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Health Insurance Premium Receipt for Mr. C

The document acknowledges the receipt of a health insurance premium payment for Mr. Saravana Ruban C's policy, which is valid from June 29, 2024, to June 28, 2025. The total gross premium is Rs. 29,805.00, including taxes, and details of the insured individuals are provided, along with tax deduction information under section 80D of the Income Tax Act, 1961.

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39 views1 page

Health Insurance Premium Receipt for Mr. C

The document acknowledges the receipt of a health insurance premium payment for Mr. Saravana Ruban C's policy, which is valid from June 29, 2024, to June 28, 2025. The total gross premium is Rs. 29,805.00, including taxes, and details of the insured individuals are provided, along with tax deduction information under section 80D of the Income Tax Act, 1961.

Uploaded by

saravana ruban
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

Dear Mr.

SARAVANA RUBAN C
NO: 2/2337-T, KAYAMBU NAGAR,
SIVAKASI
TAMIL NADU - 626123

We acknowledge the receipt of payment towards the premium of the following health insurance policy:

Policy Holder's Name Mr.SARAVANA RUBAN C Policy Number 8667542165944

Commencement Date 29/06/2024 Expiry Date 28/06/2025

Plan Opted for HC VARIANT 10L NAT 2A1C


Net Premium/Taxable Value (Rs.) 25,259.00
Integrated Goods and Service Tax (18.00 %) 4,546.62

Central Goods and Service Tax (0.00 %) 0.00


State/Union Territory Goods and Service Tax (0.00 %) 0.00
Loading(Rs.) 0.00
Gross Premium (Rs.) 29,805.00
Issuance of policy is subject to clearance of premium paid

Details of persons Insured:


Name of Person Insured Age Gender Relationship to policy holder

Mr.SARAVANA RUBAN C 27 Male Applicant

Mrs. Divya A 30 Female Spouse


Ms. Yazhaisai S 1 Female Daughter

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 of the income Tax Act, 1961, please consult your tax advisor for more details. 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 this premium receipt

GSTI No.: 07AAFCM7916H1ZA SAC Code / Type of Service : 997133 / General Insurance Services

Niva Bupa State Code: 7 Customer State Code / Customer GSTI No.: 33 /NA

Policy issuing office: Delhi, Consolidated Stamp Duty deposited as per the order of Government of National Capital Territory of Delhi.

Location: New Delhi Chief Operating Officer


Date: 29/06/2024 For and on behalf of Niva Bupa Health Insurance Company Limited

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