State Bank Of India [SBI] — Unable to proceed with the Sail Mediclaim renewal from SBI Collect

Please find the below steps which have been performed.

Go to https://www.onlinesbi.sbi/ and click on the ‘SB collect’ tab on the menu bar.
2) Click on "Industry" from the category.
3) Name of Industry as "Steel Authority of India" and State as "National Capital Territory of Delhi"
4) Select payment category as "SAIL Mediclaim(Spouse)"
5) Enter "SPOUSE Min" - ******
6) Enter "TOP UP" - ****
7) Once I click on "Fetch payment details" getting below error, please look into this matter.

Error:-
Please verify the data entered and try again.