Page 3 - PROHLT010039075_04 _Policy document
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NOTE:
  Basic premium is inclusive of opted Add on's and after adjustment of premium discounts, wherever applicable.
  In the event of dishonor of cheque, this policy document automatically stands cancelled from inception, irrespective of whether a separate
  communication is sent or not.
  This Policy has been issued based on the information provided by you on the proposal form. Attached with this Policy Schedule are the Policy Terms
  & Conditions and Annexures. Please ensure that these documents have been received, read and understood. If any of these documents have not
  been received, please contact our Customer Service at the below mentioned details at the earliest. In case you find any discrepancy in the same,
  please contact us immediately.
  For any grievance related to the policy you may write to The Grievance Officer at the policy issuing office address mentioned above or email at
  headcustomercare@cignattk.in
  You may also write to us at customercare@cignattk.in Or call us at HealthLine No. (Toll Free): 1-800-10-24462
                                     Cigna TTK ProHealth Insurance
                                               POLICY SCHEDULE


       Policy Issuing Office:                             Policy Servicing Office:

       Cigna TTK Health Insurance Company Limited,        Cigna TTK Health Insurance Company Limited,F 5 – 6, 5th Floor
       401/402, Raheja Titanium, Western Express Highway,  Pinncal Business Park,Shanti Nagar, Mahakali Caves Roan, Andheri
       Goregaon (East), Mumbai - 400063.                  (E), Mumbai 400093. Ph02262274601
       Intermediary Name:  Hardesh Lakhere


       Code:  1600066-01                               Contact Numbers:  9167979171

       POLICYHOLDER DETAILS:
       Name:  Ms. Asma Javed  Pathan                                  Customer ID: 1000047467
       Address: MORYA CRYSTAL ROOM NO 105 1ST FLOOR, OPP NIRON HOSPITAL VAKOLA SANTACRUZ E
               Mumbai - 400055, Maharashtra
        Telephone number(s):  (R) 0                         (O) 2266738322              (M) 9969145745
        Email ID:  syedasma83@gmail.com

       POLICY DETAILS:
        Plan:    ProHealth - Protect                         Policy Number:  PROHLT010039075
        Policy Period: Inception Date: From: 00:00 hrs on 14/04/2019  Expiry date: To: 24:00 hrs on 13/04/2020  Tenure (in years) : 1
        Policy Type:  Individual                         Zone of Cover:  ZONE1
        Roll Over / Portable Case:  No                   Policy Category: Renewal_04
        Premium Payment Mode:  Single Payment
        Pre- Existing Disease waiting period :Covered after 48 months of continuous coverage

        INSURED PERSON'S DETAILS:
                                                       Completed
                                 Relationship                    Pre-existing
       Sr. Name Of The Insured  Date of          Date of  Age                                  Sum    Cumulative Bonus
       No.    Person(s)   Inception  With  Gender  Birth   In   Disease/ Illness/ Customer IDOccupation  Insured  Earned
                                 Policyholder                     Condition
                                                         years
                                                                                                        %    Amount
           Humera Moniruddin
        1                23/03/2015  Sister  Female 17/04/1997  21   Nil    1000047565  Student  250000  20  50000
                Syed
       Address of the Insured:
        Sr.                                         Medical Condition Acquried post
        No.  Name Of The Insured Person(s)  Customer ID  Inssurance of the policy         Health Rewards
                                                                               Points Earned through Point Earned through
                                                                                Wellness Programs   Premium Paid
        1     Humera Moniruddin Syed   1000047565               Nil                            44




       NOMINEE DETAILS:
        Nominee Name:   Hoorbano Moniruddin Syed                         Relationship with proposer:   Mother


       BENEFITS UNDER THE POLICY:
                                                        Protect Plan
                                                        Base covers
                                   For Sum Insured up to 5.5 Lacs -Covered up to Single Private Room ; For Sum Insured 7.5 Lacs and Above
        In-patient Hospitalization
                                   -Covered up to any Room Category except Suite or higher category
        Pre - Hospitalization      Medical Expenses Covered up to 60 days before date of hospitalisation
        Post - Hospitalization     Medical Expenses Covered up to 90 days post discharge from hospital
        Day Care Treatment         Covered up to the limit of Sum Insured opted
        Domiciliary Treatment      Covered up to the limit of Sum Insured opted
        Ambulance Cover            Up to ₹ 2000 per hospitalization event
        Donor Expenses             Covered upto full Sum Insured
        Worldwide Emergency Cover  Covered upto full Sum Insured once in a policy year
        Restoration Of Sum Insured  Multiple Restoration is available in a Policy Year for unrelated illnesses in addition to the Sum Insured opted
        Ayush Cover                Covered up to full Sum Insured
        Health Maintenance Benefit  Covered up to 500 per policy year
                                                     Value Added Covers
        Health Check-Up            Available once every 3rd Policy year to all insured persons who have completed 18years of Age
        Expert Opinion on Critical illness  Available once during the Policy Year
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