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Date Dat e : 23 Octo Octobe berr 2013 2013 Mr Banke Bihari Arora T-16/696 Gali Gusaian Katra Bhai Sant Singh 1/S Beri Gate Amritsar Amritsar 143001 Punjab Policy No. : 10004419 Mobile No. : 9463401230
Subject : Renewal of Policy No. 10004419 Dear Mr Banke Bihari Arora, We take this opportunity to thank you once again for entrusting us with your health; and assure you of our commitment to keep you worry-free….hamesha. We are pleased p leased to confirm conf irm renewal rene wal of your y our policy; pol icy; and enclosed enclose d are the th e following follo wing documents doc uments with w ith regard regar d to the th e same : Policy Certificate Premium Acknowledgement (including tax certificate) To enjoy seamless services offered by your policy, please note the following : - Renewal of this policy does not change or alter the Policy Terms and Conditions of “Care”. - Health Cards and all other documents issued along with your first policy shall continue to be valid. - To enable quicker processing, we request you to mention your Member Card Number / Policy Number in all future correspondence correspondence with us. For any clarifications, please feel free to mail us at customerfirst@religarehealthinsuran
[email protected] ce.com or call us at 1800-200-4488. 1800-200-4488.
Wishing you Health….Hamesha! Team Religare Health Insurance
Religare Health Insurance Company Limited GYS Global, Plot No. A3, A4, A5, Sector - 125, Noida, U.P.-201301 www.religarehealthinsurance.com
Policy Certificate
Plan Name
10004419 CARE
Cover type
Floater
Policy No.
Mr Banke Bihari Arora T-16/696 Gali Gusaian Katra
Policy Period - Start Date
20-Oct-2013
Bhai Sant Singh 1/S Beri Gate
Policy Period - E nd Date
1 9- Oc t- 20 14
Amritsar
Nominee Name (Relationship) Ms Puja Arora (WI) Premium Paid Rs. 8150 ( Premium 7,253.72 + Service Tax 896.56 ) Premium Payment Mode Single Premium
Amritsar 143001 Punjab
7, 289 Policyholder
Date of Birth
Client ID
Banke Bihari Arora
16-Mar-1978
50061997
fo 18
Details of Insured Name
Client ID
Date of Birth
Relationship
Insured with the Company (since)
Pre-existing diseases
*#No Claim Bonus
Banke Bihari Arora
50061997 16-Mar-1978
MEMBER
20-Oct-2012
20,000
Puja Arora
50062242 09-Jun-1976
SPOUSE
20-Oct-2012
20,000
Prachi Arora
50062243 10-Jan-2008
DAUGHTER
20-Oct-2012
20,000
Mridul Arora
50062244 28-Nov-2011 SON
20-Oct-2012
20,000
*The No Claim Bonus shown in the Policy Certificate is provisional. The No Claim Bonus calculated on the Expiry Date, shall only be considered as final. However, in case of any change in provisional No Claim Bonus, the same shall be intimated to the Policyholder by the Company through a separate endorsement. #Subject to the Policy Terms&Conditions, the No Claim Bonus shown above would be available only up to the maximum amount of Rs. 20,000 for all the Insureds collectively. 1
Details of Cover S No.
Particulars
Details
1
Sum Insured
Rs.2,00,000
1
Intermediary Details Name
Code
Contact Number
Umesh Aggarwal
20000739
9216613217
for Claims & Assistance: Call 1800-200-4488
9
Benefits S No.
Particulars
Basis of Offering (On Annual Basis)
Hospitalization Expenses (Conditions for Medical Expenses)
Upto Rs.2,00,000 (i.Room Rent = 1% of Benefit 1 Sum Insured per day; ii.ICUCharges = 2% of Benefit 1 Su m Insured per day)
Pre-hospitalisation & Post-hospitalization Expenses
Pre-hospitalization upto 30 days; Post-hospitalization upto 60 days
3
Ambulance Cover
Upto Rs. 1,500 per Claim
4
Organ Donor Cover
Upto Rs. 50,000 per Policy Year
5
Domiciliary Hospitalization
Upto 10% of Sum Insured per Policy Year
6
Health Check-up
1 Check-up per adult, per Policy Year
7
Recharge of Sum Insured
1 re-instatement upto Sum Insured per Policy Year
8
Daily Allowance
Rs. 500 per day, maximum up to 5 days per Claim
9
No Claims Bonus
10% of Sum Insured for each Claim free year, maximum upto 50% of Sum Insured; reduced by 10% of Sum Insured in case of Claim
1 2
0 1
Special Conditions S No.
Particulars
1
Floater Cover
For Religare Health Insurance Company Limited
Authorized Signatory
Date of Issue : 23-Oct-2013
Correspondence Address: Religare Health Insurance Company Limited GYS Global, Plot No. A3, A4, A5,Sector-125,Noida,UP-201301 Website : www.religarehealthinsurance.com
Place of Issue : Saket, New Delhi
23-Oc Contact No : 1800-200-4488
Fax:1800-200-6677
Email :
[email protected]
Consolidated Stamp Duty paid vide Certificate No. F.No.10(6023)/COS(HQ)/Cons.Duty/2308 dated 17th July, 2012 Service Tax Registration No:AADCR628INSD001
IRDA Registration Number - 148
UIN : IRDA/NL-HLT/RHI/P-H/V.I/253/13-14
Note:
Attached wit h this Policy Certificate are the Policy Terms and Conditions and Annexures. Please ensure that these documents have been received, read and understood. If any of these documents have not been received, please email at
[email protected] or write to the Company. This Policy Certificate in orig inal must be surrendered to the Company in case of cancellation of the Policy.
PUJA ARORA 50062242 09-Jun-1976
BANKE BIHARI ARORA 50061997 16-Mar-1978
PRACHI ARORA 50062243 10-Jan-2008
MRIDUL ARORA 50062244 28-Nov-2011
0
REN
Premium Acknowledgement
Policy No.
10004419
Client ID
50061997
Policyholder Address
Mr Banke Bihari Arora
Policy Period
20-Oct-2013 to 19-Oct-2014
T-16/696 Gali Gusaian Katra Bhai Sant Singh 1/S Beri Gate Amritsar Amritsar 143001, Punjab
Premium Details Amount (in Rs.)
Particulars
8, 1
Gross Premium CARE
7,253.72
V
Service Tax & Levies
896.56
Total
8,150.00
The Premium is rounded off to the nearest rupee.
Eligibility of Premium for Deduction u/s 80D of the Income Tax Act, 1961
This is to certify that Religare Health Insurance Co.Ltd. has received an amount of Rs. 8,150.00/- from Mr Banke Bihari Arora towards Payment of Health insurance premium as per the details mentioned above. The premium paid for this policy is eligible for applicable tax benefits u/s 80D of the Income Tax Act, 1961 and amendments thereof.
For Religare Health Insurance Company Limited
Authorized Signatory This
Mr
fro
Date of Issue: 23-Oct-2013
Place of Issue: Saket, New Delhi
725 towa
Note 1)
In case of any discrepancy, the Policyholder is requested to contact the Company immediately.
2)
Any amount paid in cash towards the premium would not qualify for tax benefits as mentioned above.
3)
This document must be surrendered to the Company in case of Cancellation of the Policy or for the issuance of a fresh certificate in the case of any alteration in the Policy.
Religare Health Insurance Company Limited GYS Global, Plot No. A3, A4, A5, Sector - 125, Noida, U.P.-201301 Website : www.religarehealthinsurance.com
E-mai l :
[email protected]
Call Us : 18 00-200-4488
