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R D C

Location:
Nashik, Maharashtra, India
Salary:
Account
Posted:
October 05, 2025

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Resume:

UIN : IRDA/NL-HLT/BAGI/P-H/V.I/***/**-**

SANKAT MOCHAN- POLICY SCHEDULE

Invoice No:

Period of Insurance

Policy Number

Policy Issued on Policy Status

Policy Details

GSTIN / UIN

Company GST No:

Expiry Date

Place of Supply/State

Code/Name

Company PAN

12-6402-0000323643-00 Endorsement No

12/07/2025

11/07/2026

NA

ACTIVE

From 12/07/2025 00:00 Hrs To

11/07/2026 Midnight

272507I003129371

27 - MAHARASHTRA

AABCB5730G

Unregistered

27AABCB5730G1ZX

Member Name Customer ID Gender Date of Birth Age Relation Nominee Name &

Relation

First Policy

Inception Date

Vikas Anil Ujgare PI34894719 Male 06/06/1997 28 Self 1. Seema Vikas

Ujgare - Spouse

12/07/2025

SWARBABA NAGAR, BEHIND MUTHA HOS, GAUTAM NAGAR, NASHIK,, SATPUR, NASHIK, MAHARASHTRA, 422007, INDIA

Insured Address

Insured Member Details

Member Name Occupation Premium Plan Basic(SI)

Wider

(SI)

Comprehensive(SI)

Accidental

Hospitalization

(SI)

Hospital

Confinement

Allowance(Per Day)

Vikas Anil Ujgare Other Class 2 319 Plan 1 200***-*-*-****** 0 Cover Details

Amount

Three Hundred Eighteen Rupees State GST(9%)

Description

270 270

318

Amount

Gross Premium

Central GST(9%)

Gross Premium:

Base Premium

Description

Premium Details

IGST

UTGST

CESS

0

0

0

Net Premium

24

24

Customer ID

902-***-****

Proposer Details

Email ID

PI34894719

Proposer Address

Proposer Name

Phone No ***********@*****.***

NASIK-Bajaj Allianz General Insurance Co Ltd,3rd Floor, Sumangal Business Court,Plot No.39, Yeolekar Mala,Near Shraddha Petrol Pump, Beside 3m Car Mall,Nashik,Maharashtra,422005,INDIA Previous Policy No

Policy issuing office and Correspondence address for communication by policyholder for claim, service request, notice, summons, etc. Vikas Anil Ujgare

SWARBABA NAGAR, BEHIND MUTHA HOS, GAUTAM NAGAR, NASHIK,, SATPUR, NASHIK, MAHARASHTRA, 422007, INDIA

NA Previous Policy Expiry Date NA

UIN : IRDA/NL-HLT/BAGI/P-H/V.I/147/13-14

SANKAT MOCHAN- POLICY SCHEDULE

"As per the GST regulations, the amount of GST will not be refunded if the policy / endorsement is cancelled after 30th September of the next financial year E. & O.E"

"In case no GSTIN or incorrect GSTIN is provided by the Proposer at Proposal stage, Bajaj Allianz General Insurance Company Ltd shall not be responsible for any Input Tax Credit losses and no subsequent revision of invoice will be undertaken."

“I/We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the aggregate turnover notified under sub-rule (4) of rule 48, we are not required to prepare an invoice in terms of the provisions of the said sub-rule.” It is mandatory to keep your policy with updated contact (Mobile No., Email ID and PAN Card) and bank account details, to process any of your service requests faster and hassle-free in future. You can update the same through Caringly yours App – {https://play.google.com/store/apps/details?id=com.ba.cp.controller&hl=en_IN}, WhatsApp Service { Say ‘Hi’ on WhatsApp - +91-750**-*****}, Contact our 24-Hour Call Center at 1-800-***-****, 180*-***-****, Give a Missed Call on – 808*******, SMS “WORRY” to 575758, Email – {*********@************.**.**}, website – {www.bajajallianz.com}, contact your agent or nearest branch.

AGENCY NAME EMAIL ID

AGENCY CODE 10025404 CONTACT NO

Vicky Kanyalal Valecha

988*******

***********@*****.***

Assignment Details NA

Type of Assignment NA

Assignment Wording NA

Special Exclusion at Policy

Level NA

Additional Remarks NA

Premium Payment Details

Receipt Number: SYS-25-000********* Date: 12/07/2025 Premium Payer ID: PI34894719 Float: NA; Payment Frequency: Single Premium ** If Premium paid through Cheque, the Policy is void ab-initio in case of dishonour of Cheque

Financial Institution Ref. No. NA

Member Name Exclusion

Vikas Anil Ujgare NA

Exclusions

This document is digitally signed,hence counter signature / stamp is not required Principal Location : Bajaj Allianz House,Airport Road,Yerwada,Pune-411006 PH- 66026666 Services Accounting Code : 997133 Accident and health insurance services. No reverse charge is payable on these services

Consolidated stamp duty Rs.10 paid for insurance policy stamps Challan No. MH015538899202425M DEFACED NO 0008972915202425 Order No. CSD/19/2025/816 Order Dated 20-FEB-25 Defaced Dated 20-FEB-25 having validity from 01-MAR-25 to 28- FEB-27 of General Stamp Office, Mumbai, India.

Bajaj Allianz General Insurance Company Ltd.

For & on the behalf

Authorized Signatory

Rs.10/-

Stamp Duty

SUB 10025404 / NA

UIN : IRDA/NL-HLT/BAGI/P-H/V.I/147/13-14

SANKAT MOCHAN- POLICY SCHEDULE

1-800-***-****

Policy Verification

http://twitter.com/BajajAllianz

SMS 'WORRY' to

Contact our 24-Hour Call Center at

575758

http://www.linkedin.com/company/bajaj-allianz-general-insurance Give a Missed Call on

www.bajajallianz.com

Bajaj Allianz General Insurance Co.Ltd.

http://www.facebook.com/BajajAllianz

Claim Registration

Bajaj Allianz House,Airport Road,Yerwada,Pune - 411006. Reg.No.:113 CIN:U66010PN2000PLC015329 808*******,

“The amounts present in the document are calculated with INR currency if not mentioned otherwise.”



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