THE NEW INDIA ASSURANCE CO. LTD. (Government of India

THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

POLICY SCHEDULE

NEW INDIA FLEXI FLOATER GROUP MEDICLAIM POLICY

UIN:NIAHLGP21281V022021

Insured Name

:

M/S. RASHTRIYA ISPAT NIGAM LIMITED-GMIP GROUP C

Insured's Details

Issuing Office Details

Customer ID

:

PO88675212

Office Code

:

VIZAG DO-III TIED DO 620300

(620300)

Address

:

VISAKHAPATNAM STEEL PLANT

Address

:

D.NO.49-01-09, IIND FLOOR, DALI

VISAKHAPATNAM

RAJU SUPER MARKET,

VISAKHAPATNAM ,ANDHRA

AKKAYYAPALEM MAIN

ROAD,VISHAKAPATNAM - 530 016

PRADESH, 530040

,530016

Phone No

:

//

Phone No

:

08912517737 / 08912591977

Fax

:

Fax

:

08912517781

E-mail/Fax

:

rk_kandula@vizagsteell.com, /

E-mail/Fax

:

nia.620300@newindia.co.in /

08912517781

PAN No

:

AABCR0435L

S.Tax Regn. No

:

AAACN4165CST178

GSTIN/UIN

:

37AABCR0435L1ZD / NA

GSTIN

:

37AAACN4165C2ZP

:

SAC

:

997133 (Accident and health insurance

services)

Policy Details

Business Source Code

Policy Number

:

62030034220400000003

Dev.Off level./Broker /

:

DIRECT BUSINESS NA NA -

Direct/Corp. Agent/Web

(1D3937283)

Aggregator/CPSC User

Period of Insurance

:

From:01/04/2022 12:00:01 AM To:

Agent/Bancassurance/Spe

:

31/03/2023 11:59:59 PM

cified Person

Date of Proposal

:

01/04/2022

Phone No

:

NA / NA

Prev. Policy no.

:

NA

E-mail/Fax

:

/

Client Type

:

Non-Corporate

Financier(s) Details

:

NA

Premium

GST

Total

Receipt No. & Date:

₹12044118

₹2167942

₹14212060

62030081220000000094

(RUPEES ONE CRORE FORTY-TWO LAC

11/04/2022

TWELVE THOUSAND SIXTY ONLY)

Details of TPA

Name

:

VIDAL HEALTH INSURANCE TPA PVT. LTD

Telephone

:

08046267018

Address

:

1ST FLOOR, TOWER 2, SJR I PARK,PLOT

Fax

:

18004252626

NO.13,14,15, EPIP ZONE,

WHITEFIELD,BANGALORE

PLOT NO.13,14,15, EPIP ZONE, WHITEFIELD

Email

:

help@vidalhealthtpa.com,

help@vidalhealthtpa.com

BANGALORE

Toll Free No

:

18604250251

Co-Insurance Details

Incoming/Outgoing

Company

Office Code

% Share

Premium Share (₹)

OUT

HDFC ERGO GENERAL INSURANCE

001310_001310

40

4817648

CO. LTD.

OUT

NEW INDIA ASSURANCE CO. LTD.

VIZAG DO-III TIED

60

7226470

DO 620300

No. of Employees / Members

:

0

No. of persons covered

:

0

covered

Signature Not

Verified

Digitally signed

Policy No. : 62030034220400000003 Document generated by 36136 at 11/04/2022 13:38:39 Hours.

by SRINIVASAN

VAIDESWARAN

Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.

Date: 2022.04.11

For13:38:47redressalIST 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 office of Insurance

Ombudsman, please visit our website http://newindia.co.in.

Page 1 of 4

THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

Maternity Benefits

Normal Delivery

:

NA

Zone Opted

:

I (Mumbai)

Opted

Limit ₹

Caesarian Section

:

NA

Limit ₹

Deletion of 9 months waiting period

:

NO

Pre-existing cover Opted

:

YES

Deletion of 30 days waiting period

:

YES

Deletion of 2/4 year exclusion

:

YES

Limit of additional ambulance charges

:

2500

per person

Additional cover Opted

:

YES

SL.No

Name of Cover

Limit per family

Overall Policy Limit

Special Conditions

Special Condition 1

:

1)Waiver of Room rent restriction,

2)Waiver of Proportionate capping,

3)AMBULANCE LIMIT:1% OF THE SUM INSURED SUBJECT TO A MAXIMUM OF

RS.2500,

4)NO CO-PAY,

5)NO OPD,

6)SI:RS.2.5LAC FOR SINGLE AND 5LAC FOR COUPLE

Special Condition 2

:

7)Midterm addition of Employee &Dependents will be permitted for new retirees

only and not for existing retired employees i.e.,who were already retired earlier.

8)Rest of the terms and conditions are as incorporated in separate endorsement

* This Policy is subject to NEW INDIA FLEXI FLOATER GROUP MEDICLAIM POLICY Clause as attached

In the event of death of the insured person(s) due to an insured peril all benefits payable, in respect thereof under this insurance, shall

become payable to the Nominee declared in the proposal (incoporated herein as the Schedule) and the Nominee declared in the proposal

(incorporated herein as the schedule) and the receipt shall be construed as full and final discharge to the Company in respect of all liability

under this policy.

Premium and GST Details

Rate of Tax

Amount in INR

Premium

₹ 12044118.00

SGST

9

1083971

CGST

9

1083971

IGST

0

In witness whereof the undersigned being duly authorised by the Insurers and on behalf of the Insurers has (have) hereunder set

his (their) hand(s) on this __________ day of __________________20__.

For and on behalf of

The New India Assurance Company Limited

Date of Issue: 11/04/2022

Duly Constituted Attorney(s)

Mudrank_____________Dt.___________consolidated Stamp Fees Paid by Pay Order Number_______________vide receipt

Policy No. : 62030034220400000003 Document generated by 36136 at 11/04/2022 13:38:39 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 office of Insurance Ombudsman,

please visit our website http://newindia.co.in.

Page 2 of 4

THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

number___________dt.__________.

Stamp Duty under the Policy is ₹1/-.

PREMIUM CERTIFICATE FOR THE PURPOSE OF DEDUCTION UNDER SECTION 80 D OF INCOME TAX

(AMENDMENT) ACT 1986

This is to certify that Mr./Mrs. M/S. RASHTRIYA ISPAT NIGAM LIMITED-GMIP GROUP C has paid ₹ RUPEES ONE CRORE TWENTY LAC

FORTY-FOUR THOUSAND ONE HUNDRED EIGHTEEN ONLY (in words)

towards premium and GST of ₹2167942 for New India Flexi Floater Mediclaim for:

Policy period

:

01/04/2022 12:00:01 AM to 31/03/2023 11:59:59

PM

Policy Certificate no.

:

62030034220400000003

Reciept no. & date

:

62030081220000000094 and 11/04/2022

Date of Issue: 11/04/2022

Policy No. : 62030034220400000003 Document generated by 36136 at 11/04/2022 13:38:39 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 office of Insurance Ombudsman,

please visit our website http://newindia.co.in.

Page 3 of 4

THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

IMPORTANT

This policy is subject to the terms and conditions contained in the policy document (Clauses).

This policy is governed by Health Insurance Regulations 2016 issued by Insurance Regulatory

Development Authority of India on 12.07.2016.

This policy is also governed by IRDAI (Protection of Policyholders' Interest) Regulations, 2017.

This Schedule comes attached with the policy document (Clauses). If not attached, please ask

for the same.

Health Insurance Regulation 2016 and IRDAI (Protection of Policyholders' Interest) Regulations,

2017 are available on the website of IRDAI.

Beware of spurious calls offering alluring benefits. Never share any policy details with unknown

callers. Call 1800-209-1415 for any enquiry or contact the nearest operating office of New India

Assurance Co Ltd.

Tax Invoice No : 62030022P0000129

IRDA Registration Number: 190

NIA PAN NUMBER: AAACN4165C

Policy No. : 62030034220400000003 Document generated by 36136 at 11/04/2022 13:38:39 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

office of Insurance Ombudsman, please visit our website http://newindia.co.in.

Page 4 of 4