Policy Schedule

Policy Servicing Office SBU 82

IFFCO-TOKIO General Insurance Company Limited IFFCO-TOKIO General Insurance Co.

Regd. Office: IFFCO SADAN,C1 Distt Centre ,Saket,New Delhi-110017 Ltd., No. 201B, 2nd Floor, Shangri La
Plaza, Opposite KBR Park, Banjara Hills
Corporate Identification Number (CIN) U74899DL2000PLC107621, IRDA Reg. No. 106 Road No. 2, Hyderabad,
Telangana.500034
Group Personal Accident Insurance Policy Schedule
CUM TAX INVOICE

General Insurance Service :9971

GSTIN
36AAACI7573H1ZD
Invoice No. 54687089
Insured Telangana Engineering Departments Contributory Pension Scheme
Employees Welfare Association (Affinity Group)
Policy No 54687089
Address Stilt Floor Jalasoud Building Irrigation CAD Department Covernote No -
Khairtabad, Hyderabad Telangana
500082 Period of Insurance
GSTIN State
Phone Code :
Number 36 from 00.00 hours on 22/06/2020
Phone No Agent Code 82000020 To Mid Night on 21/06/2021
Total Members Covered 306 Co-insurance Details
Intra State
Premium Details IFFCO TOKIO General Insurance Co. Ltd. 100%
Taxable Value 117,732
CGST @ 9% 10,596
SGST @ 9% 10,596
IGST @ 18% -
Total Value 138,924
Policy Conditions/ Extensions/ Endorsements
Group Composition: Employees of the Insured
Basis of Policy Named Cover
Table "A": Benefit 1, Table "B1": Benefit 1-4, Table "B": Benefit 1-5, Table "C": Benefit 1-6
Coverage Table "B" & "C"
Day 1 cover for new Joinees is allowed subject to receipt of premium / sufficient CD balance as on effective date of cover
and declaration by 15th of every succeding month.
Refund of premium on account of Mid -term Deletion of Members is allowed from the date of separation subject to receipt
of intimation by 15th day of every succeeding month failing which refund will be calculated from the date of submission of
intimation to ITGI. No refund is allowed in case of claim preferred on ITGI.
Terrorism is covered under the policy AOA : AOY Limit of Liability Rs. 10 Crores or the policy sum insured which ever is lower
per policy period.
Terrorism Inclusion Warranty : Notwithstanding anything stated to the contrary It Is hereby declared and agreed that point
no 5 of ‘what is not covered’ Viz Terrorism / Terrorist Incident is held covered but excludes Nuclear / Chemical / Biological
Terrorism Attack .
Sanction Limitation and Exclusion Clause : No insurer shall be deemed to provide cover and no insurer shall be liable to pay
any claim or provide any benefit hereunder to the extent that the provisions of such cover, payment of such claim or
provision of such claim or provision of such benefit would expose that insurer to any sanction, prohibition or restriction
under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United
Kingdom or United States of America.

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Policy Schedule

* Losses or damages caused directly or indirectly due to any infectious or contagious disease, pandemic /epidemics as
declared by WHO and / or Government of India will be an exclusion under this policy as per the attached clause.

In case employee/employer relationship is not there, claim will be paid directly to the beneficiary.
Subject otherwise to the terms, conditions, exceptions and limitations of this policy.
- The coverage is as per policy wordings / endorsements / clauses attached. Please go through the Group Personal Accident
Insurance Policy and in case of any discrepancy, please inform us.
- Policy is cancelled ab-initio in case of Cheque Dishonour.
1)"Policy Issuing Office: Delhi"
2) " Consolidated Stamp Duty deposited as per the order of Government of National Capital Territory of Delhi"
Toll Free: 1800-103-5499 (24 hours all days) or SMS For IFFCO-TOKIO General Insurance Co. Ltd
"CLAIM" to 56161.
Service Tax No : AAACI7573HST001 Authorized Signatory

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 Group Personal Accident Insurance - Policy Wordings
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This POLICY is evidence of the contract between YOU and US. The proposal form along with any written statement(s)
declaration(s) of YOURS for purpose of this POLICY forms part of this contract.

This POLICY witnesses that in consideration of YOUR having paid the premium for the period stated in the schedule
or for any further period for which WE may accept the payment for renewal of this policy. WE will insure the Insured
Person(s) and accordingly WE will pay to YOU or YOUR legal personal representative(s) as the case may be in
respect of events occurring during the period of insurance in the manner and to the extent set-forth in the policy
including endorsements provided that all the terms, conditions, provisions, and exceptions of this policy in so far as
they relate to anything to be done or complied with by YOU have been met.

The Schedule shall form part of this POLICY and the term ‘POLICY’ whenever used shall be read as including the
Schedule.

Any word or expression to which a specific meaning has been attached in any part of this POLICY or of Schedule shall
bear such meaning whenever it may appear.

The POLICY is based on information which have been given to US about Insured Person(s) pertaining to risk insured
under the policy and the truth of these information shall be condition precedent to YOUR right to recover under this
POLICY.

Definition of Words:

1. Proposal
It means any signed proposal by filling up the questionnaires and declarations written statements and any
information in addition thereto supplied to US by YOU.

2. Policy
It means the policy booklet, the Schedule and any applicable endorsement or memoranda. The policy contains
details of the extent of cover available to insured person (s), what is excluded from the cover and the conditions on
which the policy is issued.

3. Schedule
It means latest Schedule issued by US as part of the policy. It provides details of the insured person(s), which are in
force and the level of cover Insured Person(s) have.

4. Capital Sum Insured

It means the monetary amount shown against Insured Person.

5. We/Our/Us
It means IFFCO-TOKIO GENERAL INSURANCE COMPANY LIMITED.

6. You/Your
It means the person(s) named as Insured in the Schedule.

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7. Insured Person:
The person named as Insured person(s) in the Schedule lodged with US by YOU which will include YOU, YOUR family
inclusive of dependent parents, blood relatives i.e. dependent brothers, sisters.

8. Period of Insurance
It means the duration of this policy as shown in the Schedule.

9. Standard Type of Aircraft

It means any aircraft duly licensed to carry passengers (for hire or otherwise) by appropriate authority irrespective of
whether such an aircraft is privately owned or chartered or operated by a regular airline or whether such an aircraft
has a single engine or multiengine.

10. Injury
It means accidental physical bodily harm excluding illness or disease, solely and directly caused by external, violent
and visible and evident means which is verified and certified by a Medical Practitioner.

11. Accident
It means a sudden, unforeseen and involuntary event caused by external, visible and violent means.

12. Air Accident

It shall mean an accident while the Insured Person is on board the standard type of Aircraft and the Aircraft meets
with an accident causing injury to Insured Person.

13. Loss of Limbs

It shall mean physical separation of one or both hands or feet or permanent and total loss of use of one or both
hands or feet.

14. Physical Separation

It shall mean separation at or above the wrist and/or of the foot at or above the ankle respectively.

15. Permanent Total Disablement

The bodily injury, which as its direct consequence immediately and/or in foreseeable future, will permanently, totally
and absolutely prevent Insured Person from engaging in any kind of occupation.

16. Temporary Total Disablement

The bodily injury which as its direct consequence will prevent the Insured Person from engaging in all types of the
occupation or any employment whatsoever for a period not exceeding 104 weeks since the date of injury to the
time, Insured Person is fit enough to resume duty or engage in any kind of occupation as certified by Medical
practitioners.

17. Dependent child

It means a child (natural or legally adopted), who is financially dependent on the primary insured or proposer and
does not have his/her independent sources of income.

18. Medical Practitioner

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A Medical Practitioner is a person who holds a valid registration from the Medical Council of any State or Medical
Council of India or Council for Indian Medicine or for Homeopathy set up by the Government of India or a State
Government and is thereby entitled to practice medicine within its jurisdiction; and is acting within the scope and
jurisdiction of license.

19. Reasonable and Customary Charges

It means the charges for services or supplies, which are the standard charges for the specific provider and consistent
with the prevailing charges in the geographical area for identical or similar services , taking into account the nature of
the injury involved.

20. Hospitalisation
It means admission in a Hospital for Inpatient Care for consecutive hours except for specified procedures/

treatments, where such admission could be for a period of less than 24(twenty four) consecutive hours.

21. Medical Expenses

It means those expenses that an Insured Person has/you have necessarily and actually incurred for medical
treatment on account of Accident on the advice of a Medical Practitioner, as long as these are no more than would
have been payable if the Insured Person had not been insured and no more than other hospitals or doctors in the
same locality would have charged for the same medical treatment.

22. Notification of Claim

It means the process of notifying a claim to us by specifying the timelines as well as the address / telephone number
to which it should be notified.

23. Disclosure to information norm

This means the Policy shall be void and all premium paid hereon shall be forfeited to us, in the event of
misrepresentation, mis-description or non-disclosure of any material fact.

24. Renewal
It means the terms on which the contract of insurance can be renewed on mutual consent.

25. Alternative treatments

It means forms of treatments other than treatment "Allopathic" or "modern medicine" and includes Ayurvedic,
Unani, Sidha and Homeopathy in the Indian context.

26. Terrorism / Terrorist Incident

Means any actual or threatened use of force or violence directed at or causing damage, injury, harm or disruption, or
the commission of an act dangerous to human life or property, against any individual, property or government, with
the stated or unstated objective of pursuing economic, ethnic, nationalistic, political, racial or religious interests,
whether such interests are declared or not. Robberies or other criminal acts, primarily committed for personal gain
and acts arising primarily from prior personal relationships between perpetrator(s) and victim(s) shall not be
considered terrorist activity.
Terrorism shall also include any act, which is verified or recognized by the relevant Government as an act of
Terrorism.

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 Group Personal Accident Insurance - Policy Wordings
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General Conditions:

1. Reasonable Precaution and Care of Property

YOU/Insured Person shall take all reasonable precautions to prevent injury, illness, disease or damage in order to
minimize claims.

2. Notice
YOU will give every notice and communication in writing to OUR office through which this insurance is affected.

3. Misdescription
The Policy shall be void and all premium paid by YOU to US be forfeited in the event of misrepresentation or
concealment of any material information.

4. Disclosure To Information Norm

This means the Policy shall be void and all premium paid hereon shall be forfeited to us, in the event of
misrepresentation, mis-description or non-disclosure of any material fact.

5. Free Lookup Period

You will be allowed a period of at least 15 (fifteen) days from the date of receipt of the policy to review the terms
and conditions of the policy and to return the same if not acceptable stating the reasons therein for doing so.
a) If you have not made any claim during the free look period, then you shall be entitled to :
I. A refund of the premium paid less any expenses incurred by us
II. Where the risk has already commenced and the option of return of the policy is exercised by you, a
deduction towards the proportionate risk premium for period on cover less any expenses incurred by us
III. Where only a part of the risk has commenced, such proportionate risk premium commensurate with the risk
covered during such period less any expenses incurred by us on medical examination of the insured persons and the
stamp duty charges.

6. Changes in Circumstances:
YOU must inform US, as soon as reasonably possible of any change in information YOU have provided to US about
Insured person(s) which may affect the Insurance cover provided e.g. duty, business, occupation and obtain from US
an endorsement to this effect.

7.Claim Procedure and Requirements

An event, which might become a claim under the policy, must be reported to US as soon as possible. In case of death,
written notice also of death must, unless reasonable cause is shown, be given before internment/ cremation and in
any case, within one calendar month after the death, and in the event of loss of sight or amputation of limbs, written
notice thereof must also be given within one calendar month after such loss of sight or amputation. A written
statement of the claim will be required and a claim form will be provided.

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YOU or YOUR personal representative must give immediate written notice but within 14(fourteen) days of
occurrence of injury, disease.

All certificates, information and evidence from a Medical Attendant or otherwise required by US shall be furnished
by YOU, YOUR personal representative/assignee in the manner and form as WE may prescribe. In such claims YOUR
legal representative, Nominee, beneficiary will allow OUR representative to carry out examination and ascertain
details if and when WE may reasonably require and in the event of death get the post-mortem examination done in
respect of body of Insured Person(s). In the event of claim in respect of loss of sight and loss of speech, the Insured
person(s) shall undergo at YOUR expenses such operations or treatment as WE may reasonably deem desirable.

8. Fraud
If a claim is fraudulent in any respect or supported by any fraudulent statement or device with or without your
knowledge, all benefit(s) under this Policy shall be forfeited.

9. Renewal
Renewal shall not be refused unless justified on grounds of fraud, moral hazard or misrepresentation or
non‐cooperation by the insured, provided, however, that you apply for renewal and remit the requisite premium
before the expiry of this policy.

10. Cancellation
a) We may cancel the policy on grounds of fraud, moral hazard or misrepresentation or non‐cooperation by you by
sending 30(thirty) days notice by registered post to your last known address. You will then be entitled to, except in
case of fraud or illegality on your part, a pro-rata refund of premium for unexpired period of this policy in respect of
such insured person(s) in respect for whom no claim has arisen.
b) You may cancel the policy by sending written notice to us under registered post. We will then allow a refund on
following scale, except for those insured person(s) for whom claim has been preferred on us under the current
policy:
Period of Cover upto Refund of Annual Premium rate(%)
1(one) month 75% (seventy five percent)
3(three) months 50% (fifty percent)
6(six) months 25% (twenty five percent)
Exceeding Six Months NIL

11. We will not be bound to take notice or be affected by any notice of any trust, charge, lien, assignment or other
dealings with or relating to this policy. Your receipt or receipt of Insured Person shall in all cases be an effective
discharge to US.

12. Arbitration

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If any dispute or difference shall arise as to the quantum to be paid under the policy (liability being otherwise
admitted) such difference shall independently of all other questions be referred to the decision of the sole arbitrator
to be appointed in writing by the parties to or if they cannot agree upon a single arbitrator within 30 (thirty) days of
any party invoking arbitration the same shall be referred to a panel of three arbitrators, comprising of two
arbitrators, one to be appointed by each of the parties to the dispute/difference and the third arbitrator to be
appointed by two such arbitrators and arbitration shall be conducted under and in accordance with the provisions of
the arbitration and conciliation act, 1996. It is clearly agreed and understood that no difference or dispute shall be
referable to arbitration as herein before provided, if we have disputed or not accepted liability under or in respect of
this policy. It is understood, however, that the insured shall have the right at all times during currency of the policy to
communicate only, with the leading or issuing office in all matters pertaining to this insurance.

13. Disclaimer Clause:

If WE shall disclaim OUR liability in any claim and such claim shall not have been made subject matter of suit in a
court of law within 12(twelve) months from date of disclaimer, then the claim shall for all purpose be deemed to
have been abandoned and shall not thereafter be recoverable under this Policy.

14. No sum payable under this policy shall carry any interest/ penalty.

15. The geographical scope of this policy will be WORLDWIDE, however the claims shall be settled in India in Indian
rupees. The provisions of this policy shall be governed by the laws of India for the time being in force. The parties
hereto unconditionally submit to the jurisdiction of the courts in India.

16. Grievance or Complaint:

You may register a grievance or complaint by visiting our website www.itgi.co.in you may also contact the branches

from where you have bought the policy or grievance officer who can be reached at our corporate office.

16. Withdrawal & Alteration of Policy Conditions:

The policy terms and conditions may undergo alteration as per the IRDA Regulation. However the same shall be duly
notified to you at least three months prior to the date when such alteration or revision comes into effect by
registered post at your last declared correspondence address. The timeliness for revision in terms and rates shall be
as per the IRDA Regulation.
A product may be withdrawn with the prior approval of the Authority and information of withdrawal shall be given
to you in advance as per the IRDA guidelines with details of options provided by us. If we do not receive your
response on the intimation of withdrawal, the existing product shall be withdrawn on the renewal date and you shall
have to take a new policy available with us, subject to terms & conditions.

17. Sum Insured Enhancement:

In case of increase in Capital Sum Insured more than 10% (ten percent) of last year capital Sum Insured at the time of
renewal, subject to underwriter’s discretion.

18. Payment of premium:

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 Group Personal Accident Insurance - Policy Wordings
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The premium payable shall be paid in advance before commencement of risk. No receipt for premium shall be valid
except on our official form signed by our duly authorized official. In similar way, no waiver of any terms, provision,
conditions and endorsements of this policy shall be valid unless made in writing and signed by our authorized official.

19. Protection of Policy Holder’s Interest :

in the event of a claim, if the same is found admissible under the policy, we shall make an offer of settlement or
convey the rejection of the claim within 30(thirty) days of receipt of all relevant documents and investigation/
assessment report (if required). In case the claim is admitted, the claim proceeds shall be paid within 7(seven) days
of your acceptance of our offer. In case of delay in payment, we shall be liable to pay interest at a rate which is 2.0%
(two percent) above the bank rate prevalent at the beginning of financial year in which the claim is received by us.

PROVISIONS:

PROVIDED THAT ALL SUMS PAYABLE HEREUNDER SHALL BE PAYABLE :

(i) In case of claim by death or permanent total disablement i.e. Benefit 1) to Benefit 4) of Table of Benefits only after
deleting by an endorsement the name of Insured Person(s) in respect of whom such sums shall become payable
without any refund of premium.

(ii) In case of claim by permanent partial disablement i.e. Benefit 5) of Table of Benefits only after reduction by an
endorsement of Capital Sum Insured by the amount admissible under the claim in respect of Insured person in
respect of whom such sum shall become payable.

(iii) In case of Temporary Total Disablement Benefit i.e. 6) of Table of Benefits only upon termination of such
disablement in respect of Insured person for whom the claim has been lodged.

General Exclusions

WE will not pay for any compensation in respect of death, Injury or disablement of the Insured Person.

1. As consequence of war, invasion, act of foreign enemy, hostilities (whether war be declared or not) civil war,
rebellion, revolution, insurrection, mutiny military or usurped power, confiscation, seizure, capture, assault,
restraint, nationalization, civil commotion or loot or pillage in connection herewith.

2. Directly or indirectly caused by contributed to by or arising from:

(a) Ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the
combustion of nuclear fuel. For the purpose of this exclusion, combustion shall include any self sustaining process of
nuclear fission.
b) (b) The radioactive, toxic, explosive or the hazardous properties of any nuclear assembly or nuclear component.

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Coverage :

WHAT IS COVERED WHAT IS NOT COVERED

If following Bodily injury which solely and directly causes
Insured Person to death or disablement within 12 months
of injury as stated in Table of Benefits, WE shall pay to YOU WE will not liable for
or YOUR legal personal representative / assignee / 1. Compensation under more than one of the benefits
nominee the sum or sums hereinafter set forth in Table of mentioned in Table of Benefits in respect of same period
Benefits. of disablement.
2. Any other payment after a claim under one of the
benefits 1,2,3 and 4 in Table of benefits has been
admitted and becomes payable.
3. Any payment in case of more than one claim under
this section during any one period of Insurance by which
OUR liability in that period would exceed sum payable
under benefits(1) of this policy.
4. Payment of compensation in respect of injury as a
consequence of
a) Committing or attempting suicide, intentional self-
injury.
b) Whilst under influence of intoxicating liquor.
c) Drug addiction or alcoholism.
d) Whilst engaging in Aviation or Ballooning or whilst
mounting into, dismounting from or travelling in any
balloon or aircraft other than as passenger (fare paying
or otherwise) in any duly licensed standard type of
aircraft.
e) Pregnancy or childbirth.
f) Venereal disease or insanity.
g) Contracting any illness directly or indirectly arising
from or attributable to HIV and/or any HIV related illness
including AIDS and /or any mutant derivative or variation
of HIV or AIDS.
h) Committing any breach of law with criminal intent.
5. Terrorism / Terrorist Incident of whatsoever nature
directly or indirectly caused by, resulting from or in
connection with any act of terrorism regardless of any
other cause or event contributing concurrently or in any
other sequence to the loss.

TABLE OF BENEFITS % OF CAPITAL SUM INSURED

1. Death 100
Table 2,3,4 - PTD - Permanent Total Disablement

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2.a) Loss of sight (both eyes) 100

b) Loss of two limbs 100
c) Loss of one limb and one eye 100
3.a) Loss of sight of one eye 50
b) Loss of one limb 50
4. Permanent Total and absolute disablement 100
Table 5 - PPD - Permanent Partial Disablement
5.i) Loss of toes-all 20
ii) Great-both phalanges 5
iii) Great-one phalanx 2
iv) Other than great, if more than one toe lost-each 1
i) Loss of hearing – both ears 50
ii) Loss of hearing – one ear 15
c) Loss of Speech 50
d) Loss of four fingers and thumb of one hand 40
e)Loss of four fingers 35
f) Loss of thumb
i)_Both phalanges 25
ii)One phalanx 10
g) Loss of index finger
i)Three phalanges 10
ii)Two phalanges 8
iii)One phalanx 4
h).Loss of middle finger
i) Three phalanges 6
ii) Two phalanges 4
iii) One phalanx 2
i)Loss of ring finger
i)Three phalanges 5
ii)Two phalanges 4
ii)One phalanx 2
j) Loss of little finger
i)Three phalanges 4
ii)Two phalanges 3
iii)One phalanx 2
k)Loss of Metacarpals
i)First or second (additional) 3
ii)Third, fourth or fifth (additional) 2
l) Any other permanent partial disablement % as assessed by Doctor
6. Temporary Total disablement benefit at the rate per 1% of Table C Sum Insured or Rs. 25,000 whichever is
week lower.
Table "A": Benefit 1, Table "B1": Benefit 1-4, Table "B": Benefit 1-5, Table "C": Benefit 1-6

Special Inbuilt Benefits under the Policy in addition to capital sum insured
A. In the event of death of Insured Person outside his/her 2% of Capital Sum Insured or 2,500/- (Two thousand five
Home, transportation cost for carriage of dead body to hundred) whichever is lower.
Home including funeral charges is payable.

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A. In the event of death of Insured Person outside his/her 2% of Capital Sum Insured or 2,500/- (Two thousand five
Home, transportation cost for carriage of dead body to hundred) whichever is lower.
Home including funeral charges is payable.

B. Cost of Clothing damaged in the Accident as described Rs. 1000 (one thousand) per insured person any one
above and liability is admitted by us. accident or actual expenses whichever is lower.

C. Ambulance charges for transportation of Insured person Rs. 1000 (one thousand) per insured person any one
to Hospital following Accident which result in liability accident or actual expenses whichever is lower.
having been admitted by us as per 1 to 6 of Table of
Benefits.

D. Education Fund: In the event of death, permanent

total disablement i.e. 1 to 4 of Table of Benefit of Insured
person, We will approve compensation towards Education
Fund for dependent children as below
a) For one child upto the age of 23 yrs.
-10% (Ten percent) of C.S.I Subject to a maximum of Rs.
b) For more than one children upto the age of 23 yrs. 5000/-
-10% (Ten percent) of C.S.I Subject to a maximum of Rs.
10000/-
E. Loss of Employment: In the event of accident leading to - Rs. 15000 or 1% of CSI whichever is lower.
loss of employment as a consequence of 2,3 and 4 of table
of benefits.

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List of Insured Persons
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Sl No Name of the Employee Designation Date of Birth SI Table C Table B

1 V. RAMAKRISHNA DEE 18.04.1980 1000000 500000 500000
2 JANGITI KRISHNAMOORTHY DEE 10.08.1970 1000000 500000 500000
3 R.BALAKRISHNA AEE 10.03.1977 1000000 500000 500000
4 T. DINESH REDDY AEE 02.06.1990 1000000 500000 500000
5 DATTATRI DEE 20.07.1982 1000000 500000 500000
6 S.SHAILAJA AEE 04.08.1976 1000000 500000 500000
7 SRAVANTHI SHAKKER AEE 16.08.1985 1000000 500000 500000
8 A.ABHISHEK SAI AEE 16.05.1986 1000000 500000 500000
9 K.SANDHYA AEE 04.05.1980 1000000 500000 500000
10 M.V.MAHESWARA REDDY DEE 30.05.1978 1000000 500000 500000
11 D RAVINDER REDDY AEE 19.08.1988 1000000 500000 500000
12 G.N.SREELATHA AEE 08.07.1978 1000000 500000 500000
13 P.RAVICHANDRA AEE 08.10.1980 1000000 500000 500000
14 DARAVATH SARAIAH AEE 06.07.1974 1000000 500000 500000
15 A.RAMCHANDER AEE 25.12.1978 1000000 500000 500000
16 M.RAJESH AEE 12.03.1989 1000000 500000 500000
17 CHITYALA YAKAIAH AEE 14.12.1969 1000000 500000 500000
18 DAVA SHRAVANKUMAR AEE 18.06.1986 1000000 500000 500000
19 B.ARCHNA DEE 11.08.1983 1000000 500000 500000
20 K. RAMA DEVI AEE 19.01.1981 1000000 500000 500000
21 S SAMARA SIDDARTHA REDDY AEE 09.03.1990 1000000 500000 500000
22 M. MARY CHANDRA RADHIKA AEE 05.09.1983 1000000 500000 500000
23 P. SRAVANTHI AEE 25.07.1972 1000000 500000 500000
24 SHAIK MOHAMMED QUDRATULLAH AE 25.06.1986 1000000 500000 500000
25 DONTHU RAMA MOHAN RAO AEE 21.04.1973 1000000 500000 500000
26 E. MANIKYAM AEE 24.10.1984 1000000 500000 500000
27 M.SWATHI NAYAK AEE 12.08.1993 1000000 500000 500000
28 P.CHANDRA SHEKHAR AEE 28.04.1980 1000000 500000 500000
29 N.JAGATHI DEE 06.10.1974 1000000 500000 500000
30 L.NAGARAJU AEE 02.03.1988 1000000 500000 500000
31 SYEDA SARA JABEEN FATIMA AEE 09.05.1986 1000000 500000 500000
32 D.KRANTHI AEE 27.07.1986 1000000 500000 500000
33 K.SHRUTI AEE 07.11.1987 1000000 500000 500000
34 PANUGANTI ARUN JYOTHI DEE 06.11.1976 1000000 500000 500000
35 B.BHUPUTRA AEE 29.01.1980 1000000 500000 500000
36 K.SANDHYA RANI AEE 13.02.1978 1000000 500000 500000
37 SUGGUNA BHAVANI AEE 05.04.1983 1000000 500000 500000
38 VEMULA MADHAVI LATHA AEE 26.11.1979 1000000 500000 500000
39 V.PRANITHA AEE 10.02.1984 1000000 500000 500000
40 P.SRINIVAS AEE 07.05.1980 1000000 500000 500000
41 B.PRIYANKA AEE 08.04.1987 1000000 500000 500000
42 KURAPATI SHAILAJA AEE 24.11.1982 1000000 500000 500000
43 P. PRASHANTH KUMAR AEE 06.11.1976 1000000 500000 500000
44 ATHELLY NARESH KUMAR GOUD AEE 11.09.1982 1000000 500000 500000
45 G.KIRANKUMAR AEE 04.01.1985 1000000 500000 500000
46 A.SRUTHI AEE 05.08.1988 1000000 500000 500000
47 M.APPAIAH AEE 04.09.1972 1000000 500000 500000
48 GUNDEMONI USHA RANI DEE 02.08.1980 1000000 500000 500000
49 K. YADAGIRI NARSIMHA AEE 13.06.1989 1000000 500000 500000
50 S.MRUDULA DEVI AEE 07.08.1985 1000000 500000 500000
51 T.HEMALATHA DEE 13.08.1981 1000000 500000 500000
52 PUPPALA SOUJANYA AEE 01.01.1982 1000000 500000 500000
53 G. PRUTHVI AEE 06.01.1987 1000000 500000 500000
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Authorised Signatory
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List of Insured Persons
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54 K.SRIDHAR AEE 10.05.1983 1000000 500000 500000
55 K. LAXMI DEVAMMA AEE 10.10.1978 1000000 500000 500000
56 P. NIKHITHA AEE 15.11.1985 1000000 500000 500000
57 CHINTALA INDIRA AEE 22.09.1978 1000000 500000 500000
58 V CH SRINIVAS RAO CHENNU DEE 10.05.1980 1000000 500000 500000
59 PUNNA VIJAYALAKSHMI DEE 16.12.1980 1000000 500000 500000
60 SABIHA BEGUM DEE 25.08.1974 1000000 500000 500000
61 RATHOD SWAPNA DEE 02.01.1985 1000000 500000 500000
62 MADARI SANTHOSH KUMAR AEE 22.03.1988 1000000 500000 500000
63 NAMURI RAMADEVI AEE 16.05.1978 1000000 500000 500000
64 P.ARUNA KUMARI AEE 15.08.1977 1000000 500000 500000
65 CH.PRAVEEN KUMAR DEE 20.01.1981 1000000 500000 500000
66 PRIYANKA DWARAPUREDDY AEE 15.12.1983 1000000 500000 500000
67 B.SRAVAN KUMAR AEE 28.05.1986 1000000 500000 500000
68 M.VIJAYAKUMAR AEE 10.06.1979 1000000 500000 500000
69 CHANDU NAMEWAR AEE 06.05.1984 1000000 500000 500000
70 S. BALAMURALI AEE 26.03.1980 1000000 500000 500000
71 GOPARAJU VENKATA NAGAHANUMANTHA RAO AEE 15.08.1978 1000000 500000 500000
72 N.BALAMANI DEE 24.10.1980 1000000 500000 500000
73 RAM MAHENDER EPPA AEE 21.04.1983 1000000 500000 500000
74 SHEIK VAJEED AEE 18.08.1989 1000000 500000 500000
75 T.K SRIKANTH AEE 29.09.1978 1000000 500000 500000
76 MERUGU MADHUSUDHAN AEE 07.09.1977 1000000 500000 500000
77 POTHAGANI SRILATHA AEE 11.11.1981 1000000 500000 500000
78 CHALLA DINESH AEE 15.02.1989 1000000 500000 500000
79 PALLEPATI DHANA LAKSHMI AEE 16.07.1981 1000000 500000 500000
80 KONDA SANTHOSHI AEE 21.08.1982 1000000 500000 500000
81 DONTHULA SEKHAR AEE 20.081972 1000000 500000 500000
82 DANDU JAYA LAKSHMI AEE 24.04.1982 1000000 500000 500000
83 VELDANDI MUNEENDRA DEE 26.04.1979 1000000 500000 500000
84 PRATHYUSHA KASU AEE 31.08.1985 1000000 500000 500000
85 G.RAJESH KUMAR AEE 28.10.1980 1000000 500000 500000
86 SONAI UDAY KIRAN AEE 06.04.1995 1000000 500000 500000
87 MD GULAM YAZDANI AEE 11.02.1983 1000000 500000 500000
88 K.AMRUTHAVALLI AEE 18.09.1989 1000000 500000 500000
89 KOTLA MADHAVI AEE 17.04.1971 1000000 500000 500000
90 KUKUTLA VENKATESHAM AEE 22.05.1975 1000000 500000 500000
91 SUKKA CHANDER KUMAR AEE 12.01.1982 1000000 500000 500000
92 CHETLAPALLY ROHITH GOUD AEE 02.06.1986 1000000 500000 500000
93 BAIRI PRADEEP KUMAR AEE 04.06.1986 1000000 500000 500000
94 K. RAMAKANTH KOUSHIK AEE 31.10.1984 1000000 500000 500000
95 M.RADHIKA AEE 22.01.1984 1000000 500000 500000
96 Y.SAILAJA AEE 05.06.1976 1000000 500000 500000
97 R ANJANEYULU DEE 05.02.1981 1000000 500000 500000
98 JULURI SANTOSH DEE 14.08.1983 1000000 500000 500000
99 DEEPTI SREE KESIREDDY AEE 13.07.1981 1000000 500000 500000
100 YENUGULA PRASAD AEE 04.03.1971 1000000 500000 500000
101 MADHU BINDU BARLA AEE 03.08.1986 1000000 500000 500000
102 DATTA VISWAM KUMAR AEE 29.06.1987 1000000 500000 500000
103 N.KANAKA LAXMI AEE 26.01.1984 1000000 500000 500000
104 RAJU KURLA AEE 25.05.1975 1000000 500000 500000
105 CH.SREEKANTH AEE 21.06.1977 1000000 500000 500000
106 NENAVATH PREM KUMAR AEE 25.05.1982 1000000 500000 500000
107 K.GAJANAND AEE 1.1.1979 1000000 500000 500000
108 K.SANDEEP AEE 27.07.1992 1000000 500000 500000
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Authorised Signatory
Attaching to and forming part of Policy No: 54687089 Page No: 14 / 18
List of Insured Persons
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109 K.SUNEETHA AEE 16.08.1981 1000000 500000 500000
110 M.YOGENDER SINGH AEE 17.03.1982 1000000 500000 500000
111 K.HIMABINDU DEE 12.03.1977 1000000 500000 500000
112 CH.RANJITH KUMAR DEE 27.12.1989 1000000 500000 500000
113 S.FAKRUNNISA BEGUM AEE 02.06.1975 1000000 500000 500000
114 MOHAMMAD SARWARUDDIN AEE 10.03.1990 1000000 500000 500000
115 JANAGAM SWATHI AEE 30.09.1988 1000000 500000 500000
116 EDIGI SREEKANTH GOUD AE 24.11.1992 1000000 500000 500000
117 NARAYANA AEE 10.06.1981 1000000 500000 500000
118 ARAKALA. JYOTHIRMAYI AEE 14.02.1975 1000000 500000 500000
119 ASMA TABASSUM AEE 19.02.1990 1000000 500000 500000
120 UMADEVI GUNDU AEE 11.05.1989 1000000 500000 500000
121 SRIRAMOJU SRINIVAS DEE 16.05.1980 1000000 500000 500000
122 T.CHANDRAKALA AEE 27.02.1972 1000000 500000 500000
123 AKUNURI PRIYADARSHINI AEE 27.11.1985 1000000 500000 500000
124 RAMTANKI SHIKHA AEE 05.06.1988 1000000 500000 500000
125 B.SANDHYA RANI AEE 30.06.1988 1000000 500000 500000
126 R.SUMALATHA DEE 15.07.1981 1000000 500000 500000
127 ADLAPALLI GANESH DEE 01.09.1984 1000000 500000 500000
128 GOWTHAMI GUDIPUDI AEE 10.02.1990 1000000 500000 500000
129 T.V.PRASAD AEE 12.12.1977 1000000 500000 500000
130 JALKOTE JYOTI SHARADKUMAR AEE 24.06.1980 1000000 500000 500000
131 BASPARAJU MORANRAJU AEE 02.09.1986 1000000 500000 500000
132 P. SRICHAND AEE 10.06.1977 1000000 500000 500000
133 GUGULOTHU VENKANNA AEE 05.12.1975 1000000 500000 500000
134 KADURUGANTI BHOOMANNA AEE 22.08.1977 1000000 500000 500000
135 M.RAVI KUMAR DEE 07.07.1982 1000000 500000 500000
136 RAGOTHVAM VENKATA SWAMY DEE 13.03.1980 1000000 500000 500000
137 B.PADMAVATHI DEE 23.04.1983 1000000 500000 500000
138 MOGILIGARI JEEVAN AE 25.04.1993 1000000 500000 500000
139 SRAVANTHI NALLAGONI AE 02.08.1994 1000000 500000 500000
140 SINGIREDDY ANURADHA DEE 14.01.1985 1000000 500000 500000
141 Y. SHIVA KUMAR AE 06.03.1989 1000000 500000 500000
142 E SURENDAR REDDY AEE 17.051979 1000000 500000 500000
143 K. VAMSHEE KRISHNA AEE 06.04.1985 1000000 500000 500000
144 GOTETI YAMINI KRISHNA PRIYA AEE 25.12.1981 1000000 500000 500000
145 VARAKANTHAM VISHAL REDDY AEE 19.02.1992 1000000 500000 500000
146 YADAIAH BODA DEE 17.06.1975 1000000 500000 500000
147 CHEEMALA SRINADH REDDY AEE 08.08.1994 1000000 500000 500000
148 CH.DEEPA DEE 14.05.1987 1000000 500000 500000
149 M.SHARATH BABU DEE 03.06.1981 1000000 500000 500000
150 KALLURI JANAKIRAM REDDY AEE 01.05.1994 1000000 500000 500000
151 S.KRISHNA REDDY AEE 07.04.1985 1000000 500000 500000
152 RAMAGIRI PRAVEEN AE 23.06.1994 1000000 500000 500000
153 GADDAM SUJATHA AEE 08.02.1978 1000000 500000 500000
154 G.SATHEESH AEE 23.12.1983 1000000 500000 500000
155 Y LEELA NAGA SOUJANYA AEE 12.07.1985 1000000 500000 500000
156 S. RAJANI DEE 17.08.1980 1000000 500000 500000
157 CHAKALI NAGABHUSHANAM DEE 05.06.1981 1000000 500000 500000
158 KODAM VENKATA PATHI DEE 10.05.1973 1000000 500000 500000
159 N.TIRUMALESH DEE 13.05.1982 1000000 500000 500000
160 SHYAMALA DEVI PALAKURTHI AEE 21.06.1981 1000000 500000 500000
161 DOSALA SRIKANTH AEE 05.03.1992 1000000 500000 500000
162 BOKKALAPALLY NARENDAR REDDY AEE 15.07.1979 1000000 500000 500000
163 SAMALA UDAY KUMAR AEE 09.11.1987 1000000 500000 500000
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Authorised Signatory
Attaching to and forming part of Policy No: 54687089 Page No: 15 / 18
List of Insured Persons
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164 GAYATHRI.G AEE 24.06.1984 1000000 500000 500000
165 KOORA MADHUSUDAN DEE 28.05.1984 1000000 500000 500000
166 VAMSHIDHAR RAO VAVILALA ATO 03.12.1977 1000000 500000 500000
167 RAKESH K DEE 20.03.1984 1000000 500000 500000
168 MANDULA SAMPATH KUMAR DEE 06.05.1970 1000000 500000 500000
169 SWAPNA SUNKOJU DEE 28.08.1983 1000000 500000 500000
170 ANUMANDLA SANDEEP DEE 20.08.1984 1000000 500000 500000
171 SUVARCHALA K DEE 07.08.1984 1000000 500000 500000
172 K SUNITHA AEE 04.01.1982 1000000 500000 500000
173 RAMESH MOOTA AEE 15.11.1979 1000000 500000 500000
174 PATHI KIRAN KUMAR AE 10.12.1980 1000000 500000 500000
175 S. MAMATHA AEE 25.06.1982 1000000 500000 500000
176 S.DIVYA BHARATHI AEE 19.03.1992 1000000 500000 500000
177 G.MADHAVI DEE 05.11.1974 1000000 500000 500000
178 DAKOJU . V.V. GOPALA KRISHNA AEE 13.08.1971 1000000 500000 500000
179 E.V.PARIMALA AEE 10.8.1995 1000000 500000 500000
180 S.MONIKA AEE 28.02.1976 1000000 500000 500000
181 AZEEZUNNISA BEGUM DEE 03.08.1975 1000000 500000 500000
182 SINGIREDDY RAJENDER AEE 26.08.1994 1000000 500000 500000
183 KANNEBOINA SRINIVASULU DEE 10.02.1971 1000000 500000 500000
184 CHILAGANI SUSMITHA AEE 24.06.1990 1000000 500000 500000
185 PORANDLA SATHISH KUMAR AEE 04.01.1983 1000000 500000 500000
186 KISAR RAJASHEKAR AEE 02.09.1982 1000000 500000 500000
187 NARENDER TOGUTA DEE 20.07.1979 1000000 500000 500000
188 KENCHA ASHOK KUMAR AEE 06.06.1980 1000000 500000 500000
189 RAJENDAR DODLA AEE 20.4.1974 1000000 500000 500000
190 GUMMADI RAVI KUMAR AEE 13.7.1972 1000000 500000 500000
191 PORANDLA PRASHANTH DEE 04.04.1975 1000000 500000 500000
192 RAMA SUBBA RAO KOLAVENNU AEE 15.05.1981 1000000 500000 500000
193 KOTTHA RAVI AEE 14.05.1971 1000000 500000 500000
194 S. LALITHANARAYANA AEE 15.06.1976 1000000 500000 500000
195 SHARMILA MOHAMMAD DEE 24.05.1980 1000000 500000 500000
196 SRIVASTO PRATHAP AE 24.08.1987 1000000 500000 500000
197 SINGIREDDY ARCHANA ALO 23.05.1990 1000000 500000 500000
198 B.GANGADHAR ALO 17.05.1988 1000000 500000 500000
199 MD SIRAJ BASID AEE 12.07.1983 1000000 500000 500000
200 RAJOLE VANDANA AEE 15.01.1971 1000000 500000 500000
201 KATROTH JAIRAM AEE 10.05.1981 1000000 500000 500000
202 K.SARITHA RANI DEE 05.10.1979 1000000 500000 500000
203 BANDARI SAMPATH KUMAR AEE 04.05.1974 1000000 500000 500000
204 VUDAYARAJ SUSHMA AEE 18.8.1980 1000000 500000 500000
205 P.BALAKRISHNA DEE 24.05.1973 1000000 500000 500000
206 RENUKA PUDUTHA AEE 31.10.1976 1000000 500000 500000
207 J.S.MADHAVI DEE 06.09.1988 1000000 500000 500000
208 G.RAMU AEE 16.05.1987 1000000 500000 500000
209 K.BABU AEE 01.01.1989 1000000 500000 500000
210 GUBBLA NAGESWARA RAO AEE 25.06.1969 1000000 500000 500000
211 G. LAXMI BHAVANI AEE 23.08.1988 1000000 500000 500000
212 B.R.VISHNUGIRI DEE 18.07.1983 1000000 500000 500000
213 PALLE PICHAIAH AEE 06.05.1970 1000000 500000 500000
214 SRINIVASU GANJI Sr.Asst. 12.06.1976 1000000 500000 500000
215 C VAMSHEE KRUSHNA AEE 27.04.1982 1000000 500000 500000
216 K.LEELA GANESH AEE 03.12.1987 1000000 500000 500000
217 P.MANJULATHA AEE 04.02.1978 1000000 500000 500000
218 S.MADHUSUDHAN AEE 25.06.1976 1000000 500000 500000
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Authorised Signatory
Attaching to and forming part of Policy No: 54687089 Page No: 16 / 18
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219 K.VAMSHIDHAR AEE 17.07.1990 1000000 500000 500000
220 CHANDRAM SRIKANTH AEE 27.05.1986 1000000 500000 500000
221 D.RAMA AEE 02.08.1969 1000000 500000 500000
222 G.VANI AEE 08.05.1984 1000000 500000 500000
223 M.SANDHYA DEE 09.07.1980 1000000 500000 500000
224 V. DHEERAJ KUMAR APO 15.09.1978 1000000 500000 500000
225 GANNU SWATHI AE 07.05.1992 1000000 500000 500000
226 E. MURALEEDHAR GOUD DEE 07.10.1980 1000000 500000 500000
227 S.SUJATHA RANI AEE 17.09.1977 1000000 500000 500000
228 K.BUTCHAIAH AEE 01.01.1980 1000000 500000 500000
229 ANMANDLA RAVI KUMAR DEE 23.05.1974 1000000 500000 500000
230 K DHAMMANAND SAGAR AEE 05.06.1975 1000000 500000 500000
231 KUNTA SUBHASHINI AEE 25.04.1979 1000000 500000 500000
232 SAMUDRALA VENKAT AEE 31.01.1988 1000000 500000 500000
233 CH.SUPRAJA AEE 07.10.1984 1000000 500000 500000
234 S.VIJAYA KUMAR AEE 20.07.1980 1000000 500000 500000
235 A SURESH KUMAR DEE 05.07.1983 1000000 500000 500000
236 GUJJU RADHA AEE 03.11.1985 1000000 500000 500000
237 P.V. ANIRUDH KUMAR AEE 23.08.1988 1000000 500000 500000
238 D.KRANTHI DEE 11.06.1979 1000000 500000 500000
239 K.CHAITHANYA AEE 06.07.1987 1000000 500000 500000
240 GAJJELLI SUMALATHA DEE 28.03.1985 1000000 500000 500000
241 AKHIL KUMAR VANGARI AEE 22.11.1994 1000000 500000 500000
242 GADE JYOTHI DEE 15.04.1977 1000000 500000 500000
243 SAI SRIVATSAVA AE 15.07.1990 1000000 500000 500000
244 ASRA JABEEN AEE 16.05.1984 1000000 500000 500000
245 PRAVEEN CHILKAPATI AEE 20.04.1980 1000000 500000 500000
246 VAVILALA SRIKANTH AEE 10.03.1993 1000000 500000 500000
247 V.PRAVEEN KUMAR DEE 22.02.1976 1000000 500000 500000
248 TALARI GEETA AEE 16.06.1979 1000000 500000 500000
249 SRIDHAR MUDA AEE 05.09.1978 1000000 500000 500000
250 NAGUBOTHU VISHNU PRASAD DEE 22.08.1979 1000000 500000 500000
251 VANKAR VENU AEE 07.9.1982 1000000 500000 500000
252 D.PRANEETH AEE 31.03.1986 1000000 500000 500000
253 SAIKUMAR REDDY SANDIRI AEE 06.08.1992 1000000 500000 500000
254 APPIDI JYOTHI AEE 10.08.1977 1000000 500000 500000
255 OMPRAKASH ORSU AEE 26.09.1986 1000000 500000 500000
256 MD.KHAJA HABEEBUDDDIN AEE 06.07.1976 1000000 500000 500000
257 J.HARIKA AEE 27.07.1985 1000000 500000 500000
258 GANDAM AMBICA AEE 05.07.1982 1000000 500000 500000
259 M.SATHISH DEE 10.11.1977 1000000 500000 500000
260 A.PREM RAJ DEE 10.05.1982 1000000 500000 500000
261 P.V.V.LAKSHMI DEE 10.07.1979 1000000 500000 500000
262 SARADA PAMARTHY AEE 15.07.1974 1000000 500000 500000
263 K.KAMESHWARI AEE 30.10.1981 1000000 500000 500000
264 KM.ABDUL GAFFAR AEE 14.03.1971 1000000 500000 500000
265 CHILUKARAJU VENKANNA AEE 10.02.1992 1000000 500000 500000
266 K.Madhuri Latha AEE 08.05.1974 1000000 500000 500000
267 KATABATHULA MOHAN AEE 08.03.1974 1000000 500000 500000
268 RAGIRI SATYANARAYANA DEE 29.06.1982 1000000 500000 500000
269 NAMMIKA GANGADHAR AEE 17.06.1984 1000000 500000 500000
270 P MARUHI VARAPRASAD RAO DEE 01.08.1973 1000000 500000 500000
271 ADEPU PARAMESHWAR AEE 07.02.1976 1000000 500000 500000
272 KUMARASWAMY BOINA DEE 12.04.1975 1000000 500000 500000
273 Mohammed Ahmed Pasha AEE 12.06.1993 1000000 500000 500000
For IFFCO TOKIO General Insurance Company limited

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Authorised Signatory
Attaching to and forming part of Policy No: 54687089 Page No: 17 / 18
List of Insured Persons
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274 D Karthik Kiran AEE 31.10.1988 1000000 500000 500000
275 Tulsiram Chennabathni DEE 27.08.1970 1000000 500000 500000
276 ARUN KUMAR JAGANNADAM AEE 04.06.1977 1000000 500000 500000
277 Rakesh katukuri AEE 14.01.1986 1000000 500000 500000
278 GANJI NAGENDAR AEE 30.12.1983 1000000 500000 500000
279 Ramdev agarwal AEE 06.05.1988 1000000 500000 500000
280 GEESA SIRISH AEE 13.08.1994 1000000 500000 500000
281 MUNDRAI SATYABABU AEE 15.03.1980 1000000 500000 500000
282 M Kiran AEE 18.08.1987 1000000 500000 500000
283 Chittepu Damodar Reddy AEE 15.06.1979 1000000 500000 500000
284 Nallavelly Vijendar Reddy DEE 12.05.1977 1000000 500000 500000
285 Kakulavaram vijaya sree DEE 05.08.1981 1000000 500000 500000
286 GAJULA RAVI KUMAR AEE 14.01.1978 1000000 500000 500000
287 R BHARATH KUMAR AEE 07.04.1988 1000000 500000 500000
288 M PRABHU AEE 15.12.1987 1000000 500000 500000
289 PREMKUMAR RACHAMALLA AEE 15.06.1981 1000000 500000 500000
290 NAVEEN BIKUMANDLA AEE 12.10.1993 1000000 500000 500000
291 YADAVALLI KONDALA RAO AEE 01.07.1967 1000000 500000 500000
292 Ramesh Toshakana AEE 26.05.1973 1000000 500000 500000
293 VALLALA MADHUSUDHAN DEE 05.02.1975 1000000 500000 500000
294 K SEETHA RAM RAJU AEE 14.07.1975 1000000 500000 500000
295 VENU VADDEPALLY AEE 16.08.1982 1000000 500000 500000
296 Eslavath Srinivas Naik AEE 01.12.1981 1000000 500000 500000
297 K PURNA CHANDRA CHARY AEE 04.02.1974 1000000 500000 500000
298 Vadthya Shiva Kumar AEE 10.06.1983 1000000 500000 500000
299 Bhai Venkateswar Rao AEE 10.05.1980 1000000 500000 500000
300 M. Neelima DEE 10.08.1979 1000000 500000 500000
301 R.Ravi Kumar DEE 06.05.1975 1000000 500000 500000
302 Valeem Mohammad AEE 15.07.1985 1000000 500000 500000
303 D.V. Hanuman Prasad AEE 14.11.1989 1000000 500000 500000
304 PINNAPUREDDY NALINI AEE 24.07.1976 1000000 500000 500000
305 MERGU RAJU DEE 10.05.1984 1000000 500000 500000
306 KURUMETI MANOHAR DEE 29.07.1979 1000000 500000 500000

For IFFCO TOKIO General Insurance Company limited

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Authorised Signatory
Attaching to and forming part of Policy No: 54687089 Page No: 18 / 18