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Sush Insurance

This document is a premium receipt for Mr. Maria Simon's health insurance policy 'Aspire' with policy number 34433362202400. The policy covers a base sum insured of ₹10,00,000 for the period from 12/11/2024 to 11/11/2025, with a gross premium of ₹19,087.14 after applicable discounts and taxes. It includes details of the insured persons and mentions the tax deduction eligibility under section 80D of the Income Tax Act, 1961.

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vivek simon
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37 views1 page

Sush Insurance

This document is a premium receipt for Mr. Maria Simon's health insurance policy 'Aspire' with policy number 34433362202400. The policy covers a base sum insured of ₹10,00,000 for the period from 12/11/2024 to 11/11/2025, with a gross premium of ₹19,087.14 after applicable discounts and taxes. It includes details of the insured persons and mentions the tax deduction eligibility under section 80D of the Income Tax Act, 1961.

Uploaded by

vivek simon
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 - Aspire

Dear MR. MARIA SIMON


BENGALURU, KARNATAKA
BENGALURU
-
KARNATAKA - 560084

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

Policyholder Name Mr. Maria Simon Policy Number 34433362202400

Product Name Aspire Plan Opted 1+1 Base Sum Insured 10,00,000
#
Policy Commencement Date 12/11/2024 Policy Expiry Date 11/11/2025

Premium Calculation for Installment period 12/11/2024 to 11/11/2025

Premium (Rs.) - Base Product 17,323.00

Underwriting Loading (Rs.) 0.00

Digital Discount (Rs.) 300.00

Net Premium / Taxable value (Rs.) 17,023.00

Integrated Goods and Service Tax (18.00 %) 3067.14

Central Goods and Service Tax (0.00 %) 0.00

State/UT Goods and Service Tax (0.00 %) 0.00

Cash-Bag Discount (Rs.) 1,000.00

Gross Premium (Rs.) 19,087.14


#
Issuance of policy is subject to clearance of premium paid
Please note that GST is applied on the premium before adjusting Cash-Bag.

Details of persons Insured:


Name of Persons Insured Age Gender Relationship**

Mr. Maria Vivek Simon 30 Male Policy Holder

Mrs. Sushmitha V 28 Female Spouse

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. For your eligibility and deductions, please refer to provisions of Income Tax Act 1961 as modified and consult your tax consultant. In the
event of non-realization of premium, tax benefits cannot be obtained against this premium receipt.

Upon issuance of this receipt, all previously issued temporary receipts, if any, related to this policy are considered null and void.

GSTI No.: 27AAFCM7916H9Z8 SAC Code / Type of Service : 997133 / General Insurance Services

Niva Bupa State Code: 27 Customer State Code / Customer GSTI No.: 29 /NA

Location: New Delhi Director - Operations & Customer Service


Date: 12/11/2024 For and on behalf of Niva Bupa Health Insurance Company Limited
(formerly known as Max Bupa Health Insurance Co. Ltd.)

Product Name: Aspire, Product UIN: NBHHLIP24129V012324

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