz General Insurance Co. Ltd.,

1.68 1.68

Upto 75CC 75CC to 150 CC

Select NCB :- 20 19885 CALCULATION CALCULA

Select Zone :- B 21 1.68 333 1.68 333

Select Age :- < 5 Yrs 0 0 0 0

(-) De-Tariff Discount :- 0 0 0 0

Total OD (After De-Tariff Disc):- 333 333

(-) No Claim Bonus : 20 67 20 67

P.A Cover : Total Own Damage : 267 267

Loading : 0 300 300

Voluntary Dec : (+) Compulsory PA : 50 50

Total Premium :- 617 617

(+) Additional Loading :- 0 0

Discount allowed : No FCV 617 617

Enter Discount % : 15 Service Tax :- 10.3 64 10.3 64

. FINAL PREMIUM :- 681 68626

RATE(%)

RATE(%)

Public Liability:- Basic T.P :

TWO WHEELERS :

NCB VEHICLE IDV Upto 75 cc 76 cc to 150 cc

Additional Opitions :-

De-Tariff Ratings :-

1515

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ToMr. P. PrabhakarChitoor

QUOTATION OF FOUR WHEELER

Thank You,For Bajaj Allianz General Insurance Ltd.,(Authorised Signatory)

Ex-Showroom : 0 5%idv: 0

3.04 3.19 3

NCB SUM INSURED< 1000CC > 1000 CC to < 1500 CC

Enter here :- 0 550000 CALCULATION CALCULATION

Zone :- B 3.04 16715 3.19 17551 3

Age of Vehicle :- < 5 Yrs (+) Electronic Accessories : 4 0 4 0

(+) Own Damaga CNG KIT : 4 0 4

(-) Voluntary Deductible : 0 0 0 0

(-) De-Tariff Discount :- 15 2507 35 6143

P.A Cover : 0 Total OD (After De-Tariff Disc):- 14207 11408

Elec Accessories : 0 (-) No Claim Bonus : 0 0 0 0

CNG KIT : 0 (+) Total Own Damage : 14207 11408

Voluntary Decd : 0 670 800

Additional Loading : (+) Compulsory PA : 1 100 1 100

(+) LL to Employee : 1 25 1 25

(+) Public Liability of CNG/LPG Kit : 0 0 0 0

Discount allowed : Yes (+) Additional P.A : 1 100 2

Enter Discount % : 15 (+) Additional Loading : 0 0 0 0

Net Premium : 15102 12333

Service Tax : 10.3 1556 10.3 1270 1

FINAL PREMIUM :- 16658 13603

RATE(%)

RATE(%)

RAT

Public Liability:- Basic T.P :

PRIVATE CAR :-

Additional Coverages :-

NCB VEHICLE IDV Upto 1000 cc 1001 cc to 1500 cc A


VEHICLE IDV

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ToMr. Amit MohantyVisakhapatnam.

QUOTATION FOR COMMERCIAL VEHICLE Date : 09/18/2010

Thank You,For Bajaj Allianz General Insurance Co. Ltd.,(Authorised Signatory)

1.73

PASSENGER CARRIER

NCB :- 45 1000000 RATE CALCULATION

Actual Weight :- 402001.73 17260

Add Passenger :- (+) Surcharge for G.V.W : 28200 7614

Age of Vehicle :- < 5 Years (-) De-Tariff Discount :- 20 4975

Zone :- C Total OD (After De-Tariff Disc):-19899

(-) No Claim Bonus :45 8955

0

Discount allowed : Yes TOTAL OD DAMAGE : 10945 20

Enter Discount % : 20 6770 25

Yes (+) No. of Passengers : 3 300 35

No (+) Comp P.A. Cover : 0 100 45

(+) LL to Employee : 3 50 50

Net Premium : . 18165

Service Tax : 10.3 1871

FINAL PREMIUM :- 20036

Own Damage :- Basic OD :

Liability:- Basic T.P :

NCB SUM INSURED AMOUNT

HEAVY GOODS VEHICLES (LORRIES / MAX /ACE / JEEP etc) :-


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TOMr. N. Satish,Visakhapatnam.

QUOTATION OF MISC AND SPECIAL TYPE OF VEHICLE Date : 09/18/2010


Select NCB Here :- 0 725000

Select Overturning here :- NO 1.23 8932

Age of Vehicle :- 5 to 7 (+) Overturning : 0 0

Zone :- B (-) De-Tariff Discount :- 27.95 2496

Total OD (After De-Tariff Disc):- 6436

Discount allowed : YES (-) No Claim Bonus : 0 0

Enter Discount % : 27.95 TOTAL OD DAMAGE : 6436

800

(+) LL to Employee : 1 25

(+) Comp P.A. Cover : 1 100

YES Net Premium : 7361

NO Service Tax : 10.3 759

FINAL PREMIUM :- 8120INCLUDING EXTENDED WARRANT PREMIUM :-

Own Damage:- Basic OD :

Public Liability :- Basic T.P :

NCB SUM INSURED

RATE% AMOUNTRs.


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ToQUOTATION FOR COMMERCIAL VEHICLES

(PASSENGER CARRIER MORE THAN 6 NOS. BUSES, ETC.,)


1.67 1.67 1.67

NCB Percentage :- 0 846600 CALCULATION CALCULATION

Zone :- B 1.67 14155 1.67 14155 1.67

Age of vehicle :- > 5 Years (+) Basic OD amount : 350 350 450 450 550

(-) De-Tariff Discount :- 0 0 20 2921 0

Total OD (After De-Tariff Disc):- 14505 11684

(-) No Claim Bonus : 0 0 0 0 0

No. of Passengers:- 24 (+) Total Own Damage : 14505 11684

LL TO EMP :- 2 3160 3160

PA COVER :- 1 (+) Comp P.A. Cover : 1 100 100

(+) LL to Employee : 50 50

Discount allowed : No (+) LL to passengers : 9 5640 24 5640 24

Enter Discount % : 0 Net Premium : 23455 20634

. Service Tax : 10.3 2416 10.3 2126 10.3

Yes FINAL Premium :- 25871 22760No

RATE(%)

RATE(%)

RATE(%)



NCB SUM INSURED < 18 Passengers 19 to 36 Passengers 37 t

Additional Coverages :-

COMMERCIAL VEHICLES (BUSES, TOURIST VEHICLES etc.,) :-


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ToMr. N.Sateesh,Visakhapatnam

QUOTATION FOR TRACTOR Date : 09/18/


300000 RATE TRACTOR TRAILOR DESCRIPTION

0 Tractor OD : 1.19 3570 3570 0 Tractor OD : 1.19 3570 3570

20 Trailor OD : 1.05 0 0 0 Trailor OD : 1.05 0 0

> 5 Year (-) No Claim Bonus : 20 714 714 0 TOTAL : 3570 3570

C TOTAL OWN DAMAGE : 2856 2856 0 (-) No Claim Bonus: 20 714 714

800 800 0 TOTAL : 2856 2856

(+) Comp P.A : 100 100 0 (+) Loading : 25 714 714

(+) LL to Employee : 25 25 0 TOTAL OD PREMIUM : 3570 3570

(+) Fire Contents/ burglary at Farmers 55 0 0 800 800

400 0 400 (+) Comp P.A : 100 100

No. of Coolies : 0 0 0 0 (+) L.L.to Emp : 25 25

Net PREMIUM : 4236 3781 400 (+) Fire Content : 40 0

Service Tax : 10.3 436 389 41 (+) Basic Trailor T.P 550 0

FINAL PREMIUM :- 4672 4170 441 (+) No of Coolies : 0 0 0NET PREMIUM : 5085 4495

365762 :- EX-Show room Price Service Tax 10.3 524 463

347474 FINAL PREMIUM :- 5609 4958

TRACTOR CUMTRAILOR

RATE%

TRACTORCUM

TRAILOR

ONLYTRACTO

Tractor Public Liability :-Basic T.P :

LIABILITY:-Basic T.P :

Trailor Public Liability :-Basic T.P :

:- 5% Dep IDV

TRACTORSUM

INSUREDAGRICULTURAL TRACTOR

ALTR

ACTOR

COMMERCIAL TRACTOR(With 25% Loading)

TRAILOR SUM INSURED

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ToMr. N. Satish,

isakhapatnamQUOTATION FOR MOTOR TRADE ROAD TRANSIT Date : 09/18/2010


0.80

Enter Kms here :- 2500 2500000 CALCULATION

0.80 20000

Manual Rating : No (-) De-Tariff Discount :- 0 0

Enter Rate : 10 Total OD (After De-Tariff Disc):- 20000

Yes 500

No NET PREMIUM :- 20500

(+) Addl Loading :- 500



GERCARRIE

RATE%



DISTANCE SUM INSURED PREMIUM COMPUTATION

MOTOR TRADE ROAD TRANSIT (CLASS E) :-


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ToMr. N. Satish,Visakhapatnam.

QUOTATION FOR MOTOR TRADE ROAD RISK Date : 09/18/2010


No. of Add Certificates :- 1 100000 CALCULATION

Demonistration Usage :- YES 0.45 450

(+) Additional Loss of Damage : 0 0

YES (+) OD of Additional Certificates : 1 85

NO TOTAL OD DAMAGE : 535

300

(+) TP of Additional Certificates : 1 150

(+) L.L. to Employee : 0 0

12 TOTAL (OD + LIB) : 985

(+) Demonistration : 12 118

Net Premium : 1103



GERCARRIE

RATE%



AddDetails SUM INSURED PREMIUM COMPUTATION

MOTOR TRADE (TWO WHEELERS) :-

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CALCULATION OF OWNERSHIP TRANSFER FEE

DESCRIPTION FROM TO DAYS

Enter Policy Effecting 11/2/2006 11/1/2007 Total days 364

Transfer Effecting 1/9/2007 11/1/2007 Remaing days 296

Enter Actual NCB Given in Policy :- 1666 Gross Amount 1355S.T 10.30% 140

NCB Recovery Amount :- 1495 Net Amount 1494Transfer Fee :- 50

Total Premium for Tranfer :-

1545

DESCRIPTION FROM TO

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BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.,AREA OFFICE, VISAKHAPATNAM

STANDALONE TP PREMIUMS

Motor Cycles/Scooters

Two Wheelers

Upto 350 cc 300 386 331

Above 350 cc 620 739 684

Private Cars

Private Cars

Upto 1000 cc 670 849 739 877

Between 1000cc & 1500 cc 800 993 882 1020

Above 1500 cc 2500 2868 2758 2895

Goods Carrying 3 Wheelers - Public Carriers

Goods Carrying Vehicles Public Carriers

Goods carrying Commercial ( 3 Wheelers) 1530 1798 1688 1825

Goods Carrying 3 Wheelers - Private Carriers


Goods carrying Commercial ( 3 Wheelers) 1450 1710 1599 1737

Goods Carrying Otherthan 3 Wheelers - Public Carriers


Not Exceeding 7500 Kgs 5580 6265 6155 6293

Exceeding 7500 Kgs but not exceeding 12000 Kgs 5920 6640 6530 6668



Exceeding 40000 Kgs 6770 7578 7467 7605

Goods Carrying Otherthan 3 Wheelers - Private Carriers

Goods Carrying Vehicles Private Carriers

Base TPPremium

TP Premiumincl. Coverage

for Owner-Cum-Driver PA

incl. S.Tax

TP PremiumExcl.

Coverage forOwner -Cum-

Driver PA

incl. S.Tax

Base TPPremium



incl. S.Tax

TP PremiumExcl.


Driver PAincl. S.Tax

Incl. Paid Driverincl. S.Tax

Base TPPremium



incl. S.Tax

TP PremiumExcl.




Base TPPremium



incl. S.Tax

TP PremiumExcl.




Base TPPremium

TP Premium

incl. Coveragefor Owner-Cum-Driver PA

incl. S.Tax

TP PremiumExcl.




Base TP

Premium



incl. S.Tax

TP PremiumExcl.

Coverage for

Owner -Cum-Driver PAincl. S.Tax

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BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.,AREA OFFICE, VISAKHAPATNAM

STANDALONE TP PREMIUMS

Passenger Carrying Autos

Upto 6 Passengers 510 673 563 700

Between 7 and 17 Passengers 1560 1831 1721 1859

Exceeding 17 Passengers 3160 3596 3485 3623

For Eg. If licenced carrying capacity is 3 then 315 x 3= Rs.945


Passenger Carrying -Taxis - Upto 6 Seaters

4 wh Upto 1000 cc 1650 1930 1820 1958

4 wh Between 1000cc & 1500 cc 2330 2680 2570 2708

4 wh Above 1500 cc 2840 3243 3133 3270


Passenger/Employee Carrying Buses / School Buses

Exceeding 6 passengers 3160 3596 3485 3623


Tractors/Cranes/Excavators/Tippers/Dumpers etc

Tractors etc

Misc/ Agr / Commercial Tractors 800 993 882 1020

Agr / Commercial Trailors 550 607

3 wh Passenger Carrying VehiclesBase TPPremium



incl. S.Tax

TP PremiumExcl.




Add: Premium for LL to passengers @ 315 X

Carrying Capacity (Upto below 17 Pass)

Add: Premium for LL to passengers @ 235 XCarrying Capacity (Above 17 Pass)

4 wh Passenger Carrying Vehicles upto 6passengers

Base TPPremium



Incl.S.Tax

TP PremiumExcl.


Driver PAIncl.S.Tax


Add: Premium for LL to passengers @ 350 XCarrying Capacity

4 or more Weheelers Passenger CarryingVehicles Exceeding 6 passengers incl. School

Buses

Base TPPremium



Incl.S.Tax

TP PremiumExcl.


Driver PAIncl.S.Tax


Add: Premium for LL to passengers @ 235 XCarrying Capacity

Base TPPremium



Incl.S.Tax

TP PremiumExcl.


Driver PAIncl.S.Tax


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FIRE SIMPLE RISK CALCULATION

Risk Description Building/ Content EARTH QUAKE

Select Risk here:-Dwellings, Places of worshi Building Zone - IVTERRORISM

Nil

SUM INSURED FIRE CALCULATION

Enter Sum Insured here :- 200000

RATE : 3.8 760

EARTH QUAKE : 0.1 20

TERRORISM : 0.3 60

NET PREMIUM : 840

SERVICE TAX : 10.3 87

TOTAL PREMIUM :- 927

1 Zone - III :- West Godavari, Krishna, Khammam, Warangal, Karimnagar, Anantapur

2 Zone - IV :-

RATE(%)

AMOUNT(Rs.)

Chitoor, Nellore, Cuddapah, Kurnool, Mahaboobnagar, Ranga Reddy, MedaNalgonda, Prakasam, East Godavari Dist, Kakinada, Visakhapatnam, GuntuSrikakulam, Hyderabad and Yanam ( Pondicherry )

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Sateesh, Vsp

Your Risk Description :-

Building Contents

0.5 0.5 FALSE

1.8 1.8 FALSE

2.8 2.8 FALSE

3.8 3.8 TRUE

EARTH QUAKE :-

Nil 0 0.1

Zone - III 0.2

Zone - IV 0.1

TERRORISM :-

Nil 0 0.3

Industrial Risk 0.3

Non Industrial Risk 0.2

Residential 0.1

GATEWAY

Dwellings, Places of worships,Libraries, Museums, Schools,

Colleges, Hospitals including X-rayand other Diagnostic clinics, Office

premises, Meeting Rooms,Auditoriums, Planetarium, Mess

Houses, Clubs, Marriage Halls,Showrooms and display centres

where

DESCRIPTION

Dwellings,Places of

Cafes,Restauran

Shopsdealing in

Shopsdealing in

k, Nizambad, Adilabad,r, Vizianagaram,

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TRUE 0.5 3.8

TRUE 1.8

TRUE 2.8

TRUE 3.8

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ToMr. N. Satish,Visakhapatnam

QUOTATION FOR FIRE SPECIAL PERILSPOLICY

Date : 09/18/2010


500000

RATE :

1.5 750EARTH QUAKE :

0 0

TERRORISM :0 0

NET PREMIUM :750

SERVICE TAX : 10.377


RATE(%)

AMOUNT(Rs.)

SUM INSUREDPREMIUM

COMPUTATION

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ToMr. N.Satish,Visakhapatnam.

QUOTATION FOR LONG TERM DWELLING POLICYDate : 09/18/2010


DISCOUNT

Enter here :- 1500000 50

Enter Years :- 10 RATE :0.5 3750

EARTH QUAKE :0.1 1500

TERRORISM :0 0

NET PREMIUM :5250

SERVICE TAX : 10.3541


RATE(%)

AMOUNT(Rs.)

SUMINSURED

DISCOUNTPREMIUM

COMPUTATION

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FIRE TARI

Section

4 8 5

Earthquake

Zone Rate

1 1

2 0.5

3 0.2

4 0.1

BACK

RiskCode

RateCode
http://opt/scribd/conversion/tmp/scratch3617/http://opt/scribd/conversion/tmp/scratch3617/

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F (INDUSTRIAL / MANUFACTURING RISK)

DescriptionRate

Aluminium ,Zinc,Copper Factories1.5

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QUOTATION FOR SHOP KEEPERS PACKAGE POLICY

8/9/2007

SECTION SECTION DESCRIPTION RATE SUM INSURED PREMIUM

SECTION 1 FIRE - BUILDING 2.25 0

FIRE - CONTENTS 2.25 315000 709

TERRORISM COVER EXTENSION 0.20 0 0

SECTION 2 BURGLARY & HOUSEBREAKING CONTENTS 2.25 315000 709

FIRST LOSS BASIS 3.37 0 0

SECTION 3 MONEY INSURANCE 1.50 4500 7

SECTION 4 PLATE GLASS 10.00 0

SECTION 5 BREAKDOWN OF APPLIANCES ( WINDOW/ SPLIT A/C ) 25.00 0 0

GENERATOR SET 15.00 0 0

OTHER EQUIPMENT 15.00 0 0

BAGGAGE 10.00 1000 50

SECTION 6 NEON / GLOW SIGN 10.00 0 0


SECTION 7 ELECTRONIC EQUIPMENTS 10.00 0 0

SECTION 8 FIDELITY GUARANTEE 10.00 0 0

SECTION 9 PERSONAL ACCIDENT 1.50 0

SECTION 10 A PUBLIC LIABILITY 0.50 1500 50

SECTION 10 B WORKMEN COMPENSATION 4.50 0 0

SECTION 11 BUSINESS INTERRUPTION 2.25 0 0


TOTAL PREMIUM 1524

TOTAL( EXCL. SECTION 1,7&11) 816

SECTIONAL DISCOUNT 5 15% 122

NET PREMIUM 1402

S.TAX. INCL. ECU. CESS @ 10.30% 10.30% 144

TOTAL AMOUNT PAYABLE 1547

NAME OF THECUSTOMER :

PNB A/C: M/s MAMTA ENTERPRISES, OPP- ORIENTBANK OF COMMERCE, AJMER ROAD, JAIPUR

DATE OF ISSUE OFQUOTATION :

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QUOTATION FOR OFFICE PACKAGE POLICY

Thank you,For Bajaj Allianz General Insurance. Ltd.,


SECTION 1 FIRE - BUILDING 0.50 150000 75

FIRE - CONTENTS 0.50 20000 10


SECTION 2 BURGLARY & HOUSEBREAKING CONTENTS 1.00 0 0

SECTION 3 MONEY INSURANCE 1.50 0 0

SECTION 4 PLATE GLASS 10.00 0 0

SECTION 5 BREAKDOWN OF APPLIANCES 15.00 0 0

SECTION 6 BAGGAGE 10.00 0 0

SECTION 7 ELECTRONIC EQUIPMENTS 10.00 0 0

TERRORISM PREMIUM 0.20 0 0

SECTION 8 FIDELITY GUARANTEE 10.00 100000 1000

SECTION 9 PERSONAL ACCIDENT 2.00 0 0

SECTION 10 A PUBLIC LIABILITY 5.00 0 0

SECTION 10 B WORKMEN COMPENSATION 0 0

SECTION 11 HOSPITAL CASH 0


NET PREMIUM 1085

S.TAX. INCL. EDU. CESS @ 10.30% 1030.00% 112


NOTE : 1. PLEASE ENTER THE RATES FOR SECTION 1, SECTION 9, SECTION 10B AND SECTION 11 AS PER GUI

2. SECTION 1 & SECTION 2 ARE COMPULSARY

NAME OF THECUSTOMER : DATE OF ISSUE OFQUOTATION :

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QUOTATION FOR WORK MEN COMPENSATION

Thank you,For Bajaj Allianz General Insurance. Ltd.,(Authorised Signature)

NAME OF THE INSURED : DATE :

DESCRIPTION

1 12 0 30.00 0.0 0

1 3 0 6.25 2.0 0

1 3 0 67.10 2.0 0

1 3 0 12.15 2.0 0

1 3 0 12.15 2.0 0

1 3 0 67.10 2.0 0

1 3 0 67.10 2.0 0

1 3 0 30.15 2.0 0

1 3 0 30.15 2.0 0

1 3 0 30.15 2.0 0

TOTAL NET PREMIUM 0

SER.TAX INCL. EDU. CESS @ 10.30% 0

TOTAL AMOUNT PAYABLE ! 0

SALARY PERMONTH

TOTALNO.

NUMBER OFMONTHS

TOTAL SUMINSURED

RATE%o

RATEABOVE

4000

NETPREMIUM

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QUOTATION FOR MOTER DEALER PACKAGE POLICY


S.NO. DETAILS SECTION SUM INSURED RATE (Permile) PREMIUM

1Fire (Buildings) I 1.9 0

Fire (Contents) I 3.9 0

2 Burglary II 2.5 0

3 Damage III 15 0

4 Neon Sign IV 10 0

5 Bussiness Interruption V 0 0

6 Breakdown of Bussiness Equip VI 15 0

7 Money Insurance VII 1.5 0

8 Plate Glass VIII 10 0

9 Elec.& Electronic IX 10 0

10 Fedility Guarantee X 7.5 011 Public Liablity XIV 5 0

TOTAL : 0 Net Premium :- 0

0

Special Discount @ 0% : 0

0

Service Tax @ 10.30% : 0

Final Premium :- 0

EXCEPT BELOW SEC :- SECTIONAL DISCOUNTS

1 FIRE Upto 5 10%3 DAMAGE Above 5 15%

9 BREAK DOWN

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ToMr. N. Sateesh,Vizag.

QUOTATION FOR PERSONAL ACCIDENT POLICY Date : 09/18/2010


RISK 1 :-

COVER RATE

RISK - 1

PREMIUM PREMIUM PREMIUM

Principle Spouse Child - 1 Chil

BASIC 0.45 0.00 0.00 0.00

WIDER 1 0.00 0.00 0.00

COMPREHENSIVE 1.5 300,000 450.00 0.00 0.00

INDIVIDUAL PREMIUM : 450.00 0.00 0.00

Base Premium : 450.00

Add :-Medical Expenses @ 25% : NO 0.00

Add:-Hospital Confinment (Rs.300/-) : NO 0.00

Gross Premium : 450.00

Less :Family discount @ 10 % : NO 0.00 RISK - 1 :-

Net Premium : 450.00 TOTAL PREMIUM PAYABLE : 496

Add :-Service Tax : 10.30% 46.35

FINAL PREMIUM :- 496.35

SUMINSURED

SUMINSURED

SUMINSURED

SUMINSURED

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ToMr. N. Sateesh,Vizag.

QUOTATION FOR PERSONAL ACCIDENT POLICY Date : 09/18/2010


PREMIUM

ld - 2

0.00

0.00

0.00

0.00

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QUOTATION FOR TRAVEL COMPANION


(Authorised Signature)

TRAVEL TYPE :- Travel Value USA/CANADA :- Including

DAYS TO TRAVEL 76-90

MEMBER AGE

PROPOSER 25-Aug-1947 63 0

Note :- WHOLE FAMILY PREMIUM

1) PROPOSER 1383

SPOUSE 1610

CHILD 1

CHILD 22)

NET PREMIUM PAYABLE :- 2993

Travel Value

D O BDD-MMM-YYYY

INDVIDUALPREMIUM

If Additional Family MemberPlease Check Their IndividualPremium and entered sameinto whole family table to get

Net Premium Payable

Travel Age Must be between 61to 70 Yrs. Only

This policy offers high value benefits for the individual traveling abroad. Covers allmedical eventualities including Hospitalization and other incidental expenses withenhance medical coverage of $5,00,000 and increased limit of $ 1,500 for emergency ca

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QUOTATION FOR HOUSE HOLDERS PACKAGE POLICY



SECTION 1FIRE - BUILDING 0.50 1300000 650

FIRE - CONTENTS 0.50 80000 40

TERRORISM PREMIUM 0.30 0

SECTION 2CONTENTS - BURGLARY 2.25 80000 180

FIRST LOSS BASIS 3.37 0

SECTION 3 JEWELLERY & VALUABLES 10.00 5000 50

SECTION 4 PLATE GLASS 10.00 0

SECTION 5A BREAKDOWN OF DOMESTIC APPLIANCES (NON A/C) 2.50 0

SECTION 5B WINDOW AIRCONDITIONER INCLUDING SPLIT UNITS 10.00 0

SECTION 6ELECTRONIC EQUIPMENTS 10.00 0

TERRORISM PREMIUM 0.30 0

SECTION 7 PEDAL CYCLES 10.00 0

SECTION 8 BAGGAGE 7.50 0

SECTION 9 PERSONAL ACCIDENT 1.50 0

SECTION 10 A PUBLIC LIABILITY 0.50 0

SECTION 10 B WORKMEN COMPENSATION 0

TOTAL PREMIUM EXCLUDING SECTION 1 230


NET PREMIUM 920

S.TAX. INCL. ECU. CESS @ 10.30% 10.30% 95


2. SECTION 1 & SECTION 2 ARE COMPULSARY

NAME OF THECUSTOMER :

DATE OF ISSUE OFQUOTATION :

NOTE: 1. PLEASE ENTER THE RATES FOR SECTION 9 AND SECTION 10 B AS PER GUIDELINES

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QUOTATION OF HEALTH GUARD INSURANCE


MEMBER DETAILS AGE SUM INSURED

Proposer 10-Jan-1979 31 100000

Spouse 10-Jan-1981 29 100000

Child 10-Jan-2000 10 300000

Child 10-Jan-2002 8 300000

Employee 10-Jan-2002 8 150000

Loading (%) 11400SMOKER NO 0 0

ASTHAMA PATIENT NO 0 0

BASE PREMIUM 11400

Y

NET PREMIUM 10830

SERVICE TAX @ 10.30 % 1115


D O B (DD-MMM-YYYY)

FAMILY DISCOUNT **

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FIRE TARIFF - SIMPLE RISK

SECTION DESCRIPTION

3 1 1

3 2 2

3 3 21

3 4 22

BACK

RISKCODE

RATECODE

Dwellings, Places of worships, Libraries, Museums,Schools, Colleges, Hospitals including X-ray and otherDiagnostic clinics, Office premises, Meeting Rooms,Auditoriums, Planetarium, Mess Houses, Clubs,Marriage Halls, Showrooms and display centres where

Cafes, Restaurants, Hotels, Confectioner & Sweetmeat sellers

Shops dealing in goods otherwise not provided forincluding Laundries, Battery Charging Service Stations,Dry Cleaning, Amusement parks, Hoarding, Neon signsand Sports Galleries, Outdoor stadiums.

Shops dealing in hazardous goods as per the list belowand Arms & Ammunition dealers, Motor Vehicleshowroom including sales and service, Petrol / DieselKiosks

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0.5 0.5

Sateesh, Vsp

1.8 1.8

1.8 2.8

1.8 3.8

BUILDINGRATE

CONTENTRATE

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FIRE TARIFF - STORAGE RISK (Section

DESCRIPTION

MATERIAL

GODOWN AND SILOS

18 3 1

19 Storage of Category I hazardous Goods 9 2.5

20 15 4.5

21 18 5.5

22 18 5.5

23 Storage of Coir waste, Coir Fibre, Caddies 23 12

24 Cold Storage Premises 9 2.5

RISK

CODERATECODE

RATE(Per Mile)

Storage of Non hazardous Goods Subject to warrantythat hazardous goods of Category I, II, III, Coir waster,Coir firbre and Caddies are not stored therein

Storage of hazardous Goods listed in Category IISubject to Warranty that goods listed in Category III,Coir waste, Coir Fibre and adies are not stored therein

Storage of hazardous Goods listed in Category IIIsubject to warranty that Coir waste, Coir fibre and,Caddies are not stored therein

Transporter's godown & godown of clearing andforwarding agents

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- VI)

STORED IN

OPEN

9 2.5

Sateesh, Vsp

19 6

21 8.5

22 10.5

22 10.5

25 17

- -

BACK

RATECODE

RATE(Per Mile)

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QUOTATION FOR HOSPITAL CASH INSURANCE


(Authorised Signature)

MEMBER DETAILS AGE SUM INSURED

30 DAYS :- Proposer 6-Oct-1973 36 2000

Spouse

Child2

Spouse

Child1

60 DAYS :- Proposer

Spouse

Child2

Child3

Child3

BASE PREMIUM 850

Y

NET PREMIUM 808

SERVICE TAX @ 10.30 % 83


D O BDD-MMM-YYYY

FAMILY DISCOUNT **

prem. calc

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