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CERTIFICATE OF INSURANCE

EASY DOMESTIC TRAVEL INSURANCE [PLATINUM]


The benefits available are described in the Policy and will be subject to the policy terms, conditions and exclusions. The complete policy terms, conditions
and exclusions can be viewed or downloaded online from [www.apollomunichinsurance.com]. A copy of this Certificate of Insurance must be carried by
the Insured Person during the Risk Period. Please refer to the policy wordings or contact us for any further information or clarification.
Policy details :
Policy No: 900001/35001/A000000061 Certificate No : A000000061/480590
Risk Period: From 14-Mar-2011 05:45 hrs or the boarding of the To 12-Apr-2011 05:45 hrs or the return to the usual place of
carrier from the place of origin, whichever is later residence, whichever is earlier. (Expiry of Risk Period)
(Commencement of Risk Period)
Insured Person's
Persons' details :
Member ID Insured Person’s name Age
X0175520 Shriram Narakassery 23

Coverage details: Subject to Terms & Conditions of the Policy


S.No. Benefits Sum Insured Deductible

1. Accident: Medical Treatment Rs. 1,00,000.00 Nil


2. Flight Delay Rs. 1,000.00 Nil
3. Total Loss of Checked-in Baggage Rs. 7,500.00 Nil
4. Personal Accident [24 Hours] Rs. 5,00,000.00 Nil
5. Accident: Medical Evacuation Rs. 1,00,000.00 Nil
6. Trip Cancellation Rs. 15,000.00 Nil
7. Trip Curtailment Rs. 15,000.00 Nil
8. Emergency Travel Rs. 10,000.00 Nil
9. Emergency Hotel Rs. 10,000.00 Nil
10. Transportation of Mortal Remains Rs. 1,00,000.00 Nil
Premium details:
Net premium (Rs.) Service tax (Rs.) Education and secondary Gross premium (Rs.)
education cess (Rs.)
100.64 10.06 0.30 111.00
Amount payable: 111.00 (Rs. One Hundred Eleven )

Assistance Company and claims notification Address for claims submission

Toll Free No.: 1800-102-0333, Travel Claim Department,


Fax: 0124-4584111, Apollo Munich Insurance Company Limited,
E-mail: domestictravel@apollomunichinsurance.com 10th Floor, Tower - B, Building No. 10, DLF Cyber City,
DLF City Phase II, Gurgaon, Haryana - 122002.

Service Tax No.: AAGCA1654HST002


Location: Gurgaon For and on behalf of Apollo Munich Health Insurance Company Limited

Date: 23-Feb-2011 01:20 hrs Authorized Signatory

Apollo Munich Insurance Company Ltd.: Corp. Off.: 10th Floor, Tower - B, Building No. 10, DLF Cyber City, DLF City Phase II, Gurgaon, Haryana - 122002. Regd. Off.: Apollo Hospitals Complex,
Jubilee Hills, Hyderabad - 500033.Toll Free No.: 1800 - 102 -0333, E-mail: customerservice@apollomunichinsurance.com, Website: www.apollomunichinsurance.com