Scribd Logo
Upload

Welcome to Scribd!

  • 7 views

    Abhinav - Navi Health Policy

    Uploaded by

    Abhinav Niranjan

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Abhinav - Navi Health Policy

    Uploaded by

    Abhinav Niranjan
    7 views23 pages

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    7 views23 pages

    Abhinav - Navi Health Policy

    Uploaded by

    Abhinav Niranjan

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 23

    Navi Health Insurance Policy

    Policy Schedule

    Policyholder Name Abhinav Patel

    Policyholder Id PH02721705

    Policy Issued On 09/12/2023

    UIN No NAVHLIP22133V012122

    Policy No RA01LNIQ

    Policy Valid Upto 08/12/2024

    Insurance Agent/Intermediary Details

    Name Direct Digital

    Code P040203000

    Contact No. +91 81475 44555


    Insured Person Details

    Member ID: RA01LNIQ-01

    Insured Person Name ABHINAV PATEL

    Relation with Policyholder Self

    Date of Birth (DD/MM/YYYY) 25/06/2002

    Age(Years) 21

    Gender MALE

    First Enrolment Date 09/12/2021

    Waiting Periods 0 - 10L

    Pre Existing Disease NA(0 Year)

    30 days waiting period NOT APPLICABLE


    Specific Disease/ Procedure NA(0 Year)
    Premium Details

    Premium ₹ 5,332

    Loading ₹0

    Discounts ₹ 799.8

    Total Premium ₹ 4,532.2

    GST @ 18% ₹ 815.8

    Total Amount (inlc GST) ₹ 5,348


    Premium Certificate

    This is to certify that Abhinav Patel has paid a


    total amount of ₹ 5,348 towards premium for this
    policy effective from 00:00 Hrs on 09/12/2023.

    For the purpose of deduction under section 80 D


    of Income Tax Act, 1961 and any amendments
    thereafter
    Scope of Cover

    Type Individual

    Plan Plan 2

    Base Medical Cover Amount ₹ 1000000

    Medical Cover Amount (Base + Cumulative


    Bonus)

    ₹ 1500000

    Home Hospitalisation Cover

    Up to 100% of medical cover

    Additional Medical Cover Amount for Accidental


    injury
    Up to 100% of medical cover

    Organ Donor Expenses

    Up to 100% of medical cover

    Cumulative (No Claim) Bonus

    25% of Medical Cover per year up to 100%

    Emergency Road Transportation

    Up to 100% of medical cover

    In-patient Hospitalisation

    Up to 100% of medical cover

    Online Doctor Consultations Unlimited

    Post-Hospitalisation 90 Days
    Daily cash for shared room occupancy

    ₹ 1000 per day

    Pre-Hospitalisation 60 Days

    Automatic Restoration of Medical Cover

    Unlimited Number of Times

    Wellness Benefits Covered


    Policy Service Office

    Name Navi General Insurance Limited

    Date of Signature of Proposal 14/11/2023

    Receipt Number

    Place of Supply Bengaluru

    State Code

    HSN No 997133

    Stamp Duty

    The Stamp Duty of Rs. 0.50 paid vide defaced no.


    BNGAUG2020138386 dated 2023-09-22
    Address

    Navi General Insurance Limited


    Registered & Corporate Office: NAVI GENERAL
    INSURANCE LIMITED, Vaishnavi Tech Square, 7th
    Floor, Iballur Village, Begur Hobli, Bengaluru-
    560102

    Policy Servicing Office :NAVI GENERAL


    INSURANCE LIMITED, Vaishnavi Tech Square, 7th
    Floor, Iballur Village, Begur Hobli, Bengaluru-
    560102

    Document Digitally Signed

    (Bhagwat Sattadhish)
    Claim Service Office

    TPA Name Navi Health Insurance claims

    Toll Free Number 8147544555

    Email insurance.help@navi.com

    TPA Address

    Navi General Insurance Limited Registered &


    Corporate Office: NAVI GENERAL INSURANCE
    LIMITED, Vaishnavi Tech Square, 7th Floor, Iballur
    Village, Begur Hobli, Bengaluru, Karnataka-
    560102
    Important Note
    This Schedule, Policy terms and conditions and
    Endorsement shall be read together and word or expression
    to which a specific meaning has been attached in any part
    of Navi Health Insurance policy or of the Schedule shall
    bear the same meaning wherever it may appear. Any
    amendments/modifications/ alterations made on this
    system generated policy document is not valid and
    Company shall not be liable for any liability whatsoever
    arising from such changes. Any changes required to be
    made in the policy once issued, would be valid and
    effective, only after written request is made to the Company
    and Company accepts the requested amendments/
    modifications/alterations and records the same through
    separate endorsement to be issued by the Company. Our
    policy wordings, grievance redressal procedure and details
    about ombudsman is also available on our website. Please
    note that any misrepresentation, non-disclosure or
    withholding of material facts will lead to cancellation of
    policy ab initio with forfeiture of premium and non-
    consideration of claim, if any.
    Transcript of Navi Health Proposal Form

    This Insurance policy has been issued on the basis


    of the information provided by you. In case of
    discrepancy in the below information, you may
    please write to us on insurance.help@navi.com
    within 15 days of the receipt of the Policy,
    otherwise below information will be deemed as
    correct.
    Proposer Details

    Name Abhinav Patel

    Date of Birth 25/06/2002


    Plan Details

    Tenure 1 Year

    Period 09/12/2023 to 08/12/2024

    Type Individual

    Sum Insured ₹ 1000000

    Plan Plan 2
    Insured Details - Member

    Name ABHINAV PATEL

    Gender MALE

    Date of Birth (DD/MM/YYYY) 25/06/2002

    Relation with Proposer Self


    Nominee Details

    Name Pradeep Kumar Niranjan

    Relation with Proposer Father

    Date of Birth (DD/MM/YYYY) 01/07/1976


    Medical & Health Information

    1.Do you have any existing illnesses or history of


    hospitalisation due to an illness?

    No

    ✓ I/We hereby declare that I have read and understood the


    mentioned Terms & Conditions. I/We confirm compliance to
    AML guidelines
    I hereby consent that the Policy Documents shall be sent to
    me by e-mail only on my registered e-mail Id. I understand
    that this authorisation can berevoked by me at the time of
    renewal by contacting your branch office personally or
    customer care by writing a mail/ calling your toll-free
    number.
    I hereby declare, on my behalf and on behalf of all persons
    proposed to be insured, that the above statements, answers
    and/or particulars given by me are true and complete in all
    respects to the best of my knowledge and that I am
    authorised to propose on behalf of these other persons.
    I understand that the information provided by me will form
    the basis of the insurance policy, is subject to the Board
    approved underwriting policy of the insurer and that the
    policy will come into force only after full payment of the
    premium chargeable.
    I further declare that I will notify in writing any change
    occurring in the occupation or general health of the life to
    be insured/proposer after the proposal has been submitted
    but before communication of the risk acceptance by the
    company.
    I declare that I consent to the company seeking medical
    information from any doctor or hospital who/which at any
    time has attended on the person to be insured/proposer or
    from any past or present employer concerning anything
    which affects the physical or mental health of the person to
    be insured/proposer and seeking information from any
    insurer to whom an application for insurance on the person
    to be insured /proposer has been made for the purpose of
    underwriting the proposal and/or claim settlement.
    I authorize the company to share information pertaining to
    my proposal including the medical records of the insured/
    proposer for the sole purpose of underwriting the proposal
    and/or claims settlement and with any Governmental and/
    or Regulatory authority.”
    Any GST liability and payment for the same is dependent on
    the details (viz GSTIN, address, zero-rating entitlement etc)
    provided by me. Navi General Insurance Limited will rely on
    such information for the purpose of compliance with
    applicable GST regulations and shall not be under
    obligation to evaluate authenticity/accuracy of the same.
    Further, in case any GST liability (in terms of tax, interest,
    penalty and associated litigation cost) arises on Navi
    General Insurance Limited on account of any incorrect/
    incomplete/ non-compliance on behalf of me. I will be
    immediately liable to pay the same on notification by Navi
    General Insurance Limited. The said liability shall vest
    irrespective of the completion of the insurance period
    covered within the policy contract.
    I hereby consent to and authorize Navi General Insurance
    Limited to make welcome calls, service calls or any other
    communication (electronic or otherwise) with respect to the
    proposed or existing policy of the Company from time to
    time.
    I/We hereby confirm that all premiums have been/will be
    paid from bonafide sources and no premiums have been/
    will be paid out of proceeds of crime related to any of the
    offence listed in Prevention of MoneyLaundering Act,2002. I
    understand that the Company has the right to call for
    documents to establish sources of funds. The insurance
    company has right to cancel the insurance contract in case
    I am/have been found guilty by any competent court of law
    under any of the statutes, directly or indirectly governing
    the prevention of money laundering in India.

    UIN No.: NAVHLIP22133V012122

    IRDAI Registration Number: 155


    GSTIN: 29AAFCD7985H1Z0
    CIN: U66000KA2016PLC148551
    Registered & Corporate Office: NAVI GENERAL
    INSURANCE LIMITED, Vaishnavi Tech Square, 7th Floor,
    Iballur Village, Begur Hobli, Bengaluru- 560102
    Policy Servicing Office : NAVI GENERAL INSURANCE
    LIMITED, AMR Tech Park, Ground Floor, No. 23 & 24 Hosur
    Road, Bommanahalli, Bangalore Karnataka 560068 India
    Toll-Free No: +91 81475 44555
    Web: www.naviinsurance.com
    Email: insurance.help@navi.com
    Navi Health(by Navi General Insurance) is the Trademark
    used by Navi General Insurance Ltd. for its digital
    platform.

    You might also like