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    DOC-20241215-WA0003_20241221_055858_0000

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    DOC-20241215-WA0003_20241221_055858_0000

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    DOC-20241215-WA0003_20241221_055858_0000

    Uploaded by

    srinivasdme97

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    HN0132645987321 A

    HDFC ERGO General Insurance Company Limited

    SARV SURAKSHA ADVANTAGE POLICY SCHEDULE

    Policy No: 887540267 Issued On : 07/09/2024 Location : Mumbai

    PERSONAL DETAILS

    Name of Proposer Qeetyujii


    Address
    Xxxxxxxxxx
    ccmmmccccc
    hhhjjiook

    Yuufdsasjk

    Contact Nos Tel.(Res.) Office No.

    Mobile No. 13479994556

    Email id Wwwtuii@.com

    Name of Nominee Yuufffss Relationship to the Insured FATH ER

    POLICY AND PREMIUM DETAILS


    Policy Commencement 07/09/2024 Policy Expiry Date 06/09/2025

    Sr.No. Date of Birth Age Benefit %


    List of Insured Persons/Dependents Relationship Nominee Name
    (Yrs)
    1 12346788 FATHER 10/03/1962 62 100% Shjjjddhhj

    Sr.No. Cov e ra ge D esc ri ptio n Sum Insured (Rs)

    1 Personal Accident Accidental Death and Permanent Disablement 8,00,000

    TERMS & CONDITIONS

    1.. The maximum claim amount payable on this certificate is Rs. 1,000,000. The maximum claim amount payable for each member
    2. specified under this certificate shall be restricted to the Benefit % of the SI as shown in the schedule.
    The operative time for this Policy shall be 24 Hrs.
    3. The Territorial Limits for this policy shall be worldwide
    4.

    PREMIUM DETAILS

    Gross Premium (Rs.) 45500


    Tax, as applicable (Rs.) 5812
    Net Premium (Rs.) 51312

    Address of Issuing Office 6th Floor,Leela Business Park,Andheri-Kurla Road,Andheri (East) Mumbai 400059.

    Date 07/09/2024

    Consolidated stamp duty for this Insurance Policy is paid by Demand Draft,vide Receipt/Challan no. 91232 dated 07/09/2024 as prescribed in
    Government Notification Revenue and Forest Department No Mudrank 2004/4125/CR 690/M-1, dated 31/12/2004.

    Agent Code: 3467895432104

    Agent Name: HDFC BANK CC HEALTH

    Phone No: 022-28561818

    Insurance is the subject matter of the solicitation.


    6th Floor, Leela Business Park , Andheri Kurla Road , Andheri (East), Mumbai 400 059, Toll-Free No. 1800-2-700-700 Fax : 91 22 6638 3699 care@hdfcergo.com www.hdfcergo.com
    Registered Office : Ramon House , H.T. Parekh Marg, 169 , Backbay Reclamation , Mumbai 400 020.
    HDFC ERGO General Insurance Company Limited

    SARV SURAKSHA ADVANTAGE POLICY SCHEDULE


    For HDFC ERGO General Insurance Company Limited
    Service Tax Reg. No.: AABCH0055EST325

    Duly Constituted Attorney

    Insurance is the subject matter of the solicitation.


    6th Floor, Leela Business Park , Andheri Kurla Road , Andheri (East), Mumbai 400 059, Toll-Free No. 1800-2-700-700 Fax : 91 22 6638 3699 care@hdfcergo.com www.hdfcergo.com
    Registered Office : Ramon House , H.T. Parekh Marg, 169 , Backbay Reclamation , Mumbai 400 020.

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