OPTIONAL TRAVEL INSURANCE COVER FOR E-TICKET PASSENGERS OF IRCTC

Certificate of Insurance

Certificate Number AG56051232474747

Name and Address of the Group
Organizer/Group Policy holder
Name of the Insured
Indian Railway Catering and Tourism Corporation
12th floor, IRCTC Corporate Office Statesman House,
Barakhamba Road, New Delhi
Pin 110001.
Mr.VISHNU P

Trip : From 27/11/2017 To 28/11/2017

Originating Station : MADURAI JN

Destination Station : KSR BENGALURU

INSURED DETAILS
PNR NO. 4338578107
Name Age Gender
Mr.VISHNU P 18 Male

PREMIUM
Premium 0.5800
IGST(18%) 0.1044
Total 0.6844

Trip means the actual departure of train from the originating station to actual arrival of train at the destination station as
mentioned in booked ticket through which insurance cover has been opted and premium paid, including process of entraining
and process of detraining the train

SUM INSURED DETAILS

Permanent total Permanent partial Hospitalisation Transportation of

Death
disability disability expenses for Injury mortal remains
Rs.10,00,000/- Rs.10,00,000/- Rs.7,50,000/- Rs.2,00,000/- Rs.10,000/-
Table of Benefits
As per Group Personal Accident Policy Terms and Conditions attached to the Policy No. AG00056051000100

The premium for this Policy is received from the Group Policy Holder Indian Railway Catering and Tourism
Corporation

Encl : Annexure 1 Claims procedure & documentation and Important Exclusions under the Policy
Please quote the Certificate Number in all your correspondence.
28/11/2017
IN WITNESS WHEREOF, this Policy of Insurance has been signed on ________________.
GSTIN:HRABCSGST PAN Number : AABCR 7106G

For Royal Sundaram General Insurance Co. Limited

Duly Authorised Signatory

Optional Travel Insurance Cover for E-Ticket Passengers of IRCTC

UIN: IRDAI/HLT/RSGI/P-H(G)/V.I/44/2016-17
IRDAI Registration Number:102