PREMIUM PAYMENT ACKNOWLEDGEMENT

Policy Number : C267778706

Policy Owner Name : VINOTH KUMAR R

Plan Name : TATA AIG MEDICARE PREMIER (110N129V03)

Payment Mode : ANNUAL

Premium due date : 27-SEP-2023

Transaction Receipt Payment Payment Method Instrument Number Amount

Date Number Type Instrument Date Bank Name Received

IU0420258 Renewal 202309270 26,038.00

27-SEP-2023

27-SEP-2023 ONLINE

Please note :

• This document can be used as a proof for claiming deduction while filing your tax returns and tax benefits would be
applicable as per the prevailing tax laws.

• The above amount will be credited to your policy on the due date, subject to credit. Premium receipt will be sent on your registered
email id within 2 working days thereafter.

• For ULIP policies, if the premium is received before 3:00 PM, NAV of the same business day will be applied, else next business
day's NAV will be applied.

• Applicable govt taxes, surcharge, cess including GST would be charged in accordance to applicable laws and the Company will
have the right to recover the same from policyholder.

• Please refer policy document for detailed terms and conditions.

Payment Received at : Tata AIG General Insurance Co.Ltd.

Address. 15th Floor, Tower A, Peninsula Business Park, G K Marg, Lower Parel, Mumbai, Maharashtra, 400013

This is an auto generated document, hence does not need any signature.

TATA AIG GENERAL INSURANCE COMPANY LTD. (IRDA of India Regn. No. 110)(CIN - U66010MH2000PLC128403)
Regd. & Corporate office: 14th Floor, Tower A, Peninsula Business Park, Senapati Bapat Marg, Lower Parel, Mumbai-400 013 .
.
Please contact us at 1860-266-9966 (local charges apply) or write to us at customercare@tataaig.com or SMS ‘SERVICE’ to 58888

IRDAI is not involved in activities like selling insurance policies, announcing bonus or investment of premiums.
Public receiving such phone calls are requested to lodge a police complaint.