,


,
ZZ01 C262656195 BD 127/196 Term_EIA C-88
SHABBIR SHAIK June 3, 2021
3-5-100/A/2,
KOTHAGUDEM BAZAR
NEAR ESWAR TALKIES
SURYAPET
NALGONDA 508213
TELANGANA INDIA
M- 9985002781
Dear SHABBIR SHAIK,

Thank you for choosing us for your insurance needs. Tata AIA Life is committed to give you world-class products and
professional service.

We take great pleasure in presenting your Policy Document. Please check your personal details and the policy provisions
carefully. Should you have any queries, please contact your agent or contact us at the address mentioned below. You can
also reach us via email at customercare@tataaia.com or call our helpline number 1860-266-9966 (Local charges apply).

Agent Name: Tata AIA Life Insurance Company Ltd

Agency Code: 004471705
Agent Contact details: 18602669966 / websales@tataaia.com

In order to provide your better services, We request you to intimate us in the event of any change in the address of the
Policyholder or the nominee.

If you are not satisfied with the terms & conditions/features of the policy, you have the right to cancel the policy by
providing a written notice to the Company stating objections/reasons and receive the refund of all premiums paid
without interest after deducting proportionate risk premium, stamp duty and  medical examination cost along with
applicable taxes, cesses and levies which have been incurred for issuing the policy.  Such notice must be signed by you
and received directly by the Company within 15 days from the date of receipt of the policy document by you or person
authorized by you. The said period of 15 days shall stand extended to 30 days, if the policy is sourced through distance
marketing or electronic mode, which includes solicitation through any means of communication other than in person.

At Tata AIA Life we believe that life inspires us to think ahead. Our insurance solutions are therefore designed to be a
step ahead, thus giving you an advantage to adapt to tomorrow’s changes, starting today.

We look forward to a long and cherished relationship with you.

Best wishes,
For and on behalf of
Tata AIA Life Insurance Company Limited

Naveen Tahilyani
CEO & Managing Director
Authorised Signatory

Policy Servicing Branch : B-9th Flr,IThink Techno Campus, Off Pokharan Rd no.2,Thane-(w) - 400607
Tata AIA Life Insurance Company Ltd (IRDA of India Regn.No.110) (CIN - U66010MH2000PLC128403)
Registered & Corporate Office: 14th Floor, Tower A, Peninsula Business Park, Senapati Bapat Marg, Lower Parel, Mumbai 400013.
C262656195 Page 1 of 100
"The Stamp duty of (`) 2220/-(Rupees Two Thousand Two Hundred And Twenty only) paid vide MUDRANK
2004/4125/CR 690/M-1 Dated 31.12.2004, CSD/12/2021/1508 dated 19/04/2021"

(Signature)
Proper Officer

Tata AIA Life Insurance Maha Raksha Supreme

INSURED: SHABBIR SHAIK

POLICY NUMBER C262656195

Policy Terms and Conditions and Privileges within referred to

This Policy is the evidence of the contract between Tata AIA Life Insurance Company Limited and the Policyholder
referred to below.

PREAMBLE

Tata AIA Life Insurance Company Limited (“the Company”) a leading Company in Life Insurance Sector, having
received a Proposal form and other related documents with Declaration thereto and initial premium from the Policy
holder hereby issues Tata AIA Life Insurance Maha Raksha Supreme. Company basis the assurance by this Policy;
do agree in consideration and subject to Policy conditions to pay the benefits under the Policy on happening of an
Insured event, while the Policy is in force. The basic insurance plan provided by this Policy, with its amount of coverage
and Premium is specified on the Policy Schedule. Entitlement to benefits, conditions for payment and other policy
details are also set out inside. This Policy is subject to term and conditions mentioned herein below along with
endorsements if any.

Signature valid
Signed by: KUMARESH
Date:
Location:
Registrar Managing Director

This is a system generated document requiring no physical signature.

C262656195 Page 2 of 100

 , 
,
ZZ01 C262656195 BD 127/196 Term_EIA C-88
SHABBIR SHAIK June 3, 2021
3-5-100/A/2,
KOTHAGUDEM BAZAR
NEAR ESWAR TALKIES
SURYAPET
NALGONDA 508213
TELANGANA INDIA
M- 9985002781
Tata AIA Life Insurance Non-Linked Comprehensive Health Rider (UIN: 110B031V02)
Non-linked, Non-participating Individual Health Rider
Tata AIA Life Insurance Non-Linked Comprehensive Protection Rider (UIN: 110B033V02)
Non-linked, Non-participating Individual Health Rider

PART A

Dear SHABBIR SHAIK,

Thank you for choosing us for your insurance needs. Tata AIA Life is committed to give you world-class products and
professional service.
We take great pleasure in presenting your Rider Pack for our Tata AIA Life Insurance Non-Linked Comprehensive
Health Rider, a Non-linked, Non-participating Individual Health Rider and Tata AIA Life Insurance Non-Linked
Comprehensive Protection Rider, a Non-linked, Non-participating Individual Health Rider. Please check your personal
details and the rider provisions carefully. Should you have any queries, please contact your agent or contact us at the
address mentioned below. You can also reach us via email at customercare@tataaia.com or call our helpline number
1860-266-9966 (Local charges apply).

Agent Name: Tata AIA Life Insurance Company Ltd

Agency Code: 004471705
Agent Contact details: 18602669966 / websales@tataaia.com
In order to provide better service, We request you to intimate us in the event of any change in the address of the
Policyholder or the nominee.
You have a free look period of 15 days from the date of receipt of the Rider document and period of 30 days in case of
Rider obtained electronic or distance mode, to review the terms and conditions of the Rider. If You disagree to any of
those terms or conditions, You have the option to return the Rider document for cancellation of the benefit option,
stating the reasons for objection and be entitled to a refund of the premiums paid, for the benefit option, without
interest after deduction of proportionate risk premium, stamp duty and medical examination cost along with applicable
taxes and cesses or levies, if any.
On examination of the Rider, if you notice any mistake, please return the Rider document to the Company immediately
for correction.
At Tata AIA Life we believe that life inspires us to think ahead. Our insurance solutions are therefore designed to be a
step ahead, thus giving you an advantage to adapt to tomorrow’s changes, starting today.
We look forward to a long and cherished relationship with you.
Best wishes,
For and on behalf of
Tata AIA Life Insurance Company Limited

Naveen Tahilyani
CEO & Managing Director
Authorised Signatory

Policy Servicing Branch : B-9th Flr,IThink Techno Campus, Off Pokharan Rd no.2,Thane-(w) - 400607
Tata AIA Life Insurance Company Ltd (IRDA of India Regn.No.110) (CIN - U66010MH2000PLC128403)
Registered & Corporate Office: 14th Floor, Tower A, Peninsula Business Park, Senapati Bapat Marg, Lower Parel, Mumbai 400013.
C262656195 Page 3 of 100
"The Stamp duty of (`) 2220/-(Rupees Two Thousand Two Hundred And Twenty only) paid vide MUDRANK
2004/4125/CR 690/M-1 Dated 31.12.2004, CSD/12/2021/1508 dated 19/04/2021"

(Signature)
Proper Officer

Tata AIA Life Insurance Non-Linked Comprehensive Health Rider (UIN: 110B031V02), a Non-linked,
Non-participating Individual Health Rider

Tata AIA Life Insurance Non-Linked Comprehensive Protection Rider (UIN: 110B033V02), a Non-linked,
Non-participating Individual Health Rider

Tata AIA Life Insurance Company Limited

INSURED: SHABBIR SHAIK

RIDER NUMBER: C262656195

PREAMBLE

Tata AIA Life Insurance Company Limited has entered into this contract of insurance on the basis of the information
given in the Proposal Form together with the premium deposit, statements, reports or other documents and
declarations received from or on behalf of the proposer for effecting a life insurance contract on the life of the person
named in the Schedule below.

We agree to pay the benefits under the Rider on the happening of the insured event, while the Policy and Rider are in
force subject to the terms and conditions stated herein.

Signature valid
Signed by: KUMARESH
Date:
Location:

Registrar Managing Director

Tata AIA Life Insurance Company Limited

This is a system generated document requiring no physical signature.

C262656195 Page 4 of 100

 POLICY SCHEDULE

Tata AIA Life Insurance Maha Raksha Supreme (110N102V03)

THIS SCHEDULE MUST BE READ WITH THE POLICY DOCUMENT AND IS PART OF THE LIFE INSURANCE CONTRACT

Personal Details
Name of Policyholder : SHABBIR SHAIK Name of Life Assured : SHABBIR SHAIK
Address of Policyholder : 3-5-100/A/2, Address of Life Assured : N/A
KOTHAGUDEM BAZAR N/A
NEAR ESWAR TALKIES N/A
SURYAPET N/A
N/A
NALGONDA N/A
508213 N/A
TELANGANA
INDIA
Client ID of Policyholder : 298014578 Client ID of Life Assured : 298014578
Date of Birth of Policyholder : 1989/01/15 Date of Birth of Life Assured : 1989/01/15
Age at entry of Policyholder : 32 Age at entry of Life Assured : 32
Gender : Male Age Admitted : YES
Gender : Male

Policy Details
Policy Number : C262656195 Policy Term : 28
Plan Option : Pure Protection Cover Premium Paying Term : 28
Date of Commencement of Policy : 2021/06/03 Mode of Premium Payment : Annual
Date of Commencement of Risk : 2021/06/03 Annualised Premium (Excl. taxes) Rs. : 11400.00
Date of Maturity of Policy : 2049/06/03 Premium (Excl. taxes) Rs. : 11779.00
Premium Due Date (s) : 2022/06/03 Applicable taxes, cessess and levies Rs. : 2,120.00
Total Modal Premium (Incl. taxes) Rs. 13899.00

Base Plan/Rider Name Sum Assured Premium (Incl. Date of Maturity Date of Last Policy Premium
(Rs.) taxes) (Rs.) of Policy Premium Payment Term Payment Term
(Years) (Years)
Tata AIA Life Insurance Maha
Raksha Supreme 1,00,00,000.00 13452 03/06/2049 03/06/2048 28 28
(110N102V03)
Please refer to Schedule Page 2 for Rider details

Benefit Payable
Maturity Benefit As per Clause 4 of Part B
Death Benefit As per Clause 1 of Part B

Nominee details (under section 39 of the Insurance Act 1938)

Name of the Nominee (s) Relationship with Life Assured Age Nomination %
SHAIK SARIYA Children 1 33.00
SHAIK ATHUFA SHIREEN Children 4 33.00
SHAIK ASMA BEGAM Spouse 28 34.00

Appointee Details (Applicable in case the Nominee is a minor)

Name of the Appointee (s) Relationship with nominee Age
SHAIK ASMA BEGAM PARENTS 28

On examination of the Policy, if you notice any mistake, please return the Policy to the Company immediately for correction.

C262656195 Page 5 of 100

 SCHEDULE

Tata AIA Life Insurance Non-Linked Comprehensive Protection Rider - (UIN: 110B033V02)
Non-Linked, Non-Participating Individual Health Rider
Tata AIA Life Insurance Non-Linked Comprehensive Health Rider - (UIN: 110B031V02)
Non-Linked, Non-Participating Individual Health Rider
Accidental Total and
Benefit Option HospiCare Benefit Permanent Disability
Benefit
UIN 110B031V02 110B033V02
Life Insured Name SHABBIR SHAIK SHABBIR SHAIK
Address as per proposal form as per proposal form
Client ID 298014578 298014578
DOB 15/01/1989 15/01/1989
Age at entry (Years) 32 32
Age Admitted Y Y
Gender Male Male
Sum Assured under Benefit 1,00,000.00 10,00,000.00
Option (Rs.)
Benefit Payout Option Lumpsum Combination of Lumpsum
and Income
Lumpsum (Rs.) 1,00,000.00 10,00,000.00
Income p.a. (Rs.) 0 0
Income Duration (Years) 0 0
Return of Balance premium No No
option
Coverage Term (Years) 28 28
Premium Payment Term 28 28
(Years)
Date of Commencement of Risk 03/06/2021 03/06/2021
Due Date of Last Premium 03/06/2048 03/06/2048
Payment
Maturity/Expiry Date 03/06/2049 03/06/2049
Annualised Premium (Excl 88.00 270.00
taxes) (Rs.)
Modal Premium (Excl taxes) 109.00 270.00
(Rs.)
Tax, Surcharge and Cess (Rs.) 20.00 49.00
Total Modal Premium 129.00 319.00
(Incl taxes) (Rs.)

Details of Nominee (not applicable if Benefit Payout Option is Partner Care)

As per Base Plan
Details of Partner (applicable only if Benefit Payout Option is Partner Care)
Relationship with
Benefit DOB of
Name of Rider Life Insured Name of Partner Gender Percentage Rider Life
Option Partner
Insured

Note: This schedule must be read with the accompanying policy document and is part of the life insurance contract

C262656195 Page 6 of 100

C262656195 Page 7 of 100
 You are the
Rakshakaran Hero.

Dear SHABBIR SHAIK,

You are now the proud owner of a Tata AIA Life Insurance Maha Raksha
Supreme. (Policy number C262656195)
We at Tata AIA Life Insurance have embarked on an initiative – Rakshakaran Hero –
through which we will plant a sapling for every Term plan that we sell. We will do this
on your behalf, thereby ensuring that you safeguard your family’s financial future and
also secure the world.
Your decision to secure your family is truly commendable in more ways than one.
You secured your family’s financial future and have also helped protect the world.
Your sapling is geo-tagged with a unique number 2666731
You can log on to https://www.grow-trees.com/locatetree.php.
Enter your unique number to view the location of your sapling.
Congratulations on becoming a Rakshakaran Hero and making the world a
greener and better place.

Naveen Tahilyani
Managing Director & Chief Executive Officer
Tata AIA Life Insurance

For more details on risk factors, terms and conditions please read sales brochure carefully before concluding a sale. Tata AIA Life Insurance Company Limited (IRDAI Regn. No.110) CIN:
U66010MH2000PLC128403. Registered & Corporate Office: 14th Floor, Tower A, Peninsula Business Park, Senapati Bapat Marg, Lower Parel, Mumbai - 400013. Trade logo displayed above
belongs to Tata Sons Ltd and AIA Group Ltd. and is used by Tata AIA Life Insurance Company Ltd under a license. For any information including cancellation, claims and complaints, please contact
our Insurance Advisor / Intermediary or visit Tata AIA Life’s nearest branch office or call 1-860-266-9966 (local charges apply) or write to us at customercare@tataaia.com. Visit us at:
www.tataaia.com or SMS 'LIFE’ to 58888. Ÿ UIN:110N129V03 Ÿ L&C/Misc/2019/Sep/351
BEWARE OF SPURIOUS/ IRDAI is not involved in activities like selling insurance policies, announcing bonus or investment of premiums. Public receiving C262656195
such phone calls
Pageare8requested
of 100 to
FRAUD PHONE CALLS! lodge a police complaint.
Certificate Number: 2666731

Presented to

SHABBIR SHAIK
Policy Number: C262656195
Project Name : Trees for Water, Khandwa, Madhya Pradesh, India
A token of appreciation for securing your family’s financial
cial future
cia
and protecting the world, one tree at a time.

Naveen Tahilyani
Managing Director & Chief Executive Officer, Tata AIA Life Insurance

Tata AIA Life Insurance Company Ltd. (IRDA of India Regn. No. 110). CIN: U66010MH2000PLC128403.
Registered & Corporate Office: 14th Floor, Tower A, Peninsula Business Park, Senapati Bapat Marg, Lower Parel, Mumbai 400013.

C262656195 Page 9 of 100

 OTHER ENDORSEMENT

This policy has been issued under the Married Women’s Property Act (MWPA) and the beneficiaries are as mentioned
below:
Sr No. Beneficiaries Name
1. SHAIK SARIYA
2. SHAIK ATHUFA SHIREEN
3. SHAIK ASMA BEGAM

C262656195 Page 10 of 100

 Tata AIA Life Insurance Maha Raksha Supreme

Tata AIA Life Insurance Maha Raksha Supreme is a Non-Linked, Non-Participating, Individual Life Insurance Pure Risk Premium Plan. This product
provides Pure Protection Cover during the Policy term.
You have an option to take Life Stage Plus Option under “Pure Protection Cover” at the inception of the Policy
A. BASIC DEFENITIONS • 125% of Single Premium
In this Policy: Death benefit shall be payable after, deduction of any due premiums,
1. “You” or “Your” means the Policyholder of this Policy. which are unpaid as on date of death. The Policy will terminate upon
death of the insured and no other benefit under the policy shall be
2. “We”, “Us”, “Our” or “Company” refers to Tata AIA Life Insurance payable.
Company Limited.
2) PAYOUT ACCELERATOR BENEFIT
3. “Date of Commencement of Risk” is as mentioned on the Policy
Schedule. A Payout Accelerator Benefit equal to 50% of the basic sum assured under
the policy shall be paid to the Insured, provided the policy is in force and the
4. “Revival Date” is the approval date of revival of the Policy.
life expectancy of the Insured under the policy is established to be no greater
5. “Policy” means this contract of insurance than 6 months due to a “Terminal Illness”, as per the definition herein.
6. “Policy Date” as shown in the Policy Schedule is the date from which The benefit shall be subject to the following conditions:
Policy Anniversaries, Policy Years, Policy Months and Premium Due
i. The benefit will commence after two years from the date of issue
Dates are determined.
of the policy.
7. “Policy Anniversary” refers to the same date each year as the Policy
ii. This is an accelerated benefit, i.e. on payment of this benefit, the
Date.
death benefit under the policy is automatically reduced by the
8. “Expiry Date” of this Policy is shown in the Policy Schedule. amount paid under this benefit
9. “Insured” means the person whose life is insured under the Policy as iii. You will continue to pay the regular premiums as due under the policy
shown in the Policy Schedule. even after a terminal illness claim is admitted under this benefit.
10. “Basic Sum Assured” is the guaranteed amount of the benefit that is iv. This benefit is not available on the additional sum assured taken
payable on the death of the Insured under this Policy. The Basic Sum under Life Stage Plus option.
Assured when the Policy is issued is shown in the Policy Schedule. If
v. If the death of Insured doesn’t occur within the six months period,
the Basic Sum Assured is subsequently altered according to the terms
the death benefit as mentioned above will be paid on death, if
and conditions of the Policy, the adjusted amount after such alteration
occurred within the policy term, provided the policy is in force.
as evidenced by an endorsement issued by Us to this effect will
become the Basic Sum Assured 3) Life Stage Plus Option
11. “Annualised Premium” shall be the premium amount payable in a You also have the option to take an additional Sum Assured, over and
year chosen by the policy holder, excluding the taxes, rider premiums above the Basic Sum Assured, provided the policy is in force, without
underwriting extra premiums and loading for modal premiums, if any. any further medical underwriting on the occurrence of a prescribed
lifestyle event, as mentioned below, at the inception of the policy.
12. “Total Premiums Paid" means total of all the Premiums received,
excluding any extra premium, any rider premium and taxes. This option shall be subject to the following conditions:
13. “Indebtedness” means any unpaid policy loans including accrued i. You may request to exercise this option during the policy term
interest, unpaid premiums, deductibles and any other amounts owed subject to occurrence of any of the ‘lifestyle events’ mentioned
to the Company. below:
14. “Terminal Illness” means an irreversible terminal medical condition of a. Marriage of the Insured
the Insured: b. Child Birth /Legal adoption of a child (first two
i. the signs or symptoms of which first occur or commence after 2 children in both cases)
years of continuous cover under this Policy or endorsement; as ii. The documents required in case of any of the ‘lifestyle events’ are
the case may be as follows:
ii. for which the diagnosis is supported by evidence of the advanced a. Marriage of the Insured – Marriage certificate
stage of the medical condition such as clinical, radiological & b. Child Birth – Birth certificate
laboratory evidence; and c. Legal adoption of a child – Adoption deed
iii. that is expected to result in death of the Insured within 6 months iii. Additional premium for this option is payable only when the
of diagnosis, and is certified to be so by two physicians or additional sum assured is availed during the term of the policy.
registered medical practitioners specializing in treatment of such Such additional premium will be based on the attained age of the
illness and approved by the company, at least one year before the Insured and the outstanding policy term at the time of exercising
expiry date of the policy. this option and will be calculated with reference to the same
15. “Policy Term” is the maximum period in years for which the policy can premium table used to calculate the premium for the initial basic
remain in force and is mentioned in the Policy Schedule. sum assured.
16. “Premium Payment Term” is the number of years that premium is iv. Minimum additional sum assured that can be availed under this
payable for and is mentioned in the Policy Schedule. option is 10% of the Basic Sum Assured (in multiples of `5,00,000).
17. Interpretation: Whenever the context requires, the masculine form Maximum additional sum assured that can be availed under this
shall apply to feminine and singular terms shall include the plural. option is 50% of Basic Sum Assured, subject to a maximum of
`50,00,000 (in multiples of `5,00,000).
B. BENEFIT PROVISIONS
v. This option can be exercised at one or more of the events listed
1. DEATH BENEFIT above by applying to the company within one year of the
Upon death of the Insured during the term of the policy, provided the policy occurrence of such “lifestyle events”, provided the total additional
is in force, the death benefit payable shall be the Sum Assured on Death sum assured is not more than the maximum sum assured
along with Additional sum assured under Life Stage Plus option, if any, less mentioned above. This option can be exercised up to a maximum
Payout Accelerator Benefit already paid, if any of three (3) times during the entire policy term.
“Sum Assured on death” shall be defined as the highest of the vi. This option is exercisable only on the next policy anniversary.
following for Regular Pay/Limited Pay/Pay to Age 60: Request should be received atleast 30 days before the next policy
• Basic Sum Assured; or anniversary.
• 10 times Annualised Premium; or vii. This option is not available after he/she attains the age of 50 years
• 105% of the Total Premium Paid up to the date of death viii. This option is not available during the last 10 Policy years
“Sum Assured on death shall be defined as the highest of the following ix. “Payout Accelerator Benefit” would not be available on such
for Single Pay; additional sum assured.
• Basic Sum Assured x. The option is irrevocable.

Tata AIA Life Insurance Maha Raksha Supreme (UIN: 110N102V03) • IRDA of India Regn no. 110

C2020-60
C262656195 Page 11 of 100
 xi. Post acceptance of “Payout Accelerator Benefit” claim under the Insured as to travel, residence or occupation. Even though there are no
policy, the option cannot be exercised. restrictions under this Policy, the attached riders (if any) may have
xii. The premium payment frequency for the additional sum assured occupational exclusions for the cover as specified in the rider terms and
will be same as the premium payment frequency for the basic sum conditions.
assured. 10. CLAIM PROCEDURES
xiii. Large sum assured discount shall be applicable to additional Notice of Claim – All cases of death must be notified immediately to us
sum assured.
in writing. However, any delay in notifying shall require to be substantiated
4) MATURITY BENEFIT: to Our satisfaction. In case of any delay on the part of the Company to
There is no Maturity Benefit under this Policy process the claim within extant regulatory timeline, We shall pay interest as
5) PLAN CHANGE / CONVERSION OPTION may be prescribed by the IRDAI from time to time.
Plan change/ Conversion is not allowed under this Policy Please note that all death claims will be payable to the nominee/legal heir
of the Insured policy holder.
C. GENERAL PROVISIONS
Filing Proof of Claim – Affirmative proof of loss and any appropriate forms
1. POLICY CONTRACT as required by us must be completed and furnished to us, at the claimant’s
This Policy is made in consideration of Your proposal and payment of the expenses, within 90 days after the date the Insured event happens, unless
required premium. The Policy, proposal for it, the Policy Schedule and any specified otherwise. A list of primary claim documents listing the normally
attached endorsements constitute the entire contract. The terms and required documents is attached to the Policy. Submission of the listed
conditions of this Policy cannot be changed or waived except by documents, forms or other proof, however, shall not be construed as an
endorsement duly signed by Our authorized officer. admission of liabilities by the Company.
Your Policy consists of the basic insurance plan and any endorsements In case of diagnosed Terminal Illness, We would require evidence of the
which may be attached to it advance stage of the medical condition certified by two physicians or
2. FRAUD AND NON-DISCLOSURE registered medical practitioners and any forms as required by us must be
Any non-disclosure, fraud or mis-representation under the Policy shall be completed and furnished to us, at the claimant’s expenses.
dealt in accordance with Section 45 of the Insurance Act, 1938 as We reserve the right to require any additional proof and documents in
amended from time to time. The simplified version of the provisions of support of the claim.
Section 45 is enclosed in annexure – (3) for reference.
Proof of Continuing Loss – In the case of disability or other losses as We
3. EXCLUSION deem appropriate, We will require, at reasonable intervals, proof of
3.1. SUICIDE continuing disability or loss. If such proof is not submitted as required, or
In case of death due to suicide within 12 months from the Date of such disability or loss ceases, claims for such disability or loss will not be
Commencement of Risk under the Policy or from the date of revival of the considered.
Policy, as applicable, the nominee or beneficiary of the Policyholder shall 11. CLAIMS REQUIREMENTS
be entitled to at least 80% of the Total Premiums Paid till the date of death 11.1. Death claims requirements
or the Surrender Value available as on the date of death whichever is
higher, provided the Policy is in force. For processing the claim request under this Policy, we will require the
following documents:
4. MISSTATEMENT OF AGE AND GENDER
Type of Claim Requirement
This Policy is issued at the age and gender shown on the Policy Schedule
a) Claim Forms
which is the Insured’s declared age at last birthday and declared gender in
the proposal. If the age and/or gender is misstated and higher premium • Part I: Application Form for Death Claim
should have been charged, the benefit payable under this Policy shall be (Claimant's Statement) along with NEFT form
after deduction of such difference of premium along with interest thereon. • Part II: Physician's Statement - to be filled by last
In such cases, the policy shall be subject to re-underwriting and the Sum attending physician
Assured shall be subject to Your eligibility as per Our Underwriting norms b) Death Certificate issued by a local government
and the premium to be deducted shall be calculated proportionately on body like Municipal Corporation
such Sum Assured payable. If the Insured’s age/gender is misstated and c) Medical Records (Admission Notes,
lower premium should have been charged, the Company will refund any Discharge/Death Summary, Indoor Case Papers,
excess premiums paid without interest. If at the correct age/gender the Test Reports etc)1
Insured is not insurable under this Policy pursuant to our Underwriting Death: (all causes of
rules, the Policy shall be void-ab-initio and the Company will refund the death other than the d) Claimant's Photo ID with age proof & relationship
Accidental Death) with the Insured along with Address proof of the
Total Premiums paid without interest after deducting all applicable charges
claimant and Cancelled cheque with name and
like medical, Stamp duty, Risk, applicable taxes, cesses and levies etc., account number printed or cancelled cheque with
incurred by the Company under the Policy. copy of Bank Passbook / Bank Statement
5. THE POLICYHOLDER If no nomination - Proof of legal title to the claim
Only You can, during the Policy Term, exercise all rights, privileges and proceeds (e.g. legal succession paper)
options provided under this Policy subject to any Nominee’s vested In case of accidental death in addition to the
interest or Assignee’s rights. above documents, we would require the following
6. NOMINEE If Death due to documents -
Nomination allowed as per provisions of Section 39 of the Insurance Act Accident (to be - Postmortem report (Autopsy report) & Chemical
1938 as amended from time to time. submitted in addition Viscera report - if performed;
to the above) - All Police Papers – Panchnama, Inquest, First
The simplified version of the provisions of Section 39 is enclosed in
Information Report (FIR) and Final Investigation
annexure – (2) for reference.
Report.
7. ASSIGNMENT
1
This is applicable if insured was in hospital at the time of death or any time
Assignment allowed as per provisions of Section 38 of the Insurance Act
prior to the date of death.
1938 as amended from time to time.
Please submit copies of the following documents certified / attested by the
The simplified version of the provisions of Section 38 is enclosed in
issuing authority. (Original Seen Verified (OSV) by Branch Personnel will
annexure – (1) for reference.
also be accepted) –
8. CURRENCY AND PLACE OF PAYMENT - All Police papers – Panchnama, Inquest, First Information Report and
All amounts payable either to or by Us will be paid in the Indian currency. Final Investigation Report.
Such amounts will be paid by a negotiable bank draft or cheque drawn on - Medical Records (Admission Notes, Discharge/Death Summary,
a bank or NEFT (National Electronic Funds Transfer) or electronic clearing Indoor Case Papers, Test Reports etc).
systems. All amounts due from Us will be payable from Our office shown
on the Policy Schedule. - Postmortem report (Autopsy report) & Chemical Viscera report
(certified by Police / Magistrate / Court will also be accepted)
9. FREEDOM FROM RESTRICTIONS
Copies of the other documents to be submitted by self-attestation of
Unless otherwise specified, this Policy is free from any restrictions upon the the claimant
Tata AIA Life Insurance Maha Raksha Supreme (UIN: 110N102V03) • IRDA of India Regn no. 110

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NOTE: 6. REVIVAL
• In case the claim warrants any additional requirement, the Company If a premium is in default beyond the Grace Period and subject to the
reserves the right to call for the same. Policy not having been surrendered, it may be revived, within five years
• Notification of claim & submission of the claim requirements does not after the due date of the first unpaid premium and before maturity subject
mean admission of the claim liability by the Company. to: (i) Your written application for revival; (ii) production of Insured’s current
No agent is authorized to admit any liabilities on behalf of the Company, health certificate and other evidence of insurability satisfactory to Us; (iii)
nor to alter this list of documents or any claims requirements called for by payment of all overdue premiums with interest.
the Company. Interest on premiums will be compounded at an annual rate which We
11.2. Claims Intimation Process shall determine.
Please inform the company immediately upon occurrence of death. Any evidence of insurability requested at the time of revival will be based
on the prevailing underwriting guidelines duly approved by the Board.
A claim can be made through any of the following avenues:-
a. Online at www.tataaia.com Any revival shall only cover loss or Insured event which occurs after the
Revival Date.
b. Email - Customercare@tataaia.com
The applicable interest rate for revival is determined using the State Bank
c. Call our helpline number 1-860-266-9966 (local charges apply)
of India (SBI) [or any other public sector undertaking bank] domestic term
d. Walk into any of the Company branch office deposit rate (for tenure ‘1 year to less than 2 years’), plus 2% and will be
e. Write directly to us on following address: reviewed semi annually. The current interest rate on revival from 1st
Tata AIA Life Insurance Company Limited October 2019 is 8.50% simple p.a. (i.e. SBI interest rate of 6.50% + 2%)
B - Wing, 9th Floor, I-Think Techno Campus, Behind TCS, Pokhran 7. LOAN
Road No.2, Close to Eastern Express Highway, Thane (West) – 400
607, Maharashtra. Loan is not available under this Policy.
12. TAXES E. NON FORFEITURE PROVISIONS
All Premiums, Charges, and interest payable under the policy are exclusive No Surrender Benefit is available under this product for Regular Pay.
of applicable taxes, duties, surcharge, cesses or levies which will be However, if Single Pay/Limited Pay/Pay to 60 payment option is chosen,
entirely borne/ paid by the Policyholder, in addition to the payment of such the policy can be surrendered any time during the policy term and the
Premium, charges or interest. Tata AIA Life shall have the right to claim, surrender benefit payable (if any) is as follows:
deduct, adjust and recover the amount of any applicable tax or imposition,
levied by any statutory or administrative body, from the benefits payable For Single Pay policies, Surrender Value = 75% * (Policy term less policy
under the Policy. duration in complete years)/Policy Term * Single premium
13. FREE LOOK PERIOD For Limited Pay policies (Including Premium Payment Terms 5/10/12 years
and “Pay to Age 60”), Surrender Value = Surrender Value Factor (% as per
If you are not satisfied with the terms & conditions/features of the policy, Annexure A) * Annualised Premium.
you have the right to cancel the policy by providing a written notice to the
Company stating objections/reasons and receive the refund of all CONSUMER INFORMATION
premiums paid without interest after deducting stamp duty and medical POLICYHOLDER'S SERVICING
examination cost along with applicable taxes, cesses and levies which
With regards to any query or issue related to the Policy, the Policyholder
have been incurred for issuing the policy. Such notice must be signed by
you and received directly by the Company within 15 days from the date of can contact the Company through the following service avenues
receipt of the policy document by you or person authorized by you. The • Contact your Tata AIA Life agent / distributor
said period of 15 days shall stand extended to 30 days, if the policy is
• Call our helpline number at 1-860-266-9966 (local charges apply)
sourced through distance marketing or electronic mode, which includes
solicitation through any means of communication other than in person. • E-mail us at customercare@tataaia.com
14. CHANGE IN BASIC SUM ASSURED • Visit the nearest the Tata AIA Life branch or CAMS Service Center
Increase / Decrease in Basic Sum Assured is not allowed in this Policy. • Log on to Online Customer Portal by visiting www.tataaia.com
15. CHANGE IN ADDRESS OF POLICYHOLDER OR NOMINEE • Write to Us at: B-Wing, 9th Floor, I-Think Techno Campus, Behind
In order to provide You better services, We request You to intimate us in TCS, Pokhran Road No.2, Close to Eastern Express Highway,
the event of any change in the address of the Policyholder or the nominee. Thane (West) – 400 607, Maharashtra.
D. PROVISIONS GRIEVANCE REDRESSAL PROCEDURE
1. PAYMENT 1) Resolution of Grievances
a. All premiums are payable on or before their due dates to us either Customers can register their grievances through multiple service avenues:
at our issuing office or to our authorized Officer or Cashier.
• Call our helpline number at 1-860-266-9966 (local call charges apply)
b. Collection of advance premium shall be allowed, if the premium is
collected within the same financial year. • Email us at life.complaints@tataaia.com
c. The Premium so collected in advance shall only be adjusted on the • Login to online policy account on www.tataaia.com
due date of the premium. • Visit any of the nearest Tata AIA Life branches or CAMS Service Centers
2. CHANGE OF FREQUENCY OF PREMIUM PAYMENT • Contact your Tata AIA Life agent / distributor
You may change the frequency of premium payments by written request. • Write to us on the following address:
Subject to our minimum premium requirements, premiums may be paid on
an annual, semi-annual, quarterly or monthly mode at the premium rates Grievance Redressal Department Tata AIA Life Insurance Company
applicable on the Issue Date. Limited - B- wing, 9th Floor, I-Think Techno Campus, Behind TCS,
3. DEFAULT Pokhran Road No.2, Close to Eastern Express Highway, Thane (West)
– 400 607, Maharashtra.
After payment of the first premium, failure to pay a subsequent premium on
or before its due date will constitute a default in premium payment. - We shall acknowledge a customer's grievance within 3 business
4. GRACE PERIOD days by providing the customer with the name of the Grievance
Redressal Executive who is responsible to handle the grievance.
A Grace Period of fifteen (15) days for monthly mode and thirty (30) days
for all other modes, from the due date will be allowed for payment of each - We shall provide the customer with an equitable resolution within
subsequent premium. The Policy will remain in force during this period. If 2 weeks of receipt of the grievance.
any premium remains unpaid at the end of its Grace Period, the Policy shall
- In case customers wishes to contact us during the course of the
lapse and have no further value except as may be provided under the
Non-Forfeiture Provisions. assessment, they can contact us at any of the above mentioned
touch points.
5. DEDUCTION OF PREMIUM AT CLAIM
- All Tata AIA Life branches have a Grievance Redressal Officer
If a claim is payable under this Policy, any balance of the premiums due for
the full policy year in which death occurs shall be deducted from the who can be contacted for any support during the grievance
proceeds payable under the Policy. redressal process

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2) Escalation Mechanism the escalation above, the customer may represent the case to the
In case customers are not satisfied with the decision of the above offices, Ombudsman for Redressal of the grievance, if it pertains to the following:
or has not received any response within the stipulated timelines, they may - Delay in settlement of claim
contact the following officials for resolution: - Partial or total rejection of claim;
• 1st level of Escalation: Head - Customer Service - Dispute with regard to premium;
• 2nd level of Escalation: Grievance Redressal Officer (GRO) - Misrepresentation of policy terms and conditions;
For escalations, customers can email to - Legal construction of the policy in so far as dispute related to claim;
head.customerservice@tataaia.com or write to – Tata AIA Life - Grievance relating to policy servicing;
Insurance Company Limited,
B-Wing, 9th Floor, I-Think Techno Campus, Behind TCS, Pokhran Road - Issuance of policy which is not in conformity with proposal form;
No.2, Close to Eastern Express Highway, Thane (West) – 400 607, - Non- issuance of your insurance document; and
Maharashtra. - Any other matter resulting from the violation of provisions of the
We request our customers to follow the escalation mechanism in case of Insurance Act, 1938 or the regulations, circulars, guidelines or
non-receipt of response or unsatisfactory response from the concerned instructions issued by the IRDAI from time to time or the terms and
persons mentioned above. conditions of the policy contract, in so far as they relate to issues
If you are not satisfied with the response or do not receive a response from mentioned hereinabove.
us within 15 days, you may approach the Grievance Cell of the Insurance Please refer to our website www.tataaia.com for further details in this regard.
Regulatory and Development Authority of India (IRDAI) on the following The list of Ombudsman address is attached as Annexure B
contact details:
The complaint should be made in writing duly signed by the complainant
IRDAI Grievance Call Centre (IGCC) TOLL FREE NO:155255 or
or through his legal heirs, nominee or assignee, and shall state clearly the
1800 4254 732
name and address of the complainant, the name of the branch or office of
Email ID: complaints@irdai.gov.in the insurer against whom the complaint is made, the facts giving rise to the
You can also register your complaint online at complaint, supported by documents, the nature and extent of the loss
http://www.igms.irda.gov.in/ caused to the complainant and the relief sought from the Insurance
Address for communication for complaints by fax/paper: Ombudsman. As per provision 14(3) of the Insurance Ombudsman Rules,
Consumer Affairs Department - Grievance Redressal Cell 2017; the complaint to the Ombudsman can be made:
Insurance Regulatory and Development Authority of India • Only if the grievance has been rejected by the Grievance Redressal
Machinery of the Insurer; or
Sy.No.115/1, Financial District, Nanakramguda, Gachibowli,
Hyderabad – 500 032. • the complainant had not received any reply within a period of one
month after the Insurer received his representation; or
3) Insurance Ombudsman:
Where the redressal provided by the Company is not satisfactory despite • the complainant is not satisfied with the reply given to him by the Insurer.

ANNEXURE A
SURRENDER VALUE FACTORS (%)
Surrender Value Factors: 5 Pay
Year \
Term 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 10 10 10 10 10 25 25 25 25 25 35 35 35 35 35 45 45
4 15 50 50 50 50 50 65 65 65 65 65 80 80 80 80 80 90 90
5 50 85 85 85 85 85 105 105 105 105 105 120 120 120 120 120 130 130
6 40 80 80 80 80 80 100 100 100 100 100 115 115 115 115 115 130 130
7 35 70 70 70 70 70 95 95 95 95 95 115 115 115 115 115 125 125
8 25 65 65 65 65 65 90 90 90 90 90 110 110 110 110 110 125 125
9 10 60 60 60 60 60 90 90 90 90 90 110 110 110 110 110 120 120
10 0 50 50 50 50 50 85 85 85 85 85 105 105 105 105 105 120 120
11 0 40 40 40 40 75 75 75 75 75 100 100 100 100 100 120 120
12 0 30 30 30 70 70 70 70 70 100 100 100 100 100 115 115
13 0 25 25 65 65 65 65 65 95 95 95 95 95 110 110
14 0 10 60 60 60 60 60 90 90 90 90 90 110 110
15 0 50 50 50 50 50 85 85 85 85 85 105 105
16 0 40 40 40 40 80 80 80 80 80 105 105
17 0 35 35 35 75 75 75 75 75 100 100
18 0 25 25 65 65 65 65 65 95 95
19 0 10 60 60 60 60 60 90 90
20 0 50 50 50 50 50 85 85
21 0 45 45 45 45 80 80
22 0 35 35 35 70 70
23 0 25 25 65 65
24 0 10 60 60
25 0 50 50
26 0 40
27 0
Year \
Term 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5
3 45 45 45 50 50 50 50 50 50 50 50 50 50 50 50 50 50 50
4 90 90 90 95 95 95 95 95 95 95 95 95 95 95 95 95 95 95
5 130 130 130 140 140 140 140 140 140 140 140 140 140 140 140 140 140 140
6 130 130 130 140 140 140 140 140 140 140 140 140 140 140 140 140 140 140
7 125 125 125 135 135 135 135 135 140 140 140 140 140 140 140 140 140 140

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Year \
Term 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
8 125 125 125 135 135 135 135 135 135 135 135 135 135 140 140 140 140 140
9 120 120 120 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135
10 120 120 120 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135
11 120 120 120 130 130 130 130 130 135 135 135 135 135 135 135 135 135 135
12 115 115 115 130 130 130 130 130 135 135 135 135 135 135 135 135 135 135
13 110 110 110 130 130 130 130 130 130 130 130 130 130 135 135 135 135 135
14 110 110 110 125 125 125 125 125 130 130 130 130 130 135 135 135 135 135
15 105 105 105 125 125 125 125 125 130 130 130 130 130 130 130 130 130 130
16 105 105 105 120 120 120 120 120 125 125 125 125 125 130 130 130 130 130
17 100 100 100 120 120 120 120 120 125 125 125 125 125 130 130 130 130 130
18 95 95 95 115 115 115 115 115 125 125 125 125 125 130 130 130 130 130
19 90 90 90 110 110 110 110 110 120 120 120 120 120 125 125 125 125 125
20 85 85 85 110 110 110 110 110 120 120 120 120 120 125 125 125 125 125
21 80 80 80 105 105 105 105 105 115 115 115 115 115 125 125 125 125 125
22 70 70 70 100 100 100 100 100 115 115 115 115 115 120 120 120 120 120
23 65 65 65 95 95 95 95 95 110 110 110 110 110 120 120 120 120 120
24 60 60 60 90 90 90 90 90 105 105 105 105 105 115 115 115 115 115
25 50 50 50 85 85 85 85 85 105 105 105 105 105 115 115 115 115 115
26 40 40 40 80 80 80 80 80 100 100 100 100 100 110 110 110 110 110
27 30 30 30 70 70 70 70 70 95 95 95 95 95 110 110 110 110 110
28 0 20 20 65 65 65 65 65 90 90 90 90 90 105 105 105 105 105
29 0 10 55 55 55 55 55 85 85 85 85 85 105 105 105 105 105
30 0 50 50 50 50 50 80 80 80 80 80 100 100 100 100 100
31 0 40 40 40 40 75 75 75 75 75 95 95 95 95 95
32 0 30 30 30 70 70 70 70 70 90 90 90 90 90
33 0 20 20 60 60 60 60 60 85 85 85 85 85
34 0 10 55 55 55 55 55 80 80 80 80 80
35 0 45 45 45 45 45 75 75 75 75 75
36 0 40 40 40 40 70 70 70 70 70
37 0 30 30 30 65 65 65 65 65
38 0 20 20 60 60 60 60 60
39 0 10 55 55 55 55 55
40 0 45 45 45 45 45
41 0 40 40 40 40
42 0 30 30 30
43 0 20 20
44 0 10
45 0
Year \
Term 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 5 5 5 5 5 25 25 25 25 25 30 30 30 30 30 30 30 30
3 50 50 50 50 50 70 70 70 70 70 85 85 85 85 85 100 100 100
4 95 95 95 95 95 120 120 120 120 120 135 135 135 135 135 150 150 150
5 145 145 145 145 145 165 165 165 165 165 180 180 180 180 180 195 195 195
6 145 145 145 145 145 165 165 165 165 165 180 180 180 180 180 195 195 195
7 145 145 145 145 145 165 165 165 165 165 180 180 180 180 180 195 195 195
8 145 145 145 145 145 165 165 165 165 165 180 180 180 180 180 195 195 195
9 145 145 145 145 145 165 165 165 165 165 180 180 180 180 180 195 195 195
10 145 145 145 145 145 165 165 165 165 165 180 180 180 180 180 195 195 195
11 140 140 140 140 140 165 165 165 165 165 180 180 180 180 180 195 195 195
12 140 140 140 140 140 165 165 165 165 165 180 180 180 180 180 195 195 195
13 140 140 140 140 140 160 160 160 160 160 175 175 175 175 175 185 185 185
14 140 140 140 140 140 160 160 160 160 160 175 175 175 175 175 185 185 185
15 140 140 140 140 140 160 160 160 160 160 175 175 175 175 175 185 185 185
16 140 140 140 140 140 160 160 160 160 160 175 175 175 175 175 185 185 185
17 140 140 140 140 140 160 160 160 160 160 175 175 175 175 175 185 185 185
18 135 135 135 135 135 160 160 160 160 160 175 175 175 175 175 185 185 185
19 135 135 135 135 135 160 160 160 160 160 175 175 175 175 175 185 185 185
20 135 135 135 135 135 160 160 160 160 160 175 175 175 175 175 185 185 185
21 135 135 135 135 135 155 155 155 155 155 165 165 165 165 165 180 180 180
22 130 130 130 130 130 155 155 155 155 155 165 165 165 165 165 180 180 180
23 130 130 130 130 130 155 155 155 155 155 165 165 165 165 165 180 180 180
24 130 130 130 130 130 155 155 155 155 155 165 165 165 165 165 180 180 180
25 130 130 130 130 130 155 155 155 155 155 165 165 165 165 165 180 180 180
26 125 125 125 125 125 150 150 150 150 150 160 160 160 160 160 170 170 170
27 125 125 125 125 125 150 150 150 150 150 160 160 160 160 160 170 170 170
28 120 120 120 120 120 150 150 150 150 150 160 160 160 160 160 170 170 170
29 120 120 120 120 120 145 145 145 145 145 155 155 155 155 155 160 160 160
30 115 115 115 115 115 145 145 145 145 145 155 155 155 155 155 160 160 160
31 115 115 115 115 115 145 145 145 145 145 155 155 155 155 155 160 160 160

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Year \
Term 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63
32 110 110 110 110 110 140 140 140 140 140 145 145 145 145 145 155 155 155
33 110 110 110 110 110 140 140 140 140 140 145 145 145 145 145 155 155 155
34 105 105 105 105 105 135 135 135 135 135 140 140 140 140 140 145 145 145
35 105 105 105 105 105 135 135 135 135 135 140 140 140 140 140 145 145 145
36 100 100 100 100 100 130 130 130 130 130 135 135 135 135 135 140 140 140
37 95 95 95 95 95 130 130 130 130 130 135 135 135 135 135 140 140 140
38 90 90 90 90 90 125 125 125 125 125 130 130 130 130 130 135 135 135
39 85 85 85 85 85 125 125 125 125 125 130 130 130 130 130 135 135 135
40 80 80 80 80 80 120 120 120 120 120 125 125 125 125 125 130 130 130
41 75 75 75 75 75 115 115 115 115 115 120 120 120 120 120 120 120 120
42 70 70 70 70 70 110 110 110 110 110 115 115 115 115 115 115 115 115
43 65 65 65 65 65 110 110 110 110 110 115 115 115 115 115 115 115 115
44 60 60 60 60 60 105 105 105 105 105 110 110 110 110 110 110 110 110
45 50 50 50 50 50 100 100 100 100 100 105 105 105 105 105 105 105 105
46 0 45 45 45 45 90 90 90 90 90 95 95 95 95 95 95 95 95
47 0 35 35 35 85 85 85 85 85 90 90 90 90 90 90 90 90
48 0 25 25 80 80 80 80 80 85 85 85 85 85 90 90 90
49 0 10 70 70 70 70 70 75 75 75 75 75 80 80 80
50 0 60 60 60 60 60 65 65 65 65 65 70 70 70
51 0 50 50 50 50 60 60 60 60 60 65 65 65
52 0 40 40 40 50 50 50 50 50 60 60 60
53 0 30 30 40 40 40 40 40 55 55 55
54 0 15 30 30 30 30 30 45 45 45
55 0 25 25 25 25 25 40 40 40
56 0 20 20 20 20 35 35 35
57 0 20 20 20 30 30 30
58 0 15 15 25 25 25
59 0 5 20 20 20
60 0 15 15 15
61 0 15 15
62 0 10
63 0

Year \
Term 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 30 30 30 30 30 30 30 115 115 115 115 115 115 115 115 115 115 115 115
3 100 100 100 100 100 100 100 165 165 165 165 165 165 165 165 165 165 165 165
4 150 150 150 150 150 150 150 210 210 210 210 210 210 210 210 210 210 210 210
5 195 195 195 195 195 195 195 210 210 210 210 210 210 210 210 210 210 210 210
6 195 195 195 195 195 195 195 210 210 210 210 210 210 210 210 210 210 210 210
7 195 195 195 195 195 195 195 210 210 210 210 210 210 210 210 210 210 210 210
8 195 195 195 195 195 195 195 210 210 210 210 210 210 210 210 210 210 210 210
9 195 195 195 195 195 195 195 210 210 210 210 210 210 210 210 210 210 210 210
10 195 195 195 195 195 195 195 210 210 210 210 210 210 210 210 210 210 210 210
11 195 195 195 195 195 195 195 210 210 210 210 210 210 210 210 210 210 210 210
12 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195 195
13 185 185 185 185 185 185 185 195 195 195 195 195 195 195 195 195 195 195 195
14 185 185 185 185 185 185 185 195 195 195 195 195 195 195 195 195 195 195 195
15 185 185 185 185 185 185 185 195 195 195 195 195 195 195 195 195 195 195 195
16 185 185 185 185 185 185 185 195 195 195 195 195 195 195 195 195 195 195 195
17 185 185 185 185 185 185 185 195 195 195 195 195 195 195 195 195 195 195 195
18 185 185 185 185 185 185 185 195 195 195 195 195 195 195 195 195 195 195 195
19 185 185 185 185 185 185 185 195 195 195 195 195 195 195 195 195 195 195 195
20 185 185 185 185 185 185 185 190 190 190 190 190 190 190 190 190 190 190 190
21 180 180 180 180 180 180 180 190 190 190 190 190 190 190 190 190 190 190 190
22 180 180 180 180 180 180 180 190 190 190 190 190 190 190 190 190 190 190 190
23 180 180 180 180 180 180 180 190 190 190 190 190 190 190 190 190 190 190 190
24 180 180 180 180 180 180 180 190 190 190 190 190 190 190 190 190 190 190 190
25 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180 180
26 170 170 170 170 170 170 170 180 180 180 180 180 180 180 180 180 180 180 180
27 170 170 170 170 170 170 170 180 180 180 180 180 180 180 180 180 180 180 180
28 170 170 170 170 170 170 170 165 165 165 165 165 165 165 165 165 165 165 165
29 160 160 160 160 160 160 160 165 165 165 165 165 165 165 165 165 165 165 165
30 160 160 160 160 160 160 160 165 165 165 165 165 165 165 165 165 165 165 165
31 160 160 160 160 160 160 160 160 160 160 160 160 160 160 160 160 160 160 160
32 155 155 155 155 155 155 155 160 160 160 160 160 160 160 160 160 160 160 160
33 155 155 155 155 155 155 155 150 150 150 150 150 150 150 150 150 150 150 150
34 145 145 145 145 145 145 145 150 150 150 150 150 150 150 150 150 150 150 150
35 145 145 145 145 145 145 145 145 145 145 145 145 145 145 145 145 145 145 145
36 140 140 140 140 140 140 140 145 145 145 145 145 145 145 145 145 145 145 145
37 140 140 140 140 140 140 140 140 140 140 140 140 140 140 140 140 140 140 140

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 Year \
Term 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82
38 135 135 135 135 135 135 135 140 140 140 140 140 140 140 140 140 140 140 140
39 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135
40 130 130 130 130 130 130 130 125 125 125 125 125 125 125 125 125 125 125 125
41 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120 120
42 115 115 115 115 115 115 115 120 120 120 120 120 120 120 120 120 120 120 120
43 115 115 115 115 115 115 115 115 115 115 115 115 115 115 115 115 115 115 115
44 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110 110
45 105 105 105 105 105 105 105 100 100 100 100 100 100 100 100 100 100 100 100
46 95 95 95 95 95 95 95 95 95 95 95 95 95 95 95 95 95 95 95
47 90 90 90 90 90 90 90 95 95 95 95 95 95 95 95 95 95 95 95
48 90 90 90 90 90 90 90 85 85 85 85 85 85 85 85 85 85 85 85
49 80 80 80 80 80 80 80 75 75 75 75 75 75 75 75 75 75 75 75
50 70 70 70 70 70 70 70 70 70 70 70 70 70 70 70 70 70 70 70
51 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65 65
52 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60
53 55 55 55 55 55 55 55 50 50 50 50 50 50 50 50 50 50 50 50
54 45 45 45 45 45 45 45 45 45 45 45 45 45 45 45 45 45 45 45
55 40 40 40 40 40 40 40 40 40 40 40 40 40 40 40 40 40 40 40
56 35 35 35 35 35 35 35 35 35 35 35 35 35 35 35 35 35 35 35
57 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30
58 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25
59 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20
60 15 15 15 15 15 15 15 20 20 20 20 20 20 20 20 20 20 20 20
61 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15 15
62 10 10 10 10 10 10 10 15 15 15 15 15 15 15 15 15 15 15 15
63 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
64 0 5 5 5 5 5 5 10 10 10 10 10 10 10 10 10 10 10 10
65 0 5 5 5 5 5 10 10 10 10 10 10 10 10 10 10 10 10
66 0 5 5 5 5 10 10 10 10 10 10 10 10 10 10 10 10
67 0 5 5 5 10 10 10 10 10 10 10 10 10 10 10 10
68 0 5 5 10 10 10 10 10 10 10 10 10 10 10 10
69 0 5 5 5 5 5 5 5 5 5 5 5 5 5
70 0 5 5 5 5 5 5 5 5 5 5 5 5
71 0 5 5 5 5 5 5 5 5 5 5 5
72 0 5 5 5 5 5 5 5 5 5 5
73 0 5 5 5 5 5 5 5 5 5
74 0 5 5 5 5 5 5 5 5
75 0 5 5 5 5 5 5 5
76 0 5 5 5 5 5 5
77 0 5 5 5 5 5
78 0 5 5 5 5
79 0 5 5 5
80 0 5 5
81 0 5
82 0

SURRENDER VALUE FACTORS (%)

Surrender Value Factors: 10 Pay
Year \
Term 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
1 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 0 0 0 0 0 5 5 5 5 5 20 20
6 0 15 15 15 15 15 40 40 40 40 40 50 50
7 10 45 45 45 45 45 70 70 70 70 70 85 85
8 30 70 70 70 70 70 95 95 95 95 95 115 115
9 50 95 95 95 95 95 125 125 125 125 125 145 145
10 70 115 115 115 115 115 155 155 155 155 155 180 180
11 60 105 105 105 105 105 150 150 150 150 150 175 175
12 45 100 100 100 100 100 145 145 145 145 145 175 175
13 35 90 90 90 90 90 140 140 140 140 140 170 170
14 15 80 80 80 80 80 130 130 130 130 130 165 165
15 0 70 70 70 70 70 125 125 125 125 125 160 160
16 0 60 60 60 60 115 115 115 115 115 155 155
17 0 45 45 45 110 110 110 110 110 150 150
18 0 35 35 100 100 100 100 100 140 140
19 0 15 90 90 90 90 90 135 135
20 0 75 75 75 75 75 125 125
21 0 65 65 65 65 120 120

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Year \
Term 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
22 0 50 50 50 110 110
23 0 35 35 100 100
24 0 20 90 90
25 0 75 75
26 0 60
27 0
Year \
Term 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 5 5 5 5 5
5 20 20 20 25 25 25 25 25 30 30 30 30 30 40 40 40 40 40
6 50 50 50 60 60 60 60 60 65 65 65 65 65 80 80 80 80 80
7 85 85 85 95 95 95 95 95 100 100 100 100 100 115 115 115 115 115
8 115 115 115 125 125 125 125 125 135 135 135 135 135 150 150 150 150 150
9 145 145 145 160 160 160 160 160 170 170 170 170 170 185 185 185 185 185
10 180 180 180 195 195 195 195 195 205 205 205 205 205 225 225 225 225 225
11 175 175 175 195 195 195 195 195 205 205 205 205 205 225 225 225 225 225
12 175 175 175 190 190 190 190 190 200 200 200 200 200 220 220 220 220 220
13 170 170 170 185 185 185 185 185 200 200 200 200 200 220 220 220 220 220
14 165 165 165 185 185 185 185 185 200 200 200 200 200 220 220 220 220 220
15 160 160 160 180 180 180 180 180 195 195 195 195 195 220 220 220 220 220
16 155 155 155 175 175 175 175 175 195 195 195 195 195 215 215 215 215 215
17 150 150 150 175 175 175 175 175 190 190 190 190 190 215 215 215 215 215
18 140 140 140 170 170 170 170 170 185 185 185 185 185 210 210 210 210 210
19 135 135 135 165 165 165 165 165 185 185 185 185 185 210 210 210 210 210
20 125 125 125 160 160 160 160 160 180 180 180 180 180 205 205 205 205 205
21 120 120 120 155 155 155 155 155 175 175 175 175 175 205 205 205 205 205
22 110 110 110 145 145 145 145 145 170 170 170 170 170 200 200 200 200 200
23 100 100 100 140 140 140 140 140 165 165 165 165 165 195 195 195 195 195
24 90 90 90 130 130 130 130 130 160 160 160 160 160 195 195 195 195 195
25 75 75 75 125 125 125 125 125 155 155 155 155 155 190 190 190 190 190
26 60 60 60 115 115 115 115 115 150 150 150 150 150 185 185 185 185 185
27 50 50 50 105 105 105 105 105 145 145 145 145 145 180 180 180 180 180
28 0 35 35 95 95 95 95 95 135 135 135 135 135 175 175 175 175 175
29 0 15 85 85 85 85 85 130 130 130 130 130 170 170 170 170 170
30 0 75 75 75 75 75 120 120 120 120 120 165 165 165 165 165
31 0 60 60 60 60 115 115 115 115 115 160 160 160 160 160
32 0 45 45 45 105 105 105 105 105 150 150 150 150 150
33 0 30 30 95 95 95 95 95 145 145 145 145 145
34 0 15 85 85 85 85 85 135 135 135 135 135
35 0 70 70 70 70 70 130 130 130 130 130
36 0 60 60 60 60 120 120 120 120 120
37 0 45 45 45 110 110 110 110 110
38 0 30 30 100 100 100 100 100
39 0 15 90 90 90 90 90
40 0 75 75 75 75 75
41 0 65 65 65 65
42 0 50 50 50
43 0 35 35
44 0 20
45 0
Year \
Term 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 15 15 15 15 15 20 20 20 20 20 25 25 25 25 25 25 25 25
5 55 55 55 55 55 55 55 55 55 55 65 65 65 65 65 75 75 75
6 95 95 95 95 95 95 95 95 95 95 105 105 105 105 105 115 115 115
7 130 130 130 130 130 135 135 135 135 135 150 150 150 150 150 160 160 160
8 170 170 170 170 170 175 175 175 175 175 190 190 190 190 190 205 205 205
9 205 205 205 205 205 210 210 210 210 210 225 225 225 225 225 240 240 240
10 245 245 245 245 245 250 250 250 250 250 265 265 265 265 265 280 280 280
11 245 245 245 245 245 250 250 250 250 250 265 265 265 265 265 280 280 280
12 245 245 245 245 245 250 250 250 250 250 265 265 265 265 265 280 280 280
13 240 240 240 240 240 250 250 250 250 250 265 265 265 265 265 280 280 280
14 240 240 240 240 240 250 250 250 250 250 265 265 265 265 265 280 280 280
15 240 240 240 240 240 245 245 245 245 245 255 255 255 255 255 265 265 265
16 240 240 240 240 240 245 245 245 245 245 255 255 255 255 255 265 265 265

Tata AIA Life Insurance Maha Raksha Supreme (UIN: 110N102V03) • IRDA of India Regn no. 110

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Year \
Term 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63
17 235 235 235 235 235 245 245 245 245 245 255 255 255 255 255 265 265 265
18 235 235 235 235 235 245 245 245 245 245 255 255 255 255 255 265 265 265
19 235 235 235 235 235 245 245 245 245 245 255 255 255 255 255 265 265 265
20 230 230 230 230 230 240 240 240 240 240 245 245 245 245 245 255 255 255
21 230 230 230 230 230 240 240 240 240 240 245 245 245 245 245 255 255 255
22 230 230 230 230 230 240 240 240 240 240 245 245 245 245 245 255 255 255
23 225 225 225 225 225 240 240 240 240 240 245 245 245 245 245 255 255 255
24 225 225 225 225 225 235 235 235 235 235 240 240 240 240 240 245 245 245
25 220 220 220 220 220 235 235 235 235 235 240 240 240 240 240 245 245 245
26 215 215 215 215 215 230 230 230 230 230 230 230 230 230 230 230 230 230
27 215 215 215 215 215 230 230 230 230 230 230 230 230 230 230 230 230 230
28 210 210 210 210 210 230 230 230 230 230 230 230 230 230 230 230 230 230
29 205 205 205 205 205 225 225 225 225 225 225 225 225 225 225 225 225 225
30 200 200 200 200 200 225 225 225 225 225 225 225 225 225 225 225 225 225
31 200 200 200 200 200 220 220 220 220 220 220 220 220 220 220 220 220 220
32 195 195 195 195 195 215 215 215 215 215 215 215 215 215 215 215 215 215
33 190 190 190 190 190 215 215 215 215 215 215 215 215 215 215 215 215 215
34 185 185 185 185 185 210 210 210 210 210 210 210 210 210 210 210 210 210
35 175 175 175 175 175 205 205 205 205 205 205 205 205 205 205 205 205 205
36 170 170 170 170 170 205 205 205 205 205 205 205 205 205 205 205 205 205
37 165 165 165 165 165 200 200 200 200 200 200 200 200 200 200 200 200 200
38 155 155 155 155 155 195 195 195 195 195 195 195 195 195 195 195 195 195
39 150 150 150 150 150 190 190 190 190 190 190 190 190 190 190 190 190 190
40 140 140 140 140 140 185 185 185 185 185 185 185 185 185 185 185 185 185
41 130 130 130 130 130 180 180 180 180 180 180 180 180 180 180 180 180 180
42 120 120 120 120 120 170 170 170 170 170 170 170 170 170 170 170 170 170
43 110 110 110 110 110 165 165 165 165 165 165 165 165 165 165 165 165 165
44 100 100 100 100 100 160 160 160 160 160 160 160 160 160 160 160 160 160
45 85 85 85 85 85 150 150 150 150 150 150 150 150 150 150 150 150 150
46 0 75 75 75 75 140 140 140 140 140 140 140 140 140 140 140 140 140
47 0 60 60 60 130 130 130 130 130 130 130 130 130 130 130 130 130
48 0 40 40 120 120 120 120 120 120 120 120 120 120 120 120 120
49 0 20 110 110 110 110 110 110 110 110 110 110 110 110 110
50 0 95 95 95 95 95 95 95 95 95 95 95 95 95
51 0 80 80 80 80 80 80 80 80 80 80 80 80
52 0 65 65 65 70 70 70 70 70 70 70 70
53 0 45 45 50 50 50 50 50 60 60 60
54 0 25 35 35 35 35 35 45 45 45
55 0 30 30 30 30 30 40 40 40
56 0 25 25 25 25 35 35 35
57 0 20 20 20 30 30 30
58 0 15 15 20 20 20
59 0 10 15 15 15
60 0 15 15 15
61 0 10 10
62 0 10
63 0
Year \
Term 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 25 25 25 25 25 25 25 30 30 30 30 30 30 30 30 30 30 30 30
5 75 75 75 75 75 75 75 90 90 90 90 90 90 90 90 90 90 90 90
6 115 115 115 115 115 115 115 130 130 130 130 130 130 130 130 130 130 130 130
7 160 160 160 160 160 160 160 175 175 175 175 175 175 175 175 175 175 175 175
8 205 205 205 205 205 205 205 220 220 220 220 220 220 220 220 220 220 220 220
9 240 240 240 240 240 240 240 255 255 255 255 255 255 255 255 255 255 255 255
10 280 280 280 280 280 280 280 295 295 295 295 295 295 295 295 295 295 295 295
11 280 280 280 280 280 280 280 295 295 295 295 295 295 295 295 295 295 295 295
12 280 280 280 280 280 280 280 295 295 295 295 295 295 295 295 295 295 295 295
13 280 280 280 280 280 280 280 295 295 295 295 295 295 295 295 295 295 295 295
14 280 280 280 280 280 280 280 295 295 295 295 295 295 295 295 295 295 295 295
15 265 265 265 265 265 265 265 275 275 275 275 275 275 275 275 275 275 275 275
16 265 265 265 265 265 265 265 275 275 275 275 275 275 275 275 275 275 275 275
17 265 265 265 265 265 265 265 275 275 275 275 275 275 275 275 275 275 275 275
18 265 265 265 265 265 265 265 275 275 275 275 275 275 275 275 275 275 275 275
19 265 265 265 265 265 265 265 275 275 275 275 275 275 275 275 275 275 275 275
20 255 255 255 255 255 255 255 265 265 265 265 265 265 265 265 265 265 265 265
21 255 255 255 255 255 255 255 265 265 265 265 265 265 265 265 265 265 265 265
22 255 255 255 255 255 255 255 265 265 265 265 265 265 265 265 265 265 265 265

Tata AIA Life Insurance Maha Raksha Supreme (UIN: 110N102V03) • IRDA of India Regn no. 110

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Year \
Term 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82
23 255 255 255 255 255 255 255 265 265 265 265 265 265 265 265 265 265 265 265
24 245 245 245 245 245 245 245 255 255 255 255 255 255 255 255 255 255 255 255
25 245 245 245 245 245 245 245 255 255 255 255 255 255 255 255 255 255 255 255
26 230 230 230 230 230 230 230 240 240 240 240 240 240 240 240 240 240 240 240
27 230 230 230 230 230 230 230 240 240 240 240 240 240 240 240 240 240 240 240
28 230 230 230 230 230 230 230 240 240 240 240 240 240 240 240 240 240 240 240
29 225 225 225 225 225 225 225 235 235 235 235 235 235 235 235 235 235 235 235
30 225 225 225 225 225 225 225 235 235 235 235 235 235 235 235 235 235 235 235
31 220 220 220 220 220 220 220 225 225 225 225 225 225 225 225 225 225 225 225
32 215 215 215 215 215 215 215 220 220 220 220 220 220 220 220 220 220 220 220
33 215 215 215 215 215 215 215 220 220 220 220 220 220 220 220 220 220 220 220
34 210 210 210 210 210 210 210 215 215 215 215 215 215 215 215 215 215 215 215
35 205 205 205 205 205 205 205 210 210 210 210 210 210 210 210 210 210 210 210
36 205 205 205 205 205 205 205 210 210 210 210 210 210 210 210 210 210 210 210
37 200 200 200 200 200 200 200 205 205 205 205 205 205 205 205 205 205 205 205
38 195 195 195 195 195 195 195 200 200 200 200 200 200 200 200 200 200 200 200
39 190 190 190 190 190 190 190 195 195 195 195 195 195 195 195 195 195 195 195
40 185 185 185 185 185 185 185 190 190 190 190 190 190 190 190 190 190 190 190
41 180 180 180 180 180 180 180 185 185 185 185 185 185 185 185 185 185 185 185
42 170 170 170 170 170 170 170 175 175 175 175 175 175 175 175 175 175 175 175
43 165 165 165 165 165 165 165 170 170 170 170 170 170 170 170 170 170 170 170
44 160 160 160 160 160 160 160 165 165 165 165 165 165 165 165 165 165 165 165
45 150 150 150 150 150 150 150 155 155 155 155 155 155 155 155 155 155 155 155
46 140 140 140 140 140 140 140 145 145 145 145 145 145 145 145 145 145 145 145
47 130 130 130 130 130 130 130 135 135 135 135 135 135 135 135 135 135 135 135
48 120 120 120 120 120 120 120 125 125 125 125 125 125 125 125 125 125 125 125
49 110 110 110 110 110 110 110 115 115 115 115 115 115 115 115 115 115 115 115
50 95 95 95 95 95 95 95 100 100 100 100 100 100 100 100 100 100 100 100
51 80 80 80 80 80 80 80 85 85 85 85 85 85 85 85 85 85 85 85
52 70 70 70 70 70 70 70 75 75 75 75 75 75 75 75 75 75 75 75
53 60 60 60 60 60 60 60 65 65 65 65 65 65 65 65 65 65 65 65
54 45 45 45 45 45 45 45 50 50 50 50 50 50 50 50 50 50 50 50
55 40 40 40 40 40 40 40 45 45 45 45 45 45 45 45 45 45 45 45
56 35 35 35 35 35 35 35 40 40 40 40 40 40 40 40 40 40 40 40
57 30 30 30 30 30 30 30 35 35 35 35 35 35 35 35 35 35 35 35
58 20 20 20 20 20 20 20 25 25 25 25 25 25 25 25 25 25 25 25
59 15 15 15 15 15 15 15 20 20 20 20 20 20 20 20 20 20 20 20
60 15 15 15 15 15 15 15 20 20 20 20 20 20 20 20 20 20 20 20
61 10 10 10 10 10 10 10 15 15 15 15 15 15 15 15 15 15 15 15
62 10 10 10 10 10 10 10 15 15 15 15 15 15 15 15 15 15 15 15
63 5 5 5 5 5 5 5 10 10 10 10 10 10 10 10 10 10 10 10
64 0 5 5 5 5 5 5 10 10 10 10 10 10 10 10 10 10 10 10
65 0 5 5 5 5 5 10 10 10 10 10 10 10 10 10 10 10 10
66 0 5 5 5 5 10 10 10 10 10 10 10 10 10 10 10 10
67 0 5 5 5 10 10 10 10 10 10 10 10 10 10 10 10
68 0 5 5 10 10 10 10 10 10 10 10 10 10 10 10
69 0 5 10 10 10 10 10 10 10 10 10 10 10 10
70 0 5 5 5 5 5 5 5 5 5 5 5 5
71 0 5 5 5 5 5 5 5 5 5 5 5
72 0 5 5 5 5 5 5 5 5 5 5
73 0 5 5 5 5 5 5 5 5 5
74 0 5 5 5 5 5 5 5 5
75 0 5 5 5 5 5 5 5
76 0 5 5 5 5 5 5
77 0 5 5 5 5 5
78 0 5 5 5 5
79 0 5 5 5
80 0 5 5
81 0 5
82 0

Tata AIA Life Insurance Maha Raksha Supreme (UIN: 110N102V03) • IRDA of India Regn no. 110

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SURRENDER VALUE FACTORS (%)
Surrender Value Factors: 12 Pay
Year \
Term 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
1 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 0 0 0 0 0 5 5 5 5 5 20 20
6 0 15 15 15 15 15 5 5 5 5 5 20 20
7 10 15 15 15 15 15 10 10 10 10 10 25 25
8 10 20 20 20 20 20 45 45 45 45 45 55 55
9 15 50 50 50 50 50 75 75 75 75 75 90 90
10 35 75 75 75 75 75 100 100 100 100 100 120 120
11 55 100 100 100 100 100 130 130 130 130 130 150 150
12 75 120 120 120 120 120 160 160 160 160 160 185 185
13 65 110 110 110 110 110 155 155 155 155 155 180 180
14 50 105 105 105 105 105 150 150 150 150 150 180 180
15 0 95 95 95 95 95 145 145 145 145 145 175 175
16 0 85 85 85 85 135 135 135 135 135 170 170
17 0 75 75 75 130 130 130 130 130 165 165
18 0 65 65 120 120 120 120 120 160 160
19 0 50 115 115 115 115 115 155 155
20 0 105 105 105 105 105 145 145
21 0 95 95 95 95 140 140
22 0 80 80 80 130 130
23 0 70 70 125 125
24 0 55 115 115
25 0 105 105
26 0 95
27 0

Year \
Term 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 5 5 5 5 5
5 20 20 20 25 25 25 25 25 30 30 30 30 30 5 5 5 5 5
6 20 20 20 25 25 25 25 25 30 30 30 30 30 10 10 10 10 10
7 25 25 25 30 30 30 30 30 35 35 35 35 35 45 45 45 45 45
8 55 55 55 65 65 65 65 65 70 70 70 70 70 85 85 85 85 85
9 90 90 90 100 100 100 100 100 105 105 105 105 105 120 120 120 120 120
10 120 120 120 130 130 130 130 130 140 140 140 140 140 155 155 155 155 155
11 150 150 150 165 165 165 165 165 175 175 175 175 175 190 190 190 190 190
12 185 185 185 200 200 200 200 200 210 210 210 210 210 230 230 230 230 230
13 180 180 180 200 200 200 200 200 210 210 210 210 210 230 230 230 230 230
14 180 180 180 195 195 195 195 195 205 205 205 205 205 225 225 225 225 225
15 175 175 175 190 190 190 190 190 205 205 205 205 205 225 225 225 225 225
16 170 170 170 190 190 190 190 190 205 205 205 205 205 225 225 225 225 225
17 165 165 165 185 185 185 185 185 200 200 200 200 200 225 225 225 225 225
18 160 160 160 180 180 180 180 180 200 200 200 200 200 220 220 220 220 220
19 155 155 155 180 180 180 180 180 195 195 195 195 195 220 220 220 220 220
20 145 145 145 175 175 175 175 175 190 190 190 190 190 215 215 215 215 215
21 140 140 140 170 170 170 170 170 190 190 190 190 190 215 215 215 215 215
22 130 130 130 165 165 165 165 165 185 185 185 185 185 210 210 210 210 210
23 125 125 125 160 160 160 160 160 180 180 180 180 180 210 210 210 210 210
24 115 115 115 150 150 150 150 150 175 175 175 175 175 205 205 205 205 205
25 105 105 105 145 145 145 145 145 170 170 170 170 170 200 200 200 200 200
26 95 95 95 135 135 135 135 135 165 165 165 165 165 200 200 200 200 200
27 80 80 80 130 130 130 130 130 160 160 160 160 160 195 195 195 195 195
28 0 65 65 120 120 120 120 120 155 155 155 155 155 190 190 190 190 190
29 0 55 110 110 110 110 110 150 150 150 150 150 185 185 185 185 185
30 0 100 100 100 100 100 140 140 140 140 140 180 180 180 180 180
31 0 90 90 90 90 135 135 135 135 135 175 175 175 175 175
32 0 80 80 80 125 125 125 125 125 170 170 170 170 170
33 0 65 65 120 120 120 120 120 165 165 165 165 165
34 0 50 110 110 110 110 110 155 155 155 155 155
35 0 100 100 100 100 100 150 150 150 150 150
36 0 90 90 90 90 140 140 140 140 140
37 0 75 75 75 135 135 135 135 135
38 0 65 65 125 125 125 125 125
39 0 50 115 115 115 115 115

Tata AIA Life Insurance Maha Raksha Supreme (UIN: 110N102V03) • IRDA of India Regn no. 110

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Year \
Term 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
40 0 105 105 105 105 105
41 0 95 95 95 95
42 0 80 80 80
43 0 70 70
44 0 55
45 0
Year \
Term 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 15 15 15 15 15 20 20 20 20 20 25 25 25 25 25 25 25 25
5 15 15 15 15 15 20 20 20 20 20 25 25 25 25 25 25 25 25
6 20 20 20 20 20 25 25 25 25 25 30 30 30 30 30 30 30 30
7 60 60 60 60 60 60 60 60 60 60 70 70 70 70 70 80 80 80
8 100 100 100 100 100 100 100 100 100 100 110 110 110 110 110 120 120 120
9 135 135 135 135 135 140 140 140 140 140 155 155 155 155 155 165 165 165
10 175 175 175 175 175 180 180 180 180 180 195 195 195 195 195 210 210 210
11 210 210 210 210 210 215 215 215 215 215 230 230 230 230 230 245 245 245
12 250 250 250 250 250 255 255 255 255 255 270 270 270 270 270 285 285 285
13 250 250 250 250 250 255 255 255 255 255 270 270 270 270 270 285 285 285
14 250 250 250 250 250 255 255 255 255 255 270 270 270 270 270 285 285 285
15 245 245 245 245 245 255 255 255 255 255 270 270 270 270 270 285 285 285
16 245 245 245 245 245 255 255 255 255 255 270 270 270 270 270 285 285 285
17 245 245 245 245 245 250 250 250 250 250 260 260 260 260 260 270 270 270
18 245 245 245 245 245 250 250 250 250 250 260 260 260 260 260 270 270 270
19 240 240 240 240 240 250 250 250 250 250 260 260 260 260 260 270 270 270
20 240 240 240 240 240 250 250 250 250 250 260 260 260 260 260 270 270 270
21 240 240 240 240 240 250 250 250 250 250 260 260 260 260 260 270 270 270
22 235 235 235 235 235 245 245 245 245 245 250 250 250 250 250 260 260 260
23 235 235 235 235 235 245 245 245 245 245 250 250 250 250 250 260 260 260
24 235 235 235 235 235 245 245 245 245 245 250 250 250 250 250 260 260 260
25 230 230 230 230 230 245 245 245 245 245 250 250 250 250 250 260 260 260
26 230 230 230 230 230 240 240 240 240 240 245 245 245 245 245 250 250 250
27 225 225 225 225 225 240 240 240 240 240 245 245 245 245 245 250 250 250
28 220 220 220 220 220 235 235 235 235 235 235 235 235 235 235 235 235 235
29 220 220 220 220 220 235 235 235 235 235 235 235 235 235 235 235 235 235
30 215 215 215 215 215 235 235 235 235 235 235 235 235 235 235 235 235 235
31 210 210 210 210 210 230 230 230 230 230 230 230 230 230 230 230 230 230
32 205 205 205 205 205 230 230 230 230 230 230 230 230 230 230 230 230 230
33 205 205 205 205 205 225 225 225 225 225 225 225 225 225 225 225 225 225
34 200 200 200 200 200 220 220 220 220 220 220 220 220 220 220 220 220 220
35 195 195 195 195 195 220 220 220 220 220 220 220 220 220 220 220 220 220
36 190 190 190 190 190 215 215 215 215 215 215 215 215 215 215 215 215 215
37 180 180 180 180 180 210 210 210 210 210 210 210 210 210 210 210 210 210
38 175 175 175 175 175 210 210 210 210 210 210 210 210 210 210 210 210 210
39 170 170 170 170 170 205 205 205 205 205 205 205 205 205 205 205 205 205
40 160 160 160 160 160 200 200 200 200 200 200 200 200 200 200 200 200 200
41 155 155 155 155 155 195 195 195 195 195 195 195 195 195 195 195 195 195
42 145 145 145 145 145 190 190 190 190 190 190 190 190 190 190 190 190 190
43 135 135 135 135 135 185 185 185 185 185 185 185 185 185 185 185 185 185
44 125 125 125 125 125 175 175 175 175 175 175 175 175 175 175 175 175 175
45 115 115 115 115 115 170 170 170 170 170 170 170 170 170 170 170 170 170
46 0 105 105 105 105 165 165 165 165 165 165 165 165 165 165 165 165 165
47 0 90 90 90 155 155 155 155 155 155 155 155 155 155 155 155 155
48 0 80 80 145 145 145 145 145 145 145 145 145 145 145 145 145
49 0 65 135 135 135 135 135 135 135 135 135 135 135 135 135
50 0 125 125 125 125 125 125 125 125 125 125 125 125 125
51 0 115 115 115 115 115 115 115 115 115 115 115 115
52 0 100 100 100 100 100 100 100 100 100 100 100
53 0 85 85 85 85 85 85 85 85 85 85
54 0 70 75 75 75 75 75 75 75 75
55 0 55 55 55 55 55 65 65 65
56 0 40 40 40 40 50 50 50
57 0 35 35 35 45 45 45
58 0 30 30 40 40 40
59 0 25 35 35 35
60 0 25 25 25
61 0 20 20
62 0 20
63 0

Tata AIA Life Insurance Maha Raksha Supreme (UIN: 110N102V03) • IRDA of India Regn no. 110

C2020-60
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Year \
Term 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 25 25 25 25 25 25 25 30 30 30 30 30 30 30 30 30 30 30 30
5 25 25 25 25 25 25 25 30 30 30 30 30 30 30 30 30 30 30 30
6 30 30 30 30 30 30 30 35 35 35 35 35 35 35 35 35 35 35 35
7 80 80 80 80 80 80 80 95 95 95 95 95 95 95 95 95 95 95 95
8 120 120 120 120 120 120 120 135 135 135 135 135 135 135 135 135 135 135 135
9 165 165 165 165 165 165 165 180 180 180 180 180 180 180 180 180 180 180 180
10 210 210 210 210 210 210 210 225 225 225 225 225 225 225 225 225 225 225 225
11 245 245 245 245 245 245 245 260 260 260 260 260 260 260 260 260 260 260 260
12 285 285 285 285 285 285 285 300 300 300 300 300 300 300 300 300 300 300 300
13 285 285 285 285 285 285 285 300 300 300 300 300 300 300 300 300 300 300 300
14 285 285 285 285 285 285 285 300 300 300 300 300 300 300 300 300 300 300 300
15 285 285 285 285 285 285 285 300 300 300 300 300 300 300 300 300 300 300 300
16 285 285 285 285 285 285 285 300 300 300 300 300 300 300 300 300 300 300 300
17 270 270 270 270 270 270 270 280 280 280 280 280 280 280 280 280 280 280 280
18 270 270 270 270 270 270 270 280 280 280 280 280 280 280 280 280 280 280 280
19 270 270 270 270 270 270 270 280 280 280 280 280 280 280 280 280 280 280 280
20 270 270 270 270 270 270 270 280 280 280 280 280 280 280 280 280 280 280 280
21 270 270 270 270 270 270 270 280 280 280 280 280 280 280 280 280 280 280 280
22 260 260 260 260 260 260 260 270 270 270 270 270 270 270 270 270 270 270 270
23 260 260 260 260 260 260 260 270 270 270 270 270 270 270 270 270 270 270 270
24 260 260 260 260 260 260 260 270 270 270 270 270 270 270 270 270 270 270 270
25 260 260 260 260 260 260 260 270 270 270 270 270 270 270 270 270 270 270 270
26 250 250 250 250 250 250 250 260 260 260 260 260 260 260 260 260 260 260 260
27 250 250 250 250 250 250 250 260 260 260 260 260 260 260 260 260 260 260 260
28 235 235 235 235 235 235 235 245 245 245 245 245 245 245 245 245 245 245 245
29 235 235 235 235 235 235 235 245 245 245 245 245 245 245 245 245 245 245 245
30 235 235 235 235 235 235 235 245 245 245 245 245 245 245 245 245 245 245 245
31 230 230 230 230 230 230 230 240 240 240 240 240 240 240 240 240 240 240 240
32 230 230 230 230 230 230 230 240 240 240 240 240 240 240 240 240 240 240 240
33 225 225 225 225 225 225 225 230 230 230 230 230 230 230 230 230 230 230 230
34 220 220 220 220 220 220 220 225 225 225 225 225 225 225 225 225 225 225 225
35 220 220 220 220 220 220 220 225 225 225 225 225 225 225 225 225 225 225 225
36 215 215 215 215 215 215 215 220 220 220 220 220 220 220 220 220 220 220 220
37 210 210 210 210 210 210 210 215 215 215 215 215 215 215 215 215 215 215 215
38 210 210 210 210 210 210 210 215 215 215 215 215 215 215 215 215 215 215 215
39 205 205 205 205 205 205 205 210 210 210 210 210 210 210 210 210 210 210 210
40 200 200 200 200 200 200 200 205 205 205 205 205 205 205 205 205 205 205 205
41 195 195 195 195 195 195 195 200 200 200 200 200 200 200 200 200 200 200 200
42 190 190 190 190 190 190 190 195 195 195 195 195 195 195 195 195 195 195 195
43 185 185 185 185 185 185 185 190 190 190 190 190 190 190 190 190 190 190 190
44 175 175 175 175 175 175 175 180 180 180 180 180 180 180 180 180 180 180 180
45 170 170 170 170 170 170 170 175 175 175 175 175 175 175 175 175 175 175 175
46 165 165 165 165 165 165 165 170 170 170 170 170 170 170 170 170 170 170 170
47 155 155 155 155 155 155 155 160 160 160 160 160 160 160 160 160 160 160 160
48 145 145 145 145 145 145 145 150 150 150 150 150 150 150 150 150 150 150 150
49 135 135 135 135 135 135 135 140 140 140 140 140 140 140 140 140 140 140 140
50 125 125 125 125 125 125 125 130 130 130 130 130 130 130 130 130 130 130 130
51 115 115 115 115 115 115 115 120 120 120 120 120 120 120 120 120 120 120 120
52 100 100 100 100 100 100 100 105 105 105 105 105 105 105 105 105 105 105 105
53 85 85 85 85 85 85 85 90 90 90 90 90 90 90 90 90 90 90 90
54 75 75 75 75 75 75 75 80 80 80 80 80 80 80 80 80 80 80 80
55 65 65 65 65 65 65 65 70 70 70 70 70 70 70 70 70 70 70 70
56 50 50 50 50 50 50 50 55 55 55 55 55 55 55 55 55 55 55 55
57 45 45 45 45 45 45 45 50 50 50 50 50 50 50 50 50 50 50 50
58 40 40 40 40 40 40 40 45 45 45 45 45 45 45 45 45 45 45 45
59 35 35 35 35 35 35 35 40 40 40 40 40 40 40 40 40 40 40 40
60 25 25 25 25 25 25 25 30 30 30 30 30 30 30 30 30 30 30 30
61 20 20 20 20 20 20 20 25 25 25 25 25 25 25 25 25 25 25 25
62 20 20 20 20 20 20 20 25 25 25 25 25 25 25 25 25 25 25 25
63 15 15 15 15 15 15 15 20 20 20 20 20 20 20 20 20 20 20 20
64 0 15 15 15 15 15 15 20 20 20 20 20 20 20 20 20 20 20 20
65 0 10 10 10 10 10 15 15 15 15 15 15 15 15 15 15 15 15
66 0 10 10 10 10 15 15 15 15 15 15 15 15 15 15 15 15
67 0 10 10 10 15 15 15 15 15 15 15 15 15 15 15 15
68 0 10 10 15 15 15 15 15 15 15 15 15 15 15 15
69 0 10 15 15 15 15 15 15 15 15 15 15 15 15
70 0 15 15 15 15 15 15 15 15 15 15 15 15
71 0 15 15 15 15 15 15 15 15 15 15 15

Tata AIA Life Insurance Maha Raksha Supreme (UIN: 110N102V03) • IRDA of India Regn no. 110

C2020-60
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 Year \
Term 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82
72 0 10 10 10 10 10 10 10 10 10 10
73 0 10 10 10 10 10 10 10 10 10
74 0 10 10 10 10 10 10 10 10
75 0 10 10 10 10 10 10 10
76 0 10 10 10 10 10 10
77 0 10 10 10 10 10
78 0 10 10 10 10
79 0 10 10 10
80 0 10 10
81 0 10
82 0

SURRENDER VALUE FACTORS (%)

Whole Life, Pay to age 60
Year \
Term 55 56 57 58 59 60 61 62 63 64 65 66 67 68
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 30 30 30 30 30 0 0 0 0 0 0 0 0 0
9 60 60 60 60 60 0 0 0 0 0 0 0 0 0
10 85 85 85 85 85 15 15 15 15 15 0 0 0 0
11 110 110 110 110 110 35 35 35 35 35 0 0 0 0
12 135 135 135 135 135 60 60 60 60 60 0 0 0 0
13 165 165 165 165 165 80 80 80 80 80 15 15 15 15
14 190 190 190 190 190 100 100 100 100 100 35 35 35 35
15 215 215 215 215 215 120 120 120 120 120 50 50 50 50
16 240 240 240 240 240 140 140 140 140 140 70 70 70 70
17 265 265 265 265 265 160 160 160 160 160 85 85 85 85
18 295 295 295 295 295 180 180 180 180 180 100 100 100 100
19 320 320 320 320 320 205 205 205 205 205 115 115 115 115
20 350 350 350 350 350 225 225 225 225 225 135 135 135 135
21 350 350 350 350 350 245 245 245 245 245 150 150 150 150
22 345 345 345 345 345 265 265 265 265 265 165 165 165 165
23 345 345 345 345 345 290 290 290 290 290 180 180 180 180
24 345 345 345 345 345 310 310 310 310 310 195 195 195 195
25 345 345 345 345 345 335 335 335 335 335 215 215 215 215
26 340 340 340 340 340 335 335 335 335 335 230 230 230 230
27 340 340 340 340 340 330 330 330 330 330 245 245 245 245
28 340 340 340 340 340 330 330 330 330 330 265 265 265 265
29 335 335 335 335 335 330 330 330 330 330 285 285 285 285
30 335 335 335 335 335 330 330 330 330 330 305 305 305 305
31 335 335 335 335 335 325 325 325 325 325 300 300 300 300
32 330 330 330 330 330 325 325 325 325 325 300 300 300 300
33 330 330 330 330 330 325 325 325 325 325 300 300 300 300
34 325 325 325 325 325 320 320 320 320 320 300 300 300 300
35 325 325 325 325 325 320 320 320 320 320 295 295 295 295
36 320 320 320 320 320 320 320 320 320 320 295 295 295 295
37 315 315 315 315 315 315 315 315 315 315 295 295 295 295
38 310 310 310 310 310 315 315 315 315 315 295 295 295 295
39 310 310 310 310 310 310 310 310 310 310 290 290 290 290
40 305 305 305 305 305 310 310 310 310 310 290 290 290 290
41 295 295 295 295 295 305 305 305 305 305 290 290 290 290
42 290 290 290 290 290 300 300 300 300 300 285 285 285 285
43 285 285 285 285 285 300 300 300 300 300 285 285 285 285
44 275 275 275 275 275 295 295 295 295 295 280 280 280 280
45 270 270 270 270 270 290 290 290 290 290 280 280 280 280
46 260 260 260 260 260 285 285 285 285 285 275 275 275 275
47 250 250 250 250 250 280 280 280 280 280 275 275 275 275
48 235 235 235 235 235 270 270 270 270 270 270 270 270 270
49 225 225 225 225 225 265 265 265 265 265 265 265 265 265
50 210 210 210 210 210 255 255 255 255 255 260 260 260 260
51 195 195 195 195 195 245 245 245 245 245 255 255 255 255
52 175 175 175 175 175 235 235 235 235 235 250 250 250 250
53 155 155 155 155 155 225 225 225 225 225 245 245 245 245
54 135 135 135 135 135 215 215 215 215 215 240 240 240 240
55 0 115 115 115 115 200 200 200 200 200 230 230 230 230

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Year \
Term 55 56 57 58 59 60 61 62 63 64 65 66 67 68
56 0 90 90 90 185 185 185 185 185 225 225 225 225
57 0 60 60 170 170 170 170 170 215 215 215 215
58 0 30 150 150 150 150 150 205 205 205 205
59 0 130 130 130 130 130 195 195 195 195
60 0 110 110 110 110 180 180 180 180
61 0 85 85 85 165 165 165 165
62 0 60 60 150 150 150 150
63 0 30 135 135 135 135
64 0 115 115 115 115
65 0 95 95 95
66 0 75 75
67 0 50
68 0
Year \
Term 69 70 71 72 73 74 75 76 77 78 79 80 81 82
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 15 0 0 0 0 0 0 0 0 0 0 0 0 0
14 35 0 0 0 0 0 0 0 0 0 0 0 0 0
15 50 0 0 0 0 0 0 0 0 0 0 0 0 0
16 70 15 15 15 15 15 0 0 0 0 0 0 0 0
17 85 30 30 30 30 30 0 0 0 0 0 0 0 0
18 100 45 45 45 45 45 5 5 5 5 5 5 5 5
19 115 55 55 55 55 55 15 15 15 15 15 15 15 15
20 135 70 70 70 70 70 25 25 25 25 25 25 25 25
21 150 80 80 80 80 80 35 35 35 35 35 35 35 35
22 165 95 95 95 95 95 45 45 45 45 45 45 45 45
23 180 105 105 105 105 105 55 55 55 55 55 55 55 55
24 195 115 115 115 115 115 65 65 65 65 65 65 65 65
25 215 130 130 130 130 130 70 70 70 70 70 70 70 70
26 230 140 140 140 140 140 80 80 80 80 80 80 80 80
27 245 155 155 155 155 155 90 90 90 90 90 90 90 90
28 265 165 165 165 165 165 100 100 100 100 100 100 100 100
29 285 180 180 180 180 180 110 110 110 110 110 110 110 110
30 305 190 190 190 190 190 115 115 115 115 115 115 115 115
31 300 205 205 205 205 205 125 125 125 125 125 125 125 125
32 300 220 220 220 220 220 135 135 135 135 135 135 135 135
33 300 235 235 235 235 235 145 145 145 145 145 145 145 145
34 300 250 250 250 250 250 155 155 155 155 155 155 155 155
35 295 265 265 265 265 265 165 165 165 165 165 165 165 165
36 295 265 265 265 265 265 175 175 175 175 175 175 175 175
37 295 260 260 260 260 260 185 185 185 185 185 185 185 185
38 295 260 260 260 260 260 200 200 200 200 200 200 200 200
39 290 260 260 260 260 260 210 210 210 210 210 210 210 210
40 290 260 260 260 260 260 220 220 220 220 220 220 220 220
41 290 260 260 260 260 260 220 220 220 220 220 220 220 220
42 285 255 255 255 255 255 220 220 220 220 220 220 220 220
43 285 255 255 255 255 255 220 220 220 220 220 220 220 220
44 280 255 255 255 255 255 220 220 220 220 220 220 220 220
45 280 250 250 250 250 250 220 220 220 220 220 220 220 220
46 275 250 250 250 250 250 215 215 215 215 215 215 215 215
47 275 250 250 250 250 250 215 215 215 215 215 215 215 215
48 270 245 245 245 245 245 215 215 215 215 215 215 215 215
49 265 245 245 245 245 245 215 215 215 215 215 215 215 215
50 260 245 245 245 245 245 210 210 210 210 210 210 210 210
51 255 240 240 240 240 240 210 210 210 210 210 210 210 210
52 250 240 240 240 240 240 210 210 210 210 210 210 210 210
53 245 235 235 235 235 235 210 210 210 210 210 210 210 210
54 240 230 230 230 230 230 205 205 205 205 205 205 205 205
55 230 225 225 225 225 225 205 205 205 205 205 205 205 205
56 225 225 225 225 225 225 200 200 200 200 200 200 200 200

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 Year \
Term 69 70 71 72 73 74 75 76 77 78 79 80 81 82
57 215 220 220 220 220 220 200 200 200 200 200 200 200 200
58 205 215 215 215 215 215 195 195 195 195 195 195 195 195
59 195 205 205 205 205 205 195 195 195 195 195 195 195 195
60 180 200 200 200 200 200 190 190 190 190 190 190 190 190
61 165 195 195 195 195 195 185 185 185 185 185 185 185 185
62 150 185 185 185 185 185 185 185 185 185 185 185 185 185
63 135 175 175 175 175 175 180 180 180 180 180 180 180 180
64 115 165 165 165 165 165 175 175 175 175 175 175 175 175
65 95 155 155 155 155 155 170 170 170 170 170 170 170 170
66 75 145 145 145 145 145 160 160 160 160 160 160 160 160
67 50 130 130 130 130 130 155 155 155 155 155 155 155 155
68 25 115 115 115 115 115 150 150 150 150 150 150 150 150
69 0 100 100 100 100 100 140 140 140 140 140 140 140 140
70 0 85 85 85 85 130 130 130 130 130 130 130 130
71 0 65 65 65 120 120 120 120 120 120 120 120
72 0 45 45 110 110 110 110 110 110 110 110
73 0 25 100 100 100 100 100 100 100 100
74 0 85 85 85 85 85 85 85 85
75 0 70 70 70 70 70 70 70
76 0 55 55 55 55 55 55
77 0 40 40 40 40 40
78 0 20 20 20 20
79 0 20 20 20
80 0 20 20
81 0 20
82 0

Pondicherry). JAIPUR - Office of the Insurance Ombudsman, Jeevan

ANNEXURE – B Nidhi - II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005. Tel.: 0141
- 2740363, Email: bimalokpal.jaipur@ecoi.co.in, (Jurisdiction: Rajasthan).
NAMES OF OMBUDSMAN AND ADDRESSES OF KOLKATA - Office of the Insurance Ombudsman, Hindustan Bldg.
OMBUDSMAN CENTRES Annexe, 4th Floor, 4, C.R. Avenue, Kolkata - 700 072. Tel.: 033 -
AHMEDABAD - Office of the Insurance Ombudsman, Jeevan Prakash 22124339 / 22124340, Fax : 033 - 22124341, Email:
Building, 6th floor, Tilak Marg, Relief Road, Ahmedabad - 380 001. Tel.: bimalokpal.kolkata@ecoi.co.in, (Jurisdiction: West Bengal, Sikkim,
079 - 25501201/02/05/06, Email: bimalokpal.ahmedabad@ecoi.co.in, Andaman & Nicobar Islands). LUCKNOW - Office of the Insurance
(Jurisdiction: Gujarat, Dadra & Nagar Haveli, Daman and Diu). Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road,
BENGALURU - Office of the Insurance Ombudsman, Jeevan Soudha Hazratganj, Lucknow - 226 001. Tel.: 0522 - 2231330/2231331, Fax:
Building, PID No. 57-27-N-19, Ground Floor, 19/19, 24th Main Road, JP 0522 - 2231310, Email: bimalokpal.lucknow@ecoi.co.in, (Jurisdiction:
Nagar, Ist Phase, Bengaluru - 560 078. Tel.: 080 - 26652048/26652049, Districts of Uttar Pradesh: Laitpur, Jhansi, Mahoba, Hamirpur, Banda,
Email: bimalokpal.bengaluru@ecoi.co.in, (Jurisdiction: Karnataka). Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh,
BHOPAL - Office of the Insurance Ombudsman, Janak Vihar Complex, Jaunpur, Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur,
2nd Floor, 6, Malviya Nagar, Opp. Airtel Office, Near New Market, Bhopal - Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad,
462 003. Tel.: 0755 - 2769201/2769202, Fax: 0755 - 2769203, Email: Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur,
bimalokpal.bhopal@ecoi.co.in, (Jurisdiction: Madhya Pradesh, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria,
Chattisgarh). BHUBANESHWAR - Office of the Insurance Ombudsman, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar). MUMBAI - Office of
62, Forest park, Bhubneshwar – 751 009. Tel.: 0674 - 2596461/2596455, the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road,
Fax: 0674 - 2596429, Email: bimalokpal.bhubaneswar@ecoi.co.in, Santacruz (W), Mumbai - 400 054. Tel.: 022 - 26106552/26106960, Fax:
(Jurisdiction: Orissa). CHANDIGARH - Office of the Insurance 022 - 26106052, Email: bimalokpal.mumbai@ecoi.co.in, (Jurisdiction:
Ombudsman, S.C.O. No. 101, 102 & 103, 2nd Floor, Batra Building, Goa, Mumbai Metropolitan Region excluding Navi Mumbai & Thane).
Sector 17 - D, Chandigarh - 160 017. Tel.: 0172 - 2706196/2706468, Fax: NOIDA - Office of the Insurance Ombudsman, Bhagwan Sahai Palace,
0172 - 2708274, Email: bimalokpal.chandigarh@ecoi.co.in, (Jurisdiction: 4th Floor, Main Road, Naya Bans, Sector 15, Dist: Gautam Buddh Nagar,
Punjab, Haryana, Himachal Pradesh, Jammu & Kashmir, Chandigarh). U.P-201301. Tel.: 0120 - 2514250 / 2514252 / 2514253, Email:
CHENNAI - Office of the Insurance Ombudsman, Fatima Akhtar Court, bimalokpal.noida@ecoi.co.in, (Jurisdiction: State of Uttaranchal and the
4th Floor, 453, Anna Salai, Teynampet, Chennai - 600 018. Tel.: 044 - following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor,
24333668 / 24335284, Fax: 044 - 24333664, Email: Budaun, Bulandshehar, Etah, Kanooj, Mainpuri, Mathura, Meerut,
bimalokpal.chennai@ecoi.co.in, (Jurisdiction: Tamil Nadu, Pondicherry Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad,
Town and Karaikal {which are part of Pondicherry}). DELHI - Office of the Firozbad, Gautambodhanagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur,
Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar,
Road, New Delhi - 110 002. Tel.: 011 - 23232481/23213504, Email: Saharanpur). PATNA - Office of the Insurance Ombudsman, 1st Floor,
bimalokpal.delhi@ecoi.co.in, (Jurisdiction: Delhi). ERNAKULAM - Office of Kalpana Arcade Building, Bazar Samiti Road, Bahadurpur, Patna 800 006.
the Insurance Ombudsman, 2nd Floor, Pulinat Bldg., Opp. Cochin Tel.: 0612-2680952, Email: bimalokpal.patna@ecoi.co.in, (Jurisdiction:
Shipyard, M. G. Road, Ernakulam - 682 015. Tel.: 0484 - 2358759/ Bihar, Jharkhand). PUNE - Office of the Insurance Ombudsman, Jeevan
2359338, Fax: 0484 - 2359336, Email: bimalokpal.ernakulam@ecoi.co.in, Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road,
(Jurisdiction: Kerala, Lakshadweep, Mahe-a part of Pondicherry). Narayan Peth, Pune - 411 030. Tel.: 020-41312555, Email:
GUWAHATI - Office of the Insurance Ombudsman, Jeevan Nivesh, 5th bimalokpal.pune@ecoi.co.in, (Jurisdiction: Maharashtra, Area of Navi
Floor, Nr. Panbazar over bridge, S.S. Road, Guwahati - 781001(ASSAM). Mumbai and Thane excluding Mumbai Metropolitan Region).
Tel.: 0361 - 2132204 / 2132205, Fax: 0361 - 2732937, Email:
bimalokpal.guwahati@ecoi.co.in, (Jurisdiction: Assam, Meghalaya, For further information or latest updated list of Ombudsman Office
Manipur, Mizoram, Arunachal Pradesh, Nagaland and Tripura). addresses, kindly visit the IRDA of India website
HYDERABAD - Office of the Insurance Ombudsman, 6-2-46, 1st floor, ‘http://www.policyholder.gov.in/- Ombudsman / List of Insurance
Moin Court, Lane Opp. Saleem Function Palace, A. C. Guards, Ombudsmen OR our website www.tataaia.com
Lakdi-Ka-Pool, Hyderabad - 500 004. Tel.: 040 - 67504123/23312122, ANNEXURE - 1
Fax: 040 - 23376599, Email: bimalokpal.hyderabad@ecoi.co.in, A. Section 38 - Assignment and Transfer of Insurance Policies
(Jurisdiction: Andhra Pradesh, Telangana, Yanam and part of Territory of

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Assignment or transfer of a policy should be in accordance with Section 38 of the Insurance Laws (Amendment) Act, 2015 shall not be affected by
of the Insurance Act, 1938 as amended by Insurance Laws (Amendment) this section.
Act, 2015.The extant provisions in this regard are as follows: [Disclaimer: This is not a comprehensive list of amendments of Insurance
01. This policy may be transferred/assigned, wholly or in part, with or Laws (Amendment) Act, 2015 and only a simplified version prepared for
without consideration. general information. Policyholders are advised to refer to Insurance Laws
02. An Assignment may be effected in a policy by an endorsement upon (Amendment) Act, 2015 for complete and accurate details. ]
the policy itself or by a separate instrument under notice to the Insurer.
03. The instrument of assignment should indicate the fact of transfer or ANNEXURE - 2
assignment and the reasons for the assignment or transfer, B. Section 39 - Nomination by Policyholder
antecedents of the assignee and terms on which assignment is made.
Nomination of a life insurance Policy is as below in accordance with
04. The assignment must be signed by the transferor or assignor or duly Section 39 of the Insurance Act, 1938 as amended by Insurance Laws
authorized agent and attested by at least one witness. (Amendment) Act, 2015. The extant provisions in this regard are as follows:
05. The transfer of assignment shall not be operative as against an insurer 01. The Policyholder of a life insurance on his own life may nominate a
until a notice in writing of the transfer or assignment and either the said person or persons to whom money secured by the policy shall be paid
endorsement or instrument itself or copy there of certified to be correct in the event of his death.
by both transferor and transferee or their duly authorised agents have
02. Where the nominee is a minor, the Policyholder may appoint any
been delivered to the insurer.
person to receive the money secured by the policy in the event of
06. Fee to be paid for assignment or transfer can be specified by the Policyholder’s death during the minority of the nominee. The manner of
Authority through Regulations. appointment to be laid down by the insurer.
07. On receipt of notice with fee, the insurer should Grant a written 03. Nomination can be made at any time before the maturity of the policy.
acknowledgement of receipt of notice. Such notice shall be conclusive
04. Nomination may be incorporated in the text of the policy itself or may
evidence against the insurer of duly receiving the notice.
be endorsed on the policy communicated to the insurer and can be
08. If the insurer maintains one or more places of business, such notices registered by the insurer in the records relating to the policy.
shall be delivered only at the place where the policy is being serviced. 05. Nomination can be cancelled or changed at any time before policy
09. The insurer may accept or decline to act upon any transfer or matures, by an endorsement or a further endorsement or a will as the
assignment or endorsement, if it has sufficient reasons to believe that case may be.
it is 06. A notice in writing of Change or Cancellation of nomination must be
a. not bonafide or delivered to the insurer for the insurer to be liable to such nominee.
b. not in the interest of the Policyholder or Otherwise, insurer will not be liable if a bonafide payment is made to
the person named in the text of the policy or in the registered records
c. not in public interest or of the insurer.
d. is for the purpose of trading of the insurance policy. 07. Fee to be paid to the insurer for registering change or cancellation of a
10. Before refusing to act upon endorsement, the Insurer should record nomination can be specified by the Authority through Regulations.
the reasons in writing and communicate the same in writing to 08. On receipt of notice with fee, the insurer should grant a written
Policyholder within 30 days from the date of Policyholder giving a acknowledgement to the Policyholder of having registered a
notice of transfer or assignment. nomination or cancellation or change thereof.
11. In case of refusal to act upon the endorsement by the Insurer, any 09. A transfer or assignment made in accordance with Section 38 shall
person aggrieved by the refusal may prefer a claim to IRDAI within 30 automatically cancel the nomination except in case of assignment to
days of receipt of the refusal letter from the Insurer. the insurer or other transferee or assignee for purpose of loan or
12. The priority of claims of persons interested in an insurance policy against security or its reassignment after repayment. In such case, the
would depend on the date on which the notices of assignment or nomination will not get cancelled to the extent of insurer’s or
transfer is delivered to the insurer; where there are more than one transferee’s or assignee’s interest in the policy. The nomination will get
instruments of transfer or assignment, the priority will depend on dates revived on repayment of the loan.
of delivery of such notices. Any dispute in this regard as to priority 10. The right of any creditor to be paid out of the proceeds of any policy of
should be referred to Authority. life insurance shall not be affected by the nomination.
13. Every assignment or transfer shall be deemed to be absolute 11. In case of nomination by Policyholder whose life is insured, if the
assignment or transfer and the assignee or transferee shall be deemed nominees die before the Policyholder, the proceeds are payable to
to be absolute assignee or transferee, except Policyholder or his heirs or legal representatives or holder of
a. where assignment or transfer is subject to terms and conditions of succession certificate.
transfer or assignment OR 12. In case nominee(s) survive the person whose life is insured, the amount
secured by the policy shall be paid to such survivor(s).
b. where the transfer or assignment is made upon condition that
13. Where the Policyholder whose life is Life Assured nominates his
i. the proceeds under the policy shall become payable to
Policyholder or nominee(s) in the event of assignee or transferee a. parents or
dying before the Life Assured OR b. spouse or
ii. the Life Assured surviving the term of the policy c. children or
Such conditional assignee will not be entitled to obtain a loan on policy or d. spouse and children
surrender the policy. This provision will prevail notwithstanding any law or e. or any of them
custom having force of law which is contrary to the above position.
the nominees are beneficially entitled to the amount payable by the
14. In other cases, the insurer shall, subject to terms and conditions of insurer to the Policyholder unless it is proved that Policyholder could
assignment, recognize the transferee or assignee named in the notice not have conferred such beneficial title on the nominee having regard
as the absolute transferee or assignee and such person to the nature of his title.
a. shall be subject to all liabilities and equities to which the transferor or 14. If nominee(s) die after the Policyholder but before his share of the
assignor was subject to at the date of transfer or assignment and amount secured under the policy is paid, the share of the expired
b. may institute any proceedings in relation to the policy nominee(s) shall be payable to the heirs or legal representative of the
nominee or holder of succession certificate of such nominee(s).
c. obtain loan under the policy or surrender the policy without obtaining the
consent of the transferor or assignor or making him a party to the 15. The provisions of sub-section 7 and 8 (13 and 14 above) shall apply to
proceedings all life insurance policies maturing for payment after the
commencement of Insurance Laws (Amendment) Act, 2015.
15. Any rights and remedies of an assignee or transferee of a life insurance
policy under an assignment or transfer effected before commencement 16. If Policyholder dies after maturity but the proceeds and benefit of the

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policy has not been paid to him because of his death, his nominee(s) shall 08. Fact shall not be considered material unless it has a direct bearing on
be entitled to the proceeds and benefit of the policy. the risk undertaken by the insurer. The onus is on insurer to show that
17. The provisions of Section 39 are not applicable to any life insurance if the insurer had been aware of the said fact, no life insurance policy
policy to which Section 6 of Married Women’s Property Act, 1874 would have been issued to the insured.
applies or has at any time applied except where before or after 09. The insurer can call for proof of age at any time if he is entitled to do so
Insurance Laws (Amendment) Act, 2015., a nomination is made in and no policy shall be deemed to be called in question merely because
favour of spouse or children or spouse and children whether or not on the terms of the policy are adjusted on subsequent proof of age of life
the face of the policy it is mentioned that it is made under Section 39. insured. So, this Section will not be applicable for questioning age or
Where nomination is intended to be made to spouse or children or adjustment based on proof of age submitted subsequently.
spouse and children under Section 6 of MWP Act, it should be [Disclaimer: This is not a comprehensive list of amendments of Insurance
specifically mentioned on the policy. In such a case only, the provisions Laws (Amendment) Act, 2015. and only a simplified version prepared for
of Section 39 will not apply. general information. Policyholders are advised to refer to Insurance Laws
[Disclaimer: This is not a comprehensive list of amendments of Insurance (Amendment) Act, 2015 for complete and accurate details.]
Laws (Amendment) Act, 2015 and only a simplified version prepared for
general information. Policyholders are advised to refer to Insurance Laws
(Amendment) Act, 2015 for complete and accurate details. ]
ANNEXURE - 3
C. Section 45 – Policy shall not be called in question on the ground of
mis-statement after three years
Provisions regarding policy not being called into question in terms of
Section 45 of the Insurance Act, 1938, as amended by Insurance Laws
(Amendment) Act, 2015. are as follows:
01. No Policy of Life Insurance shall be called in question on any ground
whatsoever after expiry of 3 yrs from
a. the date of issuance of policy or
b. the date of commencement of risk or
c. the date of revival of policy or
d. the date of rider to the policy
whichever is later.
02. On the ground of fraud, a policy of Life Insurance may be called in
question within 3 years from
a. the date of issuance of policy or
b. the date of commencement of risk or
c. the date of revival of policy or
d. the date of rider to the policy
whichever is later.
For this, the insurer should communicate in writing to the Life Assured or
legal representative or nominee or assignees of insured, as applicable,
mentioning the ground and materials on which such decision is based.
03. Fraud means any of the following acts committed by Life Assured or
by his agent, with the intent to deceive the insurer or to induce the
insurer to issue a life insurance policy:
a. The suggestion, as a fact of that which is not true and which the Life
Assured does not believe to be true;
b. The active concealment of a fact by the Life Assured having
knowledge or belief of the fact;
c. Any other act fitted to deceive; and
d. Any such act or omission as the law specifically declares to be
fraudulent.
04. Mere silence is not fraud unless, depending on circumstances of the
case, it is the duty of the Life Assured or his agent keeping silence to
speak or silence is in itself equivalent to speak.
05. No Insurer shall repudiate a life insurance Policy on the ground of
Fraud, if the Life Assured/ beneficiary can prove that the misstatement
was true to the best of his knowledge and there was no deliberate
intention to suppress the fact or that such mis-statement of or
suppression of material fact are within the knowledge of the insurer.
Onus of disproving is upon the Policyholder, if alive, or beneficiaries.
06. Life insurance Policy can be called in question within 3 years on the
ground that any statement of or suppression of a fact material to
expectancy of life of the Life Assured was incorrectly made in the
proposal or other document basis which policy was issued or revived
or rider issued. For this, the insurer should communicate in writing to
the Life Assured or legal representative or nominee or assignees of
insured, as applicable, mentioning the ground and materials on which
decision to repudiate the policy of life insurance is based.
07. In case repudiation is on ground of mis-statement and not on fraud,
the premium collected on policy till the date of repudiation shall be paid
to the Life Assured or legal representative or nominee or assignees of
insured, within a period of 90 days from the date of repudiation.
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 Tata AIA Life Insurance Non-Linked Comprehensive Protection Rider

PART B the Schedule, who is the policyholder under the Base Plan and Rider.
Tata AIA Life Insurance Non-Linked Comprehensive Protection Rider is a The capitalized words used but not defined herein, shall borrow
non-linked, non-participating Individual Health Rider. meaning as per the term and conditions of the Policy.
DEFINITIONS PART C
The words and phrases listed below will have the meanings attributed to 1. BENEFITS
them wherever they appear in this Rider unless the context otherwise
The benefits shall depend on the Benefit Option/s chosen by You, which
requires. The terms used in this Rider but not defined will derive their cannot be changed once chosen. Subject to insurable interest between
meaning from the Policy. the Policyholder and the Life Insured, and as per the Board Approved
1. “Age” means age as on the last birthday; i.e. the age of the Life Underwriting Policy, You may propose to avail additional Benefit Option/s
Insured in completed years as on Date of Commencement of Policy under the Rider on one or more lives (may or may not include coverage on
and is as shown in the Policy Schedule. self), except in ‘CritiCare Benefit’, where the Life Insured under the Benefit
2. “Annualised Premium” means the Rider Premium payable in a year Option must be the same as Life Insured under the Base Plan. Such
chosen by the Policyholder, excluding the taxes, underwriting extra Benefit Option can be added:
premiums and loadings for modal Rider Premium, if any, as specified a) In case of Single Pay: at the inception or any policy anniversary of the
in the Schedule. Base Plan, post premium payment term of the Base Plan provided the
3. “Claimant” means the person entitled to receive the Policy benefits Base Plan is fully paid-up.
and includes the Policyholder, the nominee, the assignee, the legal b) In case of Non-Single Pay: at the inception or any policy anniversary of
heir, the legal representative(s) or the holder(s) of succession certificate the Base Plan during the premium payment term of the Base Plan.
as the case may be; If there is an overlapping benefit between the Base Plan and the Benefit
4. “Coverage Term” means the term in respect of the chosen Benefit option, the Benefit option shall not be offered.
Option as specified in the Schedule; At no point both unit-deduction rider and this rider shall be allowed to be
5. “Insured Amount” shall be - attached during the Policy Term of a unit-linked policy.
a) Combination of Lump sum and Income: Highest of: Provided the Rider/Base Plan is in force, the following benefit(s) shall be
• 11 times the Annualised Premium for Limited Pay/Regular Pay payable:
and 1.25 times for Single Premium [excluding the underwriting I. TERM BENEFIT WITH ACCELERATED TERMINAL ILLNESS
extra premiums, modal loading and applicable taxes, cess or In the case of death or Diagnosis of Terminal Illness (as detailed in
levies (if any)] for the respective Benefit Option.
Annexure A) of the Life Insured, the Insured Amount shall be payable.
• 105% of Total Premiums Paid (Excluding loading for modal Rider
This benefit is payable only once during the Coverage Term and shall
Premiums) up to the date of occurrence of the insured event.
terminate upon death or Diagnosis of Terminal Illness of the Life Insured or
• Sum Assured under Benefit Option. expiry of the Coverage Term, whichever is earlier.
b) Partner Care: Equal to the Sum Assured under Benefit Option as II. ACCIDENTAL DEATH BENEFIT
specified in the Schedule.
In the event of the death of the Life Insured due to an Accident (as detailed
c) Waiver of Premium Benefit – The outstanding future Premium under in Annexure A) during the Coverage Term, We shall pay the Insured Amount,
the Base Plan, Rider/s and any attached Benefit Option/s, if any. In
provided the death occurs within 180 days from the date of that Accident.
case the payout under Waiver of Premium Benefit is triggered, the
Premiums waived shall be added to the Premiums paid by You for the The benefit shall be payable even if the Accident takes place within the
calculation of the Insured amount for that condition. Coverage Term and the death occurs beyond the Coverage Term, provided
6. “IRDAI” means the Insurance Regulatory and Development Authority the date of death is within 180 days of the Accident.
of India;
DOUBLE BENEFIT
7. “Life Insured” shall mean the person insured under the respective
We shall pay twice the amount of this benefit if the death occurs under any
Benefit Option as specified in the Schedule;
of the following circumstances:
8. “Maturity/Expiry Date” means the date specified in the Schedule, on
which the Coverage Term expires; 1. While the Life Insured is riding as a fare paying passenger on
commercially licensed public land transportation over an established
9. “Policy/Base Plan” means the base policy to which this Rider route such as a bus, tram or train. A taxi or any form of transport
is attached; chartered for private travel is excluded;
10. “Rider” means this rider contract containing these terms and 2. While the Life Insured is in an elevator car (elevators in mines, rigs and
conditions; on construction sites excluded) duly certified to carry passengers;
11. “Rider Premium” means an amount specified in the Schedule against 3. As a direct result of the burning of the following public buildings only:
respective Benefit Option, payable by You, by the due dates to secure theatre, cinema, public auditorium, hotel, school and hospital; or
the benefits under the Rider, excluding applicable taxes, cesses or
levies, if any; 4. When the Life Insured is on a commercial passenger airline on a
regular scheduled passenger trip over its established passenger route.
12. “Sum Assured” refers to the sum assured under respective Benefit
Option as specified in the Schedule. This benefit is payable only once during the Coverage Term and shall
terminate upon death of the Life Insured or expiry of the Coverage Term,
13. “Schedule” means the Policy schedule and any endorsements whichever earlier.
attached to and forming part of the Base Plan and Rider and if any,
updated Schedule is issued, then, the Schedule latest in time; III. ACCIDENTAL TOTAL AND PERMANENT DISABILITY BENEFIT
14. “Survival Period” in respect of a chosen Benefit Option shall be: In the event of the Total and Permanent Disability (as detailed in Annexure
A) of the Life Insured due to an Accident within the Coverage Term, the
Benefit option Survival Period (from the date of diagnosis
Insured Amount shall be payable, provided the Total and Permanent
of illness/actual undergoing of procedure)
Disability occurs within 180 days from the date of that Accident.
CritiCare Plus Benefit 30 days
The benefit shall be payable even if the Accident takes place within
15. “Total Premiums Paid” shall be defined as the sum of all the the Coverage Term and the Total and Permanent Disability occurs
Premiums paid to date in respect of chosen Benefit Option/s, beyond the Coverage Term, provided the date of death is within 180
excluding underwriting extra premiums and applicable taxes, cesses days of the Accident.
or levies, if any.
This benefit is payable only once during the Coverage Term and shall
16. “Underwriting Policy” means an underwriting policy approved by terminate upon payment of benefit or expiry of the Coverage Term,
Our board of directors; whichever earlier.
17. “We”, “Us” or “Our” means Tata AIA Life Insurance Company
Limited; and DOUBLE BENEFIT
18. “You”, “Your” or “Policyholder” means the policyholder as named in If you have not chosen Waiver of Premium Benefit, We shall pay twice the

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amount of this benefit if the disability occurs under any of the following V. CRITICARE PLUS BENEFIT
circumstances: The Insured Amount under the Benefit Option shall be paid upon first
1. While the Life Insured is riding as a fare paying passenger on Diagnosis of or actual undergoing of any of the below listed illnesses or
commercially licensed public land transportation over an established procedure (as explained in Annexure A), provided the Life Insured survives
route such as a bus, tram or train. A taxi or any form of transport during the Survival Period:
chartered for private travel is excluded.
No Illness / Procedure
2. While the Life Insured is in an elevator car (elevators in mines, rigs and
on construction sites excluded) duly certified to carry passengers; Cancer:
3. As a direct result of the burning of the following public buildings only: 1 Cancer of Specified Severity
theatre, cinema, public auditorium, hotel, school and hospital; or Cardiac Conditions:
4. When the Life Insured is on a commercial passenger airline on a 2 Myocardial Infarction (First Heart Attack of specified severity)
regular scheduled passenger trip over its established passenger route. 3 Open Chest CABG (Coronary Artery Bypass Graft)
IV. CRITICARE BENEFIT 4 Open Heart Replacement or Repair of Heart Valves
It accelerates the payout of death benefit under the Base Plan upon first 5 Major surgery of Aorta
Diagnosis of or actual undergoing of any of the below listed illnesses or 6 Heart transplant
procedure (as explained in Annexure A): 7 Cardiomyopathy (of specified severity)
No Illness / Procedure 8 Stroke resulting into permanent symptoms
Cancer: 9 Primary (Idiopathic) Pulmonary Hypertension
1 Cancer of Specified Severity Critical Illness:
Cardiac Conditions: 10 Apallic Syndrome
2 Myocardial Infarction (First Heart Attack of specified severity) 11 Benign Brain Tumor
3 Open Chest CABG (Coronary Artery Bypass Graft) 12 Blindness
4 Open Heart Replacement or Repair of Heart Valves 13 Severe Rheumatoid Arthritis
5 Major surgery of Aorta 14 End Stage Lung Failure
6 Heart transplant 15 Coma of Specified Severity
7 Cardiomyopathy (of specified severity) 16 End Stage Liver Failure
8 Stroke resulting into permanent symptoms 17 Kidney Failure requiring Regular Dialysis
9 Primary (Idiopathic) Pulmonary Hypertension 18 Encephalitis
Critical Illness: 19 Third Degree Burns
10 Apallic Syndrome 20 Major Head Trauma
11 Benign Brain Tumor 21 Major Organ (less heart)/ Bone Marrow Transplant
12 Blindness 22 Permanent Paralysis of Limbs
13 Severe Rheumatoid Arthritis 23 Loss of limbs
14 End Stage Lung Failure 24 Fulminant Viral Hepatitis
15 Coma of Specified Severity 25 Alzheimer's Disease
16 End Stage Liver Failure 26 Aplastic Anaemia
17 Kidney Failure requiring Regular Dialysis 27 Deafness
18 Encephalitis 28 Loss of Speech
19 Third Degree Burns 29 Medullary Cystic Kidney Disease
20 Major Head Trauma 30 Motor Neuron Disease with Permanent Symptoms
21 Major Organ (less heart)/ Bone Marrow Transplant 31 Multiple Sclerosis with Persisting Symptoms
22 Permanent Paralysis of Limbs 32 Muscular Dystrophy
23 Loss of limbs 33 Parkinson's Disease
24 Fulminant Viral Hepatitis 34 Progressive Scleroderma
25 Alzheimer's Disease 35 SLE with Renal Involvement
26 Aplastic Anaemia 36 Bacterial Meningitis
27 Deafness 37 Chronic Recurrent Pancreatitis
28 Loss of Speech 38 Loss of Independent Existence
29 Medullary Cystic Kidney Disease 39 Poliomyelitis
30 Motor Neuron Disease with Permanent Symptoms 40 Creutzfeldt-Jacob disease
31 Multiple Sclerosis with Persisting Symptoms This benefit is payable only once during the Coverage Term and shall
32 Muscular Dystrophy terminate upon payout of the benefit.
33 Parkinson's Disease The benefit will be payable only if the Diagnosis/procedure of any of the
34 Progressive Scleroderma covered condition is the first Diagnosis/procedure of that condition in the
35 SLE with Renal Involvement lifetime of the Life Insured.
36 Bacterial Meningitis 2. MATURITY BENEFIT
37 Chronic Recurrent Pancreatitis If You have chosen Return of Premium option at the inception of the Rider,
38 Loss of Independent Existence on survival till end of the Coverage Term, the Total Premiums Paid
39 Poliomyelitis (Excluding loading for modal Rider Premiums) towards the respective
40 Creutzfeldt-Jacob disease Benefit Option shall be returned, after deduction of any claim payout made
under the under the respective Benefit Option, provided the Rider/Benefit
This benefit is payable only once during the Coverage Term and the cover
Option is not terminated.
shall terminate upon payout of the benefit. The Base Plan shall continue for
the balance Sum Assured on Death. In case the payout under Return of Premium option is triggered, the
The benefit will be payable only if the Diagnosis/procedure of any of the Premiums waived (if any) shall be added to the Total Premiums Paid by the
covered condition is the first Diagnosis/procedure of that condition in the Policyholder for the calculation of the Return of Balance Premium for the
lifetime of the Life Insured. respective Benefit Option.

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3. SERVICE FEATURE Where the Insured Amount is higher than the Sum Assured under Benefit
I. MEDICAL SECOND OPINION Option, the amount in excess of Sum Assured under Benefit Option shall
be paid in lump sum.
The Life Insured may avail second opinion / personal medical case
management services from the service provider/s affiliated The Claimant also has an option to receive the commuted value of the
to/registered with Us. The services are expected to assist the Life future income benefits as a lumpsum, discounted at the higher of -
Insured to ascertain correct diagnosis of a medical condition and a) 4.00%,
obtain due care to the Life Insured in case of illness. These services b) SBI domestic term deposit rate for ‘5 years and up to 10 years’ +
are subject to: 2.00%.
- the availability of a suitable service provider; b) Partner Care: Upon occurrence of the insured event, Insured Amount
- primary diagnosis has been done by a registered medical shall be paid to the chosen dependent partner/s as a regular income.
practitioner as may be authorized by a competent statutory The mode of payout shall be annual, quarterly, half yearly or monthly
authority; and from the occurrence of the insured event, as may be chosen by You at
the inception of the Benefit Option. The payout frequency can’t be
- the eligibility of the Life Insured as may be determined by the changed once the regular income commences. Any accrued income,
Company from time to time. due before intimation of the insured event, shall be paid with the first
Note: payout under this option.
- Medical Second Opinion/Personal Medical Case Management is The regular income instalments for frequencies other than annual shall
an optional service offered to You at no additional cost. You may be as specified below, where the Yearly Income below refers to the
exercise Your own discretion to avail the services and to follow the regular income payable in respect of annual frequency:
treatment path suggested by the service provider.
Frequency Income Instalment (per frequency)
- These services shall be directly provided by the service provider.
Half-yearly 98% of Yearly Income x 1/2
- The services can be availed only where the policy / rider is
Quarterly 97% of Yearly Income x 1/4
in-force.
Monthly 96% of Yearly Income x 1/12
- All the supporting medical records should be available to avail the
service. The income streams are payable as per the payout frequency chosen
and shall continue, -
- We reserve the right to discontinue the service or change the
service provider at any time. a) till the partner dies or reaches age 100 (last birthday), whichever
happens first, if one dependent partner is chosen to receive income;
- The services are being provided by third party service provider
and We will not be liable for any liability. b) till the last surviving partner dies or reaches age 100 (last birthday),
whichever happens first, if two dependent partners are chosen to
4. PAYMENT OF PREMIUM receive income.
You may pay the Rider Premiums in annual, semi-annual, quarterly or The regular income shall be triggered only once during the Coverage
monthly payment modes, as specified below, provided that the Rider Term. If the partner/surviving partner dies before the Coverage Term
Premium payment mode under this Rider shall always be same as the and insured event occurs after such death, the claimant shall be
premium payment mode of the Base Plan and can only be changed with the entitled to receive ‘Surrender Benefit’ as per Clause 4 of Part D.
change of premium payment mode of the Base Plan. The Rider Premium will In case of a Reduced Paid-up Rider, the regular income payout shall
change, if the premium payment mode under Base Plan is changed by You. be based on the adjusted Yearly Income defined as: (Number of
Premiums paid under Benefit Option / Number of Premiums payable
5. MODE OF PAYOUT
under Benefit Option) * Yearly Income applicable at the time of
For ‘CritiCare Benefit’, the only payout option available is “Combination of Reduced Paid-Up.
Lump Sum and Income”, and for ‘Accidental Death Benefit’, the payout
c) Waiver of Premium Benefit: : Under this mode, payout is available as
options available shall be “Combination of Lump Sum and Income” or
a Regular Pay without Return of Balance of Premium option. Under
“Partner Care”.
this mode of payout, the future Premium under the Base Plan, Rider/s
You may choose one of the following options to receive benefit, depending and any attached Benefit Option/s, if any, shall be waived off
on the Benefit Option selected: throughout the remaining Premium Payment Term of the Base
a) Combination of Lump sum and Income: You may choose to receive Plan/Rider or until the termination of the Base Plan/Rider, whichever is
the payout as either: earlier. The ‘Waiver of Premium Benefit’ opted shall not be applicable
• Lump sum benefit OR for Benefit Options availed subsequent to the selection of ‘Waiver of
Premium Benefit’ option and You may opt for ‘Waiver of Premium
• Income for the income period chosen OR Benefit’ additionally in respect of such Benefit Options chosen
• Combination of lump sum and income for the income period chosen. subsequently. Where Waiver of Premium Benefit is opted under
If ‘Combination of lump sum and income for the income period multiple Benefit Options, benefit of waiver under this mode of payment
chosen’ has been opted, You shall have the flexibility to choose shall terminate all the Waiver of Premium Benefits under the Rider.
payout in the form of lump-sum and/or income for the chosen income
6. PREMIUM GUARANTEE
period. Along with the lump sum amount, the Claimant shall also
receive regular income in arrears for chosen income period as per the The sum assured shall remain unchanged for a period as specified
chosen frequency which can be Annual / Half Yearly / Quarterly / under ‘Guaranteed Period’ from the policy commencement date of the
Monthly, from the date of occurrence of insured event. The payment benefit option. Upon the completion of ‘Guaranteed Period’, the sum
frequency cannot be changed once the regular income commences. assured as applicable for the benefit option may be revised subject to
Any accrued income, due before intimation, will be paid along with first IRDAI's approval. Any revision in the sum assured under the benefit
payout under this option. option shall be notified to the policyholder at least three months prior
to the policy anniversary (i.e. the effective date of change) and policy
The income chosen will be paid as per the frequency chosen for the holder will be given a period of 30 days from the effective date of
income period (A period up to 10 years as chosen). change to confirm with the revised terms under the benefit option. If
The regular income instalments for frequencies other than annual shall the policy holder is not willing to continue the benefit option with the
be as specified below, where the ‘Yearly Income’ below refers to the revised terms, all coverage under the respective benefit option benefit
regular income payable in respect of annual frequency: will get surrendered. The Sum Assured, if and when revised, shall be
guaranteed to the policyholder for a subsequent block as specified
Frequency Income Instalment (per frequency) under ‘Guaranteed Period’.
Half-yearly 98% of Yearly Income x 1/2
Benefit Option Guaranteed Period
Quarterly 97% of Yearly Income x 1/4
CritiCare Plus Benefit 5 years
Monthly 96% of Yearly Income x 1/12
CritiCare Benefit 10 years
In case of a Reduced Paid-up Rider, the regular income payable shall be
All other Benefit Options Entire term of the Benefit Option
based on the adjusted Yearly Income defined as: (Number of premiums
paid under benefit option / Number of premiums payable under benefit 7. WAITING PERIOD
option) * Yearly Income applicable at the time of Reduced Paid-Up
‘Waiting Period’ means a period during which specified
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diseases/treatments which have been diagnosed and/or have received • Regular Pay - Without Return of balance premium: No Surrender Value
medical advice/treatment are not covered. In the event of occurrence of
• Regular Pay - With Return of Balance Premium
any of such scenarios during the applicable Waiting Period,
If at least 2 full GSV Factor x Return of
- No benefit shall be payable; SSV Factor x Return of Balance
years’ Premiums Balance Premiums as
- the Premiums paid towards the Benefit Option during the Waiting
Premiums as on date of surrender
have been paid on date of surrender
Period will be refunded without any interest; and • Limited Pay - Without Return of balance premium
- the Benefit Option shall terminate and no future Premiums and
75% * (sum of Premiums paid
benefits shall be payable. excluding the first years’ Premium) *
Waiting Period as per the chosen Benefit Option shall be as under:
If at least 2 full (1-Premium Paying Term / Benefit
years’ Premiums Not available Option Coverage Term) * (Balance
Benefit Option Waiting Period applicable^ have been paid Benefit Option Coverage Term / Benefit
Criticare Benefit A waiting period of 90 days is applicable on Option Coverage Term)
Criticare Plus Benefit the first Diagnosis of any of the illness covered • Limited Pay - With Return of Balance Premium
under the respective Benefit Option
If at least 2 full GSV Factor x Return of
^
The Waiting Period for all benefits shall be applicable from later of: years’ Premiums Balance Premiums as SSV Factor x Return of Balance
• Date of Commencement of Risk, if Benefit Option is opted at have been paid on date of surrender Premiums as on date of surrender
inception;
• Policy Anniversary at which Benefit Option is opted (If Benefit Option is As the pricing interest rate reflects the prevailing market conditions, the
opted for on the Policy Anniversary); or Company may revise the SSV factors from time to time. However, any
change in the methodology/formula for calculating SSV factors shall be
• Date of revival (in case of revival of the Benefit Option). subject to IRDAI approval. Any change in SSV factors shall be filed with the
Authority and any changes therein shall be communicated to the
8. GRACE PERIOD
Policyholder. Please refer Company’s website or visit nearest branch for
A Grace Period of fifteen (15) days for monthly mode and thirty (30) days more details on the applicable GSV or SSV factor.
for all other modes, from the due date of Rider Premium will be allowed for
The SSV factors are applicable at the end of the year and shall be
payment of each subsequent Rider Premium. The coverage under the
interpolated, on a daily basis, to arrive at the factors applicable at the time
chosen Benefit Option will remain in force during this period. If the full Rider
of surrender.
Premium for the first 2 years from the Date of Commencement of Risk
under Rider remains unpaid at the end of Grace Period, the coverage All or any of the Benefit Options may be surrendered / discontinued
under the chosen Benefit Option shall lapse from the due date of the first separately or it gets surrendered / discontinued if the Base Plan is
unpaid Rider Premium. If any claim occurs during the Grace Period, any surrendered / discontinued or made paid-up.
due Rider Premium (without interest) for the full coverage year, in which the
insured event has occurred will be deducted from the claim pay-out. No surrender benefit is payable if the total claim/s value paid exceeds the
Total Premiums Paid.
PART D
5. REDUCED PAID-UP
POLICY SERVICING If any Rider Premium for a non-single pay Benefit Option remains unpaid at the
1. FREE LOOK PERIOD end of the Grace Period, the Benefit Option shall lapse/be converted to a
Reduced Paid-up Rider from the due date of the first unpaid Rider Premium.
You have a free look period of 15 days from the date of receipt of the Rider
The following is the treatment under various scenarios:
document and period of 30 days in case of Rider obtained through
distribution channels like Web Aggregators, online mode and direct sales Cover Continuance
(other than in person), to review the terms and conditions of the Rider. If PPT Before 2 years’ After 2 years’
You disagree to any of those terms or conditions, You have the option to premium paid premium paid
return the Rider for cancellation, stating the reasons for objection and be Without Return of Balance Premium
entitled to a refund of the premiums paid without interest after deduction Regular Pay / Cover ceases Cover ceases
of proportionate risk premium, stamp duty and medical examination cost Limited Pay to exist to exist
along with applicable taxes and cesses or levies, if any. With Return of Balance Premium
2. LOANS Regular Pay / Cover ceases Cover continues with
You are not entitled to any loans under this Rider.
Limited Pay to exist Reduced Paid-Up
Sum Assured if the
3. NON-FORFEITURE PROVISIONS Base Plan is converted
to Reduced Paid-up
If any Rider Premium for a non-single pay Benefit Option remains unpaid at Policy/Cover cease to
the end of the Grace Period, the Benefit Option shall lapse/be converted to exist if Base Plan
a Reduced Paid-up Policy from the due date of the first unpaid Rider is lapsed.
Premium. No benefits are payable under a lapsed Benefit Option.
In case a Policy is converted to Reduced Paid-up on Premium
4. SURRENDER BENEFIT discontinuance, the coverage will continue to be in reduced paid-up status
Surrender Benefit shall be the higher of the Guaranteed Surrender Value (GSV) with the Insured Amount re-set to the Reduced Paid Up Sum Assured under
or Special Surrender Value (SSV) payable under the following scenarios: the Benefit Option less any claims paid/payable.

Conditions for Guaranteed Under Reduced Paid-up (“RPU”) Rider, the RPU Sum Assured shall be as
acquiring Surrender Value Special Surrender Value (SSV) below:
Surrender Value (GSV) RPU Sum Assured = (Number of Premiums Paid under Benefit
• Single Pay - Without Return of balance premium Option/ Number of Premiums payable under Benefit Option) x Sum
Assured under the Benefit Option
75% * (sum of Premiums paid) *
Immediately on (1-Premium Paying Term / Benefit Maturity Benefit – As per ‘MATURITY BENEFIT provisions under Part
receiving the Not available Option Coverage Term) * (Balance C ‘BENEFITS’ of this Rider.
Premium Benefit Option Coverage Term / Benefit
6. REVIVAL OF THE RIDER
Option Coverage Term)
6.1 The lapsed Benefit Option may be revived (along with the Base Plan)
• Single Pay - With Return of balance premium on the payment of all due Premiums within Revival Period as applicable
Immediately on GSV Factor x Return of under the Base Plan, by paying interest or late payment fee, if any.
SSV Factor x Return of Balance
receiving the Balance Premiums as Premiums as on date of surrender
Premium on date of surrender If there is default in Premium beyond the Grace Period (as applicable under
the Base Plan) and subject to the Rider not having been surrendered, it
may be revived, in accordance with the prevailing Underwriting Policy
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within Revival Period (as applicable under the Base Plan) but before the 4. FRAUD AND NON-DISCLOSURE
Maturity/Expiry Date of Benefit Option, subject to: As per base Policy.
- - Your written application for reinstatement / revival;
5. CURRENCY AND PLACE OF PAYMENT
- Production of Insured’s current health certificate and other evidence of
insurability satisfactory to Us; and As per base Policy.
- Payment of all overdue premiums with interest. 6. FREEDOM FROM RESTRICTIONS
6.2 If the Rider/Benefit Option is not revived along with the Base Plan, the There are no restrictions on travel or occupation under this Rider.
Rider/Benefit Option shall be terminated by paying any residual Surrender
7. NOMINEE
Value (if any) as on the date of revival of the Base Plan and revival of such
terminated Rider/Benefit Option will not be allowed at a later stage. As per Base Plan.
6.3 The applicable interest rate for revival shall be the same as Base Plan. 8. ASSIGNMENT
Any alteration in the formula basis of determination of interest rate will be As per Base Plan.
subject to prior approval of IRDAI.
9. CHANGE IN ADDRESS
6.4 Upon revival, the benefits option shall be restored with effect from the
date of revival. In order to provide better service, We request you to intimate us in the
event of any change in the address of the Policyholder or the nominee.
6.5 The Benefit Option cannot be revived independently and can only be
revived along with the revival of the Base Plan. 10. DUPLICATE RIDER DOCUMENT
7. PAYMENT OF RIDER BENEFITS If the Rider document is lost or destroyed, then at Your request, the
Company will issue a duplicate Rider document. Upon the issuance of the
As per base Policy. duplicate Rider document, the original Rider document immediately and
8. TERMINATION OF THE RIDER/BENEFIT OPTION automatically ceases to have any validity. The Company will charge a fee of
Rs. 250/- along with the applicable taxes, cesses or levies, if any, for the
8.1 The Benefit Option shall terminate upon the happening of the first of issuance of a duplicate Rider document. These charges are subject to
the following events: revision by the Company from time to time.
8.1.1 on the expiry of Coverage Term;
11. AMENDMENT
8.1.2 on payment of Surrender Value of the Benefit Option;
As per base Policy.
8.1.3 on the date on which We receive free look cancellation request for
the Benefit Option within requisite period; 12. REGULATORY AND JUDICIAL INTERVENTION
8.1.4 on the payment of the benefit under Benefit Option or last instalment As per base Policy.
of income benefit payment or the date of intimation of repudiation of the 13. COMMUNICATION AND NOTICES
claim by Us;
As per base Policy.
8.1.5 on the expiry of the Revival Period, if the lapsed Benefit Option has
not been revived; 14. GOVERNING LAW AND JURISDICTION
8.1.6 on termination of Base Plan As per base Policy.
8.1.7 on the Maturity/Expiry Date or the date on which the Base Plan is PART G
surrendered, terminated or cancelled for any reason;
1. CONSUMER INFORMATION
8.1.8 on receipt of Your written request for cancellation of the Benefit
Option effective from the next Premium Due Date, after the completion of As per base Policy.
the free look period;
ANNEXURE 1 – DEFINITIONS AND EXCLUSIONS
8.1.9 on cancellation/ termination of this Rider/Benefit Option by Us on
grounds of misrepresentation, fraud or non- disclosure established in terms Definitions of Conditions covered (as applicable under the respective
of Section 45 of the Insurance Act, 1938 as amended from time to time. benefit)

PART E A. Term Benefit with Accelerated Terminal Illness

Terminal Illness: Terminal Illness is defined as an advanced or rapidly
1. FEES/CHARGES progressing incurable and un-correctable medical condition which, in the
This Rider is a Non-Linked Rider, therefore Part E is not applicable to this opinion of two (2) independent Medical Practitioners specializing in
Rider. treatment of such illness, life expectancy is no greater than twelve months
from the date of notification of claim. The terminal illness must be
PART F diagnosed and confirmed by independent medical practitioners’
GENERAL PROVISIONS specializing in treatment of such illness and registered with the Indian
Medical Association and the diagnosis of Terminal Illness should be
1. TAXES approved by the Company. The Company reserve the right for
1.1 All Premiums, Charges and interest payable under the Benefit Option independent assessment of the Terminal Illness.
are exclusive of applicable taxes, cesses or levies, if any, which will be
entirely borne/paid by You, in addition to the payment of such Premium, B. Accidental Death Benefit
charges or interest. We shall have the right to claim, deduct, adjust, recover C. Accidental Total and Permanent Disability
the amount of any applicable tax or imposition, levied by any statutory or
Accidental Death: Accidental Death shall mean death which
administrative body from the benefits payable under the Benefit Option.
• is caused by bodily injury resulting from an accident and
1.2 Tax benefits and liabilities under the Benefit Option are subject to
prevailing tax laws. Tax laws and the benefits arising thereunder are subject • occurs due to the said bodily injury solely, directly and independently
to change. You are advised to seek an opinion of Your tax advisor in of any other causes and
relation to the tax benefits and liabilities applicable to You. • occurs within 180 days of the occurrence of such accident

2. CLAIM PROCEDURE The benefit due to accidental death will be payable if the accident occurs
within the Benefit Option term even if death occurs beyond the term
As per base Policy. (however within 180 days of the accident)
3. MISTATEMENT OF AGE Accidental Total and Permanent Disability: Accidental Total and
As per base Policy. Permanent Disability means disability as a result of bodily injury caused by

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an accident and such injury shall within 180 days of its occurrence solely, viii. All Gastro-Intestinal Stromal Tumors histologically classified as
directly and independently of any other cause, result in the Member's T1N0M0 (TNM Classification) or below and with mitotic count of less
disability which must be total and permanent, and must result in at least than or equal to 5/50 HPFs;
one of the following: 2. Cardiomyopathy (of specified severity):
i. iLoss of sight in both eyes An impaired function of the heart muscle, unequivocally diagnosed as
ii. Loss of both arms or both hands; Cardiomyopathy by a Registered Medical Practitioner who is a
iii. Loss of one arm and one leg; cardiologist, and which results in permanent physical impairment to the
degree of New York Heart Association Classification Class III or Class IV,
iv. Loss of one arm and one foot;
or its equivalent, for at least six (6) months based on the following
v. Loss of one hand and one foot; classification criteria:
vi. Loss of one hand and one leg; • • Class III - Marked functional limitation. Affected patients are
vii. Loss of both legs; comfortable at rest but performing activities involving less than
ordinary exertion will lead to symptoms of congestive cardiac failure
viii. Loss of both feet;
• Class IV - Inability to carry out any activity without discomfort.
ix. Removal of the entire lower jaw Symptoms of congestive cardiac failure are present even at rest. With
x. Loss of one hand and loss of sight in one eye any increase in physical activity, discomfort will be experienced and
xi. Loss of one foot and loss of sight in one eye Echocardiography findings confirming presence of cardiomyopathy
and Left Ventricular Ejection Fraction (LVEF %) of 40% or less.
If the disability is due to amputation/dismemberment, the loss of hand will
mean amputation/dismemberment above wrist, the loss of arm will mean The following are excluded:
amputation/ dismemberment above elbow, the loss of feet will mean Cardiomyopathy directly related to alcohol or drug abuse.
amputation/dismemberment above ankle and the loss of leg will mean 3. Heart Transplant:
amputation/dismemberment above knee. This will include medically
necessary amputation necessitated by injury or disease. The separation The actual undergoing of a transplant of human heart that resulted from
has to be permanent without any chance of surgical correction. If the irreversible end stage heart failure. The undergoing of a heart transplant
disability is not due to amputation/dismemberment, the loss will mean loss has to be confirmed by a specialist medical practitioner.
of usage of both limbs and the limbs should have motor power grade 0/5, Stem Cell transplants are excluded.
1/5 or 2/5 only. 4. Major Surgery of Aorta:
Loss of a limb resulting directly or indirectly from self-inflicted injury, alcohol The actual undergoing of major surgery to repair or correct an aneurysm,
or drug abuse is excluded. The loss of use of the particular limb must be narrowing, obstruction or dissection of the aorta through surgical opening
certified by a relevant Medical Practitioner and documented for an of the chest or abdomen. For the purpose of this definition, aorta shall
uninterrupted period of at least six months. mean the thoracic and abdominal aorta but not its branches (including
The total Loss of Sight in one eye means total, permanent and irreversible aortofemoral or aortoiliac bypass grafts). The surgery must be determined
loss of all vision in an eye as a result of accident, evidenced by: to be medically necessary by a Consultant Cardiologist / Surgeon and
i. corrected visual acuity being 3/60 or less in one eye or; supported by imaging findings.
ii. the field of vision being less than 10 degrees in one eye The following are excluded:
The diagnosis of Loss of Sight in one eye must be certified by an • Surgery performed using only minimally invasive or intra-arterial
Ophthalmologist to be permanent in nature and must not be correctable techniques.
by aids or surgical procedure • Procedures done for treatment of Congenital heart disease are
excluded.
Loss of Sight in both eyes - Total, permanent and irreversible loss of all
vision in both eyes as a result of accident, evidenced by: 5. Myocardial Infarction (First Heart Attack of specified severity):
i. icorrected visual acuity being 3/60 or less in both eyes or; The first occurrence of heart attack or myocardial infarction, which means
ii. the field of vision being less than 10 degrees in both eyes the death of a portion of the heart muscle as a result of inadequate blood
supply to the relevant area. The diagnosis for Myocardial Infarction should
The diagnosis of Loss of Sight in both eyes must be certified by an
be evidenced by all of the following criteria:
Ophthalmologist to be permanent in nature and must not be correctable
by aids or surgical procedure. i. A history of typical clinical symptoms consistent with the diagnosis of
acute myocardial infarction (For e.g. typical chest pain)
D. Criticare ii. New characteristic electrocardiogram changes
E. Criticare Plus Benefit iii. Elevation of infarction specific enzymes, Troponins or other specific
biochemical markers.
1. Cancer of specified severity:
The following are excluded:
A malignant tumor characterized by the uncontrolled growth and spread of
malignant cells with invasion and destruction of normal tissues. This i. Other acute Coronary Syndromes
diagnosis must be supported by histological evidence of malignancy. The ii. Any type of angina pectoris
term cancer includes leukemia, lymphoma and sarcoma. iii. A rise in cardiac biomarkers or Troponin T or I in absence of overt
ischemic heart disease OR following an intra-arterial cardiac
The following are excluded –
procedure.
i. All tumors which are histologically described as carcinoma in situ,
benign, pre-malignant, borderline malignant, low malignant potential, 6. Open Chest CABG (Coronary Artery Bypass Graft):
neoplasm of unknown behavior, or non-invasive, including but not The actual undergoing of heart surgery to correct blockage or narrowing in
limited to: Carcinoma in situ of breasts, Cervical dysplasia CIN-1, CIN one or more coronary artery(s), by coronary artery bypass grafting done via
-2 and CIN-3. a sternotomy (cutting through the breast bone) or minimally invasive
ii. Any non-melanoma skin carcinoma unless there is evidence of keyhole coronary artery bypass procedures. The diagnosis must be
metastases to lymph nodes or beyond; supported by a coronary angiography and the realization of surgery has to
be confirmed by a cardiologist.
iii. Malignant melanoma that has not caused invasion beyond the
epidermis; The following are excluded:
iv. All tumors of the prostate unless histologically classified as having a - Angioplasty and/or any other intra-arterial procedures
Gleason score greater than 6 or having progressed to at least clinical 7. Open Heart Replacement or Repair of Heart Valves:
TNM classification T2N0M0
The actual undergoing of open-heart valve surgery is to replace or repair
v. All Thyroid cancers histologically classified as T1N0M0 (TNM one or more heart valves, as a consequence of defects in, abnormalities
Classification) or below; of, or disease affected cardiac valve(s). The diagnosis of the valve
vi. Chronic lymphocytic leukemia less than RAI stage 3 abnormality must be supported by an echocardiography and the
vii. Non-invasive papillary cancer of the bladder histologically described realization of surgery has to be confirmed by a specialist medical
as TaN0M0 or of a lesser classification, practitioner. Catheter based techniques including but not limited to,

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balloon valvotomy/valvuloplasty are excluded. A definite diagnosis of bacterial meningitis resulting in a persistent
8. Primary (Idiopathic) Pulmonary Hypertension: neurological deficit documented for at least 3 months following the date
of diagnosis. The diagnosis must be confirmed by a Consultant
A. An unequivocal diagnosis of Primary (Idiopathic) Pulmonary
Hypertension by a Cardiologist or Specialist in respiratory medicine Neurologist and supported by growth of pathogenic bacteria from
with evidence of right ventricular enlargement and the pulmonary cerebrospinal fluid culture.
artery pressure above 30 mm of Hg on Cardiac Cauterization. There For the above definition, the following are not covered:
must be permanent irreversible physical impairment to the degree of at - Aseptic, viral, parasitic or non-infectious meningitis
least Class IV of the New York Heart Association Classification (NYHA)
of cardiac impairment. 14. Benign Brain Tumor
B. The NYHA Classification of Cardiac Impairment are as follows: Benign brain tumor is defined as a life threatening, non-cancerous tumor
i. i. Class III: Marked limitation of physical activity. Comfortable at in the brain, cranial nerves or meninges within the skull. The presence of
rest, but less than ordinary activity causes symptoms. the underlying tumor must be confirmed by imaging studies such as CT
scan or MRI.
ii. Class IV: Unable to engage in any physical activity without
discomfort. Symptoms may be present even at rest. This brain tumor must result in at least one of the following and must be
C. Pulmonary hypertension associated with lung disease, chronic confirmed by the relevant medical specialist:
hypoventilation, pulmonary thromboembolic disease, drugs and • Permanent Neurological deficit with persisting clinical symptoms for a
toxins, diseases of the left side of the heart, congenital heart disease continuous period of at least 90 consecutive days or
and any secondary cause are specifically excluded • Undergone surgical resection or radiation therapy to treat the brain
9. Stroke resulting into permanent symptoms: tumor
Any cerebrovascular incident producing permanent neurological sequelae. The following conditions are excluded:
This includes infarction of brain tissue, thrombosis in an intracranial vessel,
haemorrhage and embolisation from an extra cranial source. Diagnosis Cysts, Granulomas, malformations in the arteries or veins of the brain,
has to be confirmed by a specialist medical practitioner and evidenced by hematomas, abscesses, pituitary tumors, tumors of skull bones and
typical clinical symptoms as well as typical findings in CT Scan or MRI of tumors of the spinal cord.
the brain. Evidence of permanent neurological deficit lasting for at least 3 15. Blindness:
months has to be produced. Total, permanent and irreversible loss of all vision in both eyes as a result
The following are excluded: of illness or accident.
• Transient ischemic attacks (TIA) The Blindness is evidenced by:
• Traumatic injury of the brain • corrected visual acuity being 3/60 or less in both eyes or;
• Vascular disease affecting only the eye or optic nerve or vestibular • the field of vision being less than 10 degrees in both eyes.
functions.
The diagnosis of blindness must be confirmed and must not be
10. Alzheimer's Disease correctable by aids or surgical procedure.
Progressive and permanent deterioration of memory and intellectual 16. Chronic Recurrent Pancreatitis:
capacity as evidenced by accepted standardised questionnaires and
An unequivocal diagnosis of Chronic Relapsing Pancreatitis, made by a
cerebral imaging. The diagnosis of Alzheimer’s disease must be confirmed
Specialist in gastroenterology and confirmed as a continuing inflammatory
by an appropriate consultant and supported by the Company’s appointed
disease of the pancreas characterised by irreversible morphological
doctor. There must be significant reduction in mental and social
change and typically causing pain and/or permanent impairment of
functioning requiring the continuous supervision of the life assured. There
function. The condition must be confirmed by pancreatic function tests
must also be an inability of the Life Assured to perform (whether aided or
and radiographic and imaging evidence.
unaided) at least 3 of the 6 “Activities of Daily Living” (defined in ‘Generic
Definitions’ section below) for a continuous period of at least 3 months. Relapsing Pancreatitis caused directly or indirectly, wholly or partly, by
alcohol is excluded.
The following are excluded:
17. Coma of Specified Severity:
• Any other type of irreversible organic disorder/dementia
• Non-organic disease such as neurosis and psychiatric illnesses; and A state of unconsciousness with no reaction or response to external stimuli
or internal needs. This diagnosis must be supported by evidence of all of
• Alcohol-related brain damage. the following:
11. Apallic Syndrome: • No response to external stimuli continuously for at least 96 hours;
A persistent vegetative state in which patients with severe brain damage • Life support measures are necessary to sustain life; and
(universal necrosis of the brain cortex with the brainstem remaining intact),
• Permanent neurological deficit which must be assessed at least 30
are in a state of partial arousal rather than true awareness. The Diagnosis
days after the onset of the coma.
must be confirmed by a Specialist Medical Practitioner (Neurologist)
acceptable to the Company and condition must be documented for at The condition has to be confirmed by a specialist medical practitioner.
least 30 days Coma resulting from alcohol or drug abuse is excluded.
12. Aplastic Anaemia: 18. Creutzfeldt-Jacob disease:
Chronic Irreversible persistent bone marrow failure which results in Creutzfeldt-Jacob disease is an incurable brain infection that causes
anaemia, neutropenia and thrombocytopenia requiring treatment with at rapidly progressive deterioration of mental function and movement. A
least two (2) of the following: neurologist must make a definite diagnosis of Creutzfeldt-Jacob disease
based on clinical assessment, EEG and imaging. There must be objective
(a) Regular Blood product transfusion;
permanent neurological abnormalities persisting for more than 180 days
(b) Marrow stimulating agents; along with severe progressive dementia.
(c) Immunosuppressive agents; or 19. Deafness:
(d) Bone marrow transplantation. Total and irreversible loss of hearing in both ears as a result of illness or
The Diagnosis and suggested line of treatment of aplastic anaemia must accident. This diagnosis must be supported by pure tone audiogram test
be confirmed by a Haematologist acceptable to the company using and certified by an Ear, Nose and Throat (ENT) specialist. Total means “the
relevant laboratory investigations including bone marrow biopsy. Two out loss of hearing to the extent that the loss is greater than 90decibels across
of the following three values should be present: all frequencies of hearing” in both ears.
• Absolute Neutrophil count of 500 per cubic millimetre or less; 20. Encephalitis:
• Absolute Reticulocyte count of 20,000 per cubic millimetre or less; and Severe inflammation of the brain substance (cerebral hemisphere,
• Platelet count of 20,000 per cubic millimetre or less. brainstem or cerebellum) caused by viral infection and resulting in
Temporary or reversible aplastic anaemia is excluded permanent neurological deficit for a min period of 60 days. This diagnosis
must be certified by a consultant neurologist and the permanent
13. Bacterial Meningitis: neurological deficit must result in an inability to perform at least three of the
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Activities of Daily Living (defined in ‘Generic Definitions’ section below) a continuous period of 12 months. This diagnosis must be supported by
either with or without the use of mechanical equipment, special devices or medical evidence furnished by an Ear, Nose, and Throat (ENT) specialist.
other aids and adaptations in use for disabled persons. All psychiatric related causes are excluded.
21. End Stage Liver Failure: 28. Major Head Trauma:
Permanent and irreversible failure of liver function that has resulted in all Accidental head injury resulting in permanent Neurological deficit to be
three of the following: assessed no sooner than 3 months from the date of the accident. This
• permanent jaundice; and diagnosis must be supported by unequivocal findings on Magnetic
Resonance Imaging, Computerized Tomography, or other reliable imaging
• ascites; and
techniques. The accident must be caused solely and directly by
• hepatic encephalopathy. accidental, violent, external and visible means and independently of all
Liver failure secondary to drug or alcohol abuse is excluded. other causes.
22. End Stage Lung Failure: The Accidental Head injury must result in an inability to perform at least
End stage lung disease, causing chronic respiratory failure, as confirmed three (3) of the following Activities of Daily Living (defined in ‘Generic
and evidenced by all of the following: Definitions’ section below) either with or without the use of mechanical
equipment, special devices or other aids and adaptations in use for
• FEV1 test results consistently less than 1 litre measured on 3 disabled persons. For the purpose of this benefit, the word “permanent”
occasions 3 months apart; and
shall mean beyond the scope of recovery with current medical knowledge
• Requiring continuous permanent supplementary oxygen therapy for and technology.
hypoxemia; and
The following are excluded:
• Arterial blood gas analyses with partial oxygen pressures of 55mmHg
or less (PaO2 < 55 mmHg); and - Spinal cord injury
• Dyspnea at rest. 29. Major Organ (less heart)/ Bone Marrow Transplant:
The actual undergoing of a transplant of:
23. Fulminant Viral Hepatitis: • One of the following human organs: lung, liver, kidney, pancreas, that
resulted from irreversible end stage failure of the relevant organ, or
A definite diagnosis of fulminant viral hepatitis evidenced by all of the
• Human bone marrow using haematopoietic stem cells
following:
The undergoing of a transplant has to be confirmed by a specialist medical
• Typical serological course of acute viral hepatitis
practitioner.
• Development of hepatic encephalopathy
The following are excluded:
• Decrease in liver size
• Other stem-cell transplants
• Increase in bilirubin levels
• Where only Islets of Langerhans are transplanted
• Coagulopathy with an international normalized ratio (INR) greater than
1.5 30. Medullary Cystic Kidney Disease:
• Development of liver failure within 7 days of onset of symptoms Medullary Cystic Disease is a disease where the following criteria are met:
• No known history of liver disease • The presence in the kidney of multiple cysts in the renal medulla
accompanied by the presence of tubular atrophy and interstitial
The diagnosis must be confirmed by a Consultant Gastroenterologist.
fibrosis;
For the above definition, the following are not covered:
• Clinical manifestations of anaemia, polyuria and progressive
• All other non-viral causes of acute liver failure (including but not limited deterioration in kidney function; and
to paracetamol or aflatoxin intoxication)
• The diagnosis of medullary cystic disease is confirmed by renal biopsy.
• Fulminant viral hepatitis associated with intravenous drug use
• Isolated or benign kidney cysts are specifically excluded from this
24. Kidney Failure Requiring Dialysis: benefit.
End stage renal disease presenting as chronic irreversible failure of both 31. Motor Neuron Disease with Permanent Symptoms:
kidneys to function, as a result of which either regular renal dialysis
(hemodialysis or peritoneal dialysis) is instituted or renal transplantation is Motor neuron disease diagnosed by a Specialist Medical Practitioner as
carried out. Diagnosis has to be confirmed by a specialist medical spinal muscular atrophy, progressive bulbar palsy, amyotrophic lateral
practitioner. sclerosis or primary lateral sclerosis. There must be progressive
degeneration of corticospinal tracts and anterior horn cells or bulbar
25. Loss of Independent Existence: efferent neurons. There must be current significant and permanent
Confirmation by a consultant physician acceptable to the Company of the functional neurological impairment with objective evidence of motor
loss of independent existence due to illness or trauma, which has lasted dysfunction that has persisted for a continuous period of at least 3 months.
for a minimum period of 6 months and results in a permanent inability to 32. Multiple Sclerosis with Persisting Symptoms:
perform at least three (3) of the Activities of Daily Living (either with or
without the use of mechanical equipment, special devices or other aids The unequivocal diagnosis of Definite Multiple Sclerosis confirmed and
and adaptations in use for disabled persons). For the purpose of this evidenced by all of the following:
benefit, the word “permanent”, shall mean beyond the hope of recovery • investigations including typical MRI findings which unequivocally
with current medical knowledge and technology. The “Activities of Daily confirm the diagnosis to be multiple sclerosis and
Living” have been defined in ‘Generic Definitions’ section below • there must be current clinical impairment of motor or sensory function,
The following is excluded: which must have persisted for a continuous period of at least 6
Any injury or loss as a result of War, invasion, hostilities (whether war is months.
declared or not), civil war, rebellion, revolution or taking part in a riot or civil Other causes of neurological damage such as SLE are excluded.
commotion. 33. Muscular Dystrophy:
26. Loss of Limbs: Muscular Dystrophy is a disease of the muscle causing progressive and
The physical separation of two or more limbs, at or above the wrist or ankle permanent weakening of certain muscle groups. The diagnosis of
level limbs as a result of injury or disease. This will include medically muscular dystrophy must be made by a consultant neurologist, and
necessary amputation necessitated by injury or disease. The separation confirmed with the appropriate laboratory, biochemical, histological, and
has to be permanent without any chance of surgical correction. Loss of electromyographic evidence. The disease must result in the permanent
Limbs resulting directly or indirectly from self-inflicted injury, alcohol or inability of the insured to perform (whether aided or unaided) at least three
drug abuse is excluded. (3) of the six (6) “Activities of Daily Living” (defined in ‘Generic Definitions’
27. Loss of Speech: section below).

Total and irrecoverable loss of the ability to speak as a result of injury or 34. Parkinson's Disease:
disease to the vocal cords. The inability to speak must be established for Unequivocal Diagnosis of progressive degenerative primary idiopathic
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Parkinson’s disease (all other forms of Parkinsonism are excluded) by a with only hematological and joint involvement are specifically excluded.
Registered Medical Practitioner who is a neurologist where the condition: Abbreviated ISN/RPS classification of lupus nephritis (2003):
• cannot be controlled with medication; and Class I - Minimal mesangial lupus nephritis
• shows objective signs of progressive impairment; and Class II - Mesangial proliferative lupus nephritis
• Activities of Daily Living assessment confirms the inability of the Class III - Focal lupus nephritis
Member to perform at least 3 of the Activities of Daily Living as defined
in “Generic Definitions” section below, either with or without the use of Class IV - Diffuse segmental (IV-S) or global (IV-G) lupus nephritis
mechanical equipment, special devices or other aids or adaptations in Class V - Membranous lupus nephritis
use for disabled persons, for a continuous period of six months. Class VI - Advanced sclerosing lupus nephritis
35. Permanent Paralysis of Limbs: The final diagnosis must be confirmed by a certified doctor specialising in
Total and irreversible loss of use of two or more limbs as a result of injury Rheumatology and Immunology.
or disease of the brain or spinal cord. A specialist medical practitioner must 40. Third Degree Burns:
be of the opinion that the paralysis will be permanent with no hope of
recovery and must be present for more than 3 months. There must be third-degree burns with scarring that cover at least 20% of
the body’s surface area. The diagnosis must confirm the total area
36. Poliomyelitis:
involved using standardized, clinically accepted, body surface area charts
The first occurrence of poliomyelitis where the following conditions covering 20% of the body surface area.
are met:
i. Poliovirus is identified as the cause and is provided by stool analysis Generic Definitions

ii. Paralysis of the limb muscles or respiratory muscles must be present Accident: An Accident means sudden, unforeseen and involuntary event
and persist for at least 3 months caused by external, visible and violent means.
Activities of Daily Living: The Activities of Daily Living are:
37. Progressive Scleroderma: i. Washing: the ability to wash in the bath or shower (including getting into
and out of the bath or shower) or wash satisfactorily by other means;
A systemic collagen-vascular disease causing progressive diffuse fibrosis
in the skin, blood vessels and visceral organs. This diagnosis must be ii. Dressing: the ability to put on, take off, secure and unfasten all
unequivocally supported by biopsy and serological evidence and the garments and, as appropriate, any braces, artificial limbs or other
disorder must have reached systemic proportions to involve the heart, surgical appliances;
lungs or kidneys. iii. Transferring: the ability to move from a bed to an upright chair or
The systemic involvement should be evidenced by any two of the following wheelchair and vice versa;
findings - iv. Mobility: the ability to move indoors from room to room on level
• Lung fibrosis with a diffusing capacity (DCO) of less than 70% of surfaces;
predicted v. Toileting: the ability to use the lavatory or otherwise manage bowel and
• Pulmonary hypertension with a mean pulmonary artery pressure of bladder functions so as to maintain a satisfactory level of personal
more than 25 mmHg at rest measured by right heart catheterization hygiene;

• Chronic kidney disease with a GFR of less than 60 ml/min vi. Feeding: the ability to feed oneself once food has been prepared and
(MDRD-formula) made available.

• Echocardiographic findings suggestive of Grade III and above left Adventurous Pursuits or Hobbies: Adventurous Pursuits or Hobbies
ventricular diastolic dysfunction include but are not limited to any kind martial arts, racing (other than on
foot or swimming); potholing, rock climbing (except on man-made walls),
The diagnosis must be confirmed by a Consultant Rheumatologist or hunting, mountaineering or climbing requiring the use of ropes or guides,
Nephrologist. any underwater activities involving the use of underwater breathing
The following conditions are excluded: apparatus including deep sea diving, sky diving, cliff diving, bungee
• Localised scleroderma (linear scleroderma or morphea); jumping, paragliding, hand gliding and parachuting.
• Eosinophilic fascitis; and Biological attack: Biological attack or weapons means the emission,
discharge, dispersal, release or escape of any pathogenic (disease
• CREST syndrome producing) microorganisms and/or biologically produced toxins (including
38. Severe Rheumatoid Arthritis: genetically modified organisms and chemically synthesized toxins) which
are capable of causing any Illness, incapacitating disablement or death.
Unequivocal Diagnosis of systemic immune disorder of rheumatoid
arthritis where all of the following criteria are met: Chemical attack: Chemical attack or weapons means the emission,
discharge, dispersal, release or escape of any solid, liquid or gaseous
(a) Diagnostic criteria of the American College of Rheumatology for chemical compound which, when suitably distributed, is capable of
Rheumatoid Arthritis and has been diagnosed by a Rheumatologist; causing any Illness, incapacitating disablement or death.
(b) Permanent inability to perform at least three (3) of the six (6) Activities Congenital Anomaly: Congenital Anomaly means a condition which is
of Daily Living (defined in ‘Generic Definitions’ section below); present since birth, and which is abnormal with reference to form,
(c) Widespread joint destruction and major clinical deformity of three (3) or structure or position.
more of the following joint areas: hands, wrists, elbows, knees, hips, a) Internal Congenital Anomaly: Congenital anomaly which is not in the
ankle, cervical spine or feet confirmed by clinical and radiological visible and accessible parts of the body.
evidence; and b) External Congenital Anomaly: Congenital anomaly which is in the
(d) The foregoing conditions have been present for at least six (6) months. visible and accessible parts of the body
For the above definition, the following are not covered: Cooling Off Period: In case of multiple minor stage claims under the same
category (Critical illness, Cancer or Cardiac as applicable), the acceptance
- Reactive arthritis, psoriatic arthritis and activated osteoarthritis
of the claims shall be subject to a Cooling Off Period. Cooling off Period
39. Systemic Lupus Erythematosus (SLE) with Renal Involvement: shall apply after each occurrence of the condition/procedure, provided
Multi-system, autoimmune disorder characterized by the development of such occurrence resulted into a valid minor stage claim.
auto-antibodies, directed against various self-antigens. For purposes of • For multiple minor stage claims, there needs to be a period of at least
the definition of “Critical Illness”, SLE is restricted to only those forms of 180 days between the date of occurrence of a minor stage condition
systemic lupus erythematosus, which involve the kidneys and are and date of occurrence of a subsequent minor stage condition. No
characterized as Class III, Class IV, Class V or Class VI lupus nephritis minor claims shall be payable in this period for the aforementioned
under the Abbreviated International Society of Nephrology/Renal scenario.
Pathology Society (ISN/RPS) classification of lupus nephritis (2003) below • Date of occurrence is the date of diagnosis of a covered illness or the
based on renal biopsy. Other forms such as discoid lupus, and those forms date of undergoing of any procedure covered under minor conditions

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• However, this requirement of 180 days is not applicable in case of by the insured;
diagnosis of a major stage condition following a minor stage claim. • must not exceed the level of care necessary to provide safe, adequate
• A particular minor condition can be claimed only once during the and appropriate medical care in scope, duration, or intensity;
Benefit Option Term. • must have been prescribed by a medical practitioner;
Hospital: A Hospital means any institution established for in-patient care • must conform to the professional standards widely accepted in
and day care treatment of illness and/or injuries and which has been international medical practice or by the medical community in India.
registered as a hospital with the local authorities under the Clinical
Establishments (Registration and Regulation) Act, 2010 or under Pre-Existing disease: Pre-Existing condition means any condition,
enactments specified under the Schedule of Section 56(1) and the said Act ailment, injury or disease:
or, complies with all minimum criteria as under: • That is/are diagnosed by a physician within 48 months prior to the
effective date of the policy issued by the Company or its revival
• Has at least 10 inpatient beds, in those towns having a population of
less than 10,00,000 and atleast 15 inpatient beds in all other places; • For which medical advice or treatment was recommended by, or
received from, a physician within 48 months prior to the effective date
• Has qualified nursing staff under its employment round the clock;
of the policy issued by the Company or its revival
• Has qualified medical practitioner(s) in charge round the clock;
Surgery / Surgical Procedure: Surgery / Surgical Procedure means
• Has a fully equipped operation theatre of its own where surgical manual and/or operative procedure(s) required for treatment of an illness
procedures are carried out; and or injury, correction of deformities and defects, diagnosis and cure of
• Maintains daily records of patients and makes these accessible to the diseases, relief from suffering or prolongation of life, performed in a
Tata AIA’s authorized personnel. hospital or day care centre by a medical practitioner.
Hospitalization: Hospitalization means admission in hospital for minimum Symptom: Symptom is a physical or mental feature which is regarded as
period of 24 consecutive ‘In patient care’ hours except for specified indicating presence of a disease, particularly such a feature is apparent to
procedures / treatments, where such admission could be for a period of an individual and will result in a medical consultation and/or further
less than 24 consecutive hours. investigations to confirm the cause.
Illness: An Illness means a sickness or a disease or pathological condition
Exclusions:
leading to the impairment of normal physiological function and requires
medical treatment. Details of the Exclusions applicable under the various 'Health Benefit
options' are given below
(a) Acute condition - Acute condition is a disease, illness or injury that is
likely to respond quickly to treatment which aims to return the person Term Benefit with Accelerated Terminal Illness (T&TI)
to his or her state of health immediately before suffering the disease/ Suicide Exclusion: In case of death due to suicide within 12 months
illness/ injury which leads to full recovery from the date of commencement of risk under the policy or from the
(b) Chronic condition - A chronic condition is defined as a disease, date of revival of the policy, as applicable, the nominee or beneficiary
illness, or injury that has one or more of the following characteristics: of the policyholder shall be entitled to at least 80% of the total
premiums paid till the date of death or the surrender value available as
1. it needs ongoing or long-term monitoring through consultations,
examinations, check-ups, and /or tests
on the date of death whichever is higher, provided the policy is in
force.
2. it needs ongoing or long-term control or relief of symptoms
No other claim would be entertained by the Company except the
3. it requires rehabilitation for the patient or for the patient to be refund of 80% Total Premiums Paid or the acquired surrender value,
specially trained to cope with it as applicable.
4. it continues indefinitely
Apart from Suicide exclusion detailed above, no other exclusion is
5. it recurs or is likely to recur applicable in the event of death.
Injury: An Injury means accidental physical bodily harm excluding illness or Terminal Illness Exclusion: The Life Insured will not be entitled to any
disease solely and directly caused by external, violent and visible and Terminal Illness benefit if it is caused directly or indirectly due to or
evident means which is verified and certified by a Medical Practitioner. occasioned, accelerated or aggravated by intentional self-inflicted
Intensive Care Unit: Intensive Care Unit (ICU) means an identified section, injury or attempted suicide, whether medically sane or insane.
ward or wing of a hospital which is under the constant supervision of a Accidental Death Benefit (ADB)
dedicated medical practitioner(s), and which is specially equipped for the
Accidental Death Benefit shall not be payable for any losses caused
continuous monitoring and treatment of patients who are in a critical
directly or indirectly, wholly or partly, by any one of the following
condition, or require life support facilities and where the level of care and
occurrences:
supervision is considerably more sophisticated and intensive than in the
ordinary and other wards. • Death as a result of any disease or infection
Medical Advice: Medical Advice means any consultation or advice from a • Death arising due to any condition other than death solely and
Medical Practitioner including the issuance of any prescription or follow-up directly as a result of an accident
prescription. • Any Pre-existing condition or Disability arising out of a Pre-existing
Diseases or any complication arising therefrom. Wherever the
Medical Practitioner: A Medical Practitioner means person who holds a
proximate cause is accident which has occurred after the rider
valid registration from the Medical Council of any State or Medical Council
inception date, this exclusion shall not apply.
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 • Suicide, attempted suicide, intentional self-inflicted injury, acts of
practice medicine within its jurisdiction; and is acting within its scope and self-destruction, irrespective of mental condition.
jurisdiction of license. • Death arising from or caused due to use, abuse or a consequence or
The person must be qualified in allopathic system of medicine and shall influence of an abuse of any substance, intoxicant, drug, alcohol or
hallucinogen
not be
• Death arising out of or attributable to foreign invasion, act of foreign
• The Policyholder/ Insured person himself/herself; or
enemies, hostilities, warlike operations (whether war be declared or
• An authorized Insurance Intermediary (or related persons) involved not or while performing duties in the armed forces of any country
with selling or servicing the insurance contract in question; or during war or at peace time), participation in any naval, military or
• Employed by or under contractual engagement with the Insurance air-force operation, civil war, public defense, rebellion, revolution,
Company; insurrection, military or usurped power.
• Related to the Policyholder/ Insured person by blood or marriage. • Death caused by participation of the insured person in any flying
activity, except as a bona fide, fare-paying passenger of a
Medically Necessary Treatment: Medically Necessary Treatment means recognized airline on regular routes and on a scheduled timetable.
any treatment, tests, medication, or stay in hospital or part of a stay in
hospital which
• Insured Person whilst engaging in a speed contest or racing of any
kind (other than on foot), bungee jumping, parasailing, ballooning,
• is required for the medical management of the illness or injury suffered parachuting, skydiving, paragliding, hang gliding, mountain or rock
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C262656195 Page 38 of 100

 climbing necessitating the use of guides or ropes, potholing, the policy is caused or aggravated directly or indirectly by any of the
abseiling, deep sea diving using hard helmet and breathing following:
apparatus, polo, snow and ice sports in so far as they involve the • Pre-Existing Diseases are not covered. Any pre-existing disease at
training for or participation in competitions or professional sports, the time of inception of the policy.
or involving a naval, military or air force operation and is specifically
specified in the Policy Schedule. • Any investigation or treatment for any Illness, disorder,
complication or ailment arising out of or connected with the
• Working in underground mines, tunnelling or explosives, or
involving electrical installation with high tension supply, or as pre-existing Illness shall be considered part of that pre-existing
jockeys or circus personnel, or engaged in Hazardous Activities illness.
• Death arising or resulting from the Insured Person committing • No benefits will be payable for any condition(s) which is a direct or
any breach of law or participating in an actual or attempted indirect result of any pre-existing conditions unless Life Assured
felony, riot, crime, misdemeanor, or civil commotion with has disclosed the same at the time of proposal or date of revival
criminal intent. whichever is later and the Company has accepted the same.
• Death arising from or caused by ionizing radiation or contamination • Any covered condition which is diagnosed and/or received medical
by radioactivity from any nuclear fuel (explosive or hazardous form) advice/treatment within the waiting period.
or resulting from or from any other cause or event contributing • Self-inflicted injuries, attempted suicide, insanity, and deliberate
concurrently or in any other sequence to the loss, claim or expense participation of the Life Assured in an illegal or criminal act with
from any nuclear waste from the combustion of nuclear fuel, criminal intent.
nuclear, chemical or biological attack. • Use of intoxicating drugs / alcohol / solvent, taking of drugs except
Accidental Total and Permanent Disability Benefit (ATPD) under the direction of a medical practitioner.
Accidental Disability Benefit shall be not payable for any losses caused • Any illness due to an external congenital defect
directly or indirectly, wholly or partly, by any one of the following • Engaging in hazardous sports / pastimes, i.e. taking part in (or
occurrences: practising for) boxing, caving, climbing, horse racing, jet skiing,
• Disablement as a result of any disease or infection martial arts, mountaineering, off pastel skiing, pot holing, power
• Disablement arising due to any condition other than disablement boat racing, underwater diving, yacht racing or any race, trial or
solely and directly as a result of an accident timed motor sport, bungee jumping, hand gliding etc.
• Any Pre-existing condition or Disability arising out of a Pre-existing • Any injury, sickness or disease received as a result of aviation
Diseases or any complication arising therefrom. Wherever the (including parachuting or skydiving), gliding or any form of aerial
proximate cause is accident which has occurred after the rider flight other than as a fare-paying passenger or crew on a licensed
inception date, this exclusion shall not apply. passenger-carrying commercial aircraft operating on regular routes
and on a scheduled timetable unless agreed by special
• If the Disability has not persisted for at least 180 days and is not in endorsement.
the opinion of a medical practitioner, deemed to be permanent.
• War, invasion, hostilities (whether war is declared or not), civil war,
• Attempted suicide, intentional self-inflicted injury, acts of rebellion, terrorist activity, revolution or taking part in a riot or civil
self-destruction irrespective of mental condition. commotion, strikes or industrial action.
• Disablement arising from or caused due to use, abuse or a • Any treatment of a donor for the replacement of an organ
consequence or influence of an abuse of any substance,
intoxicant, drug, alcohol or hallucinogen • Nuclear reaction, Biological, Chemical or Radioactive
contamination due to nuclear accident
• Disablement arising out of or attributable to foreign invasion, act of
foreign enemies, hostilities, warlike operations (whether war be • Diagnosis and treatment outside India.
declared or not or while performing duties in the armed forces of • Ayurvedic, Homeopathy, Unani, herbalist treatment, any other
any country during war or at peace time), participation in any naval, treatments other than Allopathy / western medicines.
military or air-force operation, civil war, public defense, rebellion,
revolution, insurrection, military or usurped power.
• Disablement caused by participation of the insured person in any
flying activity, except as a bona fide, fare-paying passenger of a
recognized airline on regular routes and on a scheduled timetable.
• Insured Person whilst engaging in a speed contest or racing of any
kind (other than on foot), bungee jumping, parasailing, ballooning,
parachuting, skydiving, paragliding, hang gliding, mountain or rock
climbing necessitating the use of guides or ropes, potholing,
abseiling, deep sea diving using hard helmet and breathing
apparatus, polo, snow and ice sports in so far as they involve the
training for or participation in competitions or professional sports,
or involving a naval, military or air force operation and is specifically
specified in the Policy Schedule.
• Working in underground mines, tunnelling or explosives, or
involving electrical installation with high tension supply, or as
jockeys or circus personnel, or engaged in Hazardous Activities
• Disablement arising or resulting from the Insured Person
committing any breach of law or participating in an actual or
attempted felony, riot, crime, misdemeanor, or civil commotion with
criminal intent.
• Disablement arising from or caused by ionizing radiation or
contamination by radioactivity from any nuclear fuel (explosive or
hazardous form) or resulting from or from any other cause or event
contributing concurrently or in any other sequence to the loss,
claim or expense from any nuclear waste from the combustion of
nuclear fuel, nuclear, chemical or biological attack.
CritiCare Benefit (CB) and CritiCare Plus Benefit (CPB)
In addition to the disease specific exclusions given along with
definitions of the respective diseases covered under the Benefit
Option, no benefit will be payable if death or the illness covered under
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C262656195 Page 39 of 100

 Tata AIA Life Insurance Non-Linked Comprehensive Health Rider

PART B inception of the Rider, which cannot be changed once chosen. However,
Tata AIA Life Insurance Non-Linked Comprehensive Health Rider is a You may propose to avail additional benefit/s under the Rider in future on
non-linked, non-participating Individual Health Rider. one or more lives (may or may not include coverage on self) subject to
insurable interest between the Policyholder and the Life Insured, and as
DEFINITIONS per the Board Approved Underwriting Policy.
The words and phrases listed below will have the meanings attributed to If there is an overlapping benefit between the Base Plan and the Benefit
them wherever they appear in this Rider unless the context otherwise option, the Benefit option shall not be offered.
requires. The terms used in this Rider but not defined will derive their At no point both unit-deduction rider and this rider shall be allowed to be
meaning from the Policy. attached during the Policy Term of a unit-linked policy.
1. “Annualised Rider Premium” means the premium payable in a year Provided the Rider/Base Plan is in force, the following benefit(s) shall be
chosen by the Policyholder, excluding the taxes, underwriting extra payable:
premiums and loadings for modal Rider Premiums, if any, as specified I. HOSPICARE BENEFIT
in the Schedule.
In case of hospitalization, after completion of hospitalization for a
2. “Coverage Term” means the term under the chosen benefit option as minimum period of continuous 24 hours, for a medically necessary
specified in the Schedule; treatment of any illness or injury, We shall pay the Insured Amount as
3. “Date of Commencement of Risk” means the date as specified in below:
the Schedule, on which the coverage under this Rider/benefit option
a) Hospital Cash Benefit:
commences;
You can claim daily cash Benefit, i.e. 0.5% of the Insured Amount
4. “Insured Amount” under a benefit option shall be the highest of:
per day, payable from the first day for the duration of
- 11 times the Annualised Premium for Limited Pay/Regular Pay hospitalization. Hospital Cash Benefit is payable for a maximum
and 1.25 times for Single Premium [excluding the underwriting 30 days per Policy Year, subject to a maximum of 200 days during
extra premiums, modal loading and applicable taxes, cess or the entire Rider Term.
levies (if any)] for the respective benefit option;
b) ICU Benefit:
- 105% of Total Premiums Paid (excluding loading for modal
Premiums) as up to the date of occurrence of the underlying An additional 0.5% of Insured Amount per day shall be payable for
insured event; and each day of stay in the Intensive Care Unit (ICU) subject to the
daily cash benefit being payable at the time of hospitalization. This
- Sum Assured under the Benefit Option. benefit is payable for hospitalization up to 15 days per coverage
5. “IRDAI” means the Insurance Regulatory and Development Authority year. This benefit is a fixed per-day benefit and will be paid
of India; irrespective of actual hospitalization expenses.
6. “Life Insured” shall mean the person insured under the respective c) Recuperating Benefit:
benefit option as specified in the Schedule;
A lump sum benefit equal to 1.5% of the Insured Amount shall be
7. “Maturity/Expiry Date” means the date specified in the Schedule, on payable in case of continuous hospitalization in one or more
which the Coverage Term expires; hospitals for 7 or more days (excluding the time taken for transit
8. “Policy/Base Plan” means the base policy to which this Rider is between hospitals) for the same insured event, subject to the daily
attached; cash benefit under Clause 1.1 being payable at the time of
9. “Rider” means this rider contract containing these terms and hospitalization.
conditions; This benefit shall be paid once in a coverage year. This
10. “Rider Premium” means an amount specified in the Schedule against benefit is not payable if the Life Insured dies during the
respective benefit option, payable by You, by the due dates to secure hospitalization period.
the benefits under the Rider, excluding applicable taxes, cesses or The benefit can be claimed up to 100% of the Insured Amount
levies, if any; under the benefit option throughout the chosen Coverage Term
11. “Sum Assured under the Benefit Option” shall be the sum of (a) under the benefit option.
lump sum and (b) present value all future income streams chosen II. ACCIDENTAL PERMANENT TOTAL / PARTIAL DISABILITY
under the respective benefit option, and shall be as specified in the BENEFIT
schedule. In the event of the Total and Permanent Disability (as detailed in Annexure
12. “Schedule” means the Policy schedule and any endorsements A) of the Life Insured due to an Accident within the Coverage Term, the
attached to and forming part of the Base Plan and Rider and if any, Insured Amount shall be payable, provided the Total and Permanent
updated Schedule is issued, then, the Schedule latest in time; Disability occurs within 180 days from the date of that Accident.
13. “Survival Period” in respect of a chosen benefit option shall be: In the event of Permanent and Partial Disability (as explained below) of the
Benefit option Survival period Life Insured due to an Accident within the Coverage Term, a percentage of
Insured Amount shall be payable, provided the event occurs within 180
Multistage Cancer Care Benefit 7 days days from the date of that Accident (even if the event occurs beyond the
Multistage Cardiac Care Benefit 14 days Coverage Term).
Multistage Critical Illness Benefit 30 days Amount of Benefit
Survival Period shall not Applicable for Accidental Permanent Total / Description of Disability (% of Rider
Partial Disability Benefit. Insured Amount)
14. “Total Rider Premiums Paid” shall be defined as the sum of all the Total and Permanent Disability 100%
premiums paid to date in respect of chosen benefit option/s, excluding Partial and Permanent Disability:
Extra Premiums, applicable taxes, cesses or levies, if any. Permanent loss of -
15. “Underwriting Policy” means an underwriting policy approved by - each arm at the shoulder joint 60%
Our board of directors; - each arm to a point above elbow joint 55%
16. “We”, “Us” or “Our” means Tata AIA Life Insurance Company - each arm below elbow joint 50%
Limited; and
- each hand at the wrist 50%
17. “You”, “Your” or “Policyholder” means the policyholder as named in
- each thumb 20%
the Schedule, who is the policyholder under the Base Plan and Rider.
- each index finger 10%
The capitalized words used but not defined herein, shall borrow
meaning as per the term and conditions of the Policy. - each finger other than the thumb or index finger 5%
- each leg above center of the femur 60%
PART C - each leg up to a point below the femur 55%
1. BENEFITS - each leg to a point below the knee 50%
The benefits shall depend on the plan option chosen by You at the - each foot at the ankle 40%
Tata AIA Life Insurance Non-Linked Comprehensive Health Rider (UIN - 110A031V02) • IRDA of India Regn no. 110

C262656195 Page 40 of 100

 Description of Disability Amount of Benefit No Minor Critical Illnesses/Procedure
(% of Rider 23 Muscular Dystrophy
Insured Amount)
24 Parkinson's Disease
- each big toe 5%
25 Progressive Scleroderma
- each toe other than the big toe 2%
26 SLE with Renal Involvement
Loss of sight in each eye 50%
27 Bacterial Meningitis
Loss of Hearing in each ear 30%
28 Chronic Recurrent Pancreatitis
Upon payment of a benefit under this benefit option, the Insured Amount 29 Loss of Independent Existence
shall be reduced to the extent of benefit paid and the cover shall continue 30 Poliomyelitis
for the balance Insured Amount, if any. This benefit option shall terminate
31 Creutzfeldt - Jacob disease
on payment of a cumulative 100% of the Insured Amount under this
benefit. For calculation of the cumulative value of Insured Amount, only the a) Minor Critical Illness –
payout to the extent of percentage of the Insured Amount mentioned
above shall be considered. Upon Diagnosis of illness or actual undergoing of the procedure of the
covered Minor Critical Illness (as detailed in Annexure A), 25% of the
DOUBLE BENEFIT Insured Amount shall be payable.
If you have chosen Accidental Permanent Total/Partial Disability Benefit, Multiple claims for different Minor Critical Illness shall be admissible till
We shall pay twice the amount of this benefit if the disability occurs under the aggregate payout under the benefit does not exceed 100% of the
any of the following circumstances: Insured Amount. For multiple claims (except Major Critical Illness),
1. While the Life Insured is riding as a fare paying passenger on there needs to be a period of at least 180 days between the date of
commercially licensed public land transportation over an established occurrence of insured event and the date of occurrence of a
route such as a bus, tram or train. A taxi or any form of transport subsequent insured event. A particular Minor Critical Illness can be
chartered for private travel is excluded. claimed only once during the Coverage Term.
2. While the Life Insured is in an elevator car (elevators in mines, rigs and b) Major Critical Illness –
on construction sites excluded) duly certified to carry passengers;
On Diagnosis of illness or actual undergoing of the procedure of the
3. As a direct result of the burning of the following public buildings only: covered Major Critical Illness (as detailed in Annexure A), We shall pay
theatre, cinema, public auditorium, hotel, school and hospital; or
the Insured Amount less any already payments already made for Minor
4. When the Life Insured is on a commercial passenger airline on a Critical Illness or Women Specific Critical Illness.
regular scheduled passenger trip over its established passenger route.
Upon payment of a benefit under this Rider, the Insured Amount shall be
The evidence of travel in public land transportation, airline or visit to
reduced to the extent of the benefit paid and the benefit will continue for
theatre, cinema, public auditorium, hotel shall be required for this benefit.
the balance Insured Amount, if any. This benefit shall terminate upon
III. MULTISTAGE CRITICAL ILLNESS BENEFIT
payment of a cumulative 100% of the Insured Amount under this benefit.
This benefit is payable, if the Life Insured survives during the Survival
Period following Diagnosis of any of the covered illness or actual The benefit will be payable only if the Diagnosis/procedure of the covered
undergoing of the procedure (“Critical Illness”) below: Critical illness is the first Diagnosis/procedure of that condition in the
lifetime of the Life Insured.
No Minor Critical Illnesses/Procedure
IV. MULTISTAGE CANCER CARE BENEFIT
1 Severe Osteoporosis
2 Brain Surgery This benefit shall cover below cancer conditions:
3 Pneumonectomy Minor Stage Cancer Major Stage Cancer
4 Small Bowel Transplant - Early stage Cancers - Cancer of Specified Severity
5 Cirrhosis of the Liver - Carcinoma-in-Situ
6 Nephrectomy/removal of one kidney
a) Minor Stage Cancer –
7 Portal vein Thrombosis
8 Ulcerative Colitis Upon Diagnosis of a Minor Stage Cancer (as detailed in Annexure
A), 25% of the Insured Amount will be paid.
Major Critical Illnesses/Procedure
1 Apallic Syndrome Multiple claims for different Minor Stage Cancer shall be admissible
2 Benign Brain Tumor till the aggregate payout under the benefit does not exceed 100%
of the Insured Amount. For multiple claims, there needs to be a
3 Blindness
period of at least 180 days between the date of Diagnosis of a
4 Severe Rheumatoid Arthritis Minor Stage Cancer and date of Diagnosis of the subsequent
5 End Stage Lung Failure Minor Stage Cancer. A particular Minor Stage Cancer can be
6 Coma of Specified Severity claimed only once during the Coverage Term. However, more than
7 End Stage Liver Failure one unrelated Minor Stage Cancer condition may be claimed.
8 Kidney Failure requiring Regular Dialysis Unrelated Minor Stage Cancer condition means a cancer which
9 Encephalitis does not belong to the same organ and same histological type or
has not metastasized and occurred because of a prior cancer.
10 Third Degree Burns
Where the organs are in a pair such as breasts, lungs, kidneys,
11 Major Head Trauma
testes, ovaries etc., the entire pair is considered as one organ.
12 Major Organ (less heart)/ Bone Marrow Transplant
b) Major Stage Cancer –
13 Permanent Paralysis of Limbs
14 Loss of limbs Upon Diagnosis of Major Stage Cancer (as detailed in Annexure A),
We shall pay an amount equal to the Insured Amount less any payout
15 Fulminant Viral Hepatitis
made previously under Multistage Cancer Care Benefit, if any.
16 Alzheimer's Disease
17 Aplastic Anaemia c) Reconstructive Breast Surgery (Only for Female Life Insured) –
18 Deafness If the Life Insured is diagnosed as suffering from Breast Cancer
19 Loss of Speech as defined under “Major stage cancer of specified severity” (as
20 Medullary Cystic Kidney Disease detailed in Annexure A), an additional benefit amount of 30% of
the Insured Amount shall be payable for reconstructive breast
21 Motor Neuron Disease with Permanent Symptoms
surgery. This benefit shall be paid on the actual undergoing of
22 Multiple Sclerosis with Persisting Symptoms
Reconstructive Breast Surgery on the Diagnosis of the Breast
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C262656195 Page 41 of 100

 Cancer confirmed by an Oncologist supported by surgical, 2. MATURITY BENEFIT
clinical, radiological, histological and laboratory evidence If You have chosen Return of Balance Premium option, on survival till end
acceptable to the Company. of the Coverage Term, the Total Rider Premiums Paid towards the
Upon payment of a benefit under this benefit option, the Insured Amount respective benefit option shall be returned, after deduction of any claim
shall be reduced to the extent of the benefit paid and the benefit shall payout made under the under the respective benefit option, provided the
continue for the balance Insured Amount, if any. This cover shall terminate Rider is in force and all due Rider Premiums have been paid.
on payment of a cumulative 100% of the Insured Amount.
3. SERVICE FEATURE
The benefit will be payable only if the Diagnosis of any of the covered
condition is the first Diagnosis of that condition in the lifetime of the Life 3.1 MEDICAL SECOND OPINION
Insured. The Life Insured may avail second opinion / personal medical case
management services from the service provider/s affiliated to/registered
V. MULTISTAGE CARDIAC CARE BENEFIT
with Us. The services are expected to assist the Life Insured to ascertain
If the Life Insured survives during the Survival Period following the correct diagnosis of a medical condition and obtain due care to the Life
Diagnosis of illness or actual undergoing of the procedure of covered Insured in case of illness. These services are subject to:
Cardiac Condition and subject to conditions specified below, We shall pay
- the availability of a suitable service provider;
the Insured Amount.
- primary diagnosis has been done by a registered medical practitioner
No Minor Stage Cardiac Conditions as may be authorized by a competent statutory authority; and
1 Angioplasty - the eligibility of the Life Insured as may be determined by the Company
2 Balloon Valvotomy or Valvuloplasty from time to time.
3 Carotid Artery Surgery
Note:
4 Implantable Cardioverter Defibrillator
5 Implantation of Pacemaker of Heart - Medical Second Opinion/Personal Medical Case Management is an
optional service offered to You at no additional cost. You may exercise
6 Infective Endocarditis
Your own discretion to avail the services and to follow the treatment
7 Minimally Invasive Surgery of Aorta
path suggested by the service provider.
8 Pericardiectomy
9 Pulmonary Thromboembolism - These services shall be directly provided by the service provider.
10 Surgery for Cardiac Arrhythmia - The services can be availed only where the policy / rider is in-force.
11 Surgery to Place Ventricular Assist Devices or Total Artificial Hearts - All the supporting medical records should be available to avail the
12 Renal Angioplasty service.
13 Pulmonary Artery Graft - We reserve the right to discontinue the service or change the service
14 Percutaneous Procedures for Heart Valve Surgery provider at any time.
Major Stage Cardiac Conditions
- The services are being provided by third party service provider and We
1 Myocardial Infarction (First Heart Attack of specified severity)
will not be liable for any liability.
2 Open Chest CABG (Coronary Artery Bypass Graft)
3 Open Heart Replacement or Repair of Heart Valves 4. PAYMENT OF PREMIUM
4 Major surgery of Aorta a) You may pay the Rider Premiums in annual, semi-annual, quarterly or
5 Heart transplant monthly payment modes, as specified below, provided that the Rider
Premium payment mode under this Rider shall always be same as the
6 Cardiomyopathy (of specified severity)
premium payment mode of the Base Plan and can only be changed
7 Stroke resulting into permanent symptoms
with the change of premium payment mode of the Base Plan. The
8 Primary (Idiopathic) Pulmonary Hypertension Rider Premium will change, if the premium payment mode under Base
a) Minor Stage Cardiac Condition – Plan is changed by You.
Upon Diagnosis of illness or actual undergoing of procedure of MODE MODAL LOADING
Minor Stage Cardiac Condition (as detailed in Annexure A), We
Annual Multiply Annual Premium Rate by 1
shall pay 25% of the Insured Amount. In case the Life Insured
undergoes angioplasty (as detailed in Annexure A), the amount of Half - Yearly Multiply Annual Premium Rate by 0.51
benefit shall be subject to a maximum of Rs.5 Lacs. Quarterly Multiply Annual Premium Rate by 0.26
A claim can be preferred for a particular condition under the Minor Monthly Multiply Annual Premium Rate by 0.0883
Stage Cardiac Condition only once during the Coverage Term.
b) The Rider can be added or removed from the Base Plan upon
Multiple claims for different Minor Stage Cardiac Condition shall
be admissible till the aggregate payout under the benefit does not Your request during the Coverage Term, provided that all the due
exceed 100% of the Insured Amount. For multiple claims, there Premiums under the benefit option are paid. However, any such
needs to be a period of at least 180 days between the date of addition or removal of the Rider shall take effect from the next
occurrence of insured event and the date of occurrence of a policy anniversary of the Base Plan.
subsequent insured event. c) The addition of the Rider shall take effect only after We have
b) Major Stage Cardiac Condition – approved the same in accordance with Our Underwriting Policy
and communicated Our decision to You in writing.
Upon Diagnosis of illness or actual undergoing of procedure of
Major Stage Cardiac Condition (as detailed in Annexure A), We 5. MODE OF PAYMENT
shall pay an amount equal to Insured Amount less any payout
You may choose one of the following options to receive benefit, depending
made previously under Minor Stage Cardiac Condition, if any.
on the benefit option selected:
Upon payment of a benefit under this benefit option, the Insured Amount
shall be reduced to the extent of the benefit paid and the cover will continue a) Lump Sum: 100% of the Insured Amount chosen is paid as a lump
for the balance Insured Amount, if any. This cover shall terminate on sum.
payment of a cumulative 100% of the Insured Amount under this benefit. b) Income for Specified Period: Income chosen will be paid for the
The benefit shall be payable only if the Diagnosis/procedure of any of the chosen income period (A period up to 10 years as chosen).
condition is the first Diagnosis/procedure of that condition in the lifetime of c) Combination of Lump sum and Income for the Income Period
the Life Insured.
Chosen: 100% of the Insured Amount chosen to be received in lump

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C262656195 Page 42 of 100

 sum is paid as a lump sum. Along with the lump sum amount, the - the Premiums paid towards the benefit option during the Waiting
Claimant shall also receive regular income in arrears as per the chosen Period will be refunded without any interest; and
frequency chosen for income period (A period up to 10 years as - the benefit option shall terminate and no future Premiums and benefits
chosen), starting from the date of occurrence of insured event shall be payable.
The income frequency can be Annual / Half Yearly / Quarterly / Monthly. Waiting Period as per the chosen benefit option shall be as under:
The regular income shall be paid in arrears as per the chosen payment Benefit Option Waiting Period applicable^
frequency for the income period (up to 10 years) selected, from the date of A waiting period of 90 days is
occurrence of insured event. The payment frequency can’t be changed applicable for all benefits payable under
once the regular income commences. Any accrued income, due before Hospicare Benefit (except for
hospitalization due to an accident).
intimation of the insured event, shall be paid along with the first payout HospiCare Benefit
A specific waiting period of 2 years for
under this option. The income option is not applicable for the HospiCare the specific conditions as mentioned in
Benefit. The payment frequency cannot be changed once the regular the Annexure A – Definitions and
Exclusions will be applicable for all
income commences. benefits covered under the benefit.
The regular income instalments for frequencies other than annual shall be
A waiting period of 90 days is
as specified below, where the Yearly Income below refers to the regular applicable on the first diagnosis of any
Multistage Critical Illness Benefit of the major illness covered under the
income payable in respect of annual frequency:
Multistage Cancer Care Benefit respective benefit option.
Frequency Income Instalment (per frequency) Multistage Cardiac Care Benefit A waiting period of 180 days is
Half-yearly 98% of Yearly Income x 1/2 applicable on the first diagnosis of any
of the minor illness covered under the
Quarterly 97% of Yearly Income x 1/4 respective benefit option.
Monthly 96% of Yearly Income x 1/12
^
The Waiting Period for all benefits shall be applicable from later of:
In case of a Reduced Paid-up policy, the regular income payable shall be
based on the adjusted Yearly Income defined as: • Date of commencement of risk, if benefit option is opted at inception;

(Number of premiums paid under Benefit Option / Number of premiums • Policy Anniversary at which benefit option is opted (if benefit option is
payable under Benefit Option) * Yearly Income applicable at the time of opted for on the Policy Anniversary); or
Reduced Paid-Up • Date of revival (in case of revival of the benefit option).
Where the Insured Amount is higher than the Sum Assured under Benefit 8. GRACE PERIOD
Option, the amount in excess of Sum Assured under Benefit Option shall
A Grace Period of fifteen (15) days for monthly mode and thirty (30) days
be paid in lump sum.
for all other modes, from the due date of Rider Premium will be allowed for
Under sub-clause (b) & (c) of this clause, the Claimant shall have an option payment of each subsequent Rider Premium. The coverage under the
to receive the commuted value of the future income benefits as a lump chosen benefit option will remain in force during this period. If the full Rider
sum, discounted at the higher of: Premium for the first 2 years from the Date of Commencement of Risk
- 4.00%, under Rider remains unpaid at the end of Grace Period and the Rider has
not acquired surrender value, the coverage under the chosen benefit
- SBI domestic term deposit rate for ‘5 years and up to 10 years’ +
option shall lapse from the due date of the first unpaid Rider Premium. If
2.00%).
any claim occurs during the Grace Period, any due Rider Premium (without
6. PREMIUM GUARANTEE interest) for the full coverage year, in which the insured event has occurred
The Sum Assured under Benefit Option shall remain unchanged for a will be deducted from the claim pay-out.
period as specified under ‘Guaranteed Period’ from the Date of
Commencement of the Benefit Option. Upon the completion of PART D
‘Guaranteed Period’, the Sum Assured under Benefit Option may be POLICY SERVICING
revised subject to IRDAI's approval. Any revision in the Sum Assured
1. FREE LOOK PERIOD
under Benefit Option shall be notified to You at least three months prior to
the policy anniversary (i.e. the effective date of change) and You will be You have a free look period of 15 days from the date of receipt of the Rider
given a period of 30 days from effective date of change to confirm with the document and period of 30 days in case of Rider obtained through
revised terms under the Benefit Option. If You are not willing to continue distribution channels like Web Aggregators, online mode and direct sales
the Benefit Option with the revised terms, all coverage under the (other than in person), to review the terms and conditions of the Rider. If
respective Benefit Option benefit will get surrendered. The Sum Assured You disagree to any of those terms or conditions, You have the option to
under Benefit Option, if and when revised, shall be guaranteed to You for return the Rider for cancellation, stating the reasons for objection and be
a subsequent block as specified under ‘Guaranteed Period’.
entitled to a refund of the premiums paid without interest after deduction
Health Benefit Option Guaranteed Period of proportionate risk premium, stamp duty and medical examination cost
Multistage Cancer Care Benefit along with applicable taxes and cesses or levies, if any.
Multistage Cardiac Care Benefit 3 years 2. LOANS
Multistage Critical Illness Benefit You are not entitled to any loans under this Rider.
HospiCare Benefit
3. NON-FORFEITURE PROVISIONS
Accidental Permanent Total / 5 years
Partial Disability Benefit At any time during the Rider Term, if the Premiums are not paid within the
Grace Period and the Rider has not acquired surrender value, the Rider will
7. WAITING PERIOD
lapse. No benefits are payable under a lapsed benefit option.
‘Waiting Period’ means a period during which specified
4. SURRENDER BENEFIT
diseases/treatments which have been diagnosed and/or have received
medical advice/treatment are not covered . In the event of occurrence of Surrender Benefit shall be payable, as higher of the Guaranteed Surrender
any of such scenarios during the applicable Waiting Period, Value (GSV) or Special Surrender Value (SSV) under the following
scenarios:
- No benefit shall be payable;

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C262656195 Page 43 of 100

 Conditions for Guaranteed Under Reduced Paid-up (“RPU”) Rider, the RPU Sum Assured shall be as
acquiring Surrender Value Special Surrender Value (SSV) below:
Surrender Value (GSV) RPU Sum Assured = (Number of Premiums Paid under benefit option/
• Single Pay - Without Return of balance premium Number of Premiums payable under benefit option)
x Sum Assured under the Benefit Option
75% * (sum of premiums paid) *
Immediately on (1-premium paying term / benefit 6. REVIVAL OF THE RIDER
receiving the Not available option term) * (Balance benefit option
premium term / benefit option term) less any 6.1 The lapsed benefit option may be revived (along with the Base Plan)
claims paid/payable on the payment of all due Premiums within Revival Period as applicable
under the Base Plan, by paying interest or late payment fee, if any.
• Single Pay - With Return of balance premium
Immediately on GSV Factor x Return of If there is default in Premium beyond the Grace Period (as applicable under
SSV Factor x Return of Balance the Base Plan) and subject to the Rider not having been surrendered, it
receiving the Balance Premiums as Premiums as on date of surrender
premium on date of surrender may be revived, in accordance with Underwriting Policy within Revival
Period (as applicable under the Base Plan) but before the Maturity/Expiry
• Regular Pay - Without Return of balance premium: No Surrender Value
Date of benefit option, subject to:
• Regular Pay - With Return of Balance Premium
- Your written application for revival;
If at least 2 full GSV Factor x Return of
SSV Factor x Return of Balance - Production of Insured’s current health certificate and other evidence of
years’ premiums Balance Premiums as
Premiums as on date of surrender insurability satisfactory to Us; and
have been paid on date of surrender
- Payment of all overdue premiums with interest.
• Limited Pay - Without Return of balance premium
The applicable interest rate for revival shall be the same as Base Plan. Any
75% * (sum of premiums paid
alteration in the formula basis of determination of interest rate will be
excluding the first years’ premium) *
If at least 2 full (1-premium paying term / benefit subject to prior approval of IRDAI.
years’ premiums Not available option term) * (Balance benefit option Upon revival, the benefits option shall be restored with effect from the date
have been paid term / benefit option term) less any of revival, subject to the Waiting Period as may be applicable for the
claims paid/payable respective Benefit Option.
• Limited Pay - With Return of Balance Premium 6.2 The benefit option cannot be revived independently.
If at least 2 full GSV Factor x Return of
years’ premiums Balance Premiums as SSV Factor x Return of Balance 7. PAYMENT OF RIDER BENEFITS
have been paid on date of surrender Premiums as on date of surrender As per base Policy.
‘Return of Balance Premiums’ shall be the total Premiums paid towards 8. TERMINATION OF THE RIDER/BENEFIT OPTION
the respective Benefit Option, less any claim amount already paid. 8.1 The benefit option shall terminate upon the happening of the first of
As the pricing interest rate reflects the prevailing market conditions, the the following events:
Company may revise the SSV factors from time to time. However, any
change in the methodology/formula for calculating SSV factors shall be 8.1.1 on the expiry of Coverage Term;
subject to IRDAI approval. Any change in SSV factors shall be filed with the 8.1.2 on payment of surrender value of the benefit option;
Authority and any changes therein shall be communicated to the
Policyholder. Please refer Company’s website or visit nearest branch for 8.1.3 on the date on which We receive free look cancellation request for
more details on the applicable GSV or SSV factor. the benefit option within requisite period;
The SSV factors are applicable at the end of the year and shall be 8.1.4 on the payment of the benefit as per the terms of the benefit option
interpolated, on a daily basis, to arrive at the factors applicable at the time or commencement of income benefit payment or the date of intimation of
of surrender. repudiation of the claim by Us;
Any individual benefit option under the Rider may be surrendered / 8.1.5 on the expiry of the Revival Period, if the lapsed benefit option has
discontinued separately or it gets surrendered / discontinued if the Base not been revived;
Plan is surrendered / discontinued or made paid-up.
8.1.6 on termination of Base Plan;
No surrender benefit is payable if the total claim/s value paid exceeds the
Total Rider Premiums Paid. The surrender benefit payable will be the 8.1.7 on the Maturity/Expiry Date or the date on which the Base Plan is
surrender value calculated less any claims paid under this Rider. surrendered, converted into reduced paid-up (when the benefit option has
not acquired surrender value), terminated or cancelled for any reason;
5. REDUCED PAID-UP
8.1.8 on receipt of Your written request for cancellation of the benefit
If You have opted for a Return of Balance Premium option, the Reduced option effective from the next Premium Due Date, after the completion of
Paid-up Benefit shall apply to all regular/limited-premium paying benefit the free look period;
options (if chosen), as specified below-
8.1.9 on cancellation/ termination of this Rider/benefit option by Us on
Cover Continuance grounds of misrepresentation, fraud or non- disclosure established in
PPT Before 2 years’ After 2 years’ terms of Section 45 of the Insurance Act, 1938 as amended from time
premium paid premium paid to time.
Without Return of Balance Premium PART E
Regular Pay / Cover ceases Cover ceases
Limited Pay to exist to exist 1. FEES/CHARGES
With Return of Balance Premium This Rider is a Non-Linked Rider; therefore, Part E is not applicable to
this Rider.
Regular Pay / Cover ceases Cover continues with
Limited Pay to exist Reduced Paid-Up PART F
Insured Amount if the
Base Plan is converted GENERAL PROVISIONS
to Reduced Paid-up
1. TAXES
Policy/Cover cease to
exist if Base Plan 1.1 All Premiums, Charges and interest payable under the benefit option
is lapsed. are exclusive of applicable taxes, cesses or levies, if any, which will be
In case a Policy is converted to Reduced Paid-up on Premium entirely borne/paid by You, in addition to the payment of such Premium,
charges or interest. We shall have the right to claim, deduct, adjust,
discontinuance, the coverage will continue to be in reduced paid-up status
recover the amount of any applicable tax or imposition, levied by any
with the Insured Amount re-set to the Reduced Paid Up Sum Assured
statutory or administrative body from the benefits payable under the
under the Benefit Option less any claims paid/payable. benefit option.
Tata AIA Life Insurance Non-Linked Comprehensive Health Rider (UIN - 110A031V02) • IRDA of India Regn no. 110

C262656195 Page 44 of 100

1.2 Tax benefits and liabilities under the benefit option are subject to Type of Claim Requirement
prevailing tax laws. Tax laws and the benefits arising thereunder are
subject to change. You are advised to seek an opinion of Your tax advisor If claim arise due
All police reports-
in relation to the tax benefits and liabilities applicable to You. to Accident (to be
submitted in First Information Report
2. CLAIM PROCEDURE addition to the Final Police Investigation Report
For processing the claim request under this policy, we will require the above)
following documents:
Please submit copies of the following documents certified / attested by the
Type of Claim Requirement issuing authority. (Original Seen Verified (OSV) by Branch Personnel will
a) Claim Forms also be accepted) –
- Part I: Application Form for Disability/Dismember- - All Police papers – Panchnama, Inquest, First Information Report and
ment Claim (Claimant's Statement) along with Final Investigation Report.
NEFT form
- Medical Records (Admission Notes, Discharge/Death Summary,
- Part II: Confidential Medical Report - to be filled by Indoor Case Papers, Test Reports etc).
attending physician
- Postmortem report (Autopsy report) & Chemical Viscera report
b) Hospital Bills for the confinement. (certified by Police / Magistrate / Court will also be accepted)
c) Attested True Copy of Indoor Case Papers of the
Copies of the other documents to be submitted by self-attestation of the
Hospital. The evidence of "full histopathological
diagnosis" of the cancer, including stage and claimant
grading. Note-
Critical Illness d) Discharge Summary of Present and Past Hospi- In case the claim warrants any additional requirement, We reserve the right
Claim/ Cardiac talizations to call for the same.
Care Claim/ e) Photo Identity of insured with age and address Notification of claim & submission of the claim requirements does not
Hospitalization proof mean admission of the claim liability by the Company.
Claim/ Cancer
f) Bank Details of the claimant – Cancelled cheque No agent is authorized to admit any liabilities on behalf of the Company,
Care Claim (with printed name and account number)/bank nor to alter this list of documents or any claims requirements called for by
(If opted) passbook the Company.
g) Certificate of Diagnosis
3. MISTATEMENT OF AGE
h) Medical Examination Certificate (First Consulta-
tion Notes). As per base Policy.
i) All related clinical Reports pertaining to the claim 4. FRAUD AND NON-DISCLOSURE
event - Laboratory test reports
As per base Policy.
- X-Ray / CT Scan / MRI Reports &
- Plates Ultrasonography Report 5. CURRENCY AND PLACE OF PAYMENT
- Histopathology Report As per base Policy.
- Clinical / Hospital Reports
6. FREEDOM FROM RESTRICTIONS
- Angiography Reports & Plates.
There are no restrictions on travel or occupation under this Rider.
- Others (please specify).
h) All follow-up Consultation Notes in relation to the 7. NOMINEE
hospitalized condition As per Base Plan.
If claim arise due to
Accident (to be All police reports- 8. ASSIGNMENT
submitted in First Information Report As per Base Plan.
addition to the Final Police Investigation Report
above) 9. CHANGE IN ADDRESS
In order to provide better service, We request you to intimate us in the
Type of Claim Requirement event of any change in the address of the Policyholder or the nominee.
a) Claim Forms
10. AMENDMENT
- Part I: Application Form for
Disability/Dismemberment Claim (Claimant's As per base Policy.
Statement) along with NEFT form
11. REGULATORY AND JUDICIAL INTERVENTION
- Part II: Confidential Medical Report - to be filled by
attending physician As per base Policy.
b) Attested True Copy of Indoor Case Papers of the
Hospital 12. COMMUNICATION AND NOTICES
c) Discharge Summary of Present and Past As per base Policy.
Hospitalizations
13. GOVERNING LAW AND JURISDICTION
d) Insured’s PAN Card OR Form 60, Insured’s
Disability and Address proof As per base Policy.
Dismemberment
e) Bank Details of the Insured – Cancelled cheque PART G
Claim (If opted) (with printed name and account number)/bank
passbook CONSUMER INFORMATION
f) Disability Certificate by attending Physician / As per base Policy.
Institute for disabled
g) Rehabilitation Certificate - if applicable
h) Employer’s written confirmation / statement - for
Disability claim
i) All related Medical Examination Reports, e.g.
Laboratory test reports
X-Ray / CT Scan / MRI Reports & Plates,
Ultrasonography Report
Clinical / Hospital Reports
j) Clinical Photographs showing the injured areas - if
available
Tata AIA Life Insurance Non-Linked Comprehensive Health Rider (UIN - 110A031V02) • IRDA of India Regn no. 110

C262656195 Page 45 of 100

 ANNEXURE A – DEFINITIONS AND EXCLUSIONS vii. Loss of both legs;
Definitions of Conditions covered (as applicable under the respective viii. Loss of both feet;
benefit option) ix. Removal of the entire lower jaw
A. Accidental Permanent Total / Partial Disability Benefit x. Loss of one hand and loss of sight in one eye
1. Accidental Permanent Partial Disability: xi. Loss of one foot and loss of sight in one eye
Accidental Permanent Partial Disability is defined as a disability of the If the disability is due to amputation/dismemberment, the loss of hand will
Life Assured as a result of bodily injury caused by an accident solely, mean amputation/dismemberment above wrist, the loss of arm will mean
directly and independently of any other cause within 180 days of the amputation/ dismemberment above elbow, the loss of feet will mean
accident and must result in one of the following: amputation/dismemberment above ankle and the loss of leg will mean
amputation/dismemberment above knee. This will include medically
Amount of Benefit necessary amputation necessitated by injury or disease. The separation
(% of Insured has to be permanent without any chance of surgical correction. If the
Description of Disability disability is not due to amputation/dismemberment, the loss will mean loss
Amount under
the Benefit Option) of usage of both limbs and the limbs should have motor power grade 0/5,
Permanent loss of
1/5 or 2/5 only.
- each arm at the shoulder joint 60% Loss of a limb resulting directly or indirectly from self-inflicted injury, alcohol
or drug abuse is excluded. The loss of use of the particular limb must be
- each arm to a point above elbow joint 55% certified by a relevant Medical Practitioner and documented for an
- each arm below elbow joint 50% uninterrupted period of at least six months.
- each hand at the wrist 50% The total Loss of Sight in one eye means total, permanent and irreversible
- each thumb 20% loss of all vision in an eye as a result of accident, evidenced by:
- each index finger 10% i. corrected visual acuity being 3/60 or less in one eye or ;
- each finger other than the thumb or index finger 5% ii. the field of vision being less than 10 degrees in one eye
- each leg above center of the femur 60% The diagnosis of loss of sight in one eye must be certified by an
- each leg up to a point below the femur 55% ophthalmologist to be permanent in nature and must not be correctable by
- each leg to a point below the knee 50% aids or surgical procedure.
- each foot at the ankle 40% Loss of Sight in both eyes - Total, permanent and irreversible loss of all
vision in both eyes as a result of accident, evidenced by:
- each big toe 5%
i. corrected visual acuity being 3/60 or less in both eyes or;
- each toe other than the big toe 2%
ii. the field of vision being less than 10 degrees in both eyes
Loss of Sight in each eye* 50%
Loss of Hearing in each ear* 30% The diagnosis of Loss of Sight in both eyes must be certified by an
Ophthalmologist to be permanent in nature and must not be correctable
The disability has to be certified by a Registered Medical Practitioner to be by aids or surgical procedure.
permanent in nature. 3. Double Benefit:
If the disability is due to amputation/dismemberment, the loss of hand will
If you have chosen Accidental Permanent Total/Partial Disability Benefit,
mean amputation/dismemberment above wrist, the loss of arm will mean
twice the amount of the respective benefit will be paid if the disability (as
amputation/ dismemberment above elbow, the loss of feet will mean
applicable) occurs under any of the following circumstances:
amputation/dismemberment above ankle and the loss of leg will mean
amputation/dismemberment above knee. This will include medically 1. While the Insured is riding as a fare paying passenger on commercially
necessary amputation necessitated by injury or disease. The separation licensed public land transportation over an established route such as
has to be permanent without any chance of surgical correction. If the a bus, tram or train. A taxi or any form of transport chartered for private
disability is not due to amputation/dismemberment, the loss will mean loss travel is excluded.
of usage of both limbs and the limbs should have motor power grade 0/5, 2. While the Insured is in an elevator car (elevators in mines, rigs and on
1/5 or 2/5 only. construction sites excluded) duly certified to carry passengers; or
Loss of a Limb resulting directly or indirectly from self-inflicted injury, 3. As a direct result of the burning of the following public buildings ONLY:
alcohol or drug abuse is excluded. The loss of use of the particular limb theatre, cinema, public auditorium, hotel, school and hospital.
must be certified by a relevant Medical Practitioner and documented for an
4. When the Insured is on a commercial passenger airline on a regular
uninterrupted period of at least six months.
scheduled passenger trip over its established passenger route.
*Loss of hearing - Total and irreversible loss of hearing as a result of illness
or accident. This diagnosis must be supported by pure tone audiogram The evidence of travel in public land transportation, airline or visit to
test and certified by an Ear, Nose and Throat (ENT) specialist. Total means theatre, cinema, public auditorium, hotel will be required for this benefit
“the loss of hearing to the extent that the loss is greater than 90 decibels to be considered.
across all frequencies of hearing” in ears. B. Multistage Cancer Care Benefit
*The total Loss of Sight in one eye means total, permanent and
1. Cancer of specified severity:
irreversible loss of all vision in an eye as a result of accident evidenced by:
i. corrected visual acuity being 3/60 or less in one eye or ; A malignant tumor characterized by the uncontrolled growth and spread
ii. the field of vision being less than 10 degrees in one eye of malignant cells with invasion and destruction of normal tissues. This
diagnosis must be supported by histological evidence of malignancy.
The diagnosis of Loss of sight in one eye must be certified by an
ophthalmologist to be permanent in nature and must not be correctable by The term cancer includes leukemia, lymphoma and sarcoma.
aids or surgical procedure. The following are excluded –
2. Accidental Total and Permanent Disability: i. All tumors which are histologically described as carcinoma in situ,
Accidental Total and Permanent Disability means disability as a result of benign, pre-malignant, borderline malignant, low malignant potential,
bodily injury caused by an accident and such injury shall within 180 days of neoplasm of unknown behavior, or non-invasive, including but not
its occurrence solely, directly and independently of any other cause, result limited to: Carcinoma in situ of breasts, Cervical dysplasia CIN-1, CIN
in the Member's disability which must be total and permanent, and must -2 and CIN-3.
result in at least one of the following:
ii. Any non-melanoma skin carcinoma unless there is evidence of
i. Loss of sight in both eyes
metastases to lymph nodes or beyond;
ii. Loss of both arms or both hands;
iii. Malignant melanoma that has not caused invasion beyond the
iii. Loss of one arm and one leg;
epidermis;
iv. Loss of one arm and one foot;
iv. All tumors of the prostate unless histologically classified as having a
v. Loss of one hand and one foot; Gleason score greater than 6 or having progressed to at least clinical
vi. Loss of one hand and one leg; TNM classification T2N0M0

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C262656195 Page 46 of 100

v. All Thyroid cancers histologically classified as T1N0M0 (TNM Coronary arteries herein refer to left main stem, left anterior descending,
Classification) or below; circumflex and right coronary artery.
vi. Chronic lymphocytic leukemia less than RAI stage 3 Diagnostic angiography or investigation procedures without
angioplasty/stent insertion are excluded.
vii. Non-invasive papillary cancer of the bladder histologically described
as TaN0M0 or of a lesser classification, Note: A lower of INR 5 lakhs or 25% of Cardiac Insured Amount shall be
made in case the Life Assured undergoes Angioplasty; Cardiac Care
viii. All Gastro-Intestinal Stromal Tumors histologically classified as Benefit shall continue with the balance Insured Amount, if any; for the
T1N0M0 (TNM Classification) or below and with mitotic count of less remaining insured cardiac ailments.
than or equal to 5/50 HPFs;
2. Balloon Valvotomy or Valvuloplasty:
Reconstructive Breast Surgery (Only For Female Life)
The actual undergoing of percutaneous intravascular Valvotomy or
If the life assured is diagnosed as suffering from breast cancer as defined percutaneous intravascular Valvuloplasty not involving the deployment of
above under “Major stage cancer of specified severity”, and the same is any device or prosthesis necessitated by damage of the heart valve as
intimated to the company within 30 days of diagnosis, an additional benefit confirmed by a specialist in the relevant field and established by a cardiac
amount of 30% (thirty percentage) of the Insured Amount under the Benefit echocardiogram or any other appropriate diagnostic test that is available.
Option will be payable to her for Reconstructive breast surgery. This The following are excluded:
payment will be made on the actual undergoing of Reconstructive Breast
Surgery on the diagnosis of the breast cancer and it being confirmed by an • All other surgical corrective methods will be excluded from this benefit.
oncologist supported by surgical, clinical, radiological, histological and • Procedures done for treatment of Congenital Heart Disease.
laboratory evidence acceptable to the Company.
3. Cardiomyopathy (of specified severity):
1. Carcinoma in-situ
An impaired function of the heart muscle, unequivocally diagnosed as
Carcinoma-in-situ means the presence of malignant cancer cells that remain Cardiomyopathy by a Registered Medical Practitioner who is a
within the cell group from which they arose. It must involve the full thickness cardiologist, and which results in permanent physical impairment to the
of the epithelium but does not cross basement membranes and it does not degree of New York Heart Association Classification Class III or Class IV,
invade the surrounding tissue or organ. The diagnosis of which must be or its equivalent, for at least six (6) months based on the following
positively established by microscopic examination of fixed tissues supported classification criteria:
by biopsy result. The diagnosis must be established by histological evidence
• Class III - Marked functional limitation. Affected patients are
and be confirmed by an independent Medical Practitioner who is an
comfortable at rest but performing activities involving less than
Oncologist. Clinical diagnosis does not meet this standard
ordinary exertion will lead to symptoms of congestive cardiac failure
The following are specifically excluded from all minor cancer benefits: • Class IV - Inability to carry out any activity without discomfort.
• All tumors which are histologically described as benign, borderline Symptoms of congestive cardiac failure are present even at rest. With
malignant, or low malignant potential any increase in physical activity, discomfort will be experienced and
• Dysplasia, intra-epithelial neoplasia or squamous intra-epithelial Echocardiography findings confirming presence of cardiomyopathy
lesions and Left Ventricular Ejection Fraction (LVEF %) of 40% or less.
• Clinical diagnosis or Cervical Intraepithelial Neoplasia (CIN) The following are excluded:
classification which reports CIN I, and CIN II. In the case of the cervix Cardiomyopathy directly related to alcohol or drug abuse.
uteri, Pap smear alone is not acceptable and should be accompanied
4. Pulmonary Artery Graft :
with cone biopsy or colposcopy with the cervical biopsy report clearly
indicating presence of CIS. The undergoing of surgery requiring median sternotomy for disease to the
pulmonary artery with excision and surgical replacement of a portion of the
• Carcinoma in-situ of skin and Melanoma in-situ
diseased pulmonary artery with a graft.
• Any non-melanoma skin carcinoma unless there is evidence of
For the above definition, the following are not covered:
metastases to lymph nodes or beyond
• Any other surgical procedure for example the insertion of stents or
• Malignant melanoma that has not caused invasion beyond the
endovascular repairs
epidermis
5. Carotid Artery Surgery
2. Early Stage Cancer
The actual undergoing of surgery to the Carotid Artery to treat carotid
It shall mean the presence of one of the following malignant conditions. artery stenosis of fifty percent (50%) and above, as proven by angiographic
The Diagnosis must be based on histopathological features and confirmed evidence, of one (1) or more carotid arteries. Both criteria (a) and (b) below
by an independent Medical Practitioner who is an Oncologist. must be met:
Pre-malignant lesions and conditions, unless listed below, are excluded.
(a) Either:
• Prostate Cancer – Minor Stage: Minor Prostate Cancer that is
histologically described using the TNM classification as T1a, T1b & • Actual undergoing of endarterectomy to alleviate the symptoms;
T1c with a Gleason Score 2 (two) to 6(six). or
• Thyroid Cancer – Minor Stage: All thyroid cancers that are less than • Actual undergoing of an endovascular intervention such as
2.0 cm and histologically classified as T1N0M0 according to TNM angioplasty and/or stenting or atherectomy to alleviate the
classification. symptoms; and
• Bladder Cancer – Minor Stage: All tumors of the urinary bladder (b) The Diagnosis and medical necessity of the treatment must be
histologically classified as T1N0M0 according to TNM classification. confirmed by a Registered Medical Practitioner who is a specialist
in the relevant field.
• Chronic Lymphocytic Leukaemia – Minor Stage: Chronic
Lymphocytic Leukaemia categorized as stage 1(one) to 2 (two) as per 6. Heart Transplant:
the Rai classification. The actual undergoing of a transplant of human heart that resulted from
The following are specifically excluded from all minor cancer benefits: irreversible end stage heart failure. The undergoing of a heart transplant
has to be confirmed by a specialist medical practitioner.
• All tumors which are histologically described as benign, borderline
malignant, or low malignant potential Stem Cell transplants are excluded.
• Dysplasia, intra-epithelial neoplasia or squamous intra-epithelial lesions 7. Implantable Cardioverter Defibrillator
• Carcinoma in-situ of skin and Melanoma in-situ Actual undergoing of insertion of an implantable cardiac defibrillator to
correct serious cardiac arrhythmia which cannot be treated via other
C. Multistage Cardiac Care Benefit methods or the insertion of permanent cardiac defibrillator to correct
1. Angioplasty sudden loss of heart function with cessation of blood circulation around
the body resulting in unconsciousness Insertion of Cardiac Defibrillator
Coronary Angioplasty is defined as percutaneous coronary intervention by means surgical implantation of either Implantable Cardioverter Defibrillator
way of balloon angioplasty with or without stenting for treatment of the (ICD), or Cardiac Resynchronization Therapy with Defibrillator (CRT-D).
narrowing or blockage of minimum 50 % of one or more major coronary
arteries. The intervention must be determined to be medically necessary The insertion of a permanent Cardioverter-Defibrillator (ICD) must be
by a cardiologist and supported by a coronary angiogram (CAG). certified to be absolutely necessary by a specialist in the relevant field.

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C262656195 Page 47 of 100

- Cardiac arrest secondary to alcohol or drug misuse will be excluded. of, or disease affected cardiac valve(s). The diagnosis of the valve
abnormality must be supported by an echocardiography and the
8. Implantation of Pacemaker of Heart:
realization of surgery has to be confirmed by a specialist medical
Actual undergoing of Insertion of a permanent cardiac pacemaker to practitioner. Catheter based techniques including but not limited to,
correct serious cardiac arrhythmia which cannot be treated via other balloon valvotomy/valvuloplasty are excluded.
means. The insertion of the cardiac pacemaker must be certified to be
medically necessary by a Cardiologist. Cardiac arrhythmias to be 15. Percutaneous Procedures for Heart Valve Surgery:
evidenced by 24 Holter monitoring report or any such other established The actual undergoing of surgery to replace existing heart valve by the
diagnostic reports. The insertion of any other type of temporary cardiac deployment of a new replacement valve by percutaneous intravascular
pacemaker is specifically excluded. Cardiac arrest secondary to alcohol or techniques not involving a thoracotomy. Percutaneous or transcatheter based
drug misuse will be excluded. repair procedures not involving replacement with a new valve are excluded.
9. Infective Endocarditis: The diagnosis of heart valve abnormality must be supported by cardiac
catheterization or Echocardiogram and the procedure must be considered
Inflammation of the inner lining of the heart caused by infectious medically necessary by a consultant cardiologist.
organisms, where all of the following criteria are met:
16. Pericardectomy:
• Positive result of the blood culture proving presence of the infectious
organism(s) The undergoing of a pericardectomy performed by open heart surgery or
keyhole techniques as a result of pericardial disease. The surgical
• Presence of at least moderate heart valve incompetence (meaning
procedures must be certified to be medically necessary by a consultant
regurgitate fraction of twenty percent (20%) or above) or moderate
cardiologist.
heart valve stenosis (resulting in heart valve area of thirty percent (30%)
or less of normal value) attributable to Infective Endocarditis; and The following are excluded:
• The diagnosis of Infective Endocarditis and the severity of valvular - Other procedures on the pericardium including pericardial biopsies,
impairment are confirmed by a consultant cardiologist. and pericardial drainage procedures by needle aspiration are
excluded.
10. Major Surgery of Aorta:
17. Primary (Idiopathic) Pulmonary Hypertension:
The actual undergoing of major surgery to repair or correct an aneurysm,
narrowing, obstruction or dissection of the aorta through surgical opening A. An unequivocal diagnosis of Primary (Idiopathic) Pulmonary
of the chest or abdomen. For the purpose of this definition, aorta shall Hypertension by a Cardiologist or Specialist in respiratory medicine
mean the thoracic and abdominal aorta but not its branches (including with evidence of right ventricular enlargement and the pulmonary
aortofemoral or aortoiliac bypass grafts). The surgery must be determined artery pressure above 30 mm of Hg on Cardiac Cauterization. There
to be medically necessary by a Consultant Cardiologist / Surgeon and must be permanent irreversible physical impairment to the degree of at
supported by imaging findings. least Class IV of the New York Heart Association Classification (NYHA)
of cardiac impairment.
The following are excluded:
B. The NYHA Classification of Cardiac Impairment are as follows:
• Surgery performed using only minimally invasive or intra-arterial
techniques. a) a) Class III: Marked limitation of physical activity. Comfortable at
rest, but less than ordinary activity causes symptoms.
• Procedures done for treatment of Congenital Heart Disease.
b) Class IV: Unable to engage in any physical activity without
11. Minimally Invasive Surgery of Aorta discomfort. Symptoms may be present even at rest.
The actual undergoing of minimally invasive surgical repair (i.e. via C. Pulmonary hypertension associated with lung disease, chronic
percutaneous intra-arterial route) of a diseased portion of an aorta to repair hypoventilation, pulmonary thromboembolic disease, drugs and
or correct an aneurysm, narrowing, obstruction or dissection of the aorta toxins, diseases of the left side of the heart, congenital heart disease
with a graft. For the purpose of this definition, aorta shall mean the thoracic and any secondary cause are specifically excluded
and abdominal aorta but not its branches.
18. Pulmonary Thromboembolism:
The following are excluded:
Acute Pulmonary Thromboembolism: means the blockage of an artery in
Procedures done for treatment of Congenital Heart Disease..
the lung by a clot or other tissue from another part of the body. The
12. Myocardial Infarction (First Heart Attack of specified severity): Pulmonary Embolus must be unequivocally diagnosed by a specialist on
The first occurrence of heart attack or myocardial infarction, which means either a V/Q scan (the isotope investigation which shows the ventilation
the death of a portion of the heart muscle as a result of inadequate blood and perfusion of the lungs), angiography or echocardiography, with
supply to the relevant area. The diagnosis for Myocardial Infarction should evidence of right ventricular dysfunction and requiring medical or surgical
be evidenced by all of the following criteria: treatment on an inpatient basis.
i. A history of typical clinical symptoms consistent with the diagnosis of 19. Renal Angioplasty:
acute myocardial infarction (For e.g. typical chest pain) Means the actual undergoing for the first time of Renal Artery Angioplasty
ii. New characteristic electrocardiogram changes or the insertion of a stent to correct the stenosis, of one or more renal
arteries as shown by Angiographic or appropriate imaging evidence. The
iii. Elevation of infarction specific enzymes, Troponins or other specific
revascularization must be considered medically necessary by an
biochemical markers.
appropriate specialist.
The following are excluded: Intra Arterial investigative procedures and Diagnostic Angiography are
i. Other acute Coronary Syndromes excluded.
ii. Any type of angina pectoris 20. Stroke resulting into permanent symptoms:
iii. A rise in cardiac biomarkers or Troponin T or I in absence of overt Any cerebrovascular incident producing permanent neurological sequelae.
ischemic heart disease OR following an intra-arterial cardiac This includes infarction of brain tissue, thrombosis in an intracranial vessel,
procedure. haemorrhage and embolisation from an extra cranial source. Diagnosis
13. Open Chest CABG (Coronary Artery Bypass Graft): has to be confirmed by a specialist medical practitioner and evidenced by
typical clinical symptoms as well as typical findings in CT Scan or MRI of
The actual undergoing of heart surgery to correct blockage or narrowing in the brain. Evidence of permanent neurological deficit lasting for at least 3
one or more coronary artery(s), by coronary artery bypass grafting done via months has to be produced.
a sternotomy (cutting through the breast bone) or minimally invasive
keyhole coronary artery bypass procedures. The diagnosis must be The following are excluded:
supported by a coronary angiography and the realization of surgery has to • Transient ischemic attacks (TIA)
be confirmed by a cardiologist.
• Traumatic injury of the brain
The following are excluded:
• Vascular disease affecting only the eye or optic nerve or vestibular
- Angioplasty and/or any other intra-arterial procedures functions.
14. Open Heart Replacement or Repair of Heart Valves: 21. Surgery for Cardiac Arrhythmia:
The actual undergoing of open-heart valve surgery is to replace or repair Procedures like Maze surgery, RF Ablation therapy necessitated by a
one or more heart valves, as a consequence of defects in, abnormalities cardiologist to treat life threatening arrhythmias. Diagnosis must be

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evidenced by Electrophysiological Study, monitoring through a Holter • Permanent Neurological deficit with persisting clinical symptoms for a
monitor, event monitor or loop recorder and should be confirmed by a continuous period of at least 90 consecutive days or
consultant cardiologist. Ablation procedures should ideally immediately • Undergone surgical resection or radiation therapy to treat the brain
follow the diagnostic electrophysiology study. tumor
The following are excluded: The following conditions are excluded:
- Cardio version and any other form of non-surgical treatments Cysts, Granulomas, malformations in the arteries or veins of the brain,
- Procedures done for treatment of Congenital Heart Disease hematomas, abscesses, pituitary tumors, tumors of skull bones and
tumors of the spinal cord.
22. Surgery to Place Ventricular Assist Devices or Total Artificial
Hearts: 6. Blindness:
The actual undergoing of open heart surgery to place a Ventricular Assist Total, permanent and irreversible loss of all vision in both eyes as a result
Device or Total Artificial Heart medically necessitated by severe ventricular of illness or accident.
dysfunction or severe heart failure, with cardiac echocardiographic The Blindness is evidenced by:
evidence of reduced left ventricular ejection fraction of less than 30%.
• corrected visual acuity being 3/60 or less in both eyes or;
The following are excluded:
• the field of vision being less than 10 degrees in both eyes.
Ventricular dysfunction or Heart failure directly related to alcohol or drug
The diagnosis of blindness must be confirmed and must not be
abuse is excluded.
correctable by aids or surgical procedure.
D. Multistage Critical Illness Benefit
7. Brain Surgery:
1. Apallic Syndrome: The actual undergoing of surgery to the brain, under general anaesthesia
A persistent vegetative state in which patients with severe brain damage during which a Craniotomy is performed. Burr hole and brain surgery as a
(universal necrosis of the brain cortex with the brainstem remaining intact), result of an Accident is excluded. The procedure must be considered
are in a state of partial arousal rather than true awareness. The Diagnosis necessary by a qualified specialist and the benefit shall only be payable
must be confirmed by a Specialist Medical Practitioner (Neurologist) once corrective surgery has been carried out.
acceptable to the Company and condition must be documented for at This requirement of surgery must be supported by unequivocal findings on
least 30 days Magnetic Resonance Imaging, Computerized Tomography, or other
2. Aplastic Anaemia: reliable imaging techniques and certified by a neurosurgeon or qualified
medical doctor of relevant specialty
Chronic Irreversible persistent bone marrow failure which results in
anaemia, neutropenia and thrombocytopenia requiring treatment with at 8. Coma of Specified Severity:
least two (2) of the following: A state of unconsciousness with no reaction or response to external stimuli
(a) Regular Blood product transfusion; or internal needs. This diagnosis must be supported by evidence of all of
(b) Marrow stimulating agents; the following:
(c) Immunosuppressive agents; or • No response to external stimuli continuously for at least 96 hours;
(d) Bone marrow transplantation. • Life support measures are necessary to sustain life; and
The Diagnosis and suggested line of treatment of aplastic anaemia must • Permanent neurological deficit which must be assessed at least 30
be confirmed by a Haematologist acceptable to the Company using days after the onset of the coma.
relevant laboratory investigations including bone marrow biopsy. Two out The condition has to be confirmed by a specialist medical practitioner.
of the following three values should be present: Coma resulting from alcohol or drug abuse is excluded.
• Absolute Neutrophil count of 500 per cubic millimetre or less; 9. Chronic Recurrent Pancreatitis:
• Absolute Reticulocyte count of 20,000 per cubic millimetre or less; and An unequivocal diagnosis of Chronic Relapsing Pancreatitis, made by a
• Platelet count of 20,000 per cubic millimetre or less. Specialist in gastroenterology and confirmed as a continuing inflammatory
disease of the pancreas characterised by irreversible morphological
Temporary or reversible aplastic anaemia is excluded
change and typically causing pain and/or permanent impairment of
3. Alzheimer's Disease function. The condition must be confirmed by pancreatic function tests
Progressive and permanent deterioration of memory and intellectual and radiographic and imaging evidence.
capacity as evidenced by accepted standardised questionnaires and Relapsing Pancreatitis caused directly or indirectly, wholly or partly, by
cerebral imaging. The diagnosis of Alzheimer’s disease must be confirmed alcohol is excluded.
by an appropriate consultant and supported by the Company’s appointed
10. Cirrhosis of the Liver:
doctor. There must be significant reduction in mental and social
functioning requiring the continuous supervision of the life assured. There Chronic hepatitis due to hepatitis virus infection having progressed to liver
must also be an inability of the Life Assured to perform (whether aided or cirrhosis. At time of claim all of below must be fulfilled:
unaided) at least 3 of the 6 “Activities of Daily Living” (defined in ‘Generic 1. clinical evidence of chronic viral hepatitis in the form of serology and
Definitions’ section below) for a continuous period of at least 3 months. other laboratory tests.
The following are excluded: 2. unequivocal diagnosis of liver cirrhosis caused by viral hepatitis must
• Any other type of irreversible organic disorder/dementia be made based on liver tissue histopathology, clinical findings and
medical history by gastroenterologist in a hospital recognized by the
• Non-organic disease such as neurosis and psychiatric illnesses; and insurer.
• Alcohol-related brain damage. 3. histopathological report shows stage F4 by Metavir grading8 or a
4. Bacterial Meningitis: Knodell fibrosis score9 of 4.
A definite diagnosis of bacterial meningitis resulting in a persistent Liver disease caused by alcohol or drug abuse is excluded.
neurological deficit documented for at least 3 months following the date of 11. Creutzfeldt-Jacob disease:
diagnosis. The diagnosis must be confirmed by a Consultant Neurologist and
supported by growth of pathogenic bacteria from cerebrospinal fluid culture. Creutzfeldt-Jacob disease is an incurable brain infection that causes
rapidly progressive deterioration of mental function and movement. A
For the above definition, the following are not covered: neurologist must make a definite diagnosis of Creutzfeldt-Jacob disease
- Aseptic, viral, parasitic or non-infectious meningitis based on clinical assessment, EEG and imaging. There must be objective
permanent neurological abnormalities persisting for more than 180 days
5. Benign Brain Tumor
along with severe progressive dementia.
Benign brain tumor is defined as a life threatening, non-cancerous tumor
in the brain, cranial nerves or meninges within the skull. The presence of 12. Deafness:
the underlying tumor must be confirmed by imaging studies such as CT Total and irreversible loss of hearing in both ears as a result of illness or
scan or MRI. accident. This diagnosis must be supported by pure tone audiogram test
This brain tumor must result in at least one of the following and must be and certified by an Ear, Nose and Throat (ENT) specialist. Total means “the
confirmed by the relevant medical specialist: loss of hearing to the extent that the loss is greater than 90decibels across
all frequencies of hearing” in both ears.
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13. Encephalitis: 20. Loss of Speech:
Severe inflammation of the brain substance (cerebral hemisphere, Total and irrecoverable loss of the ability to speak as a result of injury or
brainstem or cerebellum) caused by viral infection and resulting in disease to the vocal cords. The inability to speak must be established for
permanent neurological deficit for a min period of 60 days. This diagnosis a continuous period of 12 months. This diagnosis must be supported by
must be certified by a consultant neurologist and the permanent medical evidence furnished by an Ear, Nose, and Throat (ENT) specialist.
neurological deficit must result in an inability to perform at least three of the All psychiatric related causes are excluded.
Activities of Daily Living (defined in ‘Generic Definitions’ section below)
21. Major Head Trauma:
either with or without the use of mechanical equipment, special devices or
other aids and adaptations in use for disabled persons. Accidental head injury resulting in permanent Neurological deficit to be
assessed no sooner than 3 months from the date of the accident. This
14. End Stage Liver Failure: diagnosis must be supported by unequivocal findings on Magnetic
Permanent and irreversible failure of liver function that has resulted in all Resonance Imaging, Computerized Tomography, or other reliable imaging
three of the following: techniques. The accident must be caused solely and directly by
• permanent jaundice; and accidental, violent, external and visible means and independently of all
other causes.
• ascites; and
The Accidental Head injury must result in an inability to perform at least
• hepatic encephalopathy. three (3) of the following Activities of Daily Living (defined in ‘Generic
Liver failure secondary to drug or alcohol abuse is excluded. Definitions’ section below) either with or without the use of mechanical
equipment, special devices or other aids and adaptations in use for
15. End Stage Lung Failure: disabled persons. For the purpose of this benefit, the word “permanent”
End stage lung disease, causing chronic respiratory failure, as confirmed shall mean beyond the scope of recovery with current medical knowledge
and evidenced by all of the following: and technology.
• FEV1 test results consistently less than 1 litre measured on 3 The following are excluded:
occasions 3 months apart; and - Spinal cord injury
• Requiring continuous permanent supplementary oxygen therapy for
hypoxemia; and 22. Major Organ (less heart)/ Bone Marrow Transplant:
• Arterial blood gas analyses with partial oxygen pressures of 55mmHg The actual undergoing of a transplant of:
or less (PaO2 < 55 mmHg); and • One of the following human organs: lung, liver, kidney, pancreas, that
• Dyspnea at rest. resulted from irreversible end stage failure of the relevant organ, or
• Human bone marrow using haematopoietic stem cells
16. Fulminant Viral Hepatitis:
The undergoing of a transplant has to be confirmed by a specialist
A definite diagnosis of fulminant viral hepatitis evidenced by all of the medical practitioner.
following:
The following are excluded:
• Typical serological course of acute viral hepatitis
• Other stem-cell transplants
• Development of hepatic encephalopathy
• Where only Islets of Langerhans are transplanted
• Decrease in liver size
• Increase in bilirubin levels 23. Medullary Cystic Kidney Disease:
• Coagulopathy with an international normalized ratio (INR) greater Medullary Cystic Disease is a disease where the following criteria are met:
than 1.5 • The presence in the kidney of multiple cysts in the renal
• Development of liver failure within 7 days of onset of symptoms medulla accompanied by the presence of tubular atrophy and
interstitial fibrosis;
• No known history of liver disease
• Clinical manifestations of anaemia, polyuria and progressive
The diagnosis must be confirmed by a Consultant Gastroenterologist. deterioration in kidney function; and
For the above definition, the following are not covered: • The diagnosis of medullary cystic disease is confirmed by renal biopsy.
• All other non-viral causes of acute liver failure (including but not • Isolated or benign kidney cysts are specifically excluded from
limited to paracetamol or aflatoxin intoxication) this benefit.
• Fulminant viral hepatitis associated with intravenous drug use 24. Motor Neuron Disease with Permanent Symptoms:
17. Kidney Failure Requiring Dialysis: Motor neuron disease diagnosed by a Specialist Medical Practitioner as
End stage renal disease presenting as chronic irreversible failure of both spinal muscular atrophy, progressive bulbar palsy, amyotrophic lateral
kidneys to function, as a result of which either regular renal dialysis sclerosis or primary lateral sclerosis. There must be progressive
(hemodialysis or peritoneal dialysis) is instituted or renal transplantation is degeneration of corticospinal tracts and anterior horn cells or bulbar
carried out. Diagnosis has to be confirmed by a specialist medical efferent neurons. There must be current significant and permanent
practitioner. functional neurological impairment with objective evidence of motor
18. Loss of Independent Existence: dysfunction that has persisted for a continuous period of at least 3 months.
Confirmation by a consultant physician acceptable to the Company of the 25. Multiple Sclerosis with Persisting Symptoms:
loss of independent existence due to illness or trauma, which has lasted
for a minimum period of 6 months and results in a permanent inability to The unequivocal diagnosis of Definite Multiple Sclerosis confirmed and
perform at least three (3) of the Activities of Daily Living (either with or evidenced by all of the following:
without the use of mechanical equipment, special devices or other aids • investigations including typical MRI findings which unequivocally
and adaptations in use for disabled persons). For the purpose of this confirm the diagnosis to be multiple sclerosis and
benefit, the word “permanent”, shall mean beyond the hope of recovery
with current medical knowledge and technology. The “Activities of Daily • there must be current clinical impairment of motor or sensory function,
Living” have been defined in ‘Generic Definitions’ section below. which must have persisted for a continuous period of at least 6 months.
The following is excluded: Other causes of neurological damage such as SLE are excluded.
Any injury or loss as a result of War, invasion, hostilities (whether war is 26. Muscular Dystrophy:
declared or not), civil war, rebellion, revolution or taking part in a riot or
Muscular Dystrophy is a disease of the muscle causing progressive and
civil commotion.
permanent weakening of certain muscle groups. The diagnosis of
19. Loss of Limbs: muscular dystrophy must be made by a consultant neurologist, and
The physical separation of two or more limbs, at or above the wrist or ankle confirmed with the appropriate laboratory, biochemical, histological, and
level limbs as a result of injury or disease. This will include medically electromyographic evidence. The disease must result in the permanent
necessary amputation necessitated by injury or disease. The separation inability of the insured to perform (whether aided or unaided) at least three
has to be permanent without any chance of surgical correction. Loss of (3) of the six (6) “Activities of Daily Living” (defined in ‘Generic Definitions’
Limbs resulting directly or indirectly from self-inflicted injury, alcohol or section below).
drug abuse is excluded. 27. Nephrectomy/Removal of One Kidney:
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The actual undergoing of a complete nephrectomy due to illness, disease Activities of Daily Living are defined as:
or Accident. Nephrectomy for the purpose of organ donation is specifically (a) Washing: The ability to wash in the bath or shower (including
excluded. The requirement of surgery has to be confirmed by a specialist getting into and out of the bath or shower) or wash satisfactorily by
medical practitioner
other means;
28. Parkinson's Disease: (b) Dressing: The ability to put on, take off, secure and unfasten all
Unequivocal Diagnosis of progressive degenerative primary idiopathic garments and, as appropriate, any braces, artificial limbs or other
Parkinson’s disease (all other forms of Parkinsonism are excluded) by a surgical appliances;
Registered Medical Practitioner who is a neurologist where the condition: (c) Transferring: The ability to move from a bed to an upright chair or
• cannot be controlled with medication; and wheelchair and vice versa;
• shows objective signs of progressive impairment; and (d) Toileting: The ability to use the lavatory or otherwise manage bowel
• Activities of Daily Living assessment confirms the inability of the and bladder functions so as to maintain a satisfactory level of personal
Member to perform at least 3 of the Activities of Daily Living as defined hygiene;
in “Generic Definitions” section below, either with or without the use of (e) Feeding: The ability to feed oneself once food has been prepared and
mechanical equipment, special devices or other aids or adaptations in made available.
use for disabled persons, for a continuous period of six months:
WHO Definition of Osteoporosis: Bone density reading with a T-score of
Only idiopathic Parkinson’s Disease is covered. Drug-induced or toxic less than –2.5 (i.e. 2.5 standard deviation below the peak bone density of
causes of Parkinson’s Disease are excluded. a normal 25- 30 year old adult).
29. Permanent Paralysis of Limbs: 35. Severe Rheumatoid Arthritis:
Total and irreversible loss of use of two or more limbs as a result of injury Unequivocal Diagnosis of systemic immune disorder of rheumatoid
or disease of the brain or spinal cord. A specialist medical practitioner must arthritis where all of the following criteria are met:
be of the opinion that the paralysis will be permanent with no hope of
(a) Diagnostic criteria of the American College of Rheumatology for
recovery and must be present for more than 3 months.
Rheumatoid Arthritis and has been diagnosed by a Rheumatologist;
30. Portal Vein Thrombosis (b) Permanent inability to perform at least three (3) of the six (6) Activities
Portal vein thrombosis is blockage or narrowing of the portal vein (the of Daily Living (defined in ‘Generic Definitions’ section below);
blood vessel that brings blood to the liver from the intestines) by a blood (c) Widespread joint destruction and major clinical deformity of three (3) or
clot. It should be characterized by the following: more of the following joint areas: hands, wrists, elbows, knees, hips,
i. Bleeding from varicose veins in the esophagus or stomach and/or ankle, cervical spine or feet confirmed by clinical and radiological
ii. An enlarged spleen evidence; and
Doppler ultrasonography /magnetic resonance imaging (MRI) or computed (d) The foregoing conditions have been present for at least six (6) months.
tomography (CT) and a Gastroenterologists report is necessary. For the above definition, the following are not covered:
31. Progressive Scleroderma: - Reactive arthritis, psoriatic arthritis and activated osteoarthritis
A systemic collagen-vascular disease causing progressive diffuse fibrosis 36. Small Bowel Transplant:
in the skin, blood vessels and visceral organs. This diagnosis must be Certified by a gastroenterologist that the surgery is necessary in case of
unequivocally supported by biopsy and serological evidence and the person has a small intestinal failure (serious malfunctioning bowel), and has
disorder must have reached systemic proportions to involve the heart, developed complications from total parenteral nutrition or are unable to
lungs or kidneys. tolerate this form of feeding. Payout will be based on the actual undergoing
The systemic involvement should be evidenced by any two of the of surgery.
following findings - Drug or alcohol abuse leading to intestinal failure is excluded.
• Lung fibrosis with a diffusing capacity (DCO) of less than 70% of
37. Systemic Lupus Erythematosus (SLE) with Renal Involvement:
predicted
Multi-system, autoimmune disorder characterized by the development of
• Pulmonary hypertension with a mean pulmonary artery pressure of
auto-antibodies, directed against various self-antigens. For purposes of
more than 25 mmHg at rest measured by right heart catheterization
the definition of “Critical Illness”, SLE is restricted to only those forms of
• Chronic kidney disease with a GFR of less than 60 ml/min systemic lupus erythematosus, which involve the kidneys and are
(MDRD-formula) characterized as Class III, Class IV, Class V or Class VI lupus nephritis
• Echocardiographic findings suggestive of Grade III and above left under the Abbreviated International Society of Nephrology/Renal
ventricular diastolic dysfunction Pathology Society (ISN/RPS) classification of lupus nephritis (2003) below
based on renal biopsy. Other forms such as discoid lupus, and those forms
The diagnosis must be confirmed by a Consultant Rheumatologist or
with only hematological and joint involvement are specifically excluded.
Nephrologist.
Abbreviated ISN/RPS classification of lupus nephritis (2003):
The following conditions are excluded:
Class I - Minimal mesangial lupus nephritis
• Localised scleroderma (linear scleroderma or morphea);
Class II - Mesangial proliferative lupus nephritis
• Eosinophilic fascitis; and
Class III - Focal lupus nephritis
• CREST syndrome
Class IV - Diffuse segmental (IV-S) or global (IV-G) lupus nephritis
32. Pneumonectomy:
Class V - Membranous lupus nephritis
The actual undergoing of surgery on the advice of a consultant medical
specialist to remove an entire lung for any physical injury or disease. Class VI - Advanced sclerosing lupus nephritis
The final diagnosis must be confirmed by a certified doctor specialising in
33. Poliomyelitis: Rheumatology and Immunology.
The first occurrence of poliomyelitis where the following conditions
are met: 38. Third Degree Burns:
i. Poliovirus is identified as the cause and is provided by stool analysis There must be third-degree burns with scarring that cover at least 20% of
the body’s surface area. The diagnosis must confirm the total area
ii. Paralysis of the limb muscles or respiratory muscles must be present involved using standardized, clinically accepted, body surface area charts
and persist for at least 3 months covering 20% of the body surface area.
34. Severe Osteoporosis: 39. Ulcerative Colitis:
A certified medical consultant must make the definite diagnosis of Ulcerative Colitis is a chronic inflammation of the large intestine, not
osteoporosis that follows the WHO definition where there is testing
caused by bacteria, which results in ulceration and bleeding. The
evidence of bone density reading with a T-score of less than –2.5 (2.5
standard deviation below the peak bone density of a normal 25-30 year diagnosis must be confirmed by a Gastro-Enterologist and the disease
old adult). The osteoporosis must have caused multiple fractures resulting must be treated with either steroids or immunomodulatory medication for
in the Insured’s permanent inability to perform at least 3 of 5 Activities of a period of at least six months. It should be supported with Endoscopy and
Daily Living (ADLs). histopathological report.

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Generic Definitions • Has a fully equipped operation theatre of its own where surgical
Accident: An Accident means sudden, unforeseen and involuntary event procedures are carried out; and
caused by external, visible and violent means. • Maintains daily records of patients and makes these accessible to the
Tata AIA’s authorized personnel.
Activities of Daily Living: The Activities of Daily Living are:
Hospitalization: Hospitalization means admission in hospital for minimum
i. Washing: the ability to wash in the bath or shower (including getting
period of 24 consecutive ‘In patient care’ hours except for specified
into and out of the bath or shower) or wash satisfactorily by other
procedures / treatments, where such admission could be for a period of
means;
less than 24 consecutive hours.
ii. Dressing: the ability to put on, take off, secure and unfasten all
Illness: An Illness means a sickness or a disease or pathological condition
garments and, as appropriate, any braces, artificial limbs or other
leading to the impairment of normal physiological function and requires
surgical appliances;
medical treatment.
iii. Transferring: the ability to move from a bed to an upright chair or
(a) Acute condition - Acute condition is a disease, illness or injury that is
wheelchair and vice versa;
likely to respond quickly to treatment which aims to return the person
iv. Mobility: the ability to move indoors from room to room on level to his or her state of health immediately before suffering the disease/
surfaces; illness/ injury which leads to full recovery
v. Toileting: the ability to use the lavatory or otherwise manage bowel (b) Chronic condition - A chronic condition is defined as a disease,
and bladder functions so as to maintain a satisfactory level of personal illness, or injury that has one or more of the following characteristics:
hygiene; 1. it needs ongoing or long-term monitoring through consultations,
vi. Feeding: the ability to feed oneself once food has been prepared and examinations, check-ups, and /or tests
made available. 2. it needs ongoing or long-term control or relief of symptoms
Adventurous Pursuits or Hobbies: Adventurous Pursuits or Hobbies 3. it requires rehabilitation for the patient or for the patient to be specially
include but are not limited to any kind martial arts, racing (other than on trained to cope with it
foot or swimming); potholing, rock climbing (except on man-made walls), 4. it continues indefinitely
hunting, mountaineering or climbing requiring the use of ropes or guides,
5. it recurs or is likely to recur
any underwater activities involving the use of underwater breathing
apparatus including deep sea diving, sky diving, cliff diving, bungee Injury: An Injury means accidental physical bodily harm excluding illness or
jumping, paragliding, hand gliding and parachuting. disease solely and directly caused by external, violent and visible and
evident means which is verified and certified by a Medical Practitioner.
Biological attack: Biological attack or weapons means the emission,
discharge, dispersal, release or escape of any pathogenic (disease Intensive Care Unit: Intensive Care Unit (ICU) means an identified section,
producing) microorganisms and/or biologically produced toxins (including ward or wing of a hospital which is under the constant supervision of a
genetically modified organisms and chemically synthesized toxins) which dedicated medical practitioner(s), and which is specially equipped for the
are capable of causing any Illness, incapacitating disablement or death. continuous monitoring and treatment of patients who are in a critical
condition, or require life support facilities and where the level of care and
Chemical attack: Chemical attack or weapons means the emission,
supervision is considerably more sophisticated and intensive than in the
discharge, dispersal, release or escape of any solid, liquid or gaseous
ordinary and other wards.
chemical compound which, when suitably distributed, is capable of
causing any Illness, incapacitating disablement or death. Medical Advice: Medical Advice means any consultation or advice from a
Medical Practitioner including the issuance of any prescription or follow-up
Congenital Anomaly: Congenital Anomaly means a condition which is
prescription
present since birth, and which is abnormal with reference to form,
structure or position. Medical Practitioner: A Medical Practitioner means person who holds a
valid registration from the Medical Council of any State or Medical Council
a) Internal Congenital Anomaly: Congenital anomaly which is not in the
of India or Council for Indian Medicine or for Homeopathy set up by the
visible and accessible parts of the body.
Government of India or a State Government and is thereby entitled to
b) External Congenital Anomaly: Congenital anomaly which is in the practice medicine within its jurisdiction; and is acting within its scope and
visible and accessible parts of the body jurisdiction of license.
Cooling Off Period: In case of multiple minor stage claims under the same The person must be qualified in allopathic system of medicine and shall
category (Critical illness, Cancer or Cardiac as applicable), the acceptance not be
of the claims shall be subject to a Cooling Off Period. Cooling off Period • The Policyholder/ Insured person himself/herself; or
shall apply after each occurrence of the condition/procedure, provided
• An authorized Insurance Intermediary (or related persons) involved
such occurrence resulted into a valid minor stage claim.
with selling or servicing the insurance contract in question; or
• For multiple minor stage claims, there needs to be a period of at least
• Employed by or under contractual engagement with the Insurance
180 days between the date of occurrence of a minor stage condition and
Company;
date of occurrence of a subsequent minor stage condition. No minor
claims shall be payable in this period for the aforementioned scenario. • Related to the Policyholder/ Insured person by blood or marriage.

• Date of occurrence is the date of diagnosis of a covered illness or the Medically Necessary Treatment: Medically Necessary Treatment means
date of undergoing of any procedure covered under minor conditions any treatment, tests, medication, or stay in hospital or part of a stay in
hospital which
• However, this requirement of 180 days is not applicable in case of
• is required for the medical management of the illness or injury suffered
diagnosis of a major stage condition following a minor stage claim.
by the insured;
• A particular minor condition can be claimed only once during the
• must not exceed the level of care necessary to provide safe, adequate
Benefit Option Term.
and appropriate medical care in scope, duration, or intensity;
Hospital: A Hospital means any institution established for in-patient care • must have been prescribed by a medical practitioner;
and day care treatment of illness and/or injuries and which has been
• must conform to the professional standards widely accepted in
registered as a hospital with the local authorities under the Clinical
international medical practice or by the medical community in India.
Establishments (Registration and Regulation) Act, 2010 or under
enactments specified under the Schedule of Section 56(1) and the said Act Pre-Existing disease: Pre-Existing condition means any condition,
or, complies with all minimum criteria as under: ailment, injury or disease:
• Has at least 10 inpatient beds in those towns having a population of • That is/are diagnosed by a physician within 48 months prior to the
less than 10,00,000 and atleast 15 inpatient beds in all other places; effective date of the policy issued by the Company or its revival
• Has qualified nursing staff under its employment round the clock; • For which medical advice or treatment was recommended by, or
• Has qualified medical practitioner(s) in charge round the clock; received from, a Physician within 48 months prior to the effective date

Tata AIA Life Insurance Non-Linked Comprehensive Health Rider (UIN - 110A031V02) • IRDA of India Regn no. 110

C262656195 Page 52 of 100

 of the policy issued by the Company or its revival • Complications of Sexually Transmitted Diseases or Veneral Disease
Surgery / Surgical Procedure: Surgery / Surgical Procedure means • Any covered condition which is diagnosed and/or received medical
manual and/or operative procedure(s) required for treatment of an illness advice/treatment within the waiting period.
or injury, correction of deformities and defects, diagnosis and cure of • Engaging or Taking part in or practicing for any professional sport(s) or
diseases, relief from suffering or prolongation of life, performed in a any adventurous pursuits or hazardous sports / pastimes including but
hospital or day care centre by a medical practitioner. not limited to taking part in (or practicing for) boxing, caving, climbing,
Symptom is a physical or mental feature which is regarded as indicating horse racing, jet skiing, martial arts, mountaineering, off pastel skiing,
presence of a disease, particularly such a feature is apparent to an pot holing, power boat racing, underwater diving, yacht racing or any
individual and will result in a medical consultation and/or further race, trial or timed motor sport, bungee jumping, hand gliding etc.
investigations to confirm the cause. • A Participation by the insured person in any flying activity, except as a
Exclusions: bona fide, fare-paying passenger of a recognized airline on regular
routes and on a scheduled timetable.
Details of the Exclusions applicable under the various 'Health Benefit
• Insured person being under the influence of drugs, alcohol, narcotics
options' are given below
or psychotropic substances unless taken in accordance with the
Accidental Total / Partial and Permanent Disability Benefit lawful directions and prescription of a registered medical practitioner.
Accidental Disability Benefit shall be not payable for any losses caused • War, invasion, act of foreign enemy, hostilities (whether war is declared
directly or indirectly, wholly or partly, by any one of the following or not), terrorism, civil war, mutiny, rebellion, revolution, insurrection,
occurrences: military or usurped power or taking part in any riot, strikes, industrial
• Injury occurred before the risk commencement date disputes or civil commotion.
• If the Disability occurs after 180 days from the date of the accident • Taking part in any act of a criminal or illegal nature or committing any
• If the Disability has not persisted for at least 180 days and is not in the breach of law with criminal intent
opinion of a medical practitioner, deemed to be permanent. • Nuclear Contamination; the radio-active, explosive or hazardous
• Attempted suicide, attempted self-destruction or self-inflicted injury, nature of nuclear fuel materials or property contaminated by nuclear
irrespective of mental condition. fuel materials or accident arising from such nature and any kind of
• No benefits will be payable for any condition(s) which is a direct or biological and chemical contamination.
indirect result of any pre-existing conditions unless Life Assured has • Taking part in any naval, military or air force operation during peace
disclosed the same at the time of proposal or date of revival whichever time.
is later and the Company has accepted the same. Wherever the • Admission, Diagnosis or Treatment taken outside India
proximate cause is accident which has occurred after the rider
inception date, this exclusion shall not apply. • Circumcision, any cosmetic procedures or plastic surgery
• Insured person being under the influence of drugs, alcohol, narcotics • Pregnancy, childbirth or their complications, abortion, medical
or psychotropic substances unless taken in accordance with the termination of pregnancy, infertility including IVF surrogate or vicarious
lawful directions and prescription of a registered medical practitioner. pregnancy or services including complications arising due to supplying
services or Assisted Reproductive Technology or sex change operation
• War, invasion, act of foreign enemy, hostilities (whether war is declared
or not), terrorism, civil war, mutiny, rebellion, revolution, insurrection, • Organ donation (as a donor)
military or usurped power or taking part in any riot, strikes, industrial • External and known congenital conditions or birth defects
disputes or civil commotion • Dental treatment except if arising from an accident
• Participation by the insured person in any flying activity, except as a • Any form of Non-Allopathic treatment
bona fide, fare-paying passenger of a recognized airline on regular
• Purely investigative procedure not resulting in any treatment or elective
routes and on a scheduled timetable.
procedures
• Taking part in any naval, military or air force operation during peace
• All preventive care, vaccinations including inoculation and
time.
immunizations
• Engaging or Taking part in or practicing for any professional sport(s) or
• Study and treatment of sleep disorder or sleep apnea
any adventurous pursuits or hazardous sports / pastimes including but
not limited to taking part in (or practicing for) boxing, caving, climbing, • Any hospitalization/surgery performed within 90 days from the start of
horse racing, jet skiing, martial arts, mountaineering, off pastel skiing, coverage or the revival date.
pot holing, power boat racing, underwater diving, yacht racing or any • Treatment for developmental problems including learning difficulties
race, trial or timed motor sport, bungee jumping, hand gliding etc. e.g. Dyslexia, behavioral problems
• Taking part in any act of a criminal or illegal nature or committing any • Any treatment received in convalescent homes, convalescent
breach of law with criminal intent hospitals, nature cure clinics, rest care, rehabilitation, or similar
• Nuclear Contamination; the radio-active, explosive or hazardous establishments
nature of nuclear fuel materials or property contaminated by nuclear • Charges incurred in connection with cost of external aids, spectacles and
fuel materials or accident arising from such nature and any kind of contact lenses, hearing aids, laser surgery for correction of refractive
biological and chemical contamination. errors other than for focal error of +/-7 or more and medically necessary.
• Disability as a result of any disease or infection • Routine eye examinations and ear examinations, cochlear implants,
any treatment and associated expenses for alopecia, baldness, wigs,
HospiCare Benefit (HCB) or toupees, hair fall treatment & products, and all other similar external
The Life Insured will not be entitled to any benefits if the surgery or appliances and / or devices whether for diagnosis or treatment.
hospitalization is directly or indirectly caused by, based on, arising out of or • Any experimental or unproven pharmacological regimens or usage
howsoever attributable to any of the following: of any unproven treatment devices any Illness or treatment, which
• Any pre-existing condition (disease, illness or injury) and its is a result or a consequence of undergoing such experimental or
complications which manifested itself prior to the effective date of the unproven treatment.
Benefit Option or its latest revival date, whichever is later. Wherever • Any Stem Cell Transplant therapies or hormone replacement therapy
the proximate cause is accident which has occurred after the rider
inception date, this exclusion shall not apply. • Treatment of obesity or morbid obesity including any complication
• Any investigation or treatment for any Illness, disorder, complication or arising from these treatments or any other weight control programme.
ailment arising out of or connected with the pre-existing Illness shall be • Artificial life maintenance, including life support machine use, where
considered part of that pre-existing illness. such treatment will not result in recovery or restoration of the previous
• Attempted suicide, attempted self-destruction or self-inflicted injury, state of health and/ or who has been declared brain dead, as
irrespective of mental condition. demonstrated by:
Tata AIA Life Insurance Non-Linked Comprehensive Health Rider (UIN - 110A031V02) • IRDA of India Regn no. 110

C262656195 Page 53 of 100

 - Deep coma and unresponsiveness to all forms of stimulation; or • Engaging in hazardous sports / pastimes, i.e. taking part in (or
practising for) boxing, caving, climbing, horse racing, jet skiing, martial
- Absent pupillary light reaction; or
arts, mountaineering, off pastel skiing, pot holing, power boat racing,
- Absent oculovestibular and corneal reflexes; or underwater diving, yacht racing or any race, trial or timed motor sport,
bungee jumping, hand gliding etc.
- Complete apnea.
• Any injury, sickness or disease received as a result of aviation
• Screening, counseling, treatment or complications related to
(including parachuting or skydiving), gliding or any form of aerial flight
autoimmune diseases.
other than as a fare-paying passenger or crew on a licensed
• Hospitalization only for investigation, evaluation and observation not passenger-carrying commercial aircraft operating on regular routes
covered. and on a scheduled timetable unless agreed by special endorsement.
Excluded for first two policy years • War, invasion, hostilities (whether war is declared or not), civil war,
rebellion, terrorist activity, revolution or taking part in a riot or civil
Specific waiting period of 2 years from policy issue date or revival date for commotion, strikes or industrial action.
conditions/procedures mentioned below will apply for all benefits.
• Any treatment of a donor for the replacement of an organ
• Hernia Repair
• Nuclear reaction due to nuclear accident, Biological, Chemical or
• Corrective procedure for gall stones Radioactive contamination
• Corrective procedure for kidney or urinary tract stones • Diagnosis and treatment outside India.
• Discectomy, Laminectomy • Ayurvedic, Homeopathy, Unani, herbalist treatment, any other
• Hemi / Partial Thyroidectomy treatments other than Allopathy / western medicines.
• Corrective procedure for anal fistula or anal fissure, abscess of anal
and pilonidal sinus
• Removal of uterus, fallopian tubes and/or ovaries, except for
malignancy
• Corrective procedure for female genital Prolapse, Endometriosis/
Adenomyosis, Polycystic Ovarian Disease, fibroids, uterine prolapse,
or dysfunctional uterine bleeding
• Corrective procedures for Hemorrhoids
• Cataract & Joint replacement surgeries (other than caused by
accidents)
• Hyperplasia of Prostate (BPH), Hydrocele, and spermatocele
• Knee replacement surgery (other than caused by accidents)
• Non-infectious Arthritis, Gout, Rheumatism, Oestoarthritis and
Osteoposrosis, Prolapse of Intervertibral discs (other than caused by
Accident), all Vertebrae Disorders, including but not limited to
Spondylitis, Spondylosis, Spondylolisthesis
• Varicose veins and varicose ulcers of lower extremities,
• Disease of middle ear and mastoid including Otitis Media (CSOM),
Cholesteatoma, Perforation of Tympanic Membrane, any other benign
ear, nose and throat disorder or surgery.
• All internal or external benign or In Situ Neoplasms/Tumours, Cyst,
Sinus, Polyp, Nodules, Swelling, Mass or Lump,
• Ulcer, Erosion and Varices of Upper Gastro Intestinal Tract,
• Tonsils and Adenoids, Nasal Septum including deviated nasal sinus
and Nasal Sinuses, sinusitis and related disorder,
• Internal Congenital Anomaly
Multistage Cancer Care Benefit / Multistage Cardiac Care Benefit
/ Multistage Critical Illness Benefit
In addition to the disease specific exclusions given along with definitions of
the respective diseases covered under the Benefit Option, no benefit will
be payable if death or the illness covered under the policy is caused or
aggravated directly or indirectly by any of the following:
• Pre-Existing Diseases are not covered. Any pre-existing disease at the
time of inception of the policy.
• Any investigation or treatment for any Illness, disorder, complication or
ailment arising out of or connected with the pre-existing Illness shall be
considered part of that pre-existing illness.
• No benefits will be payable for any condition(s) which is a direct or
indirect result of any pre-existing conditions unless Life Assured has
disclosed the same at the time of proposal or date of revival whichever
is later and the Company has accepted the same.
• Any covered condition which is diagnosed and/or received medical
advice/treatment within the waiting period.
• Self-inflicted injuries, attempted suicide, insanity, and deliberate
participation of the Life Assured in an illegal or criminal act with criminal
intent.
• Use of intoxicating drugs / alcohol / solvent, taking of drugs except
under the direction of a medical practitioner.
• Any illness due to an external congenital defect

Tata AIA Life Insurance Non-Linked Comprehensive Health Rider (UIN - 110A031V02) • IRDA of India Regn no. 110

C262656195 Page 54 of 100

CUSTOMER INFORMATION SHEET
Description is illustrative and not exhaustive

POLICY
Sr.
TITLE DESCRIPTION CLAUSE
NO
NUMBER
Tata AIA Life Insurance Non-Linked Comprehensive Health Rider (UIN: 110B031V02)
1 Product Name
(A Non-Linked, Non- Participating Individual Health Rider)
HospiCare Benefit: This benefit is payable in case of hospitalization of the Life Insured for medically necessary treatment
of any illness or injury for a minimum period of consecutive 24 hours.
Hospital Cash Benefit: Policyholder can claim daily cash benefit in case of hospitalization for medically necessary
treatment of any illness or injury for a minimum period of 24 hours, payable from the first day for the duration of
hospitalization. Hospital Cash benefit is payable for a maximum 30 days per policy year, subject to a maximum of 200
days during the entire policy term of contract.
ICU Benefit: ICU benefit is payable for hospitalization up to 15 days per Policy year. This benefit amount is a fixed per-day
benefit and will be paid irrespective of actual hospitalization expenses. Part C
What am I
2 Clause 1
covered for: Recuperating Benefit: A recuperating benefit which is a lump sum benefit and is equivalent to 1.5% of the Hospicare (I)
benefit Insured Amount will be payable in case of continuous hospitalization* in one or more hospitals for 7 or more days
(excluding the time taken for transit between hospitals) for the same injury or disease, subject to the daily cash benefit
being payable at the time of hospitalization. This benefit will be paid once in a Policy year. This benefit is not payable if the
Life Insured dies during hospitalization.
*The gap in the stay between two hospitals due to transit cannot exceed 7 days and only one such break is allowed.
HospiCare benefit will terminate on payment of a 100% of the ‘Insured Amount under the Benefit Option’.
Please refer Policy Document (Annexure A) for definitions etc
Life Insured will not be entitled to any benefits if the surgery or hospitalization is directly or indirectly caused by, based on,
arising out of or howsoever attributable to any of the following:
• Any pre-existing condition (disease, illness or injury) and its complications which manifested itself prior to the effective
date of the Benefit Option or its latest revival date, whichever is later. Wherever the proximate cause is accident
which has occurred after the rider inception date, this exclusion shall not apply
• Any investigation or treatment for any Illness, disorder, complication or ailment arising out of or connected with the
pre-existing Illness shall be considered part of that pre-existing illness.
• Attempted suicide, attempted self-destruction or self-inflicted injury, irrespective of mental condition.
• Complications of Sexually Transmitted Diseases or Veneral Disease
• Any covered condition which is diagnosed and/or received medical advice/treatment within the waiting period.
• Engaging or Taking part in or practicing for any professional sport(s) or any adventurous pursuits or hazardous sports
/ pastimes including but not limited to taking part in (or practicing for) boxing, caving, climbing, horse racing, jet
skiing, martial arts, mountaineering, off pastel skiing, pot holing, power boat racing, underwater diving, yacht racing
or any race, trial or timed motor sport, bungee jumping, hand gliding etc.
• A Participation by the insured person in any flying activity, except as a bona fide, fare-paying passenger of a
recognized airline on regular routes and on a scheduled timetable.
• Insured person being under the influence of drugs, alcohol, narcotics or psychotropic substances unless taken in
accordance with the lawful directions and prescription of a registered Medical Practitioner.
• War, invasion, act of foreign enemy, hostilities (whether war is declared or not), terrorism, civil war, mutiny, rebellion,
revolution, insurrection, military or usurped power or taking part in any riot, strikes, industrial disputes or civil commotion.
• Taking part in any act of a criminal or illegal nature or committing any breach of law with criminal intent
What are the • Nuclear Contamination; the radio-active, explosive or hazardous nature of nuclear fuel materials or property
contaminated by nuclear fuel materials or accident arising from such nature and any kind of biological and
major
chemical contamination. Annexure
3 exclusions in
A
the policy: • Taking part in any naval, military or air force operation during peace time.
Exclusions
• Admission, Diagnosis or Treatment taken outside India
• Circumcision, any cosmetic procedures or plastic surgery
• Pregnancy, childbirth or their complications, abortion, medical termination of pregnancy, infertility including IVF
surrogate or vicarious pregnancy or services including complications arising due to supplying services of Assisted
Reproductive technology or sex change operation
• Organ donation (as a donor)
• External and known congenital conditions or birth defects
• Dental treatment except if arising from an accident
• Any form of Non-Allopathic treatment
• Purely investigative procedure not resulting in any treatment or elective procedures
• All preventive care, vaccinations including inoculation and immunizations
• Study and treatment of sleep disorder or sleep apnea.
• Any hospitalization/surgery performed within 90 days from the start of coverage or the revival date.
• Treatment for developmental problems including learning difficulties e.g. Dyslexia, behavioral problems
• Any treatment received in convalescent homes, convalescent hospitals, nature cure clinics, rest care, rehabilitation,
or similar establishments
• Charges incurred in connection with cost of external aids, spectacles and contact lenses, hearing aids, laser surgery
for correction of refractive errors other than for focal error of +/-7 or more and medically necessary.
• Routine eye examinations and ear examinations, cochlear implants, any treatment and associated expenses for
alopecia, baldness, wigs, or toupees, hair fall treatment & products, and all other similar external appliances and / or
devices whether for diagnosis or treatment.

C262656195 Page 55 of 100

 • Any experimental or unproven pharmacological regimens or usage of any unproven treatment devices any Illness or
treatment, which is a result or a consequence of undergoing such experimental or unproven treatment.
• Any Stem Cell Transplant therapies or hormone replacement therapy
• Treatment of obesity or morbid obesity including any complication arising from these treatments or any other weight
control programme.
• Artificial life maintenance, including life support machine use, where such treatment will not result in recovery or
restoration of the previous state of health and/ or who has been declared brain dead, as demonstrated by:
- Deep coma and unresponsiveness to all forms of stimulation; or
- Absent pupillary light reaction; or
- Absent oculovestibular and corneal reflexes; or
- Complete apnea.
• Screening, counseling, treatment or complications related to autoimmune diseases.
• Hospitalization only for investigation, evaluation and observation not covered.
Excluded for first two policy years
Specific waiting period of 2 years from policy issue date or revival date for conditions/procedures mentioned below will
apply for all benefits.
• Hernia Repair
What are the
• Corrective procedure for gall stones
major
• Corrective procedure for kidney or urinary tract stones Annexure
3 exclusions in
A
the policy: • Discectomy, Laminectomy
Exclusions
• Hemi / Partial Thyroidectomy
• Corrective procedure for anal fistula or anal fissure, abscess of anal and pilonidal sinus
• Removal of uterus, fallopian tubes and/or ovaries, except for malignancy
• Corrective procedure for female genital Prolapse, Endometriosis/ Adenomyosis, Polycystic Ovarian Disease, fibroids,
uterine prolapse, or dysfunctional uterine bleeding
• Corrective procedures for Hemorrhoids
• Cataract & Joint replacement surgeries (other than caused by accidents)
• Hyperplasia of Prostate (BPH), Hydrocele, and spermatocele
• Knee replacement surgery (other than caused by accidents)
• Non-infectious Arthritis, Gout, Rheumatism, Oestoarthritis and Osteoposrosis, Prolapse of Intervertibral discs (other
than caused by Accident), all Vertebrae Disorders, including but not limited to Spondylitis, Spondylosis,
Spondylolisthesis
• Varicose veins and varicose ulcers of lower extremities,
• Disease of middle ear and mastoid including Otitis Media (CSOM), Cholesteatoma, Perforation of Tympanic
Membrane, any other benign ear, nose and throat disorder or surgery.
• All internal or external benign or In Situ Neoplasms/Tumours, Cyst, Sinus, Polyp, Nodules, Swelling, Mass or Lump,
• Ulcer, Erosion and Varices of Upper Gastro Intestinal Tract,
• Tonsils and Adenoids, Nasal Septum including deviated nasal sinus and Nasal Sinuses, sinusitis and related disorder,
• Internal Congenital Anomaly
A Waiting Period of 90 days is applicable for all benefits payable under HospiCare Benefit (except for hospitalization due
to an accident). Part C
4 Waiting period
A specific waiting period of 2 years for specific conditions mentioned in the Exclusion section above will be applicable for Clause 7
all benefits covered under the Hospicare Benefit
Part C
Payment
5 Fixed amount as described in Part C Clause 1(I) of the Policy Document will be paid on the occurrence of a covered event. Clause 1
Basis
(I)

6 Loss Sharing Not Applicable -

Renewal
7 Not Applicable -
Conditions
Renewal
8 Not Applicable -
Benefits:
This policy will be cancelled, and no claim or refund would be due to you if
a. You have not correctly disclosed details about current and past health status OR
9 Cancellation b) Have otherwise encouraged or participated in any fraudulent claim under the policy OR
c) In case of misrepresentation of material information
Also, this Benefit Option shall automatically terminate on the occurrence of any of the events described in Part D Clause 8
For processing the claim request under this rider, please share documents as listed under Part F Clause 2 of the Part F
10 Claims
Policy Document. Clause 2
Policy
Part D
Servicing/ For details on policy servicing/grievance/complaints, please refer the terms and conditions of the base plan.
11 and
Grievance/
Part G
Complaints

C262656195 Page 56 of 100

 • Free look & Revival: For the purpose of this Supplementary Contract, the provisions of the base plan in respect of
Free look cancellation and revival, shall apply.
Insured’s
12 • Turn Around Time (TAT) for Claim Processing: For Health Claims: The claim will be decided within 30 days of Part D
Right
receiving all documents and clarification. If the claim is investigated, the investigation will be completed within 30
days and the claim decided in another 15 days, therefore not exceeding 45 days in total.
• Please disclose all pre-existing disease/s or condition/s before buying a Policy. Non-disclosure may result in claim
not being paid.
• Disclosure of Material Information and any changes therein during the Policy period should be communicated
to us by
Insured’s
13 - Sending an email to customercare@tataaia.com from your email id registered with us Part F
Obligations
Clause 4
- Submission of the Request for Change form* (filled and signed) at any Tata AIA Life Insurance Branch or
Service Centre
*Request for Change form is available on our website – www.tataaia.com

1) Kindly note that this document does not substitute the Policy Contract.
2) In case the age is found to be higher/lower than the actual age, the rights and remedies would get affected
(LEGAL DISCLAIMER) NOTE: The information must be read in conjunction with the Product Brochure and Policy Document. In case of any conflict between
the Customer Information Sheet and the Policy Document, the terms and conditions mentioned in the Policy Document shall prevail.

Tata AIA Life Insurance Company Limited (IRDAI Regn. No.110) CIN: U66010MH2000PLC128403. Registered & Corporate Office: 14th Floor, Tower A, Peninsula Business Park,
Senapati Bapat Marg, Lower Parel, Mumbai - 400013. Trade logo displayed above belongs to Tata Sons Ltd and AIA Group Ltd. and is used by Tata AIA Life Insurance Company Ltd under a
license. For any information including cancellation, claims and complaints, please contact our Insurance Advisor / Intermediary or visit Tata AIA Life’s nearest branch office or call
1-860-266-9966 (local charges apply) or write to us at customercare@tataaia.com. Visit us at: www.tataaia.com. • L&C/Misc/2020/Dec/0438. C262656195 Page 57 of 100
CUSTOMER INFORMATION SHEET
Description is illustrative and not exhaustive

POLICY
Sr.
TITLE DESCRIPTION CLAUSE
NO
NUMBER
Tata AIA Life Insurance Non-Linked Comprehensive Protection Rider (UIN: 110B033V02)
1 Product Name
(A Non-Linked, Non- Participating Individual Health Rider)
Benefit Option: Accidental Total and Permanent Disability Benefit:
Part C
What am I 100% of the Insured Amount under this Benefit Option will be payable in the event of the Total and Permanent Disability
2 Clause 1
covered for: of the Life Insured due to an accident within the Benefit Option Term, provided the disability occurs within 180 days from (III)
that accident as per Part C Clause 1 (III) of the Policy Document.
Accidental Disability Benefit shall be not payable for any losses caused directly or indirectly, wholly or partly, by any one of
the following occurrences:
• Disablement as a result of any disease or infection.
• Disablement arising due to any condition other than disablement solely and directly as a result of an accident.
• Any pre-existing condition or disability arising out of a pre-existing diseases or any complication arising
therefrom. Wherever the proximate cause is accident which has occurred after the rider inception date, this
exclusion shall not apply
• If the Disability has not persisted for at least 180 days and is not in the opinion of a medical practitioner, deemed to
be permanent.
• Attempted suicide, attempted self-destruction or self-inflicted injury, irrespective of mental condition.
• Disablement arising from or caused due to use, abuse or a consequence or influence of an abuse of any substance,
intoxicant, drug, alcohol or hallucinogen
What are the • Disablement arising out of or attributable to foreign invasion, act of foreign enemies, hostilities, warlike operations
major (whether war be declared or not or while performing duties in the armed forces of any country during war or at peace Annexure 1
3 exclusions in time), participation in any naval, military or air-force operation, civil war, public defense, rebellion, revolution, ‘Exclusions’
the policy: insurrection, military or usurped power Section
• Disablement caused by Participation by the insured person in any flying activity, except as a bona fide, fare-paying
passenger of a recognized airline on regular routes and on a scheduled timetable.
• Insured Person whilst engaging in a speed contest or racing of any kind (other than on foot), bungee jumping,
parasailing, ballooning, parachuting, skydiving, paragliding, hang gliding, mountain or rock climbing necessitating
the use of guides or ropes, potholing, abseiling, deep sea diving using hard helmet and breathing apparatus, polo,
snow and ice sports in so far as they involve the training for or participation in competitions or professional sports,
or involving a naval, military or air force operation and is specifically specified in the Policy Schedule
• Working in underground mines, tunnelling or explosives, or involving electrical installation with high tension supply,
or as jockeys or circus personnel, or engaged in Hazardous Activities
• Disablement arising or resulting from the Insured Person committing any breach of law or participating in an actual
or attempted felony, riot, crime, misdemeanor, or civil commotion with criminal intent.
• Disablement arising from or caused by ionizing radiation or contamination by radioactivity from any nuclear fuel
(explosive or hazardous form) or resulting from or from any other cause or event contributing concurrently or in any
other sequence to the loss, claim or expense from any nuclear waste from the combustion of nuclear fuel, nuclear,
chemical or biological attack.
4 Waiting period Not Applicable -
Benefit as described in Part C Clause 1 (III) of the Policy Document will be paid on the occurrence of a covered event. You
can choose to receive the benefits as a
Payment 1. Combination of Lump sum and income for a fixed income period chosen Part C
5
Basis 2. Income till survival of chosen dependent partner(s) (Partner Care) Clause 5
3. Waiver of future premiums
For more details please refer Part C, Clause 5 of Policy Document
6 Loss Sharing Not Applicable -
Renewal
7 Not Applicable -
Conditions
Renewal
8 Not Applicable -
Benefits:
This policy will be cancelled, and no claim or refund would be due to you if;
a. You have not correctly disclosed details about current and past health status OR
9 Cancellation b) Have otherwise encouraged or participated in any fraudulent claim under the policy OR
c) In case of misrepresentation of material information
Also, this Benefit Option shall automatically terminate on the occurrence of any of the events described in Part D Clause 8
For processing the claim request under this rider, please share documents as listed under Part F Clause 2 of the
Policy Document. Part F
10 Claims
The evidence of travel in public land transportation, airline or visit to theatre, cinema, public auditorium, hotel will be Clause 2
required for Double Benefit claim to be considered.
Policy
Part D
Servicing/ For details on policy servicing/grievances/complaints, please refer the terms and conditions of the base plan
11 and
Grievance/
Part G
Complaints

C262656195 Page 58 of 100

 • Free look & Revival: For the purpose of this Supplementary Contract, the provisions of the base plan in respect of
Free look cancellation and revival, shall apply.
Insured’s
12 • Turn Around Time (TAT) for Claim Processing: For Health Claims: The claim will be decided within 30 days of Part D
Right
receiving all documents and clarification. If the claim is investigated, the investigation will be completed within 30
days and the claim decided in another 15 days, therefore not exceeding 45 days in total.
• Please disclose all pre-existing disease/s or condition/s before buying a Policy. Non-disclosure may result in claim
not being paid.
• Disclosure of Material Information and any changes therein during the Policy period should be communicated
to us by:
Insured’s
13 - Sending an email to customercare@tataaia.com from your email id registered with us Part F
Obligations
Clause 4
- Submission of the Request for Change form* (filled and signed) at any Tata AIA Life Insurance Branch or
Service Centre
*Request for Change form is available on our website – www.tataaia.com

1) Kindly note that this document does not substitute the Policy Contract.
2) In case the age is found to be higher/lower than the actual age, the rights and remedies would get affected
(LEGAL DISCLAIMER) NOTE: The information must be read in conjunction with the Product Brochure and Policy Document. In case of any conflict between
the Customer Information Sheet and the Policy Document, the terms and conditions mentioned in the Policy Document shall prevail.

Tata AIA Life Insurance Company Limited (IRDAI Regn. No.110) CIN: U66010MH2000PLC128403. Registered & Corporate Office: 14th Floor, Tower A, Peninsula Business Park,
Senapati Bapat Marg, Lower Parel, Mumbai - 400013. Trade logo displayed above belongs to Tata Sons Ltd and AIA Group Ltd. and is used by Tata AIA Life Insurance Company Ltd under a
license. For any information including cancellation, claims and complaints, please contact our Insurance Advisor / Intermediary or visit Tata AIA Life’s nearest branch office or call
1-860-266-9966 (local charges apply) or write to us at customercare@tataaia.com. Visit us at: www.tataaia.com. • L&C/Misc/2020/Dec/0434. C262656195 Page 59 of 100
 CLAIM DOCUMENT LIST

Requirements for Hospitalization & Critical Requirements for Disability and Requirements for Death Claim (all causes of
Illness Claim Dismemberment Claim Death)
A Claim Forms A Claim Forms A Claim Forms
Part I: Application Form for Hospitalization/Critical Part I: Application Form for Part I: Application Form for Death Claim
Illness Claim (Claimant's Statement) along with Disability/Dismemberment Claim (Claimant's (Claimant's Statement) along with NEFT form
NEFT form Statement) along with NEFT form Part II:Physician's Statement - to be filled by last
Part II: Confidential Medical Report -to be filled by Part II: Confidential Medical Report -to be filled by attending physician
attending physician attending physician

B Hospital Bills for the confinement. B Attested True Copy of Indoor Case Papers of the B Death Certificate issued by a local government
Hospital body like Municipal Corporation
C Attested True Copy of Indoor Case Papers of the C Discharge Summary of Present and Past C Medical Records (Admission Notes,
Hospital Hospitalizations Discharge/Death Summary, Indoor Case Papers,
Test Reports etc)1

D Discharge Summary of Present and Past D Photo Identity of insured with age and address D Original Policy document
Hospitalizations proof

E Photo Identity of insured with age and address E Bank Details of the claimant – Cancelled cheque E Claimant's Photo ID with age proof & relationship
proof (with printed name and account number)/bank with the Insured along with Address proof of the
passbook and NEFT Form claimant and Cancelled cheque with name and
account number printed or cancelled cheque with
copy of Bank Passbook / Bank Statement

If no nomination - Proof of legal title to the claim

proceeds (e.g. legal succession paper)

F Bank Details of the claimant – Cancelled cheque F Disability Certificate by attending Physician /
(with printed name and account number)/bank Institute for disabled
passbook and NEFT Form
G Certificate of Diagnosis G Rehabilitation Certificate - if applicable

H Medical Examination Certificate (First H Employer’s written confirmation / statement - for

Consultation Notes). Disability claim

I All related clinical Reports pertaining to the claim I All related Medical Examination Reports, e.g. -
event - Laboratory test reports
Laboratory test reports X-Ray / CT Scan / MRI Reports & Plates
X-Ray / CT Scan / MRI Reports & Ultrasonography Report
PlatesUltrasonography Report Clinical / Hospital Reports
Histopathology Report
Clinical / Hospital Reports
Angiography Reports & Plates.
Others (please specify).
J All follow-up Consultation Notes in relation to the J Clinical Photographs showing the injured areas -
hospitalized condition. if available
If Claims is due to accidental causes (submit in If Claims is due to accidental causes (submit in In case of accidental death inaddition to the above
addition to the above) addition to the above). documents, we would require the following
documents –
K All police reports- K All police reports- F Postmortem report (Autopsy report) &
First Information Report First Information Report Chemical Viscera report - if performed
Final Investigation Report Final Investigation Report
G All Police Papers – Panchnama, Inquest, First
Information Report (FIR) and Final Investigation
Report
H Newspaper cutting / Photographs of the accident -
if available

1. This is applicable if insured was in hospital at the time of death or any time prior to the date of death.
• Please submit copies of the following documents certified / attested by the issuing authority. ( Original Seen Verified (OSV) by Branch Personnel will also be accepted) -
o All Police papers – Panchnama, Inquest, First Information Report and Final Investigation Report
o Medical Records (Admission Notes, Discharge/Death Summary, Indoor Case Papers, Test Reports etc)1
o Postmortem report (Autopsy report) & Chemical Viscera report (certified by Police / Magistrate / Court will also be accepted)
• Copies of the other documents to be submitted by self attestation of the claimant

NOTE:
- In case the claim warrants any additional requirement, TATA AIA LIFE reserves the right to call for the same.
- Notification of claim & submission of the claim requirements does not mean admission of the claim liability by the Company.
- No agent is authorized to admit any liabilities on behalf of the Company, nor to alter this list of documents or any claims requirements called for by the Company.

C262656195 Page 60 of 100

 FREQUENTLY ASKED QUESTIONS (FAQs)

1. How can I cancel my policy under Free Look?

 The policy can be cancelled anytime within 30 days from the date of receipt of the
policy document. Kindly submit the policy document along with a duly signed letter at any of the
Tata AIA Life branches#.

2. How can I change the premium payment mode?

 Please submit a duly signed copy of the Mode change form* at any of the Tata AIA Life
branches# at least 10 days before the due date of the policy.
 Please contact the branch or call center for mode changes allowed on your policy

3. How can I make the below mentioned changes in my policy?

- Name change - Address / Contact Number Change
- Ownership Change - Signature Change
- Nominee Change - Basic Plan Change
 Please submit a duly signed copy of the respective change form* along with the documents
mentioned in the form at any of the Tata AIA Life branches#.

4. Can I opt for automatic premium payment facility on my policy?

 You can avail of any of the following facilities wherein your account / Credit Card will be
debited on the due date of your policy.
o ECS - A signed copy of the ECS form* along with a cancelled cheque or copy of cancelled
cheque needs to be submitted at any of the Tata AIA Life branches at least 10 days prior to the
due date
o Credit Card – A signed copy of the Credit Card form* along with a copy of Front page of
credit card needs to be submitted at any of the Tata AIA Life branches at least 10 days prior to the
due date
o Direct debit – You can avail of Direct Debit facility by providing a copy of an 'ECS &
Direct Debit' form* with copy of cancelled cheque or bank attestation at least 30 days before the
due date. To know the list of banks wherein this facility is available, kindly visit the 'Premium
Payment Options' on www.tataaia.com.

5. I have lost my PIP and need a duplicate PIP.

 Please submit a duly signed copy of the Duplicate PIP form* along with the documents
mentioned in the form at any of the Tata AIA Life branches#.

6. How can I view my policy related details online?

 You can create your online account by logging in to www.tataaia.com and avail of the
following benefits –
o Easy access to policy related details (Premium Due Date, NAV, Payment Summary, etc.,)
o Single access for all your policies
o Perform Online ULIP transactions
o Pay Premium Online
o Generate e-statements (Premium Certificates, Unit Statements)
o Raise Service Requests

7. How do I request for a Premium Payment Certificate for my policies?

 You can request for your Premium Certificate through the following modes -
o Online Customer Portal - Kindly logon to your Online Account by visiting
www.tataaia.com
o SMS - Kindly SMS the following to 5676799:

C262656195 Page 61 of 100

  PCT <space> 10 digit policy no <space> email address (in case you wish to receive by
email, else will be sent to your communication address) <space> financial year (yyyy-yyyy
format)
 The mobile number from where the SMS has been sent should be registered with the
company. In case your mobile number is not registered, please send the following SMS to
5676799:
REG <space> 10 digit policy no <space> Insured's DOB in DDMMYYYY format <space>
Sum Assured
(For Health, Annuity and Pension plans, Sum Assured should be mentioned as '0')
o Email / Call / Branch - Request for the Premium Certificate by sending an email to
customercare@tataaia.com or call our helpline number at 1-860-266-9966 (local charges apply)
or visit the nearest branch#.

8. For my unit linked policy, how can I request for Fund Switch, Premium Redirection & Top-up?
 You can create your online account by logging in to www.tataaia.com and perform Fund
Switch, Premium Redirection and Top-up transactions instantly (or)
 Please submit a duly signed copy of the Fund Allocation, Switch & Top-up form* pertaining
to your product at any of the Tata AIA Life branches#.

* You can download the forms by visiting 'Customer Services' section on www.tataaia.com
#
For your nearest Tata AIA Life branch, please visit 'Contact Us' section on www.tataaia.com.

You can also send the forms along with the documents to the below mentioned address –
Policy Owners Services
Tata AIA Life Insurance Company Limited,
B-Wing, 9th Floor, I-Think Techno Campus,
Behind TCS, Pokhran Road No.2,
Close to Eastern Express Highway,
Thane (West) – 400 607, Maharashtra

C262656195 Page 62 of 100

 PROPOSAL FORM

Tata AIA Life Insurance Company Limited.

COMMON PROPOSAL FORM

Kindly Fill the form in CAPITAL and only in blue or black

(For Official Use only)

Proposal Number: C262656195 Branch Code:

Channel: WEBSALES Campaign Code:

Sub Office Code: RM CAMS Code:

Agent/Broker/Specified Person/Employee:

Code: Contact Details: License No. & Validity Details:

Customer Relationship No. (For Bancassurance Channel) PAN No.

IMPORTANT GUIDELINES: 1) IN UNIT-LINKED INSURANCE POLICIES (ULIPs), THE INVESTMENT RISK IN INVESTMENT PORTFOLIO IS BORNE BY THE POLICYHOLDER. 2)
Insurance is a contract of utmost good faith between the Insurer and the Insured. The Proposer and the Life to be Assured are required to disclose all facts in response to the
questions in this application form. 3) Any cancellation/alteration is to be signed by Proposer/Life to be assured as applicable. 4) KYC documents will be required for all the parties to the
contract.

I. GENERIC DETAILS

Is this policy self-proposed? Yes. If No, please answer the following details Type of Proposer: Individual Life

Relation with Life Assured: Self Type of Proposal:

II. ELECTRONIC INSURANCE ACCOUNT (eIA) DETAILS OF THE PROPOSER/POLICYOWNER

If you have an e-Insurance Account (eIA) Number, please provide:

I would like to receive my Insurance Policy and all the information related to the proposed Insurance Policy through Tata AIA Life Insurance Company Ltd. In Electronic format
(Physical copy would be sent even if proposer opts for electronic format; however, in case proposer has e-Insurance Account, only electronic copy of the Insurance Policy will be
provided)
I would like to receive my Insurance Policy and all the information related to the proposed Insurance Policy through Insurance Repository in the Electronic Format as and when
applicable. Please select the name of the Insurance Repository.
NSDL

III. PRODUCT DETAILS

Premium ( )
Return
Unit Sum Premium (Inclusive of Premium
Policy of
Base Plan/ Rider (Benefit Option) Name Linked Life Insured Name Assured Paying applicable Paying
Term(Years) Premium
(Yes/No) ( ) Term(Years) taxes, cesses Mode
option
& levies )

TATA AIA Life Insurance Maha Raksha Supreme No Mr. shabbir shaik 10000000 28 28 13452 Annual NA

Tata AIA Life Insurance Non Linked

No Mr. shabbir shaik 100000 28 28 104 Annual No
Comprehensive Health Rider (HospiCare Benefit)

Tata AIA Life Insurance Non Linked

Comprehensive Protection Rider (Accidental Total No Mr. shabbir shaik 1000000 28 28 319 Annual No
and Permanent Disability Benefit)

Life Insured Details Benefit Payout Option Details

Rider (Benefit Option) Name Benefit Payout Option
Lumpsum Income Income Income
Name DOB Gender
( ) p.a ( ) Duration(Years) Frequency

Tata AIA Life Insurance Non Linked

Comprehensive Health Rider Mr. shabbir shaik 15/01/1989 M Lumpsum 100000 NA NA NA
(HospiCare Benefit)

Tata AIA Life Insurance Non Linked

Comprehensive Protection Rider Combination of
Mr. shabbir shaik 15/01/1989 M 1000000 Nil NA NA
(Accidental Total and Permanent Lumpsum & Income
Disability Benefit)

Kindly DATE BACK my Application to 1. Allowed only as per product specifications 2. Allowed within the same financial year 3. In case of juvenile (less than 1 year) back date is not
allowed. 4. Date Back of policy is allowed only up to the official launch date of the product.
FUND SELECTION DETAILS (To be filled for Unit Linked Products) a. Kindly mention the names of the fund chosen b. Incase you opt for a specific Portfolio Strategy (as available
with individual products), kindly mention the Fund Names or other details as applicable c. Kindly fill in whole numbers in percentage only. Decimals and Fractions not allowed.

Portfolio Strategy
Name of Fund % Allocation
Funds for the chosen Portfolio Strategy (If Applicable )
OR
Debt oriented fund Equity oriented fund

Other Details(if applicable)

IV. PROPOSER / POLICYHOLDER DETAILS (Please fill in details of Life Assured if same as Proposer)

1. Title Mr.

2. Name shabbir shaik

3. Father's Name / Spouse Name Shaik Basheer

4. Mother's Name Shaik Bipasha

C262656195 Page 63 of 100

5. Maiden Name(For female lives only)

6. Gender/Date of Birth Male 15-01-1989

7. Which is your Dominant Hand? (Question to be answered only if ADDL

Rider is selected )

8. Marital Status Married

Resident Indian (Nationality) INDIA

Country of Residence : INDIA
9. Nationality (If other than resident Indian, Passport as an age proof is mandatory)
(If country of residence or nationality outside India then FATCA/ CRS-Self Certification Form to be
mandatorily completed)

Residence for Tax purposes in Jurisdiction(s) outside India No (If Yes then FATCA/ CRS-Self Certification Form to be mandatorily completed)

10. Highest Educational Qualification Graduate

3-5-100/A/2, KOTHAGUDEM BAZAR Near Eswar talkies

11. Current Residence Address Landmark: Suryapet City: NALGONDA

State: TELANGANA Country: INDIA Pin code: 508213

3-5-100/A/2, KOTHAGUDEM BAZAR Near Eswar talkies

12. Permanent Address Landmark: Suryapet City: NALGONDA

State: TELANGANA Country: INDIA Pin code: 508213

13. Address for Communication Current

Residence No: Mobile No: 9985002781

14. Telephone and Email Details
E-mail: shabbir2shaik@gmail.com

15. Occupation Class Salaried

a. Name of Organisation /School / College WIPRO LIMITED

b. Organisation Type Public Limited

c. Industry Information Technology

d. Nature of Work Software Professional

e. Annual Income ( ) 500000

16. Income Proof Salary Slip of Last three months

17. Identity Proof (In case of Passport & Driving License please mention expiry Aadhar card, UID Expiry Date :
date) XXXXXXXX2588

18. Address Proof (Utility bills should not be older than 2 months) Aadhar card, UID

COTPS7177F (kindly attach copy of Pan card)

19. Permanent Account Number ( PAN ) :
Yes I do not have PAN (kindly attach copy of Form 60 duly signed)

20. CKYC No. (If available)

21. Source of Funds

22. Are you a Politically Exposed Person? No. (Definition of PEP: "PEP are individuals who are or have been entrusted with prominent public functions, domestically/in an international organisation /in a foreign
country. This would include individuals who have or have had positions of Heads of State or of government, senior politicians, senior government, judicial or military officials, senior executives of state owned corporations,
important political party officials". "Close relations of PEP: Family members are individuals who are related to a PEP either directly (consanguinity) or through marriage or similar (civil) forms of partnership. Close
associates are individuals closely connected to a PEP, either socially or professionally")

V. LIFE ASSURED DETAILS (Please fill in this section only if Life Assured is different from Proposer)

1. Title

2. Name

3. Maiden Name(For female lives only)

4. Gender/Date of Birth

5. Which is your Dominant Hand? (Question to be answered only if ADDL

Rider is selected )

6. Marital Status

(Nationality)
7. Nationality (If other than resident Indian, Passport as an age proof is mandatory)
Country of Residence

C262656195 Page 64 of 100

8. Highest Educational Qualification

9. Occupation Class

10. Name of Organisation/ School/College

11. Organisation Type

12. Industry

13. Nature of Work

14. Annual Income ( )

15. Income Proof

16. Identity Proof (In case of Passport & Driving License please mention expiry Expiry Date :
date) Others :

17. Address Proof (Utility bills should not be older than 2 months)

(kindly attach copy of Pan card)

18. Permanent Account Number (PAN):
Yes I do not have PAN (kindly attach copy of Form 60 duly signed)

19. Are you a Politically Exposed Person? (Definition of PEP: PEP are individuals who are or have been entrusted with prominent public functions, domestically/in an international organisation /in a foreign country.
This would include individuals who have or have had positions of Heads of State or of government, senior politicians, senior government, judicial or military officials, senior executives of state owned corporations,
important political party officials. Close relations of PEP: Family members are individuals who are related to a PEP either directly (consanguinity) or through marriage or similar (civil) forms of partnership. Close associates
are individuals closely connected to a PEP, either socially or professionally)

VI. HEALTH & LIFESTYLE DETAILS OF THE LIFE ASSURED

1. Nature of Age proof (Non-standard age proof submission will attract extra premium)
PAN Card

2. a) Height (cms or ft) b) Weight ( kg or lbs). 163 cms 60 kgs

PART A: LIFESTYLE DETAILS

1. Are you employed in the Armed Forces, Paramilitary, Police Forces, Fire Brigade or any other similar occupation? No

2. Is your occupation/your hobbies associated with any specific accident/health hazard or are dangerous in any way (e.g. working with dangerous or corrosive chemicals,
explosives, radiation, working underwater/underground or at height, working in mines, non-commercial flying activities, diving, mountaineering, any form of motorbike/car racing No
etc.)?

3. Do you intend to live or travel outside India for more than 30 days for reason other than family vacation in next 6 months? No

4. Have you ever been charge sheeted or convicted of any criminal proceedings or have any criminal case or charge pending against you in any court of law in India or abroad? If
Yes, please provide complete details. No

5. Do you consume or have consumed any of the following? Please tick all relevant options and provide details No

Substance Yes/ Consumed Quantity/ Per Day for Tobacco & Per week for Alcohol No. of If stopped consumption, mention month and year in which
Consumed No As and Narcotics Years last consumed

Tobacco No

Alcohol No

Any Narcotics No

PART B: HEALTH & PERSONAL DETAILS

1. Has any of your insurance application or reinstatement application on life, accident, medical or health, critical illness, or disability ever been declined, postponed or accepted at
No
extra premium or modified terms?

2. Did you have any loss or Gain of weight of 10 kgs or more in the last six months? No

3. Do you have any physical deformity / handicap or congenital defect / abnormality? No

4. Have you ever been advised to and / or have undergone any tests, investigations or surgery or had signs or symptoms of any condition, aliment or injury and / or were advised
No
treatment for or have been hospitalized for check-up or treatment other than minor flu, cold or influenza?

5. Have you ever been diagnosed with or investigated for any of the following: No

a. Cardio: High or Low Blood Pressure / Raised Cholesterol / Chest Pain / Palpitation / Rheumatic Fever / Heart Murmur / Shortness of Breath / Heart Attack / Stroke / Any
No
other heart condition

b. Hormonal: High Blood Sugar/ Diabetes / Thyroid or endocrine disorder / Sugar in Urine / Any other hormonal disorder No

c. Respiratory: Asthma / Tuberculosis / chronic cough, chronic bronchitis, emphysema, pneumonia / Any other respiratory disorder No

d. Blood/Cellular: Cancer / Tumor or malignant growth / Leukemia / Anemia / Enlarged lymph nodes/ Any blood disorder No

e. Digestive/Regulatory: Recurrent indigestion / Gastritis / Stomach or Duodenal Ulcer / Hernia / Jaundice / Disorders of the liver / Cirrhosis and Gastrointestinal System/ Any
No
other disease

C262656195 Page 65 of 100

 f. Mental/Psychiatric / Neurological ailment: Symptoms or ailment relating to Brain Depression / Anxiety / Brain Disorder or disease / Mental / Psychiatric / Transient
No
ischemic attack /Parkinson's disease / Multiple Sclerosis / Nervous disorder / Paralysis or Paraplegia / Epilepsy / Any other mental or psychiatric ailment

g. Neural/Skeletal/Muscular: Musculoskeletal disorders such as Arthritis / Recurrent Back Pain / muscular dystrophies/ musculoskeletal deformities/ Slipped disc or any other
disorder of Spine, Joints, Limbs or Leprosy; / Disorders of Eye, Ear, Nose,Throat including defective sight / Disorder of speech or hearing and discharge from ears / Any other No
disorder

h. Infectious/Contagious: Were you or your spouse ever tested for Hepatitis B or C, HIV /AIDS or any other Sexually Transmitted Disease / Any other disorder No

i. Genitourinary: Hydrocele / fistula / piles / symptoms or ailment relating to Kidney / Kidney Stones/ Prostate, Urinary System or Reproductive System / Any other disorder No

6. Have you had/ are having any other illness or impairment not mentioned above? No

7. Are you presently in good health? Yes

8. Has any of your family member (Parents and Siblings) ever been diagnosed with diabetes, Hypertension, Kidney Failure, Cancer, Heart Attack or any Hereditary Disorder
No
before the age of 60?

9. Have you ever been advised to undergo any surgery or treatment or laboratory investigations (stress ECG, echocardiogram, angiography, MRI/CT scan etc.) by any doctor or
No
specialist?

10. Have you been off work due to illness for a continuous period of 7 days and above during the last 5 years? No

11. Female Life Questionnaire

a. Are you now Pregnant? If Yes, kindly state expected delivery date

b. Have you undergone any gynecological investigations for illness, internal checkups, breast checks such as mammogram or biopsy?

c. Have you ever consulted a doctor because of an irregularity at the breast, vagina, uterus, ovary, fallopian tubes, menstruation, complications during pregnancy or child
delivery or a sexually transmitted disease?

d. Have you suffered from any other disorder of the breast or reproductive organs, abnormal smear test(s) and irregular menses?

12. If answer to any of the question above is yes, kindly give full details noting the question number (attach relevant copies)
Question No.: Details:

13. Family Details (Mandatory if the life to insured is Juvenile/Student/Housewife)

Family Details Name Gender (M / F) Date of Birth Occupation Annual Income ( ) Insurance Details (Existing /Applied for)

Father/Husband

First Child / Sibling

Second Child / Sibling

14. Family Details to be filled for Life Assured only Father Mother Brother Sister Spouse

a. If Alive, Health Status

b. If Deceased, Cause of Death

c. Age at Death/Current Age

VII. EXISTING INSURANCE DETAILS

Do you currently hold or have applied for Life Insurance/Pension/Health (Cancer/Cardiac/Critical Illness)/Personal Accident Policies? Y / N If Yes, kindly provide details as
below:

Life Assured Proposer (If Life Assured is Juvenile/Student/Housewife)

Co
Type of Insurance (Life/ Health (Cancer/Cardiac/Critical Basic Sum Type of Insurance (Life/ Health (Cancer/Cardiac/Critical Company Basic Sum
mpany
Illness)/ Unit Linked /Pension/Personal Accident) Assured ( ) Illness)/ Unit Linked /Pension/Personal Accident) Name Assured ( )
Name

VIII. NOMINEE DETAILS (Required only if Proposer & Life Assured are the same)

Base Plan / Rider (Benefit Option) Date of Gender (Male /Female Percentage ( % ) (Do not enter % in decimals & total %
Name Relationship
Name Birth /Transgender) should be equal to 100)

TATA AIA Life Insurance Maha Shaik Asma

07-01-1993 Female Spouse 34
Raksha Supreme Begam

shaik Athufa
23-02-2017 Female Daughter 33
Shireen

shaik sariya 27-08-2019 Female Daughter 33

IX. APPOINTEE DETAILS (Required only if Nominee is less than 18 years of age)

Name Date of Birth Gender (Male /Female /Transgender) Relationship

Shaik Asma Begam 07-01-1993 Female Mother

C262656195 Page 66 of 100

X. PAYMENT DETAILS

Premium Payment Method: Payment via Link

Name of Credit Card/Debit Card Holder: Credit Card/Debit Card Number
Cheque/DD No. Issuing Bank Branch Amount Date: DD/MM/YYYY
Premium# 11758 + Taxes, cesses & levies 2116 = Total Payment 13874 for months initial deposit (To be filled for monthly mode only)
On the first policy/modal anniversary I would like to change the premium payment mode to , subject to policy contract provisions. For Annual/Monthly mode issued policies mode
change shall be accepted only on completion of first policy anniversary. # Premium is exclusive of applicable taxes, cesses & levies. All Premiums are subject to applicable taxes,
cesses & levies which will entirely be borne by the Policyholder and will always be paid by the Policyholder along with the payment of Premium. If any imposition (tax or otherwise) is
levied by any statutory or administrative body under the Policy, Tata AIA Life Insurance Company Limited reserves the right to claim the same from the Policyholder. Alternatively, Tata
AIA Life Insurance Company Limited has the right to deduct the amount from the benefits payable by Us under the Policy. Cheque/DD should be drawn in favor of Tata AIA Life
Insurance Company Ltd. (Proposal No). Do not issue blank cheque.
Renewal Payment Mode: NA

XI. Mandatory Bank Account Details:

Please provide below bank details. Bank details provided should be in the name of Proposer. All policy payouts will be made to the below mentioned bank account through electronic
transfer (NEFT). Payout would be in accordance and subject to terms and conditions of the policy.

Name of Account Holder Bank Account No. Bank Name and Branch Account Type IFSC Code

shabbir shaik 34930080362 STATE BANK OF INDIA sbin Saving SBIN0017569

Note: 1. Please provide a cancelled copy of your personalized cheque. If personalized cancelled cheque is not available, attach bank statement showing account holder name, address
and account number. 2. In case of Non-Credit to the given bank account with/without assigning any reason thereof or if the transaction is delayed or not effected at all for any reason of
incomplete information, Tata AIA Life Insurance Co Ltd will not be responsible. 3. Further, the Company reserves the right to use any alternative payout option inspite of opting for
Direct Credit option. 4. If Account type is NRE/NRO then FATCA/CRS-Self Certification Form to be mandatorily completed.

XII. DECLARATION & CONSENT

I hereby declare, on my behalf and on behalf of all persons proposed to be insured, that the above statements, answers and/or particulars given by me are true and complete in all
respects to the best of my knowledge and that I am authorised to propose on behalf of these other persons (applicable where the proposer and life insured are different).
I understand that the information provided by me will form the basis of the insurance policy, is subject to the Board approved underwriting policy of the insurer and that the policy will
come into force only after full payment of the premium chargeable.
I further declare that I will notify in writing any change occurring in the occupation or general health of the life to be insured/proposer after the proposal has been submitted but
before communication of the risk acceptance by the company.
I declare that I consent to the company seeking medical information from any doctor or hospital who/which at any time has attended on the person to be insured/ proposer or from
any past or present employer concerning anything which affects the physical or mental health of the person to be insured/ proposer and seeking information from any insurer to
whom an application for insurance on the person to be insured /proposer has been made for the purpose of underwriting the proposal and/or claim settlement.
I authorize the company to share information pertaining to my proposal including the medical records of the insured/proposer (if any) for the sole purpose of underwriting the
proposal and/or claims settlement and with any Governmental and/or Regulatory authority.
I confirm that I have understood the contents of this Proposal Form and I am submitting this Proposal Form with all the details which are true and correct. I have not withheld any
material information or suppressed any fact which are essential for issuance of the policy. I also hereby authorize the Company to ascertain all the details from any third parties, as
may be required for assessing the risk.
I agree to undergo all medical tests as determined by the Company for obtaining the policy and I further understand that the Company reserves the right to issue the policy if all the
required criteria are met and in case of any fraud or misstatement being established, the insurer shall take action in accordance with Section 45 of the Insurance Act, 1938 as
amended time to time. I understand that the contract will be governed by the provisions of the Insurance Act, 1938 as amended time to time, the IRDA Act, 1999 and the
Regulations framed there under and that the contract will not commence until the Company's written acceptance of this Proposal Form is received. In case of the life to be insured
being a minor, I further declare and affirm that this proposal of insurance is for the benefit of the life to be insured.
Anti-Money Laundering Declaration: I hereby confirm that all premiums will be paid from bonafide sources and no premiums will be paid out of proceeds of crime related to any of
the offence listed in Prevention of Money Laundering Act, 2002. The Company has the right to peruse my financial profile and also agree that the Company has right to cancel the
insurance contract in case I have been found guilty of any of the provisions of any law, directly or indirectly, having relation to the laws governing prevention of money laundering in
the country, by any competent court of law.
I/We understand that in accordance with the IRDAI (Protection of Policyholders Interests) Regulations, 2017, the insurer is permitted to share policyholder information only with the
statutory authorities. I permit/authorize the Company to collect, store, communicate and process information relating to the Policy/Account and all transactions therein, by the
Company and any of its affiliates or service providers wherever situated including sharing, transfer and disclosure between them or with any entity or entities for the purpose of
underwriting, policyholder servicing and claims; and to the authorities in and/or outside India for compliance with any law or regulation whether domestic or foreign.

Date:
26-05-2021
Place:
Signature/Thumb Signature/Thumb impression of Life Assured OTP 6561 has been used to authenticate your proposal form no. C262656195
Impression of Proposer and its benefit illustration no. 6068625417618 as well as suitability analysis

I hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief and I undertake to inform you of any changes therein, immediately in
case any of the above information is found to be false or untrue or misleading or misstated, before issuance of the proposal. I, the undersigned confirm that I have verified photocopies
of the proofs submitted along with this proposal form against the originals and certify the same to be true copy.
I declare and confirm that I have carried out necessary suitability analysis while advising this product to the proposer and that the product is suitable to the proposer.

Signature of Agent/ Specified Person/ Broker/ Employee

ACKNOWLEDGEMENT
Tear away portion (To be handed over to the customer)
Proposal Number: ___________________
Dear Customer
We acknowledge receipt of your Cash/Cheque/DD for Rs.______________ by number ______________ dated ___ /___ /___ drawn on _______________ toward's Initial Deposit. We
request you to kindly verify the details filled in the proposal form before signing the same. Please do insist on Official Receipt issued by Tata AIA Life from your advisor within 2 working
days from submission of this proposal form. In case you do not hear from us or do not receive your policy within 15 days from the date of submission of your proposal, please visit us at
www.tataaia.com or call our helpline number 1860 266 9966 (local charges apply) or email us at customercare@tataaia.com
This is only acknowledgement slip and not the premium receipt.

Agent code Agent name Signature of Agent Date of Acknowledgement

C262656195 Page 67 of 100

 IN CASE ANSWERS TO THE QUESTIONS ARE FILLED IN BY A PERSON OTHER THAN THE PROPOSER OR WHERE THE ANSWERS/SIGNATURE OF THE PROPOSER
ARE IN VERNACULAR.
Note: The below must be witnessed by someone other than advisor/employee of the company.
Declaration by Agent/Intermediary of Tata AIA Life Insurance Company Limited
I, _______________________________________ (name) have explained the contents of this proposal to the _________________________________________ (Proposer) in
____________________ (language) and ensured that the contents have been fully understood by him/her. I have accurately recorded the Proposer responses to the information
sought in the proposal form and I have read out the responses to the Proposer and he/she has confirmed that they are correct.

Date: 26-05-2021
Place:

(Signature of the person making the declaration)

Address of the person making the declaration:

Declaration by Proposer/ Life Assured:

I have understood the contents of this proposal explained to me in ______________ language and confirm that the responses provided by me are correct.

Date: 26-05-2021 Date: 26-05-2021

Place: Place:
Signature/Thumb Impression of Proposer Signature/Thumb impression of the Life Assured

(Prohibition of Rebates) Section 41 - of the Insurance Act, 1938 as amended from time to time: 1. No person shall allow or offer to allow, either directly or indirectly, as an
inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the
commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebate as may
be allowed in accordance with the published prospectuses or tables of the insurer. 2. Any person making default in complying with the provisions of this section shall be liable for a
penalty which may extend to ten lakh rupees."
SECTION 45 OF THE INSURANCE ACT, 1938 STATES: No policy of life insurance shall be called in question on any ground whatsoever after the expiry of three years from the date of
policy, i.e. from the date of issuance of the policy or the date of commencement of risk or the date of revival of the policy or the date of the rider to the policy, whichever is later. A policy
of life insurance may be called in question at any time within three years from the date of issuance of the policy or the date of commencement of risk or the date of revival of the policy or
the date of the rider to the policy, whichever is later, on the ground of fraud: Provided that the insurer shall have to communicate in writing to the insured or the legal representatives or
nominees or assignees of the insured the grounds and materials on which such decision is based. Nothing in this section shall prevent the insurer from calling for proof of age at any time
if he is entitled to do so, and no policy shall be deemed to be called in question merely because the terms of the policy adjusted on subsequent proof that the age of the life insured was
incorrectly stated in the proposal. For further details, please refer to the Insurance Act, as amended from time to time.
Disclaimers: IN CASE OF A ULIP POLICY, THE INVESTMENT RISK IN INVESTMENT PORTFOLIO IS BORNE BY THE POLICYHOLDER. Tata AIA Life Insurance Company Limited
is only the name of the Company and any contract bearing the prefix "Tata AIA Life" is only the name of the contract and does not in any way indicate the quality of the contracts, its
future prospects or returns. Premium paid in ULIP is subject to investment risks associated with capital markets & the NAV of the units may go up or down based on the performance of
the funds and factors influencing capital markets and the insured is responsible for his decision. Past performance is not indicative of future results. For more details on risk factors, terms
and conditions please read sales brochure carefully before concluding a sale.

L&C/Advt/2021/Jan/0064/CAF/V1

1. Please carry valid Identity card to the medical examination center wherever applicable. 2. For cash payment, please visit our nearest Tata AIA Life branch. Please do not handover
cash to Agent. If handed over to the agent, the company will not be liable for any loss. 3. In case there is any change in the particulars given above including Life Assured/Proposer's
health and/or medical and/or financial and/or occupational status and/or being charged with and/or arrested for any criminal offence after the date of proposal but before risk
acceptance by the company; please inform the company. 4. Acceptance of premium does not constitute risk commencement. 5. Risk commencement starts after the acceptance of risk
by the company. 6. Freelook Period: If you are not satisfied with the terms & conditions/features of the policy, you have the right to cancel the Policy by providing written notice to the
Company and receive the premiums after deducting a) Proportionate risk premium for theperiod on cover & b) Stamp duty and medical examination costs including applicable taxes,
cesses & levies, which have been incurred for issuing the Policy. Such notice must be signed by you and received directly by the Company within 15 days from the date of receipt of
the policy document by you or person authorized by you. The said period of 15 days shall stand extended to 30 days, if the policy sourced through distance marketing mode which
includes solicitation through any means of communication other than in person. For Unit Linked Life Insurance products, you would receive the non allocated premiums plus charges
levied by cancellation of units plus fund value at the date of cancellation and after deducting the charges as mentioned in (a) & (b) above.

Tata AIA Life Insurance Company Limited (IRDAI Regn. No.110 CIN: U66010MH2000PLC128403). Registered & Corporate Office: 14th Floor, Tower A, Peninsula Business Park,
Senapati Bapat Marg, Lower Parel, Mumbai - 400013. Trade logo displayed above belongs to Tata Sons Ltd and AIA Group Ltd. and is used by Tata AIA Life Insurance Company Ltd
under a license. For any information including cancellation, claims and complaints, please contact our Insurance Advisor/ Intermediary or visit Tata AIA Life's nearest branch office or
call 1- 860-266-9966 (local charges apply) or write to us at customercare@tataaia.com. Visit us at: www.tataaia.com.

C262656195 Page 68 of 100

 Name of the Prospect/Policyholder: shabbir shaik Proposal No: 6068625417618

Age (years) : 32 Gender: Male Name of the Product: Tata AIA Life Insurance Maha Raksha
Supreme
Name of the Life Assured : shabbir shaik
Tag Line : Non-Linked, Non-Participating, Individual
Age (years) : 32 Gender: Male Smoker: No Life Insurance Pure Risk Premium Product
i
am
Policy Term (years) : 28 Unique Identification No.: 110N102V03
red
Premium Payment Term (years) : 28 GST Rate: 18.0%

Amount of Instalment 13874

Premium(Rs.):
i am red
Mode of Payment of Premium : Annual

This benefit illustration is intended to show year-wise premiums payable and benefits under the policy.

Policy Details
Policy Option Pure Protection Cover Sum Assured (Rs.) 10000000
Sum Assured on Death (at inception of the policy) Rs. 10000000

Rider Details

Details of Life
Insured/Partner under the Benefit Payout
Rider Name/UIN^ Benefit Option Return of Benefit Premium Sum Premium
(Benefit Option/Benefit Payout premium Option Payment Assured without
Option) Income option Term Term (Rs.) GST (Rs.)
Lumpsum Income
Name Age(yrs) Gender Duration
(Rs.) p.a.(Rs.)
(yrs)

CHR - HospiCare Benefit (Lumpsum shabbir

32 M 100000 0 0 No 28 28 100000 88
Benefit) shaik

CPR - Accidental Total and Permanent shabbir

Disability Benefit (Lump Sum & Fixed 32 M 1000000 0 0 No 28 28 1000000 270
shaik
income)

^CPR: Tata AIA Life Insurance Non-Linked Comprehensive Protection Rider, UIN:110B033V02
^CHR: Tata AIA Life Insurance Non-Linked Comprehensive Health Rider, UIN:110B031V02

Premium Summary
Base Plan Riders Total Instalment Premium

Instalment Premium without GST (Rs.) 11400 358 11758

Instalment Premium with First year GST (Rs.) 13452 422 13874
Instalment Premium with GST 2nd year onwards (Rs.) 13452 422 13874

C262656195 Page 69 of 100

 (Amount in Rupees)
Guaranteed Non - Guaranteed

Policy Single/ Annualised Survival

Year Premium Benefit / Other Benefits, if Maturity Death Min Guaranteed Surrender Special Surrender
Loyalty any Benefit Benefit Value Value
Additions
1 11400 NA NA NA 10000000 0 NA

2 11400 NA NA NA 10000000 0 NA
3 11400 NA NA NA 10000000 0 NA
4 11400 NA NA NA 10000000 0 NA

5 11400 NA NA NA 10000000 0 NA
6 11400 NA NA NA 10000000 0 NA
7 11400 NA NA NA 10000000 0 NA

8 11400 NA NA NA 10000000 0 NA
9 11400 NA NA NA 10000000 0 NA
10 11400 NA NA NA 10000000 0 NA

11 11400 NA NA NA 10000000 0 NA
12 11400 NA NA NA 10000000 0 NA
13 11400 NA NA NA 10000000 0 NA

14 11400 NA NA NA 10000000 0 NA

15 11400 NA NA NA 10000000 0 NA

16 11400 NA NA NA 10000000 0 NA
17 11400 NA NA NA 10000000 0 NA

18 11400 NA NA NA 10000000 0 NA

19 11400 NA NA NA 10000000 0 NA
20 11400 NA NA NA 10000000 0 NA

21 11400 NA NA NA 10000000 0 NA

22 11400 NA NA NA 10000000 0 NA
23 11400 NA NA NA 10000000 0 NA

24 11400 NA NA NA 10000000 0 NA
25 11400 NA NA NA 10000000 0 NA

26 11400 NA NA NA 10000000 0 NA

27 11400 NA NA NA 10000000 0 NA
28 11400 NA NA NA 10000000 0 NA

Note: Annualised premium excludes underwriting extra premium, frequency loadings on premiums, the premium paid towards the riders, if any, and Goods
and Services Tax.

I _____________________________________ (name), have explained I _____________________________________ (name), having

the premiums and benefits under the product fully to the prospect / received the information with respect to the above, have understood the
policyholder. above statement before entering into the contract.

Place: i am red
Date: Signature of Agent/ Intermediary/ Official Date: Signature of Prospect/ Policyholder

Unique Reference Number - L&C/Advt/2020/Feb/331 (Rider- L&C/Advt/2020/Dec/1539)

Tata AIA Life Insurance Company Ltd. (IRDA of India Regn No. 110) (CIN: U66010MH2000PLC009086)
Registered and Corporate Office: 14th Floor, Tower A, Peninsula Business Park, Senapati Bapat Marg, Lower Parel, Mumbai- 400013
Trade logo displayed above belongs to Tata Sons Ltd and AIA Group Ltd. and is used by Tata AIA Life Insurance Company Ltd under a license.
For more information, Call the Tata AIA Life Insurance Company Ltd Helpline number1860-266-9966 (local charges apply) or Visit us at: www.tataaia.com

25-05-2021,09:15
(I)V.94.00/FY2021-2022_Q1/RELEASE 01-04-21/EXPIRY 30-06-2021 WS
AM

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 03/06/2021

C262656195 Tata AIA Life Insurance Maha Raksha Supreme (110N102V03)

SHABBIR SHAIK SHABBIR SHAIK
SHABBIR2SHAIK@GMAIL.COM Tata AIA Life Insurance Company Ltd
9985002781 18602669966

11779.00 Annual
2,120.00 CASH/CHEQUE
13899.00 03/06/2022
13,900.00 1.00

13520.00 .00 379.00

TB1267751 26/05/2021 13,874.00

TB1268646 28/05/2021 1.00
TB1273133 03/06/2021 25.00

Base Premium Taxable Value CGST .00% SGST/UTGST .00% IGST 18.00% Reverse Charge
` 11779.00 ` 11779.00 ` .00 ` .00 ` 2120.00 N
Tata AIA Life Insurance State MAHARASHTRA Tata AIA Life Insurance GST IN 27AABCT3784C1ZD SAC Description Life Insurance
Policy Owner's GST State TELANGANA Policy Owner's GSTIN NOT REGISTERED SAC Code 997132

C262656195 Page 99 of 100

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