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    Bajaj Allianz General Insurance Company Ltd. Bajaj Allianz House, Airport Road, Yerawada, Pune - 411006 Group Personal Accident Policy Schedule

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    hari bharadwaj
    This document is an insurance policy schedule that provides: 1) Coverage details for a group personal accident policy for 216 KCC account holders of Canara Bank, with a sum insured of Rs. 1,50,000 per member for a total of Rs. 3,24,00,000. 2) The policy details such as the policy number, period of coverage, insured name and address, premium amount, and scope of coverage. 3) Instructions that proof of employment must be submitted at the time of any claim and the claim would not be payable if the number of insured does not match on the date of loss.

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    Bajaj Allianz General Insurance Company Ltd. Bajaj Allianz House, Airport Road, Yerawada, Pune - 411006 Group Personal Accident Policy Schedule

    Uploaded by

    hari bharadwaj
    176 views2 pages
    This document is an insurance policy schedule that provides: 1) Coverage details for a group personal accident policy for 216 KCC account holders of Canara Bank, with a sum insured of Rs. 1,50,000 per member for a total of Rs. 3,24,00,000. 2) The policy details such as the policy number, period of coverage, insured name and address, premium amount, and scope of coverage. 3) Instructions that proof of employment must be submitted at the time of any claim and the claim would not be payable if the number of insured does not match on the date of loss.

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    Policy.pdf

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    This document is an insurance policy schedule that provides: 1) Coverage details for a group personal accident policy for 216 KCC account holders of Canara Bank, with a sum insured of Rs. 1,50,000 per member for a total of Rs. 3,24,00,000. 2) The policy details such as the policy number, period of coverage, insured name and address, premium amount, and scope of coverage. 3) Instructions that proof of employment must be submitted at the time of any claim and the claim would not be payable if the number of insured does not match on the date of loss.

    Copyright:

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

    Bajaj Allianz General Insurance Company Ltd. Bajaj Allianz House, Airport Road, Yerawada, Pune - 411006 Group Personal Accident Policy Schedule

    Uploaded by

    hari bharadwaj
    This document is an insurance policy schedule that provides: 1) Coverage details for a group personal accident policy for 216 KCC account holders of Canara Bank, with a sum insured of Rs. 1,50,000 per member for a total of Rs. 3,24,00,000. 2) The policy details such as the policy number, period of coverage, insured name and address, premium amount, and scope of coverage. 3) Instructions that proof of employment must be submitted at the time of any claim and the claim would not be payable if the number of insured does not match on the date of loss.

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    © All Rights Reserved
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    Bajaj Allianz General Insurance Company Ltd.


    Bajaj Allianz House, Airport Road, Yerawada, Pune - 411006
    GROUP PERSONAL ACCIDENT POLICY SCHEDULE
    Policy issuing office and Correspondence address for com- BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LIM-
    munication by policyholder for claim, service request, notice, ITED,, D No :1-7-690/20,Subedari Main Road,, Loyola Ar-
    summons, etc. : cade, 1st Floor,, Hanamkonda, WARANGAL-506001 Phone
    No :0870-2438080
    Policy No. OG-20-1805-9902-00000057
    Product GROUP PERSONAL ACCIDENT
    Period of Insurance From 19:26:45 05-MAR-20 To 04-MAR-21 Policy Issued On 06-MAR-20
    Midnight
    Co-Insurance Details Own Share: 100%
    Insured Name CANARA BANK (DP BANK ) 1877
    Insured Address KOMPALLY, , PO Area - -, , NALGONDA, TELANGANA - 508202
    Bank Details : No Details No Details
    GSTIN / UIN NA Place of Supply/State 36 - Telangana
    Code/Name
    Company GST No : 36AABCB5730G1ZY Invoice No : 151575455/1
    Company PAN : AABCB5730G
    Bank Reference No. 98964 Scrutiny No 162110387
    Description Sum Insured (Rs)
    216 Kcc Account Holders Wider Coverage Opted Per each member SUM INSURED Rs 1,50,000/- 3,24,00,000.00
    Additional** Loading @ 0%
    Additional Discount@ 0%
    Base Premium 4,576.00
    Special Discount 0
    Net Premium 4,576.00
    Terrorism** Surcharge 0
    Stamp Duty
    State GST (9%) 412.00
    Central GST (9%) 412.00
    Final Premium 5,400.00
    *** All Premium figures are in Rupee.

    Scope of Cover As per the policy wording attached.


    Risk Covered NAMED GROUP PERSONAL ACCIDENT POLICY - Wider Cover per each member Sum Insured
    1,50,000, for canara bank KCC Account holders.
    Special Perils Wider Cover per each member Sum Insured 1,50,000
    Special Exclusions AS PER STANDARD WORDINGS ATTACHED
    Subject to Clauses AS PER STANDARD WORDINGS ATTACHED
    Warranties 1.Claims related to accidental hospitalization are consideredthoughtheclaimisnot payable under the
    GPAcover (i.e. not triggered in GPA) unlike medicalextensioncover.2. 24 hrs hospitalization is warranted
    forthese claims arising due to accident only
    Special Conditions AT THE TIME OF CLAIM, EMPLOYMENT PROOF SHOULD BE SUBMITTED. ON ALL OR NONEBAS-
    IS.IF THE NOS DO NOT MATCH ON THE DATE OF LOSS, THE CLAIM WOULD NOT BE PAY-
    ABLE.SUM INSURED TO COMMENSURATE WITH SALARIES
    Comments AS PER STANDARD WORDINGS ATTACHED--Beneficiary will be Canara Bank KCC account holders
    Bank RM Employee Code : Y
    Agency Code 10045514 Channel Name : BA
    Agency Name : CANARA BANK
    Contact No : 0-8093650660/0-0
    Email - CB4148@CANARABANK.COM
    Premium Collection Details [Receipt No/Collection No/Amount] Rs. 5400 By Float No : 10045514
    *** If Premium paid through Cheque, the Policy is void ab-initio in case of dishonour of Cheque
    *** This policy is subject to the standard policy wordings, warranties and conditions applicable for this product in addition to any specific
    warranty or condition attached
    For & On Behalf of Bajaj Allianz General Insurance Company Ltd.
    Stamp
    Duty Rs.
    7.5
    
    

    Authorized Signatory This document is digitally signed, hence counter signature / stamp is not required
    Printed , Signed and Executed at Pune

    Regd Office : Bajaj Allianz House,Airport Road, Yerwada Pune-411006 (India), A Company incorporated under Indian Companies Act, 1956 and licensed by In-
    surance Regulatory and Development Authority of India [IRDA] vide Reg No.113, Corporate Identification Number U66010PN2000PLC015329.
    Consolidated Stamp Duty of Rs.7.5/- paid towards Insurance Stamps vide Challan No. MH008583958201920M Defaced No. 0004665448201920 ORDER
    NO.CSD/240/2019/5894/19 ORDER DATED 07.12.2019DEFACED DATE dated 07-DEC-19 timing 16:28:29 of General Stamp Office,Mumbai,India.
    Principal Location : Bajaj Allianz General Insurance Co Ltd, 4th Floor, North East Plaza, Erramanzil X Roads, Beside BMW Showroom, HY-
    DERABAD - 500082 PH:04033122800 | Services Accounting Code : 997133 - Accident and health insurance services. No reverse charge is
    payable on these services.

    In case of any claim, please contact our 24 Hour Call centre at 1800-22-5858, 1800-102-5858 (Toll Free) / 91-020-30305858
    (chargeable, add area code before this number in case of mobile call) or email us at 'Bagichelp@bajajallianz.co.in'.
    162110387/-/10045514/1877/-
    Prefix your area code if you are calling from a Mobile Device.
    A Company incorporated under Indian Companies Act, 1956 and licensed by Insurance Regulatory and Development Authority of India [IRDA] vide
    Reg No.113, Corporate Identification Number U66010PN2000PLC015329.
    Generated by Silent_Printing

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