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HEALTH CARD

Policy No: OG-13-1901-8403-00000021


Valid Upto: 31-DEC-2012
Name : MOHAMMED RIYAZ AHMED
Gender : MALE
Date of Birth : 02-Oct-1991
ID Card No : SKI-12-6618
Company Name : Skf India Ltd
CAShLESS h0SP|IAL|ZAI|0N SUBIECI I0 PR|0R APPR0VAL |R0N BAIAI ALL|ANZ 0NLY
24 h0URS hELPL|NE 1800 105 2529 * /(020) 50505858 **
*Io|| free Number **SI0
Signature of Policyholder
Cashless hospitalisation in network hospitals can be obtained only if this card is produced alongwith a
letter of authorisation from Bajaj Allianz except for emergency cases. This is subject to terms and
conditions of the policy.
Please quote your ID number for assistance. Intimation to Bajaj Allianz Helpline is mandatory in case of
any hospitalisation.
HOSPITAL ALERT:In emergency,Patient may approach with ID card;please call Bajaj Allianz helpline to
verify coverage and cashless authorization.
BAJAJ ALLIANZ
GE Plaza,Airport Road,Yerwada,Pune-411006.Phone:(020) 30512200 Fax:(020) 30512224
Email:health@bajajallianz.co.in/ Website: www.bajajallianz.co.in
Ihis card is not a credit card and is propert] of Bajaj A||iant

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