IMPORTANT

To, 27-JUN-22

Rishi Kochar
GH-1/235, Archana Apartments
Paschim Vihar, West Delhi

New Delhi -110063

Mobile : 9711696261

Dear Customer,

Re: Health Insurance Policy - P/161100/01/2023/011212

We are extremely thankful for availing health insurance from us and we enclose the policy along with the terms and
conditions.

The said policy has been prepared based on the details furnished by you in the proposal form (copy enclosed) and the
medical reports, wherever applicable. We shall thank you if you can verify the policy to ensure that all the details are
incorporated correctly as per the proposal. In case of any discrepancy noticed, please communicate the same to us
immediately. You will appreciate that it is the primary duty of the proposer to fill the proposal form and also to make sure
that the proposal contains all the details correctly so also the policy has incorporated the details correctly. If you or any
of the insured person(s) have suffered or suffering from any of the diseases which has not been mentioned in the
proposal, the claim that may arise will result in the repudiation of the claim/ cancellation of the policy. The other option
for you is to continue with the previous insurer.

This insurance policy is subject to various exclusions including exclusion for pre-existing diseases and conditions in this
policy.

We would like to mention that we have incorporated the name of the intermediary as indicated by you in the proposal who
will be of assistance to you.

The policy is subject to the condition of "free look period". As per this condition, a free look period of 15 days from the date
of receipt of the policy is available to you to review the terms and conditions of the policy. In case you are not satisfied
with the terms and conditions, you may seek cancellation of the policy and in such an event, we shall allow refund of
premium paid after adjusting the cost of pre-acceptance medical screening, if any, stamp duty charges, and
proportionate risk premium for the period on cover, provided no claim has been made until such cancellation.

We wish you good health and we look forward to serve you in the days to come.

With kind regards,

Authorised Signatory
"Let Star Health help you to become healthier and happier. Star Wellness Benefits includes Mind Body healing and other
Condition management programmes (Weight management, Diabetes etc....) Visit www.starhealth.in / customer portal login and start
your journey with us to Better Health".

In case of a need for hospitalization, kindly prefer our network hospital (list is available in our website) for a quick
response to your claim request.

Please select the room as per your eligibility stipulated in your policy to avoid additional payment from your
pocket towards the proportionate increase which would invariably be charged by the hospital for the higher
room category occupied.

Sum insured of this Policy is meant for utilization till its expiry. Bearing this aspect in mind, we have no doubt, you will
choose appropriate hospital, room rent and treatment charges, etc.

Should you need any assistance, our customer care will be delighted to assist you, whose toll free no. is 1800-425-
CN=RMargabandhu
SERALNUMBER=0082dc76d6537e33318479e45e7b43861b154
75488cd3b2c3c26c3c9ST=TAMLNADUOD25417=600034

2255/1800-102-4477. R Margabandhu OD25420=513b7b332ce96023148ea208744690e09638750806c

a6589e151795e50aOU=UNDERWRTNG-CheRskOcer
O=STARHEALTHANDALLEDNSURANCECOMPANYC=N
DaeSunJun27122139ST2021

Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800 Toll Free Fax No:1800-425-5522
Toll Free No:1800-425-2255 / 1800-102-4477,CIN :U66010TN2005PLC056649 Email :support@starthealth.in Website :www.starhealth.in IRDAI Regn.no: 129
 YOUNG STAR INSURANCE POLICY
SCHEDULE (Individual)
UNIQUE ID:SHAHLIP22036V042122

Policy No. : P/161100/01/2022/011212 Previous Policy No.:360303502010000951

Customer Code : AA0019457798 GSTIN : 07AAJCS4517L1Z0
Customer Name : Rishi Kochar SAC Code : 997133/Accident and Health Insurance Services
Proposer's Code : 22625697 Issuing Office Code : 161100
Proposer's Name : Rishi Kochar Issuing Office Name : Area Office - Delhi
Address : GH-1/235, Archana Apartments Address : 1st Floor, Himalaya House, 23,
appart Paschim Vihar, West Delhi Kasturba Gandhi Marg,
New Delhi - 110001.
New Delhi-122003
Phone No : /9711696261/ Phone No:011- 23464610
E-mail Id : rishikochar294@gmail.com E-mail Id : delhi.ao1@starhealth.in
Proposer GSTIN : - Place of Supply:-
Proposal date : 27/06/2022 Fulfiller Code:SH46541
Date of Inception of first policy : 01-JUL-2022
Renewal Year : Intermediary Code : BA0000407332
Collection Number : 1061012058
Name : Mr.SANDEEP BAJAJ
Receipt Date : 27/06/2022

Premium :Rs 44,000 /- Phone No : 9891538356/9891537556

CGST @9% : 3,960 /- SGST @9% : 3,960 /- E-mail Id : SANDEEP.BAJAJ53@YA
HOO.IN
Stamp Duty :Rs 10 /- Total Premium :Rs 51,930/-

Total Premium In Words : Rupees Fifty One Thousand Nine Hundred Thirty Only Installment Facility Optn :No
Premium Payment Frequency : Annual Installment Amount Rs. : 0

Period of Insurance : FROM 01/07/2022 00:00 TO : Midnight of 30/06/2023 Term : 1 Year

Details of Insured Persons :

Age in Relationship Pre Existing Disease Inception

Sl. Name of the Insured Sex Date of ID Card No Plan Sum Insured Bonus Date
Yrs with
no. Birth Proposer
1 Rishi Kochar M 16/02/1994 28 SELF 22625697-1 GOLD 5000000 0 No PED declared 01/07/2022

Please check whether the details given by you about the insured persons in the proposal form are incorporated correctly in the policy schedule. If you
find any discrepancy, please inform us within 15 days from the date of receipt of the policy, failing which the details relating to the insured person
given in the policy schedule are deemed to have been accepted by you.
Warranted that in case of dishonor of premium cheque(s), the Company shall not be liable under the policy and the policy shall be void abinitio
(from inception).
Sector Classification :

Entered by : STAR_PORTAL For Star Health and Allied Insurance Company Ltd.
Approved by : SH0561

IRDAI Regn. No 129

Corporate Identity Number U66010TN2005PLC056649 Authorised Signatory
Email ID : info@starhealth.in
2 of 6

Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800 Toll Free Fax No:1800-425-5522
Toll Free No:1800-425-2255 / 1800-102-4477,CIN :U66010TN2005PLC056649 Email :support@starthealth.in Website :www.starhealth.in IRDAI Regn.no: 129