Policy Certificate ICICI
Policy Certificate ICICI
Policy Certificate ICICI
Date: 22-11-2022
We thank you for placing your confidence with ICICI Lombard for your Insurance needs.
Please find attached herewith Policy No. : 4200/270713949/00/000 , which has been issued based on the details furnished
by the applicant in the proposal form
Insured Details
Name of the Relationship with Date Of Age in Gender Occupation Pre Existing
Insured Applicant Birth Years illness
HARISH SINGH SELF 01/07/1987 35 Male
Please go through the details as furnished in the format and the policy document. Please confirm that same are in order. In
case there is any discrepancies / variations, you are requested to write back to us immediately at
[email protected] or contact at 24 hour helpline number 1800 2666 for necessary changes / rectification.
In the absence of any communication from you in this connection within a period of 15 days of receipt of this letter, we
would take it that the issued policy is in order and as per your proposal.
The certificate issued to the customers/employees/members of HDFC AUTO MOTOR under the signature of an authorized
signatory of ICICI Lombard General Insurance Company Limited, represents the availability of the Benefits under the Policy to the
Insured Person named below, subject to the terms, conditions and exclusions expressed in the said Policy, but not exceeding the
Sum Insured as specified below.
corporate
Insured Details
136071668
Name of the Insured Relationship with Applicant Date Of Birth Age in Years Gender Occupation Pre Existing illness
HARISH SINGH SELF 01/07/1987 35 Male
LOAN DETAILS
Name of Assignee Nature of Assignment
Loan Account 136071668 Loan Tenure 3
Number
Loan Sanction Date Loan Sanction Amount
Loan Disbursal Date 21/11/2022 Basis of SumInsured Fixed
Status in the Loan
2. Details of the Insured Event along with the Benefits (as per tablebelow):
Premium Details
Basic Premium 6660.18 Stamp Duty 7.4002
CGST % 9.0 CGST Amount 599.42
SGST % 9.0 SGST Amount 599.42
Total Tax Payable 1198.84 Total Premium 7859
Place of Supply MAHARASHTRA
IL GSTIN Registration No. HSN/SAC Code The stamp duty of `7.4002 paid vide deface no.
997133 / GENERAL INSURANCE CSD36420222395 dated 03-Jun-2022
27AAACI7904G1ZN
SERVICES
We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the
aggregate turnover notified under sub-rule (4) of rule 48, we are not required to prepare an invoice in terms of the provisions of
the said sub-rule.
SPECIAL CONDITION
1) Maximum Sum insured in the policy will be capped at INR 10 lacs (i.e. maximum upto 2.50 Lac per EMI, Sum insured is
equivalent to 4 EMIs. 2)Insured Both self (borrower) and co borrower can opt the policy, premium will be payable for both lives
separately. 3)In any case, the maximum number of EMIs payable for any person is 4 EMIs in one policy year. 4) Sum Insured
(25% of SI paid each for 2nd/4th/6th and 7th day of continuous hospitalization for one policy year. 5) Sum Insured in the policy
is for one policy year and in case of multi-year policy the Insured is covered for the Sum Insured on yearly basis (I.e. Maximum
upto 4 EMIs for each policy year). 6) An initial waiting period of 30 days will be applicable (Except in the case of Accidents). 7)
Pre-existing diseases/Specific diseases Covered from Day 1. 8) Customer can claim only upto 4 EMIs, each on hospitalization
days as specified in the policy certificate in one policy year irrespective of number of hospitalizations
Important Notes:
1. Insurance cover will start only on receipt of full premium (First Installment in case the customer has opted for Periodic
Premium Payment option) stated in PART I of the Policy Schedule by ICICI Lombard General Insurance Company Limited.
2. Insurance cover is subject to the terms and conditions mentioned in the Policy wordings provided to you with this Certificate.
3. On renewal of policy benefits and terms & conditions of policy including premium may be subject to change.
4. The above covers would not be applicable for persons occupied in underground mines, explosives and electrical installations on
high tension lines unless otherwise covered and stated in the Policy Schedule.
5. Major exclusions: Intentional self-injury, suicide or attempted suicide whilst under the influence of intoxicating liquor or drugs,
any loss arising from an act of breach of law with or without criminal intent. Please refer to the Policy wordings for a complete
list of exclusions.
6. For any endorsements such as name correction or change in nominee details, you can contact us at Toll Free Number
1800-2666 or Email us at [email protected] or visit our nearest branch.
7. The claimant can contact us at Toll Free Number 1800-2666 or Email us at [email protected] for lodging the
claim.
8. Address for claim notification: IL Health Care, ICICI LOMBARD HEALTHCARE ICICI BANK TOWER, PLOT NO.12,
FINANCIAL DISTRICT, NANAKRAM GUDA, GACHIBOWLI, HYDERABAD, ANDHRA PRADESH PIN CODE: 500032