Mrs. Pinki Rani

HDFC ERGO General Insurance Company Limited 2811205711082700000
2811205711082700000
MRS. PINKI RANI

S/O MAHADEV 92 WNO 15GURU NANAK PURA MOHALA RAMPURA
Bathinda BATHINDA, 151103
PUNJAB
Contact No : 85XXXXXXX2
Date : 22/09/2023
We welcome you to be a part of our family!
Your Health insurance certificate no. 2811205711082700000 is confirmed on the basis of the information and declaration given by you.The details of coverage are mentioned in
the enclosed Certificate of insurance.
As a measure of our customer convenience we have implemented a Lifetime Validity Health Card. For you, this simply means that your Health Card is valid for all subsequent
renewals and as long as your policy is active with us. Hence, you need not replace your health card every year.
We value your relationship with us and assure you our best services at all times and we look forward to serve you.
Proposer details have been updated basis the information present in the KYC documents. If you find any detail which needs to be corrected, request you to create/ modify the
eKYC ID and place a request for endorsement.
Soft copy of the policy is valid for all purposes including claims.
For HDFC ERGO General Insurance Company Ltd.
Arun Sharma
Head - Customer Experience Management
HDFC ERGO General Insurance Company Limited

TAX CERTIFICATE
Dear MRS. Pinki Rani,

Subject : Certificate for the purpose of deduction under section 80 D of Income Tax (Amendment) Act, 1986
This is to certify that we have received an amount of ` 12519 towards premium Certificate of Insurance 2811205711082700000 issued to MRS. PINKI RANI for the
period 22/09/2023 to 21/09/2024.
Note : This is subject to the provisions of Section 80D of income tax (Amendment) Act, 1986 as amended from time to time.
For HDFC ERGO General Insurance Company Ltd.
Date : 22/09/2023
Policy Issuing Office: Mumbai
Duly Constituted Attorney
HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN : HDFHLGP21116V012021. Customer Service Address: D 301, 3rd Floor,
CIN : U66030MH2007PLC177117. Registered & Corporate Office: 1st Floor, HDFC House, Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078.
165/166 Backbay Reclamation, H.T.Parekh Marg, Churchgate, Mumbai - 400 020. Customer Service No : +91 22-62346234/+91-120 6234 6234 | www.hdfcergo.com
Certificate of Insurance
HDFC Group Health Insurance
2811205711082700000
Certificate No. . :2811 2057 1108 2700 000 Issuance Date :22/09/2023
Period of Insurance :From 22/09/2023 15:04 hrs To 21/09/2024 Midnight
Invoice No. :205711082700000 Policy Type :Individual
Proposer Name :Mrs. Pinki Rani Premium Frequency :Single
MRS. PINKI RANI
0
S/O MAHADEV 92 WNO 15GURU NANAK PURA MOHALA HSN Code :997133 Plan Type: :Gold
RAMPURA Bathinda BATHINDA Customer Id :1006670473810002
PUNJAB, 151103
Contact No : 85XXXXXXX2 Name of the Policy
:HDFC BANK Customer UIN:
Holder:
Master Policy No :2999203685057502000
Payment Details : 99823092200109 , Bank Name :BIZDIRECT

Email ID : [email protected]
Insured Person’s Details & Sum Insured In (`)
Insured's Name Relation with Gender Date of Nominee Name Nominee 1st Policy Sum CB Pre-existing
policy holder Birth Relationship Inception Insured Amount disease
Pinki Rani Self Female 01/01/1981 Tilak Raj Husband 22/09/2023 400000 0 No
The nominee must be an immediate relative of the policyholder. For all other Insured Persons the policy holder shall be the nominee
Coverage Details
Coverage Details Coverage Details
In-Patient Hospitalisation Covered Pre-Hospitalization Medical Expenses Cover 60
1% of Sum Insured,Max Rs.
Post-Hospitalization Medical Expenses Cover 90 Room Rent Per Day (Normal)
3,000/-
Room Rent Per Day (ICU) 2% of Sum Insured Road Ambulance Cover Rs. 2,000/- per hospitalization
30 Day Waiting Period Applicable Waiting period for specified illnesses 24 Months
Waiting Period for Pre-existing Diseases 36 Months Day Care Procedures Covered
1% of Sum Insured, max Rs.
Domiciliary Hospitalization Covered Preventive Health Check-up
2,000/- in a block of 3 years
10% for each claim free year, max
Organ Donor Expenses Covered Cumulative Bonus
50%
Disease Capping None Restore Benefit Not Applicable
Hospital Cash Rs. 500 per day, max 30 days
Please refer Policy wordings for all the standard coverage offered b y the Company to its customers. Your entitlement for coverage/benefits shall be restricted to the coverage/benefits a s mentioned in this Certificate
of Insurance. Policy wordings are available at www.hdfcergo.com
• Room rent per day – Room rent and all other related charges covered in accordance with room rent restriction o r actual, whichever i s less. In the event of a person getting admitted in higher category, the related
charges will be pro-rated to the eligible room rent limit. All other related charges will among other things include OT Charges, Doctors Charges, Nursing charges, Diagnostics and the same will be payable a s per
room rent entitlement.
• Life Long Renewability- As long as master policy is renewed with us and proposer continues to be member of the group
Premium Details (`)
Basic Premium (A) 10,609.00
Medical Underwriting Loading (B) 0.00
Total Premium (A+B) 10,609.00
Integrated Tax 18 % 1,910.00
Gross Premium 12,519.00
Applicable only to HDFC BANK Customers

Entry Age – 18 years to 65 years, Dependent child – 3 months to 25 years
(Please refer to the Master Policy issued to and available with HDFC BANK Customers for full particulars and details)
Special Conditions :Age proof/identity proof will be collected in event of claim under the policy.
For Claim/Policy related queries call us at +91- 22 6234 6234/+91- 120 6234 6234 or Visit Help Section on www.hdfcergo.com for policy copy/tax certificate/make changes/register & track claim.
If the premium is not realised the policy shall be void from inception.The stamp duty of Rs. 1/- ( Rupees One And Zero Paise Only ) paid vide e-stamp Certificate No.(LOA/ENF-1/CSD/34/2023/ Validity Period Dt.
28/12/2023 to Dt. 31/12/2026. OW No. 6045 Date 27/Dec/2023 GRN NO. MH011651000202324M Dt. 05/12/2023, SBI Bank & DEFACE No. 0006692260202324 Dt. 21/12/2023) dated 27/12/2023 as prescribed in
Government of Maharashtra Order No. Mudrank-2017/CR.97/M-1, dated the 09th January 2018&;. Goods & Tax Registration No: 27AABCL5045N1Z8. GST for this invoice is not payable under reverse charge
basis. 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
Branch :leela business park, 6th flr, andheri - kurla rd, mumbai
Agent Name : HDFC BANK LTD For HDFC ERGO General Insurance Company Ltd.
Agent Code : 201587086428 Tel No. : 91-22-61606161
Duly Constituted Attorney
"For detailed policy terms and conditions please visit our website https://www.hdfcergo.com/download/policy-wordings "
2811205711082700000

Policy No.:2811205711082700000 This card is for identification purpose only.
Valid From: 22/09/2023 Renewal Date: 21 September
Card has to be presented to the Network Service Provider at the time of admission/ availing
cashless hospitalization o r any other services. Insurance claim will be processed in accordance
Insured Name Member ID Date Of Birth Gender
with the policy term & conditions. Card does not guarantee cashless hospitalization or any other
service. For more details and updated list of Network Service Provider please refer our website or
Pinki rani 2023310032017830 01/01/1981 Female call our call centre. This card is valid till the time policy is active.
Customer Service No : 022 - 6234 6234 / 0120 - 6234 6234
Email : [email protected]
Processing Centre : HDFC ERGO General Insurance Company Ltd. 5th
floor,Tower 1, Steller IT Park, C-25,
Sector-62,Noida-201301.
Website : www.hdfcergo.com
2811205711082700000
Customer
Section Transcript
Response
Good Morning Sir / Madam, Am I speaking to Mr/ Ms.PINKI RANI on Phone no 8557800962 I am & AV certificate no. calling you from HDFC Bank Ltd. HDFC Bank is Corporate Agent of
HDFC ERGO General insurance co. ltd having Corporate Agency code -CA0010 .
Sir/Madam, Please let us know the preferred language i.e English, Hindi or local language.
Introduction Sir/ Madam, we would like to inform you that the conversation is being recorded and your consent will be the basis for the issuance of the insurance policy, more over the call records is OK
available wtih us for future references if necessary.
Sir / Madam - Please confirm that you are voluntarily enrolling yourself / your family to the policy without ANY OFFERS ?
This call is regarding the HDFC Group Health Insurance offered to HDFC Bank Credit Card customers by HDFC ERGO General Insurance Co ltd.Should we continue.
This Insurance is 1 Year Policy
This is a annual policy which ideminify the Insured in the event of hospitalisation of any of the covered members of the family.The policy can be issued for individuals as well as families up
to 2 adults and up to 4 children. The cover would be on a Individual basis., which covers all your / your familys in-patient expenses on cashless/reimbursement basis.Please note that the
company would be liable for payment of the medical expenses under this policy Policy also includes Pre & Post Hospitalization expenses (60 days immediately before hospitalisation and 90
days after hospitalisation).
Additionally,policy also covers optional cover "Hospital Cash " benefit for period of hospitalisation up to a maximum of 30 Days. For detailed coverage under the product please refer policy
wording available at www.hdfcergo.com
This policy does not cover any pre-existing diseases until a waiting period of 36 months, which means any disease that you or any of your family members is or have been suffering from will
not be covered under policy for 36 months from the date of policy inception.
Policy also has a waiting period of 2 years on medical conditions like Hernia, Cataract, Piles, Gall bladder stones & Kidney stones. This list is not exhaustive, the complete list of Exclusion
will be mentioned in the policy document.
Product Also please note that the policy will not cover any medical hospitalization for first 30 days, however Accidental hospitalization will be covered from day one. Maternity, dental & cosmetic OK
features surgery are not covered in this policy. Dental surgery due to any accident is covered. Minimum 24 hours of hospitalization is required for all inpatient treatments.
This policy has a waiting period for 2 years for medical conditions like Hernia, Cataract, Piles, gall bladder stones & kidney stones This list is not exhaustive, the complete list is mentioned
in the policy document.
The policy coverage under the product is ofered to you as per HDFC Group Health Insurance HDFC BANK GOLD NEW selected.
We also would like to inform you that we offer life long renewability on this product
Thank you so much for your valuable time given to us, to explain the features of the products offered.
Dear Sir/Madam, If our underwriter refers you for any Pre Policy Checkup then the entire cost for check up will be reimbursed by us if referred to network provider. In case of non-network
provider, 50% of the Medical test charges will be reimbursed on acceptance of Proposal. If Proposal is declined post Pre Policy Check-up, 50% of the Medical test charges incurred will be
reimbursed
These are the terms and condition of "HDFC Group Health Insurance" product which we have explained to you, hope you have understood the same.
The policy coverage under the product is offered to you as per HDFC Group Health Insurance HDFC BANK GOLD NEW For detailed inclusions, exclusions and other terms & conditions of
the policy, please refer to the policy wordings / prospectus on the website of the Company at www.hdfcergo.com and the same would be shared on your email id available with us
Thank you so much for your valuable time given to us, to explain the features of the products offered.
We would like to confirm the details of the Persons covered within the Policy:
Family
Nominee relationship
details Name of Insured Person Relationship Date of Birth Occupation Name of Nominee OK
with Insured
Pinki rani Self 01/01/1981 Tilak raj Husband
Dear Sir/Madam, The Company will confidentially retain personal information and health details provided by you. However, to assess and underwrite the risk, issuance of policy and claim
settlement, the Company may disseminate the same with insurance intermediaries like TPA or Insurance repositories or and other service provider(s). Yes/No :
The premium amount for your insurance policy is Rs. 12519 for 1 Year.
Authorisa You can pay the premium in a Single Pay through Online Payment . Premiums are based on the Sum insured. Any change in the premium will be as per the premium tables approved by
tion IRDAI.
There will not be any refund of policy premium amount post expiry of the policy. Kindly note, in case of cancellation request during policy period,cancellation clause mentioned in the policy
clause will be applicable. Yes
Thank you Sir/Madam, we will issue your policy and the premium will reflect in your HDFC Bank Account statement. Request you to please maintain the Account balance upto premium of
Rs.12519 in your HDFC Bank Account so that your request can be processed
You will be entitled for a Free Look period of 15 days from the date of receipt of the policy to review its terms and conditions. In case you disagree with or object to any terms or conditions of
the Policy, you have an option to request for cancellation of the policy stating the reasons for cancellation. The premium paid by you will be refunded after deducting the expenses incurred
by HDFC ERGO on medical check - up, stamp duty charges and proportionate risk premium.
Please note that your insurance cover starts from the date of debit of the premium amount , and it is 1 Year policy to be renewed after every 1 Year to enjoy the benefits.
Dear Sir/Madam, Also Would like to inform you that there are no freebees provided along with this policy
Hope you are aware of similar insurance plans available in the market. Sir/Madam, can you please confirm if you have understood the terms and conditions under the policy? Please
Ok Agreed
reconfirm that all the information provided are accurate enabling us to issue & dispatch the policy to you.
May I confirm your DOB details
Thank you very much for re-confirming the details. You will receive your policy document within 15 working days by courier on your credit card mailing address. On the basis of the
information and confirmation given by you HDFC Group Health Insurance insurance policy detailing the terms and conditions shall be issued to you in due course.We request you to please Ok Agreed
Closure acknowledge the receipt of the same.Is there anything else you would like us to assist you with?
Incase of any discrepancy, request you to get back to us on "022-6234 6234 or 0120 6234 6234"
or Customer Service Address:D-301, 3rd Floor, Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West),Mumbai - 400 078. [email protected] | www.hdfcergo.com.
For further information about the policy, please refer policy terms and conditions sent with the policy schedule or log on to www.hdfcergo.com Ok Agreed
Is there anything else you would like us to assist you with? Ok Agreed
Thank you & Have a nice day! OK

Mrs. Pinki Rani

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HDFC ERGO General Insurance Company Limited 2811205711082700000

MRS. PINKI RANI

We welcome you to be a part of our family!

For HDFC ERGO General Insurance Company Ltd.

HDFC ERGO General Insurance Company Limited

Dear MRS. Pinki Rani,

For HDFC ERGO General Insurance Company Ltd.

Payment Details : 99823092200109 , Bank Name :BIZDIRECT

Applicable only to HDFC BANK Customers

Duly Constituted Attorney

HDFC ERGO General Insurance Company Limited 1

Customer Service No : 022 - 6234 6234 / 0120 - 6234 6234

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