Scribd Logo
Upload

Welcome to Scribd!

  • 259 views

    CPOLICYdoc 01050048194100210965 PDF

    Uploaded by

    Tanish Maan
    1) Jitender Singh took out an Arogya Raksha medical insurance policy from United India Insurance Company with a sum insured of Rs. 500,000 valid from August 14, 2019 to July 31, 2020. 2) The policy covers Jitender Singh, his wife Anuradha, son Kunal, and daughter Diksha. 3) Jitender Singh paid a premium of Rs. 9,425 through his account at Indian Bank to receive this medical insurance coverage.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    CPOLICYdoc 01050048194100210965 PDF

    Uploaded by

    Tanish Maan
    259 views2 pages
    1) Jitender Singh took out an Arogya Raksha medical insurance policy from United India Insurance Company with a sum insured of Rs. 500,000 valid from August 14, 2019 to July 31, 2020. 2) The policy covers Jitender Singh, his wife Anuradha, son Kunal, and daughter Diksha. 3) Jitender Singh paid a premium of Rs. 9,425 through his account at Indian Bank to receive this medical insurance coverage.

    Original Title

    CPOLICYdoc_01050048194100210965 (1).pdf

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    1) Jitender Singh took out an Arogya Raksha medical insurance policy from United India Insurance Company with a sum insured of Rs. 500,000 valid from August 14, 2019 to July 31, 2020. 2) The policy covers Jitender Singh, his wife Anuradha, son Kunal, and daughter Diksha. 3) Jitender Singh paid a premium of Rs. 9,425 through his account at Indian Bank to receive this medical insurance coverage.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    259 views2 pages

    CPOLICYdoc 01050048194100210965 PDF

    Uploaded by

    Tanish Maan
    1) Jitender Singh took out an Arogya Raksha medical insurance policy from United India Insurance Company with a sum insured of Rs. 500,000 valid from August 14, 2019 to July 31, 2020. 2) The policy covers Jitender Singh, his wife Anuradha, son Kunal, and daughter Diksha. 3) Jitender Singh paid a premium of Rs. 9,425 through his account at Indian Bank to receive this medical insurance coverage.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    UNITED INDIA INSURANCE COMPANY LIMITED

    Divisional Office : 010500


    Catholic Centre, 64, Armenian Street, Chennai 600001
    POLICY-CUM-CERTIFICATE FOR AROGYA RAKSHA
    UIN NO. IRDA/NL-HLT/UII/P-H/V.1/386/13-14
    Policy Particulars
    Policy Number 0105002019484100000863721 Bank Reference Number 10148337
    Policy Validity Period From Date To Date
    14/08/2019 31/7/2020
    Policy Plan B Sum Insured 500000

    Bank Details
    Branch Code Branch Name Account Number Voucher Date
    B155 6741848126 20190814
    Previous Insurance history
    Previous Policy From Date To Date
    null null null

    Premium Overview
    Proposer Details Mediclaim PA Premium GST Total Amount (Incl.
    Premium GST )
    JITENDER SINGH 9425 285 IGST@18% : 1747 11458
    Village Shimla mulana;
    Chandoli;
    Panipat
    PANIPAT,Haryana,
    Pin:132103,
    Mob : 9802801000 / Phone: -
    Mail: -
    In case you have a policy other than Arogya Raksha, the onus is on you to give the copy of the previous year policy
    details as well as the claim details.
    NOMINEE DETAILS: Name:ANURADHA, Relation: WIFE

    Third Party Administrator Details


    GoodHealth TPA Services Good Health TPA Services Ltd , Plot No 49,Nagarjuna Hills
    Panjagutta, Hyderabad 500082.
    Email:[email protected]

    TOLL FREE: 18604253232 | Web: http://goodhealthtpa.com

    Policy Issuing Office Details


    United India Insurance Company Ltd., DO CATHOLIC CENTRE , Office Code 010500 , Catholic Centre, NO.64,
    Armenian street, ChennaI - 600001,
    OFFICE GST No.: 33AAACU5552C1ZQ,Phone: 044-25389793/25389794 , Fax: 044-25386298,
    E-mail: [email protected]
    Download policies/ provisional e-cards at:http://portal.uiic.in/ArogyaSuraksha/renewLandingCustomer.jsp

    Details of family members covered (* Pre-Existing Diseases within 36 months prior to the first
    policy are not covered.)
    Sl. Name Birth Date Sex Relation Medical History Treatment Taken
    No
    1 JITENDER SINGH 05/05/1975 M SELF Nil Nil
    2 ANURADHA 22/12/1978 F SPOUSE Nil Nil
    3 KUNAL 05/11/2001 M SON Nil Nil
    4 DIKSHA 07/07/2007 F DAUGHTER Nil Nil

    Declaration
    Policy subject to terms, conditions, exclusion and definitions. Summary of terms and conditions of the policy can be
    downloaded from http://portal.uiic.in/ArogyaSuraksha/renewLandingCustomer.jsp. The detailed terms and conditions
    can be obtained from Indian Bank branch or United Inda Insurance Company Office . The proposal and declaration
    by the insured is the basis of this contract and deemed to be incorporated.

    Date 20190814 Authorized signatory


    INDIAN BANK
    CERTIFICATE OF MEDICAL INSURANCE PREMIUM PAID
    (for the purpose of deduction u/s 80 D of the Income Tax Act, 1986)

    This is to certify that Mr.JITENDER SINGH having account number 6741848126


    with Indian Bank, has paid Rs 9425/- at Indian Bank branch
    for Medical Insurance as premium for policy no: 0105002019484100000863721 on 20190814
    for Indian Bank Arogya Raksha Policy under PLAN B

    For Indian Bank

    .
    Date ____ /____ / _______

    Branch Manager

    You might also like