request for proposal for providing group personal accident

www.pfrda.com/tenders

REQUEST FOR PROPOSAL FOR PROVIDING GROUP PERSONAL ACCIDENT POLICY TO PFRDA FOR F.Y. 2022 – 2023 CLARIFICATION TO THE QUERIES RAISED DURING PRE-BID MEETING HELD ON 09.03.2022

Query Clarification

Claim details for the last three years. The claims during the last three years has been 'Nil'.

Policy Document may be provided for the last year.

As per Annexure.

The maximum age limit of dependent children under Dependent Child Education Benefit.

25 years

The expenses to be covered under the Dependent Child Education Benefit.

Tuition Fees is to be covered.

GROUP PERSONAL ACCIDENT SCHEDULECorporate Office/Policy Issuing Office: Reliance General Insurance Co. Ltd.Reliance Centre, 4th Floor, South Wing,Off. Western Express Highway,Santacruz (East), Mumbai - 400 055, India

Policy Servicing Branch: Flat No 10-15, 14th floor, Vijaya Building,17, Barakhamba Road, New Delhi 110001Delhi

Policy Branch Office Code: 1301 Agent/Broker Code:Direct

Policy No: 130131929140000013

Date of proposal:23/03/2019 Details of previous policy (in case of renewal)

ProposalNo:P031519116963 Previous policy No:

Date of expiry:

TaxInvoice No & Date :P031519116963 & 3/23/2019 2:51:00 PM

INSURED NAME : M/S PENSION FUND REGULATORY AND DEVELOPMENT AUTHORITY

GSTIN /UN of the insured

Policy Holder Address / Place Of Supply :

CHATRAPATI SHIVAJI BHAWAN,1ST FLOOR,B-14/A,QUTAB INSTITUTIONAL AREA,KATWARIA SARAI

NEW DELHI

110016

Period of Insurance: From 15/03/2019 to mid night on 14/03/2020

Total No of Employees Covered 58

Total No of Lives Covered 58

Type of Policy Named

Total Sum Insured(Rs) 406908360.00

Description of Group Employees

Nature of Business

Coverage Details and List of members covered as per Schedule attached.

Premium (Rs) 81382.20

CGST (@9.00%) 7324.40

SGST (@9.00 %) 7324.40

TOTAL PREMIUM PAYABLE(Rs) 96031.00

Branch GSTIN :07AABCR6747B1ZI;HSN Code :9971;Description Of Services :Financial and related services;

Consolidated Stamp duty Paid vide Letter of Authorisation No. CSD/298/2019/143/19 dated 11th January 2019 at General Stamp Office, Mumbai.** Not Applicable for the State of Jammu & Kashmir

This document shall be treated as a Tax Invoice as perRule 9(2) of the Goods and Services Tax Invoice Rules.

Reliance General Insurance Company Limited. IRDAI Registration No. 103. Registered Office: H Block, 1st Floor, Dhirubhai Ambani Knowledge City, Navi Mumbai 400710Corporate Office: Reliance Centre, 4th Floor, South Wing, Off. Western Express Highway, Santacruz (East), Mumbai - 400 055.Corporate Identity Number U66603MH2000PLC128300. UIN No. :IRDA/NL-HLT/RGI/P-P/V.I/320/13-14RGI/UW/CO/ 2914 /PS/VER. 1.0/310118

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*Trade Logo displayed above belongs to Anil Dhirubhai Ambani Ventures Private Limited and used by Reliance General Insurance Company Limited under License.

An ISO 9001:2008 Certified Company

(Registered Office: Reliance General Insurance Co.Ltd., H Block, 1st Floor, Dhirubhai Ambani Knowledge City, Navi Mumbai - 400710), Maharashtra

Annexure

In the event of dishonor of Cheque, this policy automatically stands cancelled from inception irrespective of whether a separate communication is sent or not.

In witness whereof this policy has been signed at Mumbai on 23/03/2019

In case of a renewal, the benefits provided under the policy and/or terms and conditions of the policy including premium rate may be subject to change.

Grievance Clause: For resolution of any query or grievance, Insured may contact the respective branch office of the Company or may call at 1800 3009 or may write an email at rgicl.services@relianceada.com. In case the insured is not satisfied with the response of the office, insured may contact the Nodal Grievance Officer of the Company at rgicl.grievances@relianceada.com. In the event of unsatisfactory response from the Nodal Grievance Officer, insured may email to Head Grievance Officer at rgicl.headgrievances@relianceada.com. In the event of unsatisfactory response from the Head Grievance Officer, he/she may, subject to vested jurisdiction, approach the Insurance Ombudsman for the redressal of grievance. Details of the offices of the Insurance Ombudsman are available at IRDAI website www.irda.gov.in or on company website www.reliancegeneral.co.in or on www.gbic.co.in. The insured may also contact the following office of the Insurance Ombudsman within whose territorial jurisdiction the branch or office of the Company is located.Smt. Sandhya Baliga Office of the Insurance Ombudsman,2/2 A,Universal Insurance Building,Asaf Ali Road,New Delhi – 110 002. Tel.: 011 - 23239633 / 23237532 Fax: 011 - 23230858 Email: bimalokpal.delhi@gbic.co.in

For and on behalf of

Reliance General Insurance Company Limited.

Agent Code Direct

Agent Contact No Authorised Signatory

User ID: 70273497 Policy Generation Date :23/03/2019

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Schedule attached to and forming part of Policy No.130131929140000013

Cover Name Sum insured Co-pay Special Conditions

Table C-Death +Permanent Total Disability +Permanent Partial Disability

Covered - Accidental only

Table D-Death +Permanent Total Disability +Permanent Partial Disability + Temporary Total Disablement

Covered-Accidental only

Medical expenses Medical Extension is limited to 40% of the compensation paid in settlement of a valid claim or 20% of the relevant sum insured whichever is less.

Education Grant Dependent Child Education benefit:- cover below age 25 years with limit for 1 child amount equal to 10% of the capital sum insured subject to maximum of Rs. 5,000 and for two children an amount equal to 10% of the capital sum insured subject to maximum of Rs.10,000

General Conditions: Maximum any one life limit will be (Rs.)- 14,848,680

Coverage:-1.Weekly Compensation (Temporary total disability benefit)- 1% Sum insured or actual weekly salary or Rs 5,000 whichever is less per week, maximum for 100 weeks.2.Transportation of mortal remains: - 2% of Capital Sum Insured or Rs. 2,500/- whichever is less.3.Terrorism is covered, however, terrorism activity arising out of Nuclear, Biological and/or Chemical means is excluded from the scope of this policy4.24*7 coverage5.Age restricted between 18 years -65 years.

Warranties:1.Policy is on NAMED BASIS 2.Warranted all the employees without any selection are covered under the policy 3.Warranted that weekly benefit is sum insured restricted to 24 times the monthly salary or the sum insured against the individual or Rs 5 lakhs whichever is less ,4.Total Sum insured should not exceed 60 times of monthly salary of an employee. Insured to submit salary certificate of month prior to date of accident at the time of claim.5.Mid-term increase in sum insured is not permitted.6.Contractual employee/labor are out of the scope of the policy7.Warranted that armed security guards & fire fighters are not covered under the policy.8.Warranted that all the employees belong to Risk category I & II only

Addition & deletion process:-1."Mid term addition is allowed only on the ground of new joiners. 2.Insured to submit monthly list of additions & deletions of new joiners/ those who have left the organization during the month by 7th of succeeding month. 3.New joiners will be covered from the date of joining subject to sufficient CD balance from date of inclusion or else from the date of receipt of premium. 4.Deletion of an employee will be from the date employee leaving the organization. 5.Premium for addition & deletion will be on pro-rata basis. 6.No refund is allowed against employees who have claimed.7.In case of delayed declaration, addition/deletion will be from the date of receipt of request to insurer subject to sufficient CD balance subject to nil claims."

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Specific Exclusions:A.Lives involved in the below mentioned activities/occupation shall be outside the scope of the policy:-1.Employee involved in any hazardous activity or manual labour.2.While engaged in aviation, or whilst mounting or dismounting from or traveling in any aircraft. ( Not applicable for fare Paying Passengers)3.Participation in any kind of motor speed contest4.Professional sports team in respect of specific benefit for inability to perform5.Underground mining & contractor specializing in tunneling6.Naval, military or air force personnel7.Radioactivity, Nuclear risks, ionizing radiation8.Suicide, attempt to Suicide or intentionally self- inflicted injury, sexually transmitted conditions, mental disorder, anxiety, stress or depression.9.Being under influence of drugs, alcohol, or other intoxication or hallucinogens10.Participation in actual or attempted felony, riot, civil commotion, crime misdemeanor11.Committing any breach of law of land with criminal intent.12.Death or disablement resulting from Pregnancy or childbirth13.Offshore activities & related risks are out of the scope of policyB.Lives employed under the occupation under Risk Category III are excluded under the scope of the policy i.e. . Persons working in mines, explosives, Electrical installations on high tension lines, Racing, Circus People, skiing, mountaineering, big game hunting, ballooning, hang gliding, river rafting, winter sports, skiing, ice hockey ,polo & such other persons engaged in occupation of similar hazard. Rest of Terms & Conditions& exclusions as per the Group Personal Accident Policy. "Attached with this Policy schedule, are the Policy wording along with terms and condition, Endorsement, and Annexure. If you (Policyholder) have not received any of these, please E-mail/write to the company at rgicl.services@relianceada.com or contact us on 1800 3009 (toll free) within 15 days of receipt of this policy. This policy Schedule in original must be surrender to the company in case of cancellation of the policy. In the event of any incorrect representation, the liability shall be upon the policy holder. "

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SCHEDULE ATTACHED TO AND FORMING PART OF POLICY NO.: '130131929140000013' MEDICAL EXPENSES EXTENSION (Group Insurance)Endorsement extending Insurance under Policy No. '130131929140000013' in the name of 'M/S PENSION FUND REGULATORY AND DEVELOPMENT AUTHORITY ' In consideration of the payment of an additional premium paid under the policy it is hereby agreed and declared that notwithstanding anything in the within written policy contained to the contrary, this insurance is extended to cover the medical expenses necessarily incurred and expended in connection with any accident as specified in the Policy, for which a claim is made by the Insured and admitted by the Company. The Company shall reimburse to the insured person an amount up to but not exceeding ___% of the Admissible Claim or ___% of claim amount or actual whichever is less. Further, it is a condition precedent to the payment of such medical expenses that the medical attendant’s detailed account shall, if the Company so requires be submitted to and is approved by the Company.

PROVIDED ALWAYS THAT:1. The insurance shall not apply, in so far as it applies to a female to expenses incurred in respect of any condition arising from the traceable to any disease of the organs of generation, malignant diseases of mammary glands, pregnancy, childbirth, abortion or miscarriage or any complications and or sequels arising from the foregoing, unless otherwise provided hereafter.2. The Company shall not be liable to may any payment under this Policy in respect of :-i. Disease, Injury, Death or Disablement directly or indirectly due to war, Invasion, Act of Foreign Enemy Hostilities or Warlike Operations (whether war be declared or not) or Civil War or Rebellion, Revolution, Insurrection Mutiny, Military, Naval or Air Service or Breach of Law of Hunting Steeple chasing or engaging in aviation or Ballooning other than as a passenger (fare paying or otherwise) in any licensed Standard Type of Aircraft.ii. Circumcision or Strictures of Vaccination or Inoculation or change of life or beauty treatment of any description of dental or eye treatment other than treatment for the diseases etc. or Intentional self injury or insanity or dissipation or Nervous Breakdown (which expression shall cover also general debility "run down" conditions and General "overhaul") or Venereal Disease or intemperance or the use of intoxicating drugs or liquors or any diseases, injury, death or disablement directly or indirectly due to any one or more of them.

Subject otherwise to the terms, exceptions, conditions and limitations of the Policy.

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Schedule of Members covered attached to and forming part of Policy No 130131929140000013

SNo Emp Code

Name Nominee Grade Age Table A Table B

Table C Table D

Total Sum Insured

DateofJoining

Location Remarks

1 002 MS. SONIA SINGH KANNAMMA SINGH

ASSISTANT GENERAL MANAGER

41 Yr 00 M

0 0 5940880 500000 6440880

2 003 SH. DEEP PRAKASH JOSHI

ASHA JOSHI GENERAL ASSISTANT

49 Yr 00 M

0 0 5014240 500000 5514240

3 005 SH. VENKATESWARLU PERI

N. SUBHADRA CHARI

CHIEF GENERAL MANAGER

50 Yr 00 M

0 0 13423060 500000 13923060

4 006 MS. MAMTA ROHIT ROHIT KUMAR AGARWAL

51 Yr 00 M

0 0 14001580 500000 14501580

5 007 SH. SUMIT KUMAR CHITRA GENERAL MANAGER

42 Yr 00 M

0 0 9821740 500000 10321740

6 009 SH. SANJEEV KUMAR JHA

USHA JHA DEPUTY GENERAL MANAGER

46 Yr 00 M

0 0 8953960 500000 9453960

7 010 SH. ASHISH KUMAR TRIPTI SRIVASTAVA

50 Yr 00 M

0 0 11417500 500000 11917500

8 011 MS. SUMEET KAUR KAPOOR

UTPAL KAPOOR

48 Yr 00 M

0 0 13423060 500000 13923060

9 012 MS. (DR.) PURNIMA SHARMA

NAYONIKA (GUARDIAN - PREETI SHARMA)

DEPUTY GENERAL MANAGER

43 Yr 00 M

0 0 9821740 500000 10321740

10 013 SH. K.MOHAN GANDHI

G.BHARATHI GENERAL MANAGER

47 Yr 00 M

0 0 10887220 500000 11387220

11 015 SH. PRAVESH KUMAR

PRAMILA GOND

GENERAL MANAGER

42 Yr 00 M

0 0 10887220 500000 11387220

12 016 SH. MONO MOHON GOGOI PHUKON

KABITA AIDEO

GENERAL MANAGER

44 Yr 00 M

0 0 10887220 500000 11387220

13 017 SH. VIKAS KUMAR SINGH

DEEPIKA SINGH

GENERAL MANAGER

43 Yr 00 M

0 0 10887220 500000 11387220

14 019 MS. MANJU BHALLA BIMLA BHALLA

47 Yr 00 M

0 0 9604840 500000 10104840

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SNo Emp Code

Table C Table D

Total Sum Insured

DateofJoining

Location Remarks

15 020 SH. SACHIN JONEJA RATI JONEJA DEPUTY GENERAL MANAGER

40 Yr 00 M

0 0 8322460 500000 8822460

16 021 SH. ANANTA GOPAL DAS

INDIRA DAS EXECUTIVE DIRECTOR

54 Yr 00 M

0 0 14348680 500000 14848680

17 022 MS. ALPANA VATS AANSHI ARYA (GUARDIAN - SANAT VATS)

42 Yr 00 M

0 0 8322460 500000 8822460

18 023 MS. VINITA CHOUDHARY

B.B.CHOUDHARY

MANAGER

37 Yr 00 M

0 0 4581340 500000 5081340

19 024 MS. PRIYANKA GUPTA

PALLAV JAIN ASSISTANT GENERAL MANAGER

37 Yr 00 M

0 0 6109600 500000 6609600

20 026 SH. (DR.) ASHISH V.DONGARE

KIRTI DONGARE

MANAGER

32 Yr 00 M

0 0 4581340 500000 5081340

21 027 MS. JASPREET KAUR SAINI

HARPREET SINGH SAINI

37 Yr 00 M

0 0 6109600 500000 6609600

22 029 SH. ASHISH KUMAR BHARATI

RUBY BHARATI

41 Yr 00 M

0 0 8322460 500000 8822460

23 030 SH. K.R. DAULATH ALI KHAN

Y.SALMA DEPUTY GENERAL MANAGER

41 Yr 00 M

0 0 8322460 500000 8822460

24 031 SH. DEVESH MITTAL DEEPIKA MITTAL

MANAGER

34 Yr 00 M

0 0 4581340 500000 5081340

25 032 SH. MOHIT YADAV SANGEETA YADAV

MANAGER

34 Yr 00 M

0 0 4581340 500000 5081340

26 033 SH. M. ISMAIL SALAM

HATHEEJA BEGUM

36 Yr 00 M

0 0 6109600 500000 6609600

27 034 SH. MANOJ KUMAR TIWARI

VANDANA TIWARI

MANAGER

34 Yr 00 M

0 0 4581340 500000 5081340

28 036 MS. GURMINDER KAUR

TAJINDER SINGH

39 Yr 00 M

0 0 8322460 500000 8822460

29 037 MS. PUJA UPADHYAY

PRABHAKAR UPADHYAY

MANAGER

34 Yr 00 M

0 0 3867820 500000 4367820

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SNo Emp Code

Table C Table D

Total Sum Insured

DateofJoining

Location Remarks

30 038 SH. SAJEESH MATHEW

JEENA JOHNY MANAGER

32 Yr 00 M

0 0 4581340 500000 5081340

31 039 SH. AKHILESH KUMAR

VANDANA KUMARI

GENERAL MANAGER

46 Yr 00 M

0 0 10646140 500000 11146140

32 040 SH. ARUMUGARANGARAJAN P

PREMALATHA GENERAL MANAGER

45 Yr 00 M

0 0 9821740 500000 10321740

33 041 SH. PRITHVI RAJ GURJAR

VARSHA GURJAR

MANAGER

35 Yr 00 M

0 0 4581340 500000 5081340

34 042 SH. VISHAL SINGH RATHOUR

ANUPAMA RATHOUR

MANAGER

36 Yr 00 M

0 0 4581340 500000 5081340

35 043 MS. BHAWNA MALHOTRA

DHEERAJ NIJHAWAN

MANAGER

34 Yr 00 M

0 0 4354720 500000 4854720

36 044 SH. VISHAL CHOURASIA

PRATEEKSHA CHOURASIA

MANAGER

32 Yr 00 M

0 0 4581340 500000 5081340

37 045 SH. MANISH MANI SONIYA RAJAK

MANAGER

35 Yr 00 M

0 0 4581340 500000 5081340

38 046 SH. PRODEEPTO CHATTERJEE

SIBANI KUMARI

MANAGER

34 Yr 00 M

0 0 4581340 500000 5081340

39 047 MS. KAVITA SINGAM XAVIER

HARRY FRANCIS XAVIER

37 Yr 00 M

0 0 6109600 500000 6609600

40 048 SH. RAJESH MOHAN PRATIBHA SRIVASTAVA

41 Yr 00 M

0 0 6109600 500000 6609600

41 049 SH. SUDHIR SINGH NIDHI SINGH ASSISTANT GENERAL MANAGER

36 Yr 00 M

0 0 6109600 500000 6609600

42 050 SH. BHAGWAN PRASAD

SUMAN DEVI STAFF CAR DRIVER

37 Yr 00 M

0 0 888460 500000 1388460

43 056 SH. RUBY VINAYAK BHAOSAGAR

AVISHKAR BHAOSAGAR

ASSISTANT MANAGER

27 Yr 00 M

0 0 3098860 500000 3598860

44 057 SH. LAKSHAY KUMAR CHOWDHURY

PARTH KUMAR CHOWDHURY

ASSISTANT MANAGER

25 Yr 00 M

0 0 3098860 500000 3598860

45 058 SH. MILLIND KHANDATE

BHUMED SINGH KHANDATE

ASSISTANT MANAGER

28 Yr 00 M

0 0 3098860 500000 3598860

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SNo Emp Code

Table C Table D

Total Sum Insured

DateofJoining

Location Remarks

46 059 SH. CHETAN SINGHAL

ANUGYA AGARWAL

ASSISTANT MANAGER

27 Yr 00 M

0 0 3098860 500000 3598860

47 060 MS. PRACHI JAIN MAMTA JAIN ASSISTANT MANAGER

27 Yr 00 M

0 0 3098860 500000 3598860

48 061 MS. SHIVIKA SINGHAL

ALKA SINGHAL

ASSISTANT MANAGER

27 Yr 00 M

0 0 3098860 500000 3598860

49 062 SH. ARASHDEEP SINGH

POOJA MITTAL

ASSISTANT MANAGER

26 Yr 00 M

0 0 3098860 500000 3598860

50 064 MS. KHUSHBU PARMANAND SHUKLA

VASANTI SHUKLA

ASSISTANT MANAGER

26 Yr 00 M

0 0 3098860 500000 3598860

51 065 SH. MANMEET NAGAR

GIRIRAJ PRASAD

ASSISTANT MANAGER

26 Yr 00 M

0 0 3098860 500000 3598860

52 066 SH. SACHIN KUMAR GOYEL

ANITA DEVI ASSISTANT MANAGER

29 Yr 00 M

0 0 3098860 500000 3598860

53 067 SH. A. RAMESH KUMAR

G.THANGAVELAMMAL

ASSISTANT MANAGER

27 Yr 00 M

0 0 3098860 500000 3598860

54 068 SH. VAIBHAV NAGAR RASHI JAIN ASSISTANT MANAGER

27 Yr 00 M

0 0 3098860 500000 3598860

55 070 SH. BALAJI B. SHANTHI.B ASSISTANT MANAGER

29 Yr 00 M

0 0 3098860 500000 3598860

56 071 SH. SURAJKUMAR MAGANBHAI SEESARA

KIRANBEN VANIYA

ASSISTANT MANAGER

26 Yr 00 M

0 0 3098860 500000 3598860

57 072 SH. NAVEEN BALU K.S.

SENGODAN.M ASSISTANT MANAGER

27 Yr 00 M

0 0 2949400 500000 3449400

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SNo Emp Code

Table C Table D

Total Sum Insured

DateofJoining

Location Remarks

58 075 SH. PRAVEEN TRIVEDI

RASHMI TRIVEDI

EXECUTIVE DIRECTOR

51 Yr 00 M

0 0 14011240 500000 14511240

Grand Total 0 0 377908360

29000000

406908360

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Issuing Office:1301 Endorsement No: 31001

Date of Issue : 12/04/2019

Policy No. :130131929140000013

Policy Start Date:15/03/2019

Policy End Date:14/03/2020

Debit Note No & Date :E041019118831 & 4/12/2019 11:36:00 AM

Original Tax Invoice No & Date &

Insured: M/S PENSION FUND REGULATORY AND DEVELOPMENT AUTHORITY

GSTIN / UN of the Insured

Address:

CHATRAPATI SHIVAJI BHAWAN,1ST FLOOR,B-14/A,QUTAB INSTITUTIONAL AREA,KATWARIA SARAI

NEW DELHI

110016

It is hereby agreed and declared that this endorsement is passed on the above mentioned policy to incorporate the following changesin coverage/s.

Effective date of Endorsement : 15/03/2019

Cover description Sum insured restriction

Co-pay Special conditions Status

Other Condition Funeral expenses - 1% of Sum Insured or Rs. 5,000/- or actual amount claimed, whichever is less.

Education Grant Education Grant - "Dependent Child Education benefit - ln case of death or PTD of the insured,for one dependent child below 23 years of age Rs. 10,000/- and in case of two dependent child below the age of 23 years, Rs. 20,000/-."

Modified

Endorsement Premium Details :

PREMIUM (Rs) 0.00

TOTAL PREMIUM PAYABLE(Rs) 0.00

Branch GSTIN :07AABCR6747B1ZI;HSN Code :9971;Description Of Services :Financial and related services.

UIN No. :IRDA/NL-HLT/RGI/P-P/V.I/320/13-14

Reliance General Insurance Company Limited. IRDAI Registration No. 103. An ISO 9001:2008 Certified Company

Registered Office: H Block, 1st Floor, Dhirubhai Ambani Knowledge City, Navi Mumbai 400710Corporate Office: Reliance Centre, 4th Floor, South Wing, Off. Western Express Highway, Santacruz (East), Mumbai - 400 055.Corporate Identity Number U66603MH2000PLC128300. UIN No. :IRDA/NL-HLT/RGI/P-P/V.I/320/13-14RGI/UW/CO/ 2914 /ES/VER. 1.0/310118*Trade Logo displayed above belongs to Anil Dhirubhai Ambani Ventures Private Limited and used by Reliance General Insurance Company Limited under License.

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ENDORSEMENT SCHEDULE

Consolidated Stamp duty Paid vide Letter of Authorisation No. CSD/298/2019/143/19 dated 11th January 2019 at General Stamp Office, Mumbai.** Not Applicable for the State of Jammu & Kashmir

This document shall be treated as a Tax Invoice as perRule 9(2) of the Goods and Services Tax Invoice Rules.

All other terms and conditions of the original policy stand unaltered.

For Reliance General Insurance Company Limited

Place:Mumbai

UserID:70273497 Authorized Signatory

Date: 12/04/2019

Reliance General Insurance Company Limited. IRDAI Registration No. 103. An ISO 9001:2008 Certified Company

Registered Office: H Block, 1st Floor, Dhirubhai Ambani Knowledge City, Navi Mumbai 400710Corporate Office: Reliance Centre, 4th Floor, South Wing, Off. Western Express Highway, Santacruz (East), Mumbai - 400 055.Corporate Identity Number U66603MH2000PLC128300. UIN No. :IRDA/NL-HLT/RGI/P-P/V.I/320/13-14RGI/UW/CO/ 2914 /ES/VER. 1.0/310118*Trade Logo displayed above belongs to Anil Dhirubhai Ambani Ventures Private Limited and used by Reliance General Insurance Company Limited under License.

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ENDORSEMENT SCHEDULE

6 I C Page 1 of 2 Reports

4? Chola MS MONEY RECEIPT

Payer's Name -

Payer Id -

Address -

PENSION FUND REGULATORY AND DEVELOPMENT AUTHORITY

100845330968

CHATRAPATI SHIVAJI BHAWAN,B 14 A,QUTULI INSTITUTIONAL AREA KATWARIA SARAI,NEW DELHI SARVA PRIYA VIHAR SOUTH DELHI DELHI PIN - 110016 Tel No - 26517501 ,Mobile No -

Branch - DELHI COMMERCIAL OFFICE

Receipt No. - 1018255637

Date - 20/04/2020

Rupees - 131069.00/-

Purpose of Payment: Towards Insurance Premium

Received with thanks from PENSION FUND REGULATORY AND DEVELOPMENT AUTHORITY ,a sum of Rs. One Lakh Thirty One Thousand Sixty Nine Only vide DD No.I0BAN20078174270 drawn on HDFC Bank CMS-Cheque dated 18/03/2020 towards insurance premium.

NOTE:Upon issuance of this receipt all previously issued temporary receipts are considered null and void. Excess payment, if any, will be refunded or will be utilized in future policy issuance without any interest.

Affix revenue stamp

FOR CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LTD

Cashier

Proposal Details as per annexure

This is a computer generated receipt and does not require signature.

This receipt is null and void ab initio, if the cheque/any valid negotiable instrument as per the Negotiable Instruments Act 1881 as receipted by this company via this receipt is dishonoured. Issuance of the receipt does not tantamount to risk acceptance. Acceptance of risk is dependent on the company's underwriting practices. In case the proposal is rejected, a full refund without any interest will be made.

GST No :

33AABCC6633 K 1ZQ

Toll free No. :1800-208-5544

5G5/go

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GENERAL INSURANCE

ANNEXURE - I

Reports Page 2 of 2

%#S% C1101a MS GENERAL INSURANCE

ANNEXURE

Receipt No 1018255637

Proposal No Amount

GPAPENSION 18032020

131069/-

This is a computer generated receipt and does not require signature.

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Conditions I Other Clause 1. The Insurers liability in any one mciden

C. Premium Component

Total Sum Insured :Rs. 617.001520.00

Premium :Rs. 111.07500 COST ts%) : Rs. 9597.00

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.SAC licaT Immo AccM, an.11/calch Immo

Business Location: DELHI COMMERCIAL OFFICE

Policy Number 2023/001222561000/00 Customer Code: 100345330968

A. Insured Details

Name of Insured PENSION FUND REGULATORY AND DEVELOPMENT AUTHORITY

2 BuSineSS / Profession A STATUTORY PENSION SECTOR REGULATORY BODY UNDER MINISTRY OF FINANCE, GOVERNMENT OF INDIA

Address of Insured

Pin Code

CHATRAPATI SHIVAJI BHAVVAN,B 14 ACIUTUB INSTITUTIONAL AREA,KATWARIA SARALNEW DELHI.SARVA PRIYA VIHAR

SOUTH DELHI

110010

4 Aadhar No.

5 PAN No, AAALP029IL

Penod of Isurance I Insured Period From (time) 00:01 18/03/2020 (effective dale)

To (time) Midnight of 17/03/2021 (expiration dale)

8 Premium Receipt 1010255637

Dale: 18/03/2020

B. Benefits Covered :

Accident Death Benefit

_____ Covered

Benefits Vv....a+)

PermanentTotal Disability Benefit Covered

Permanent Partial Disability Benefit Covered

Accident Medical Reimbursement Covered

Accident Weekly Indemnity Covered

Educational Benefit Covered

57 E mployees are covered under this policy (list enemata)

D.Co- Insurance Details:

\/ nolamancialam MS General Insurance 1 100%

lit is warranted that m rase el dishonour of pre iunictoque4he Insurance Company shall net be liable under the polity and the policy Man be void abfratio (from inception).

coltiUmm;

Consolidated Stamp Duty Paid Vida G 0 RI No MT al raves and Registration oll Department. Tamil Nadu dated I I M2/2020

Intermediary Name:DIRECT

Code:- Contact No:44-30445400

Note. The Certificate of Insurance f Polio Schedule is an rm fon cd based on your dectuation. We request you to lea) the derails and ensure dial en thinµ is is order. In case of any diccrepan 1rs.pl contact us l.ilbitl 15 days from die date of Issuance of PO

Employee List

Whether tax is payable under reverse charge basis - No. licgd edlcad 011ice:Darc House_ 2nd Floor, Not N S C Bmc Road, CIpennal-M

1166030TN2001PLC0479771IRD 4I keg No. I23

Annexure attached to and forming part of Policy No. 2823/00122056/000/00

Insured: PENSION FUND REGULATORY AND DEVELOPMENT AUTHORITY

This Policy shall be subject to the following:

1. Cover is valid for insured persons between age of 18 years to 69 years of completed age.

2. Sum Insured is restricted upto 60 times of the monthly salary S/t Salary Certificate of month prior to date of accident at the time of claim should be provided.

3. Permanent Total Disability = as per the Annexure-II sheet attached provided in tender document.

4. Accidental Medical Benefit = 10% of the admissible claim amount under the basic cover or 40% of the Sum Insured or actual amount whichever is less will be paid.

5. Temporary Total Disability (Weekly Benefit) = 1% of the Sum Insured or actual wages or Rs.20,000/- whichever is less will be paid per week for 100 weeks.

6. Education Benefit = 5% of S.I. or Rs.1,00.000/- or actual expenses, whichever is less in case of two dependent children and 3% of S,I. or Rs.50,000/- or actual expenses, whichever is less in case of one dependent child.

7. Transportation of Mortal Remains =1% of S.I. or Rs.30,000/- or actual expenses, whichever is less will be paid.

8. Funeral Expenses = 1% of the sum insured or Rs.10,000/- or actual claimed amount whichever is less will be paid.

9. Ambulance Hiring Charges = as per actuals.

10. Claims arising out of terrorism or terrorist acts shall be covered. Thus, Exclusion 4 stands modified.

For Cholamandalam MS General Insurance Company Limited

Authorized Signatory

Policy No : 2823/00122056/000/00 Company Name : PENSION FUND REGULATORY AND DEVELOPMENT AUTHORITY

CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED (Regd. & Head Office: "Dare House",II Floor, Old No-234, New No-2, NSC Bose Road, Chennai-600001)

Issuing Office: DELHI COMMERCIAL OFFICE

PERSONAL ACCIDENT INSURANCE POLICY

WHEREAS the Insured named in the Schedule attached hereto has made or caused to be made to Cholamandalam MS General Insurance Company Limited (The Company) a written proposal which is the basis of this contract and is deemed to be incorporated herein and has paid the premium for the insurance specified hereinafter for the period stated in the Schedule.

The Company hereby agrees that subject to the definitions, terms, exclusions and conditions contained herein or endorsed or otherwise expressed hereon will pay as hereinafter mentioned:

If at any time during the currency of this policy the Insured Person shall sustain any bodily injury then The Company shall pay to him or his legal assignee or heir(s), the percentage of Principal Sum stated in the Schedule at the rates mentioned below if such injury shall within 12 calendar months of its occurrence be the sole and direct cause of death or disability described in benefits Schedule:

Part I — GENERAL DEFINITIONS

We use certain words in this policy and the Schedule, which have a specific meaning and are shown under the heading of definitions in the policy. They have this meaning wherever they appear in the policy or the Schedule and are shown with Bold Letters. Where the context so permits, references to the singular shall also include references to the plural and references to the male gender shall also include references to the female gender and vice versa in both cases.

Accident means a sudden, unforeseen and unexpected physical event caused by external, violent and visible means.

Acquired Immune Deficiency Syndrome has the meanings assigned to it by the World Health Organization. Acquired Immune Deficiency Syndrome shall include HIV (Human Immune-deficiency Virus), encephalapathy (dementia), HIV Wasting Syndrome, and ARC (AIDS Related Condition).

Family means Spouse and/or Eligible Children and/or Dependent Parents named on the Schedule.

Spouse means the legal husband or wife living with the Insured/Insured Person.

Eligible Children means all of the Insured Person's dependent Children aged between six (6) months and eighteen (18) years and up to twenty three (23) years (if attending an accredited institution of higher learning) who are unmarried and who permanently reside with him.

Dependent Parents means parents of the Insured Person up to 70 years of age who permanently reside with the Insured as named in the Schedule.

Injury means bodily injury caused solely and directly by violent, accidental, external and visible means and occurring during the Insured Period. For the avoidance of doubt, the definition of Injury does not extend to the non-physical consequences (such as mental, nervous or emotional disorders, depression or anxiety) of any Accident and these are specifically agreed to be excluded for the purposes of this Policy.

Insured Period means the period commencing with the Policy Effective Date and time and terminating at midnight with the Policy Expiration Date as stated in the Schedule.

Insured means the person/organisation named on the Schedule who has made Proposal and whose name in the policy has been issued.

Insured Person means the person(s) named in the Schedule and who live normally in India for whom premium has been paid and proposal has been approved by The Company.

Principal Sum means the amount stated in the Schedule with respect to and Insured Person named in the Schedule.

Proposal means the Proposal Form and Declaration, which is the basis for the policy and is deemed to be incorporated in this policy.

Schedule means the Schedule of Benefits which are attached and which form a part of this policy.

Part II - EXCLUSIONS

This policy does not provide benefits for any death, disability, expense or loss incurred in result of any Injury attributable directly or indirectly to the following:

1. intentionally self-inflicted injury, suicide or any attempt thereat while sane or insane; 2. Injury or Disease directly or indirectly caused by or contributed by ionizing radiation or contamination

by radioactivity from any nuclear fuel or from any nuclear waste from burning nuclear fuel; 3. Injury or Disease directly or indirectly caused by or contributed by the radioactive, toxic, explosive or

other dangerous properties of any explosive nuclear equipment or any part of that equipment; 4. war, invasion, act of foreign enemy, hostilities (whether war be declared or not), civil war, rebellion,

revolution, insurrection, mutiny, military or usurped power, seizure, capture, arrests, restraints and detainment of all kings, princes, and people of whatsoever nation condition or quality, terrorism

5. The Insured Person's participation in naval, military or air force operations whether in the form of military ecercises or war games or actual engagement with the enemy with foreign or domestic;

6. loss sustained or contracted in consequence of the Insured being under the influence of alcohol or drugs unless administered on the advice of a physician;

7. any loss of which a contributing cause was the Insured's actual or attempted commission of, or willful participation in, an illegal act or any violation or attempted violation of the law or resistance to arrest;

8. any loss sustained whilst engaging in aviation or ballooning, whilst mounting into, dismounting from or travelling in any balloon or aircraft other than as a passenger (fare paying otherwise) in any duly licensed standard type of aircraft anywhere in the world;

9. any opportunistic infection and/or malignant neoplasm, if at the time of the accident or sickness the Insured had an Acquired Immune Deficiency Syndrome (AIDS) or having an antibody positive blood test to HIV (Human Immune-deficiency Virus). Opportunistic infection shall include but will not be limited to pneumosystis carinii pneumonia, organism of Kaposi's Sarcoma, central nervous system lymphoma, and/other malignancies now known or which become known as causes of death in the presence of Acquired Immune Deficiency Syndrome;

10. any loss sustained while the Insured is participating in contests of speed using a motorized vehicle or bicycle and/or hunting and/or skiing and/or skydiving and/or gliding and/or mounteering and/or winter sports;

11. any loss resulting directly or indirectly from or, contributed or aggravated or prolonged by childbirth or from pregnancy.

Part III- CONDITIONS

1. ENTIRE CONTRACT — CHANGES: This policy, the Schedule, the Proposal, any forms, benefits, endorsements and any memorandum hereto, shall be read together as one contract and any words or expression to which specific meanings attached shall bear such specific meanings wherever they shall appear. No change or alteration in this policy shall be valid until approved and endorsed by The Company's authorized officer in writing. No other person including The Company's agent has any authority to change or alter this policy or to waive any of the provisions thereof.

2. NOTICE: Every notice, communication or intimation required or contemplated under this Policy to be given by the Insured or anyone on behalf of the Insured in respect of any claim or matter arising under or out of this Policy shall be in writing and addressed to The Company's office through which this insurance is effected, unless otherwise directed by The Company in writing. No such notice, communication or intimation shall be valid unless it contains full particulars of the policy, the Insured and other details as may be necessary.

3. CONSIDERATION: This policy is issued subject to payment of premium in advance. No payment shall be valid unless made under The Company's official receipt.

4. EFFECTIVE DATE: This policy shall commence on the Effective Date and time stated in the Schedule and continue to be in force for the period mentioned therein, unless cancelled or terminated earlier and end at midnight on the date of expiry.

5. RENEWAL CONDITIONS: This policy may be renewed only by mutual consent and subject to payment in advance of the total premium at the rate in force at the time of renewal. The Company, however, shall not be bound to give notice that policy is due for renewal or to accept any renewal premium. Unless renewed as herein provided, this policy shall automatically terminate at the expiry of the period for which premium has already been paid.

6. CANCELLATION OF COVER: This policy may be cancelled by The Company at any time without assigning any reason by giving 7 days written notice delivered, to the Insured, or mailed to his last address as shown in the records. On such cancellation by The Company the Insured shall be entitled to refund of pro-rata premium for the unexpired portion of the policy on the date of cancellation. The Insured may also cancel the policy at any time in which event The Company shall be entitled to premium at Short Period Scale for the period during which the policy was in force from the Effective Date till the date of cancellation by the Insured. Any excess premium available with the Company after adjustment at Short Period Scale as provided herein below shall be refunded to the Insured provided no claim has occurred up to the date of cancellation. In case of claim having been made by the Insured no premium will be refunded, in the event of cancellation by the Insured.

Period of risk Upto one month Exceeding one month &Upto three months Exceeding three months & Upto six months Exceeding six months & Upto eight months Exceeding eight months

Short period scale Proportionate of annual premium to be retained

25% of the annual premium 50% of the annual premium 75% of the annual premium 85% of the annual premium 100% of the annual premium

7. CLAIMS NOTIFICATION: It shall be a condition precedent for any claim to be made by the Insured under this policy or for liability attaching to The Company hereunder that written notice of claim must be given to The Company immediately upon the occurrence or commencement of any loss, or as soon thereafter as reasonably possible, and in any event not later than 30 days of such occurrence or commencement.

8. CLAIM FORMS: Besides such immediate notice of occurrence or commencement of loss the Insured shall also furnish further particulars as may be required in the Claim Form provided by The Company.

9. TIME FOR FILING CLAIM FORMS AND EVIDENCE: Completed Claim Form with written evidence of loss must be furnished to The Company within thirty (30) days after the date of such loss. Failure to furnish evidence within such time as required shall not invalidate or reduce the claim if the Insured satisfies that it was not reasonably possible to do so within such time. In any event, no proof furnished beyond one (1) year from the date of loss shall be accepted. The Insured shall obtain and furnish The Company all original bills, receipts and any other documentation upon which a claim is based. The Insured shall be bound to provide all such additional documents, information and assistance as may required by The Company. The Company or its authorised representatives, shall be entitled to make such Enquirer or verification with any person or persons, establishment, institution, hospital, authority, agency as it deems necessary and the Insured or anyone claiming under this Policy shall co-operate, facilitate and assist in such manner as may be necessary for such enquiry or verification by The Company.

10. MEDICAL EXAMINATION: The Company at its own expense, shall have the right to examine the Insured when and as often The Company may reasonably require during the pendency of a claim hereunder.

11. LIMITATION OF LIABILITY: In the event of accidental Injury resulting into death or disablement of the Insured Person, the total benefit payable will be limited to amount stated in the schedule and any interim payments made before death will be off-set/adjusted from the amount due. The Company's maximum liability, however should not be more than 100% of the Principal Sum.

12. PAYMENT OF CLAIMS: All Claims under this policy shall be payable in Indian currency. Any claim paid by The Company and received will discharge The Company from any further payment for the same claim. All payment made in good faith will discharge to the extent of such payment.

13. INTEREST: No sum payable under this policy shall carry any interest, penalty or any other amount whatsoever.

14. INDEMNITIES: All other indemnities of this policy are payable to the Insured. Indemnity, if any, in case of loss of life of the Insured is payable to the assignee named in the Policy or to the estate of the Insured, if no assignment is made. All payment by us in good faith pursuant to this provision shall fully discharge The Company to the extent of the payment.

15. CONSENT OF ASSIGNEE: Consent of the assignee, if any, shall not be requisite for change of assignee or to any other changes in this policy.

16. CHANGE OF ASSIGNEE: No Change of assignee under this policy shall bind The Company, unless the change is formally endorsed thereon by The Company's authorized officer.

17. CHANGE OF OCCUPATION: Any change in the professional activity/occupation as stated in the proposal, must be informed to The Company by the Insured immediately. The Company reserve the right to accept or to reject the change. The Company's approval shall be signified by endorsement upon the policy and in the event of rejection The Company will cancel the coverage and shall return the premium on pro-rata for the remaining period. The Company also reserves the right to repudiate the claim in the event of change in the nature of professional activities/occupation.

18. MISSTATEMENT OF AGE: In the event the age of the Insured has been misstated, and if according to the correct age, the coverage provided by the policy would not have become effective, or would have ceased prior to the acceptance of such premium or premiums, then The Company's liability during the period the Insured is not eligible for coverage, shall be limited to the refund, upon written request, of all premiums paid for the period not covered by the policy.

19. ADDITIONS: Any person becoming eligible after the Effective Date of this policy may be added from time to time as a named Insured Person. The Policy shall commence in respect of such person on the date when his/her proposal has been approved by The Company subject to any limitations set forth in the attached forms.

20. ARBITRATION: If any difference arises as to the quantum to be paid under this policy (liability otherwise admitted) such difference shall be referred to arbitration and to a sole arbitrator to be appointed in accordance with Arbitration and Conciliation Act, 1996, within a period of 30 days of either The Company or the Insured giving notice in this regard. The applicable law in and of the arbitration shall be the Indian law. The expenses of the arbitrator shall be shared between the parties equally and such expenses along with all reasonable costs in the conduct of the arbitration shall be awarded by the arbitrator to the successful party, or where no party can be said to have been wholly successful, to such party, as substantially succeeded. It is agreed condition precedent to any right of action or suit upon this Policy that an award by such arbitrator or arbitrators shall be first obtained. In the event that these arbitration provisions shall be held to be invalid then all such disputes shall be referred to the exclusive jurisdiction of the Indian Courts.

21. LEGAL ACTIONS: No action at law or in equity shall be brought to recover on this policy prior to the expiration of sixty (60) days after written proof of loss has been furnished in accordance with the requirements of this policy. If no proof of loss has been furnished within one (1) year of the date upon which it should have been furnished then the claim shall for all purposes be deemed to have been abandoned and shall not thereafter be recoverable under this policy.

If The Company disclaim liability for any claim, and if the Insured do not notify The Company within one [1] year from the date of receipt of the notice of such disclaimer that he does not accept such disclaimer and intend to recover this claim from The Company, then the claim shall for all purposes be deemed to have been abandoned and shall not thereafter be recoverable under this policy.

22. COMPLIANCE WITH POLICY PROVISIONS: Failure to comply with any of the provisions contained in this policy shall invalidate all claims hereunder.

23. FRADULENT AND/OR DISHONEST AND/OR DECEITFUL CLAIM(S): If the Insured, the Insured Person shall make or advance any claim knowing the same to be false or fraudulent as regards amount or otherwise, this policy shall be void and all claims or payments hereunder shall be forfeited.

24. CONDITIONS PRECEDENT TO LIABILITY: For the avoidance of doubt, it is hereby expressly stipulated and made clear that compliance with the terms and conditions of this Policy in so far as these relate to anything to be done by The Insured or on his behalf is a condition precedent to The Company's liability hereunder.

25. VALIDITY OF POLICY: Subject to provision relating to cancellation, this policy will terminate on the earliest of the following occurrence:

(a) the expiry date of the policy,

(b) In case of death of the Insured (c) Any claim paid upto the Principal Sum. (d) .For Group policies and family package policies the expiry date will be the date of expiry

mentioned in the Schedule, however for the individual Insureds cover will cease on the Insured Person's death, or on payment of the Principal Sum in respect of that person.

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BASIC COVER - ACCIDENTAL DEATH

This form is part of the policy to which it is attached and is valid only if the form number, benefit, and appropriate premium is ndicated on the Schedule for said policy or is endorsed thereon. The insurance applies to such Injuries sustained by the Insured anywhere in the world.

Benefit

When Injury results in the loss of life of the Insured within one calendar year after the date of Accident, The Company will pay the Principal Sum.

The Company will also pay in addition to Principal Sum upto 3% of Principal Sum or Rs. 6,000.00 (whichever is lower), towards the cost of transporting the mortal remains from the place of death to the hospital and/or residence and/or cremation and/or burial ground.

The Company will also pay in addition to Principal Sum, the actual costs or Rs. 5,000.00 (whichever is lower), incurred in connection with performance of religious ceremonies incurred upto the time of cremation and costs incurred for any one post cremation ceremony.

An amount of Rs. 1,000/- will be paid for Ambulance hiring charges following an accident, subject to submission of bill.

Exclusions In addition to the Exclusions listed in Part H of the policy, this form shall not cover and no payment shall be made with respect to: 1) loss caused directly or indirectly, wholly or partly by: a. bacterial infections (except pyogenic infections which shall occur through an accidental cut or wound)

or any other kind of disease; b. medical or surgical treatment except as may be necessary solely as a result of Injury;

Policy No :2523/00122056/000/00 Company Name : PENSION FUND REGULATORY AND DEVELOPMENT AUTHORITY

Benefit No. 1

PERMANENT TOTAL DISABILITY BENEFIT

This form is part of the policy to which it is attached and is valid only if the form number, benefit and appropriate premium is indicated on the Schedule for said policy or is endorsed thereon.

In consideration of payment of additional premium, it is hereby understood and agreed that in the event of Injury, causing The Insured Permanently Totally Disabled and such disability has continued for a period of 12 consecutive months, The Company will pay The Insured the percentage of the Principal Sum specified in the table below:

Benefits Table please refer the Annexure-II sheet attached in tender document.

The Company's maximum liability, however should not be more than 100% of the Principal Sum.

Definitions "Loss" wherever used herein means the permanent and•total loss of functional use or complete and permanent severance. "Totally and Permanently Disabled" wherever used in this form means the Insured is unable to engage in each and every occupation or employment for compensation or profit [for which the Insured Person is reasonably qualified by education, training or experience.] If at the time of the loss the Insured is unemployed. Totally and Permanently Disabled shall mean the total and permanent inability to perform all of the usual and customary duties and activities of a person of like age and sex. "Permanent" means lasting twelve (12) calendar months and at the end of that period being beyond hope of improvement.

This Benefit Schedule is attached to and made part of the Policy [as of the Policy Effective Date shown in the Schedule]. [effective [Month Day, Year].] It applies only with respect to accidents that occur on or after that date. It is subject to all of the provisions, limitations and exclusions of the [policy except as they are specifically modified by this Benefit Schedule.

Benefit No. - 2

PERMANENT PARTIAL DISABILITY

In consideration of payment of additional premium, it is hereby understood and agreed that in the event of Accidental Injury causing the Insured Permanent Partial Disability as mentioned in the Table Below within 12 months of the Accidental Injury being sustained, The Company will pay the Insured the percentage of the Principal Sum specified for each and every form of impairment mentioned in the table below. The Company's maximum liability, however should not be more than 1000/0 of the Principal Sum.

Benefits U to Percentage of (Principal Sum]

i. Loss of toes - all Great - both phalanges Great - one phalanx Other than great, if more than one toe lost, each

200/0 05% 020/0 02%

H. Loss of hearing - both ears 60%

H i . Loss of hearing - one ear 30%

iv. Loss of speech 60% v. Loss of four fingers and thumb of one hand 40%

vi. Loss of four fingers 35%

vii. Loss of thumb - both phalanges - one phalanx

25% 10%

viii. Loss of index finger -three phalanges or two phalanges or one phalanx

ix. Loss of middle finger -three phalanges or two phalanges or one phalanx

x. Loss or ring finger - three phalanges or two phalanges or one phalanx

xi. Loss of little finger - three phalanges or two phalanges or one phalanx

xii. Loss of metacarpals - first or second, third, fourth or fifth 03%

xiii. Sense of smell 10%

xiv. Sense of taste 0S%

xv. Sight of one eye 50%

xvi One hand 50%

XVII. One foot 50%

It is further understood and agreed that the following definitions are added to the policy:

Partial means less than total.

Permanent means lasting twelve (12) calendar months and at the end of that period being beyond hope of improvement.

Limb means a hand at or above the wrist or a foot above the metacarpophalangeal joints or metatarsophalangeal joints. "Totally and Permanently Disabled" wherever used in this form means the Insured is unable to engage in each and every occupation or employment for compensation or profit [for which the Insured Person is reasonably qualified by education, training or experience.] If at the time of the loss the Insured is unemployed. Totally and Permanently Disabled shall mean the total and permanent inability to perform all of the usual and customary duties and activities of a person of like age and sex.

This Benefit Schedule is attached to and made part of the Policy [as of the Policy Effective Date shown in the Schedule]. [effective [Month, Day, Year].] It applies only with respect to accidents that occur on or after that date. It is subject to all of the provisions, limitations and exclusions of the [policy except as they are specifically modified by this Benefit Schedule.

If the Accidental Injury sustained by the Insured causes a subsequent claim by him under Death or Permanent Total Disablement, then this part of the coverage shall not be applicable and the amounts payable under the coverage of Death or Permanent Total Disablement shall be reduced by the amount of any payment made under this coverage.

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Benefit No. - 3

ACCIDENTAL MEDICAL REIMBURSEMENT

This form is part of the policy which it is attached and is valid only if the form number, benefit and appropriate premium is indicated on the Schedule for said policy or is endorsed thereon.

Benefits In consideration of payment of additional premium, it is hereby understood and agreed that in the event of Accidental Injury, The Company will reimburse the Insured the cost of treatment by a Medical Practitioner, use of Hospital facilities for medical treatment of Injury arising out of an Accident and for which there is a valid claim under this policy, subject to a maximum of 400/0 of admissible claim amount or 100/0 of principal Sum or the actuals, whichever is less.

Definitions

Medical Practitioner - means a person who holds a degree/diploma of a recognized institution and is registered by Medical Council of respective State of India other than the Insured or a member of the Insured's immediate family. The term Medical Practitioner would include physician, specialist and surgeon.

Hospital - means a medically recognized establishment: (a) That holds a valid license (if required by law) to practice medicine, and (b) The primary function of which is to provide for the care and treatment of sick or injured persons, and (c) That has a staff of one or more Physicians actually available on the premises at all times, and (d) That provides a 24-hour nursing service and has at least one qualified and registered professional

nurse present and on duty at all times, and (e) That has organized diagnostic and surgical facilities, either on its own premises or in facilities

available to the Hospital on a pre-arranged basis, and (f) Is not, except incidentally to its primary function, a clinic, nursing home, rest home, or convalescent

home for the aged, or any similar institution.

Exclusions In addition to the Exclusions listed in Part II of the policy, this form shall not cover and no payment shall be made with respect to: 1) Loss caused directly or indirectly, wholly or partly by: a. Bacterial infections (except pyogenic infections which shall occur through an accidental cut or wound)

or any other kind of disease; b. Medical or surgical treatment except as may be necessary solely as a result of Injury; 2) Treatment of hernia resulting from any bodily injury. 3) Dental care or surgery except as occasioned by Accidental Injury.

Benefit No. - 4

ACCIDENT WEEKLY INDEMNITY

This form is part of the policy to which it is attached and is valid only if the form number, benefit, and appropriate premium is indicated on the Schedule for said policy or is endorsed thereon.

Benefits In consideration of payment of additional premium, it is hereby understood and agreed that in the event of Accidental Injury, The Company will pay a weekly benefit amount during a period of continuous Temporary Total Disability of an Insured Person, as certified by a Medical Practitioner, provided that: - such Injury shall be the sole and direct cause of Temporary Total Disablement, and so long as the

Insured Person shall be totally disabled from engaging any employment or occupation of any description whatsoever 1% of the Principal Sum subject to maximum of rs.5000.00 per week for a period not exceeding 100 weeks from the date of the accident/bodily injury. If the Insured is Totally Disabled for a portion of a week, one seventh (1/7) of the [Weekly Benefit] shall be payable for each day he is Totally Disabled. However, the amount payable per week shall not exceed the weekly gross income of the Insured member.

Definitions "Totally Disabled" wherever used in this form means the Insured is unable, due to Injury, to engage in each and every occupation or employment for compensation or profit for which he is reasonably qualified by education, training or experience. Medical Practitioner - means a person who holds a degree/diploma of a recognized institution and is registered by Medical Council of respective State of India other than the Insured or a member of the Insured's immediate family. The term Medical Practitioner would include physician, specialist and surgeon.

Exclusions In addition to the Exclusions listed in Part II of the policy, this form shall not cover and no payment shall be made with respect to: 1) loss caused directly or indirectly, wholly or partly by: c. bacterial infections (except pyogenic infections which shall occur through an accidental cut or wound)

or any other kind of disease; d. medical or surgical treatment except as may be necessary solely as a result of Injury; 2) Treatment of hernia resulting from any bodily injury. 3) pregnancy and resulting childbirth, miscarriage or diseases of the female organs of reproduction.

Benefit No. - 5

EDUCATION BENEFIT

In consideration of payment of additional premium, it is hereby understood and agreed that in the event of the Insured's Death or Permanent Total Disability due to Accidental Injury being sustained, The Company will pay the assignee or legal heir of the Insured benefits up to 100/0 of the Principal Sum subject to a maximum of Rs. 25,000.00, for on education benefit.

Definitions "Totally and Permanently Disabled" wherever used in this form means the Insured is unable to engage in each and every occupation or employment for compensation or profit [for which the Insured Person is reasonably qualified by education, training or experience.] If at the time of the loss the Insured is unemployed. Totally and Permanently Disabled shall mean the total and permanent inability to perform all of the usual and customary duties and activities of a person of like age and sex. "Permanent" means lasting twelve (12) calendar months and at the end of that period being beyond hope of improvement.

IFFCO - TOKIO GENERAL INSURANCE CO. LTD Servicing Office:

Regd. Office: IFFCO SADAN,C1 Distt Centre,Saket,New Delhi- 110017 IFFCO-TOKIO General Ins. Co. Ltd

Endorsement- Group Personal Accident Insurance IFFCO House,

Policy Schedule Cum Tax Invoice 2 & 3 Floor, 34 Nehru Place

ORIGINAL FOR RECIPIENT New Delhi -110019

GST Applicable State Code: 07, GSTIN: 07AAACI7573H1ZE

General Insurance Services:- 997133

Insured's name: PENSION FUND REGULATORY & DEVELOPMENT AUTHORITY Original Invoice No. 54851503

Address: B-14/A CHHATRAPATI SHIVAJI BHAWAN Unique Invoice No. 5485150300003

KATWARIA SARAI NEW DELHI Policy No……………………. : 54851503

NDMC (PART) DELHI 110016 Date of Issuance : 22/06/2021

State Code/ Place

of Supply:

07 Country Name: India GSTIN: Endorsement Effecitve Date : 18/06/2021

Phone Number: Agent No. 23000002 Policy effective from 0001 hrs 01/04/2021

To MidNight 31/03/2022

Not withstanding any thing contained to the contrary,it is hereby declared and agreed that

Endorsement No.02 Ref.No.18649017/19161334/001

Addition of Terms: W.e.f.: Inception

It is hereby agreed that from the date of inception of

policy all the terms and conditions, coverages and criteria

of settlement of claim will be as per tender term agreed by

IFFCO TOKIO AND PFRDA.

All coverages and table of benefit is as per coverage

mentioned by client in tender and Table of Benefit is

applicable in policy as per Annexure II of Tender.

Subject otherwise to the terms,conditions and exclusions of the policy,upon which this endorsement has been issued

Exclusion: Losses or damages caused directly or indirectly due to any infectious or contagious disease, pandemic /epidemics as declared by WHO and / or

Government of India will be an exclusion under this policy.

Taxable Value CGST SGST IGST CESS

Rate 0.00 0.00 0.00 0.00

Amount 0.00 0.00 0.00 0.00 0.00

Total Tax 0.0₹ Total Value 0.00₹

Toll Free : 1-800-103-5499 ; Other : ( 0124) 428-5499 ; SMS "claim" to 56161

Group Personal Accident Insurance (UIN : IRDAN106P0021V01200102 )

Attaching to and forming part of Policy Number 54851503

'Show Signature Properties'-->Click on 'Show signer´s Certificate'-->Go to Tab 'Trust'-->Click on 'Add to

Trusted Certificates'-->Click on 'OK'-->Click on 'Close'

Digitally signed by SUBRATA MONDALDate: 2021.06.22 11:51:22 ISTReason: Valid Policy CopyLocation: IFFCO Tokio General Insurance Company Ltd, India

Signature Not Verified

Policy Issuing Office: Delhi Consolidated Stamp Duty deposited as per the order of Government of National Capital Territory of Delhi

Group Personal Accident Insurance (UIN : IRDAN106P0021V01200102 )

IFFCO - TOKIO GENERAL INSURANCE CO. LTD Servicing Office:

Regd. Office: IFFCO SADAN,C1 Distt Centre,Saket,New Delhi- 110017 IFFCO-TOKIO General Ins. Co. Ltd

Group Personal Accident - Policy Schedule IFFCO House,

Cum Tax Invoice 2 & 3 Floor, 34 Nehru Place

ORIGINAL FOR RECIPIENT New Delhi -110019

UIN:-IRDAN106P0021V01200102 IRDA Reg No 106 State Code: 07, GSTIN: 07AAACI7573H1ZE

General Insurance Services : 9971

Proposer: PENSION FUND REGULATORY & DEVELOPMENT AUTHORITY

Address: B-14/A CHHATRAPATI SHIVAJI BHAWAN Unique Invoice No…………. : 54851503

KATWARIA SARAI NEW DELHI Policy No……………………. : 54851503

NDMC (PART) DELHI 110016 Date of Issuance…………… 09/04/2021

State Code/ Place

of Supply:

Country Name: India GSTIN: Policy effective from 0001 hrs 01/04/2021

Phone Number: Agent No. 23000002 To MidNight 31/03/2022

Total Members Covered 65

Co-Insurance Details

Name Type %

Taxable Value CGST SGST/UTGST IGST CESS

Rate 9.00 9.00 0.00 0.00

Amount 115836.67₹ 10425.30₹ 10425.30₹ 0.00₹ 0.00₹

Total Tax 20850.6₹ Total Value 136687.27₹

Policy Conditions/ Extensions/ Endorsements

Group Composition: Employee of the Insured

Basis of Policy Named Basis

Total Sum Insured 772246020

Details of Members As per attached annexure

Coverages

*Terrorism is covered under the policy.

*Day one cover for New Joinee subject to receipt of premium/

CD balance & intimation by 15th of every month.

*Refund of premium on account of Mid -term Deletion of

Members is allowed from the date of separation subject to

receipt of intimation by 15th day of every succeeding month

failing which refund will be calculated from the date of

submission of intimation to ITGI. No refund is allowed in

case of claim preferred on ITGI.

*Terrorism is covered under the policy AOA : AOY Limit of

Liability Rs. 10 Crores or the policy sum insured which

ever is lower per policy period.

-Terrorism Inclusion Warranty : Notwithstanding anything

stated to the contrary It Is hereby declared and agreed

that point no 5 of what is not covered Viz Terrorism /

Terrorist Incident is held covered but excludes Nuclear /

Chemical / Biological Terrorism Attack .

-Sanction Limitation and Exclusion Clause : No insurer shall

be deemed to provide cover and no insurer shall be liable

to pay any claim or provide any benefit hereunder to the

extent that the provisions of such cover, payment of such

claim or provision of such claim or provision of such

benefit would expose that insurer to any sanction,

prohibition or restriction under United Nations resolutions

or the trade or economic sanctions, laws or regulations of

the European Union, United Kingdom or United States of

America.

*Medical Benfit Extension 25%

-In consideration of an additional premium (as mentioned on

the schedule), It is hereby agreed and declared that

notwithstanding anything contained to the contrary within

the mentioned policy, this insurance is extended to cover

medical expenses necessarily incurred and expended in

connection with any accident as specified in the policy,

for which claim made by you and admitted by us.

-We will reimburse to You actual Expenses up to but not

exceeding 50% of the compensation paid in settlement of a

valid claim under this policy or 20% of the sum insured

whichever is less. Further it is a condition precedent to

the payment of such medical expenses that the medical

attendants detailed account shall be submitted to and is

approved by Us.

*Losses or damages caused directly or indirectly due to any

infectious or contagious disease, pandemic /epidemics as

declared by WHO and / or Government of India will be an

exclusion under this policy as per the attached clause.

Corporate Identity No (CIN) U74899DL2000PLC107621

Toll Free : 1-800-103-5499 ; Other : ( 0124) 428-5499 ; SMS "claim" to 56161

Policy Issuing Office: Delhi

Consolidated Stamp Duty deposited as per the order of Government of National Capital Territory

of Delhi

Group Personal Accident Insurance Policy Wordings

This POLICY is evidence of the contract between YOU and US. The proposal form along with any written statement(s) declaration(s) of

YOURS for purpose of this POLICY forms part of this contract.

This POLICY witnesses that in consideration of YOUR having paid the premium for the period stated in the schedule or for any further period

for which WE may accept the payment for renewal of this policy. WE will insure the Insured Person(s) and accordingly WE will pay to YOU or

YOUR legal personal representative(s) as the case may be in respect of events occurring during the period of insurance in the manner and to

the extent set-forth in the policy including endorsements provided that all the terms, conditions, provisions, and exceptions of this policy in so

far as they relate to anything to be done or complied with by YOU have been met.

The Schedule shall form part of this POLICY and the term 'POLICY' whenever used shall be read as including the Schedule.

Any word or expression to which a specific meaning has been attached in any part of this POLICY or of Schedule shall bear such meaning

whenever it may appear.

The POLICY is based on information which have been given to US about Insured Person(s) pertaining to risk insured under the policy and the

truth of these information shall be condition precedent to YOUR right to recover under this POLICY.

Definition of Words:

1. Proposal

It means any signed proposal by filling up the questionnaires and declarations written statements and any information in addition thereto

supplied to US by YOU.

2. Policy

It means the policy booklet, the Schedule and any applicable endorsement or memoranda. The policy contains details of the extent of cover

available to insured person (s), what is excluded from the cover and the conditions on which the policy is issued.

3. Schedule

It means latest Schedule issued by US as part of the policy. It provides details of the insured person(s), which are in force and the level of

cover Insured Person(s) have.

4. Capital Sum Insured

It means the monetary amount shown against Insured Person.

5. We/Our/Us

It means IFFCO-TOKIO GENERAL INSURANCE COMPANY LIMITED.

6. You/Your

It means the person(s) named as Insured in the Schedule.

7. Insured Person:

The person named as Insured person(s) in the Schedule lodged with US by YOU which will include YOU, YOUR family inclusive of dependent

parents, blood relatives i.e. dependent brothers, sisters.

8. Period of Insurance

It means the duration of this policy as shown in the Schedule.

9. Standard Type of Aircraft

It means any aircraft duly licensed to carry passengers (for hire or otherwise) by appropriate authority irrespective of whether such an aircraft

is privately owned or chartered or operated by a regular airline or whether such an aircraft has a single engine or multiengine.

10. Injury

It means accidental physical bodily harm excluding illness or disease, solely and directly caused by external, violent and visible and evident

means which is verified and certified by a Medical Practitioner.

11. Accident

It means a sudden, unforeseen and involuntary event caused by external, visible and violent means.

12. Air Accident

It shall mean an accident while the Insured Person is on board the standard type of Aircraft and the Aircraft meets with an accident causing

injury to Insured Person.

13. Loss of Limbs

It shall mean physical separation of one or both hands or feet or permanent and total loss of use of one or both hands or feet.

14. Physical Separation

It shall mean separation at or above the wrist and/or of the foot at or above the ankle respectively.

15. Permanent Total Disablement

The bodily injury, which as its direct consequence immediately and/or in foreseeable future, will permanently, totally and absolutely prevent

Insured Person from engaging in any kind of occupation.

16. Temporary Total Disablement

The bodily injury which as its direct consequence will prevent the Insured Person from engaging in all types of the occupation or any

employment whatsoever for a period not exceeding 104 weeks since the date of injury to the time, Insured Person is fit enough to resume duty

or engage in any kind of occupation as certified by Medical practitioners.

17. Dependent child

It means a child (natural or legally adopted), who is financially dependent on the primary insured or proposer and does not have his/her

independent sources of income.

18. Medical Practitioner

A Medical Practitioner is a person who holds a valid registration from the Medical Council of any State or Medical Council of India or Council

for Indian Medicine or for Homeopathy set up by the Government of India or a State Government and is thereby entitled to practice medicine

within its jurisdiction; and is acting within the scope and jurisdiction of license.

19. Reasonable and Customary Charges

It means the charges for services or supplies, which are the standard charges for the specific provider and consistent with the prevailing

charges in the geographical area for identical or similar services , taking into account the nature of the injury involved.

20. Hospitalisation

It means admission in a Hospital for Inpatient Care for consecutive hours except for specified procedures/ treatments, where such admission

could be for a period of less than 24(twenty four) consecutive hours.

21. Medical Expenses

It means those expenses that an Insured Person has/you have necessarily and actually incurred for medical treatment on account of Accident

on the advice of a Medical Practitioner, as long as these are no more than would have been payable if the Insured Person had not been

insured and no more than other hospitals or doctors in the same locality would have charged for the same medical treatment.

22. Notification of Claim

It means the process of notifying a claim to us by specifying the timelines as well as the address / telephone number to which it should be

notified.

23. Disclosure to information norm

This means the Policy shall be void and all premium paid hereon shall be forfeited to us, in the event of misrepresentation, mis-description or

non-disclosure of any material fact.

24. Renewal

It means the terms on which the contract of insurance can be renewed on mutual consent.

25. Alternative treatments

It means forms of treatments other than treatment "Allopathic" or "modern medicine" and includes Ayurvedic, Unani, Sidha and Homeopathy in

the Indian context.

26. Terrorism / Terrorist Incident

Means any actual or threatened use of force or violence directed at or causing damage, injury, harm or disruption, or the commission of an act

dangerous to human life or property, against any individual, property or government, with the stated or unstated objective of pursuing

economic, ethnic, nationalistic, political, racial or religious interests, whether such interests are declared or not. Robberies or other criminal

acts, primarily committed for personal gain and acts arising primarily from prior personal relationships between perpetrator(s) and victim(s)

shall not be considered terrorist activity.

Terrorism shall also include any act, which is verified or recognized by the relevant Government as an act of Terrorism.

General Conditions:

1. Reasonable Precaution and Care of Property

YOU/Insured Person shall take all reasonable precautions to prevent injury, illness, disease or damage in order to minimize claims.

2. Notice

YOU will give every notice and communication in writing to OUR office through which this insurance is affected.

3. Misdescription

The Policy shall be void and all premium paid by YOU to US be forfeited in the event of misrepresentation or concealment of any material

information.

4. Disclosure To Information Norm

This means the Policy shall be void and all premium paid hereon shall be forfeited to us, in the event of misrepresentation, mis-description or

non-disclosure of any material fact.

5. Free Lookup Period

You will be allowed a period of at least 15 (fifteen) days from the date of receipt of the policy to review the terms and conditions of the policy

and to return the same if not acceptable stating the reasons therein for doing so.

a) If you have not made any claim during the free look period, then you shall be entitled to :

I. A refund of the premium paid less any expenses incurred by us

II. Where the risk has already commenced and the option of return of the policy is exercised by you, a deduction towards the proportionate risk

premium for period on cover less any expenses incurred by us

III. Where only a part of the risk has commenced, such proportionate risk premium commensurate with the risk covered during such period less

any expenses incurred by us on medical examination of the insured persons and the stamp duty charges.

6. Changes in Circumstances:

YOU must inform US, as soon as reasonably possible of any change in information YOU have provided to US about Insured person(s) which

may affect the Insurance cover provided e.g. duty, business, occupation and obtain from US an endorsement to this effect.

7.Claim Procedure and Requirements

An event, which might become a claim under the policy, must be reported to US as soon as possible. In case of death, written notice also of

death must, unless reasonable cause is shown, be given before internment/ cremation and in any case, within one calendar month after the

death, and in the event of loss of sight or amputation of limbs, written notice thereof must also be given within one calendar month after such

loss of sight or amputation. A written statement of the claim will be required and a claim form will be provided.

YOU or YOUR personal representative must give immediate written notice but within 14(fourteen) days of occurrence of injury, disease.

All certificates, information and evidence from a Medical Attendant or otherwise required by US shall be furnished by YOU, YOUR personal

representative/assignee in the manner and form as WE may prescribe. In such claims YOUR legal representative, Nominee, beneficiary will

allow OUR representative to carry out examination and ascertain details if and when WE may reasonably require and in the event of death get

the post-mortem examination done in respect of body of Insured Person(s). In the event of claim in respect of loss of sight and loss of speech,

the Insured person(s) shall undergo at YOUR expenses such operations or treatment as WE may reasonably deem desirable.

8. Fraud

If a claim is fraudulent in any respect or supported by any fraudulent statement or device with or without your knowledge, all benefit(s) under

this Policy shall be forfeited.

9. Renewal

Renewal shall not be refused unless justified on grounds of fraud, moral hazard or misrepresentation or nonâ€•cooperation by the insured,

provided, however, that you apply for renewal and remit the requisite premium before the expiry of this policy.

10. Cancellation

a) We may cancel the policy on grounds of fraud, moral hazard or misrepresentation or nonâ€•cooperation by you by sending 30(thirty) days

notice by registered post to your last known address. You will then be entitled to, except in case of fraud or illegality on your part, a pro-rata

refund of premium for unexpired period of this policy in respect of such insured person(s) in respect for whom no claim has arisen.

b) You may cancel the policy by sending written notice to us under registered post. We will then allow a refund on following scale, except for

those insured person(s) for whom claim has been preferred on us under the current policy:

Period of Cover upto Refund of Annual Premium rate(%)

1(one) month 75% (seventy five percent)

3(three) months 50% (fifty percent)

6(six) months 25% (twenty five percent)

Exceeding Six Months NIL

11. We will not be bound to take notice or be affected by any notice of any trust, charge, lien, assignment or other dealings with or relating to

this policy. Your receipt or receipt of Insured Person shall in all cases be an effective discharge to US.

12. Arbitration

If any dispute or difference shall arise as to the quantum to be paid under the policy (liability being otherwise admitted) such difference shall

independently of all other questions be referred to the decision of the sole arbitrator to be appointed in writing by the parties to or if they

cannot agree upon a single arbitrator within 30 (thirty) days of any party invoking arbitration the same shall be referred to a panel of three

arbitrators, comprising of two arbitrators, one to be appointed by each of the parties to the dispute/difference and the third arbitrator to be

appointed by two such arbitrators and arbitration shall be conducted under and in accordance with the provisions of the arbitration and

conciliation act, 1996. It is clearly agreed and understood that no difference or dispute shall be referable to arbitration as herein before

provided, if we have disputed or not accepted liability under or in respect of this policy. It is understood, however, that the insured shall have

the right at all times during currency of the policy to communicate only, with the leading or issuing office in all matters pertaining to this

insurance.

13. Disclaimer Clause:

If WE shall disclaim OUR liability in any claim and such claim shall not have been made subject matter of suit in a court of law within

12(twelve) months from date of disclaimer, then the claim shall for all purpose be deemed to have been abandoned and shall not thereafter be

recoverable under this Policy.

14. No sum payable under this policy shall carry any interest/ penalty.

15. The geographical scope of this policy will be WORLDWIDE, however the claims shall be settled in India in Indian rupees. The provisions of

this policy shall be governed by the laws of India for the time being in force. The parties hereto unconditionally submit to the jurisdiction of the

courts in India.

16. Grievance or Complaint:

You may register a grievance or complaint by visiting our website www.itgi.co.in you may also contact the branches from where you have

bought the policy or grievance officer who can be reached at our corporate office.

16. Withdrawal & Alteration of Policy Conditions:

The policy terms and conditions may undergo alteration as per the IRDA Regulation. However the same shall be duly notified to you at least

three months prior to the date when such alteration or revision comes into effect by registered post at your last declared correspondence

address. The timeliness for revision in terms and rates shall be as per the IRDA Regulation.

A product may be withdrawn with the prior approval of the Authority and information of withdrawal shall be given to you in advance as per the

IRDA guidelines with details of options provided by us. If we do not receive your response on the intimation of withdrawal, the existing product

shall be withdrawn on the renewal date and you shall have to take a new policy available with us, subject to terms & conditions.

17. Sum Insured Enhancement:

In case of increase in Capital Sum Insured more than 10% (ten percent) of last year capital Sum Insured at the time of renewal, subject to

underwriter's discretion.

18. Payment of premium:

The premium payable shall be paid in advance before commencement of risk. No receipt for premium shall be valid except on our official form

signed by our duly authorized official. In similar way, no waiver of any terms, provision, conditions and endorsements of this policy shall be

valid unless made in writing and signed by our authorized official.

19. Protection of Policy Holder's Interest :

in the event of a claim, if the same is found admissible under the policy, we shall make an offer of settlement or convey the rejection of the

claim within 30(thirty) days of receipt of all relevant documents and investigation/ assessment report (if required). In case the claim is

admitted, the claim proceeds shall be paid within 7(seven) days of your acceptance of our offer. In case of delay in payment, we shall be liable

to pay interest at a rate which is 2.0% (two percent) above the bank rate prevalent at the beginning of financial year in which the claim is

received by us.

PROVISIONS:

PROVIDED THAT ALL SUMS PAYABLE HEREUNDER SHALL BE PAYABLE :

(i) In case of claim by death or permanent total disablement i.e. Benefit 1) to Benefit 4) of Table of Benefits only after deleting by an

endorsement the name of Insured Person(s) in respect of whom such sums shall become payable without any refund of premium.

(ii) In case of claim by permanent partial disablement i.e. Benefit 5) of Table of Benefits only after reduction by an endorsement of Capital Sum

Insured by the amount admissible under the claim in respect of Insured person in respect of whom such sum shall become payable.

(iii) In case of Temporary Total Disablement Benefit i.e. 6) of Table of Benefits only upon termination of such disablement in respect of Insured

person for whom the claim has been lodged.

General Exclusions

WE will not pay for any compensation in respect of death, Injury or disablement of the Insured Person.

1. As consequence of war, invasion, act of foreign enemy, hostilities (whether war be declared or not) civil war, rebellion, revolution,

insurrection, mutiny military or usurped power, confiscation, seizure, capture, assault, restraint, nationalization, civil commotion or loot or

pillage in connection herewith.

2. Directly or indirectly caused by contributed to by or arising from:

(a) Ionizing radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel. For

the purpose of this exclusion, combustion shall include any self sustaining process of nuclear fission.

b) (b) The radioactive, toxic, explosive or the hazardous properties of any nuclear assembly or nuclear component.

Coverage :

WHAT IS COVERED WHAT IS NOT COVERED

If following Bodily injury which solely and directly causes Insured Person to death or

disablement within 12 months of injury as stated in Table of Benefits, WE shall pay to YOU

or YOUR legal personal representative / assignee / nominee the sum or sums hereinafter

set forth in Table of Benefits.

WE will not liable for

1. Compensation under more than one of the

benefits mentioned in Table of Benefits in

respect of same period of disablement.

2. Any other payment after a claim under one of

the benefits 1,2,3 and 4 in Table of benefits has

been admitted and becomes payable.

3. Any payment in case of more than one claim

under this section during any one period of

Insurance by which OUR liability in that period

would exceed sum payable under benefits(1) of

this policy.

4. Payment of compensation in respect of injury

as a consequence of

a) Committing or attempting suicide, intentional

self-injury.

b) Whilst under influence of intoxicating liquor.

c) Drug addiction or alcoholism.

d) Whilst engaging in Aviation or Ballooning or

whilst mounting into, dismounting from or

travelling in any balloon or aircraft other than as

passenger (fare paying or otherwise) in any duly

licensed standard type of aircraft.

e) Pregnancy or childbirth.

f) Venereal disease or insanity.

g) Contracting any illness directly or indirectly

arising from or attributable to HIV and/or any

HIV related illness including AIDS and /or any

mutant derivative or variation of HIV or AIDS.

h) Committing any breach of law with criminal

intent.

5. Terrorism / Terrorist Incident of whatsoever

nature directly or indirectly caused by, resulting

from or in connection with any act of terrorism

regardless of any other cause or event

contributing concurrently or in any other

sequence to the loss.

TABLE OF BENEFITS % OF CAPITAL SUM INSURED

1. Death 100

Table 2,3,4 - PTD - Permanent Total Disablement

2.a) Loss of sight (both eyes)

b) Loss of two limbs

c) Loss of one limb and one eye

3.a) Loss of sight of one eye

b) Loss of one limb

4. Permanent Total and absolute disablement 100

Table 5 - PPD - Permanent Partial Disablement

5.i) Loss of toes-all

ii) Great-both phalanges

iii) Great-one phalanx

iv) Other than great, if more than one toe lost-each

i) Loss of hearing â€“ both ears

ii) Loss of hearing â€“ one ear

c) Loss of Speech 50

d) Loss of four fingers and thumb of one hand 40

e)Loss of four fingers 35

f) Loss of thumb

i)_Both phalanges

ii)One phalanx

g) Loss of index finger

i)Three phalanges

ii)Two phalanges

iii)One phalanx

h).Loss of middle finger

i) Three phalanges

ii) Two phalanges

iii) One phalanx

i)Loss of ring finger

i)Three phalanges

ii)Two phalanges

ii)One phalanx

j) Loss of little finger

i)Three phalanges

ii)Two phalanges

iii)One phalanx

k)Loss of Metacarpals

i)First or second (additional)

ii)Third, fourth or fifth (additional)

l) Any other permanent partial disablement % as assessed by Doctor

6. Temporary Total disablement benefit at the rate per week 1% of Table C Sum Insured or Rs. 25,000

whichever is lower.

Table "A": Benefit 1, Table "B1": Benefit 1-4, Table "B": Benefit 1-5, Table "C": Benefit 1-6

Special Inbuilt Benefits under the Policy in addition to capital sum insuredA. In the event of death of Insured Person outside his/her Home, transportation cost for

carriage of dead body to Home including funeral charges is payable.

2% of Capital Sum Insured or 2,500/- (Two

thousand five hundred) whichever is lower.

B. Cost of Clothing damaged in the Accident as described above and liability is admitted

by us.

Rs. 1000 (one thousand) per insured person any

one accident or actual expenses whichever is

lower.

C. Ambulance charges for transportation of Insured person to Hospital following

Accident which result in liability having been admitted by us as per 1 to 6 of Table of

Rs. 1000 (one thousand) per insured person any

one accident or actual expenses whichever is

Benefits. lower.

D. Education Fund:

In the event of death, permanent total disablement i.e. 1 to 4 of Table of Benefit of Insured

person, We will approve compensation towards Education Fund for dependent children as

a) For one child upto the age of 23 yrs.

b) For more than one children upto the age of 23 yrs.

10% (Ten percent) of C.S.I Subject to a

maximum of Rs. 5000/-

10% (Ten percent) of C.S.I Subject to a

maximum of Rs. 10000/-

E. Loss of Employment: In the event of accident leading to loss of employment as a

consequence of 2,3 and 4 of table of benefits.

Rs. 15000 or 1% of CSI whichever is lower.

S.No. Coverages as per Tender Terms

1 Basis Cover:

1. Death+PTD (Permanent Total Disability) as per list attached Annexure-II + PPD (Permanent Partial

Disability) + TTD(Temporary Total Disability)

2. Terrorism Covered

2 Additional Benefits:

3. Transportation of mortal remains- 1% of S.I. or Rs 30,000/- or actual expenses, whichever is less

4. Funeral Expenses-1% of S.I. or Rs 10,000/- or actual amount claimed, whichever is less

5. Dependent Children Education Benefit-5% of S.I. or Rs 1,00,000/- or actual expenses, whichever is less in

case of 2 dependent children and 3% of S.I. or Rs 50,000/- or actual expenses, in case of one dependent child.

6. Accidental Medical Benefits-Covered upto 40% of S.I. or 10% of admissible claim amount under the basic

cover or actual amount whichever is less.

7. Temporary Total Disability(TTD)-Temporary Total Disability is restricted to 1% of sum insured or actual

wages or Rs 20,000/-, whichever is less, per week, for 100 weeks.

8. Ambulance expenses-as per actual

Attached Annexure is forming Part of policy No.54851503 : Endorsement No.02

The Disablement

Compensation Expressed as a percentage of Total Sum Insured

1) Permanent Total Disablement 100%

2)Permanent and incurble insanity 100%

3) Permanent Total Loss of two Limbs 100%

4) Permanent Total Loss of Sight in both eyes 100%

5) Permanent Total Loss of Sight in one eye and one Limb 100%

6) Permanent Total loss of Speech 100%

7) Complete removal of lower Jaw 100%

8) Permanent total loss of Mastication 100%

9) Permanent Total Loss of the Central Nervous System or the thorax and all the abdominal organs resulting in the complete inability

to engage in any job and the inability to carry out Daily Activities essential to life without full time assistance

10) Permanent Total Loss of Hearing in both Ears 75%

11) Permanent Total Loss of one Limb 50%

12) Permanent Total Loss of Sight in one eye 50%

13) Permanent Total Loss of Hearing in one ear 15%

14) Permanent Total Loss of the lens in one eye 25%

15) Permanent Total Loss of use of four fingers and thumb of either hand 40%

16) Permanent Total Loss of use of four fingers of either hand 20%

17) Permanent Total Loss of thumb of either hand:

a) Both Joints; 20%

b) One joint 10%

18) Permanent Total Loss of one finger of either hand:

a) Three Joints 5%

b) Two Joints 3.50%

c) One Joint 2%

19) Permanent Total Loss of use of toes:

a) All-one foot 15%

b) Big-both joints 5%

c) Big- one Joint 2%

d) other than Big- each toe 2%

20) Established non-union of fractured leg or kneecap 10%

21) Shortening of leg by atleast 5 cms. 7.50%

22) Ankylosis of the elbow, hip or knee 20%23) Permanent disablement not otherwise provided for under Items 2-22 inclusive upto a maximum of 75%

ANNEXURE II

TABLE OF BENEFITS-Table (D)

request for proposal for providing group personal accident

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