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CERTIFICATE OF INSURANCE EASY DOMESTIC TRAVEL INSURANCE [PLATINUMPLUS]

The benefits available are described in the Policy and will be subject to the policy terms, conditions and exclusions. The complete policy terms, conditions and exclusions can be viewed or downloaded online from [www.apollomunichinsurance.com]. A copy of this Certificate of Insurance must be carried by the Insured Person during the Risk Period. Please refer to the policy wordings or contact us for any further information or clarification. Policy details : Policy No: Risk Period: 900001/35001/A000000249 From 08-Feb-2013 16:05 hrs or the boarding of the carrier from the place of origin, whichever is later (Commencement of Risk Period) Insured Persons name Charik Jain Certificate No : A000000249/158125

To 09-Mar-2013 16:05 hrs or the return to the usual place of residence, whichever is earlier. (Expiry of Risk Period)

Insured Person's Persons' details : Member ID Y0609429 Age 24

Coverage details: Subject to Terms & Conditions of the Policy


S.No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Benefits Accident: Medical Treatment Delay of Checked-in Baggage Total Loss of Checked-in Baggage Personal Liability Personal Accident [24 Hours] Accident: Medical Evacuation Trip Cancellation Trip Curtailment Emergency Travel Emergency Hotel Flight Delay Transportation of Mortal Remains Sum Insured Rs. 1,00,000.00 Rs. 1,000.00 Rs. 7,500.00 Rs. 1,00,000.00 Rs. 5,00,000.00 Rs. 1,00,000.00 Rs. 15,000.00 Rs. 15,000.00 Rs. 10,000.00 Rs. 10,000.00 Rs. 1,000.00 Rs. 1,00,000.00 Deductible Nil 12 Hrs Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil

Premium details: Net premium (Rs.)


Amount payable: 119.00 (Rs. One Hundred Nineteen )

Service tax (Rs.) 12.71

105.90

Education and secondary education cess (Rs.) 0.39

Gross premium (Rs.) 119.00

Assistance Company and claims notification


Toll Free No.: 1800-102-0333, Fax: 0124-4584111, E-mail: domestictravel@apollomunichinsurance.com Service Tax No.: AAGCA1654HST002 Location: Gurgaon

Address for claims submission


Travel Claim Department, Apollo Munich Insurance Company Limited, 10th Floor, Tower - B, Building No. 10, DLF Cyber City, DLF City Phase II, Gurgaon, Haryana - 122002.

For and on behalf of Apollo Munich Health Insurance Company Limited

Date: 19-Dec-2012 19:21 hrs

Authorized Signatory

Apollo Munich Insurance Company Ltd.: Corp. Off.: 10th Floor, Tower - B, Building No. 10, DLF Cyber City, DLF City Phase II, Gurgaon, Haryana - 122002. Regd. Off.: Apollo Hospitals Complex, Jubilee Hills, Hyderabad - 500033.Toll Free No.: 1800 - 102 -0333, E-mail: customerservice@apollomunichinsurance.com, Website: www.apollomunichinsurance.com

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