THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

New India Floater Mediclaim Policy

UIN : NIAHLIP21278V042021

Policy Schedule

Current Policy No 83000034212800000323 Current Policy Period From:21/04/2021 03:49:40 PM

To:20/04/2022 11:59:59 PM
Previous Policy No NA Previous Policy Period
Policyholder's Details
Policyholder Name KRISHNA PRALHAD KUDUK Customer ID ME13566667
PAN Card No BBVPK1551R
Mobile No/Phone No 9766666854
Policyholder's M-1004, RIVER RESIDENCY, Email id krishnadpk89@gmail.com,
address DEHU - ALANDI ROAD
CHIKHALI

Pune ,MAHARASHTRA, 411062

Office Name and Code
Office Email Id
Name of the Nominee GAUTAM PRALHAD KUDUK
Relation with the Policy Others
holder
GSTIN NA
Policy Issuing Office and Intermediary Details
DIGITAL HUB (830000) Office Contact No 2222150330
nia.830000@newindia.co.in Development Officer DI_DIGITAL HUB DI_DIGITAL HUB
(DI830000)
Name of the
Agent/Intermediary

Office Address 41B, 4TH FLOOR, MAKER TOWER E, Contact No. of NA / 2222150330,
CUFFE PARADE, MUMBAI 400005 Agent/Intermediary

Regional Office
Regional Contact No
Details Of TPA (Notice or Communication to be given in respect of claim)
Name of the TPA
Email-id of the TPA
,400005
E-mail id of Intermediary nia.830000@newindia.co.in,
DIGITAL HUB (830000) GSTIN 27AAACN4165C3ZP
2222150330 SAC 997133 (Accident and health insurance
services)
MDINDIA HEALTH INSURANCE TPA
PVT. LIMITED
Address of the TPA S. NO. 46/1, E-SPACE, A-2 BUILDING,
customercare@mdindia.com 3RD FLOOR, PUNE-NAGAR ROAD,
VADGAONSHERI, PUNE-411014,,

Toll Free / Contact No of 18002097800

the TPA 18002097777 /
Fax of TPA 02025300003

Highlights of New India Floater Mediclaim Policy*

* Day one baby cover.
* Critical Care Benefit 10% of the Sum Insured.
* Room rent and ICU Charges at 1% and 2% of Sum Insured per day
respectively.
* Hospital Cash up to 1% of Sum Insured.
* Midterm inclusion of newly married spouse.
* Cataract claims, up to 10% of Sum Insured or ` 50,000 whichever
less, for each eye.
* Ayurvedic / Homoeopathic / Unani treatments are covered up to 25% of the
Sum Insured.
* Optional Cover I: No Proportionate Deduction.
* Optional Cover II: Maternity Expenses Benefit for Sum Insured 5 Lakhs and
Above.
* Optional Cover III: Revision in Limit of Cataract (For 8 Lakhs & above Sum
Insured).
* For Pre Existing Diseases Waiting period is 48 Months as per clause 4.1 of the
policy document.
* For specified diseases waiting period is 24 months as per clause 4.3.1
of the policy document.
* Please refer to policy document for detailed terms and conditions.

Signature Not
Verified
Digitally signed
by Srinivasan
Vaideswaran
Date: 2021.04.21 Policy No. : 83000034212800000323Document generated by CUSTR31199 at 21/04/2021 15:49:42 Hours.
15:49:51 IST
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.

Page 1 of 5
THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

Important
*1.Date of Inception of first policy is the date from which the policyholder has been continuously obtaining health insurance cover in
India from any of the insurers without break subject to portability guidelines.
2.Enhanced Sum Insured under the policy will be subject to policy clauses 4.1,4.2 and 4.3
3. PED and specified diseases waiting periods for each of the merged policy shall be reckoned as per its date of inception of first policy.
* Please visit https://www.newindia.co.in for the list of network hospitals providing cashless facility. If network hospital is not
available in your city/location, please contact the concerned TPA." You are also requested to share your policy details when
you visit the network hospital.

Insured Persons details

S. No Name of the insued Date of birth(Age) Sex Relation *Date of inception of Pre Existing Disease
(Member ID) first policy
1 KRISHNA 07/06/1987(33) M SELF 21/04/2021 NA
PRALHAD
KUDUK(ME1356
6667)
2 ASHWINI 22/06/1992(28) F SPOUSE 21/04/2021 NA
KRISHNA KUDUK
(ME13566728)

Floater Sum Insured 500000 Floater Cumulative Bonus 0

Optional Cover Table
Policy Level - Optional Not Opted
Cover - 1
(No Proportionate
Deduction)
Member Level - Optional Opted Member Level - Optional Cover - III Not Opted
Cover - II (Revision in Cataract Limit)
(Maternity Benefit)

Member Wise - Optional Cover -II (Maternity Benefit)

S. No Name of the Insured (Opting Optional Cover - II) Date of Opting Optional Cover - II
1 Krishna Pralhad Kuduk 01/01/1970
2 Ashwini Krishna Kuduk 21/04/2021

S No Name of the Basic Premium Premium for Premium for Premium for Discount Gross Premium
Insured Optional Cover - I Optional Cover - Optional Cover -
II III
1 KRISHNA 4255 0 0 0 213 3638
PRALHAD
KUDUK
2 ASHWINI 4255 0 5000 0 463 7913
KRISHNA
KUDUK

Total Gross 11551

Premium(Without
GST)
CGST(@9%) 1040
SGST(@9%) 1040
Net Premium in Words(RUPEES THIRTEEN THOUSAND SIX HUNDRED THIRTY-ONE ONLY) IGST 0
Total GST 2080
Net Premium(With 13631
GST)

*This Policy is subject to terms and conditions of New India Floater Mediclaim.

The Policy premium is inclusive of Digital Discount ` : 1283.40

Policy No. : 83000034212800000323Document generated by CUSTR31199 at 21/04/2021 15:49:42 Hours.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.

Page 2 of 5
THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

In WITNESS WHEREOF,the undersigned being duly authorized by the Insurers and on behalf of the Insurers has(have) hereunder set
his/her(their) hand(s) on this 21st day of April 2021.

Date of Issue: 21/04/2021

( Ranjit Pati)
[Chief Manager]

FOR AND ON BEHALF OF

THE NEW INDIA ASSURANCE COMPANY LIMITED
DULY CONSTITUTED ATTORNEY(S)

Policy No. : 83000034212800000323Document generated by CUSTR31199 at 21/04/2021 15:49:42 Hours.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.

Page 3 of 5
THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

Insurer Office Code : DIGITAL HUB (830000)

Address : 41B, 4TH FLOOR, MAKER TOWER E, CUFFE
PARADE, MUMBAI 400005

,400005
Telephone : 2222150330
Fax :

New India Floater Mediclaim

PREMIUM CERTIFICATE FOR THE PURPOSE OF DEDUCTION UNDER SECTION 80 D OF INCOME TAX ( AMENDMENT ) ACT 1986

This is to certify that Mr./Mrs. KRISHNA PRALHAD KUDUK has paid ` 13631 towards premium for New India Floater Mediclaim
for the period 21/04/2021 03:49:40 PM to 20/04/2022 11:59:59 PM

Policy no. : 83000034212800000323

Receipt no. & date : 10000089210400379184
21/04/2021

Date of Issue: 21/04/2021

( Ranjit Pati)
[Chief Manager]
Authorized Signatory For and on behalf of
The New India Assurance Company
Limited
(Note: This certificate must be surrendered to the Insurance Company for issuance of fresh certificate in case of cancellation
of the policy or any alteration in the Insurance affecting the premium)

Policy No. : 83000034212800000323Document generated by CUSTR31199 at 21/04/2021 15:49:42 Hours.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.

Page 4 of 5
 THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

IMPORTANT

This policy is subject to the terms and conditions contained in the policy document (Clauses).

This policy is governed by Health Insurance Regulations 2016 issued by Insurance Regulatory
Development Authority of India on 12.07.2016.

This policy is also governed by IRDAI (Protection of Policyholders' Interest) Regulations, 2017.

This Schedule comes attached with the policy document (Clauses). If not attached, please ask for the
same.

Health Insurance Regulations 2016 and IRDAI (Protection of Policyholders' Interest) Regulations, 2017 are
available on the website of IRDAI.

Tax Invoice No : 83000021P0009998

IRDA Registration Number: 190

Policy No. : 83000034212800000323Document generated by CUSTR31199 at 21/04/2021 15:49:42 Hours.

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Give your valuable feedback on https://www.newindia.co.in/portal/policyFeedbackGen.

Page 5 of 5