Pradhan Mantri Suraksha Bima Yojana (PMSBY)
Pradhan Mantri Suraksha Bima Yojana (PMSBY) Group Personal Accident Insurance Scheme Customer ID : SB01000031 Bank Name : Master Policy Holder : Union Bank of India Branch Name : Insured's Details Insured Name : Insured Address : Issuing Office Details JOHN KLOK Office Code #203 A ,Prestige Silverwoods Bangalore Karnataka Address : DO_111900 : Asian Building, Ground Floor 17,R. Kamani IN 560096 : 02/04/1982 Account No. : 77700031 Aadhar No. : PAN No. : Date of Birth (DD/MM/YYYY) Union Bank of India Marg,Ballard Estate Mumbai-400038 Phone No. : 22679075 (D),22613674/75, 24620360/61/62/63 E-mail/Fax : [email protected] : AAACN4165CST178 S.Tax Regn. No. AQXPM1923C Policy Details Certificate Number : 42150103023110 Reference Number : NIA-UBIN-77700031 Master Policy Number : 1119004215010000113 Policy start Date : 01/06/2015 00:00:01 Previous Policy No. : NA Policy end Date : 31/05/2016 23:59:59 Name of assignee : Date of Proposal : 11/05/2015 Assignee Relationship : Premium 12.00 Service Tax 0.00 Frequency of Premium ANNUAL Total (Rs.) 12.00 Rupees (in words) Credit Advice No. & Date RUPEES TWELVE ONLY 000000000000031 & 25/05/2015 Details of the coverages under the Policy: INDIVIDUAL Coverages Sum Assured Death Rs 2 Lakhs Total and irrecoverable loss of both eyes or loss of use of both hands or feet or loss of sight of one eye and loss of use of hand or foot Total and irrecoverable loss of sight of one eyes or loss of use of one hand or foot Rs 2 Lakhs Rs 1 Lakhs This is to certify that the above member is covered under the scheme of insurance effected under the above master policy. Insurence benefits are available to the member subject to the conditions specified in the policy documents. This is a computer generated document and does not require any signature Note : 1) This certificate is primarily issued to create awareness about insurance affected in the life of the member. It does not confer any legal rights on the nominee/or any other person to claim the benefits under the policy. the benefits will be payable only to the authorised person specified in the policy and subject to the fulfilment of the conditions specified therein. 2) For informing about lodging of claims under the Scheme, please contact the bank. Policy No. :42150103023110 Document generated by Portal at 25/05/2015 00:00:00 hours. Regd. & Head Office: New India Assurance Bldg., 87 M.G.Road,Fort,Mumbai - 400 001. TOLL FREE No. 1 800 209 1415. For Redressal of your grievance, if any, you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3.Head office. In case, you are not satisfied with our own grievance redressal mechanism; you may also approach Insurance Ombudsman. For details of our office addresses and addresses of Insurance Ombudsman, please visit our website
© Copyright 2024