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Reliance Individual Mediclaim Policy Schedule
Reliance Individual Mediclaim Policy Schedule
, 570, Naigaum Cross Road, Policy Servicing Branch Office : Reliance General Insurance Co. Ltd,
Next to Royal Industrial Estate, Reliance General Insurance Co Ltd 202-21 2nd Floor MERCANTILE HOUSE
Wadala (W), Mumbai – 400031 KASTURBA GANDHI MARG New Delhi
New Delhi 110001
Name of Insured Person Gender Date of Relationship with Occupation Pre-Existing Sum Domiciliary Amount Loading Premium
Birth the Proposer Illness Insured (Rs) Hospitalisation of CB (%) (Rs)
Limit (Rs) (Rs)
KOUSHIK DUTTA Male 28/12/1980 Self Others 50000.00 500000.00 555000.00 0 18110.00
APARNA GAWAS Female 21/10/1986 Spouse Others
* Where an Insured Person is added to this Policy, either by way of endorsement or at the time of renewal, the pre-existing disease clause,first year exclusion and 30 days waiting period is
applicable considering such policy period as the first policy with us.
* Policy would be considered as a fresh policy if there would be break of fifteen or more days between the prevoius policy expiry date and current policy start date.
* Any enhanced Sum insured during subsequent policy renewals will not be available for an illness, diseases, injury already contracted under the preceding policy periods.All Waiting periods
as defined in the policy shall apply for this enhanced limit from the effective date of enhancement of such Sum Insured.
* This Insurance is subject to the terms and conditions of policy attached .The policy wordings with detailed terms , conditions and exclusions is available on our website
www.reliancegeneral.co.in
Special Conditions, if any :
Premium Certificate
Premium Certificate for the purpose of deduction under Section 80-(D) of Income Tax (Amendment) Act 1986.
This is to certify that KOUSHIK DUTTA has paid Rs.20348 (TWENTY THOUSAND THREE HUNDRED FOURTY EIGHT) towards premium for Health Insurance for the Period From
00:01 on 25/05/2016 to Midnight of 24/05/2017 on May 25 2016
Policy Number : 1301812821000291
Date : 25/05/2016 Place : Mumbai
Note: This certificate must be surrendered to the Insurance Company for issuance of fresh certificate in case of cancellation of policy or any alteration in the insurance affecting the
premium.
Registered Office: Reliance Centre, 19, Walchand Hirachand Marg,Ballard Estate ,Mumbai - 400 001