Ratnakar Bhanj Insurance

Digitally signed by Reliance
General Insurance
Company Limited
Date: 2024.02.15 19:45:40
IST
Trejhara
Personal Accident Policy Schedule

Policyholder Details
Policy Number: 202522429130000068 Proposal/Covernote No: R15022499992
Name : Mr. RATNAKAR BHANJ Policy Servicing Branch :2nd floor, Satya Sarovar Complex,
Pradhan Road, Maulaganj DARBHANGA DARBHANGA BIHAR
Correspondence Address & Place of Supply: Transaction ID :W5150224100579

S/O HARI BHANJ, CHAKRADHARPUR, Tax Invoice No. & Date :R15022499992 & 15/02/2024
ROLADIH,.,JHINKPANI,JHINKPANI,WEST
SINGHBHUM,JHARKHAND,833215
Mobile No : 6201601361 GSTIN/UIN of Policyholder : null
Contact No. Res. : Gender : Male
Email-ID :
Plan Details
Tenure: 1Year Premium Payment Mode Online
Business Type NEW
Policy Period Start Date: 16/02/2024 End Date: 15/02/2025 Renewable Date: 16/02/2025
NOMINEE DETAILS
Name DHAMATI DEVI Date Of Birth 01/01/1982 Relationship with proposer Spouse
Address of Nominee S/O HARI BHANJ, CHAKRADHARPUR, ROLADIH,.,JHINKPANI,JHINKPANI,WEST
Details Of Insured 1 2 3 4
Name RATNAKAR BHANJ
Gender Male
Relation with policy holder Self
Date of Birth (DD/MM/YYYY) 01/01/1977
Occupation Others
Table Of Benefits
Capital Sum Insured (₹) 300000
Cumulative Bonus 0
ABHA Number or ABHA ID
Policy is extended to provide for reimbursement of actual medical expenses incurred for treatment of accidental injuries for which the
claim is made under the policy, subject to a maximum of 20% of the Sum Insured or 40% of the compensation admissible in settlement
of a valid claim under the Policy, whichever is lower.
23P68298 ANTONY
Intermediary Code Intermediary Name Intermediary Contact No POS UID Aadhaar No./PAN No.
Premium Details Amount (` )

Basic Premium 270.00
Loading : Underwriting 0.00
Discount 0.00
Net Premium 270.00
IGST @ 18.00% 48.60
Total Premium (`) 319.00
Reliance General Insurance Company Limited. IRDAI Registration No. 103 An ISO 9001:2015 Certified Company
Registered Office & Corporate Office: Reliance General Insurance Company Limited 6th Floor, Oberoi Commerz, International Business Park, Oberoi Garden City, Off
Western Express Highway, Goregaon (East), Mumbai – 400 063
Corporate Identification No. U66603MH2000PLC128300. UIN. RELPAIP01002V010001. Trade logo displayed above belongs to Anil Dhirubhai Ambani Ventures Private
Limited and used by Reliance General Insurance Company Limited under. License RGI/MCOM/CO/2913/PS/Ver.1.3/010218
Page 1 of 14
Trejhara
Note :- The minimum premium under the policy is Rs.250(excluding all taxes)
GSTIN : 10AABCR6747B1ZV, HSN 997133, Description of services : null
C
As per the GST regulations, the amount of GST will not be refunded if the policy / endorsement is cancelled after 30th September of the
next financial year.
Consolidated Stamp duty Paid vide Letter of Authorisation “NO.LOA/Enf-1/CSD/35/2023/(Validity Period Dt.01/01/2024 to
Dt.01/12/2024)/52 Date 02 Jan 2024” at General Stamp Office, Mumbai.** Not Applicable for the State of Jammu & Kashmir
Benefits:
Basic Cover Limits
A As at Clauses(a) Operative Clause of Policy Wordings
B As at Clauses(a),(b),(c) and (d) of Operative Clause of Policy Wordings
C As at Clauses(a),(b),(c),(d) and (e) of Operative Clause of Policy Wordings
D As at Clauses(a),(b),(c),(d),(e)and(f) of Operative Clause of Policy Wordings
Contact details Policy Servicing Claim Servicing

Name Customer Service Team R Care
Reliance General Insurance Company Reliance General Insurance,1-89/3/B/40 to
Limited Winway Building,2nd & 3rd Floor, 42/ks/301, 3rd floor,Krishe Block, Krishe
Correspondence Address
11/12, Block No - 4, Old No-67, South Sapphire,Madhapur, Hyderabad.Pin code-
Tukoganj, Indore (M.P) - 452001 500081
E-mail ID rgicl.services@relianceada.com Rgicl.rcarehealth@relianceada.com
Contact No N/A 022 48903009
Fax No
Website www.reliancegeneral.co.in www.reliancegeneral.co.in
Paid No 022 48903009 022 48903009
Please Note:
-The Benefits which are mentioned in this Schedule shall only be available under the Policy
-This document must be surrendered to the Company in case of cancellation of the Policy or for the issuance of a fresh Schedule in the case of any alteration in the Policy. In
the event of any incorrect representation, the policy will be considered as Void and no claims shall be admissible.
-In witness whereof this Policy has been signed at Mumbai on policy tax invoice date in lieu of Proposal No. as mentioned in the policy
-This document shall be treated as a Tax Invoice as per Rule 46 of the Central Goods and Services Tax Rules 2017
-
-The policy wording with detailed terms, conditions and exclusions is available on our website www.reliancegeneral.co.in
(Policy wordings link : https://www.reliancegeneral.co.in/Insurance/About-Us/Downloads.aspx)
You can also write to us at rgicl.services@relianceada.com or call us on 022 4890 3009 (Paid) to avail the policy wording.
In case of a renewal, the benefit provided under the policy and/or terms and conditon of the policy including premium rate may be subject to change.
Page 2 of 14
Trejhara
Grievance Clause :- For resolution of any query or grievance, Insured may contact the respective branch office of the Company or may call at 02248903009 or may
write an email at rgicl.services@relianceada.com. In case the insured is not satisfied with the response of the office, insured may contact the Nodal
Grievance Officer of the Company at rgicl.grievances@relianceada.com. In the event of unsatisfactory response from the Nodal Grievance Officer,
insured may email to Head Grievance Officer at rgicl.headgrievances@relianceada.com. In the event of unsatisfactory response from the Head
Grievance Officer, he/she may, subject to vested jurisdiction, approach the Insurance Ombudsman for the redressal of grievance. Details of the
offices of the Insurance Ombudsman are available at IRDAI website www.irda.gov.in or on company website www.reliancegeneral.co.in or on
www.gbic.co.in. The insured may also contact the following office of the Insurance Ombudsman within whose territorial jurisdiction the branch or
office of the Company is located. Office of the Insurance Ombudsman, 2nd floor ,north wing, Lalit Bhawan , Bailey Road , Patna 800 001. Tel.:
0612-2680952 Email: bimalokpal.patna@cioins.co.in
For Reliance General Insurance Co. Ltd.

Special Conditions, if any:
Authorised Signatory
Page 3 of 14
Trejhara
Know your policy

Remember to carefully go through the policy documents and confirm your details.
In case of any discrepancyin the policy detail, kindly revert within 15 days from policy start date on 022 48903009(Paid No) or visit any
of our branches or mail us at rgicl.services@relianceada.com
Kindly refer to the Customer Information Sheet and Policy Wording to understand your policy better and learn more about the policy
coverages & Policy Exclusion.
How do I lodge a Claim?
What documents do you require to register a Claim (Indicative list)
1. Original claim form-completely filled and singed. 6. Photo ID proof of Insured & Nominee (PAN card/Aadhar card/Passport)
2. Original/Attested copy of Death Certificate/Disability certificate issued by 7. Original Cancelled CTS 2010 compliant cheque of the Insured
authorised officer. (disabilityauthorised officer. claims) or Nominee (in death cases)for NEFT.
3. Attested copy of First Information report (FIR) / Inquest Panchnama / Spot settled Approved claims will be settled only by mode of NEFT.
only by mode of NEFT. 8. Complete treatment record like Discharge summary, Consultation papers.
4. Attested copy of Post Mortem Examination report with supporting Investigation with supporting Investigation reports like X-ray/MRI etc
reports like X-ray/MRI etc.
5. Medico-Legal Certificate (MLC) from Treating Medical Officer.
Note: As soon as a claim occurs, please intimate immediately to our call center 022 48903009(Paid No) . Delay in intimation would result in the voilation of policy condition
How to renew your policy conveniently Payment Modes
The content of this page is for additional information & should not be considered as policy document / Schedule
Page 4 of 14
Trejhara
Online Proposal form for Reliance -Personal Accident Proposal No. :R15022499992
Proposer Details
Name of Proposer Mr. RATNAKAR BHANJ
Gender Male
Date Of Birth* 01/01/1977 Nationality Indian
Marital Status Married
Address of Proposer S/O HARI BHANJ, CHAKRADHARPUR, ROLADIH,.,JHINKPANI,JHINKPANI,WEST
Pan No.
Occupation Others Mobile Number* 6201601361
Monthly Income 0 E-mail
Nomination Details
The nominee as declared hereunder shall become eligble for claim payment under the Policy as per terms and conditions of the policy, in
the event of the death of the Policyholder. The receipt of the proceeds by the nominee would be sufficient discharge to the Company.
Nominee for all other person(s) proposed shall be the proposer himself/herself.
Name of Nominee D.O.B Relationship with propose Address of Nominee
S/O HARI BHANJ,
CHAKRADHARPUR,
ROLADIH,.,JHINKPANI,JHINKP
DHAMATI DEVI 01/01/1982 Spouse
ANI,WEST
SINGHBHUM,JHARKHAND,833
215
Section A: Details of person(s) proposed to be insured

Details Of Insured 1 2 3 4
Name RATNAKAR BHANJ
Gender Male
Relation with policy holder Self
Date of Birth (DD/MM/YYYY) 01/01/1977
Occupation Others
Table Of Benefits
Capital Sum Insured (₹) 300000
ABHA Number or ABHA ID
Details of existing physical defect or infirmity, if any, of any of the persons proposed of insurance:
Premium Payment Details
Premium Amount: 319.00 Payment Mode: Online Date: 15/02/2024
Bank Name: Amount in words: Three Hundred And Nineteen Only
Page 5 of 14
Trejhara
Declaration & Warranty on Behalf of All persons proposed to be Insured

i. I have read and understood the broucher/prospectus/sales literature/terms and conditions of the Policy and confirm to abide by the
same.
ii. I understand that the information provided by me will form basis of the insurance policy, is subjected to the Broad approved
underwrting policy of the insurance Company and that the policy will come into force only after full receipt of the premium chargable.
iii. I/We further declare that I/We will notify in writing any change occuring in the occupation or general health of the life to be
insured/proposer after the proposal has been submittedbut before communication of the risk acceptance by the Company
iv. I/We declare and consent to the Company seeking medical information from any Doctor or from a hospital who at
time has attended on the liife to be insured/proposer or from any past or present employer concerning anything which affets physical
and mental health of the life of assured/proposer has been made for the purpose underwriting the proposal and / or claim settlement.
v. I/We authorized the Company to share the information pertaining to my proposal including the medical record for sole purpose of
proposal underwiting and/or claim settlement and with any Government and/or regualatory Authority.
vi. Receipt of Proposal form by the Company shall not be constrcted as acceptance of proposal. I hereby agree that
the insurance coverage shall commence only on realization of full premieum and on receipt of complete medical reports (whenever
applicable) and subject to individual underwriting by the Company. The Company as its sole discretion reserve the right to accept or
reject or load any proposal without assigning any reason thereof.
vii. I understand that the Policy shall become void at Company's option, in the event of any untrue or incorrect statement,
misrepresentation non-description or non-disclosure of any material fact in the Proposal form / personal statement, declaration and
connected documents or any material information having been withheld by me or anyone acting on my behalf.
viii. I hereby declare that the person(s) proposed to be insured would submit to medical examinations, before the nominated doctors of
the Company or undergo diagnostic or other medical tests, as suggested by the Company for its underwriting.
ix. I consent to provide a valid age proof and identiy proof at time of claim or any other time when required by the Company.
x. I/We consent to receive information from the Comoany through physical, electronic or telecommunication from time to time.
xi. I hereby declare on my behalf & on behalf of all person proposed to be insured that the above statements, answers and/or particulars give
xii. I declare that I am submitting a proposal for health insurance policy to Reliance General Insurance Company Ltd. (Company)
through the Company's website/Portal, after satisfying myself on the truthfulness of the statements made by me herein and of the
need to disclose all material facts.
xiii. I further declare the the premium is being paid from credit/debit card/internet bank account.
xiv. You are requested to please verify details of the online proposal form and cross-check aganist the policy schedule. In case of any
discrepancy , you should report it within 15 days of the receipt of the proposal form at our Paid no: 022 48903009, else it will be
persumed that everything is in order.
IMPORTANT
• The policy has been issued based on the telephonic conversation / online proposal form, details provided wherein have been recorded in
this proposal form. In case of any discrepancy you are requested to contact our call centre at 022 48903009(Paid No) and record the
discrepancy within 15days of receipt of the policy. In case we do not get any communication from your side we will presume that all the
details provided in the policy & proposal form all complete and accurate
• The information that you give to Reliance General Insurance on this online form will be treated as the proposal form and details in any
supplemental information form or documentation supplied by you or on your behalf will influence our decision to offer insurance and the
terms upon which to offer it. It is therefore important that your answers are complete and accurate in all respect.
• I have read and understood the terms and conditions governing the online transaction facility of Reliance General Insurance Company
Ltd.
Prohibition of Rebates - Section 41 of the Insurance Act, 1938 as amended by Insurance Laws (Amendment) Act, 2015.
• 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.
• Any person making default in complying with the provisions of this section shall be punishable with fine, which may extend to five
hundred rupees.
Page 6 of 14
Trejhara
CUSTOMER INFORMATION SHEET / KNOW YOUR POLICY
This document provides key information about your policy. You are also advised to go through
your policy document.
SI TITLE DESCRIPTION POLICY
NO (Please refer to applicable Policy Clause Number in next column) CLAUSE
NUMBER
1. Name of Personal Accident
Insurance
Product /
Policy
2. Policy number 202522429130000068
3. Type of Benefit (Where an Insurance Policy pays a fixed amount under the
Insurance policy on the occurrence of a covered event)
Product /
Policy
4. Sum Insured Capital Sum
Name Table Of Benefits
(Basis) Insured (₹)
RATNAKAR BHANJ 300000
5. Policy
Coverage
Cover Name Clause No
(What the
policy
covers?) Accidental Death: Death of the insured person, due to an Injury
OPERATIV
sustained in an Accident during the Policy Period, provided that the
E CLAUSE
Insured Person's death occurs within 12 months from the date of
-a
the Accident.
Permanent Total Disability : Such Injury sustained in an Accident
during the Policy Period, which shall within twelve calendar months
of accident occurrence be the sole and direct cause of the total and
irrecoverable loss of :
- sight of both eyes, or of the actual loss by physical separation of OPERATIV
two entire hands or two entire feet or E
- one entire hand and one entire foot, or of such loss of sight of one CLAUSE-
eye and such loss of one entire hand or one entire foot. b, c
NOTE: 'physical separation' of a hand means separation at or
above the wrist and of the foot means at or above the ankle. (Please
refer policy wording for more details)
Page 7 of 14
Reliance Personal Accident Insurance. UIN: RELPAIP01002V010001. RGI/MCOM/CO/2913/PS/Ver.1.3/010218
Trejhara
Permanent Partial Disability : Such Injury sustained in an Accident

during the Policy Period, which shall within twelve calendar months
of accident occurrence be the sole and direct cause of the partial
and irrecoverable loss, e.g.
- Loss of toes - all
- Loss of hearing - both ears OPERATIV
- Loss of four fingers E
- Loss of four fingers and thumb of one hand CLAUSE- e
- Loss of thumb - one phalanx
- Loss of metacarpals - first or second (additional) or third, fourth or
fifth (additional)
- Loss of little finger - three phalanges or two phalanges or one
phalanx (Please refer policy wording for more details)
Temporary Total Disability : Such injury which shall be the sole and
direct cause of temporary total disablement, then so long as the OPERATIV
Insured Person shall be totally disabled from engaging in any E
employment or occupation of any description whatsoever. CLAUSE- f
Carriage Of Dead Body : In the event of death of the insured person

due to an accident defined in the policy outside his place of Additional
residence, the company provides transportation facilities for the Benefit - 1
dead body of the insured person to his place of residence
Education Grant : In the event of death or permanent total
disablement of the Insured due to accident, the Company shall pay
as education grant for the dependent children.
- Such Dependent Child/ Children(s) is/are pursuing an educational Additional
course as a full time student in an educational institution. Benefit - 2
- Age of the child or children as the case shall not be more than 25
completed years.
Medical Expense (Optional Cover) : It means those expenses that
an insured person has necessarily and actually incurred, during the
policy period for medical treatment on account of injury on the EXTENSIO
Medical Advice of a medical practitioner, as long as these are no N:
more than would have been payable if the insured person had not MEDICAL
been insured and no more than other hospitals or Medical EXPENSE
Practitioners in the same locality would have charged for the same
medical treatment.
Page 8 of 14
Trejhara
6. Exclusions Following is a partial list of the policy exclusions. Please refer to

the policy document for the complete list of exclusions:
1. Death or disablement resulting directly or indirectly caused by,
contributed to or aggravated or prolonged by childbirth or from
pregnancy or in consequence thereof.
2. Compensation under more than one of the foregoing Clauses in
respect of the same period of disablement of the Insured
3. Any other payment to the same person after a claim under one of
the foregoing Clauses (a), (b) or (d) has been admitted and
become payable save for payments under medical expenses
extension and for carriage of dead body.
4. Any payment in case of more than one claim in respect of such
Insured Person under the policy during any one period of
insurance by which the maximum liability of the Company
specified in the Schedule applicable to such Insured Person
5. Payment of weekly compensation until the total amount shall

have been ascertained and agreed.
6. Payment of compensation in respect of death, injury or
disablement of the Insured Person (a) from intentional selfinjury,
suicide or attempted suicide, (b) whilst under the influence of
intoxicating liquor or drugs (c) whilst engaging in aviation or
ballooning whilst mounting into, dismounting from or travelling in
any aircraft or balloon other than as a passenger (fare paying) in
any duly licensed standard type of aircraft anywhere in the world,
(d) directly or indirectly caused by venereal diseases, AIDS or
insanity, (e) arising or resulting from the Insured Person
committing any breach of law with criminal intent.
'Standard type of aircraft' means any aircraft duly licensed to carry

passengers (for hire or otherwise) by an appropriate authority
irrespective of whether such an aircraft is privately owned or
chartered or operated by a regular airline or whether such an
aircraft has a single engine or multiengine.
7. Payment of compensation in respect of death, injury or
disablement of the Insured Person due to or arising out of or
directly or indirectly connected with or traceable to war, invasion,
act of foreign enemy, hostilities (whether war be declared or not),
civil war, rebellion, revolution, insurrection, mutiny, military or
usurped power, seizure, capture, arrests, restraints and
detainments of all Kings, Princes and people of whatsoever
nation, condition or quality.
8. Payment of compensation in respect of, death of, or bodily injury
Page 9 of 14
Trejhara
or any illness to the Insured Person directly or indirectly caused

by or contributed to by or arising from: a) ionizing radiation or
contamination by radioactivity from any nuclear fuel or from any
nuclear waste or from the combustion of nuclear fuel and for the
purposes hereof, combustion shall include any self-sustaining
process of nuclear fission; b) nuclear weapons material.
Provided that due observance and fulfillment of the terms and
conditions of this policy (with conditions on all endorsements
hereon are to be read as part of this policy) shall so far as they
relate to anything to be done or not to be done by the Insured and
/ or Insured Person and truth of the statement and answers in
the said written proposal shall be a condition precedent to any
liability of the Company under this policy.
9. The insurance under this policy shall not extend to cover death or
disablement resulting directly or indirectly caused by, contributed
to or aggravated or prolonged by misfeasance, malfeasance or
nonfeasance or breach of trust in relation thereto by the Insured.
7. Waiting
period Time
period during
which
specified
diseases /
treatments
are not
Not applicable
covered It is
counted from
the beginning
of the policy
coverage
8. Financial
limits of
coverage
Sub-limit (It is
a predefined Not Applicable
limit and the
Page 10 of 14
Trejhara
insurance
company will Not Applicable
not pay any
amount in
excess of this
limit)
Co-payment
(It is a
specified
amount /
percentage of
the
Not Applicable
admissible
claim amount
to be paid by
policyholder/
insured).
Deductible (It
is a specified
amount: up to
which an
insurance
company will
not pay any
claim, and
which will be
deducted Not Applicable
from total
claim amount
(if claim
amount is
more than the
specified
amount)
Any other limit

(as Not Applicable
applicable) "
Page 11 of 14
Trejhara
9. Claims / Details of procedure to be followed for cashless service as well as

Claims for reimbursement of claim including pre and post hospitalization
Procedure
Turn Around Time (TAT) for claims settlement:
v. TAT for preauthorization of cashless facility) 2 Years
vi. TAT for cashless final bill authorization: 1 Year
Web link for following:
ix. Network Hospital details Reliance General Insurance Locator
(rgi-locator.appspot.com)
x. Helpline number +91 22 4890 3009 (Paid number)
xi. Hospitals which are blacklisted or from where no claims will be
accepted by insurer
https://www.reliancegeneral.co.in/downloads/Black_List_Hospital.p
df
xii. Downloading/getting claim form
https://www.reliancegeneral.co.in/insurance/claims/claim-page-hea
lth.aspx
10. Policy Any issues related with respect to policy, kindly E-mail us at
Servicing: rgicl.services@relianceada.com and for correspondence contact us
Reliance General Insurance Company Limited Correspondence
Address – Reliance General Insurance., Winway Building 2nd &
3rd Floor, 11/12 Block No-4, Old no-67, South Tukoganj, Indore
(M.P) - 452001 Contact No.- +91 22 4890 3009 (Paid Number)
11. Grievances/ a. Details of Grievance redressal officer refer the link (
Complaints
https://www.reliancegeneral.co.in/Insurance/About-Us/Grievance-R
edressal.aspx
b. IRDAI Integrated Grievance Management System-
https://igms.irda.gov.in/
c. Insurance Ombudsman - The contact details of the Insurance
Ombudsman offices have been provided as Annexure-B of Policy
document
12. Things to Free Look Cancellation: The Free Look Period shall be applicable
Remember on new individual health insurance policies and not on renewals or
at the time of porting/migrating the policy. The Insured Person shall
be allowed free look period of fifteen days (30 days if the policy is
sold through distance marketing or if the Policy Period is 3 years)
from date of receipt of the policy document to review the terms and
conditions of the Policy, and to return the same if not acceptable. If
the Insured has not made any claim during the Free Look Period,
the Insured shall be entitled to
Page 12 of 14
Trejhara
the Insured shall be entitled to
i. a refund of the premium paid less any expenses incurred by the
Company on medical examination of the insured person and the
stamp duty charges or
ii. where the risk has already commenced and the option of return
of the policy is exercised by the insured person, a deduction
towards the proportionate risk premium for period of cover or
iii. Where only a part of the insurance coverage has commenced,
such proportionate premium commensurate with the insurance
coverage during such period
Policy Renewal: Except on grounds of fraud, moral hazard or
misrepresentation or non- cooperation, renewal of your policy shall
not be denied, provided the policy is not withdrawn.
Migration and Portability: When your policy is due for renewal, you
may migrate to another policy with us (subject to underwriting
guidelines of company) or port your policy to another insurer
Migration: The Insured Person will have the option to migrate the
Policy to other health insurance products/plans offered by the
Company by applying for migration of the Policy atleast 30 days
before the Policy renewal date as per lRDAl guidelines on
Migration. If such person is presently covered and has been
continuously covered without any lapses under any health
insurance product/plan offered by the Company, the Insured Person
will get the accrued continuity benefits in waiting periods as per
lRDAl guidelines on migration
Portablity : The Insured Person will have the option to port the
Policy to other insurers by applying to such insurer to port the entire
Policy along with all the members of the family, if any, at least 45
days before, but not earlier than 60 days from the Policy renewal
date as per lRDAl guidelines related to portability. If such person is
presently covered and has been continuously covered without any
lapses under any health insurance policy with an Indian
General/Health insurer, the proposed Insured Person will get the
accrued continuity benefits in Waiting Periods as per lRDAl
guidelines on portability
Change in Sum Insured: Sum Insured can be changed
(increased/decreased) only at the time of renewal or at any time,
subject to underwriting by the company. For increase in SI, the
waiting period if any shall start afresh only for the enhanced portion
Page 13 of 14
Trejhara
Moratorium Period: After completion of eight continuous years

under the policy no look back to be applied. This period of eight
years is called as moratorium period. The moratorium would be
applicable for the sums insured of the first policy and subsequently
completion of eight continuous years iwould be applicable from
date of enhancement of sums insured only on the enhanced limits.
After the expiry of Moratorium Period no health insurance policy
shall be contestable except for proven fraud and permanent
exclusions specified in the policy) contract
Please disclose all pre-existing disease's or condition's before
Your buying a policy. Non-disclosure may affect the claim settlement.
13.
Obligations: Disclosure of other material information during the policy period.)
Insurer to specify the material information
The enclosed Customer Information Sheet bearing reference number CIS 202522429130000068 is
essential part of your policy schedule, Kindly review it carefully.
Declaration by the Policy Holder
I have read the above and confirm having noted the details.
Place:JHINKPANI,JHARKHAND
_________________________
Date:15/02/2024 19:02:00 (Signature of the Policy Holder)
Note:
In case of any conflict, the terms and conditions mentioned in the policy document shall prevail
Page 14 of 14

Ratnakar Bhanj Insurance

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Ratnakar Bhanj Insurance

Uploaded by

Copyright:

Available Formats

Digitally signed by Reliance

Personal Accident Policy Schedule

Correspondence Address & Place of Supply: Transaction ID :W5150224100579

Premium Details Amount (` )

Contact details Policy Servicing Claim Servicing

For Reliance General Insurance Co. Ltd.

Know your policy

How do I lodge a Claim?

What documents do you require to register a Claim (Indicative list)

How to renew your policy conveniently Payment Modes

Section A: Details of person(s) proposed to be insured

Premium Payment Details

Premium Amount: 319.00 Payment Mode: Online Date: 15/02/2024

Bank Name: Amount in words: Three Hundred And Nineteen Only

Declaration & Warranty on Behalf of All persons proposed to be Insured

CUSTOMER INFORMATION SHEET / KNOW YOUR POLICY

Permanent Partial Disability : Such Injury sustained in an Accident

Carriage Of Dead Body : In the event of death of the insured person

6. Exclusions Following is a partial list of the policy exclusions. Please refer to

5. Payment of weekly compensation until the total amount shall

'Standard type of aircraft' means any aircraft duly licensed to carry

or any illness to the Insured Person directly or indirectly caused

Any other limit

9. Claims / Details of procedure to be followed for cashless service as well as

Moratorium Period: After completion of eight continuous years

You might also like