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Mediclaim Receipt PDF
Mediclaim Receipt PDF
Name of Insured Person Gender Date of Relationship with Occupation Pre-Existing Sum Domiciliary Amount Loading Premium
Birth the Proposer Illness Insured (Rs) Hospitalisation of CB (%) (Rs)
Limit (Rs) (Rs)
NILESH GAWAS Male 02/10/1981 Self Others 50000.00 500000.00 555000.00 0 18110.00
APARNA GAWAS Female 31/03/1981 Spouse Others
* Where an Insured Person is added to this Policy, either by way of endorsement or at the time of renewal, the pre-existing disease clause,first year exclusion and 30 days
waiting period is applicable considering such policy period as the first policy with us.
* Policy would be considered as a fresh policy if there would be break of fifteen or more days between the prevoius policy expiry date and current policy start date.
* Any enhanced Sum insured during subsequent policy renewals will not be available for an illness, diseases, injury already contracted under the preceding policy periods.All
Waiting periods as defined in the policy shall apply for this enhanced limit from the effective date of enhancement of such Sum Insured.
* This Insurance is subject to the terms and conditions of policy attached .The policy wordings with detailed terms , conditions and exclusions is available on our
website www.reliancegeneral.co.in
Premium Certificate
Premium Certificate for the purpose of deduction under Section 80-(D) of Income Tax (Amendment) Act 1986.
This is to certify that NILESH GAWAS has paid Rs. 20348 (TWENTY THOUSAND THREE HUNDRED FOURTY EIGHT) towards premium for Health Insurance for the
Period From 00:01 on 25/12/2013 to Midnight of 26/12/2014 on Dec 17 2013
Policy Number : 1301722811000291
Date : 17/12/2013 Place : Mumbai
Note: This certificate must be surrendered to the Insurance Company for issuance of fresh certificate in case of cancellation of policy or any alteration in the insurance
affecting the premium.
Registered Office: Reliance Centre, 19, Walchand Hirachand Marg,Ballard Estate ,Mumbai - 400 001