26-Feb-15

Name:
Address:

MR. JAHANGIRALAM MOHAMED BAKRID

NO.29/14, LAKE VIEW ROAD,
KOTTUR,
CHENNAI - 600085.
Phone Number: 9789060107
Policy Number:

TYPS010852000100

Dear MR. JAHANGIRALAM MOHAMED BAKRID,

Sub: Welcome to the World of Online Insurance Protection from Royal Sundaram

Congratulations on buying Travel Insurance from Royal sundaram. We trust that your online experience of buying this
product on www.royalsundaram.in was quick and hassle-free.
We are enclosing the following documents for reference 1. Policy Schedule - 1
2. Policy terms and conditions
Please preserve these documents carefully as they form part of our contract with you. We request you to verify the
above documents and ensure everything is in order. In case of any discrepancies or queries, please contact our
customer service helpline or send in your request online at www.royalsundaram.in.
The original policy schedule will be couriered across to you shortly.
Assuring you of our best services at all times.

For Royal Sundaram Alliance Insurance Company Limited,

Authorised Signatory

Call: 1860 425 0000, Chat online or Write to: customer.services@royalsundaram.in

IRDA Registration No: 102

55ce534a32f2041676d0102e02f97e55

TRAVEL SHIELD SINGLE TRIP - POLICY SCHEDULE

Policy Number
Name of the Insured
Date of Birth
Gender
Address for
correspondence
(India)

Tele No. (India)

Email ID
Nominees Name
Pre-existing
diseases if any

TYPS010852000100
MR JAHANGIRALAM MOHAMED BAKRID

Issued at / Date
Period From
Period To
Trip Grouping

Chennai / 26-Feb-15
26/03/2015

CHENNAI - 600085,

Plan opted

USD 25000

- / 9789060107
drjahangir08@gmail.com
Mrs NAZREEN NAFEESA IBRAHIM GULAB JOHN
No

Details of Trip
Passport No.

F8363882

16/04/1983
MALE
NO.29/14, LAKE VIEW ROAD,
KOTTUR,

PREMIUM DETAILS
Service Tax + Cess (Rs.) : 27.0

Premium (Rs) : 216

01/04/2015(midnight)

EXCLUDING
USA/CANADA

Nominees
Relation

WIFE

Total Premium (Rs.) : 243

BENEFITS
COVERAGES

Overseas Health
Cover
Emergency Dental
Treatment
Repatriation of
remains

Accidental Death &

dismemberment 24
hours
Loss of Passport,
Visa
Automatic Extension
of Policy up to 7 days
extension

SUM INSURED
PER PERSON

EXCESS
PER CLAIM

USD 25000

USD 100

Hijack Distress Allowance

USD 300

USD 150

Trip Delay (After 12 hrs)

NA

NA

USD 7500

Nil

Accidental Death &

dismemberment Common
Carrier
Loss of Checked
Baggage
Baggage Delay (After 12
hrs)

NA

NA

USD 250

Nil

USD 50

12 hours

Home Insurance (Per

Family in Indian Rupees)
Personal Liability

NA

NA

USD 50000

USD 200

USD 5000

Nil

USD 250

USD 30

Yes

Nil

COVERAGES

SUM INSURED
PER PERSON

EXCESS
PER CLAIM

NA

NA

This policy has been issued based on your declaration about pre existing disease/surgery. Any claim arising out of a pre-existing disease/condition
will not be payable as per the terms & conditions of this policy. Please note that any suppression of existence of pre existing disease/condition shall
make the policy void from inception. Any illness arising due to Avian Influenza known as Bird Flu, Severe Acute Respiratory Syndrome (SARS) and
related disorders, Swine Flu are excluded.This schedule of insurance is a valid document. You can print and use the same as and when the need
arises.
Consolidated Stamp Duty Paid to the Government of TamilNadu.
Provided that in the case of a policy of general insurance where the remittance made by the proposer or the policyholder is not realised by the insurer, the policy shall be treated as void ab initio.

For Royal Sundaram Alliance Insurance Company Limited

Service Tax.No. AABCR7106GST001 PAN Number : AABCR 7106G

Duly Authorized Signatory

Claims Assistance Company (24 hr helpline) 91-22-40908315

USA : 001-866-9785205,001-866-3815720
Paramount Healthcare Management Pvt Ltd --- E-Mail Id- travelhealth@phmglobal.com
Important It is mandatory to contact the 24hr Assistance numbers above first and take prior authorization before
incurring any expenses. For details of coverage, refer Policy wordings.
Call: 1860 425 0000, Chat Online or Write to: customer.services@royalsundaram.in
IRDA registration no. 102

55ce534a32f2041676d0102e02f97e55