Track on / / M-727
Policy No. : 0238594140 00
Name : Ms MANISHA MAZI
Address : C/O - AYOKI FABRICON PVT LTD, 137 & 139,
AKSHAY COMPLEX DHOLE PATIL ROAD,
PUNE
PUNE - PUNE
MAHARASHTRA - 411001
919893110432
Dear Customer,
We are glad that you thought ahead and did the right thing by continuing your trust with Tata AIG MediCare,
0238594140. We value your relationship with us and appreciate your confidence in our services. We will not compromise
on your health insurance and neither should you. We will strive to serve you the best.
Please find the following documents along with letter in the parcel.
• Policy schedule
• Premium payment receipt
• 80d certificate
• Customer Information Certificate
For further queries you can visit our website www.tataaig.com or contact us on our Toll Free No.: 1800 266 7780/ For
Senior Citizens: 1800 22 9966.
For Tata AIG General Insurance Company Limited
Authorized Signatory
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 Ltd. Regd. Office: 15th floor, Tower A, Peninsula Business Park,Ganpatrao Kadam Marg, Off Senapati Bapat Marg, Lower Parel,
Mumbai 400013. IRDA of India Registration No.108, CIN No : U85110MH2000PLC128425, UIN No : TATHLIP23118V032223
Website: www.tataaig.com 24X7 Tollfree Helpline 18002667780 Email:[email protected]
Policy No. 0238594140 / M-727 Page No. 1
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Policy
Schedule } Intermediary name : SHRUTI MANTRI
Intermediary code : 21041701
Intermediary contact no. : 9765408680(mobile or landline)
Issuing Office : PUNE
Client Id : 6025863182
Proposal no : 0236577519
Policy holder’s name : MANISHA MAZI
Policy holder’s address : C/O - AYOKI FABRICON PVT LTD, 137 & 139,
AKSHAY COMPLEX DHOLE PATIL ROAD,
PUNE
PUNE,411001
PUNE MAHARASHTRA
919893110432
Insured GST No :
Place of Supply : MAHARASHTRA
Supply Code : 27
Policy Number : 0238594140 00
Product name Tata AIG MediCare
:
Plan type : Individual Basis
Policy period From 28/09/2023 00:00 hrs to 27/09/2024 on
:
11:59 PM
Business Type : RENEWAL BUSINESS
Policy Tenure : 1 Year
Premium Payment Zone : Zone B
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 Ltd. Regd. Office: 15th floor, Tower A, Peninsula Business Park,Ganpatrao Kadam Marg, Off Senapati Bapat Marg, Lower Parel,
Mumbai 400013. IRDA of India Registration No.108, CIN No : U85110MH2000PLC128425, UIN No : TATHLIP23118V032223
Website: www.tataaig.com 24X7 Tollfree Helpline 18002667780 Email:[email protected]
Policy No. 0238594140 / M-727 Page No. 2
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Insured Persons Details :
Member Insured Insured Date Age Relation- Restore Sum Insured Cumu- Accidental
ID person’s with TATA of Birth ship to Benefits (Rs.)# lative Death Sum
name AIG General proposer % Bonus Insured
Insurance (Rs.) (Rs.)
Co. Since
MPN057940010
MANISHA MAZI 29/08/2018 01/07/1987 36 Self 100 300,000.00 300000.00 0.00
1031
*For Family Floater policy, Sum Insured and cumulative bonus floats among the insured members of the family as mentioned above. This shall not be
applicable for newly added members in this policy.
# Sum Insured mentioned is excluding cumulative bonus. Earned cumulative bonus is separately mentioned
Nominee Details for Proposer:
Insured Name Nominee Name Relationship to Proposer
MANISHA MAZI TEKCHAND P MAZI Father
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 Ltd. Regd. Office: 15th floor, Tower A, Peninsula Business Park,Ganpatrao Kadam Marg, Off Senapati Bapat Marg, Lower Parel,
Mumbai 400013. IRDA of India Registration No.108, CIN No : U85110MH2000PLC128425, UIN No : TATHLIP23118V032223
Website: www.tataaig.com 24X7 Tollfree Helpline 18002667780 Email:[email protected]
Policy No. 0238594140 / M-727 Page No. 3
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Benefits table
Net Premium: (Rs) 8784.00
Cover Coverage
Discounts: (Rs) 0.00
Loading: (Rs) 0.00
In-Patient Treatment Upto Sum Insured
UGST/SGST (9%): (Rs) 790.56
Pre-Hospitalization expenses Upto 60 days CGST(9%): (Rs) 790.56
IGST(18%): (Rs)
Post-Hospitalization expenses Upto 90 days
Gross Premium: (Rs) 10365.00
Day Care Procedures Upto Sum Insured Gross Premium amount(in words) : Rupees Ten Thousand
Three Hundred And Sixty Five and Paise 00 Only
Organ Donor Upto Sum Insured
Domiciliary Treatment Upto Sum Insured Claim Servicing Details:
n Name of Claim Administrator: TAGIC Health Claims
Global cover Upto Sum Insured
n Website: www.tataaig.com
Bariatric Surgery Cover Upto Sum Insured n Email:
[email protected] n Toll Free: 1800 266 7780 or 1800 229 966 (For
In-Patient Treatment - Dental Upto Sum Insured Senior Citizens)
n Claims TATA AIG General Insurance Company
Restore benefit Upto Sum Insured Administrator Limited,
Address: 5th and 6th Floor, Imperial Towers,
AYUSH Benefit Upto Sum Insured H.No 7-1-6-617/A, GHMC No - 615,616,
Upto Rs. 3000 per
Ameerpet, Hyderabad – 500016, Telangana.
Ambulance Cover
Hospitalization
Upto 1% previous year Stamp Duty Registration Details
Health Checkup Sum Insured; max.
The stamp duty of Rs.30.00/- paid in cash or demand draft or by pay
Rs.10,000 per policy
order,vide Receipt/Challan no:LOA/CSD/120/2023/3624/23 dated the
31/08/2023
Vaccination cover Upto Rs.5000 per policy
50% of actuals;
Hearing Aid maximum Rs.10,000
per policy
Daily Cash for choosing 0.25% of base Sum For Tata AIG General Insurance Co. Ltd.
Shared Accommodation Insured; maximum
(If applicable) Rs. 2000 per day
0.25% of base Sum
Daily Cash for Accompanying
Insured; maximum
an Insured Child Authorized Signatory
Rs. 2000 per day
In the event of non-realization of premium, the
Compassionate travel Upto Rs.20,000 Company shall not be liable under the policy and the
policy shall stand cancelled ab initio (from inception).
Upto Sum Insured per
Consumables Benefit
policy year
Policy Servicing Address :
Second Opinion Covered 3rd floor,The Orion, 5 Koregaon Park Road,Pune-411001
8 teleconsultations (GP) Tel No: 020 - 66011111
Wellness Service and Ambulance
Booking Facility.
All Room Categories
Room Category
Covered
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 Ltd. Regd. Office: 15th floor, Tower A, Peninsula Business Park,Ganpatrao Kadam Marg, Off Senapati Bapat Marg, Lower Parel,
Mumbai 400013. IRDA of India Registration No.108, CIN No : U85110MH2000PLC128425, UIN No : TATHLIP23118V032223
Website: www.tataaig.com 24X7 Tollfree Helpline 18002667780 Email:[email protected]
Policy No. 0238594140 / M-727 Page No. 4
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Specific Exclusion / loading if applicable
Member ID Insured Person’s Name Pre-Existing Disease Permanent Exclusion Loading Reason Effective date for
Exclusion/loading
Portability Details (If Applicable)
This Policy is in continuation with , for below mentioned members.
Previous Policy Name of previous Previous Insurer Sum Claim Details
Member name
Number insurer policy inception Insured if any
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 Ltd. Regd. Office: 15th floor, Tower A, Peninsula Business Park,Ganpatrao Kadam Marg, Off Senapati Bapat Marg, Lower Parel,
Mumbai 400013. IRDA of India Registration No.108, CIN No : U85110MH2000PLC128425, UIN No : TATHLIP23118V032223
Website: www.tataaig.com 24X7 Tollfree Helpline 18002667780 Email:[email protected]
Policy No. 0238594140 / M-727 Page No. 5
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Certificate of Premium payment for the purpose of declaration under Section 80 D of Income Tax
(Amendment) Act, 1961*
Date: 30/09/2023
Policy Number:0238594140
Customer Name:MANISHA MAZI
GSTIN no.:
Dear Sir/Madam,
Sub: Tax Benefit Letter forTata AIG MediCare policy no. 0238594140
This is to certify that premium amount of Rupees Ten Thousand Three Hundred And Sixty Five Only for health insurance Policy
No 0238594140 issued to MANISHA MAZI for the period 28/09/2023 to 27/09/2024 has been paid.
Receipt Illustration
Receipt ID. Name of Payer Mode of payment Amount paid
102001057158837 MANISHA MAZI Online 10 365.00
Total Amount Paid 10 365.00
Premium illustration (Member wise)
Total member premium paid
Member ID Name of Member Relationship with Policyholder (Including Taxes & Loading)
MPN0579400101031 MANISHA MAZI Self 10 365.12
Total Premium Paid (Inclusive of Loading & Taxes collected) 10 365.00
Please feel free to get in touch with us for any further help or queries at our 24x7 Helpline 18002667780
(Toll-free) or email us at [email protected]
We assure you of our best services at all times.
Regards,
For Tata AIG General Insurance Company Limited
Authorized Signatory
Date of Issue: 30/09/2023
Place of Issue:PUNE
*Note
1. Tax deductions can be claimed subject to the provisions prescribed in the relevant sections of the Income-tax Act, 1961 as
amended from time to time.
2. Premium paid in advance will be applied to the policy on premium due date.
3. This premium paid certificate is conditional upon credit in company's account post clearance of the instrument/facility
including electronic mode.
4. For any confirmation / impact analysis, customer is advised to refer the matter to his/her Tax consultant.
5. This certificate must be surrendered to the company in case of cancellation of this policy. In the event of incorrect
representation of this declaration the liability shall be upon the policyholder/payer.
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 Ltd. Regd. Office: 15th floor, Tower A, Peninsula Business Park,Ganpatrao Kadam Marg, Off Senapati Bapat Marg, Lower Parel,
Mumbai 400013. IRDA of India Registration No.108, CIN No : U85110MH2000PLC128425, UIN No : TATHLIP23118V032223
Website: www.tataaig.com 24X7 Tollfree Helpline 18002667780 Email:[email protected]
Policy No. 0238594140 / M-727 Page No. 6
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Receipt } Receipt No. : 102001057158837
Receipt Date : 28/09/2023
Policy No : 0238594140 00
Received with thanks from MANISHA MAZI a sum of Rs. 10365.00 Rupees Ten Thousand Three Hundred Sixty Five And Paise
Zero Only Online
Gross Premium (`) Utilized from the receipt for policy (`) Balance (`)
10365.00 10365.00 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 void.
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 :27AABCT3518Q1ZW(GSTIN Number) MAHARASHTRA. Service Accounting Code : 997133
Revenue (consolidated) Stamp Duty duly paid vide challan No.LOA/CSD/47/2023/2581 date 22/05/2023 for applicable cases.
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 Ltd. Regd. Office: 15th floor, Tower A, Peninsula Business Park,Ganpatrao Kadam Marg, Off Senapati Bapat Marg, Lower Parel,
Mumbai 400013. IRDA of India Registration No.108, CIN No : U85110MH2000PLC128425, UIN No : TATHLIP23118V032223
Website: www.tataaig.com 24X7 Tollfree Helpline 18002667780 Email:[email protected]
Policy No. 0238594140 / M-727 Page No. 7
Tata AIG MediCare
Name : MANISHA MAZI
Age : 36years,
M-727 ( 1 to 0 )
Gender : Female
Policy No .: 0238594140
From : 28/09/2023
Member ID : MPN0579400101031
Please refer to our website or mobile application to know the list of cashless
network hospitals and excluded hospitals
TAGIC Health Claims Tata AIG General Insurance Company Limited
th th
5 and 6 Floor, Imperial Towers, H.No 7-1-6-617/A, GHMC no - 615, 616, Ameerpet,
Hyderabad – 500016, Telangana, Toll Free: 18002667780, Website: www.tataaig.com
Tata AIG Medicare UIN: TATHLIP23118V032223
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Annexure to customer information sheet(CIS)- Benefit illustration in respect of policies offered on individual and family floater basis.
Age of the Coverage opted on individual Coverage opted on individual basis covering Coverage opted on family floater basis with
members basis covering each member of multiple members of the family under a single overall Sum Insured(only one sum insured
insured the family separately(at a single policy(Sum insured available for each member of available for entire family)
point of time) the family)
Premium (`) Sum Insured (`) Premium (`) Discount if Premium Sum Premium or Floater Premium Sum
any after Insured Consolidated discount after Insured (`)
Discount (`) premium for if any discount
(`) all members (`)
of the family
(`)
36 8784.00 300000.00
Total Premium for all members of the Total Premium for all members of the family is Total Premium when policy is opted on floater
family is Rs 8784.00when each Rs_________ when they are covered under a single basis is Rs__________
member is covered separately policy
Sum Insured available for each Sum Insured available for each family member is Sum Insured of Rs____________ is available for
individual is Rs 300000.00 Rs_________________. the entire family
Note: Premium rates specified in the above illustration shall be standard premium rates without considering any loading. Also, the
premium rates shall be exclusive of taxes applicable.
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 Ltd. Regd. Office: 15th floor, Tower A, Peninsula Business Park,Ganpatrao Kadam Marg, Off Senapati Bapat Marg, Lower Parel,
Mumbai 400013. IRDA of India Registration No.108, CIN No : U85110MH2000PLC128425, UIN No : TATHLIP23118V032223
Website: www.tataaig.com 24X7 Tollfree Helpline 18002667780 Email:[email protected]
Policy No. 0238594140 / M-727 Page No. 9
