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    Health Insurance Premium Reciept

    Uploaded by

    Aayush
    1) This document is a health insurance policy document issued to Mr. Aayush Kumar Sisodia that provides coverage of Rs. 1.5 million with an annual premium of Rs. 24,378. 2) The policy details were based on information provided in the proposal form and medical reports submitted by the customer. The customer is requested to verify that all details are correctly incorporated in the policy document. 3) The policy is subject to exclusions for pre-existing diseases and conditions. It also has a 15-day free look period during which the customer can cancel the policy if not satisfied with the terms.

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    © All Rights Reserved
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    Health Insurance Premium Reciept

    Uploaded by

    Aayush
    1K views2 pages
    1) This document is a health insurance policy document issued to Mr. Aayush Kumar Sisodia that provides coverage of Rs. 1.5 million with an annual premium of Rs. 24,378. 2) The policy details were based on information provided in the proposal form and medical reports submitted by the customer. The customer is requested to verify that all details are correctly incorporated in the policy document. 3) The policy is subject to exclusions for pre-existing diseases and conditions. It also has a 15-day free look period during which the customer can cancel the policy if not satisfied with the terms.

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    1) This document is a health insurance policy document issued to Mr. Aayush Kumar Sisodia that provides coverage of Rs. 1.5 million with an annual premium of Rs. 24,378. 2) The policy details were based on information provided in the proposal form and medical reports submitted by the customer. The customer is requested to verify that all details are correctly incorporated in the policy document. 3) The policy is subject to exclusions for pre-existing diseases and conditions. It also has a 15-day free look period during which the customer can cancel the policy if not satisfied with the terms.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1K views2 pages

    Health Insurance Premium Reciept

    Uploaded by

    Aayush
    1) This document is a health insurance policy document issued to Mr. Aayush Kumar Sisodia that provides coverage of Rs. 1.5 million with an annual premium of Rs. 24,378. 2) The policy details were based on information provided in the proposal form and medical reports submitted by the customer. The customer is requested to verify that all details are correctly incorporated in the policy document. 3) The policy is subject to exclusions for pre-existing diseases and conditions. It also has a 15-day free look period during which the customer can cancel the policy if not satisfied with the terms.

    Copyright:

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

    IMPORTANT

    To, 17-JAN-20

    Mr.Aayush Kumar Sisodia

    F-588 KAMLA NAGAR,


    AGRA
    Agra,Agra,Uttar Pradesh -282005
    Mobile : 9711265575.

    Dear Customer,

    Re: Health Insurance Policy - P/231120/01/2020/009203

    We are extremely thankful for availing health insurance from us and we enclose the policy along with the terms and
    conditions.

    The said policy has been prepared based on the details furnished by you in the proposal form (copy enclosed) and the
    medical reports, wherever applicable. We shall thank you if you can verify the policy to ensure that all the details are
    incorporated correctly as per the proposal. In case of any discrepancy noticed, please communicate the same to us
    immediately. You will appreciate that it is the primary duty of the proposer to fill the proposal form and also to make
    sure that the proposal contains all the details correctly so also the policy has incorporated the details correctly.

    This insurance policy is subject to various exclusions including exclusion for pre-existing diseases and conditions in
    this policy. If there is suppression of any material fact in the proposal, the contract shall become null and void ab
    initio.

    We would like to mention that we have incorporated the name of the intermediary as indicated by you in the proposal
    who will be of assistance to you.

    The policy is subject to the condition of "free look period". As per this condition, a free look period of 15 days from
    the date of receipt of the policy is available to you to review the terms and conditions of the policy. In case you are
    not satisfied with the terms and conditions, you may seek cancellation of the policy and in such an event, we shall
    allow refund of premium paid after adjusting the cost of pre-acceptance medical screening, if any, stamp duty
    charges, and proportionate risk premium for the period on cover, provided no claim has been made until such
    cancellation.

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

    With kind regards,

    Authorised Signatory

    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 stay in eligible room as stated in the policy, to avoid payment of proportionate
    increased charges claimed by the hospitals, from your hand.

    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.

    Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800 Toll Free Fax No:1800-425-5522
    Toll Free No:1800-425-2255 / 1800-102-4477,CIN :U66010TN2005PLC056649 Email :support@starthealth.in Website :www.starhealth.in IRDAI Regn.no: 129
    STAR COMPREHENSIVE INSURANCE POLICY
    SCHEDULE (Floater)
    UNIQUE ID:SHAHLIP2077V041920
    Policy No. : P/231120/01/2020/009203 Previous Policy No. :
    Customer Code : AA000585604 GSTIN : 09AAJCS4517L1ZW
    Customer Name : Mr.AAYUSH KUMAR SAC Code : 997133/Accident and Health Insurance Services
    SISODIA
    Proposer's Code : 13394212 Issuing Office Code : 231120
    Proposer's Name : Mr.AAYUSH KUMAR Issuing Office Name : Branch Office - Aligarh
    SISODIA
    Address : F-588 Address : 2nd Floor, Krishna Complex,
    KAMLA NAGAR, J-77 Janakpur Colony
    AGRA Ramghat Road, Aligarh-202001
    Agra,Agra,Uttar Pradesh-282005

    Phone No : NA/9711265575/ Phone No : 0571-2742177 / 07351380777


    E-mail Id : aayushsisodia1989@gmail.com E-mail Id : aligarh@starhealth.in
    Proposer GSTIN : - Place of Supply : -
    Proposal date : 16/01/2020 Fulfiller Code : SH20682

    Date of Inception of first policy : 16/01/2020


    Intermediary Code : BA0000326856
    Renewal Year : NEW
    Collection Number : 1315009845
    Name : Ms.ARCHANA THAKUR
    Receipt Date : 16/01/2020
    Premium :Rs 20,660/-
    Phone No : 8126671486/8126671486
    CGST @9%: 1,859 /- SGST / UTGST @9%: 1,859/-
    Stamp Duty :Rs 1/- Total Premium :Rs 24,378/- E-mail Id : AVDESHRAJ367@GMAI
    L.COM

    Total Premium In Words : Rupees Twenty Four Thousand Three Hundred Seventy Eight Only

    Period of Insurance : FROM 16/01/2020 17:44:37 TO : Midnight Of 15/01/2021


    Basic Floater Sum Insured : Rs. 1500000 /-
    Bonus : Rs. 0 /-
    Sum Insured Under Section 1 (Health) Rs. 1500000 /- Policy Term : 1 Year
    Capital Sum Insured Under Section 10 (For Accidental Death & Permanent Total Disablement) : Rs.1500000 /-
    For Mr / Ms. AAYUSH KUMAR SISODIA Only.

    For Star Health and Allied Insurance Company Ltd.


    Entered by : SH34202

    IRDAI Regn. No 129


    Corporate Identity Number U66010TN2005PLC056649
    Authorised Signatory
    Email ID : info@starhealth.in

    Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800 Toll Free Fax No:1800-425-5522
    Toll Free No:1800-425-2255 / 1800-102-4477,CIN :U66010TN2005PLC056649 Email :support@starthealth.in Website :www.starhealth.in IRDAI Regn.no: 129

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