Branch Code: __________

Date: __________

Insure Name:

_______________________________

Address:

_____________________________ _____________________________ _____________________________ _____________________________

Pin Code:

_____________________________

Dear Sir / Madam,

Thank you for selecting "SBI General's Group Personal Accident Insurance Policy"

We wish to give you following confirmation of your insurance with us. This is based on information received from your Proposal to us. We request you to verify the information shared to us to ensure it reflects correct details. In case you have any concerns, please reach our Customer Care at 1800 22 1111/1800 102 1111 or mail us at customer.care@sbigeneral.in

SBI General has a complete range of general insurance products which are designed to meet the needs of every Indian. We look forward to serving you in the future and appreciate any opportunity you might give us to assist you.

Certificate No.:

___________________

Master Policy No.:

___________________

Name of the Insured:

___________________

Transaction ID:

_________________

Transaction Date:

_________________

Sum Insured:

₹ ________________

Policy Period:

From _______________

To:

________________________

Nominee Name:

____________________

Nominee Relationship:

____________________

Premium:

________________________

Inclusive of taxes as applicable:

_____________

SBI General Insurance Company Ltd.

Corporate & Registered Office: 'Natraj', 301, Junction of Western Express Highway & Andheri - Kurla Road, Andheri (East), Mumbai - 400 069

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