Policy No Endorsement No Previous Policy No Finance LOB

'2825203365858403 '001 '2825203365858402001 RETAIL HEALTH

'2856205650661600 '000 '121700/48/2023/4341 OPTIMA SECURE
'2866204862320901 '000 '2866204862320900000 RETAIL HEALTH
'2865202935895404 '000 '2865202935895403000 RETAIL HEALTH
'2828100826705303 '000 '2828100826705302002 RETAIL HEALTH
'2866204811958201 '000 '2866204811958200000 RETAIL HEALTH
'2866204810898801 '000 '2866204810898800000 RETAIL HEALTH
'2856205025681800 '010 ' OPTIMA SECURE
'2825202900984304 '000 '2825202900984303000 RETAIL HEALTH
'2828202208316303 '001 '2828202208316302000 RETAIL HEALTH
Product Name Booked Date Endorsement Date Start Date
MY:HEALTH SURAKSHA 04AUG2023 20MAR2023 3/20/2023
MY: OPTIMA SECURE 26AUG2023 31AUG2023 8/31/2023
MY HEALTH MEDISURE SUPER TOP UP FLOATER 28AUG2023 29AUG2023 8/29/2023
MY HEALTH MEDISURE SUPER TOP UP INDIVIDUAL 28AUG2023 21AUG2023 8/21/2023
MY:HEALTH SURAKSHA 26JUL2023 07AUG2023 8/7/2023
MY HEALTH MEDISURE SUPER TOP UP FLOATER 25JUL2023 02AUG2023 8/2/2023
MY HEALTH MEDISURE SUPER TOP UP FLOATER 31JUL2023 01AUG2023 8/1/2023
MY: OPTIMA SECURE 30JUL2023 01AUG2023 11/1/2022
MY:HEALTH SURAKSHA 01AUG2023 02AUG2023 8/2/2023
MY:HEALTH SURAKSHA 25AUG2023 11AUG2023 5/2/2023
End Date Reporting Date Pol Issue Date Agent Code Agent Name
3/19/2024 8/4/2023 3/18/2023 '201890033453 ASMABEE FARHAN SHAIKH
8/30/2024 8/31/2023 8/26/2023 '201890033453 ASMABEE FARHAN SHAIKH
8/28/2025 8/29/2023 8/28/2023 '201890033453 ASMABEE FARHAN SHAIKH
8/20/2024 8/28/2023 8/28/2023 '201890033453 ASMABEE FARHAN SHAIKH
8/6/2024 8/7/2023 7/26/2023 '201890033453 ASMABEE FARHAN SHAIKH
8/1/2025 8/2/2023 7/25/2023 '201890033453 ASMABEE FARHAN SHAIKH
7/31/2024 8/1/2023 7/31/2023 '201890033453 ASMABEE FARHAN SHAIKH
10/31/2023 8/1/2023 11/4/2022 '201890033453 ASMABEE FARHAN SHAIKH
8/1/2024 8/2/2023 8/1/2023 '201890033453 ASMABEE FARHAN SHAIKH
5/1/2024 8/25/2023 5/3/2023 '201890033453 ASMABEE FARHAN SHAIKH
Branch Name State Name Zone Endorsement Type Business Type
MUM - CORPORATE OFFICE MAHARASHTRA WEST Cancellation Renewal
MUM - CORPORATE OFFICE MAHARASHTRA WEST Policy Portability
MUM - CORPORATE OFFICE MAHARASHTRA WEST Policy Renewal
MUM - CORPORATE OFFICE MAHARASHTRA WEST Policy Renewal
MUM - CORPORATE OFFICE MAHARASHTRA WEST Policy Renewal
MUM - CORPORATE OFFICE MAHARASHTRA WEST Policy Renewal
MUM - CORPORATE OFFICE MAHARASHTRA WEST Policy Renewal
MUM - CORPORATE OFFICE MAHARASHTRA WEST Endorsement New
MUM - CORPORATE OFFICE MAHARASHTRA WEST Policy Renewal
MUM - CORPORATE OFFICE MAHARASHTRA WEST Cancellation Renewal
Our Share GWP Share % Sum Insured OD TP SSE Name Vertical
.00 100 -300000 .00 .00 SHEKHAR LAXMAN POOJARY AGENCY-HEALTH
54500.00 100 1000000 .00 .00 SHEKHAR LAXMAN POOJARY AGENCY-HEALTH
10972.00 100 1000000 .00 .00 SHEKHAR LAXMAN POOJARY AGENCY-HEALTH
3630.00 100 2000000 .00 .00 SHEKHAR LAXMAN POOJARY AGENCY-HEALTH
33404.00 100 500000 .00 .00 SHEKHAR LAXMAN POOJARY AGENCY-HEALTH
29887.00 100 2000000 .00 .00 SHEKHAR LAXMAN POOJARY AGENCY-HEALTH
5280.00 100 2000000 .00 .00 SHEKHAR LAXMAN POOJARY AGENCY-HEALTH
2198.00 100 0 .00 .00 SHEKHAR LAXMAN POOJARY AGENCY-HEALTH
17508.00 100 500000 .00 .00 SHEKHAR LAXMAN POOJARY AGENCY-HEALTH
-7461.00 100 -500000 .00 .00 SHEKHAR LAXMAN POOJARY AGENCY-HEALTH
Sub Vertical Zero Dep Flag Emergency Flag LG Code Customer Name
AGENT N N VIJAY MAHADEO SALUNKHE
AGENT N N LEENA DEEPAK GANATRA
AGENT N N RAPHICK KHAN
AGENT N N JANAK N GHELANI
AGENT N N YATIN PRAMODCHANDRA SHROFF
AGENT N N AJITH ASHOK NAIR
AGENT N N VIKRAM MAHIPAT NIRMAL
AGENT N N SADANANDAN P
AGENT N N VIKRAM MAHIPAT NIRMAL
AGENT N N RUSHANG PATEL
User ID NCB
SHRADDHA.KADAM2 0
HELIOS.AUTOPOL 0
PORTAL 0
ANANT.JAIN 0
PORTAL 0
PORTAL 0
PORTAL 0
PORTAL 0
PORTAL 0
ANSHUMAN.SINGH2 0
POL_ENDORSEMENT_REASON
Policy cancellation request due to Fraudulent Claim - without refund - 72184992 POL_POSP_CODE

ONLINE NIL ENDORSEMENT FOR MANDATE ID

IN42521379
POL_POSP_NAME POL_VC_PAN_CARD POL_MOT_MANUFACTURER_YEAR
POL_MOT_MODEL_NAME POL_MOT_VEH_REGISTRATION_NUM
POL_MOT_MANUFACTURER_NAME Mot Registration Date CHASSIS NUM ENGINE NUM
CUST_EMAIL POL_FUEL_TYPE POL_GROSS_VEH_WT
SALUNKHEVIJAY123@GMAIL.COM
LEENADGANATRA@GMAIL.COM
WICKED.JONTY@GMAIL.COM
GHELANI440@HOTMAIL.COM
PRERANAPS@REDIFFMAIL.COM
AJITH_AJITH3@YAHOO.COM
VIKRAM_VF@YAHOO.COM
PSADANANDAN@REDIFFMAIL.COM
VIKRAM_VF@YAHOO.COM
PATELRUS2000@YAHOO.COM
CUST_MOBILE_NUMBER POL_DISCOUNT_FLAG RTO Location POL_EMI_OPTED
9757479649 N
9820755520 N
9439430055 Y
9820965996 N
9869117027 N
9076493023 Y
9821498062 N
9620434883 N YES
9821498062 Y
9867699079 N
POL_PAYMENT_INSTRUMENT_NO KYC ID User Id
' 'SHRADDHA.KADAM2
90200014018878 'K4YEMPQY2J 'MOHD.SIDDIQUI2
LH2308014804 ' 'PORTAL
902000140649481 ' 'ANANT.JAIN
MH2307013342 'PKG4R4DMJ6 'PORTAL
LH2307008020 ' 'PORTAL
LH2307009460 '2WA829FHZQ 'PORTAL
pay_MJPLAEYinoIWaE ' 'PORTAL
MH2308000034 '2WA829FHZQ 'PORTAL
' 'ANSHUMAN.SINGH2