HDFC ERGO Sarv Suraksha Policy
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ranju93HDFC ERGO Sarv Suraksha Policy
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HDFC ERGO General Insurance Company Limited
SARV SURAKSHA ADVANTAGE POLICY SCHEDULE
Policy No: 51324478 Issued On : 04/10/2012 Location : Mumbai
PERSONAL DETAILS
Name of Proposer Address
MURUGAN S QUANTAM KNITS PVT LTD 181 KOLLUPALAYAM ARASUR COIMBATORE - 641407 TAMIL NADU Tel.(Res.) Mobile No. 9042870438 Office No.
Contact Nos
Email id Name of Nominee
[email protected] S SIVAKUMAR
POLICY AND PREMIUM DETAILS
Relationship to the Insured
Sibling
Policy Commencement
Sr.No.
04/10/2012
Relationship
Policy Expiry Date
Date of Birth Age Benefit % (Yrs)
03/10/2013
Nominee Name
List of Insured Persons/Dependents
1 Sr.No. 1
MURUGAN S Coverage Personal Accident
Self
09/03/1985
27
100%
S SIVAKUMAR Sum Insured (Rs) 1,000,000
Description Accidental Death and Permanent Disablement
TERMS & CONDITIONS
1. 2. 3. 4.
The maximum claim amount payable on this certificate is Rs. 1,000,000. The maximum claim amount payable for each member specified under this certificate shall be restricted to the Benefit % of the SI as shown in the schedule. The operative time for this Policy shall be 24 Hrs. The Territorial Limits for this policy shall be worldwide
PREMIUM DETAILS
Gross Premium (Rs.) Tax,duties and cess as applicable (Rs.)
Net Premium (Rs.)
700 87
787
Address of Issuing Office Date
6th Floor,Leela Business Park,Andheri-Kurla Road,Andheri (East) Mumbai 400059. 12/10/2012
Consolidated stamp duty for this Insurance Policy is paid by Demand Draft,vide Receipt/Challan no. 91232 dated 11/01/2012 as prescribed in Government Notification Revenue and Forest Department No Mudrank 2004/4125/CR 690/M-1, dated 31/12/2004.
Agent Code: 201587086428 Agent Name: HDFC BANK CC HEALTH Phone No: 022-28561818
Insurance is the subject matter of the solicitation. 6th Floor, Leela Business Park , Andheri Kurla Road , Andheri (East), Mumbai 400 059, Toll-Free No. 1800-2-700-700 Fax : 91 22 6638 3699 [email protected] www.hdfcergo.com Registered Office : Ramon House , H.T. Parekh Marg, 169 , Backbay Reclamation , Mumbai 400 020.
HDFC ERGO General Insurance Company Limited
SARV SURAKSHA ADVANTAGE POLICY SCHEDULE
Service Tax Reg. No.: AABCH0738EST004
For HDFC ERGO General Insurance Company Limited
Duly Constituted Attorney
Insurance is the subject matter of the solicitation. 6th Floor, Leela Business Park , Andheri Kurla Road , Andheri (East), Mumbai 400 059, Toll-Free No. 1800-2-700-700 Fax : 91 22 6638 3699 [email protected] www.hdfcergo.com Registered Office : Ramon House , H.T. Parekh Marg, 169 , Backbay Reclamation , Mumbai 400 020.
