0263 050720160263 Mr Rakesh Arora C-108 First Floor Jeevan Park Near Som Bazar Road Uttam Nagar New Delhi-110059 Delhi India Contact No.: 9810686935 Policy No.: 110800/11111/1000095727-04 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 80130111 1141693000 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 customerservice@apollomunichinsurance.com or call us at our 24 hours toll free number 1800-102- 0333. 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 www.apollomunichinsurance.com 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. 1800-102-0333. Intermediary Code Intermediary Name Intermediary Contact No 80130111 Bajaj Capital Insurance Broking Ltd. 1141693000
Issuing/Servicing Office: Shakti Nagar Branch Office, Ground Floor, 29/7, Nangia Park CircleShakti Nagar Delhi 110007 PH : 01145028192 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-110059 Delhi India Intermediary Code : 80130111 Intermediary Name : Bajaj Capital Insurance Broking Ltd. Intermediary Contact No : 1141693000 Policy Number : 110800/11111/1000095727-04 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) 10001041322 Mr Rakesh Arora 40 Policy Holder 0.00 0 0 10001041341 Mrs Geeta Arora 37 Wife 0.00 0 0 400000 10001041342 Baby Sanya Arora 11 Daughter 0.00 0 0 10007275359 Master Shaurya Arora 5 Son 0.00 0 0 Gross Premium (Rs) Cumulative Bonus* 24161.94 160000 *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.) 21010.39 Discounts (Rs.) 0.00 Loading (Rs.) 0.00 Service Tax/J&K GST as applicable (Rs.) 2941.45 SBC & KKC (Rs.) 210.10 Gross Premium (Rs.) 24161.94 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: 01871052106 EXCLUSION(S) / SPECIAL CONDITION(S) Member ID Person Name Details 10001041322 Mr Rakesh Arora For Rs 400000 (Rupees Four Lakh) - Sec 6A i), Sec 6A ii)) and Sec 6A 10001041341 Mrs Geeta Arora For Rs 400000 (Rupees Four Lakh) - Sec 6A i), Sec 6A ii)) and Sec 6A 10001041342 Baby Sanya Arora For Rs 400000 (Rupees Four Lakh) - Sec 6A i), Sec 6A ii)) and Sec 6A 10007275359 Master Shaurya Arora For Rs 400000 (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
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. 24161.94 (Rupees Twenty-Four Thousand One Hundred Sixty-One and Paisa Ninety-Four Only) towards premium for Easy Health Floater Standard Two Year Policy No 110800/11111/1000095727-04 issued to Mr Rajan Arora for period 11-Jul-2016 to 10-Jul-2018. 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. 5. 80D benefit is applicable for only Self, Spouse, Dependent Children and Dependent parents
Mr Rakesh Arora DOB: 27-Sep-1975 - Male Code: 359 ID :10001041322 Policy : 110800/11111/1000095727-04 Mrs Geeta Arora DOB: 06-Mar-1979 - Female Code: 359 ID :10001041341 Policy : 110800/11111/1000095727-04 Baby Sanya Arora DOB: 01-Feb-2005 - Female Code: 359 ID :10001041342 Policy : 110800/11111/1000095727-04 Master Shaurya Arora DOB: 16-Apr-2011 - Male Code: 359 ID :10007275359 Policy : 110800/11111/1000095727-04