Date : 20 Dec 2024

Mr Suraj Dattaram Gaikwad

Mohan Naik Chs Bldg No 3/5 G D
Ambekar Marg Naigaon Dadar East Mumbai
Mumbai
Mumbai 400014
Maharashtra 27

Policy No: 19618258

Mobile No: XXXXXX0202

Dear Mr Suraj Dattaram Gaikwad,

Thank You for trusting us as your preferred Health Insurer.

At Care Health insurance, it is our endeavor to make quality healthcare easily accessible for our customers as well as ensure a truly hassle-free claim
servicing experience

To help you understand our services better, please go through the 'Know your policy better' kit that accompanies this
letter and constitutes the following

⚫ Policy certificate
⚫ Premium Acknowledgement

⚫ Key Policy Information

⚫ Claim Process - http://bit.ly/3EyPRnT
⚫ Policy Terms and Conditions- https://rb.gy/x2mup and also available on Customer App

Also appended herewith for your convenience is your Care Health Card. This card should be presented at the time of an emergency or a planned
hospitalization, to avail cashless treatment at our network of over 16000+ cashless network pan-India.

To further simplify procedures, we're online as well. Visit our portal www.careinsurance.com and view network hospitals across the country, cashless
procedures and do much more.

For any assistance, please feel free to write to us at https://www.careinsurance.com/contact-us.html.

Once again, we thank you for this opportunity to serve you, and wish you and your loved ones good health always!

Team Care Health Insurance

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 Policy Certificate Policy No. 19618258
Mr Suraj Dattaram Gaikwad Plan Name CARE
Mohan Naik Chs Bldg No 3/5 G D Add-on Policy Name Care Shield
Ambekar Marg Naigaon Dadar East Mumbai Cover Type Individual
Mumbai
Policy Period - Start Date 00:00 hrs 20-Dec-2024
Mumbai 400014
Policy Period - End Date Midnight 19-Dec-2025
Maharashtra 27
Nominee Name (Relation) Suraj Dattaram Gaikwad (Son)

Premium Paid Rs.25,612.00

(Premium Rs 21705.38+Underwriting Loading
Rs 0.00+CGST Rs1,953.49+IGST Rs0.00+SGST
Rs1,953.49+UGST Rs0.00)
Premium Payment Mode Single Premium

Policyholder Date Of Birth Client ID

Mr Suraj Dattaram Gaikwad 30-Dec-1991 83172381

Details of Insured Person

Insured with the

Name Client ID Date of Birth Relationship Pre-existing diseases since
Company (since)
Chhaya Dattaram
Gaikwad 83205183 25-Aug-1968 MOTHER 20-Jan-2021 NONE

Details of Cover

Accumulated No Accumulated No Accumulated

Policy Insured Name Policy Sum Insured Claim Bonus Claim Bonus Super Inflation Shield
Amount Amount Amount

Chhaya Dattaram Gaikwad 5,00,000.00 1,50,000.00 5,00,000.00 59,200.00

- NCB/NCB Shield Protection has been applied on this renewal.
Note - Amount of No Claim Bonus / No Claim Bonus Super is calculated basis the claim status updated till Date of Payment of Renewal Premium.
This amount can vary basis the claim reported against Expiring Policy Year.
- Floater Policy, all the member coverage is on shared basis. Individual Policy each member is covered on Individual Basis.
- Coverage and Claims Subject to the Policy Terms & Conditions.

Contact details for Claims & Policy Servicing

Care Health Insurance Limited, Vipul Tech Square, Tower C, 3rd Floor, Golf Course Road, Sector-43,
Correspondence address Gurugram-122009 (Haryana)
E-mail ID for Claims [email protected]
Website www.careinsurance.com

Intermediary Details

Name Code Contact Details

Turtlemint Insurance Broking Services Private L 20017894 022-40040706

Schedule of Benefits

S No. Particulars Basis of Offering

1 In-Patient Care/Day Care Treatment Up to SI

2 Pre & Post Hospitalization Medical Expenses 30 days Pre-Hospitalization & 60 days Post-Hospitalization
Schedule of Benefits

3 Ambulance Cover Up to SI
4 Organ Donor Cover Up to Rs 1 Lac
5 Domiciliary Hospitalization Up to 10% of SI if domiciliary hospitalization exceeds 3 days
Coverage available Once in a Policy year for related and unrelated
6 Automatic Recharge Illness .Max amount per claim up to SI
7 Second Opinion Once per Major Illness / Injury per policy year
8 AYUSH Treatments Up to SI
10% of Sum Insured for each Claim free year, maximum up to 50%
9 No Claims Bonus of SI; reduced by 10% of Sum Insured in case of claim
10 Annual Health Check-up Annual
11 Initial Wait Period 30 Days
12 Named ailments 24 months
13 Pre-existing Diseases 48 months
14 Room Rent / Room Category Single Private Room
15 ICU Charges No Sub Limit

Optional Cover

S NO. Particulars Details

50% of Sum Insured for each Claim free year, maximum upto 100%
1 No Claims Bonus Super (NCBS) of Sum Insured; Reduced by 50% of Sum Insured in case of Claim

Note: The cumulative liability of the Company for all the above benefits shall be limited to Base Sum Insured /sub-limits unless specified as
over and above under General Conditions applicable to all Benefits of Policy Terms & conditions or any amount accrued by Insured during
the Policy Year

Previous Insurer Details of the Insured

Previous
Date of Sum Insured + NCB +
Policy Period Insured Name Insurer Name Policy
Enrolment NCBS + Inflation SI
Number

Chhaya Dattaram 5,00,000.00 + 1,00,000.00 +

20-Jan-2023 to 19-Jan-2024 Gaikwad Care Health Insurance Ltd 19618258 20-Jan-2020 2,50,000.00 + 25,700.00
Chhaya Dattaram 5,00,000.00 + 50,000.00 +
20-Jan-2022 to 19-Jan-2023 Gaikwad Care Health Insurance Ltd 19618258 20-Jan-2020 0.00 + 0.00
Chhaya Dattaram 5,00,000.00 + 0.00 + 0.00 +
20-Jan-2021 to 19-Jan-2022 Gaikwad Care Health Insurance Ltd 19618258 20-Jan-2020 0.00
Chhaya Dattaram ManipalCigna Health 4,50,000.00 + 0.00 + 0.00 +
20-Jan-2020 to 19-Jan-2021 Gaikwad Insurance 81157818 20-Jan-2020 0.00

Special Conditions

S No. Particulars

1 Co-payment (Applicable 61 years or above)

Add-on Policy - CARE SHIELD

UIN No- RHIHLIA21168V012021

Schedule of Benefits

S No. Particulars Description

1 Claim Shield Applicable

2 NCB Shield Applicable
3 Inflation Shield Applicable
For Care Health Insurance Limited

Authorized Signatory
Date of Issue : 20 Dec 2024
Place of Issue : Gurgaon, Haryana
Service Branch : Synergy Business Park Office no 702 & 703 7th Floor Off Aarey Road Branch Contact No. : 9289454793
Goregaon East Mumbai Maharashtra 400063Mumbai,Maharashtra,400063

Consolidated Stamp Duty paid vide E-Challan GRN no. 0107464159 dated 21 Sep 2023, RCM Applicability- N/A
SAC: 997133 and Description of Service: Accident and Health Insurance Services State
GSTIN No.: 27AADCR6281N1ZS
UIN :CHIHLIP22184V062122

Note:
- Attached with this Policy Certificate are the Policy terms and conditions, Optional Covers (if opted) and Annexures. Please ensure that
these documents have been received, read and understood. If any of these documents have not been received, please feel free to write
to us at https://www.careinsurance.com/contact-us.html
- For waiting periods and exclusions under this Policy, please refer to Clause 4 of the Policy terms and conditions.
- This Policy Certificate in original must be surrendered to the Company in case of cancellation of the Policy.
Premium Acknowledgement

Policy No. 19618258

Client ID 83172381
Policyholder Mr Suraj Dattaram Gaikwad
Mohan Naik Chs Bldg No 3/5 G D
Ambekar Marg Naigaon Dadar East Mumbai
Address Mumbai
Mumbai 400014
Maharashtra 27

Policy Period 20-Dec-2024 to 19-Dec-2025

Premium Details

Particulars Amount (in Rs.)

Gross Premium
Care 16,983.87

NCB-Super 3,396.77
Care Shield 1,324.74

Goods & Services Tax (GST) 3,906.98

Total 25,612.00

The Premium is rounded off to the nearest rupee.

Eligibility of Premium for Deduction u/s 80D of the Income Tax Act, 1961

The premium paid through any mode other than cash for this policy is eligible for Income tax benefits to the person making the payment
subject to the provisions of section 80D of the Income Tax Act, 1961 and amendments thereof. Effective from Assessment year 2019-20, in
cases where health insurance premium for multiple years is paid in one year, it will be eligible for proportionate deduction in the years in
which the health insurance continues to be effective.

For Care Health Insurance Limited

Authorized Signatory

Date of Issue : 20 Dec 2024

Place of Issue : Gurgaon, Haryana

Note:
1) In case of any discrepancy, the Policyholder is requested to contact the Company immediately.
2) Any amount paid in cash towards the premium would not qualify for tax benefits as mentioned above.
3) This document must be surrendered to the Company in case of Cancellation of the Policy or for the issuance of a fresh certificate in
the case of any alteration in the Policy.
4) This Policy is issued subject to realization of the premium amount. In case the instrument given towards the premium amount is
dishonored, then the cover provided under this Policy shall automatically get cancelled. In the given scenario, if any amount has been
paid by the Company in respect of a claim or due to any other reason than the amount so advanced by the Company shall be
refunded to the Company forthwith.
5) We may credit upto Rs. 1/- to your account for validation, before remitting any further payment.
No physical Health Cards will be dispatched. The electronic version of the card below will be accepted across all network providers.

www.careinsurance.com

Submit Your Queries/Requests: www.careinsurance.com/contact-us.html

Disclaimer
This card is not transferable
Use of this card is governed by the policy terms &
To avail cashless facility.this card needs to be produced along with photo
Valid upto policy period end date or cancellation date,whichever is earlier