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Renewal Intimation

Dear Mr Vijaybhai Karshanbhai Patel

We thank you for choosing Apollo Munich as your Personal Accident partner.
Your Individual Personal Accident Standard Policy No. 2000149444 of Sum Insured Rs.2500000 is due for renewal on 05-JUN-2016.

Relationship Cumulative
Insured Name DOB Age Benefits Sum Insured (`)
to Policy Holder Bonus (`)
Mr Vijaybhai Karshanbhai Patel 05-JUN-1966 50 Self Accidental Death 2500000 125000
Temporary Total
Disablement 500000

Premium Due for Renewal (Includes adjustment for previous years excess amount, if any.) ` 3120

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Points to note:
• Please use Change Request Form for any changes in existing policy, the same may be downloaded from our website. or filled at any of our AMHI Branches.
• Please fill NEFT form while submitting the premium, the same may be downloaded from our website or filled at any of our AMHI Branches.
• Please contact us prior to renewal in case of any change in the nature of duties/occupation of any person insured under this policy or any other desired change.
• Please note that CB is available for selected benefits like - AD, PTD, and PPD only wherever provided.
• Renewal premium mentioned above is inclusive of service Tax and cess as applicable.
• For AMHI reference Policy No. is 190100/21001/2000149444

*Tax Savings Under Section 80D is subject to changes in the Income Tax law • IRDAI Reg. No.: - 131 • CIN: U66030AP2006PLC051760 • AMHI /CR/H/0017

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2nd & 3rd •UIN: IRDA/NL-HLT /AMHI/P-P/V. • Tel: +91 124 4584333 • Fax: +91 124 4584111 • Toll Free: 1800 103 0555 • For more details on risk factors. . Telangana. Udyog Vihar. iLABS Centre. Jubilee Hills. Gurgaon-122001. • Tax laws are subject to change • IRDAI Reg. Off. please return to: Apollo Munich Health Insurance Co. Phase-III. No. terms and conditions please read sales brochure carefully before concluding a sale. Hyderabad-500033. Reg. Central Processing Center. Haryana • Corp. SCF-19. Sector-14. Plot No.1/6/13-14 • UIN: IRDA/NL-HLT/AMHI/P-H/V.1/59/14-15 .1/20/13-14 • UIN:IRDA/NL-HLT /AMHI/P-T/V. Inland Letter Card Mr Vijaybhai Karshanbhai Patel 3 Devchhaya (Swatantra) Ghatlodia Ahmedabad Ahmedabad Gujarat-380061 If undelivered.apollomunichinsurance. Ltd.131 • CIN: U66030AP2006PLC051760 • Website: www.1/74/14-15 • UIN:IRDA/NL-HLT /AMHI /MISC/P-H/V. Gurgaon-122016. 404-405. Apollo Hospitals Complex. Haryana.1/10/13-14 • UIN: IRDA/NL-HLT /AMHI/P-H/V. Off. 1st Floor.