Magma HDI General Insurance Company Limited

Renewal Notice for Your OneHealth Policy

Date: 26/12/2021 Branch name JAIPUR

Branch address 3RD FLOOR, "PRESTIGE TOWER", E-1,
To, AMARAPALI ROAD, ,VAISHALI NAGAR ,
Mr GANGA SAHAY JAIPUR -302021 ,RAJASTHAN , PH:
R/O E - 23, PHASE - 3, JHALANA DOONGRI NEAR CHAMAN KIRANA STORE (141) 4515600
JAIPUR GST Number - 08AAGCM1685C1ZJ
JAIPUR Tel. no. of branch PH: (141) 4515600
RAJASTHAN 302004 Agent code POS0005915-AFYPA5267L
8619137181 Agent name DINESH KUMAR
SRIDHARJAIPUR@GMAIL.COM Agent Contact no. 9602029955

Dear Mr GANGA SAHAY

Your OneHealth policy with policy no. P0021100004/6111/100460 is expiring on 27/01/2022

We request you to renew your policy on or before this date to continue enjoying comprehensive health coverage under our OneHealth policy.

Policy details:

Relationship with
Insured Name Date of Birth Pre-existing disease Sum Insured NCB Optional Cover* Amount claimed
proposer
GANGA SAHAY 10/12/1982 Self 500000 50000
SUMAN 16/07/1984 Spouse 500000
LOKESH KUMAR
21/04/2004 Son 500000
ALORIYA
SANJANA
14/10/2005 Daughter 500000
ALORIYA

*The optional covers will be renewed only if there was no claim under these covers in expiring policy for respective member. Premium shown in below table are
inclusive of these if available as per this condition.

With increasing cost of medical treatment, your current Sum Insured may not be sufficient. As our valued customer we offer you an option to increase your Sum
Insured:

Current SI
SI 500000
Gross Premium 10778.56
Loading 0
Fitness Rewards discount 0
Other discounts 538.93
Net premium inc GST (1 yr tenure) 12083
Net premium inc GST (2 yr tenure) 21622
Net premium inc GST (3 yr tenure) 31479

Applicable premium shown above are inclusive of cross sell discount, however, it would be applicable only if your other policy with Magma HDI is active as on
date of renewal of this policy.

Declaration: Please provide following declaration if you wish to opt our Step up offering
Post inception of your health policy with us, did you suffer from or currently suffering from any disease/illness/injury/medical condition except for common cold or
fever?
Yes No If Yes, Name of disease:__________________________ Date first diagnosed:_________________________

Please note that the acceptance of higher SI is subject to our underwriting guidelines. In case higher SI option is not acceptable, we will renew our policy as per
expiring SI and refund the extra premium paid by you.

Policy holder's signatures:_____________________________

You can pay this premium directly at any of our branches or you can connect with our Insurance intermediary for assistance for policy renewal.
If you have not yet claimed for earning Fitness rewards, and wish to do so, please claim it at least 15 days before your renewal due date by filling the Fitness
rewards earning form available on our website www.magmahdi.com

Authorized Signatory
UIN: MAGHLIP222V032021

Signed by : Magma HDI General Insurance Company limited

Time & Date : 26-Dec-2021 13:27:49 IST