Policy Schedule - Endorsed Copy Personal Accident Insurance Policy
Policy Schedule - Endorsed Copy Personal Accident Insurance Policy
Policy Schedule - Endorsed Copy Personal Accident Insurance Policy
3317202456391100002
Policy No. :3317 2024 5639 1100 002 Issuance Date : 04/02/2019
Period of Insurance :From 16/10/2018 20:09 hrs To 15/10/2021 Midnight
Invoice No. :202456391100002 Policy Type :Individual
Proposer Name :Mr Rana Biswas 1st Policy Inception :16/10/2018
1
HSN Code :997133 Territorial Limits :Worldwide
MR RANA BISWAS
18 ANANTA HARI MITRA ROAD,NEADIAR Customer Id :101182363589 Premium Frequency :Single
PARA,P.O.- KRISHNANAGAR, DIST- NADIA PAN
KRISHNAGAR, WEST BENGAL, 741101
Contact No : 9475362724 ,
Email ID : mechanical.rana98026@gmail.com
Insured Person’s Details
Insured’s Name Relationship Date of Birth Name of Nominee Relation Benefit
Rana Biswas Self 20/06/1979 Adrija Rana Biswas C 100 %
Sum Insured (`)
Coverage
Special Condition :
• Under Coverage “Hospital Cash - Accident & Sickness” , per day limit of hospitalization is Rs. 2000.
• Payment of Hospital daily cash benefit is restricted to 30days within a Certificate of Insurance period.
• One day deductible will be applicable for each and every claim.
• Any disease contracted by the Insured Person during the first thirty (30) days from the commencement date of the policy will not be covered.
• Pre existing diseases are covered from 31st day of coverage commencement date.
• 2 year waiting period for specific Illness and treatment is not applicable.
• Maternity related hospitalization is not covered.
• Territorial limit for Hospital Cash - Accident & Sickness is restricted to India only.
• Income proof is required for only Permanent Disablement cover.
I f the premium i s not realised the policy shall be void from inception. Subject otherwise to the terms,exclusions and conditions of this policy. The Maximum Compensation in respect of an Insured Person under
the policy shall not exceed 10 times the Annual Income (as declared in the Proposal Form). Income proof for availing the compensation at the time of claim is mandatory. Income proof shall mean the previous
year’s returns filed with the Income Tax Department.
Consolidated stamp duty for this Insurance Policy i s paid b y Demand Draft, vide Receipt/Challan noCSD/362/2020/1302 dated 20/03/2020 a s prescribed in Government of Maharashtra Order No. Mudrank-
2017/CR.97/M-1, dated the 09th January 2018;. .GST Registration No: 24AABCL5045N1ZE. GST for this invoice is not payable under reverse charge basis.
Branch :206, sec fl. shopper plaza iv,opp. bsnl tel exch rd, navarangpura ahmedabad
The Policy wording available at www.hdfcergo.com includes all the standard coverage offered by the Company to its customers. Your entitlement for coverage/benefits shall be restricted to the coverage/benefits as
mentioned in this policy schedule.
HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN:HDFPAIP03002V010203. 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
HDFC ERGO General Insurance Company Limited 331720245639110000
"For detailed policy terms and conditions please visit our website https://www.hdfcergo.com/download/policy-wordings."
HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN:HDFPAIP03002V010203. 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
HDFC ERGO General Insurance Company Limited 331720245639110000
TAX CERTIFICATE
HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN:HDFPAIP03002V010203. 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