I/We, hereby declare that the statements and particulars given in this Proposal form are complete, true and accurate and I/We agree that the Insurance company will not be liable under the insurance contract if it is found that any of my/our statements or particulars or declarations in this proposal form or other documents are incorrect /misleading /Fraudulent in any respect on any matter to the grant of a cover or submission of claim in future.
I declare that the premium paid under this transaction to Go Digit General Insurance Limited is being paid
by me i.e. the proposer/policyholder through a bank account or a Credit/Debit Card or a Prepaid
Payment Instrument or a UPI wallet (Wallet), held by me in my name as a primary holder
(referred to as “source account”). I confirm that it is not a third party payment made by any
other person on my behalf. I understand that in the event of a policy cancellation,
the refund of premium as per policy terms and conditions may be credited back to
such source account and such electronic transfer will constitute full and final discharge
of the Company’s obligation.
I/We declare that the rate of NCB claimed by me/us is correct and that no claim as arisen in the expiring policy period (copy of the policy enclosed). I/We further undertake that if this declaration is found to be incorrect, all benefits under the policy in respect of Section I of the Policy will stand forfeited.
I hereby affirmatively warrant that the Assured named herein/owner of the vehicle insured holds a valid Pollution Under Control (PUC) Certificate on the date of commencement of the Policy and the same has been shown to the agent/authorized person of intermediary. I further undertake to renew and maintain a valid and effective PUC Certificate during the duration of the Policy period. If the PUC certificate is not found valid on the date of loss, I understand that the Company reserves the right to cancel the policy.
I/We, hereby agree that in Case of Break in Insurance, the policy would be issued subject to acceptance of risk after evaluation of the Vehicle Inspection report. Own Damage cover (Section – I) would not commence unless the satisfactory Vehicle Inspection report has been received by us. If the Company does not receive the Vehicle Inspection report or the report is adverse, the Company, at its discretion, will cancel Policy as per the Motor Tariff.
I/We further declare that l/we will notify in writing any change in the details so furnished hereinabove occurring after the proposal has been submitted but before communication of the risk acceptance by the Company.
I/We authorize the Company to share information pertaining to my proposal including medical records for the sole purpose of proposal underwriting and/or claims settlement and with any Governmental and/or Regulatory authority.
By submitting your contact number and email ID, you authorize Go Digit General Insurance (Digit Insurance) to call, send SMS, messages over internet-based messaging application like WhatsApp and email and offer you information and services for the product(s) you have opted for as well as other products/services offered by Digit Insurance. Please note that such authorization will be over and above any registration of the contact number on TRAI’s NDNC registry.
Go Digit General Insurance Limited (formerly known as Oben General Insurance Ltd.) - Registered Office Address - 1 to 6 floors, Ananta One (AR One), Pride Hotel Lane, Narveer Tanaji Wadi, City Survey No.1579, Shivaji Nagar, Pune-411005, Maharashtra | Corporate Office Address - Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru-560095, Karnataka | Trade logo of Go Digit General Insurance Ltd. displayed above belongs to Go Digit lnfoworks Services Private Limited and is provided and used by Go Digit General Insurance Ltd. under license.