SHIO BIHARI PANDEY

Date: 04/11/2019
S.no: 4589
CB-1, SECTOR-A, SAINIK VIHAR COLONYNANDANAGAR, KUNRAGHAT GORAKHPUR
GORAKHPURUTTAR PRADESH
Contact No. : 9839513156 Pin Code : 273008

Vertical Recipient : Piyush Chavan

Health Insurance Renewal - Health Suraksha Family Policy Policy No. : 2825100272185801000
#
Due Date : 26/01/2020 Premium Payable : ` 17845

Dear Customer,
You are our valued customer and we thank you for choosing HDFC ERGO as your preferred insurance partner. We would like to remind you
that your Health Insurance Policy is due for renewal on 26-Jan-2020. We request you to kindly renew your policy before expiry date for
continuity of benefits of your existing policy.

BOSG Recipient:-
Policy Name Policy No. Date of Expiry Premium Amount (`)
Health Suraksha Family Policy 2825100272185801000 26/01/2020 15,123
GST as applicable 2722

Dispatch Location:-
Total Premium Payable 17845
The renewal premium is computed based on the age of insured person as on the date of the inception of the policy. If the insured person
moves to higher age band at renewal date, renewal premium is calculated as per the new age band.

Insured Name Type of Policy Relationship Date of Birth Age (Yrs) Sum Insured (`) Cumulative Bonus
Shio Bihari Pandey Self 16/03/1968 51

Branch name:LEELA BUSINESS PARK, 6TH FLR, ANDHERI - KURLA RD, 400059 MAHARASHTRA
Neelam Pandey Wife 01/07/1975 44
Silver 300000/- 60000
Shashank Pandey Dependent Son 11/02/1999 20
Nishant Pandey Dependent Son 23/09/2002 17

For floater policy, the sum insured / cumulative bonus is the maximum available for the entire family as an aggregate, excluding any additional
member who was not an insured person in the claim free year.

QR Code
Renewal Option

Online* Contact Us SMS Courier **

Scan for instant renewal
SMS "Renew Send premium cheque/DD to
Visit "Instant Renewal" on Call on 022 - 6234 6234 /
2825100272185801000" to customer service address
hdfcergo.com. 0120 - 6234 6234 and
9999700700 & premium cheque to customer service
Fill details & make payment renew instantly
receive call within 24 hours address
*Term & conditions apply :
**Cheque/DD in Favour of "HDFC ERGO General Insurance Company Ltd". Please mention your policy number on the
reverse side of the cheque/DD
Visit nearest branch: LEELA BUSINESS PARK, 6TH FLR, ANDHERI - KURLA RD, 400059 MAHARASHTRA
Customer Service Address : D-301, 3rd Floor, Eastern Business District ( Magnet Mall), LBS Marg, Bhandup
(West).MUMBAI - 400078. Maharashtra.

In case you wish to make changes to the policy, please visit our Customer Support section on www.hdfcergo.com for seamless query assistance and avail host of
services such as update contact details / Get policy copy /80D tax certificates/ Track your claim.

Please note, your health card issued in the first year has lifetime validity. For you, this simply means that the health card issued at the
time of first policy purchase is valid for all subsequent renewals and as long as your policy is active with us. Hence, you need not
replace your health card every year.

Terms and Conditions: This renewal letter i s issued based upon information on claims in respect of your current policy as on the date of this notice.
You shall be entitled for "Cumulative Bonus" if no claim i s reported/incurred during the current policy year. In the event of a claim being reported / IMD Code:200278133519
incurred prior to the Commencement of the renewed policy, you shall not be entitled for "Cumulative Bonus". Cumulative Bonus if already given on the
basis of this notice shall be withdrawn.The enhanced Sum Insured offered through this letter shall be treated as the 'Sum Insured' as defined under the
Policy. The enhanced Sum Insured shall be governed by the terms and conditions stipulated in the Policy.
Goods and Services Tax Reg. No. 27AABCL5045N1Z8. The Taxes will be charged as per the directions issued by Government /Regulatory Authority
from time to time.
To,
SHIO BIHARI PANDEY Serial No. : 4589
CB-1, SECTOR-A, SAINIK VIHAR COLONY Date : 04/11/2019
NANDANAGAR, KUNRAGHAT GORAKHPUR
GORAKHPUR
2825100272185801000
UTTAR PRADESH
Contact No. :9839513156
Pin Code : 273008