Policy No. Cover Note No. Insured's Code Insured Name Address : 441200/48/2012/1746 : Prev. Policy No. Cover Note Date : : -
: 48025917 : HARIDASAN POURNNAN : THOTTUMKARA PUTHEN VEEDU PERAYAM,MULAVANA P.O., KOLLAM - 691503
Issue Office Code : 441200 Issue Office Name : DO I TRIVANDRUM Address : ROHINI BUILDING THAKARAPARAMBU ROAD PAZHAVANGADI TRIVANDRUM KERALA 695023
Tel./Fax/Email
/ / NA
Tel./Fax/Email
Agent/Broker Details Dev.Off.Code : Agent/Broker Address Tel/Fax/Email : LC0000000034 1148 : 19/458, II FLOOR,,GLOBAL PLAZA,,VANCHIKULAM ROAD, POOTHOLE,TRICHUR,KERALA,680004 : 04872389703/04872380875/04872380875/
Period of Insurance : FROM 16:45 ON 06/03/2012 TO MIDNIGHT OF 05/03/2013 Collection No. & Dt. : CHQ 5219010429 - 06/03/2012 Gross Premium : 2,468 Service Tax : 254 Stamp Duty : .5 Total : 2,722
Co-insurance Details : Nil TPA Details : TPA ID TPA Name Address Telephone No : : YA0000000349 M/s TTK Healthcare TPA Pvt. Ltd. 7, Jeevan Bima Nagar, Main Road, Phase III, Bangalore BANGALORE 560075 Toll Free No. : 1800 425 8885, 1800 425 7878 1800 425 8885, 1800 425 7878, 080 40125678 FAX No. : 1800 425 2626
Particulars of the Persons covered : Sr. Name of The No. Persons 1 HARIDASAN POURNNAN Date of Birth 15/05/1984 0 Age
27 Self
2,00,000
Pre - existing Diseases : Cumulative Bonus : Total Premium in words Place : Date : TRIVANDRUM 06/03/2012
: Indian Rupees Two Thousand Seven Hundred Twenty-Two Only For and on behalf of The Oriental Insurance Company Limited
In case of any query regarding the Policy please call Toll Free No. 1800 11 8485 and 011 33208485. All the Amounts mentioned in this policy are in Indian Rupees
Now you can buy and renew selected policies online at www.orientalinsurance.org.in
The insurance under this policy is extended to cover risks of : Domiciliary Hospitalisation Cover.
Deductible : Nil The insurance under this policy is subject to conditions, clauses, warranties,endorsements as per forms attached. The policy shall pay for hospitalisation expenses for medical/surgical treatment taken as an in-patient at any Nursing Home/Hospital in INDIA as defined in the policy. In the event of a claim under the policy exceeding Rs. 1 lac or a claim for refund of premium exceeding Rs. 1 lac,the insured will comply with the provisions of the AML policy of the Company.The AML policy is available in all our operaing offices as well as Company's website. Warranted that in case the person covered under the policy has lodged any claim under the previous policy and the sum insured is enhanced under the current policy, for a further claim for the same disease during the current policy, the earlier limit of Sum Insured shall be applicable and not the enhanced sum insured. Warranted that in case of dishonour of premium cheque(s) the Company shall not be liable under the policy and the policy shall be void abinitio (from inception). "We at Oriental continuously strive to ensure that you get the best possible treatment from our network hospitals. Please contact your TPA or any of the Oriental offices for our preferred hospitals in your area before going for a treatment. This will help us serve you in the best possible manner" In witness whereof the undersigned being authorised by and on behalf of the Company has/have herein to set his/their hands at DO I TRIVANDRUM on 06-MAR-12.
For and on behalf of The Oriental Insurance Company Limited Entered By Examined By : : GEETHA A LETHAKUMARI C.A.
Authorised Signatory
Place : Date :
TRIVANDRUM 06/03/2012
In case of any query regarding the Policy please call Toll Free No. 1800 11 8485 and 011 33208485. All the Amounts mentioned in this policy are in Indian Rupees
Now you can buy and renew selected policies online at www.orientalinsurance.org.in