Circular - Up Gradation
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POL/DB/996
8 October 2009
Mr. Suman Bhowmik H/8, Cluster X Purbachal Abason, Sector - III Salt Lake City KOLKATA - 700 097 Dear Sir, POLICY NO. 911/III Kindly refer to your letter dated 30 September 2009 requesting for upgradation of the above policy to Schedule V Benefits. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self. 1 2 3 4
Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. Glaucoma E C G
The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. Thanking you, Yours faithfully, ( D Basu ) Asst. Manager - Accounts maa
POL/KD/1282
19 November 2009
Mr. Samir Kumar Dey “ Saratalay ” 1237, Keotagarbagan Sahaganj HOOGHLY - 712 104 Dear Sir, POLICY NO. 27885/IV Kindly refer to the request for upgradation of the above policy to Schedule V Benefits. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. However, as a senior citizen you will be reimbursed 50% of the cost incurred on the medical examination subject to production of money receipts to the Association and acceptance of the upgradation requested for. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self. Self
1 2 3 4
Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. Cataract / Glaucoma E C G
The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. Thanking you, Yours faithfully, ( K Das ) Finance Manager maa
POL/DB/998
8 October 2009
Mr. Chitta Ranjan Mukherjee 70, Baguiati Road KOLKATA - 700 028
Dear Sir, POLICY NO. 21302/IV - CHITTA RANJAN MUKHERJEE POLICY NO. 401241/IV - MR. SUMAN MUKHERJEE On 30 September 2009 we received your letter dated nil requesting for upgradation of the above two policies. In this connection, please note that the next renewal date of the above two policies falls due on 1 April 2010. Please, therefore, get in touch with us in the month of March 2010 to enable us to proceed further in the matter. Thanking you,
Yours faithfully,
( D Basu ) Asst. Manager - Accounts maa
POL/KD/1276
19 November 2009
Mr.Asim Kumar Mukherji 174-A, Block ‘G’ Nalini Ranjan Avenue New Alipore KOLKATA - 700 053 Dear Sir, POLICY NO. 20808/IV Kindly refer to your letter dated 9 November 2009 requesting for upgradation of the above policy to Schedule V. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. However, as a senior citizen you will be reimbursed 50% of the cost incurred on the medical examination subject to production of money receipts to the Association and acceptance of the upgradation requested for. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self and your wife. Self
Wife
1 2 3 4 1 2 3 4
Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. cataract/glaucoma E C G Blood Pressure Blood Suger - PP Report of Opthalmic surgeon reg. cataract/glaucoma E C G
The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. The balance premium payable by you on upgradation, if accepted, will be intimated to you in due course. We would also request you to take immediate action in this regard. Thanking you, Yours faithfully,
maa
POL/KD/1277
( K Das ) Finance Manager
19 November 2009
Mr. Asoke Dasgupta 2nd Floor 31/1, Lake Avenue, KOLKATA - 700 026 Dear Sir, POLICY NO. 23029/IV Kindly refer to your letter dated 9 November 2009 requesting for upgradation of the above policy to Schedule V. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. However, as a senior citizen you will be reimbursed 50% of the cost incurred on the medical examination subject to production of money receipts to the Association and acceptance of the upgradation requested for. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self and your wife. Self
Wife
1 2 3 4 1 2 3 4
Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. Glaucoma E C G Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. Glaucoma E C G
The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. Thanking you, Yours faithfully, ( K Das ) Finance Manager maa
POL/KD/1278
19 November 2009
Mrs. Keya Bhowmik “Ramroop” 12, Garfa, 4th Lane Jadavpur KOLKATA - 700 075 Dear Madam, POLICY NO. 55913/II Kindly refer to your letter dated 9 September 2009 requesting for upgradation of the above policy to Schedule III Benefits. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. However, as a senior citizen you will be reimbursed 50% of the cost incurred on the medical examination subject to production of money receipts to the Association and acceptance of the upgradation requested for. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self. 1 Blood Pressure 2 Blood Sugar - PP 3 Report of Opthalmic surgeon reg. Cataract/Glaucoma 4 E C G The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. The balance premium payable by you on upgradation, if accepted, will be intimated to you in due course. We would also request you to take immediate action in this regard. Thanking you, Yours faithfully,
maa
POL/DB/1273
( K Das ) Finance Manager
18 November 2009
Mr. Gopalaiyer Venkitachalam Iyer 18/30, Dover Lane Ground Floor KOLKATA - 700 029 Dear Sir, POLICY NO. 12168/IV Kindly refer to your letter dated 5 November 2009 requesting for upgradation of the above policy to Schedule V Benefits. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. However, as a senior citizen you will be reimbursed 50% of the cost incurred on the medical examination subject to production of money receipts to the Association and acceptance of the upgradation requested for. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self and your wife. Self
1 Blood Sugar - PP 2 Report of Opthalmic Surgeon reg. cataract/Glaucoma
Wife
1 2 3 4
Blood Pressure Blood Sugar - PP / Fasting Report of Opthalmic surgeon reg. cataract / glaucoma E C G
The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. The balance premium payable by you on upgradation, if accepted, will be intimated to you in due course. We would also request you to take immediate action in this regard. Thanking you, Yours faithfully,
maa
POL/DB/1272
( D Basu ) Asst. Manager - Accounts
18 November 2009
Mr. Edmund Ajit Gomes A-6/5, satyen Park M G Road, Joka KOLKATA - 700 104 Dear Sir, POLICY NO. 15980/II Kindly refer to your letter dated 6 November 2009 requesting for upgradation of the above policy to Schedule V Benefits. However, you can upgrade your above Policy to Schedule III or IV Benefits, next Higher Schedule. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. However, as a senior citizen you will be reimbursed 50% of the cost incurred on the medical examination subject to production of money receipts to the Association and acceptance of the upgradation requested for. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self. 1 2 3 4
Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. Cataract / Glaucoma E C G
The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. The balance premium payable by you on upgradation, if accepted, will be intimated to you in due course. We would also request you to take immediate action in this regard. Thanking you, Yours faithfully, ( K Das ) Finance Manager maa
POL/DB/983
6 October 2009
Mr. Sanjay Issar 3F, Shyamkunj 12C. Lord Sinha Road KOLKATA - 700 071 Dear Sir, POLICY NO. 52565/V Kindly refer to your letter dated 18 September 2009 requesting for upgradation of the above policy to Schedule VI Benefits. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self and your wife. Self
1 2 3 4
Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. Glaucoma E C G
Wife
1 2 3 4
Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. Glaucoma E C G
The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. Thanking you, Yours faithfully, ( D Basu ) Asst. Manager - Accounts maa
POL/AKC/1054
16 October 2009
Mr. Sukumar Banerjee 22/1, N S Road Anjan Garh Seoraphuli Sarkarpara P O Seoraphuli DIST HOOGHLY - 712 223
Dear Sir, POLICY NO. 56662/IV Please refer to your letter dated 21 September 2009 requesting for upgradation of the above policy. In this connection, please note that the next renewal date of your policy falls due on 18 May 2010. Please, therefore, get in touch with us in the month of April 2010 to enable us to proceed further in the matter. Thanking you,
Yours faithfully,
( D Basu ) Asst. Manager - Accounts maa
POL/DB/309
22 June 2009
Mr. Malay Kumar Majumder 1/3/1, Sisir Kumar Dawn Road KOLKATA - 700 036
Dear Sir, POLICY NO. 58161/III Please refer to your letter dated 16 June 2009 requesting for upgradation of your above policy from Schedule III to Schedule IV Benefits. In this connection, please note that the next renewal date of your policy falls due on 12 December 2009. Please, therefore, get in touch with us in the month of November 2009 to enable us to proceed further in the matter. Thanking you,
Yours faithfully,
( D Basu ) Asst. Manager - Accounts maa
POL/DB/281
17 June 2009
Mr. Aloke Kumar Ghosh 4, Creek Lane KOLKATA - 700 014
Dear Sir, POLICY NO. 28456/IV
Please refer to your letter dated 12 June 2009 requesting for upgradation of the above policy to Schedule V Benefits. In this connection, please note that the next renewal date of your policy falls due on 1 October 2009. Please, therefore, get in touch with us in the month of September 2009 to enable us to proceed further in the matter. Thanking you,
Yours faithfully,
( D Basu ) Asst. Manager - Accounts maa
POL/DB/282
17 June 2009
Mr. Anil Shunglu 155/1, Block G New Alipore KOLKATA - 700 053
Dear Sir, POLICY NO. 828/III Kindly refer to your letter dated 10 June 2009 requesting for upgradation of the above policy to Schedule V Benefits. In this connection, please note that the next renewal date of your policy falls due on 22 August 2009. Please, therefore, get in touch with us in the month of July 2009 to enable us to proceed further in the matter. Thanking you,
Yours faithfully,
( D Basu ) Asst. Manager - Accounts maa
POL/DB/290
18 June 2009
Mr. Gopalaiyer Venkitachalam Iyer 18/30, Dover Lane Ground Floor KOLKATA - 700 029 Dear Sir, POLICY NO. 12168/IV Please refer to your letter dated 12 June 2009. You may upgrade your above Policy to Schedule III or Schedule V, the coverage and premium being as follows :Premium Per Annum Upto Over 18 Years 18 Years
Coverage
Schedule III
Rs. 1,200/-
Rs. 1,440/- Rs. 1,15,000/- with Sub-limits
Schedule V
Rs. 1,560/-
Rs. 1,800/- Rs. 1,15,000/- without Sub-limits
Service Tax etc. extra. The upgradation is, however, subject to compliance of the conditions contained in the policy conditions of the Association. In this connection, please note that the next renewal date of your Policy falls due on 1 December 2009. Please, therefore, get in touch with us in the month of November 2009 to enable us to proceed further in the matter. Thanking you, Yours faithfully,
( D Basu ) Asst. Manager – Accounts maa
POL/DB/292
18 June 2009
Mr. Bhupinder Singh Arora Flat 2A 5, Wood Street KOLKATA - 700 016
Dear Sir, POLICY NO. 14979/V On 15 June 2009 we received your letter dated nil requesting for upgradation of the above policy. In this connection, please note that the next renewal date of your policy falls due on 1 April 2010. Please, therefore, get in touch with us in the month of March 2010 to enable us to proceed further in the matter. Thanking you,
Yours faithfully,
( D Basu ) Asst. Manager - Accounts maa
POL/DB/
June 2009
Dear Sir, POLICY NO. Kindly refer to your letter dated 20 May 2009. As regards your request for upgradation of the above Policy to the next higher Schedule, we would mention that enhancement of sum insured will be restricted to members who are not over the age of 75 years at the time of renewal of the Policy. Since you have already exceeded the age limit of 75 years, we regret our inability to upgrade the Policy. You will appreciate that we have to operate within certain restrictions and parameters and we trust that we shall continue to receive your co-operation and support for the years to come. Thanking you,
Yours faithfully,
( D Basu ) Asst. Manager - Accounts maa
SPECIMEN
POL/DB/
17 June 2009
Mr. Bhaskar Gupta 394-B, Jodhpur Park Flat 3-A KOLKATA – 700 068 Dear Sir, UPGRADATION - POLICY NO:25926/IV
Kindly refer to your letter dated 2 June 2009 requesting for upgradation of the above policy to Schedule V benefits and enclosing a cheque for Rs.1324/-. Based on your request the above Policy covering yourself and your wife is considered for upgradation to Schedule V benefits with effect from the renewal date, i.e. 1 June 2009 subject to the following condition : “Besides the waiting period of two months from the date of conversion to Schedule V Benefits, claims in respect of illness or conditions including maternity about which reasonable presumption of knowledge can be inferred at the time of conversion, will be settled under the pre-existing Schedule” Please also note that the claims in respect of the treatments for the following diseases, settled prior to conversion to Schedule V, will be processed under the same Schedules under which those were settled earlier, as shown below : NAME
Mr. Bhaskar Gupta
Mrs. Shibani Gupta
PRE-EXISTING DISEASES
PRE-EXISTING DISEASES SETTLED PRIOR TO 1 JUNE 2009 UNDER SCHEDULE
Intestinal Obstruction or any sequelae thereof Cataract Operation both eyes or any sequelae thereof
IV IV
Cholecystectomy or any sequelae thereof
II
Contd … 2
:
2
:
Kindly return the duplicate of this letter duly signed by you at the appropriate place in token of your acceptance of the above conditions on receipt of which we shall proceed further in the matter. Thanking you,
Yours faithfully,
( K Das ) Finance Manager Agreed ____________________ Signature of Policyholder Dated : Contact No. :
SPECIMEN
Endorsement No: Name of Member : Mr. Bhaskar Gupta
Policy No:25926/V
Yearly Subscription Rs. 3600/- per annum
It is hereby declared and agreed that as from 1 June 2009 you are covered under the Association’s Fifth Schedule of Benefits. Please note that your Policy No. has been changed from 25926/IV to 25926/V with effect from that date. Besides the waiting period of two months from the date of conversion to Schedule V Benefits, claims in respect of illness or conditions including maternity about which reasonable presumption of knowledge can be inferred at the time of conversion, will be settled under the pre-existing Schedule. It is further agreed that the Association will process claims for Mr. Bhaskar Gupta relating to the treatment of Intestinal Obstruction or any sequelae thereof and for Cataract operations in both eyes or any sequelae thereof under Schedule IV. It is also agreed that the Association will process claims for Mrs. Shibani Gupta relating to the treatment of Cholecystectomy or any sequelae thereof under Schedule II.
( K. Das ) Date :
June 2009Finance Manager
POL/DB/
June 2009
Dear , Please refer to your E-mail dated 11 June 2009. You may request for upgradation of your existing Schedule to Schedule III or Schedule V, the coverage and premium being as follows :Premium Per Annum Upto Over 18 Years 18 Years
Coverage
Schedule III
Rs. 1,200/-
Rs. 1,440/- Rs. 1,15,000/- with Sub-limits
Schedule V
Rs. 1,560/-
Rs. 1,800/- Rs. 1,15,000/- without Sub-limits
Service Tax etc. extra. The upgradation is, however, subject to compliance of the conditions contained in the policy conditions of the Association. Please get in touch with us nearer the time of next renewal. Please note that the selective upgradation is not possible. Thanking you, Yours faithfully,
( D Basu ) Asst. Manager – Accounts maa
Meanwhile, please ensure that the premium for the existing Schedule for the policy year ended 30 November 2010 is paid within the due date. You are also aware that default in payment of premium within 15 days’ grace period from the due date will lead to cancellation of the Policy. In case you have already paid the premium, please ignore this.
8 October 2009
Mr. Suman Bhowmik H/8, Cluster X Purbachal Abason, Sector - III Salt Lake City KOLKATA - 700 097 Dear Sir, POLICY NO. 911/III Kindly refer to your letter dated 30 September 2009 requesting for upgradation of the above policy to Schedule V Benefits. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self. 1 2 3 4
Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. Glaucoma E C G
The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. Thanking you, Yours faithfully, ( D Basu ) Asst. Manager - Accounts maa
POL/KD/1282
19 November 2009
Mr. Samir Kumar Dey “ Saratalay ” 1237, Keotagarbagan Sahaganj HOOGHLY - 712 104 Dear Sir, POLICY NO. 27885/IV Kindly refer to the request for upgradation of the above policy to Schedule V Benefits. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. However, as a senior citizen you will be reimbursed 50% of the cost incurred on the medical examination subject to production of money receipts to the Association and acceptance of the upgradation requested for. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self. Self
1 2 3 4
Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. Cataract / Glaucoma E C G
The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. Thanking you, Yours faithfully, ( K Das ) Finance Manager maa
POL/DB/998
8 October 2009
Mr. Chitta Ranjan Mukherjee 70, Baguiati Road KOLKATA - 700 028
Dear Sir, POLICY NO. 21302/IV - CHITTA RANJAN MUKHERJEE POLICY NO. 401241/IV - MR. SUMAN MUKHERJEE On 30 September 2009 we received your letter dated nil requesting for upgradation of the above two policies. In this connection, please note that the next renewal date of the above two policies falls due on 1 April 2010. Please, therefore, get in touch with us in the month of March 2010 to enable us to proceed further in the matter. Thanking you,
Yours faithfully,
( D Basu ) Asst. Manager - Accounts maa
POL/KD/1276
19 November 2009
Mr.Asim Kumar Mukherji 174-A, Block ‘G’ Nalini Ranjan Avenue New Alipore KOLKATA - 700 053 Dear Sir, POLICY NO. 20808/IV Kindly refer to your letter dated 9 November 2009 requesting for upgradation of the above policy to Schedule V. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. However, as a senior citizen you will be reimbursed 50% of the cost incurred on the medical examination subject to production of money receipts to the Association and acceptance of the upgradation requested for. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self and your wife. Self
Wife
1 2 3 4 1 2 3 4
Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. cataract/glaucoma E C G Blood Pressure Blood Suger - PP Report of Opthalmic surgeon reg. cataract/glaucoma E C G
The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. The balance premium payable by you on upgradation, if accepted, will be intimated to you in due course. We would also request you to take immediate action in this regard. Thanking you, Yours faithfully,
maa
POL/KD/1277
( K Das ) Finance Manager
19 November 2009
Mr. Asoke Dasgupta 2nd Floor 31/1, Lake Avenue, KOLKATA - 700 026 Dear Sir, POLICY NO. 23029/IV Kindly refer to your letter dated 9 November 2009 requesting for upgradation of the above policy to Schedule V. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. However, as a senior citizen you will be reimbursed 50% of the cost incurred on the medical examination subject to production of money receipts to the Association and acceptance of the upgradation requested for. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self and your wife. Self
Wife
1 2 3 4 1 2 3 4
Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. Glaucoma E C G Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. Glaucoma E C G
The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. Thanking you, Yours faithfully, ( K Das ) Finance Manager maa
POL/KD/1278
19 November 2009
Mrs. Keya Bhowmik “Ramroop” 12, Garfa, 4th Lane Jadavpur KOLKATA - 700 075 Dear Madam, POLICY NO. 55913/II Kindly refer to your letter dated 9 September 2009 requesting for upgradation of the above policy to Schedule III Benefits. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. However, as a senior citizen you will be reimbursed 50% of the cost incurred on the medical examination subject to production of money receipts to the Association and acceptance of the upgradation requested for. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self. 1 Blood Pressure 2 Blood Sugar - PP 3 Report of Opthalmic surgeon reg. Cataract/Glaucoma 4 E C G The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. The balance premium payable by you on upgradation, if accepted, will be intimated to you in due course. We would also request you to take immediate action in this regard. Thanking you, Yours faithfully,
maa
POL/DB/1273
( K Das ) Finance Manager
18 November 2009
Mr. Gopalaiyer Venkitachalam Iyer 18/30, Dover Lane Ground Floor KOLKATA - 700 029 Dear Sir, POLICY NO. 12168/IV Kindly refer to your letter dated 5 November 2009 requesting for upgradation of the above policy to Schedule V Benefits. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. However, as a senior citizen you will be reimbursed 50% of the cost incurred on the medical examination subject to production of money receipts to the Association and acceptance of the upgradation requested for. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self and your wife. Self
1 Blood Sugar - PP 2 Report of Opthalmic Surgeon reg. cataract/Glaucoma
Wife
1 2 3 4
Blood Pressure Blood Sugar - PP / Fasting Report of Opthalmic surgeon reg. cataract / glaucoma E C G
The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. The balance premium payable by you on upgradation, if accepted, will be intimated to you in due course. We would also request you to take immediate action in this regard. Thanking you, Yours faithfully,
maa
POL/DB/1272
( D Basu ) Asst. Manager - Accounts
18 November 2009
Mr. Edmund Ajit Gomes A-6/5, satyen Park M G Road, Joka KOLKATA - 700 104 Dear Sir, POLICY NO. 15980/II Kindly refer to your letter dated 6 November 2009 requesting for upgradation of the above policy to Schedule V Benefits. However, you can upgrade your above Policy to Schedule III or IV Benefits, next Higher Schedule. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. However, as a senior citizen you will be reimbursed 50% of the cost incurred on the medical examination subject to production of money receipts to the Association and acceptance of the upgradation requested for. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self. 1 2 3 4
Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. Cataract / Glaucoma E C G
The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. The balance premium payable by you on upgradation, if accepted, will be intimated to you in due course. We would also request you to take immediate action in this regard. Thanking you, Yours faithfully, ( K Das ) Finance Manager maa
POL/DB/983
6 October 2009
Mr. Sanjay Issar 3F, Shyamkunj 12C. Lord Sinha Road KOLKATA - 700 071 Dear Sir, POLICY NO. 52565/V Kindly refer to your letter dated 18 September 2009 requesting for upgradation of the above policy to Schedule VI Benefits. In this connection, we would request you to refer to Point c of the addendum of the Policy Conditions sent to you vide our circular dated 29 May 2009. You will please note therein that upgradation is subject to satisfactory medical check up, if required by the Association, at the members’ own cost. To enable us to consider the upgradation you are requested to submit the medical examination reports to the Association for the following in respect of self and your wife. Self
1 2 3 4
Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. Glaucoma E C G
Wife
1 2 3 4
Blood Pressure Blood Sugar - PP Report of Opthalmic Surgeon reg. Glaucoma E C G
The medical tests may be conducted at any hospital or nursing home or diagnostic centre registered with the concerned local authorities and is under the supervision of a registered qualified doctor. Thanking you, Yours faithfully, ( D Basu ) Asst. Manager - Accounts maa
POL/AKC/1054
16 October 2009
Mr. Sukumar Banerjee 22/1, N S Road Anjan Garh Seoraphuli Sarkarpara P O Seoraphuli DIST HOOGHLY - 712 223
Dear Sir, POLICY NO. 56662/IV Please refer to your letter dated 21 September 2009 requesting for upgradation of the above policy. In this connection, please note that the next renewal date of your policy falls due on 18 May 2010. Please, therefore, get in touch with us in the month of April 2010 to enable us to proceed further in the matter. Thanking you,
Yours faithfully,
( D Basu ) Asst. Manager - Accounts maa
POL/DB/309
22 June 2009
Mr. Malay Kumar Majumder 1/3/1, Sisir Kumar Dawn Road KOLKATA - 700 036
Dear Sir, POLICY NO. 58161/III Please refer to your letter dated 16 June 2009 requesting for upgradation of your above policy from Schedule III to Schedule IV Benefits. In this connection, please note that the next renewal date of your policy falls due on 12 December 2009. Please, therefore, get in touch with us in the month of November 2009 to enable us to proceed further in the matter. Thanking you,
Yours faithfully,
( D Basu ) Asst. Manager - Accounts maa
POL/DB/281
17 June 2009
Mr. Aloke Kumar Ghosh 4, Creek Lane KOLKATA - 700 014
Dear Sir, POLICY NO. 28456/IV
Please refer to your letter dated 12 June 2009 requesting for upgradation of the above policy to Schedule V Benefits. In this connection, please note that the next renewal date of your policy falls due on 1 October 2009. Please, therefore, get in touch with us in the month of September 2009 to enable us to proceed further in the matter. Thanking you,
Yours faithfully,
( D Basu ) Asst. Manager - Accounts maa
POL/DB/282
17 June 2009
Mr. Anil Shunglu 155/1, Block G New Alipore KOLKATA - 700 053
Dear Sir, POLICY NO. 828/III Kindly refer to your letter dated 10 June 2009 requesting for upgradation of the above policy to Schedule V Benefits. In this connection, please note that the next renewal date of your policy falls due on 22 August 2009. Please, therefore, get in touch with us in the month of July 2009 to enable us to proceed further in the matter. Thanking you,
Yours faithfully,
( D Basu ) Asst. Manager - Accounts maa
POL/DB/290
18 June 2009
Mr. Gopalaiyer Venkitachalam Iyer 18/30, Dover Lane Ground Floor KOLKATA - 700 029 Dear Sir, POLICY NO. 12168/IV Please refer to your letter dated 12 June 2009. You may upgrade your above Policy to Schedule III or Schedule V, the coverage and premium being as follows :Premium Per Annum Upto Over 18 Years 18 Years
Coverage
Schedule III
Rs. 1,200/-
Rs. 1,440/- Rs. 1,15,000/- with Sub-limits
Schedule V
Rs. 1,560/-
Rs. 1,800/- Rs. 1,15,000/- without Sub-limits
Service Tax etc. extra. The upgradation is, however, subject to compliance of the conditions contained in the policy conditions of the Association. In this connection, please note that the next renewal date of your Policy falls due on 1 December 2009. Please, therefore, get in touch with us in the month of November 2009 to enable us to proceed further in the matter. Thanking you, Yours faithfully,
( D Basu ) Asst. Manager – Accounts maa
POL/DB/292
18 June 2009
Mr. Bhupinder Singh Arora Flat 2A 5, Wood Street KOLKATA - 700 016
Dear Sir, POLICY NO. 14979/V On 15 June 2009 we received your letter dated nil requesting for upgradation of the above policy. In this connection, please note that the next renewal date of your policy falls due on 1 April 2010. Please, therefore, get in touch with us in the month of March 2010 to enable us to proceed further in the matter. Thanking you,
Yours faithfully,
( D Basu ) Asst. Manager - Accounts maa
POL/DB/
June 2009
Dear Sir, POLICY NO. Kindly refer to your letter dated 20 May 2009. As regards your request for upgradation of the above Policy to the next higher Schedule, we would mention that enhancement of sum insured will be restricted to members who are not over the age of 75 years at the time of renewal of the Policy. Since you have already exceeded the age limit of 75 years, we regret our inability to upgrade the Policy. You will appreciate that we have to operate within certain restrictions and parameters and we trust that we shall continue to receive your co-operation and support for the years to come. Thanking you,
Yours faithfully,
( D Basu ) Asst. Manager - Accounts maa
SPECIMEN
POL/DB/
17 June 2009
Mr. Bhaskar Gupta 394-B, Jodhpur Park Flat 3-A KOLKATA – 700 068 Dear Sir, UPGRADATION - POLICY NO:25926/IV
Kindly refer to your letter dated 2 June 2009 requesting for upgradation of the above policy to Schedule V benefits and enclosing a cheque for Rs.1324/-. Based on your request the above Policy covering yourself and your wife is considered for upgradation to Schedule V benefits with effect from the renewal date, i.e. 1 June 2009 subject to the following condition : “Besides the waiting period of two months from the date of conversion to Schedule V Benefits, claims in respect of illness or conditions including maternity about which reasonable presumption of knowledge can be inferred at the time of conversion, will be settled under the pre-existing Schedule” Please also note that the claims in respect of the treatments for the following diseases, settled prior to conversion to Schedule V, will be processed under the same Schedules under which those were settled earlier, as shown below : NAME
Mr. Bhaskar Gupta
Mrs. Shibani Gupta
PRE-EXISTING DISEASES
PRE-EXISTING DISEASES SETTLED PRIOR TO 1 JUNE 2009 UNDER SCHEDULE
Intestinal Obstruction or any sequelae thereof Cataract Operation both eyes or any sequelae thereof
IV IV
Cholecystectomy or any sequelae thereof
II
Contd … 2
:
2
:
Kindly return the duplicate of this letter duly signed by you at the appropriate place in token of your acceptance of the above conditions on receipt of which we shall proceed further in the matter. Thanking you,
Yours faithfully,
( K Das ) Finance Manager Agreed ____________________ Signature of Policyholder Dated : Contact No. :
SPECIMEN
Endorsement No: Name of Member : Mr. Bhaskar Gupta
Policy No:25926/V
Yearly Subscription Rs. 3600/- per annum
It is hereby declared and agreed that as from 1 June 2009 you are covered under the Association’s Fifth Schedule of Benefits. Please note that your Policy No. has been changed from 25926/IV to 25926/V with effect from that date. Besides the waiting period of two months from the date of conversion to Schedule V Benefits, claims in respect of illness or conditions including maternity about which reasonable presumption of knowledge can be inferred at the time of conversion, will be settled under the pre-existing Schedule. It is further agreed that the Association will process claims for Mr. Bhaskar Gupta relating to the treatment of Intestinal Obstruction or any sequelae thereof and for Cataract operations in both eyes or any sequelae thereof under Schedule IV. It is also agreed that the Association will process claims for Mrs. Shibani Gupta relating to the treatment of Cholecystectomy or any sequelae thereof under Schedule II.
( K. Das ) Date :
June 2009Finance Manager
POL/DB/
June 2009
Dear , Please refer to your E-mail dated 11 June 2009. You may request for upgradation of your existing Schedule to Schedule III or Schedule V, the coverage and premium being as follows :Premium Per Annum Upto Over 18 Years 18 Years
Coverage
Schedule III
Rs. 1,200/-
Rs. 1,440/- Rs. 1,15,000/- with Sub-limits
Schedule V
Rs. 1,560/-
Rs. 1,800/- Rs. 1,15,000/- without Sub-limits
Service Tax etc. extra. The upgradation is, however, subject to compliance of the conditions contained in the policy conditions of the Association. Please get in touch with us nearer the time of next renewal. Please note that the selective upgradation is not possible. Thanking you, Yours faithfully,
( D Basu ) Asst. Manager – Accounts maa
Meanwhile, please ensure that the premium for the existing Schedule for the policy year ended 30 November 2010 is paid within the due date. You are also aware that default in payment of premium within 15 days’ grace period from the due date will lead to cancellation of the Policy. In case you have already paid the premium, please ignore this.
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