Credit Card
Request for credit of amount charged against Policy No. OG-09-1901-9961-00050497 already cancelled

From :

Balraj Chugh

Flat No.3B, Ground Floor,

Plot No.45, Vikrant Appt.

Sector-13, Rohini, Delhi.

Tel No. 011-27860647, 09810195309

Dated : 26.06.2008

To

Axis Bank

Sub: Credit Card No.4718610001517714

Sir

I have been informed by your good office that a Insurance premium of Rs.6483/- (Six thousand four hundred eighty three only) has been paid by you to Bajaj Allience against Mediclaim Insurance.

I would like to inform you hat policy No. OG-09-1901-9961-00050497 was cancelled as company has charged extra premium and so they have cancelled the said policy.

Hence I request you to please credit the amount immediately in my account. As per their standard terms with documentary proof provided by Bajaj alliance premium should be Rs.4676/- & have claimed Rs.6483/-

Thanking you for an immediate action.

Your faithfully

BALRAJ CHUGH

CC. to: M/s Bajaj Allianz General Insurance Co. Ltd. G.E. Plaza, Airport Road,

Yerawada, PUNE – 411 006.