Bajaj Capital Insurance Broking Ltd.

Transcription

1 Mr Rakesh Arora C-108 First Floor Jeevan Park Near Som Bazar Road Uttam Nagar New Delhi Delhi India Contact No.: Policy No.: /11111/ This Policy Kit Contains: 1. The Policy Schedule along with income tax (80 D) certificate (wherever applicable) 2. Member cashless card/s Code Intermediary Name Contact No Bajaj Capital Insurance Broking Ltd. Renewal of Your Easy Health Insurance Policy Dear Mr Rakesh Arora, Thank You for renewing the policy with us. We are pleased to enclose your renewed Policy Kit for the period 11-Jul-2016 To 10-Jul-2018 To know more about policy related information and value added offers, you may re-register yourself at our website using your unique member ID and policy number as mentioned in the policy schedule. In case of any query, please feel free to write to or call us at our 24 hours toll free number Our customer care team will be happy to assist you. Warm Regards, Location: Location Gurgaon : Date: Date 05-Jul-2016 : Note:- - Please visit our website to access information about our company, the customer service touch points including the Grievance handling process and various forms that you can use for service support. You will also get latest updates on products, policy wordings which you can download for your reference and record. - Please update us with your latest contact details (in case of any change) so that same can be updated in our records.you can either write back to us or call us on our toll free no Intermediary Code Intermediary Name Intermediary Contact No Bajaj Capital Insurance Broking Ltd

2 Issuing/Servicing Office: Shakti Nagar Branch Office, Ground Floor, 29/7, Nangia Park CircleShakti Nagar Delhi PH : Policy Holder's Name : Mr Rakesh Arora Policy Holder's Address : C-108 First Floor Jeevan Park Near Som Bazar Road Uttam Nagar New Delhi Delhi India Intermediary Code : Intermediary Name : Bajaj Capital Insurance Broking Ltd. Intermediary Contact No : Policy Number : /11111/ First policy inception date : Policy Period : From 16:07 hrs on 11-Jul-2016 Insured Persons Details: Member ID Insured Person's Name Age Relationship to Policyholder Critical Illness (Rs.) (Rs.) 11-Jul-2010 To 24:00 hrs on 10-Jul-2018 Critical Advantage (USD$) Critical Advantage Rider Premium (Rs) Mr Rakesh Arora 40 Policy Holder Mrs Geeta Arora 37 Wife Baby Sanya Arora 11 Daughter Master Shaurya Arora 5 Son Gross Premium (Rs) Cumulative Bonus* *The cumulative bonus (CB) shown in the Policy Schedule is provisional. The CB calculated on the Expiry Date, shall only be considered as final. However, in case of any change in provisional CB, the same shall be intimated to You by Us through a separate endorsement. Nominee Name : Mrs Geeta Arora Relationship to Policyholder: The nominee must be an immediate relative of the Policyholder. For all other Insured Persons, the Policyholder shall be the nominee. Premium Calculation: SCHEDULE Easy Health Floater Standard Two Year Net Premium (Rs.) Discounts (Rs.) 0.00 Loading (Rs.) 0.00 Service Tax/J&K GST as applicable (Rs.) SBC & KKC (Rs.) Gross Premium (Rs.) Gross Premium amount (in words) Rupees Twenty-Four Thousand One Hundred Sixty-One and Paisa Ninety-Four Only The stamp duty of Rs. 1.00/- (Rupees One Only) paid vide No.F.10(783)/OS(HQ)/Con.duty/08. (Not applicable for the state of Jammu & Kashmir). Service Tax Registration No.: AAGCA1654HST002 GST TIN: EXCLUSION(S) / SPECIAL CONDITION(S) Member ID Person Name Details Mr Rakesh Arora For Rs (Rupees Four Lakh) - Sec 6A i), Sec 6A ii)) and Sec 6A Mrs Geeta Arora For Rs (Rupees Four Lakh) - Sec 6A i), Sec 6A ii)) and Sec 6A Baby Sanya Arora For Rs (Rupees Four Lakh) - Sec 6A i), Sec 6A ii)) and Sec 6A Master Shaurya Arora For Rs (Rupees Four Lakh) - Sec 6A i) and Sec 6A ii)) of the policy wording is waived and Sec 6A iii) is reduced to 1 year. Claim Administrator:Apollo Munich Claim Administrator:Not Applicable (For critical advantage rider ) For and on behalf of Apollo Munich Health Insurance Company Limited Location:Gurgaon Date: 05-Jul-2016

3 Certificate for the purpose of deduction under Section 80 D of Income Tax Act, 1961* This is to certify that the Proposer has paid Rs (Rupees Twenty-Four Thousand One Hundred Sixty-One and Paisa Ninety-Four Only) towards premium for Easy Health Floater Standard Two Year Policy No /11111/ issued to Mr Rajan Arora for period 11-Jul-2016 to 10-Jul For and on behalf of Apollo Munich Health Insurance Company Limited Location:Gurgaon Date: 05-Jul-2016 *Note 1. This is subject to the provisions of Section 80D of Income Tax Act, 1961 as amended from time to time. 2. This certificate must be surrendered to the company in case of cancellation of this policy. In event of incorrect representation of this declaration the liability shall be upon the policy holder. 3. Please note that this certificate will not be issued if the premium payment has been made in cash. 4. In case of dishonour of the premium instrument, the policy will be deemed cancelled ab initio D benefit is applicable for only Self, Spouse, Dependent Children and Dependent parents

4 Mr Rakesh Arora DOB: 27-Sep Male Code: 359 ID : Policy : /11111/ Mrs Geeta Arora DOB: 06-Mar Female Code: 359 ID : Policy : /11111/ Baby Sanya Arora DOB: 01-Feb Female Code: 359 ID : Policy : /11111/ Master Shaurya Arora DOB: 16-Apr Male Code: 359 ID : Policy : /11111/

5