<%@ taglib uri="struts-html" prefix="html" %> <%@ taglib uri="struts-bean" prefix="bean" %> <% String contextpath=request.getContextPath(); String responseXml=(String) request.getAttribute("responseXml"); if(responseXml==null){ responseXml=""; } String vehicleType=(String) request.getAttribute("vehicleType"); String vehicleSubType=(String) request.getAttribute("vehicleSubType"); String TPCCrange=(String) request.getAttribute("TPCCrange"); String TPCarryingCapacity=(String) request.getAttribute("TPCarryingCapacity"); String noOfPassengers=(String) request.getAttribute("noOfPassengers"); String insCompId=(String) request.getAttribute("insCompId"); String planId=(String) request.getAttribute("planId"); String finalAmount=(String) request.getAttribute("finalAmount"); String premiumXML=(String) request.getAttribute("premiumXML"); String CompanyShortName=(String) request.getAttribute("CompanyShortName"); String planName=(String)session.getAttribute("planName"); %> <%@ page import="org.apache.struts.action.DynaActionForm;" %> <% %> Private Car Motor Vehicle Insurance Insured Details India
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: <%=CompanyShortName%> : <%=finalAmount%>
: <%=vehicleType%> : <%=planName%>

I agree to send the following documents through Fax or Email or Courier.

  1. Photo copy of the Registration Certificate(RC).
Fax : 044 - 24526589
Email : customercare@easyinsuranceindia.com
Address : ICM Insurance Brokers Private Limited
New No.6, Old No.8, Kalakshetra Avenue, II Street,
Thiruvanmiyur, Chennai - 600041.
I/We also declare that any additions or alterations or modification are carried out in the vehicle or in the documents furnished / forming part of this Proposal Form, after the submission of this proposal form then the same would be conveyed to this insurer immediately, failing which be construed as breach of contract and my / our rights shall be forfeited.

I/We also declare that I / We shall comply with the requirement of M.V. Act. 1988, and amendments thereto from time to time and rules made there under.

I/We also declare that I/We shall inform this insurer, in case, the Government requisitions this vehicle during the currency of the Policy.

I/We hereby also declare that I/We am/are willing to accept a policy of insurance in this company's usual Form.

I/We hereby also agree that mere paying the premium / conducting the inspection do not indicate any start of insurance cover and insurance cover would be incepted only after the proposal is accepted by insurance company and a valid policy document is issued post receipt of premium.