insurance flight punetoblr july2

Domestic TravInsure - Specially designed for SpiceJet Passengers Schedule of Travel Insurance Issued at Mumbai Schedule Number: Policy Validity Dates: (Max covered period 30 days from the first departure date of the insured schedule flight unless insured returns to the station of origin earlier.) From 02/07/2013 to 02/07/2013 IF419112 Applicant/Insured Name: MONAL BHOYAR Applicant/Insured Address: TEXAS INSTRUMENTS INDIA BANGALORE 560093 Benefits subject to terms and conditions for the policy Benefits Maximum Coverage Deductible Accidental Death and Dismemberment (24 Hrs) Emergency Accidental Medical Reimbursement Emergency Medical Evacuation and Repatriation of Remains 24-hr Emergency Assistance Service Trip Cancellation Baggage Loss-Checked Flight Delay Common Carrier Delay Trip Interruption Rs 750,000 Rs 100,000 *INCLUDED *INCLUDED Up to the Original Cost of Flight Rs 7,500 Rs 1,500 per 6 Hrs delay period up to RS 10,500 Rs 1,500 per 6 Hrs delay period up to Rs 10,500 Up to the Original Cost of Flight 10% / 50% (Per Article / * Included under overall limit of Accident & Sickness Per Bag Limit) PREMIUM Tax (12.36%) Total Premium INR INR INR Agent/Broker Name: TATA AIG Agent/Broker License Code: NA Agent/Broker Contact No: 1-800-119966 14 129 115 Address for submission of claim documents Claims Department A- 501, 5th Floor, Building No. 4, Infinity Park, Gen. A. K. Vaidya Marg, Important: Any Pre-Existing Medical condition will be excluded from the policy The stamp duty of RS.1/- paid by demand draft, Signed for & on Behalf of TATA AIG General Insurance Company Ltd. TATA-AIG General Insurance Co. Ltd. Authorized Signatory Date Issued: vide Receipt/Challan no. 85112 dated 25th November 2011 Dindoshi, Malad (East), Mumbai 400097 Visit our website : www.tataaiginsurance.in OR Email at [email protected] OR Call our 24x7 toll free helpline 1800-266-7780 (All Lines) OR 1800-11-9966(BSNL/MTNL) Assistance Contact: 0008004402216 (Toll free) [email protected] Email: 21/06/2013 Declaration: The full terms & conditions of your TATA AIG Policy can be viewed or downloaded online at www.spicejet.com. It is important to read the terms & condition of the Insurance policy & Carry a copy of this certificate for ready reference. Registered Office: Peninsula Business Park, Tower A, 15th Floor, G. K. Marg, Lower Parel, Mumbai- 400013

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Page 1: Insurance Flight Punetoblr July2

Domestic TravInsure - Specially designed for SpiceJet Passengers

Schedule of Travel InsuranceIssued at Mumbai

Schedule Number:Policy Validity Dates:

(Max covered period 30 days from the first departure date of the insured schedule flight unless insured returns to the station of origin earlier.)

From 02/07/2013 to 02/07/2013

IF419112

Applicant/Insured Name: MONAL BHOYARApplicant/Insured Address: TEXAS INSTRUMENTS INDIA

BANGALORE 560093

Benefits subject to terms and conditions for the policy

Benefits Maximum Coverage Deductible

Accidental Death and Dismemberment (24 Hrs)

Emergency Accidental Medical Reimbursement

Emergency Medical Evacuation andRepatriation of Remains

24-hr Emergency Assistance Service

Trip Cancellation

Baggage Loss-Checked

Flight Delay

Common Carrier Delay

Trip Interruption

Rs 750,000

Rs 100,000

*INCLUDED

Up to the Original Cost of Flight

Rs 7,500

Rs 1,500 per 6 Hrs delay periodup to RS 10,500

Rs 1,500 per 6 Hrs delay periodup to Rs 10,500

Up to the Original Cost of Flight

10% / 50% (Per Article /

* Included under overall limit of Accident & Sickness

Per Bag Limit)

PREMIUMTax (12.36%)Total Premium

INRINR

INR Agent/Broker Name: TATA AIGAgent/Broker License Code: NAAgent/Broker Contact No: 1-800-119966

14 129

115

Address for submission of claim documentsClaims Department

A- 501, 5th Floor, Building No. 4,Infinity Park, Gen. A. K. Vaidya Marg,

Important: Any Pre-Existing Medical condition willbe excluded from the policyThe stamp duty of RS.1/- paid by demand draft,

Signed for & on Behalf of TATA AIG General Insurance Company Ltd.

TATA-AIG General Insurance Co. Ltd.

Authorized Signatory

Date Issued:

vide Receipt/Challan no. 85112 dated 25th November 2011

Dindoshi, Malad (East),

Mumbai 400097

Visit our website :www.tataaiginsurance.inOR Email at [email protected]

OR Call our 24x7 toll free helpline 1800-266-7780 (All Lines)OR 1800-11-9966(BSNL/MTNL)

Assistance Contact: 0008004402216 (Toll free)

[email protected]:

21/06/2013

Declaration: The full terms & conditions of your TATA AIG Policy can be viewed or downloaded online at www.spicejet.com.It is important to read the terms & condition of the Insurance policy & Carry a copy of this certificate for ready reference.

Registered Office: Peninsula Business Park, Tower A, 15th Floor, G. K. Marg, Lower Parel, Mumbai- 400013

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