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    Jaimin Pa 18

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    niren4u1567
    This document summarizes the renewal of an individual personal accident insurance policy for Mr. Jaimin M Patel. Key details include: - The policy has been renewed for the period of March 25, 2018 to March 24, 2019. - The policy provides accidental death coverage of Rs. 2,500,000 and temporary total disability coverage of Rs. 500,000. - Premium details and nomination of Mrs. Shitalben as beneficiary are also provided.

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    Jaimin Pa 18

    Uploaded by

    niren4u1567
    56 views2 pages
    This document summarizes the renewal of an individual personal accident insurance policy for Mr. Jaimin M Patel. Key details include: - The policy has been renewed for the period of March 25, 2018 to March 24, 2019. - The policy provides accidental death coverage of Rs. 2,500,000 and temporary total disability coverage of Rs. 500,000. - Premium details and nomination of Mrs. Shitalben as beneficiary are also provided.

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    This document summarizes the renewal of an individual personal accident insurance policy for Mr. Jaimin M Patel. Key details include: - The policy has been renewed for the period of March 25, 2018 to March 24, 2019. - The policy provides accidental death coverage of Rs. 2,500,000 and temporary total disability coverage of Rs. 500,000. - Premium details and nomination of Mrs. Shitalben as beneficiary are also provided.

    Copyright:

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

    Jaimin Pa 18

    Uploaded by

    niren4u1567
    This document summarizes the renewal of an individual personal accident insurance policy for Mr. Jaimin M Patel. Key details include: - The policy has been renewed for the period of March 25, 2018 to March 24, 2019. - The policy provides accidental death coverage of Rs. 2,500,000 and temporary total disability coverage of Rs. 500,000. - Premium details and nomination of Mrs. Shitalben as beneficiary are also provided.

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    © All Rights Reserved
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    of 2

    Digitally signed by Padmesh Nair

    Date: 2018.03.14 11:36:12 +05:30

    i4$.d-N$k
    SCM000044477

    Mr Jaimin M Patel
    34-A Swipark Swatantra
    Plot (Madhuvrund)
    Ghatlodia
    Ahmedabad, Ahmedabad
    Gujarat - 380061
    India
    Contact No.: 9825135371
    Policy No.: 190100/21001/2000259250-01
    Code Intermediary Name Contact No
    80098120 NIRENKUMAR PATEL 9909004824

    Renewal of Your Individual Personal Accident Policy

    Dear Mr Jaimin M Patel,

    Thank You for renewing the policy with us.

    We are pleased to enclose your renewed Policy Schedule for the period 25-Mar-2018 to 24-Mar-2019

    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 [email protected] 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 : Gurgaon
    Date : 13-Mar-2018
    Authorized Signatory

    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


    80098120 NIRENKUMAR PATEL 9909004824

    Page 1 of 2
    SCHEDULE - Individual Personal Accident Standard

    Issuing / Servicing Office : Ahmedabad BO, 4th Floor, Radhika, OppMayor Bunglow, Near
    Law Garden, Ellise Bridge, Gujarat - 380006
    PH : 07940049671
    GSTIN of Issuing Office : 24AAGCA1654H1ZY
    Policy Holder's Name : Mr Jaimin M Patel
    Policy Holder's Address : 34-A Swipark Swatantra
    Plot (Madhuvrund)
    Ghatlodia
    Ahmedabad, Ahmedabad
    Gujarat - 380061
    India
    Intermediary Code : 80098120
    Intermediary Name : NIRENKUMAR PATEL
    Intermediary Contact No : 9909004824

    Policy Number : 190100/21001/2000259250-01


    First Policy inception date : 25-Mar-2017
    Description/ Accounting Code of Service : Accident and Health insurance Services/ 997133
    Policy Period : From 00:00 hrs on 25-Mar-2018 To 24:00 hrs on 24-Mar-2019

    Insured Persons Details :


    Relationship
    Date of Birth Age Sum Insured Cumulative
    Member ID Insured Person's Name to Benefits
    (DD-MM-YYYY) (Years) (Rs) Bonus*
    Policyholder
    Accidental Death 2500000
    10011616503 Mr Jaimin M Patel 14-Dec-1977 40 Policy Holder 125000
    Temporary Total Disablement 500000

    For details of all benefits under this policy, please refer to the schedule of benefits enclosed.

    *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 Shitalben Relationship to Policyholder : Wife


    The nominee must be an immediate relative of the policyholder. For all other Insured Persons the policy holder shall be the nominee.

    Premium Calculation :-
    Net Premium (Rs.) 2834.00
    Discounts (Rs.) 0.00
    Loadings (Rs.) 0.00
    (CGST + SGST/UTGST) / IGST / J&K GST whichever applicable (Rs.) 510.12
    Cess or Taxes, if any (Rs.) 0.00
    Gross Premium (Rs.) 3344.12
    Gross Premium amount (in words) Rupees Three Thousand Three Hundred Forty-Four and
    Paisa Twelve Only

    The stamp duty of Rs. 1.00 /- (Rupees One Only) paid vide No.F.10(783)/COS(HQ)/Con.duty/08. (Not applicable for the state of Jammu & Kashmir).
    J&K TIN: 01871052106

    Original for Recipient/ Duplicate for Supplier


    Whether tax is payable on reverse charge basis No

    For and on behalf of Apollo Munich Health Insurance Company Limited

    Location : Gurgaon
    Date : 13-Mar-2018 Authorized Signatory

    Page 2 of 2

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