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    Karthik

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    karthiktext008

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    © All Rights Reserved
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    Karthik

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    Karthik

    Uploaded by

    karthiktext008

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    © All Rights Reserved
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    of 1

    Policy Issuing Office : Reliance General Insurance Co.

    Ltd, Policy Servicing Branch Office : Reliance General Insurance Co. Ltd,
    Reliance General Insurance Co Ltd Reliance General Insurance Co Ltd
    Sri Balaji enclave No.782, 16th main, Sri Balaji enclave No.782, 16th main,
    BTM Layout,Bangalore-560076. BTM Layout,Bangalore-560076.

    Reliance Individual Mediclaim Policy Schedule


    Name and Address of the Proposer : KARTHIK S
    73/A8 2ND STREEET,
    SANKARALINGAPURAM,
    KOVILPATTI
    628501
    India
    Mobile No: 9 3 6 1 8 7 5 5 6 2
    Policy Number 1301812821000291
    Details of previous policy (in case of
    renewal) Previous policy No. : NA
    Date of expiry : NA
    Sum Insured : As Indicated Below
    Period of Insurance : From 00:01 on 25/05/2024 to mid-night on 24/05/2025

    Name of Insured Person Gender Date of Relationship with Occupation Pre-Existing Sum Domiciliary Amount Loading Premium
    Birth the Proposer Illness Insured (Rs) Hospitalisation of CB (%) (Rs)
    Limit (Rs) (Rs)
    KARTHIK S Male 20/01/199 Self Others 50000.00 500000.00 555000.0 0 22384.00
    3 0

    * Where an Insured Person is added to this Policy, either by way of endorsement or at the time of renewal, the pre-existing disease clause,first year
    exclusion and 30 days waiting period is applicable considering such policy period as the first policy with us.
    * Policy would be considered as a fresh policy if there would be break of fifteen or more days between the prevoius policy expiry date and current policy
    start date.
    * Any enhanced Sum insured during subsequent policy renewals will not be available for an illness, diseases, injury already contracted under the
    preceding policy periods.All Waiting periods as defined in the policy shall apply for this enhanced limit from the effective date of enhancement of such
    Sum Insured.
    * This Insurance is subject to the terms and conditions of policy attached .The policy wordings with detailed terms , conditions and
    exclusions is available on our website www.reliancegeneral.co.in
    Special Conditions, if any :

    Premium Details Amount (Rs.)


    Gross Premium 22384.00
    Service Tax (12% of Net Premium)
    2686.08
    Education Cess (2% of Service Tax) 53.72
    Secondary and Higher Education Cess (1% of Service Tax) 26.86
    Total Premium 25150.00

    (Service Tax Registration No: AABCR6747BST001)


    Consolidated Stamp duty Paid vide Receipt No.20984 dated 25/05/2024 **
    ** Not applicable for the State of Jammu and Kashmir
    Note: In the event of dishonor of cheque, this policy document automatically stands cancelled from inception, irrespective of whether a separate
    communication is sent or not.
    In witness whereof this policy has been signed at Bangalore on 25/05/2024
    For any assistance with claims, please contact us on 1 800 3002 8282 (toll free) and 3989 8282 (local charges apply) or email us at
    [email protected]

    TPA/Service Provider Details


    TPA/Service Provider Name Paramount Health Services Pvt. Ltd.
    Address Please Log on to www.paramounttpa.com for locating the nearest office for submission of claim documents
    24X7 Customer Helpline Number 022-66620880/ (022) 6662 0880(TollFree)
    Fax Number (022) 2825 9543 /9743
    Email id [email protected] ( For
    Insured Grievances & for any other
    queries)

    Premium Certificate
    Premium Certificate for the purpose of deduction under Section 80-(D) of Income Tax (Amendment) Act 1986.
    This is to certify that KARTHIK S has paid Rs.25150 (TWENTY FIVE THOUSAND O N E HUNDRED FIFTY) towards premium for Health Insurance for the
    Period From 00:01 on 25/05/2024 to Midnight of 24/05/2025 on May 25 2024.
    Policy Number : 1301812821000291
    Date : 25/05/2024 Place : Bangalore
    Note: This certificate must be surrendered to the Insurance Company for issuance of fresh certificate in case of cancellation of policy or any alteration
    in the insurance affecting the premium.

    Registered Office: Reliance Centre, 19, Walchand Hirachand Marg,Ballard Estate ,Mumbai - 400 001

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