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Policy Certificate Number: COI2007242054408840000438

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ICICI Lombard General Insurance Company Limited

(A company incorporated under Indian Companies Act, 1956 and licensed by Insurance Regulatory and Development Authority of
India (IRDAI) vide Regd.No.115)
Master Policy Number : 4148/GSG/200392663/00/000 MISC Code : 148 UIN : ICIPAGP18102V011718 CIN : L67200MH2000PLC129408

Group Manager |
A quick look at your
Hospital Cash Insurance
On receipt of full premium,policy number COI2007242054408840000438 has been issued on 24/07/2020 at Mumbai,by ICICI
Lombard General Insurance Company Limited to the below mentioned Insured as specified in the Policy.

The policy is issued to the customers of Phonepe Pvt Ltd, which bears the master Policy No.4148/GSG/200392663/00/000 by an
authorised signatory of ICICI Lombard GIC Ltd, and offers the Benefits mentioned under the policy - not exceeding the sum
insured. Relevant terms, conditions and exclusions as stated in this policy apply.

Valid in Number of members

India 1

Policy Certificate Number Coverage start date Coverage end date

COI2007242054408840000438 24/07/2020 00:00 23/07/2021 23:59

Who's covered

Bikramjit Das
25 year(s)

Insured Relationship with

SELF Daily Payout Rs. 5000 (Total Cover:Rs. 75000)
buyer

Premium

Net Premium Rs. 1076.27

SGST (9%) Rs. 0.00
CGST (9%) Rs. 0.00
IGST (18%) Rs. 193.73

Rs.
Gross Premium
1270.00
Comprehensive coverage details
An extensive list of all benefits and their cover value in your policy

Section E benefits

Hospital daily cash benefit

Cover: Rs.5,000/day (Total cover: Rs.75,000)
The insured person receives a daily allowance for every day of hospitalisation for up to 15 days.
Insured person may claim multiple times but the total claimed amount across all benefits cannot exceed the cover
amount.
No bills required for claims, only discharge summary needed.
Waiting period: 30 days for all hospitalisations.
Deductible: 1st day of hospitalisation not counted towards payout.
Minimum hospitalisation: 48 hours (2 days)
Other important conditions: Pre-existing diseases not covered for 2 years (gets covered when renewed beyond 2 years)

Intensive care unit (ICU) cash benefit

Cover: Rs.10,000/day (Total cover: Rs.75,000)
If hospitalised in ICU, the insured will receive 2 times the daily amount as chosen.

Insured may claim multiple times but the total claimed amount across all benefits cannot exceed the cover
amount.
The waiting periods and deductible as applicable for Hospital daily cash benefit also apply to ICU benefit.

Important Notes and Major Exclusions

Liability to make payment for any claim under this policy with respect to an Insured Person, is subject to the following

1. Hospitalisation less than 48 hours not covered

Insured needs to be admitted for a minimum of 48 hours to be eligible for claims under this policy.

2. First 24 hours or 1 day of hospitalisation deducted

First day of hospitalisation will not be counted towards the number of days payable for claims.

3. Pre-existing diseases not covered for 24 months.Any hospitalisation not covered for first 30 days.
Hospitalisation caused due to pre-existing diseases are not covered for 24 months.On renewal of this policy beyond 24 months,pre-existing diseases
get covered. No hospitalisations in first 30 days of buying this policy are eligible for claims.

4. Standard list of procedures and diseases not covered for up to 24 months

As defined in policy wordings

Kindly refer to the policy wordings for exclusions and Terms/Conditions.

Assistance
For claims, endorsements/modifications and cancellations, reach out to ICICI Lombard General Insurance Company Limited
through any of the following channels

National Toll Free Number

For 24*7 assistance,reach the insurer at

1800-2666
 Email address
For emails,reach the insurer at

customersupport@icicilombard.com

Postal Address
To contact insurer by postal mail,reach at

IL Health Care, ICICI Lombard Healthcare ICICI Bank Tower,Plot No.12,Financial District,Nankaram Guda,Gachibowli,
Hyderabad, Andhra Pradesh PIN Code:500032

Declaration
I, on behalf of all the insured [as stated by me], understand that this policy has been issued, purely based on the
information vis-à-vis declaration, as provided by me to PhonePe. I, further understand that the policy shall not be valid from
its inception [void ab initio], if any of such information provided by me, stands incorrect. I fully understand that this policy
shall not cover any pre-existing medical condition(s)/injury(ies)/illness(es)/deformity(ies), complication(s) and likewise,
arising from them, whether declared or undeclared.

This is an electronically generated document and does not require a signature.

Stamp duty as applicable has been paid against this policy in cash or by demand draft or by pay order

Intermediary name : PhonePe Pvt Ltd, IMD Code - 820958, Phone - 0124 678 9345