Renewal Notice : Personal Accident Office Code : 300100

Business Source : 9000139889 Office Address : Third Floor, Jashwant

Chambers, Neat Roopali Cinema,Lal
Darwaja, Ahmedabad, Gujarat,
Agent Name : Ms Mehta Pallavi P Contact Number : 9427320121
Policy No : 300100422110002529

Customer name : MEET DHANESH SHAH Customer ID : 9525545937 Mobile : 9016199117

Address : 704/1, SIR CHINUBHAI BUILDING, CROSS Phone :
LANE. REVDI BAZAR, KALUPUR, Dist. : Ahmedabad, E-Mail : pcmehta73@gmail.com
Gujarat ,PIN : 380001

The undermentioned policy will be due for renewal on the date shown below. To enable the insurance to be kept in force the
annual premium should be paid on or before the date of Expiry. Please complete and return the attached sheet together with your
remittance.

Policy No Sum Insured Annual Premium Date of Expiry

300100422110002529 Rs. 6,00,000.00 Rs. 828.00 30/11/2022

Very Important : In accordance with the provisions of Insurance Act 1938, renewal of the policy may not be effected unless the premium has been paid on or
before the renewal date. Your attention is drawn to the provisions of Section 41 of Insurance Act, 1938 - Prohibition of rebates (Amended as per The Insurance
Laws (Amendment) Act, 2015)
1. No person shall allow or offer to allow either directly or indirectly, as an inducement to any person to take out or renew or continue insurance in respect of any
kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy
nor shall any person taking out or renewing or continuing a policy accept any rebate except such rebate as may be allowed in accordance with the prospectus or
tables of the Insurer.
2. Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakh rupees.

(This sheet should be completed and returned with premium remittance)

To,
National Insurance Company Limited,
HQ
Renewal of Policy no 300100422110002529 due for renewal on 30/11/2022

Dear Sir,
Please renew the above policy for a further period of twelve months from
Renewal premium remittance details :

Yours faithfully,

Signature
MEET DHANESH SHAH
704/1, SIR CHINUBHAI BUILDING, CROSS LANE. REVDI BAZAR, KALUPUR, Dist. : Ahmedabad, Gujarat
Ahmedabad-380001
Gujarat-India
Date : 08/11/2022

Note: Kindly ignore this Notice in case if you have already renewed the policy.
* This is a system generated document and does not require any signature