Policy No.: P/700019093/00754/0 Previous Policy No.

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Proposer's Code: 3629868 Issuing Office Code: 03148119
Proposer's Name: LUMBUNOV VALERII Issuing Office Name: Online Business
Address: Address:
RUSSIAN FEDERATION 20 Gracechurch Street,
London,
United Kingdom,
EC3V 0BG

Phone No.: +7 902 534‑44‑86 Toll Free No.: 0800 111 4004
E-mail id: lumbunovv@gmail.com E-mail id: info@axahealth.co.uk
Proposal date: 28.05.2024 Fulfiller Code: SO700002 Sector: Urban
Date of Inception of first policy: 27.05.2024
Renewal Year: NEW
Receipt No.: 1272007865
Receipt Date: 28.05.2024
Service Tax: 170USD
PERIOD OF INSURANCE FROM: 27.05.2024 TO: 27.05.2024

SCHEME - DESCRIPTION: 1 ADULT

PLAN - DESCRIPTION: BASIC
LIMIT OF COVERAGE: 125,000 GBP

Name of the Insured Sex Date of Birth ID Card No.

LUMBUNOV VALERII MALE 08.02.1980 3629868