22-01-2021

DR. E R D SILVA
NO 07 CONVENT ROAD , NEGOMBO , 11500

NOTICE OF LAPSE / බල රතෙ ෙදනය

Dear Policy holder,

We kindly advise you that your valuable Life Insurance Policy has Lapsed due to non-payment of premium in time.
Please note that as from the time of lapse, all benefits under the Policy cease to be operative until revival.

Therefore, we most earnestly request you to revive the Policy as soon as possible, and for this purpose you may
please contact our nearest Branch Office or your Insurance Representative. In the alternative you may contact us
direct, where we shall be glad to assist you.

තව ඔ ය,

ඔබ  ලබාගනා ලද වනා ත රෂණ ඔව සඳහා ෙගය  වාර ද යත කාලය ල
ෙගම මගහැ ඇ බැ දැනට ෙමම ඔව බල රත ඇ බව කාරැකව දවා . ඔව බල
රත  ට එය නැවත පාණව කරන රැ ඔබ අෙෂා කළ පලාභ ෙනාලැෙබන බව දවා .

එබැ ඔව යථා තවයට ප කර ගැමට අවශ තර ඔබෙ රෂණ අෙල ළධාවරයා ෙග
ෙහ ළගම ඇ අපෙ ශාඛා කායාලෙය ෙහ අප ආයතනෙය මසන. ඒ සඳහා අපෙ උපම සහය
ඔබට ලැෙබ ඇත.

Assistant General Manager- Life

සහකාර සාමානාකා - ත

We would be much obliged if you could inform us your e-mail address and the Telephone number.
ඔබෙ ඊ-ෙ නය සහ රකථන අංකය අප ෙවත දවා එවෙ න අප ඔබට ෙබෙහ කෘතඥ
ෙව.

This is a computer generated statement, No signature is required.

ෙමම පකාශනය පඝණක තය බැ ෙම වලංතාවය උෙදසා අස ම අවශ ෙනාෙ.

Union Assurance PLC (PQ12), No. 20, St. Michael's Road, Colombo 03, Sri Lanka
Telephone: Hotline (+94) 112 990 990 | Shortcode: 1330 | General (+94) 112 990 000 | Fax: Life Insurance: (+94) 112 438 165
Human Resources (+94) 112 320 595 | Email: info@unionassurance.com | Website: www.unionassurance.com 1/2
 NOTICE OF LAPSE / බල රතෙ ෙදනය

Policy Number/ ඔ අංකය Date of Lapse / බලරත  නය

0011008902101 2021-01-20

Premium / වාකය Mode / ෙගෙ ආකාරය

Rs.5,531.00 Monthly

Arrears from / ඟ වාක ට To / දවා

2020-12-21 2021-01-21

Late fee / පමාද ගාව

Rs.0.00

Amount received after date of lapse / බලරත  පව ලැ දල

Rs.0.00

Total amount payable / ෙගය   දල

Rs.11,062.00

If this policy has been revived after the date of this statement please ignore same.
ෙමම ෙදනෙ නට පව ඔව පාණව කරන ලෙ න ෙමය ෙනාසලකා හන.

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