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    Health Insurance Premium Receipt: Personal Details

    Uploaded by

    Ranjith B
    This document is a health insurance premium receipt for Mr. Vijay Kumar for a Max Life Online Term Plan Plus policy and rider for the period of 13-Dec-2021 to 13-Dec-2022. It provides details of the policy such as the plan name, policy term, premium amount of Rs. 1,344.60, total sum assured of Rs. 1,00,00,000, and agent information. The receipt acknowledges receipt of payment for the health insurance premium.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Health Insurance Premium Receipt: Personal Details

    Uploaded by

    Ranjith B
    123 views1 page
    This document is a health insurance premium receipt for Mr. Vijay Kumar for a Max Life Online Term Plan Plus policy and rider for the period of 13-Dec-2021 to 13-Dec-2022. It provides details of the policy such as the plan name, policy term, premium amount of Rs. 1,344.60, total sum assured of Rs. 1,00,00,000, and agent information. The receipt acknowledges receipt of payment for the health insurance premium.

    Original Title

    Maxl Life

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    This document is a health insurance premium receipt for Mr. Vijay Kumar for a Max Life Online Term Plan Plus policy and rider for the period of 13-Dec-2021 to 13-Dec-2022. It provides details of the policy such as the plan name, policy term, premium amount of Rs. 1,344.60, total sum assured of Rs. 1,00,00,000, and agent information. The receipt acknowledges receipt of payment for the health insurance premium.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    123 views1 page

    Health Insurance Premium Receipt: Personal Details

    Uploaded by

    Ranjith B
    This document is a health insurance premium receipt for Mr. Vijay Kumar for a Max Life Online Term Plan Plus policy and rider for the period of 13-Dec-2021 to 13-Dec-2022. It provides details of the policy such as the plan name, policy term, premium amount of Rs. 1,344.60, total sum assured of Rs. 1,00,00,000, and agent information. The receipt acknowledges receipt of payment for the health insurance premium.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    Date: 13-Dec-2021

    Receipt No.: 145664876 DEC211213

    Health Insurance Premium


    Receipt
    Duration For Which the Premium is Received: 13-DEC-2021 to 13-DEC-2022
    Personal Details
    Policy Number: 28394783
    Current residential state: Bihar
    Policyholder Name: Raj Communication
    Mobile No. 8986490886
    Address: House#419, 13th Main
    Landline no. Please inform us for regular updates
    MC Layout, Vijayanagara
    Life Insured Name: MR. Vijay Kumar
    Bengaluru
    Karnataka - 560040 PAN Number: BQJPK5050N

    2018032388.pdf
    Email ID:

    Policy Details
    Plan Name: Max Life Online Term Plan PlusMax Life Waiver Of Premium Plus Rider CO - 104N092V02
    Policy Term 36 Years Premium Payment Frequency Yearly
    Date of Commencement 13-DEC-2021 Date of Maturity 12-DEC-2057
    Last Premium Due Date 13-DEC-2021 Next Due Date 12-JAN-2018
    Reinstatement Interest (incl. GST) 0.00 Model Premium (incl. GST) 1,344.60
    Total Premium Received (incl. GST)* 1,344.60 Total Sum Assured of base plan and term 1,00,00,000.00
    rider (if any)
    Agent's Name Coverfox Insurance Brokin Agent's Contact No.
    18002005522
    Head Office
    GST Details
    Coverage Type SAC Code GST (INR) GSTIN 27AACCM3201E1Z3
    Base 997132 194.83 GST Regd. State Maharashtra
    Rider 997132 10.28
    Affix
    Reinstatement Interest 0.00 Re1
    Total 205.11 revenue
    stamp

    Important Note:
    *For payment mode other than in cash, this receipt is conditional upon the credit in our account. Payment of premium amount does not constitute commencement of risk. The risk
    commencement starts after acceptance of risk by us. *Amount received would be adjusted against the due premium as per terms and conditions of the policy. *Premium paid would
    be eligible for deduction as per the provision of Income Tax Act, 1961. Kindly consult your tax advisor for more information. Tax benefits are liable to change due to changes in
    legislation or government notification. *Applicable Taxes, Cesses and Levies, as per prevailing laws, shall be borne by you. *For GST purposes,this premium receipt is Tax
    Invoice.Assessable Value in GST for Endowment First Year is 25%, Renewal Year is 12.5%; Single Premium Annuity is 10%; Term and Health is 100%. In case of unit linked
    product GST is applicable on charges.

    Authorised signatory

    PRM20

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