Date : 29 Mar 2025
Ms Adugula Chandrakala
G4 1st Floorblue Diamondkovil Paarvai
Appartmentthindal Malai Kovil Adivaram Arul Nagar Erode
638012
Erode 638012
Tamil Nadu
State Code : 33
Policy No: 99829956
Mobile No: XXXXXX4865
Dear Ms Adugula Chandrakala,
Thank You for trusting us as your preferred Health Insurer.
At Care Health insurance, it is our endeavor to make quality healthcare easily accessible for our customers as well as ensure a truly hassle-free claim
servicing experience
To help you understand our services better, please go through the 'Know your policy better' kit that accompanies this
letter and constitutes the following
l Policy certificate
l Premium Acknowledgement
l Key Policy Information
l Claim Process - http://bit.ly/3EyPRnT
l Policy Terms and Conditions- https://bit.ly/3QfgyU8 and also available on Customer App
Also appended herewith for your convenience is your Care Health Card. This card should be presented at the time of an emergency or a planned
hospitalization, to avail cashless treatment at our network of over 16000+ cashless network pan-India.
To further simplify procedures, we're online as well. Visit our portal www.careinsurance.com and view network hospitals across the country, cashless
procedures and do much more.
For any assistance, please feel free to write to us at https://www.careinsurance.com/contact-us.html.
Once again, we thank you for this opportunity to serve you, and wish you and your loved ones good health always!
Team Care Health Insurance
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Policy Certificate Policy No. 99829956
Ms Adugula Chandrakala Plan Name Care Supreme
G4 1st Floorblue Diamondkovil Paarvai Cover Type Floater
Appartmentthindal Malai Kovil Adivaram Arul Nagar Policy Period - Start Date 00:00 hrs 27-Mar-2025
Erode
638012 Policy Period - End Date Midnight 26-Mar-2027
Erode 638012 Nominee Name (Relation) B Manav (Son)
Tamil Nadu Add-on Policy Care Advanced
Premium Paid Rs.22,916.00
( Premium Rs 19419.90 + Underwriting Loading
Rs. 0.00 + CGST Rs. 0.00 + IGST Rs. 3,495.66 +
SGST/UGST Rs. 0.00 )
Premium Payment Mode Single Premium
Policyholder Gender Date Of Birth Client ID
Ms Adugula Chandrakala Female 11-Aug-1977 E1971433
Details of Insured Person
Date of Birth Pre-existing diseases Insured with the
Name Client ID Relationship Sum Insured
(DD-MM-YYYY) (since) Company (since)
Adugula Chandrakala E1971433 MEMBER 11-Aug-1977 NONE 27-Mar-2025 7,00,000.00
B Nandana E2268103 DAUGHTER 10-Oct-2007 NONE 27-Mar-2025
B Manav E2268104 SON 14-Apr-2003 NONE 27-Mar-2025
Contact details for Claims & Policy Servicing
Care Health Insurance Limited, Vipul Tech Square, Tower C, 3rd Floor, Golf Course Road, Sector-43,
Correspondence address
Gurugram-122009 (Haryana)
E-mail ID for Claims [email protected]
Website www.careinsurance.com
Intermediary Details
Name Code Contact Details
Ruloans Distribution Services
20210584 022-67707070
Pvt Ltd
Schedule of Benefits
S No. Particulars Basis of Offering
1 Sum Insured 700000
2 In-Patient Care Up to SI
3 Day Care Treatment All Day Care Procedures
4 Advance Technology Methods Up to SI
Up to SI, Pre-Hospitalization expense cover for 60 days prior to
5 Pre-Hospitalization Medical Expenses
hospitalization
Up to SI, Post-Hospitalization expense cover for 180 days after
6 Post Hospitalization Medical Expenses
discharge
7 AYUSH Treatment Up to SI
8 Domiciliary Hospitalization Up to SI
9 Organ Donor Cover Up to SI
Schedule of Benefits
10 Ambulance Cover Up to Rs. 10,000
11 Cumulative Bonus 50% of SI, max up to 100% of SI.
12 Unlimited Automatic Recharge Available for unlimited times for unrelated or same illness.
13 Unlimited E-Consultations Available for Consultations with General Physicians
14 Health Services (Health Portal) Doctor on chat, Healthy tips reminder, etc.
Discounts on services such as consultations, diagnostics etc at our
15 Health Services (Discount Connect)
network
16 Room Rent All categories covered.
17 ICU No Limit
18 Named Ailments Coverage 24 Months
19 Pre-existing Diseases Coverage / Initial Wait Period 36 Months / 30 Days
Optional Cover
S NO. Particulars Details
Discount on renewal premium based on active days achieved.
1 Wellness Benefit Online fitness Coaching/Counselling session from Wellness
Coaches
2 Air Ambulance Cover Up to 5 lacs per year.
3 Claim Shield Coverage of specified 68 Non Payable Items as defined in T&C
Up to SI for treatment in Care Supreme-VFM Network
4 Smart Select
Hospitals.20% co-payment on claims in Non-Network Hospital.
Portability Details of the Insured
Previous Insurer : HDFC ERGO GEN INS
1st Enrollment Expiry Policy SI Rs.
Name First Policy Number Expiry Policy Number
Date (Original SI+CB)
ADUGULA CHANDRAKALA 295220415019 2952204150191602000 15-May-2021 5,00,000 + 50,000
B Nandana 295220415019 2952204150191602000 15-May-2021 5,00,000 + 50,000
B Manav 295220415019 2952204150191602000 15-May-2021 5,00,000 + 50,000
Name Continuity Benefit approved by Company
Named Ailment Wait Period Pre-Existing Disease wait period
Continuity benefit available for Coverage PED wait Period reduced to 0 year for coverage
ADUGULA CHANDRAKALA
amount upto Rs. 5,50,000.00 in 0 year amount upto Rs. 5,50,000.00
Continuity benefit available for Coverage PED wait Period reduced to 0 year for coverage
B Nandana
amount upto Rs. 5,50,000.00 in 0 year amount upto Rs. 5,50,000.00
Continuity benefit available for Coverage PED wait Period reduced to 0 year for coverage
B Manav
amount upto Rs. 5,50,000.00 in 0 year amount upto Rs. 5,50,000.00
Add-on Policy - Care Advanced
UIN NO - CHIHLIA25043V012425
Schedule of Benefits
S No. Particular Description
1 Room Rent Modification Room category of base policy gets modified to General Ward
For Care Health Insurance Limited
Authorized Signatory
Date of Issue : 29 Mar 2025
Place of Issue : Gurgaon, Haryana
Service Branch : Office No-701, 4th floor , 2nd level in the B Wing ,lift floor- 7th , Neelyog Branch Contact No. : 9289454795
Square, Patel Chowk, R.B. Mehta Road, Ghatkoper East,
Mumbai-400077Mumbai,Maharashtra,400077
Consolidated Stamp Duty paide vide E-Challan GRN No. 0117751470 dated 13/06/2024. RCM Applicability - N/A
SAC: 997133 and Description of Service: Accident and Health Insurance Services State
GSTIN No.: 27AADCR6281N1ZS
UIN :CHIHLIP25047V022425
Note:
- Attached with this Policy Certificate are the Policy terms and conditions, Optional Covers (if opted) and Annexures. Please ensure that
these documents have been received, read and understood. If any of these documents have not been received, please feel free to write
to us at https://www.careinsurance.com/contact-us.html
- For waiting periods and exclusions under this Policy, please refer to Clause 4 of the Policy terms and conditions.
- This Policy Certificate in original must be surrendered to the Company in case of cancellation of the Policy.
- This soft copy of the policy is as valid as a hard copy and can be used for claims. A physical hard copy will not be dispatched.
Premium Acknowledgement
Policy No. 99829956
Client ID E1971433
Policyholder Ms Adugula Chandrakala
G4 1st Floorblue Diamondkovil Paarvai
Appartmentthindal Malai Kovil Adivaram Arul Nagar Erode
Address 638012
Erode 638012
Tamil Nadu
Policy Period 27-Mar-2025 to 26-Mar-2027
Premium Details S.No. Receipt Number Amount Mode of Payment
1 C0516655 22,916.00 IPG
Particulars Amount (in Rs.)
Gross Premium
Care Supreme 17,523.90
Wellness Benefit (Supreme) 187.32
Air Ambulance Cover (Supreme) 832.50
Claim Shield 876.18
Goods & Services Tax (GST) 3,495.66
Total 22,916.00
The Premium is rounded off to the nearest rupee.
Eligibility of Premium for Deduction u/s 80D of the Income Tax Act, 1961
The premium paid through any mode other than cash for this policy is eligible for Income tax benefits to the person making the payment
subject to the provisions of section 80D of the Income Tax Act, 1961 and amendments thereof. Effective from Assessment year 2019-20, in
cases where health insurance premium for multiple years is paid in one year, it will be eligible for proportionate deduction in the years in
which the health insurance continues to be effective.
For Care Health Insurance Limited Signature Not Verified
Digitally signed by Manish Dodeja
Date: 20250329120628
Reason: I'm the author
Location: India
Authorized Signatory
Date of Issue : 29 Mar 2025
Place of Issue : Gurgaon, Haryana
Note:
1) In case of any discrepancy, the Policyholder is requested to contact the Company immediately.
2) Any amount paid in cash towards the premium would not qualify for tax benefits as mentioned above.
3) This document must be surrendered to the Company in case of Cancellation of the Policy or for the issuance of a fresh certificate in
the case of any alteration in the Policy.
4) This Policy is issued subject to realization of the premium amount. In case the instrument given towards the premium amount is
dishonored, then the cover provided under this Policy shall automatically get cancelled. In the given scenario, if any amount has been
paid by the Company in respect of a claim or due to any other reason than the amount so advanced by the Company shall be
refunded to the Company forthwith.
5) We may credit upto Rs. 1/- to your account for validation, before remitting any further payment.
Proposal Form-'CARE SUPREME'
Dear Ms Adugula Chandrakala
In reference to your online proposal (1120103577513) for 'Care Supreme'- Comprehensive Health Insurance policy, please find below the
details as provided by you:
Proposer Details
Name : Ms Adugula Chandrakala
Address : G4 1st Floorblue Diamondkovil Paarvai
Appartmentthindal Malai Kovil Adivaram Arul Nagar Erode
Erode 638012,Tamil Nadu
638012
Date of Birth : 11-Aug-1977
Landline :
Mobile : XXXXXX4865
E-mail : [email protected]
Details of the Persons be Insured
Name Date of Birth Relation Pre-existing Diseases
Adugula Chandrakala 11-Aug-1977 MEMBER NONE
B Nandana 10-Oct-2007 DAUGHTER NONE
B Manav 14-Apr-2003 SON NONE
Additional Details
1. Does any person(s) to be insured has any pre-existing diseases?
Insured1 Insured2 Insured3
N N N
2. Have any of the person(s) to be insured ever filed a claim with their current / previous insurer?
Insured1 Insured2 Insured3
N N N
Has any of your proposal(s) for Health insurance been declined, cancelled, charged a higher premium or issued with
3.
special condition(s)?
Insured1 Insured2 Insured3
N N N
4. Is any of the person(s) proposed for insurance covered under any other health insurance policy with the Company?
Insured1 Insured2 Insured3
N N N
You agreed to following terms & conditions of the purchase of policy
a. I have read and understood the Brochure/Prospectus/Sales Literature/Terms and Conditions of the Policy and confirm to abide by
the same.
b. Receipt of proposal form by the Company shall not be construed as acceptance of proposal. Commencement of risk under the
Policy shall be subject to realization of full premium and individual underwriting by the Company. The Company at its sole discretion
reserves the right to accept or reject or load any proposal. Policy would start from the date as specified in the Policy Certificate.
c. I understand that the Policy Period Start Date as specified in the Policy Certificate shall be from the 00:00 hours of the next day of
the Proposal receipt at branch/online, proposed policy period start date as opted by me or cheque date, whichever is later.
d. I understand that the Policy shall become void at the Company's option, in the event of any untrue or incorrect statement,
misrepresentation, non-description or non-disclosure of any material fact, in the proposal form/personal statement, declaration and
connected documents or any material information having been withheld by me or anyone acting on my behalf.
e. I hereby declare that the lives proposed to be insured would submit to medical examinations before the nominated doctors of the
Company or undergo diagnostic or other medical tests, as suggested by the Company for its underwriting.
f. I consent to and authorize the Company and/or any of its authorized representative agents to seek medical information from any
hospital/ medical practitioner or any other related entity that I have attended or may attend in future concerning any illness or injury.
g. I consent to provide a valid age proof and identity proof at the time of claims or any other time when required by the Company.
h. I authorize the Company to exchange, share or part with the information relating to myself/person(s) to be insured with any external
entity other than regulatory and statutory bodies, as may be required and I will not hold the Company or its agents liable for use/
sharing of this information.
i. I/We agree and undertake to convey to the Company any change/alterations carried out in the risk proposed for insurance after
submission of this proposal form.
j. I/We consent to receive information from the Company the through physical, electronic or telecommunication means from time to
time.
The undersigned hereby declare on my behalf and on behalf of each of the persons proposed to be insured that the above
statements and particulars are true, complete and correct in all respects and that all information which is relevant to this proposal has
been disclosed and not withheld from the Company. I declare that the money used to make the premium payment has not been
derived from any illegal activity or unaccounted funds. I further declare and agree that this declaration and the answers given above
shall be held to be promissory and shall be the basis of the contract between me/us and the Company.
By virtue of this communication, I give my implicit approval on receiving Whatsapp, SMS, E-mail (Transactional & promotional) from
the company.
The details mentioned in above proposal form have been verified through OTP received on my registered mobile number.
No physical Health Cards will be dispatched. The electronic version of the card below will be accepted across all network providers.
www.careinsurance.com
Policy No.
99829956
Member ID DOB NAME
E1971433 11-Aug-1977 Adugula Chandrakala
E2268103 10-Oct-2007 B Nandana
E2268104 14-Apr-2003 B Manav Submit Your Queries/Requests: www.careinsurance.com/contact-us.html
Disclaimer
1. This card is not transferable
2. Use of this card is governed by the policy terms &
conditions
3. To avail cashless facility.this card needs to be produced along with photo
ID Valid
4. proofupto policy period end date or cancellation date,whichever is earlier
IRDAI Registration No.148
