POLICY MIGRATION Letter for Tata AIG MediCare

Date: 26/10/2023 Branch Name: CHANDRAPUR

Dear REKHA MANOHAR DESHMUKH Branch ID: 0821

Address 1: NEAR GOVT. SCIENCE COLLEGE Agent/Intermediary Name: CANARA BANK

Address 2: SAINAGA R CHAMORSHI ROAD Agent/Intermediary Code: 0030240001

Address 3: GADCHIROLI, CHANDRAPUR, MAHARASHTRA, 442605 Agent/Intermediary Contact: NA

Mobile: 9420510277

Sub: Migration of your existing Tata AIG MediCare Policy No. 0238797729

Greetings from Tata AIG General Insurance Company Limited. We thank you for choosing us as your preferred Health Insurance partner and continued
patronage.
We would like to inform you that the premium payable for the renewal of your above mentioned policy has been revised. We would also like to mention
that owing to evolving health care needs , we are also offering value added services details of which are mentioned below:

New Benefits offered:

Tata AIG MediCare (Existing) (UIN No. Revised Tata AIG MediCare (Migration) (UIN No.
Details
TATHLIP21224V022021) TATHLIP23118V032223)

Tele consultation-General Not Available 8 teleconsultations (General physician) per year

Physician

Emergency-24*7 Ambulance Not Available Available

Booking

Your Tata AIG MediCare Policy No. 0238797729 is due for renewal on 26/01/2024.
Subsequent to revision of existing Tata AIG MediCare Policy, we are offering option of migrating your existing policy to our revised “Tata AIG MediCare”.
Details of the revised premium upon migration are mentioned below. We request you to migrate your existing policy before the expiry date to continue
enjoying your existing benefits. Upon migration to revised Tata AIG MediCare, all your continuity benefits such as waiting periods would be transferred
to the revised product.
We look forward to a long and healthy relationship with you and your family.

Tata AIG MediCare Premium Details (New UIN No. TATHLIP23118V032223)

Migration Due Date 26/01/2024
Net Premium (₹) 17,856
GST @18% 3214.08
Total Premium (₹) inclusive of GST# 21,070

Name of the Date of Relationship with Cumulative Existing Sum Enhanced Sum Enhanced Sum
Insured Member Birth Policy Holder Bonus* (₹) Insured (₹) Insured 1 (₹) Insured 2 (₹)

REKHA MANOHAR 15/08/1968 Self

DESHMUKH 4,00,000 4,00,000 5,00,000 7,50,000
GAYATRI DESHMUKH 02/10/1998 Daughter

Revised Premium payable for 1 Year (₹) 21,070 21,573 23,132

Revised Premium payable for 2 Year (5 % discount) (₹) 42,925 44,102 47,321

Revised Premium payable for 3 Year (10 % discount) (₹) 62,369 64,146 68,843

Payment of premium by you for Tata AIG MediCare (New UIN TATHLIP23118V032223) shall be considered as your consent to migrate to revised product.
#Premium is inclusive of risk loading in the same proportion as applied to your existing Tata AIG MediCare Policy.

TATA AIG General Insurance Company Limited

Registered Office: Peninsula Business Park, Tower A, 15th Floor, G.K. Marg, Lower Parel, Mumbai – 400013, Maharashtra.
24x7 Toll Free No: 1800 266 7780 or 1800 229966 (For Senior Citizens) | Email: customersupport@tataaig.com | Website: www.tataaig.com
IRDA of India Registration No: 108 | CIN: U85110MH2000PLC128425 | Tata AIG MediCare old UIN: TATHLIP21224V022021
New UIN: TATHLIP23118V032223
AML guidelines:
1. I/we hereby confirm that all premiums paid / payable in future will be from bonafide sources and not paid out of proceeds of crime and that such
premiums are not disproportionate to my/our income. I / we understand that the Company has the right to call for documents to establish sources of
funds and to cancel the insurance policy in case I / we are found guilty by any competent court of law under any of the statutes, directly or indirectly
governing the prevention of money laundering law in India.
2. I / we are not Politically Exposed Persons** nor are their close relatives. I / we shall keep the company informed if we subsequently become a
Politically Exposed Person.
**“Politically Exposed Persons” shall have the meaning assigned to it under sub clause (xii) of 3(b) of Chapter I of Master Direction – Know Your
Customer (KYC) Direction, 2016 issued by Reserve Bank of India (RBI), as amended from time to time.

Nationality: Indian Non-Indian If Non-Indian, please specify Country __________________________

Prohibition of Rebates - Section 41 of Insurance Act, 1938 as amended by 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 an 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 published prospectuses 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.

I consent to migrate my existing Tata AIG MediCare policy to the revised Tata AIG MediCare (New UIN TATHLIP23118V032223) for which I shall make the
appropriate premium payment before the due date.

Signature Email Contact Date

DD/MM/YYYY

Please pay your premium by cheque /Pay Order drawn in favor of 'Tata AIG General Insurance Company Limited' or through online mode.

In case of any assistance, please reach us on our toll free no. 1800 266 7780/Senior Citizen toll free no. 1800 229966. Or you can write to us at
customersupport@tataaig.com.

With you always!

Authorized Signatory

General Exclusions (Important):

Medical Exclusions:
Admission primarily for diagnostic and evaluation purposes only.
Congenital External Diseases, defects or anomalies.

Non-Medical Exclusions:
Any Insured Person’s participation or involvement in naval, military or air force operation.
Intentional self-injury or attempted suicide while sane or insane.
Any Insured Person attempting to commit a breach of law with criminal intent.

Please refer to Tata AIG MediCare policy (New UIN TATHLIP23118V032223) wordings for complete list of Benefits and Exclusions.

Terms and Conditions

Grace period of 30 days from the policy expiry is available. Coverage is not available for the period for which no premium is received.
Any product revision/modification/future withdrawal will be done with the approval of IRDAI and will be intimated to You at least 3 months in
advance. In case of withdrawal, you have an option to migrate to our similar health insurance product.

Insurance is the subject matter of the solicitation. For more details on risk factors, terms and conditions, please read the policy wordings carefully, before concluding
a sale.

TATA AIG General Insurance Company Limited

Registered Office: Peninsula Business Park, Tower A, 15th Floor, G.K. Marg, Lower Parel, Mumbai – 400013, Maharashtra.
24x7 Toll Free No: 1800 266 7780 or 1800 229966 (For Senior Citizens) | Email: customersupport@tataaig.com | Website: www.tataaig.com
IRDA of India Registration No: 108 | CIN: U85110MH2000PLC128425 | Tata AIG MediCare old UIN: TATHLIP21224V022021
New UIN: TATHLIP23118V032223