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80D Medical Insurance Premium Receipt

This document is a payment receipt from Max Bupa Health Insurance acknowledging receipt of payment for a health insurance policy held by Samrat Mazumder. The policy provides Rs. 5,00,000 sum insured for Samrat, his wife Kritika, and daughter Tanishka. The base premium is Rs. 21,150 with Rs. 3,807 GST, for a total gross premium of Rs. 24,957. The receipt details the commencement and expiry dates of the policy, as well as the insured persons and their relationships to the policy holder.

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Samrat Mazumder
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67 views1 page

80D Medical Insurance Premium Receipt

This document is a payment receipt from Max Bupa Health Insurance acknowledging receipt of payment for a health insurance policy held by Samrat Mazumder. The policy provides Rs. 5,00,000 sum insured for Samrat, his wife Kritika, and daughter Tanishka. The base premium is Rs. 21,150 with Rs. 3,807 GST, for a total gross premium of Rs. 24,957. The receipt details the commencement and expiry dates of the policy, as well as the insured persons and their relationships to the policy holder.

Uploaded by

Samrat Mazumder
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

PAYMENT RECEIPT

Dear Samrat Mazumder,


A504 sector 12A
Ramchandra Niwas
Navimumbai - 400709

We acknowledge the receipt of payment towards the premium of the following health insurancepolicy:

Policy Holder’s Name Mr. Samrat Mazumder Policy Number 30436062201601


Corporate Silver 05 Lacs
Plan Opted for Sum Insured (₹) 5,00,000
2Adult +1 Child
Commencement
28/06/2022 Expiry Date 27/06/2023
Date*
Base Premium (₹) 21150
GST @18%(₹) 3807
Gross Premium (₹) 24957

*Insurance of policy is subject to clearance of premium paid

Details of persons Insured:

Individual cover
Name of the Person Relationship to (₹) (only in case
insured Age Gender policy holder of Family First)
[Link] Mazumder 34 Male Applicant N/A
[Link] Mazumder 30 Female Wife N/A
Miss Tanishka Mazumder 1 Female Daughter N/A

Upon issuance of this receipt, all previously issued temporary receipts, if any, related to this policy are
considered null and void. For the purpose of deduction under section 80D, the benefit shall be as per the
provisions of the Income Tax Act,1961 and any amendments made thereafter.

In the event of non-realization of premium, Tax benefits cannot be obtained against the premium receipt.

For your eligibility and deductions please refer to provisions of Income Tax Act 1961 as modifies and consult
your tax consultant.

Goods and Service Tax Registration number: 27AACCM3201E1Z3

For and on behalf of Max Bupa Health Insurance Co. Ltd.

Ashish Mehrotra

Managing Director and Chief Executive Officer


Location: Mumbai
Date: 28/06/2022

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