Certificate of Insurance

Certificate of Insurance Group Policyholder Name L&T FINANCE LIMITED
Mr Chandra Velamuri Group Policy No. 76948365

P No 93 Samata Nagar Near Anand Rice Mill R K Puram Certificate of Insurance No 78977366
Post Hy
Plan Name Group Care 360°(L&T FS-CI-PL)
Derabad Telangana
Tirumalagiri 500056 Cover type Individual
Telangana 36 Policy Period - Start Date 00:00 hrs 06/Feb/2024
Policy Period - End Date Midnight 05/Feb/2026
Nominee Name (Relation) Vijaya Lakshmi (Wife)
Premium Paid Rs. 5,876.00

Premium Rs 4980+CGST Rs 448.20+IGST Rs
0.00+SGST Rs 448.20+UGST Rs0.00
Premium Payment Mode Single Premium
Details of Applicant
Policyholder Loan Account Number Date Of Birth Client ID

Mr Chandra Velamuri C02402032779865983 15-Jun-1968 87968732
Details of Insured Person
Insured with the

Name Client ID Date of Birth Relationship Pre-existing diseases since
Company (since)
Chandra Velamuri 87968732 15-Jun-1968 MEMBER 06-Feb-2024 NONE
Contact details for Claims & Policy Servicing
Care Health Insurance Limited, Vipul Tech Square, Tower C, 3rd Floor, Golf Course Road, Sector-43,
Correspondence address
Gurugram-122009 (Haryana)
E-mail ID for Claims claims@careinsurance.com
Website www.careinsurance.com
Intermediary Details
Name Code Contact Details
L&T FINANCE HOLDINGS LIMITED 20683502 022-62125000
Benefits
S No. Particulars Basis of Offering
1 Personal Accident Cover: Sum Insured Rs. 500000

2 Accidental Death 100% of SI
3 PPD Up to SI; As per PPD table of Group Care 360
4 PTD Up to SI: As per PTD table of Group Care 360
5 Critical Illness benefit: Sum Insured Rs. 500000
6 Critical Illness benefit 100% of SI
7 Number of critical illness 32 CI
8 Intial wait period 30 Days
9 Survival Benefit 0 Days
Key Exclusions
The company shall not be liable to make payment for any claim directly or indirectly caused by, based on, arising out of howsoever
attributable to any of the following except covered by way of an extension: page3
l Treatment taken from anyone who is not a Medical Practitioner or from a Medical Practitioner who is practicing outside the discipline
for which he is licensed or any kind of self-medication.
l Charges incurred (or Treatment undergone) in connection with routine eye examinations and ear examinations, dentures, artificial
teeth and all other similar external appliances and / or devices whether for diagnosis or treatment.
l Treatment of any external Congenital Anomaly or Illness or defects or anomalies or treatment relating to external birth defects.
l Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during
hospitalization)or expenses towards lawful medical termination of pregnancy during the policy period.
l Cosmetic surgery or plastic surgery or related treatment of any description, including any complication arising from these treatments, other
than as may be necessitated due to an Injury, cancer or burns
l Any Illness or Injury directly or indirectly resulting or arising from or occurring during commission of any breach of any law by the Insured
Member with any criminal intent
l Act of self-destruction or self-inflicted Injury, attempted suicide or suicide while sane or insane
l Any Illness or Injury attributable to consumption, use, misuse or abuse of intoxicating drugs or alcohol or Tobacco (in any Form like cigarettes
or Gutka etc..)or any other hallucinogens drugs.
Note: This is an illustrative list of exclusions. Please refer Group Policy Terms and Conditions at our website www.careinsurance.com or Group
Policy T&C issued to the Group Master Policy Holder.
Portability/Renewability
S NO. Particulars
1. You can renew the policy only if Master Policy is renewed by Group Master Policyholder.
Care Health Insurance reserves the right to change premium/benefits of the Group Policy at the time of Renewal in consultation
2.
with Master Policy Holder.
You can migrate your existing Policy from this scheme to any Health Insurance retail product of Care Health Insurance. Policy
3.
Issuance subject to Underwriting guidelines of company on the date of migration.
Once the Group Care Health Insurance policy is migrated to retail product of Care Health Insurance, customer will have to pay
4.
premium as per the New product underwriting guidelines.
Grievance Redressal/Complaints
In case of any grievance the Insured Person may contact the Company through
Website/link:https://www.careinsurance.com/contact-us.html
Mobile App : Care Health- Customer App
Toll free (WhatsApp Number): 8860402452
Courier: Any of Company's Branch Office or Corporate Office
Insured Person may also approach the grievance cell at any of the Company's branches with the details of grievance.
If Insured Person is not satisfied with the redressal of grievance through one of the above methods, Insured Person may contact the
grievance officer at Branch Office or corporate office.
For updated details of grievance officer, kindly refer the link- https://www.careinsurance.com/customer-grievance-redressal.html
If Insured Person is not satisfied with the redressal of grievance through above methods, the Insured Person may also approach the
office of Insurance Ombudsman of the respective area/region for redressal of grievance as per Insurance Ombudsman Rules 2017. The
details of insurance ombudsman offices may be referred in the annexure shared along with the Master policy document.
Grievance may also be lodged at IRDAI integrated Grievance Management System -https://bimabharosa.irdai.gov.in/
For Care Health Insurance Limited
Authorized Signatory
Date of Issue : 07/Feb/2024

Place of Issue : Gurgaon, Haryana
Service Branch : C BLOCK on the 2nd Floor BRIJ TARNAG COMMERCIAL Branch Contact No. 9289454758
COMPLEX HNo631191/1 to 631196/2C Besides Greenland :
Guest House Begumpet Hyderabad Telangana
500016Hyderabad,Telangana,500016
Consolidated Stamp Duty paid vide E-Challan GRN no. 0107464159 dated 21 Sep 2023, RCM Applicability- N/A
SAC: 997133 and Description of Service: Accident and Health Insurance Services State
GSTIN No.: 36AADCR6281N1ZT
UIN :RHIHLGP20126V011920
CIN: U66000DL2007PLC161503
Note:
1- Validity of this certificate is subject to terms and conditions of Group Policy issued to the Group Policyholder.
2- In event of non-receipt of Premium, this certificate of insurance automatically stands cancelled from inception, irrespective of whether a
separate communication is sent or not. This policy is based on the information provided by the Insured to the Group Administrator. In case
you find any discrepancy in the same, please contact us immediately.
3- This Certificate of Insurance is governed by and is subject to the Terms and Conditions of the referred Group Policy.
Premium Acknowledgement
Policy No. 78977366
Client ID 87968732
Policyholder Mr Chandra Velamuri
Address P No 93 Samata Nagar Near Anand Rice Mill R K Puram Post Hy
Derabad Telangana
Tirumalagiri 500056
Telangana 36
Policy Period 06/Feb/2024 to 05/Feb/2026
Premium Details
Particulars Amount (in Rs.)
Gross Premium
Group Care 360° 4,980.00
Goods & Services Tax (GST) 896.40
Total 5,876.00
The Premium is rounded off to the nearest rupee.
Eligibility of Premium for Deduction u/s 80D of the Income Tax Act, 1961
The premium paid through any mode other than cash for this policy is eligible for Income tax benefits to the person
making the payment subject to the provisions of section 80D of the Income Tax Act, 1961 and amendments thereof.
Effective from Assessment year 2019-20, in cases where health insurance premium for multiple years is paid in one
year, it will be eligible for proportionate deduction in the years in which the health insurance continues to be
effective.
Signature Not Verified

For Care Health Insurance Limited
Digitally signed by Manish Dodeja
Date: 20240209132559
Reason: I'm the author
Location: India
Authorized Signatory
Date of Issue : 07/Feb/2024
Place of Issue : Gurgaon, Haryana
Note:
1) In case of any discrepancy, the Policyholder is requested to contact the Company immediately.
2) Any amount paid in cash towards the premium would not qualify for tax benefits as mentioned above.
3) This document must be surrendered to the Company in case of Cancellation of the Policy or for the issuance of a fresh
certificate in the case of any alteration in the Policy.
4)This Policy is issued subject to realization of the premium amount. In case the instrument given towards the premium
amount is dishonored, then the cover provided under this Policy shall automatically get cancelled. In the given scenario, if
any amount has been paid by the Company in respect of a claim or due to any other reason than the amount so advanced
by the Company shall be refunded to the Company forthwith.
5) We may credit upto Rs. 1/- to your account for validation, before remitting any further payment.

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Certificate of Insurance Group Policyholder Name L&T FINANCE LIMITED

Mr Chandra Velamuri Group Policy No. 76948365

Premium Paid Rs. 5,876.00

Policyholder Loan Account Number Date Of Birth Client ID

Details of Insured Person

Insured with the

Chandra Velamuri 87968732 15-Jun-1968 MEMBER 06-Feb-2024 NONE

Contact details for Claims & Policy Servicing

E-mail ID for Claims claims@careinsurance.com

Name Code Contact Details

L&T FINANCE HOLDINGS LIMITED 20683502 022-62125000

1 Personal Accident Cover: Sum Insured Rs. 500000

Date of Issue : 07/Feb/2024

Policy Period 06/Feb/2024 to 05/Feb/2026

Signature Not Verified

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