STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED

FAMILY HEALTH OPTIMA INSURANCE POLICY - SCHEDULE

PoT\cy Mo.
7UUU€'¥
Online Business
Address E -4a A « UNWAR s INGH NAGAR Address No:111 -11 g,Gpkul Arc•Re-A ¥ s\ Floor
NA NGLO I Sa nar R oacl Viie Parle tEas\y
fdEAR NJLOTHT MO R Mumbai - 40O0ñi7
ONLINE BUSINESS
New Deln .west.Dem -110041
viir•ee••o 180a -42 ñ'-225ñi
online s tarruzattn.i n
Fu\fi\ler Cooe
I nterrnedlary Code Ii I fHlflfHlf lfHflfJ
PenmolYear NEW
^«ce'p'wo lz zuu 0o4 Name ' i Delhi ’f’elesnles
Receipt Date - oz 07. g014
PromJum - Rs ñ'.400.00 . - Sluice To R 6s z. oo .’ '
Phone Na
S temp g q ty ! Re 1.00 '- Total PrcmJum : Rs B ,067 .00 '’ -
N IL
Total Premium In words : Rupeee six Tnousan•s slxtv-seven only
PERtOO OF THSUPANCE FROfd , 05.’07.’2014 00:00:00 To , Midnight Of 02/07/2015
W FtEME • DEWRTPWON . 2 ADULTS + 1 CHILD sAsic receive sum i surtzo "° *o°ooo i inree Lunas oniy
LTMTT OF LOVERAGE . Rs.u00o00 /'- Sonus
Dial laof In an red W rsona .

s\. N e ,\ \tt„p gel one of glrtfi Age-y•s'uths 9eTatlonshle wnn Pte ExIs\Tng 0›seaee'’s TO cara W
No. Proposer

NDNE

FEMALE O 1 -07- 1. 987 27 Yrs 0 kTths SPDUSE NONE 36298672

NONE 3629867-3
CHILD
Wzrianted lhzt in case of d+shonor of pre m ium nhcquc (s), the Co mpa\Jy shzJI not L+o 1izbIc undc r the policy znd
I fro m i r›ceptio nJ.
Expc n scs rel ating to 4hc ho spJtal is alion w'i II be in proportion to th c room rant stated in the palicy.

UMDEP TH TS PDLJOY TS SUBJECT TO FOR DATMOMS, CLALIS ES. +f ARRANF TE S. EXCLUS IONS ETC., ATTAO HED.

iu zue EvEuz or nosoiraLiza iou or iusunEo oeasou. mzixsa”non suou¢o eE oivEu zo znE coueaMv ixsuEoia Euv,
MowEvER, wlTHiN 24 hRs rRGikñ TwE nME or AoMTssToN.

In Ine even1 gf tne r›oJioy be ir+a withdrawn in future. int•ma\ on soou1 Inc xv•tnora yoI wifi be sent 3 months prior to one ooze wnen renewal fails
due .Th e in sured wifi have the option of m ig raling to any a:hor si milar hcaJlh insurance palicy of f cr ed by the C ompanj/ at who mIcva‹it tim e.
Continuity of oe new Is tor waiting perloo and bonus. If any aria if ap4 icaDie . wiil be given prov ioeo the insured nad oeen re•tewiiq tne loiict
withou” zny brezk (ot rertewi ng a'i1hin tha grace ps nod af f ered)

Tn w tr\ess whereof the a are signeo DeiiJg au tnorized by ano on bena\T o\ the comocny lfas :et this naitd at Online eus ness

Entered 0y : STAR PORTAL Th.: i: 4n c! • '•• °!*r Fo i Star Uealtn ano All ed In sri ance Compa icy Ltd.
IRDA Regn. No 1. 29 generated don menl{ Po-ch
Corporate Identity Number, U66010T@t 9
Gmail ID : info@'starheaIth.in D:1b05P0I?