You are on page 1of 1

Hospitalisation Benefit Policy

Premium Certificate for the purpose of deduction under Section 80 D of Income Tax (Amendment) Act, 1986.
Policy No : P/122112/05/2022/002282 Type of Policy : Senior Citizens Red Carpet
Issue : 122112 - Branch Office – Coimbatore
Office
Address : 1st Floor, DBMS Complex, Tatabad,
Gandhipuram, Coimbatore – 641 012.

Tel/Fax : 0422 – 4222591 /


Email : coimbatore.100ftroad@starhealth.in

This is to certify that MR. SHANKAR GURUSWAMY has paid Rs 51230 (Total Premium: Indian Rupees Fifty-One
Thousand Two Hundred Thirty only) towards premium for Hospitalization Insurance vide Policy No:
P/122112/05/2022/002282 for the Period 05/05/2023 To 04/05/2024 issued on 22-APR-23.
Payment received by Cheque/Credit/Debit Card vide Receipt No: 4326352537 Receipt Date: 22-APR-23

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.

Date : 22/04/2023 For and On behalf of


Place : Coimbatore Start Health and Allied Insurance Company Ltd
IRDA Regn. No 129
Corporate Identity Number U66010TN2005PLC056649
Email ID : info@starhealth.in Authority signatory.

You might also like