Star Health And Allied Insurance Company Limited

Date : 27-Mar-2024
To, IMPORTANT

MS.AKSHAY VIJAY KINDRE ,

C -18 14 SHREE SAMARTH SOCIETY SECTOR -15
NAVI MUMBAI
AIROLI
Navi Mumbai,Maharashtra-400708
Mobile : ./9920729555

Dear Customer,

Re: Health Insurance Policy - 11240811967902

We are extremely thankful to you for your renewal instructions and payment of premium. We enclose the
renewed policy based on our records. We would request you to kindly study the renewed policy carefully and
revert to us if there is any discrepancy to enable us to attend to the same.

Kindly note that the above request is very important and if we do not hear anything from you within
15 days, we would presume that the policy issued by us is in order and the contract is concluded.

We would like to mention that we have incorporated the name of the intermediary as indicated by you.

We wish you good health and we look forward to serve you in the days to come.

With kind regards,

Authorised Signatory

"Let Star Health help you to become healthier and happier. Star Wellness Benefits includes Mind Body healing
and other Condition management programmes (Weight management, Diabetes etc....) Visit www.starhealth.in /
customer portal login and start your journey with us to Better Health".
In case of a need for hospitalization, kindly prefer our network hospital (list is available in our website) for a
quick response to your claim request.
Please select the room as per your eligibility stipulated in your policy to avoid additional payment
from your pocket towards the proportionate increase which would invariably be charged by the
hospital for the higher room category occupied.
Sum Insured of this Policy is meant for utilization till its expiry.Bearing this aspect in mind,we have no
doubt,you will choose appropriate hospital,room rent and treatment charges etc.

Should you need any assistance, our customer care will be delighted to assist you ,whose toll free no. is
1800-425-2255/1800-102-4477.

However,the ultimate decision will be that of yours only.

This is an electronically generated document(Policy

Schedule). CONSOLIDATED STAMP DUTY FOR POLICY
STAMPS PAID VIDE NO. LOA/CSD/667/2023/1172 DT.
28/MAR/2023

Page 1 of 6

Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800
Toll Free No:1800-425-2255 / 1800-102-4477,CIN : L66010TN2005PLC056649 Email :[email protected] Website :www.starhealth.in
IRDAI Regn.no: 129
 Star Health And Allied Insurance Company Limited

Young Star Insurance Policy

(Individual)
Unique Identification No. SHAHLIP22036V042122
POLICY SCHEDULE
In Consideration of payment of Rs. 5,375/- towards renewal premium of policy
number:P/171122/01/2023/057473, the policy stands renewed for a further period of 1 Year as per
the details given below

Renewal Endorsement No:11240811967902

Customer Code : 28326720 GSTIN : 27AAJCS4517L1ZY
Customer Name : MS.AKSHAY VIJAY KINDRE SAC Code : 997133 / Accident and Health
Insurance Services
Cust CKYC No : -
Proposer Code : 28326720 Issuing Office Code : 171122
Proposer Name : MS.AKSHAY VIJAY KINDRE Issuing Office Name : Branch Office Thane II
Proposer Address : C -18 14 SHREE SAMARTH Issuing Office Address : 1st Floor, Panama Planet,
SOCIETY SECTOR -15 Above Bharat Bank,Gokhale
NAVI MUMBAI Road
AIROLI Naupada, THANE (W)
Navi Mumbai Maharashtra 400708 Thane Town Maharashtra
400602
Phone No : ./9920729555 Phone No : 022-67668500/502/520
E-mail Id : [email protected] E-mail Id : [email protected]
n
Proposer GSTIN : NO Place of Supply : Maharashtra
Proposal date : 31-Mar-2022 Fulfiller Code : SH5190
Date of Inception : 31-Mar-2022
of first policy
Renewal Year : Second Year Intermediary : BA0000244508
Collection No : 171122/RV/2024/0118396923
Code
Collection Date : 27-Mar-2024

Premium : Rs. 4,555/-

Name : Mrs.VANDANA
KOYANDE
CGST @ 9% : Rs. 410/-
Phone No :9769792220/976979222
0
:
SGST @ 9% Rs. 410/-
E-mail Id : VANDANA2220@YAH
OO.IN
Total Premium : Rs. 5,375/-
Stamp Duty : Re. 1/-

Total Premium In Words : Rupees Five thousand three hundred seventy five
only
PERIOD OF INSURANCE : From : 31-Mar-2024 00:00 To : Midnight Of 30-Mar-2025 Policy Term :1 Year
Installment Facility Option:No Premium Payment Frequency :Annual Installment Amount Rs. : 0/-

Entered by : UBONA This is an electronically generated document(Policy For Star Health and Allied Insurance Company Ltd.
Approved by : UBONA Schedule). CONSOLIDATED STAMP DUTY FOR POLICY
STAMPS PAID VIDE NO. LOA/CSD/667/2023/1172 DT.
IRDAI Regn.No.129 28/MAR/2023
Corporate Identity Number L66010TN2005PLC056649
Authorised Signatory Page 2 of 6
Email ID: [email protected]

Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800
Toll Free No:1800-425-2255 / 1800-102-4477,CIN : L66010TN2005PLC056649 Email :[email protected] Website :www.starhealth.in
IRDAI Regn.no: 129
 Star Health And Allied Insurance Company Limited

Attached to and forming part of Policy No: 11240811967902

Details of Insured Persons :

Age Relationship
Sl. Name of the ID Card Sum Inception
Gender Date of Birth in with Plan Bonus
no Insured No Insured date
Yrs Proposer
AKSHAY V KINDRE 28326720
1 Male 25-Sep-1993 30 Self SILVER 5,00,000 0 31-Mar-2022
-1
Pre Existing Disease : No PED Declared

Nominee Details:
Nominee Details for the Proposer Appointee Details
S.No Name Relationship Age % of the Appointee Name Appointee Relationship
with proposer claim Age with nominee

1 SUVARNA V Mother 51 100

KINDRE
Sector Classification:
Urban Social

''CONSOLIDATED STAMP DUTY FOR POLICY STAMPS PAID VIDE NO. LOA/CSD/667/2023/1172 DT. 28/MAR/2023''

Please check whether the details given by you about the insured persons in the proposal form are incorporated
correctly in the policy schedule. If you find any discrepancy, please inform us within 15 days from the date of
receipt of the policy, failing which the details relating to the insured person given in the policy schedule are deemed
to have been accepted by you.
Warranted that in case of dishonor of premium cheque(s), the Company shall not be liable under the policy and the
policy shall be void abinitio (from inception).
IMPORTANT
IN THE EVENT OF HOSPITALIZATION OF INSURED PERSON, INTIMATION SHOULD BE GIVEN TO THE
COMPANY IMMEDIATELY, HOWEVER, WITHIN 24 HRS FROM THE TIME OF ADMISSION.
Toll Free No: 1800 425 2255/1800 102 4477 Email: [email protected], Fax No: 1800 425 5522
It is hereby made clear that all terms, conditions, clauses, warranties, exclusions etc., as already issued, forming
part of the policy of insurance originally issued at the time of inception of this relationship, shall continue to be
operative and unaltered, forming part of this renewal insurance cover also.

Reference may be made to those terms, conditions etc., for identifying the scope/extent of coverage.

Other excluded expenses as detailed in our website www.starhealth.in

In witness whereof the undersigned being authorized here in to set his hand at Branch Office Thane II on 27th Day
of March 2024.
As per Section 34 of CGST Act of 2017, Policy Issued in one Financial Year and Cancelled in another Financial Year
on or after 01st of December, then Only Premium Amount will be Refunded to the Customer and GST Amount will
Not be Refunded. Customer has to Claim the Refund of GST Amount from the GST Portal.

Entered by : UBONA This is an electronically generated document(Policy For Star Health and Allied Insurance Company Ltd.
Approved by : UBONA Schedule). CONSOLIDATED STAMP DUTY FOR POLICY
STAMPS PAID VIDE NO. LOA/CSD/667/2023/1172 DT.
28/MAR/2023

Authorised Signatory Page 3 of 6

Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800
Toll Free No:1800-425-2255 / 1800-102-4477,CIN : L66010TN2005PLC056649 Email :[email protected] Website :www.starhealth.in
IRDAI Regn.no: 129
 Star Health And Allied Insurance Company Limited

Hospitalisation Benefit Policy

Premium Certificate for the purpose of deduction under Section 80 D of Income Tax (Amendment) Act,1986

Policy No : 11240811967902 Type of Policy : Young Star Insurance Policy

Issue Office : 171122-Branch Office Thane II

Address : 1st Floor, Panama Planet,

Above Bharat Bank,Gokhale Road
Naupada, THANE (W)
Thane Town Maharashtra 400602

Tel / Fax : 022-67668500/502/520

Email : [email protected]

This is to certify that MS.AKSHAY VIJAY KINDRE has paid Rs 5,375/- (Total Premium : Indian Rupees Five
thousand three hundred seventy five only ) towards Premium for Hospitalization Insurance vide Policy No:
11240811967902 for the Period 31-Mar-2024 To 30-Mar-2025 issued on 27-Mar-2024.

Payment received by Payment Gateway vide Receipt No: 171122/RV/2024/0118396923/1 Receipt

Date: 27-Mar-2024

Note :- This Certificate must be surrendered to the Insurance Company for issuance of fresh Certificate in
case of Cancellation of the Policy or any alteration in the Insurance affecting the Premium.

Date : 27-Mar-2024 For and on behalf of

Place : Branch Office Thane II Star Health and Allied Insurance Company Ltd.

IRDA Regn.No.129

Corporate Identity Number L66010TN2005PLC056649 Authorised Signatory

Email ID: [email protected]

Entered by : UBONA This is an electronically generated document(Policy For Star Health and Allied Insurance Company Ltd.
Approved by : UBONA Schedule). CONSOLIDATED STAMP DUTY FOR POLICY
STAMPS PAID VIDE NO. LOA/CSD/667/2023/1172 DT.
28/MAR/2023

Authorised Signatory Page 4 of 6

Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800
Toll Free No:1800-425-2255 / 1800-102-4477,CIN : L66010TN2005PLC056649 Email :[email protected] Website :www.starhealth.in
IRDAI Regn.no: 129
 Star Health And Allied Insurance Company Limited

Tax Invoice
Invoice No. : 272403I008736580 Customer ID : 28326720
Invoice Date : 27-Mar-2024 Policy No. : 11240811967902
Recipient Supplier
GSTIN : GSTIN : 27AAJCS4517L1ZY
Name : MS.AKSHAY VIJAY KINDRE Name : Star Health and Allied Insurance Co Ltd -
Branch Office Thane II
Address : C -18 14 SHREE SAMARTH SOCIETY Address : 1st Floor, Panama Planet,
SECTOR -15
NAVI MUMBAI Above Bharat Bank,Gokhale Road
AIROLI Naupada, THANE (W)
City : Navi Mumbai Pin Code : 400708 City : Thane Town Pin Code : 400602

State : Maharashtra Client : IND State : Maharashtra Place of : Maharashtra

Category supply

Taxable IGST @ UT/SGST @ CESS @ Total Invoice

Total Discount CGST @ 9%
Value 18% 9% 1% Value
HSN / SAC Description of
Code Service(s) F=C*
D=C* E=C* G= C * H=C+D+
A B C=A-B UTGST or
IGST CGST Cess E+ F + G
SGST

Insurance
997133 4,555.00 0 4,555.00 0 410.00 410.00 0 5,375.00
Services

Total Invoice Value (in Figures) : Rs. 5,375/-

Total Invoice Value (in Words) : Rupees Five thousand three hundred seventy five only
Amount of Tax Subject to reverse Charge : No

Important Note:
The invoice is issued as per Section 31 of the CGST Act
In case no GSTIN or incorrect GSTIN is provided by the Proposer at Proposal stage, Star Health and Allied Insurance Co Ltd shall not be
responsible for any Input Tax Credit losses and no subsequent revision of invoice will be undertaken
"I/We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the aggregate
turnover notified under sub-rule (4) of rule 48, we are not required to prepare an invoice in terms of the provisions of the said sub-rule."
E. & O.E
This is a digitally signed document and hence no physical signature is required

IRDAI Regn.No.129 Corporate Identity Number L66010TN2005PLC056649 Email ID: [email protected]

Entered by : UBONA This is an electronically generated document(Policy For Star Health and Allied Insurance Company Ltd.
Approved by : UBONA Schedule). CONSOLIDATED STAMP DUTY FOR POLICY
STAMPS PAID VIDE NO. LOA/CSD/667/2023/1172 DT.
28/MAR/2023

Authorised Signatory Page 5 of 6

Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800
Toll Free No:1800-425-2255 / 1800-102-4477,CIN : L66010TN2005PLC056649 Email :[email protected] Website :www.starhealth.in
IRDAI Regn.no: 129
 Star Health And Allied Insurance Company Limited

Annexure 1A
Forming part of Policy Number : 11240811967902

Covering Flu Vaccination Approved by ICMR under Health Check Up benefit and Home Care Treatment
Notwithstanding anything stated to the contrary in the within mentioned policy it is hereby agreed and declared
that this Policy would hereinafter provide the following covers without charging additional premium till 31.03.2024:

1. Cover for Flu Vaccine Approved by ICMR under Health check up benefit as per relevant clause with the same
limits and conditions provided therein.

2. Cover for Home Care Treatment as per the details provided herein.
Home care treatment : Payable up to 10% of the sum insured subject to maximum of Rs.5 lakhs in a policy year,
for treatment availed by the Insured Person at home, only for the specified conditions mentioned below, which in
normal course would require care and treatment at a hospital but is actually taken at home provided that:

a. The Medical practitioner advises the Insured person to undergo treatment at home

b. There is a continuous active line of treatment with monitoring of the health status by a medical practitioner for
each day through the duration of the home care treatment

c. Daily monitoring chart including records of treatment administered duly signed by the treating doctor is
maintained

d. Insured can avail ‘'Home Care Treatment'' service on cashless basis, if availed from the list of our Home Health
Care Network service providers given in our website ''www.starhealth.in”

List of Conditions covered under Home care treatment

1. Fever and Infectious diseases which can be managed as Inpatient

2. Uncomplicated Urinary tract infections but needing Parenteral Antibiotics
3. Asthma and COPD -Mild Exacerbations needing Home Nebulization
4. Acute Gastritis/Gastroenteritis
5. I.V. Chemotherapy [Where advised by the doctor]
6. Palliative Cancer care requiring medical assistance
7. Acute Vertigo
8. Diabetic foot and Cellulitis
9. IVDP[Cervical and Lumbar disc diseases]
10. Major Surgeries/Arthroplasties needing IV Antibiotics Post Discharge
11. Care for Brain and Spinal Injury Cases Post Discharge
12. Post CVA Care at Home after Discharge
13. Chronic Severe Refractory Asthma

Entered by : UBONA This is an electronically generated document(Policy For Star Health and Allied Insurance Company Ltd.
Approved by : UBONA Schedule). CONSOLIDATED STAMP DUTY FOR POLICY
STAMPS PAID VIDE NO. LOA/CSD/667/2023/1172 DT.
28/MAR/2023

Authorised Signatory Page 6 of 6

Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800
Toll Free No:1800-425-2255 / 1800-102-4477,CIN : L66010TN2005PLC056649 Email :[email protected] Website :www.starhealth.in
IRDAI Regn.no: 129