Phone: +91 22 6700 1313 Fax: +91 22 6700 1606

Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656

SECURE HEALTH CONNECT POLICY

RENEWAL INVITATION
Policy Issuing Office: 10th Floor, Tower A, Peninsula Business Park, Ganpatrao Kadam Marg, Lower Parel, Mumbai - 400013. Phone: +91 22 67001313 Fax: + 91 22
67001606.

Policy Number 4218-200503-22-7000867-05-000 Date : 0 3 1 1 2 0 2 3

Insured Name Mr Ramesh Kumar Luthra
& Address S/O PIARA LAL LUTHRA, GALI DARBAR SAHIB WALI, Policy Servicing Office/ Code: Liberty General Insurance, 8th Floor, Burj Punjab,
DARSHANI GATE, DHARAR, AMRITSAR, AMRITSAR, PUNJAB - Sco 9,Ranjit Avenue, ., Punjab - 143001 Fax: +91
143115 22 67001606

Intermediary Name PANKAJ AGGARWAL

Intermediary Code IMD1110238 Intermediary Contact No. 9216613217

Ref: Renewal of your Secure Health Connect Policy Policy Number 4218-200503-22-7000867-05-000,Plan Secure Supreme

Dear Mr Ramesh Kumar Luthra,

We thank you for choosing Us for your Insurance needs. We wish to remind you that your policy is due for renewal. Your Policy Expiry Date is 16/01/2024 for which the renewal
Amount is INR. 29732.00 (Inclusive of GST). Kindly pay the premium before expiry to avail continuity benefits as offered under the Policy.

This Renewal Notice is generated considering your claim status available with us as on 03/11/2023. The Cumulative Bonus mentioned on this renewal notice is subject to
change, based on the actual claim status as on the expiry date of the current policy.

Please note that the Policy covers dependent children up to the age of 25 yrs only. Renewal premium quoted below does not include premium for children above 25 yrs.
Renewal invitation for such persons above 25 yrs is being sent separately. In case of non receipt of such Renewal Invitation or for any further assistance, please feel free to
write to us on care@libertyinsurance.in or call us on our Toll Free number 1800 266 5844 (between 8:00 am to 8:00 pm, 7 days of the week) . You may also visit our nearest
Branch or contact our Agent.

For and behalf of Liberty General Insurance Limited

(Authorized Signatory)

Trade Logo displayed above belongs to Liberty Mutual and used by the Liberty General Insurance Limited under license.
Your Renewing Policy Details

Insured Member Details Member Names Member Member Age on Relationship Sum Loyalty
Gender date of renewal with Proposer Insured Perk Earned
First Insured Person Mr RAMESH KUMAR LUTHRA Male 64 Self
400000 200000
Second Insured Person Mrs USHA RANI Female 56 Spouse

Do let us know if there is any change in the above information.

Renewal Premium Computation

Insurance is the subject matter of solicitation.

Policy Period: 1 Year Installment Opted: No

Installment Option: NA

No. of Installment Installment Premium GST (@ 18%) Installment premium with GST

NA NA NA NA
Renewal premium - Please pay by Cheque or DD only
The First Installment will be payable before the commencement of the Policy and remaining Installments will be auto-debited as per your Instructions received to us prior to
this policy.
**Please note that the premium reflected in this notice is subject to change in following any revision in tax & cess rate announced by the Govt. of India from time to time and
such revised tax & cess rate will then be charged on the net premium reflected in this notice.
**Please Note - If you wish to alter existing premium payment facility such as change in Installment option/ opt for Installment facility/ opt for full premium payment facility
kindly contact our Agent or visit our nearest Branch. % DSUnknown
q
1G
1g
0.1 0 0 0.1 9 0 cm
0 J 0 j 4 M []0 d
1i
0g
313 292 m
313 404 325 453 432 529 c

**Once the Policy is renewed with us, you will get your Policy Schedule for the current duration. We wish to inform you that the Policy wordings are unchanged and available
478 561 504 597 504 645 c
504 736 440 760 391 760 c
286 760 271 681 265 626 c
265 625 l
100 625 l
100 828 253 898 381 898 c
451 898 679 878 679 650 c
679 555 628 499 538 435 c
488 399 467 376 467 292 c
313 292 l
h
308 214 170 -164 re
f
0.44 G
1.2 w
1 1 0.4 rg
287 318 m
287 430 299 479 406 555 c
451 587 478 623 478 671 c
478 762 414 786 365 786 c
260 786 245 707 239 652 c
239 651 l
74 651 l

on our website:www.libertyinsurance.in to view and download.

74 854 227 924 355 924 c
425 924 653 904 653 676 c
653 581 602 525 512 461 c
462 425 441 402 441 318 c
287 318 l
h
282 240 170 -164 re
B
Q

Digitally signed by:

SACHIN JOSHI
We never want to miss any opportunity to serve a valued Customer like you, so always keep us updated with your: Date: 2024-01-20
15:49:54 IST
Reason: LGI
Location: Mumbai
www.libertyinsurance.in
 Phone: +91 22 6700 1313 Fax: +91 22 6700 1606
Email: care@libertyinsurance.in
IRDA registration number: 150 • CIN: U66000MH2010PLC209656

Address & Pin : Mobile:

Res. Phone:

Email ID : Off. Phone:

Payment Details

ü I support "Go Green" and agree to refer to the policy wording and hospital list on the Liberty website.
If you still require a copy of the above, please call us on our toll free no. 1800 266 5844 and we will be happy to assist you.
Please write your renewal premium Cheque or Demand Draft in favour of : Liberty General Insurance Limited
Cheque / DD Number : _________________________________ Dated :

Amount : INR. _____________________________________________________________________________________________________________________

Name of the Bank & Branch : _____________________________________________________________________________________________________________
Signature of Insured / Insured Person : ______________________________________________________________________________________________________
Date :

Branch Name / Branch Code / SM Name / SM Code : ________________________________________________________________________________________

For more details on risk factors, terms and conditions please read sales brochure carefully before concluding a sale.

ARN :

Trade Logo displayed above belongs to Liberty Mutual and used by the Liberty General Insurance Limited under license.
Insurance is the subject matter of solicitation.

% DSUnknown
q
1G
1g
0.1 0 0 0.1 9 0 cm
0 J 0 j 4 M []0 d
1i
0g
313 292 m
313 404 325 453 432 529 c
478 561 504 597 504 645 c
504 736 440 760 391 760 c
286 760 271 681 265 626 c
265 625 l
100 625 l
100 828 253 898 381 898 c
451 898 679 878 679 650 c
679 555 628 499 538 435 c
488 399 467 376 467 292 c
313 292 l
h
308 214 170 -164 re
f
0.44 G
1.2 w
1 1 0.4 rg
287 318 m
287 430 299 479 406 555 c
451 587 478 623 478 671 c
478 762 414 786 365 786 c
260 786 245 707 239 652 c
239 651 l
74 651 l
74 854 227 924 355 924 c
425 924 653 904 653 676 c
653 581 602 525 512 461 c
462 425 441 402 441 318 c
287 318 l
h
282 240 170 -164 re
B
Q

Digitally signed by:

SACHIN JOSHI
Date: 2024-01-20
15:49:54 IST
Reason: LGI
Location: Mumbai
www.libertyinsurance.in