I/We do hereby declare that I/we have read and understood the entire text, features, disclosures, benefits, terms and conditions of the policy and I/we further declare that the information furnished above are true to the best of my/our knowledge and no material information, which may be relevant, has been withheld or not disclosed. In case any of the information above is found false during verification at a later date, the company would have the right to cancel the policy and premium amount paid will be forfeited. I/We also declare that any additions or alterations are carried out after the submission of this proposal form then the same would be conveyed to the insurers immediately.

The quote displayed has been calculated based on the information provided by you and is subject to change in case you change the information while buying the policy. The product information, including the scopes of cover, terms, conditions, exclusions and limitations, available on the website is not intended to be exhaustive and is indicative in nature. I / We desire to insure with Zurich Kotak General Insurance Company (India) Limited in respect of the vehicle described above and confirm that the statements contained in this proposal are my/our true and accurate representations. I/we undertake that if any of the statements are found to be false or incorrect, the benefits under this policy would stand forfeited. I/We agree that this application and declaration shall be promissory and shall be the basis of the contract between me/us and Zurich Kotak General Insurance Company (India) Limited. I/We confirm that I/We have read and understood the coverages, the terms and conditions and agree to accept the company's policy of insurance along with the said conditions prescribed by the company. I/We also declare and undertake that if there is any change in information as submitted by me/us after this submission then the same would be conveyed to Zurich Kotak General Insurance Company (India) Limited immediately failing which it is agreed and understood by me/us that the benefits under the policy would stand forfeited. I/We agree to the company taking appropriate measures to capture the voice log for all such telephonic transactions carried out by me/us as required by the procedures/regulations internal or external to the company and shall not hold the company responsible or liable for relying / using such recorded telephonic conversation. I/We agree that the insurance would be effective only on acceptance of this application by the company and the payment of the requisite premium by me/us in advance. In the event of non-realisation of the cheque or non-receipt of the amount of premium by the company the policy shall be deemed cancelled ab-initio and the company shall not be responsible for any liabilities of whatsoever nature under this policy.

Declaration for No Claim Bonus
I/We declare that the rate of NCB claimed by me/us is correct and that NO CLAIM has arisen in the expiring policy period. I/We further undertake that if this declaration is found incorrect, all benefits under the policy in respect of section I of the policy will stand forfeited.

General exclusions:

The Company shall not be liable under this Policy in respect of

• any accidental loss or damage and/or liability caused sustained or incurred outside the geographical area;
• any claim arising out of any contractual liability. Please refer to policy wordings for detailed list of exclusions.

LIMITATIONS AS TO USE
The Policy covers use of the vehicle for any purpose other than

• Hire or Reward
• Carriage of goods (other than samples or personal luggage)
• Organized racing
• Pace making
• Speed testing
• Reliability Trials
• Use in connection with Motor Trade