RENEWAL NOTICE

Policy No.P/131112/01/2019/007048 Date : 30/11/2019

Branch Office - Tadbund-131112

ALEKHA PRASAD V
Plot No 6-3-864/4/B,SBN Arcade,3rd Floor,Opp Green Park
Flat NO - 402, SAI WIND FLOWER APARTMENT,HUDA MAYURI NAGER, Hotel,
NEAR HMDA PENCIL PARK,MIYAPUR Greenlands, Ameerpet,Hyderabad -500016
Boduppal,Rangareddi,Telangana- 500049 040 - 42222120
95XXXXXX87 / - /alXXXXXXX@gmail.com tadbund.hyderabad@starhealth.in

Proposer/Customer Code : 10485238 / AA0008051362 Reference No : R/131112/01/2020/009304 - Direct Receipt

Dear Customer,

We value your relationship with us and thank you for the same. We wish to bring to your kind notice that your Family Health Optima Insurance Policy
is due for renewal on 06/01/2020. The renewal premium, including GST, works out to Rs.13057/- as per details given below.
Age as Relationship
Date of Sum Insured Premium
S. No Name of the Insured on with proposer
Birth (Rs.) (Rs.)
Renewal

1 ALEKHA PRASAD V 03/04/1980 39 SELF 500000 11065

2 K MUTHYA LAKSHMI KALYANI 26/07/1979 40 SPOUSE
3 V BINAY 17/02/2012 7 DEPENDANT CHILD
GST@ 18% 1992
Total Renewal Premium 13057
To match escalation of medical costs, you can also opt for higher Sum Insured. The higher sum insured options and the respective premium
(including Tax) are given below
SI 1000000 Rs.17010/- SI 1500000 Rs.20066/- SI 2000000 Rs.22585/- SI 2500000 Rs.24957/-
If there is any change in the list of insured persons to be covered and/ or you desire any changes in the sum insured etc., please inform us
immediately so that we can work out the revised renewal premium and advise you. Otherwise, please arrange to remit the renewal premium of
Rs.13057/- on or before 05/01/2020. Please note that the payment of premium by any mode other than by cash will be eligible for benefit under Sec.
80 D of the Income Tax Act. If you pay by Cheque or DD, please make payment in favour of Star Health and Allied Insurance Company Limited.,

We request you to renew the policy before the renewal date to ensure continuity of cover and renewal benefits.

''Please furnish your mobile number and email id in the space provided below to enable our company to communicate with you as our valued
customer, whenever required''.
Mobile Number : Email id :

You can also update your Address / Mobile No / E Mail ID, online by visiting our website www.starhealth.in.
Please note that this policy can be renewed online or using your mobile. Kindly log on to our website www.starhealth.in to know the details.
Always at your service. Intermediary Name/Code: Mrs.TATIPELROHINI/BA0000138519

For Star Health and Allied Insurance Company Limited Phone No : 9247837147
Fulfiller Name/Code : Mr.ANJANEYULU G/SH21211
Authorised Signatory Phone No : 9000543747

IRDA Regn. No 129 Corporate Identity Number U66010TN2005PLC056649 Email ID : info@starhealth.in

Star Health and Allied Insurance Co.Ltd

Spot Acknowledgement
Acknowledged hereby receipt of Cash / Cheque / DD No.____________________ Dt _____________ for Rs. __________/- drawn on
_____________ from Mr./Mrs/Ms._____________________________ towards premium for the renewal of Policy No. _________________________.
A system generated "Advance Premium Receipt" for this payment will follow from our office, which is subject to realization of the cheque.
_________________________________ ____________________________
Name & Code of the Authorised Person Signature of Authorised Person
Place:
Date:
Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800 Toll Free Fax No: 1800-425-5522 Toll Free No:1800-425-2255 /
1800-102-4477,CIN :U66010TN2005PLC056649 Email :support@starthealth.in Website :www.starhealth.in IRDAI Regn.no: 129