a000000249_158125

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  • 7/30/2019 A000000249_158125

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    CERTIFICATE OF INSURANCE

    EASY DOMESTIC TRAVEL INSURANCE [PLATINUMPLUS]

    The benefits available are described in the Policy and will be subject to the policy terms, conditions and exclusions. The complete policy terms, conditionsand exclusions can be viewed or downloaded online from [www.apollomunichinsurance.com]. A copy of this Certificate of Insurance must be carried bythe Insured Person during the Risk Period. Please refer to the policy wordings or contact us for any further information or clarification.

    Policy details :

    Policy No: 900001/35001/A000000249 Certificate No : A000000249/158125

    Risk Period: From 08-Feb-2013 16:05 hrs or the boarding of the

    carrier from the place of origin, whichever is later(Commencement of Risk Period)

    To 09-Mar-2013 16:05 hrs or the return to the usual place of

    residence, whichever is earlier. (Expiry of Risk Period)

    Insured Persons' details :Insured Person's details :

    Member ID Insured Persons name Age

    Y0609429 Charik Jain 24

    Coverage details: Subject to Terms & Conditions of the Policy

    S.No. Benefits Sum Insured Deductible

    1. Accident: Medical Treatment Rs. 1,00,000.00 Nil2. Delay of Checked-in Baggage Rs. 1,000.00 12 Hrs3. Total Loss of Checked-in Baggage Rs. 7,500.00 Nil4. Personal Liability Rs. 1,00,000.00 Nil5. Personal Accident [24 Hours] Rs. 5,00,000.00 Nil6. Accident: Medical Evacuation Rs. 1,00,000.00 Nil7. Trip Cancellation Rs. 15,000.00 Nil8. Trip Curtailment Rs. 15,000.00 Nil9. Emergency Travel Rs. 10,000.00 Nil10. Emergency Hotel Rs. 10,000.00 Nil

    11. Flight Delay Rs. 1,000.00 Nil12. Transportation of Mortal Remains Rs. 1,00,000.00 Nil

    Premium details:

    Net premium (Rs.) Service tax (Rs.) Education and secondaryeducation cess (Rs.)

    Gross premium (Rs.)

    105.90 12.71 0.39 119.00Amount payable: 119.00 (Rs. One Hundred Nineteen )

    Assistance Company and claims notification Address for claims submission

    Toll Free No.: 1800-102-0333, Travel Claim Department,Fax: 0124-4584111, Apollo Munich Insurance Company Limited,E-mail: [email protected] 10th Floor, Tower - B, Building No. 10, DLF Cyber City,

    DLF City Phase II, Gurgaon, Haryana - 122002.

    Service Tax No.: AAGCA1654HST002

    Location: Gurgaon For and on behalf of Apollo Munich Health Insurance Company Limited

    Date: 19-Dec-2012 19:21 hrs Authorized Signatory

    Apollo Munich Insurance Company Ltd.:Corp. Off.: 10th Floor, Tower - B, Building No. 10, DLF Cyber City, DLF City Phase II, Gurgaon, Haryana - 122002. Regd. Off.: Apollo Hospitals Complex,

    Jubilee Hills, Hyderabad - 500033.Toll Free No.: 1800 - 102 -0333, E-mail: [email protected], Website: www.apollomunichinsurance.com