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Policy Receipt

This document is a premium receipt for Mr. Arif Khan's health insurance policy, with a sum insured of Rs. 11,50,000 and a net premium of Rs. 10,485. The policy is effective from 18/08/2024 to 17/08/2025, and includes details about insured persons and tax benefits under section 80D. The gross premium totals Rs. 12,372, which includes GST and is subject to clearance of the premium paid.

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62 views1 page

Policy Receipt

This document is a premium receipt for Mr. Arif Khan's health insurance policy, with a sum insured of Rs. 11,50,000 and a net premium of Rs. 10,485. The policy is effective from 18/08/2024 to 17/08/2025, and includes details about insured persons and tax benefits under section 80D. The gross premium totals Rs. 12,372, which includes GST and is subject to clearance of the premium paid.

Uploaded by

yogimishra0211
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Premium Receipt

Dear MR. ARIF KHAN


B 113 RUSTUMJI SRA CHS WESTERN EXPRESS HIGHWAY NEAR
VIRAJ TOWER ANDHERI EAST
MUMBAI
MAHARASHTRA - 400093

We acknowledge the receipt of payment towards the premium of the following health insurance policy:

Policy Holder's Name Mr. Arif Khan Policy Number 31884434202403

Plan Opted for Health Recharge Sum Insured (Rs.) 11,50,000


#
Commencement Date 18/08/2024 Expiry Date 17/08/2025

Premium (Rs.) - Base product 11,915.00


Premium (Rs.) - Personal Accident cover 0.00
Premium (Rs.) - Critical Illness cover 0.00
Premium (Rs.) - Modification in room rent 0.00

Discount (Rs.) 1,430.00

Net Premium (Rs.) 10,485.00


Integrated Goods and Service Tax (18.00 %) 1,887.30
Central Goods and Service Tax (0.00 %) 0.00
State/UT Goods and Service Tax (0.00 %) 0.00
Gross Premium (Rs.) 12,372.00
#
Issuance of policy is subject to clearance of premium paid

Details of persons Insured:


Name of Person Insured Age Gender Relationship

Mr. Mohammed Sagir Khan 62 Male Self

Mrs. Sajida Begum Khan 59 Female Spouse

Upon issuance of this receipt, all previously issued temporary receipts, if any, related to this policy are considered null and void. For the
purpose of deduction under section 80D The benefit shall be as per the provisions of the Income Tax Act, 1961 and any amendments made
thereafter.

You may get tax benefits up to Rs. 12,372.30 subject to maximum permissible limits under Income Tax Act 1961 as modified from time to time.
For more details kindly consult your tax advisor. In the event of non-realization of premium, benefits cannot be obtained against this premium
receipt.

GSTI No.: 09AAFCM7916H1Z6 SAC Code / Type of Service : 997133 / General Insurance Services

Niva Bupa State Code: 9 Customer State Code / Customer GSTI No.: 27 /NA

Policy issuing office: Delhi, Consolidated Stamp Duty deposited as per the order of Government of National Capital Territory of Delhi.

Location: New Delhi Director - Operations & Customer Service


Date: 04/08/2024 For and on behalf of Niva Bupa Health Insurance Company Limited
(formerly known as Max Bupa Health Insurance Co. Ltd.)

Product Name: Health Recharge | Product UIN: NBHHLIP22156V032122

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