Professional Documents
Culture Documents
No:
1
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15
Mr.
Mrs.
Mast.
Kum.
Mode
Yly
Members
Thomas
Jossy Thomas
Sony
Siniya
Age
30
28
12
10
Number of members
M/F Relationship
Male
Self
Female
Wife
Male
Son
Female Daughter
Principle
Insured Minor HCB
Yes
No 2000
No
No 2000
No
Yes 2000
No
Yes 2000
Term
Rider
No
No
Ver3.1
Table No 904)
Total Premium
DAB
No
No
mkandam Branch
Term
Rider SA
100000
100000
Basic
Premium
Rs. 4855
Service
Tax
704
Service
Premium Tax
1970
286
1511
219
695
101
679
98
Final
Premium
5559
Final
Premium
2256
1730
796
777
Checks
1
Benefit
in the
year
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
10
10
10
10
10
10
10
10
10
10
10
10
10
10
10
25
25
25
25
25
25
25
25
25
25
25
25
25
25
25
Maximum Allowed
HCB
MSB Category
Applicable
Member
Other
Surgical
Benefit
Quick cash
Facility
(5 times
Applicable
HCB)
(2 times
Applicable
HCB)
50 % of
MSB
Days
Amount
Cat 1-100%
Cat 2-60%
cat 3-40%
Cat 4-20%
2000
2000
2000
2000
30
30
30
30
60000
60000
60000
60000
200000
200000
120000
120000
80000
80000
40000
40000
10000
10000
10000
10000
4000
4000
4000
4000
100000
100000
100000
100000
240000
400000
240000
160000
80000
40000
16000
400000
Mr. Thomas
Mrs. Jossy Thoma
Mast. Sony
Kum. Siniya
189000
189000
189000
189000
210000
210000
126000
126000
84000
84000
42000
42000
10500
10500
10500
10500
4200
4200
4200
4200
105000
105000
105000
105000
756000
420000
252000
168000
84000
42000
16800
420000
Mr. Thomas
Mrs. Jossy Thoma
Mast. Sony
Kum. Siniya
198000
198000
198000
198000
220000
220000
132000
132000
88000
88000
44000
44000
11000
11000
11000
11000
4400
4400
4400
4400
110000
110000
110000
110000
792000
440000
264000
176000
88000
44000
17600
440000
Mr. Thomas
Mrs. Jossy Thoma
Mast. Sony
Kum. Siniya
279000
279000
279000
279000
310000
310000
186000
186000
124000
124000
62000
62000
15500
15500
15500
15500
6200
6200
6200
6200
155000
155000
155000
155000
1116000
620000
372000
248000
124000
62000
24800
620000
Mr. Thomas
Mrs. Jossy Thoma
Mast. Sony
Kum. Siniya
423000
423000
423000
423000
470000
470000
282000
282000
188000
188000
94000
94000
23500
23500
23500
23500
9400
9400
9400
9400
235000
235000
235000
235000
1692000
940000
564000
376000
188000
94000
37600
940000
Name
Mr. Thomas
Mrs. Jossy Th
Mast. Sony
Kum. Siniya
HCB
2000
2000
2000
2000
2100
2100
2100
2100
90
90
90
90
2200
2200
2200
2200
90
90
90
90
3100
3100
3100
3100
90
90
90
90
4700
4700
4700
4700
90
90
90
90
Premium Break UP
Member NameBasic Prem
No:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Day Care
Procedure
HCB/day
Mr. Thomas
Mrs. Jossy Thoma
Mast. Sony
Kum. Siniya
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
Maximum Allowed
Mr. Thomas
Mrs. Jossy Thom
Mast. Sony
Kum. Siniya
Service tax
1970
1511
695
679
Benefits at Glance
Final Premium
286
219
101
98
2256
1730
796
777
MSB
200000
200000
Day care
10000
10000
10000
10000
Other
4000
4000
4000
4000
Rs.5559
Change in HCB With Year
5000
4000
3000
2000
470000
500000
400000
3100
2000
2100
2200
Year
300000
200000
310000
200000
210000
220000
Year
100000
1000
0
1
10
25
has expired!!!!
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