Beruflich Dokumente
Kultur Dokumente
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195615961
Mr Tushar Mahendrabhai Dave
30 Picnicpark Society
B/H Navyug College
Rander Road
Surat, Surat
Gujarat - 395009
India
Contact No.: 9909921612
Policy No.: 190200/21001/2000292595-01
Code Intermediary Name Contact No
80199299 SHAH SWEETY D 9909502990
We are pleased to enclose your renewed Policy Schedule for the period 27-Sep-2018 to 26-Sep-2019
To know more about policy related information and value added offers, you may re-register yourself at our website using your unique member
ID and policy number as mentioned in the policy schedule.
In case of any query, please feel free to write to customerservice@apollomunichinsurance.com or call us at our 24 hours toll free number
1800-102-0333. Our customer care team will be happy to assist you.
Warm Regards,
Location : Gurgaon
Date : 22-Sep-2018
Authorized Signatory
Note:-
- Please visit our website www.apollomunichinsurance.com to access information about our company, the customer service touch
points including the Grievance handling process and various forms that you can use for service support. You will also get latest updates
on products, policy wordings which you can download for your reference and record.
- Please update us with your latest contact details (in case of any change) so that same can be updated in our records .You can either
write back to us or call us on our toll free no. 1800-102-0333.
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SCHEDULE - Individual Personal Accident Standard
Issuing / Servicing Office : Surat Branch Office, 1004, Upper Ground Floor21st Century
Business Center,Rustampura, Ring Road, Gujarat - 395002
PH : 02616536512
GSTIN : 24AAGCA1654H1ZY
Policy Holder's Name : Mr Tushar Mahendrabhai Dave
GSTIN/ UIN (if any) of Policy Holder :
Policy Holder's Address : 30 Picnicpark Society
B/H Navyug College
Rander Road
Surat, Surat
Gujarat - 395009
India
Policy Holder State Name & Code : Gujarat(24)
Intermediary Code : 80199299
Intermediary Name : SHAH SWEETY D
Intermediary Contact No : 9909502990
For details of all benefits under this policy, please refer to the schedule of benefits enclosed.
*The cumulative bonus (CB) shown in the Policy Schedule is provisional. The CB calculated on the Expiry Date, shall only be considered as
final. However, in case of any change in provisional CB, the same shall be intimated to You by Us through a separate endorsement.
Premium Calculation :-
Net Premium (Rs.) 1274.00
Discounts (Rs.) 0.00
Loadings (Rs.) 0.00
Taxable Premium (Rs.) 1274.00
CGST@9% (Rs.) 114.66
SGST/UTGST@9% (Rs.) 114.66
IGST@0% (Rs.) 0.00
Any other Cess or Taxes (Rs.) 0.00
Gross Premium (Rs.) 1503.32
Gross Premium amount (in words) Rupees One Thousand Five Hundred Three and Paisa
Thirty-Two Only
The stamp duty of Rs. 1.00 /- (Rupees One Only) paid vide No.F.10(783)/COS(HQ)/Con.duty/08. (Not applicable for the state of Jammu & Kashmir).
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For and on behalf of Apollo Munich Health Insurance Company Limited
Location : Gurgaon
Date : 22-Sep-2018 Authorized Signatory
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