Group Accident Guard Policy
Certificate of Insurance
New Business-SpeedPost-1-3904606 Intermediary code: CA0574
Insured Person Name & Correspondence Address:
NAZEER . . Intermediary Name: INDIA POST
AMBALATHUVEETTIL CHOWALLUR PAYMENTS BANK LIMITED
AMBALATHUVEETTIL CHOWALLUR
THRISSUR-680102
Intermediary Contact No: 155299
THRISSUR
KERALA Partner Application No.: AH1J66PA1C6
India
Place of Supply: KERALA
State Code: 32
Master Policyholder Name: INDIA POST PAYMENTS BANK LIMITED Policy Number: 0239759171
Policy Period: From 07/04/2023 00:01 Hrs To 06/04/2024 23:59 Hrs Renewal No: 00
Endorsement No: 00
Certificate No.: 10610115
Insured Person E-mail id: [email protected] Cover Period : From 25/07/2023 00:01 Hrs To 24/07/2024 23:59 Hrs
Insured Person Contact No.: 9846206290
Sum Insured Type: Fixed
Sum Insured Basis: FIXED
Premium details
Net Premium (Rs): 338.00
IGST 18% (Rs.) 60.84
Gross Premium (Rs) 399.00
GSTIN: 32AABCT3518Q1Z5-KERALA, Service Accounting Code: 997133.
Insured Details
Relationship (If Credit Linked) Loan Type,
Insured Person Id/ Loan Account
Gender DOB with Insured Sanction Loan Amount, Disbursed
Name: No.:
Person Loan Amount
Nazeer Male 02/01/1978 Self
Nominee Details
Name Gender DOB Relationship with Insured Person Address
Haseena Spouse
The nominee for all other Insured Persons proposed to be insured shall be the Insured himself/ herself.
Coverage Details:
Sr No. Coverages Self SI Spouse SI Child1SI Child 2SI Child 3SI Child 4SI Remarks
1 Accidental Death 1,000,000 0 0 0 0 0 Accountholders
Accidental Dismemberment
2 1,000,000 0 0 0 0 0 COVERED
and Paralysis
l Conditions if any :-
“In consideration of additional premium, Point No. 10 under Section 3- General Exclusions pertaining to Act of Terrorism stands deleted.”
Insurance is the subject matter of the solicitation. For more details on risk factors, terms and conditions, please read sales brochure carefully before concluding a sale.
Tata AIG General Insurance Company Limited.
Regd Office: 15th Floor, Tower A, Peninsula Business Park, G. K. Marg, Lower Parel, Mumbai - 400 013, Maharashtra, India.
Toll Free No. (24x7): 1800 266 7780 l Email: [email protected] Page 1 of 4
IRDA of India Registration No: 108 | Website: www.tataaig.com | CIN: U85110MH2000PLC128425 | UIN: TATPAGP23093V032223
IPD covered
upto Rs 60000
and OPD
3 Accidental Medical Expenses 90,000 0 0 0 0 0 covered upto
Rs 30000.
whichever is
lower
(1)IPD 60,000 0 0 0 0 0
(2)OPD 30,000 0 0 0 0 0
Rs100000 or
actuals
4 Coma 100,000 0 0 0 0 0
whichever is
lower
10 Percent of SI
or Rs 100000
or Actuals
5 Education Benefit 100,000 0 0 0 0 0 whichever is
lower for
maximum 2
eligible children
Rs25000 or
actuals
6 Family Transportation Benefit 25,000 0 0 0 0 0
whichever is
lower
Rs5000 or
actuals
7 Funeral Benefits 5,000 0 0 0 0 0
whichever is
lower
Rs 1000 per
day upto
8 In-Hospital Daily Cash 1,000 0 0 0 0 0
10days 1day
dedcuatble
9 Permanent Partial Disability 1,000,000 0 0 0 0 0 COVERED
10 Permanent Total Disability 1,000,000 0 0 0 0 0 COVERED
11 Terrorism 1,000,000 0 0 0 0 0 COVERED
l The Benefits which are mentioned in this Certificate of Insurance shall only be available under the Policy.
l This COI shall at all times be read in conjunction with Master Policy including as to the T&C of the master policy, the SI under the master
policy and the premium payable under the master policy.
l Important Exclusions:
The Policy does not provide benefits for any loss resulting in whole or in part from, or expenses incurred, in respect of:
1. Any Pre-existing Condition, any complication arising from it;
2. Any claim of Insured Person arising from:
a. suicide or attempted suicide
b. wilful self-inflicted illness or injury except injury in self-defence or to save life; or
3. being under the influence of intoxicating liquor or drugs or other intoxicants except where the insured is not directly responsible for the
injury / accident though under influence of intoxication
4. Participation in an actual or attempted felony, riot, crime, misdemeanor (excluding traffic violations) or civil commotion
This is only a summary of the product features/terms/conditions/exclusions. For more details, please refer our website www.tataaig.com
Commencement of risk cover under the policy is subject to receipt of premium by Tata AIG General Insurance Company Limited.
Stamp Duty of Rs.0/ - is paid as provided under N/A of Indian Stamp Act, 1899 and included in Consolidated Stamp Duty Paid to the
Government of Maharashtra Treasury vide Order of Addl. Controller Of Stamps, Mumbai at General Stamp Office, Fort, Mumbai -
400001., vide this Order No. Validity Period Dt. To Dt./ Date:
Insurance is the subject matter of the solicitation. For more details on risk factors, terms and conditions, please read sales brochure carefully before concluding a sale.
Tata AIG General Insurance Company Limited.
Regd Office: 15th Floor, Tower A, Peninsula Business Park, G. K. Marg, Lower Parel, Mumbai - 400 013, Maharashtra, India.
Toll Free No. (24x7): 1800 266 7780 l Email: [email protected] Page 2 of 4
IRDA of India Registration No: 108 | Website: www.tataaig.com | CIN: U85110MH2000PLC128425 | UIN: TATPAGP23093V032223
General Conditions:
l You have a period of 15 Days from the date of receipt of the Policy document to review the terms and conditions of this Certificate
of Insurance and if you have any objections you have the option of cancelling the Certificate of Insurance stating the reasons for
cancellation and the premium paid after adjusting the amounts spent on any medical check-up, stamp duty charges and proportionate
risk premium shall be refunded.
l There will be no premium refund in case of cancellation due to non-disclosure of material facts, mis-representation or fraud. In case of
non-cooperation, premium shall be refunded on short rate table basis as specified in the policy.
l Any product revision/modification/future withdrawal will be done with the approval of Insurance Regulatory & Development Authority of
India and will be intimated to you at least 3 months in advance. In case of withdrawal, you have an option to migrate to our similar health
insurance product.
l This Certificate of Insurance in original must be surrendered to the Company in case of cancellation of the Certificate of Insurance
Claims Administrator
AdministratorDetails:
Detail Insured Person(s) can notify a Claim by sending an SMS CLAIMS to 5616181 or by calling The
Company’s 24x7 toll free helpline 1800-266-7780 or 1800 229966 (only for senior citizen Policy holders). Please use the Claim Intimation
Form for intimation of a claim.
Policy Servicing/Grievances/Complaints:
l The Company is committed to extend the best possible services to its customers. However, if you are not satisfied with our services
and wish to lodge a complaint / claim, please feel free to call our 24X7 Toll free number 1800-266-7780 or you may email to the customer
service desk at [email protected]. Senior citizens can call our dedicated line at 1800 22 9966. Please refer TheCompany’s
Website for the grievance redressal policy
Prohibition of Rebates – Section 41 of Insurance Act, 1938 as amended by Insurance Laws I Amendment) Act, 2015
1. No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or renew or continue an
insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable
or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate,
except such rebate as may be allowed in accordance with the published prospectuses or tables of the insurer.
2. Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakh
rupees
Date: 25/07/2023 For TATA AIG General Insurance Company Limited
Place: THRISSUR
Authorised Signatory
For Policy wordings, please scan the below QR code :
Policy Servicing Address
Peninsula Business Park, Tower A, 15th Floor, Ganpatrao Kadam Marg, Lower Parel, MUMBAI, MAHARASHTRA-400013
Insurance is the subject matter of the solicitation. For more details on risk factors, terms and conditions, please read sales brochure carefully before concluding a sale.
Tata AIG General Insurance Company Limited.
Regd Office: 15th Floor, Tower A, Peninsula Business Park, G. K. Marg, Lower Parel, Mumbai - 400 013, Maharashtra, India.
Toll Free No. (24x7): 1800 266 7780 l Email: [email protected] Page 3 of 4
IRDA of India Registration No: 108 | Website: www.tataaig.com | CIN: U85110MH2000PLC128425 | UIN: TATPAGP23093V032223
RECEIPT
Receipt No : 109391053417182 Receipt Date : 02/08/2023
Policy No : 0239759171
Received with thanks from NAZEER - a sum of Rs. 399( Rupees Three Hundred Ninety-Nine And Paise Zero Only)Direct Debit, Branch
Bank Branch Name - Deutsche Bank , THRISSUR towards
Sr.No. Policy Number Total Premium Utilized from the receipt for policy Balance
1 0239759171 399.00 399.00 0.00
Note:
1. This is a computer generated receipt and does not require a signature.
2. Upon issuance of this Receipt, all previously issued temporary receipts, if any, related to this Policy shall be considered null and avoid.
3. Amounts received by cheque shall be subject to realisation.
4. Any amount received in excess of the Premium is being/shall be refunded by the Company.
GSTIN: 32AABCT3518Q1Z5-KERALA, Service Accounting Code: 997133
Insurance is the subject matter of the solicitation. For more details on risk factors, terms and conditions, please read sales brochure carefully before concluding a sale.
Tata AIG General Insurance Company Limited.
Regd Office: 15th Floor, Tower A, Peninsula Business Park, G. K. Marg, Lower Parel, Mumbai - 400 013, Maharashtra, India.
Toll Free No. (24x7): 1800 266 7780 l Email: [email protected] Page 4 of 4
IRDA of India Registration No: 108 | Website: www.tataaig.com | CIN: U85110MH2000PLC128425 | UIN: TATPAGP23093V032223
