State Insurance and Provident Fund Department (General Insurance Fund) Group Personal Accident Insurance Policy



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Transcription:

State Insurance and Provident Fund Department (General Insurance Fund) Group Personal Accident Insurance Policy Whereas the insured named in the Schedule hereto has made or caused to be made to the General Insurance Fund a written proposal dated as stated, in the schedule hereto (warranting the truth of the statement contained therein) which is the basis of this contract and is deemed to be incorporated herein and has paid the General Insurance Fund the premium herein stated for the insurance of the risk hereinafter specified occuring during the period General Insurance Fund may accept payment for the renewal of this policy. Now this policy witnesseth that subject to the terms, exclusions, conditions and definitions contained herein or endorsed or otherwise expressed hereon the General Insurance Fund will indemnify the insured as hereinafter mentioned. INSURED : Accounts Officer(Budget) SCHEDULE POLICY No.:GIF/81/GPA/11-12/15 Jodhpur Vidyut Vitran Nigam Ltd., Date : 31.10.11 Jodhpur ADDRESS : COVER NOTE No.: DD No. 173848 Dated 21.10.11 Rs. 5343484 PREMIUM CHEQUE NO. DATED (Premium @ 500/- + 10.30% S.T.) Prem. Rs.4844500/- + ST Rs.484450/- + Ed.Cess Rs.9689/-+H.E.C.4845/- Total = 5343484/- 9689 Employees RENEWAL OF POLICY NO. 10-11/73 PERIOD OF INSURANCE SUM INSURED FROM 24.10.11 To 23.10.12 1937800000

INSURANCE COVER Group Personal Accident Insurance for 9689 employees Sum assured for each employee Rs. 2,00,000/- Total Sum Assured Rs. 1937800000 SUBJECT TO CLAUSE : As per attached Policy Note: List of Employees not submitted fully by the Insured. Claims will be settled only after receiving the complete list of employees. 1 For THE GENERAL INSURANCE FUND State Insurance and Provident Fund Department (General Insurance Fund) Group Personal Accident Insurance Policy Whereas the insured named in the Schedule hereto has made or caused to be made to the General Insurance Fund a written proposal dated as stated, in the schedule hereto (warranting the truth of the statement contained therein) which is the basis of this contract and is deemed to be incorporated herein and has paid the General Insurance Fund the premium herein stated for the insurance of the risk hereinafter specified occuring during the period General Insurance Fund may accept payment for the renewal of this policy. Now this policy witnesseth that subject to the terms, exclusions, conditions and definitions contained herein or endorsed or otherwise expressed hereon the General Insurance Fund will indemnify the insured as hereinafter mentioned.

INSURED : Secretary Asstt.Accounts officer(cash), SCHEDULE POLICY No.:GIF/81/GPA/11-12/14 Rajasthan Rajya Vidyut Utpadan Nigam Ltd., Date : 21.10.11 Jaipur ADDRESS : COVER NOTE No.: DD No. 310961 Dated 20.10.11 Rs. 919908 PREMIUM CHEQUE NO. DATED Prem. Rs.833250/- + ST Rs.83325/- + Ed.Cess Rs.1667/-+ H.E.Cess 833/- 3333 Employees INSURED PERSON LIST ENCLOSED RENEWAL OF POLICY NO. 10-11/74 PERIOD OF INSURANCE SUM INSURED FROM 24.10.11 To 23.10.12 666600000 INSURANCE COVER Group Personal Accident Insurance for 3333 employees Sum assured for each employee Rs. 2,00,000/- Total Sum Assured Rs. 666600000 SUBJECT TO CLAUSE : As per attached Policy Note :- List of Employees has not submitted by the Insured. 2 For THE GENERAL INSURANCE FUND

State Insurance and Provident Fund Department (General Insurance Fund) Group Personal Accident Insurance Policy Whereas the insured named in the Schedule hereto has made or caused to be made to the General Insurance Fund a written proposal dated as stated, in the schedule hereto (warranting the truth of the statement contained therein) which is the basis of this contract and is deemed to be incorporated herein and has paid the General Insurance Fund the premium herein stated for the insurance of the risk hereinafter specified occuring during the period General Insurance Fund may accept payment for the renewal of this policy. Now this policy witnesseth that subject to the terms, exclusions, conditions and definitions contained herein or endorsed or otherwise expressed hereon the General Insurance Fund will indemnify the insured as hereinafter mentioned. INSURED : Secretary Accounts officer(estt. Cont.) SCHEDULE POLICY No.:GIF/81/GPA/11-12/12 Rajasthan Rajya Vidyut Prasaran Nigam Ltd., Date : 18.10.11 Vidyut Bhawan, Janpath, Jaipur ADDRESS : COVER NOTE No.: DD No. 458210 Dated 14.10.11 Rs. 1930250 PREMIUM CHEQUE NO. DATED Prem. Rs.1750000/- + ST Rs.175000/- + Ed.Cess Rs.3500/- +H.E. Cess Rs.1750/- 7000 Employees INSURED PERSON LIST ENCLOSED RENEWAL OF POLICY NO. 10-11/70 PERIOD OF INSURANCE SUM INSURED

FROM 22.10.11 To 21.10.12 1400000000 INSURANCE COVER Group Personal Accident Insurance for 7000 employees Sum assured for each employee Rs. 2,00,000/- Total Sum Assured Rs. 1400000000 SUBJECT TO CLAUSE : As per attached Policy 3 For THE GENERAL INSURANCE FUND

State Insurance and Provident Fund Department (General Insurance Fund) Group Personal Accident Insurance Policy Whereas the insured named in the Schedule hereto has made or caused to be made to the General Insurance Fund a written proposal dated as stated, in the schedule hereto (warranting the truth of the statement contained therein) which is the basis of this contract and is deemed to be incorporated herein and has paid the General Insurance Fund the premium herein stated for the insurance of the risk hereinafter specified occuring during the period General Insurance Fund may accept payment for the renewal of this policy. Now this policy witnesseth that subject to the terms, exclusions, conditions and definitions contained herein or endorsed or otherwise expressed hereon the General Insurance Fund will indemnify the insured as hereinafter mentioned. SCHEDULE INSURED : Accounts officer(cash) POLICY No.:GIF/81/GPA/11-12/13 Jaipur Vidyut Vitran Nigam Ltd., Date : 20.10.11 Vidyut Bhawan, Janpath, Jaipur ADDRESS : COVER NOTE No.: DD No. 346078 Dated 20.10.11 Rs. 8359086 PREMIUM CHEQUE NO. DATED (Premium @ 500/- + 10.30% S.T.) Prem. Rs.7578500/- + ST Rs.757850/- + Ed.Cess Rs.15157/-+ H.EDU.Cess 7579/- Total Rs. 8359086/- 15157 Employees RENEWAL OF POLICY NO. 10-11/71 PERIOD OF INSURANCE SUM INSURED

FROM 23.10.11 To 22.10.12 3031400000

INSURANCE COVER Group Personal Accident Insurance for 15157 employees Sum assured for each employee Rs. 2,00,000/- Total Sum Assured Rs. 3031400000 SUBJECT TO CLAUSE : As per attached Policy Note: List of Employees not submitted completely by Insured. Claims will be settled only after receiving the complete list of employees. 4 For THE GENERAL INSURANCE FUND State Insurance and Provident Fund Department (General Insurance Fund) Group Personal Accident Insurance Policy Whereas the insured named in the Schedule hereto has made or caused to be made to the General Insurance Fund a written proposal dated as stated, in the schedule hereto (warranting the truth of the statement contained therein) which is the basis of this contract and is deemed to be incorporated herein and has paid the General Insurance Fund the premium herein stated for the insurance of the risk hereinafter specified occuring during the period General Insurance Fund may accept payment for the renewal of this policy. Now this policy witnesseth that subject to the terms, exclusions, conditions and definitions contained herein or endorsed or otherwise expressed hereon the General Insurance Fund will indemnify the insured as hereinafter mentioned.

SCHEDULE INSURED : Secretary Sr. Accounts officer(ea & Cash) POLICY No.:GIF/81/GPA/11-12/17 Ajmer Vidyut Vitran Nigam Ltd., Date : 1.11.11 Ajmer ADDRESS : City Power House, Hathibhata, Ajmer COVER NOTE No.: DD No. 656524 Dated 31.10.11 Rs. 900000 PREMIUM CHEQUE NO. 656525 Dated 31.10.11 Rs. 900000 DATED 656526 Dated 31.10.11 Rs. 900000 656527 Dated 31.10.11 Rs. 900000 656528 Dated 31.10.11 Rs. 900000 656529 Dated 31.10.11 Rs. 900000 656530 Dated 31.10.11 Rs. 900000 656531 Dated 31.10.11 Rs. 576102 6876102 Prem. Rs.6234000/- + ST Rs.623400/- + Ed.Cess Rs.12468/-+ H.E.C. 6234/- 12468 Employees INSURED PERSON LIST ENCLOSED RENEWAL OF POLICY NO. 10-11/75 PERIOD OF INSURANCE SUM INSURED FROM 1.11.11 To 31.10.12 2493600000 INSURANCE COVER Group Personal Accident Insurance for 12468 employees Sum assured for each employee Rs. 2,00,000/- Total Sum Assured Rs. 2493600000 SUBJECT TO CLAUSE : As per attached Policy

Note:- List of Employees not Fully submitted by the Insured. For THE GENERAL INSURANCE FUND