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    hiteshmohakar15
    This document contains details of 7 employees enrolled in an insurance policy, including their names, dates of birth, ages, and policy coverage amounts. A total of 19 people are covered under the policy, including the 7 employees, their spouses and dependents. For each employee, their relationship to dependents is listed along with the dependent's name, date of birth, age, sex, and identification number. The policy provides ₹500,000 of floater coverage for each employee and their listed dependents. The document also states that insured persons will be notified about any future withdrawal from the policy 3 months in advance and will have the option to migrate to another similar health insurance plan.

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    0006

    Uploaded by

    hiteshmohakar15
    20 views4 pages
    This document contains details of 7 employees enrolled in an insurance policy, including their names, dates of birth, ages, and policy coverage amounts. A total of 19 people are covered under the policy, including the 7 employees, their spouses and dependents. For each employee, their relationship to dependents is listed along with the dependent's name, date of birth, age, sex, and identification number. The policy provides ₹500,000 of floater coverage for each employee and their listed dependents. The document also states that insured persons will be notified about any future withdrawal from the policy 3 months in advance and will have the option to migrate to another similar health insurance plan.

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    This document contains details of 7 employees enrolled in an insurance policy, including their names, dates of birth, ages, and policy coverage amounts. A total of 19 people are covered under the policy, including the 7 employees, their spouses and dependents. For each employee, their relationship to dependents is listed along with the dependent's name, date of birth, age, sex, and identification number. The policy provides ₹500,000 of floater coverage for each employee and their listed dependents. The document also states that insured persons will be notified about any future withdrawal from the policy 3 months in advance and will have the option to migrate to another similar health insurance plan.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    20 views4 pages

    0006

    Uploaded by

    hiteshmohakar15
    This document contains details of 7 employees enrolled in an insurance policy, including their names, dates of birth, ages, and policy coverage amounts. A total of 19 people are covered under the policy, including the 7 employees, their spouses and dependents. For each employee, their relationship to dependents is listed along with the dependent's name, date of birth, age, sex, and identification number. The policy provides ₹500,000 of floater coverage for each employee and their listed dependents. The document also states that insured persons will be notified about any future withdrawal from the policy 3 months in advance and will have the option to migrate to another similar health insurance plan.

    Copyright:

    © All Rights Reserved
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    Download as xlsx, pdf, or txt
    of 4

    Attached to and forming part of Policy P/161213/01/2018/003371

    INSURED PERSON DETAILS : No of Persons


    S.No Name of Employee Relationship DOB Age in Yrs Age in Mths
    I

    1 Praveen Kumar Employee 23/02/1982 35


    I I
    Dependant Details Relationship DOB Age in Yrs
    Parveen Kumari Spouse 09/01/1989 29
    Navya Badogu Daughter 29/03/2016 1
    Kanta Rani Mother 23/03/1961 56
    Ratan Mani Father 03/11/1949 68
    2 Risi Gaurav Employee 02/08/1989 28
    I I
    Dependant Details Relationship DOB Age in Yrs
    Vijay Mohan Verma Father 15/01/1957 61
    Dharna Verma Mother 07/07/1960 57
    3 Ankur Bhuvan Employee 04/03/1993 24
    I I
    Dependant Details Relationship DOB Age in Yrs
    Ajaykumar Father 29/07/1953 64
    Meena Kumari Mother 16/09/1955 62
    4 Shubam Shukla Employee 30/09/1989 28
    I I
    Dependant Details Relationship DOB Age in Yrs
    Narendra Kumar Shukla Father 15/07/1950 67
    Aruna Shukla Mother 24/10/1955 62
    5 Pradeep Kumar Satpathy Employee 18/05/1956 61
    I I
    Dependant Details Relationship DOB Age in Yrs
    Rashmi Satpathy Spouse 12/09/1957 60
    Suniti Upadhyaya Mother 27/08/1937 80
    6 Rajesh Kumar Employee 05/02/1984 34
    I I

    7 Mukesh Chand Employee I 25/01/1987 31


    I

    In the event of the policy being withdrawn in future, intimation about the withdrawal will be sent 3 months prior to the date when
    due.The insured will have the option of migrating to any other similar health insurance policy offered by the Company at the rele
    In witness whereof the undersigned being authorised by and on behalf of the company has I have herein to set his/ their hands at Branch Offi
    No of Persons Covered : 19
    ge in Yrs Age in Mths I Sex ID No Emp ld Occupation
    I I
    I
    11 Male 87493191800000100 1 Others
    I
    Age in Mths Sex ID No Remarks
    1 Female 87493191800000101
    10 Female 87493191800000102
    10 Female 87493191800000103
    3 Male 87493191800000104
    6 Male 87493191800000200 2 Others
    I
    Age in Mths Sex ID No Remarks
    0 Male 87493191800000201
    7 Female 87493191800000202
    11 Male 87493191800000300 3 Others
    I
    Age in Mths Sex ID No Remarks
    6 Male 87493191800000301
    4 Female 87493191800000302
    4 Male 87493191800000400 4 Others
    I
    Age in Mths Sex ID No Remarks
    6 Male 87493191800000401
    3 Female 87493191800000402
    8 Male 87493191800000500 5 Others
    I
    Age in Mths Sex ID No Remarks
    4 Female 87493191800000501
    5 Female 87493191800000502
    0 Male 87493191800000600 6 Others
    I

    0 Male 87493191800000700 7 Others


    I

    sent 3 months prior to the date when renewal falls


    cy offered by the Company at the relevant time. Continuity of benefits for waiting period and bonus, if any and if applicable, will be given pro
    erein to set his/ their hands at Branch Office - Karol Bagh on 16th Day of February 2018 .
    Floater SI No Dep. Remarks

    500000 4

    500000 2
    I

    500000 2
    I

    500000 2

    500000 2
    I

    500000 0
    I

    500000 0

    nd if applicable, will be given provided the insured had been renewing the policy without any break (or renewing within the grace period offe
    within the grace period offered)

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