REGISTERED OFFICE :Reliance Centre, South Wing, 4th Floor, Off.

Western Express
Highway , Santacruz (East), Mumbai - 400 055.

RELIANCE TRAVEL CARE POLICY - FOR INDIVIDUAL

POLICY SCHEDULE
Reliance Centre, South Wing, 4th
Policy Issuing Office : Policy Servicing Office Code 1107
RELIANCE CENTRE, SOUTH WING, 4TH FLOOR, OFF. WESTERN EXPRESS 2ND FLOOR,SAI INFOTECH, OFFICE .NO-210 & 211, OPP. GHATKOPAR
HIGHWAY , SANTACRUZ (EAST), MUMBAI - 400 055. STATION, PATEL CHOWK, GHATKOPAR EAST MAHARASHTRA INDIA
Policy No : 110722128170004558 Intermediary Code : Direct
Tax Invoice No. & Date : R01082100054 & 01/08/2021
Proposer Details :
Communication Address & Place of
Name of the Proposer Date of Birth Occupation Contact No.
Supply
Mrs. ZAMEELA MOIDIN BEARY 21/07/1963 HouseWife 16-108-4 BLUE STAR HOUSENEAR 0
NYARMA SHIRVA ,,UDUPI 8147467669
KARNATAKA 574106
GSTIN / UIN of the Proposer :
Details of the Insured Person :
Insured Pre-Existing
Date of
Name of the Insured Person Relationship with Passport No illness/ injury/ Suffering Since Under Medication
Birth
the proposer condition if any
Mrs. ZAMEELA MOIDIN 21-jul-1963 Self s93262125 No NA No
BEARY
Nominee Details
Nominee Name Date of Birth Nominee Relationship with proposer
mohammed sadik muloor ismail Son

Address of the Insured : 16-108-4 BLUE STAR HOUSE NEAR NYARMA SHIRVA ,,UDUPI KARNATAKA 574106
Email-ID : carabinztourism@gmail.com Telephone No : 0 Mobile No : 8147467669
Geographical Coverage : Excluding USA and Canada Group corp ID :
Name of Countries to be
visited : Qatar
Policy Period : From 00:00 Hrs on 23-Aug-2021 To 22-Oct-2021 midnight or Date of return of Insured whichever is earlier
Name of the Plan Opted : Standard
Trip Type: Single
Coverage Sum Insured (In USD) Deductible (In USD)
Medical Expenses Including Transportation Evacuation 50000 50
And Repatriation Of Mortal Remains
Dental Treatment 500 50
Loss of Passport 300 25
Total loss of checked Baggage 500 NA
Delay Of Checked In Baggage 100 12 Hours
Personal Accident 15000 NA
Accidental Death Common Carrier 2500 NA
Personal Liability 50000 NA
Compassionate Visit Return Fare for any one accompanying NA
person - spouse / child / family doctor

Reliance General Insurance Company Limited. IRDAI Registration No. 103 An ISO 9001:2015 Certified Company
Registered Office: Reliance Centre, South Wing, 4th Floor, Off. Western Express Highway , Santacruz (East), Mumbai - 400 055.
Corporate Office: Reliance Centre, South Wing, 4th Floor, Off. Western Express Highway , Santacruz (East), Mumbai - 400 055.
RGI/MCOM/CO/Trave/PS/VER.1.0/010218 Corporate Identity No. U66603MH2000PLC128300. UIN: RELTIOP08002V010708
Trade Logo displayed above belongs to Anil Dhirubhai Ambani Ventures PrivateLimited and used by Reliance General Insurance Company Limited under License.