CERTIFICATE OF INSURANCE

EASY DOMESTIC TRAVEL INSURANCE [TITANIUM]

The benefits available are described in the Policy and will be subject to the policy terms, conditions and exclusions. The complete policy terms, conditions
and exclusions can be viewed or downloaded online from [www.apollomunichinsurance.com]. A copy of this Certificate of Insurance must be carried by
the Insured Person during the Risk Period. Please refer to the policy wordings or contact us for any further information or clarification.
Policy details :
Policy No: 900001/35001/A000000330 Certificate No : A000000330/612494
Risk Period: From 29-Jul-2014 06:35 hrs or the boarding of the
carrier from the place of origin, whichever is later
(Commencement of Risk Period)
To 27-Aug-2014 06:35 hrs or the return to the usual place of
residence, whichever is earlier. (Expiry of Risk Period)
Insured Persons' details : Insured Person's details :
Member ID Insured Persons name Age
B0125482 Prabakaran Krishanmurthi 59
Coverage details: Subject to Terms & Conditions of the Policy
S.No. Benefits Sum Insured Deductible
1. Accident: Medical Treatment Rs. 1,00,000.00 Nil
2. Delay of Checked-in Baggage Rs. 2,000.00 12 Hrs
3. Total Loss of Checked-in Baggage Rs. 7,500.00 Nil
4. Personal Liability Rs. 1,00,000.00 Nil
5. Personal Accident [24 Hours] Rs. 7,50,000.00 Nil
6. Accident: Medical Evacuation Rs. 1,00,000.00 Nil
7. Trip Cancellation Rs. 20,000.00 Nil
8. Trip Curtailment Rs. 20,000.00 Nil
9. Emergency Travel Rs. 10,000.00 Nil
10. Emergency Hotel Rs. 10,000.00 Nil
11. Flight Delay Rs. 2,000.00 Nil
12. Transportation of Mortal Remains Rs. 1,00,000.00 Nil
Premium details:
Net premium (Rs.) Service tax (Rs.) Education and secondary
education cess (Rs.)
Gross premium (Rs.)
132.60 15.92 0.48 149.00
Amount payable: 149.00 (Rs. One Hundred Forty-Nine )
Assistance Company and claims notification Address for claims submission
Toll Free No.: 1800-102-0333, Travel Claim Department,
Fax: 0124-4584111, Apollo Munich Insurance Company Limited,
E-mail: domestictravel@apollomunichinsurance.com 10th Floor, Tower - B, Building No. 10, DLF Cyber City,
DLF City Phase II, Gurgaon, Haryana - 122002.
Service Tax No.: AAGCA1654HST002
Location: Gurgaon For and on behalf of Apollo Munich Health Insurance Company Limited
Date: 19-Jul-2014 18:13 hrs Authorized Signatory
Apollo Munich Insurance Company Ltd.: Corp. Off.: 10th Floor, Tower - B, Building No. 10, DLF Cyber City, DLF City Phase II, Gurgaon, Haryana - 122002. Regd. Off.: Apollo Hospitals Complex,
Jubilee Hills, Hyderabad - 500033.Toll Free No.: 1800 - 102 -0333, E-mail: customerservice@apollomunichinsurance.com, Website: www.apollomunichinsurance.com