HDFC ERGO General Insurance Company Limited

2950203834300500000

Mr Uma Shanker
134/1 Mes Tika Line Dalhousie
Chamba Chamba
Himachal Pradesh, 176304 ,
Contact No : 7018537469

Date : 20/07/2022

Dear Mr UMA SHANKER

Thank you for choosing HDFC ERGO as your preferred insurance partner. We welcome you to be a part of our family !
Your Medical insurance policy reference no 29502038364322500543 is confirmed on the basis of the information and declaration given by you.
The details of coverage are mentioned in the enclosed policy schedule of insurance.

We value your relationship with us and assure you our best services at all times and we look forward to serve you.

Now you can view your policy details and health card at your fingertips. Download our Mobile App now and experience convenience today!!

For HDFC ERGO General Insurance Company Ltd.

Vivek Rasgotra
Senior Vice President Operations and Services Group

HDFC ERGO General Insurance Company Limited

Dear Uma Shanker,

Subject : Certificate for the purpose of deduction under section 80 D of Income Tax (Amendment) Act, 1986

This is to certify that we have received an amount of 33467.00 towards premium for Critical Illness Section of Certificate
No. 2950203834300500000 issued to Uma Shanker for the period 20/07/2022 to 19/06/2027.
Note: This is subject to the provisions of Section 80D of income tax (Amendment) Act, 1986 as amended from time to time.

Date : 20/07/2022 For HDFC ERGO General Insurance Company Ltd.

Certificate Issuing Office: Mumbai

Duly Constituted Attorney

HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN:HDFPAIP10004V010910. Customer Service Address: D 301, 3rd Floor,
CIN : U66030MH2007PLC177117. Registered & Corporate Office: 1st Floor, HDFC House, Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078.
165/166 Backbay Reclamation, H.T.Parekh Marg, Churchgate, Mumbai - 400 020. Customer Service No : +91 22-62346234/+91-120 6234 6234 | www.hdfcergo.com
 HDFC ERGO General Insurance Company Limited
Certificate Of Insurance
Sarv Suraksha
( Sarv Suraksha Plus )

203834311500500
0
Certificate No. :2950 2038 3433 0510 070 Issuance Date :20/07/2022 1
Period of Insurance : From 20/07/2022 20:48 hrs To 19/06/2027 Midnight
2
Invoice No. : 203834311500500 Premium Frequency :One Time 1
Proposer Name : Mr Uma Shanker Territorial Limits :Worldwide
Mr Uma Shanker
134/1 Mes Tika LineDalhousie Chamba Chamba Customer Id :101178546986 PAN
Himachal Pradesh, 176304, Contact No : 7018537469 Master Policy No. :2999203617346400
Master Policy Holder
:HDFC BANK LTD
Name
EIA No. : Not provided
Payment Details : SL_ AL_1450_191120 , Bank Name:Hdfc Bank Ltd
Email ID : VIVU289@GMAIL.COM
Insured Details
Insured’s Name Relationship Date of Birth Benefit
Uma Shanker Self 14/05/1965 100%
Nominee Details
Insured’s Name Nominee Name Relationship Benefit
Uma Shanker Renu Spouse 100%
Coverage Details
Coverage Premium (`) Sum Insured (`) Coverage Premium (`) Sum Insured (`)
Loss Of Job (3 EMI) 873 100,000 Critical Illness 33,467 500,000
Accidental Death 747 500,000 Credit Shield Insurance 912 10,00,000
Permanent Total Disability/ Permanent Partial Disability 929 500,000 Garage Cash 821 6,700
Accidental Hospitalization 665 100,000 Householders Coverage 607 250,000
The Policy Wording attached herewith includes all the standard coverage offered by the Company to its customers. Your entitlement for coverage/benefits shall be restricted to the coverage/benefits
as mentioned in this Certificate of Insurance issued to you. Please read the Policy Wording in conjunction with the Certificate of Insurance. For any clarification please call our toll free number.
Premium Details ( ` )
Basic Premium 39021.00
Loadings 0.00
Integrated Tax 18% 7,024.00
Total Premium 46,045.00
Processing Centre 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri(E), Mumbai 400 059.
For Claim/Policy related queries call us at +91- 22 6234 6234/+91- 120 6234 6234 or Visit Help Section on www.hdfcergo.com for policy copy/tax certificate/make changes/register & track claim.
If the premium i s not realised the Certificate shall be void from inception.Consolidated stamp duty for this Insurance Policy i s paid by Demand Draft, vide
Receipt/Challan noCSD/293/2020/385/2020 dated 24/01/2020 as prescribed in Government of Maharashtra Order No. Mudrank-2017/CR.97/M-1, dated the 09th
January 2018". , GST Registration No: 03AABCL5045N1ZI.GST for this invoice is not payable under reverse charge basis.
Branch :3rd floor, nagpal tower-1, sco 128, ranjit avenue amritsar

Agent Name :HDFC BANK LTD For HDFC ERGO General Insurance Company Ltd.
Agent Code :201587086428 Tel No. : 91-22-61606161

* For description of coverages, kindly refer policy wording.

HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN:HDFPAIP10004V010910. Customer Service Address: D 301, 3rd Floor,
CIN : U66030MH2007PLC177117. Registered & Corporate Office: 1st Floor, HDFC House, Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078.
165/166 Backbay Reclamation, H.T.Parekh Marg, Churchgate, Mumbai - 400 020. Customer Service No : +91 22-62346234/+91-120 6234 6234 | www.hdfcergo.com