I/We hereby give voluntary consent to BAGIC/Company to share my/our personal information and data provided in this proposal form with its group companies or any other person in connection with the Insurance Policy or otherwise,
including for providing products and services of group companies that may be of interest to me/us, to be used in accordance with their respective privacy policies and subject to appropriate measures being in place to safeguard
my/our personal information.
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Disclaimer: I hereby authorize Bajaj Allianz General Insurance Co. Ltd. to call me on the contact number made available by me on the website with a specific request to call back. I further declare that, irrespective of my contact number being
registered on National Customer Preference Register (NCPR) under either Fully or Partially Blocked category, any call made or SMS sent in response to my request shall not be construed as an Unsolicited Commercial Communication even though
the content of the call may be for the purposes of explaining various insurance products and services or solicitation and procurement of insurance business. Furthermore, I understand that these calls will be recorded & monitored for quality
& training purposes, and may be made available to me if required.
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Please Add Following Details
1
Vehicle details
2
Select plan
3
Personal Details
4
Review details
5
Checkout
Personal Details
Vehicle Details
Please note: Third Party policy must be covered by Bajaj Allianz General Insurance.
Your Registered Vehicle Details
1.New Vehicle Details
Please select above declation and proceed
Verify details : Vehicle 1
Maruti Suzuki Brezza vxi - MH12 AQ 1234
• Policy Expired • Date: 23/6/2024
Select Plans
KM based plans protection to Own damage
Cover (Only if: Active TP is available)
₹32,087
Covers cost of damages to your car and to other vehicles
(Bundled Policy)
₹39,161
Covers cost of damages to other vehicles
₹39,161
Own Damage Cover - If active TP is available
Discover peace of mind with our
innovative add-on cover - ensuring worry-free claims and freedom from endorsement
concerns.
₹39,161
₹32,22,180 (min)
₹32,22,180
₹35,80,200 (max)
Please enter odometer km reading
Enter valid details
Please enter a day plan
Own Damage cover is valid till expiry of Days Plan or Kms Plan (whichever is earlier) from the declared KM as on date
Additional Coverage
Enter valid
details
Enter valid
details
(Cover of 15 lakhs is mandated bylaw. Select no, if you already have an active cover or your
driving license is invalid)
I
have
driving license.
I
do not have
a PA cover worth RS. 15L
Drive Assure Economy
Depreciation shield
Engine protector
24*7 Spot assistance
Drive Assure Economy
Depreciation shield
Engine protector
24*7 Spot assistance
Premium For Vehicle 1 (With Tax)-
₹32,087
Reference Number - 1234567975757
Owner name
Named Drivers
RID
RED
Product Name
Net premium
Owner 1
Named Drivers 1 , Named Drivers 2
RID 1
RED 1
Product 1
Net premium 1
Premium
breakup
Price (3 Plan)
₹99,087
₹95,087
Discount
-₹4,000
18% GST
₹1,000
Total (Excluding GST)
₹96,087
Premium Breakup
Total Premium of all Individual Plan ( Plan)
₹99,087
Discount
-₹3,000
Total Premium in New Product/Plan
₹96,087
New Premium Breakup
Total Premium of all Individual Plan ( Plan)
₹99,087
Discount
-₹3,000
Total Premium in New Product/Plan
₹96,087
Total OD Premium = ₹99,087
Discount = -₹3,000
₹96,087 + 18% GST = ₹1,13,382
Verify your vehicle details : 1
Please enter PAN number
Enter CKYC Number
Select Document
Enter Passport number
Enter Passport file number
Please enter a valid voter ID number
Please enter a valid driver's license number
Please enter Address
Please enter a valid Email ID
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Congratulations!
Your precious vehicle is now covered with our motor insurance policy.