Certificate of Insurance MONEYMILE MARKETING SERVICE PRIVATE

Group Policyholder Name

LIMITED
Ms Santhi S Group Policy No. 49905259
2 /71 -s, Lemon Tree Logout, Jekkaraplli, Bayanapa
Certificate of Insurance No 84778919
Krishnagiri
Krishnagiri Plan Name Group Care 360°(MMSPL)-PA
Krishnagiri 635115 Cover type Individual
Tamil Nadu 33 Policy Period - Start Date 00:00 hrs 06/Jun/2024
Policy Period - End Date Midnight 05/Jun/2025
Nominee Name (Relation) Anandhakumar Raja (SON)

Premium Paid Rs. 432.00

Premium Rs 366+CGST Rs 0.00+IGST Rs
65.88+SGST Rs 0.00+UGST Rs0.00
Premium Payment Mode ANNUAL PREMIUM

Details of Applicant

Policyholder Date Of Birth Client ID

Ms Santhi S 17-Jan-1976 B9272722

Details of Insured Person

Insured with the

Name Client ID Date of Birth Relationship Pre-existing diseases since
Company (since)

Santhi S B9272722 17-Jan-1976 MEMBER 06-Jun-2024 NONE

Contact details for Claims & Policy Servicing

Care Health Insurance Limited, Vipul Tech Square, Tower C, 3rd Floor, Golf Course Road, Sector-43,
Correspondence address
Gurugram-122009 (Haryana)

E-mail ID for Claims claims@careinsurance.com

Website www.careinsurance.com

Intermediary Details

Name Code Contact Details

INSUREMILE INSURANCE WEB AGGREGATOR PVT LTD 20185414 8971389714

Benefits
S No. Particulars Basis of Offering

1 Personal Accident-Sum Insured 1500000

2 Accidental Death 100% of SI
3 PPD Up to SI; As per PPD table of GC360
4 PTD Up to SI: As per PTD table of GC360
2000 per day with a deductible of 1 day for maximum 30 days (
5 Daily Cash
Only for Accidental Hospitalization)
6 Accidental OPD 500
Key Exclusions
The company shall not be liable to make payment for any claim directly or indirectly caused by, based on, arising out of howsoever
attributable to any of the following except covered by way of an extension: page3
l Treatment taken from anyone who is not a Medical Practitioner or from a Medical Practitioner who is practicing outside the discipline
for which he is licensed or any kind of self-medication.
l Charges incurred (or Treatment undergone) in connection with routine eye examinations and ear examinations, dentures, artificial
teeth and all other similar external appliances and / or devices whether for diagnosis or treatment.
l Treatment of any external Congenital Anomaly or Illness or defects or anomalies or treatment relating to external birth defects.
l Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during
hospitalization)or expenses towards lawful medical termination of pregnancy during the policy period.
l Cosmetic surgery or plastic surgery or related treatment of any description, including any complication arising from these treatments, other
than as may be necessitated due to an Injury, cancer or burns
l Any Illness or Injury directly or indirectly resulting or arising from or occurring during commission of any breach of any law by the Insured
Member with any criminal intent
l Act of self-destruction or self-inflicted Injury, attempted suicide or suicide while sane or insane
l Any Illness or Injury attributable to consumption, use, misuse or abuse of intoxicating drugs or alcohol or Tobacco (in any Form like cigarettes
or Gutka etc..)or any other hallucinogens drugs.
Note: This is an illustrative list of exclusions. Please refer Group Policy Terms and Conditions at our website www.careinsurance.com or Group
Policy T&C issued to the Group Master Policy Holder.

Portability/Renewability
S NO. Particulars

1. You can renew the policy only if Master Policy is renewed by Group Master Policyholder.

Care Health Insurance reserves the right to change premium/benefits of the Group Policy at the time of Renewal in consultation
2.
with Master Policy Holder.
You can migrate your existing Policy from this scheme to any Health Insurance retail product of Care Health Insurance. Policy
3.
Issuance subject to Underwriting guidelines of company on the date of migration.
Once the Group Care Health Insurance policy is migrated to retail product of Care Health Insurance, customer will have to pay
4.
premium as per the New product underwriting guidelines.

Grievance Redressal/Complaints
In case of any grievance the Insured Person may contact the Company through
Website/link:https://www.careinsurance.com/contact-us.html
Mobile App : Care Health- Customer App
Toll free (WhatsApp Number): 8860402452
Courier: Any of Company's Branch Office or Corporate Office
Insured Person may also approach the grievance cell at any of the Company's branches with the details of grievance.
If Insured Person is not satisfied with the redressal of grievance through one of the above methods, Insured Person may contact the
grievance officer at Branch Office or corporate office.
For updated details of grievance officer, kindly refer the link- https://www.careinsurance.com/customer-grievance-redressal.html
If Insured Person is not satisfied with the redressal of grievance through above methods, the Insured Person may also approach the
office of Insurance Ombudsman of the respective area/region for redressal of grievance as per Insurance Ombudsman Rules 2017. The
details of insurance ombudsman offices may be referred in the annexure shared along with the Master policy document.
Grievance may also be lodged at IRDAI integrated Grievance Management System -https://bimabharosa.irdai.gov.in/
For Care Health Insurance Limited

Authorized Signatory

Date of Issue : 05/Jun/2024

Place of Issue : Gurgaon, Haryana
Service Branch : Site No8 80 ft road4th Block ST Bed area Koramangala Branch Contact No. 9289454741
Bangalore Karnataka 560034Bangalore,Karnataka,560034 :

Consolidated Stamp Duty paid vide E-Challan GRN no. 0107464159 dated 21 Sep 2023, RCM Applicability- N/A
SAC: 997133 and Description of Service: Accident and Health Insurance Services State
GSTIN No.: 29AADCR6281N1ZO
UIN :RHIHLGP20126V011920
CIN: U66000DL2007PLC161503
Note:
1- Validity of this certificate is subject to terms and conditions of Group Policy issued to the Group Policyholder.
2- In event of non-receipt of Premium, this certificate of insurance automatically stands cancelled from inception, irrespective of whether a
separate communication is sent or not. This policy is based on the information provided by the Insured to the Group Administrator. In case
you find any discrepancy in the same, please contact us immediately.
3- This Certificate of Insurance is governed by and is subject to the Terms and Conditions of the referred Group Policy.
Premium Acknowledgement
Policy No. 84778919
Client ID B9272722
Policyholder Ms Santhi S
Address 2 /71 -s, Lemon Tree Logout, Jekkaraplli, Bayanapa
Krishnagiri
Krishnagiri
Krishnagiri 635115
Tamil Nadu 33

Policy Period 06/Jun/2024 to 05/Jun/2025

Premium Details
Particulars Amount (in Rs.) S.no. Receipt Number Amount Mode of Payment
1 B0673314 432.00 IPG
Gross Premium
Group Care 360° 366.00
Goods & Services Tax (GST) 65.88
Total 432.00
The Premium is rounded off to the nearest rupee.

Signature Not Verified

For Care Health Insurance Limited
Digitally signed by Manish Dodeja
Date: 20240605173508
Reason: I'm the author
Location: India

Authorized Signatory
Date of Issue : 05/Jun/2024
Place of Issue : Gurgaon, Haryana
Note:
1) In case of any discrepancy, the Policyholder is requested to contact the Company immediately.
2) Any amount paid in cash towards the premium would not qualify for tax benefits as mentioned above.
3) This document must be surrendered to the Company in case of Cancellation of the Policy or for the issuance of a fresh
certificate in the case of any alteration in the Policy.
4)This Policy is issued subject to realization of the premium amount. In case the instrument given towards the premium
amount is dishonored, then the cover provided under this Policy shall automatically get cancelled. In the given scenario, if
any amount has been paid by the Company in respect of a claim or due to any other reason than the amount so advanced
by the Company shall be refunded to the Company forthwith.
5) We may credit upto Rs. 1/- to your account for validation, before remitting any further payment.