Duplicate

PART A
Welcome to Max Life Insurance
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Date 07-Dec-2017
To MS. AMITA FRANCIS
7A/401 TOP FLOOR GAUTAM NAGAR
NEW DELHI 110049 IMPORTANT
DELHI Premium Payment Term (in years) 6
Total Premium Payable (Inclusive of GST 92,025.02
and Rider premium) Annual
Branch: X3108
Policy Maturity Date 05-Dec-2033
Policy no.: 310978457
Telephone: 9868737860 Guaranteed Maturity Sum Assured 5,63,698.00

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Welcome Dear MS. AMITA FRANCIS,
Thank you for opting for Max Life Guaranteed Income Plan.
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What to do in On examination of the policy (enclosed herewith), if you notice any mistake or error, proceed as follows:
case of errors 1. Contact our customer helpdesk or your agent immediately at the details mentioned below.
2. Return the policy to us for rectifying the same.
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Cancelling the In case you are not satisfied with the policy, you have the option to cancel it by returning the original copy with a written request,
Policy stating the objections/reasons for such disagreement, to us within the free look period of fifteen (15) days, or thirty (30) days (for
policies sourced through distance marketing modes) of receiving the document.
Result: Upon return, the policy will terminate forthwith and all rights, benefits and interests under the policy will cease immediately.
We will refund only the premiums received by us after deducting the proportionate risk premium for the period of cover, charges
of stamp duty paid and the expenses incurred on medical examination of the Life Insured, if any.
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Long term We are committed to giving you honest advice and offering you long-term savings, protection and retirement solutions backed by
protection the highest standards of customer service. We will be delighted to offer you any assistance or clarification you may require about
your policy or claim-related services at the address mentioned below. We look forward to being your partner for life.
Yours Sincerely,
Max Life Insurance Co. Ltd.

Indeevar Krishna
Executive Vice President & Head - Operations & Customer Service
Digitally signed by DS MAX LIFE INSURANCE COMPANY LIMITED 1
Date: 2024.08.07 14:28:00 IST
Reason: Max Life Insurance
Location: 90C, Gurugram

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Agent Name: AXIS BANK LTD SOUTH EXTN (598996)
Ph. no.: 9654004152,
Address: Axis Bank Ltd., Ground Floor, Shop no. G-24, G-25, G-26, G-27,G28 Property No. D-15, South, Lower Ground Floor Shop no.
LGF-13, LGF-14, LGF-15, LGF-16,, Delhi 110049
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NB13
"Visit http://www.maxlifeinsurance.com/customer-service/download_policy_pack.aspx to download the soft copy of the policy pack"

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 Key Feature Document for Guaranteed Income Plan
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Introduction This document is the summary of important points in your policy. You must read this to understand your policy
better.
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Your policy details The table below gives an overview of the details of this policy:
Life Insured Name:(name of MS. AMITA FRANCIS Policyholder Name:(person MS. AMITA FRANCIS
the person whose life is insured) in whose name the policy is
issued)

Policy No.: (please use this for 310978457 ECS Draw Date: 08th of Dec Every Year
any communication with us)
Date of Commencement: 05-DEC-17 Premium Payment Due Date: 5th of Dec Every Year
(date when the policy starts)
Premium Payment Term: 6 Policy Term: (period of 6
(period for which premium is to coverage- in years)
be paid- in years)
Last Premium Due Date: 05-Dec-2022 Maturity Date: 05-Dec-2033
Annual Premium Amount: `90,000.02 Payout Period (in years): 10 years
(applicable taxes extra) (Starts after the end of policy
term)
Monthly Income payable `3,682.50 Monthly Income payable in `7,365.00
in the first five years of the last five years of the payout
payout period: period:
Guaranteed Death Benefit: 1147500.26 Terminal Benefit: (amount `1,12,500.02
payable at the end of payout
period)
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Policy Benefits
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If the life insured On the maturity date, if we have received all the due premiums, then we will pay as follows:
lives • a monthly income for the pay out period of next 10 years;
• during this period of 10 years, monthly income you receive in the last five years, will be double of the
monthly income you received in the first five years; and
• a terminal benefit, after the completion of the payout period.

Note: You can choose to receive a lump sum payment for the outstanding monthly income and the
terminal benefits at any time before or during the payout period.
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If the life insured During the policy term, if the life insured expires and we have received all the due premiums, the claimant
expires has an option of receive the death benefit paid out as:
• one-time payment; or
• regular monthly payout for a period of ten years.
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A. Managing Your Policy - Frequently asked questions

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What you need to do You need to

• pay premiums on time for the entire premium payment term. There are various easy and convenient
payment options for you to choose from. To know more about payment options log on to
www.maxlifeinsurance.com.
• read the details of the policy document, including the proposal form, to ensure the accuracy of
information. For any error you observe, contact us for correction.
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Continued on next page

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A. Managing Your Policy - Frequently asked questions
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How can you manage Register your policy at www.maxlifeinsurance.com to get easy access to the following self-service options:
your policy? • access policy statements, receipts and premium due information.
• update your contact details.
• pay renewal premiums online.

Note: For any support or claim-related queries, you can reach us at 1800 200 4006 or
axis.helpdesk@maxlifeinsurance.com
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What happens if you To ensure continuous life insurance cover, please pay your premium on time.
delay your premium If you are unable to pay the premium by the due date
payment?
If for any reason, you are unable to pay by the due date, you have a grace period of 30 days within which
you can pay without any late fee or interest.
Note: During the grace period, the insurance cover continues. If the life insured dies during this period,
we will pay the death benefit after deducting the unpaid premium, if any.
If you are unable to pay the premium by the end of grace period
Premium unpaid by the end of the grace period will result in the following:
If your policy has... Then your...
not acquired a surrender value policy shall lapse and no benefit will be payable.
acquired a surrender value policy will be reduced paid up mode.
Note: The insurance cover will be reduced
proportionately in the ratio of the premiums
received to the total premiums payable.
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How can you revive You may revive your policy within two years from the due date of the first unpaid premium, once you
your policy? • pay all due premiums; and
• produce evidence of insurability of the life insured.
However, if a reduced paid up policy is not revived within two years, then it will continue to be under
reduced paid up mode.
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How can you cancel If your policy does not meet with your objective, you may contact us to understand the policy benefits. If
your policy? you still feel the need to cancel your policy, you have an option to cancel it within the free look period of
fifteen days from the day you receive the policy documents.
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B. Taxes and Others - Frequently asked questions

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Tax benefits Premium under the policy are tax deductible subject to fulfilling conditions prescribed under the Section
80C/80CCC/80D of Income Tax Act 1961. The benefits you receive in the policy will be exempt, subject
to fulfilling conditions prescribed under the Section 10(10D) else it will subject to TDS as per applicable
rate. Please note that tax benefits are as per prevailing provisions of Income Tax Act 1961 at the time of
payment of premium or receipt of benefits by you. Consult your tax advisor for further details.
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Are there any All risks and benefits under this policy shall cease and no benefits will be payable under this policy, in the
exclusions under event of death of the life insured due to suicide within twelve months from the date of start of the policy
the policy? or the date of revival of your policy. In such an event:
If your policy has... Then we pay...
not acquired a surrender value total premiums received.
acquired a surrender value the higher of the surrender value or total premiums
received.
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Disclaimers • The aim of this document is to summarize the key features of your policy and does not replace the
policy in any way. In case of any discrepancy between the policy contract and this document, the terms
and conditions of the policy contract shall prevail.

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"If this Key Feature Document has been issued in any language in addition to English, the English
version shall prevail in case of any inconsistency between the two languages."

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 xkjaVh'kqnk vk; ;kstuk ds fy, çeq[k fo'ks"krk nLrkost
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çLrkouk bl nLrkost esa vkidh i‚fylh esa 'kkfey egRoiw.kZ ckrksa dk lkj fn;k x;k gSA vkidks viuh i‚fylh dks csgrj le>us ds fy,
bls vo'; i<+uk pkfg,A
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vkidh i‚fylh dk C;kSjk uhps rkfydk esa bl i‚fylh dk laf{kIr C;kSjk fn;k x;k gS%
thou chek/kkjd dk uke% ¼ml O;fä MS. AMITA FRANCIS i‚fylh /kkjd dk uke% ¼og O;fä MS. AMITA FRANCIS
dk uke ftlds thou dk chek fd;k ftlds uke ls i‚fylh tkjh dh xbZ gS½
x;k gS½
i‚fylh la[;k% ¼—i;k gekjs lkFk 310978457 bZlh,l Mªk rkjh[k% 08th of Dec Every Year
fdlh Hkh i=kpkj ds fy, bldk
bLrseky djsa½
'kq: gksus dh rkjh[k% ¼og rkjh[k tc 05-DEC-17 çhfe;e Hkqxrku ns; rkjh[k% 5th of Dec Every Year
i‚fylh dh 'kq:vkr gksrh gS½
çhfe;e Hkqxrku vof/k% ¼o"kksaZ esa vof/k 6 i‚fylh dh vof/k% ¼o"kksaZ esa chek O;kfIr 6
ftlds fy, çhfe;e dk Hkqxrku fd;k dh vof/k½
tk,xk½
vafre çhfe;e ns; rkjh[k% 05-Dec-2022 ifjiDork dh rkjh[k% 05-Dec-2033

okf"kZd çhfe;e jkf'k ¼ç;ksT; dj `90,000.02 Hkqxrku vof/k ¼o"kksaZesa½% ¼i‚fylh 10 years
vfrfjä½% vof/k dh lekfIr ds ckn 'kq: gksrh gS½

Hkqxrku vof/k ds igys ikap o"kksaZ ds `3,682.50 Hkqxrku vof/k ds vafre ikap o"kksaZ `7,365.00
nkSjku ns; ekfld vk;% ds nkSjku ns; ekfld vk;%

xkjaVh'kqnk e`R;q ykHk% 1147500.26 VfeZuy ykHk% ¼Hkqxrku vof/k dh `1,12,500.02

lekfIr ij ns; jkf'k½
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i‚fylh ykHk
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;fn chek/kkjd thfor jgrk gS ifjijDork dh rkjh[k dks ;fn geus lHkh çhfe;e çkIr fd, gSa] rks ge fuEukuqlkj Hkqxrku djsaxs%
• vxys 10 o"kksaZ ds fy, Hkqxrku vof/k ds fy, ekfld vk;(
• 10 o"kksaZ dh bl vof/k ds nkSjku] vkids }kjk vafre ikap o"kksaZ ds nkSjku çkIr ekfld vk; dks igys ikap o"kksaZ dh ekfld vk;
dh rqyuk esa nqxquk dj fn;k tk,xk( vkSj
• Hkqxrku vof/k dh lekfIr ij VfeZuy ykHkA

uksV% vki Hkqxrku vof/k ls igys ;k blds nkSjku cdk;k ekfld vk; vkSj VfeZuy ykHkksa ds fy, ,deq'r Hkqxrku çkIr djuk pqu
ldrs gSa
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;fn thou chek /kkjd dh ekSr i‚fylh vof/k ds nkSjku] ;fn thou chek /kkjd dh e`R;q gks tkrh gS] vkSj geus lHkh ns; çhfe;e çkIr fd, gSa] rks nkokdrkZ dks
gks tkrh gS vnk fd, tkus okys e`R;q ykHk dks fuEufyf[kr ds :i esa pquus dk vf/kdkj gS%
• ,d eq'r Hkqxrku] ;k
• nl o"kksaZ ds fy, fu;fer ekfld HkqxrkuA
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d½ viuh i‚fylh dk çcU/ku& vDlj iwNs tkus okys ç'u

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vkidks D;k djuk pkfg, vkidks

• iwjh çhfe;e vof/k ds fy, le; ij çhfe;e dk Hkqxrku djuk pkfg,A fofHkUu ljy vkSj lqfo/kktud Hkqxrku fodYi gSa ftuesa
ls vki viuk fodYi pqu ldrs gSaA Hkqxrku fodYiksa ds ckjs esa vf/kd tkuus ds fy, www.maxlifeinsurance.com
ij ykx v‚u djsaA
• çLrko çi= lfgr i‚fylh nLrkost dk C;kSjk i<+ ysuk pkfg, rkfd tkudkjh lVhdrk dks lqfuf'pr fd;k tk ldsA vkids
}kjk ns[kh xbZ fdlh Hkh =qfV dks lgh djokus ds fy, ge ls laidZ djsaA
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vxys ist ij tkjh

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d½ viuh i‚fylh dk çcU/ku& vDlj iwNs tkus okys ç'u
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vki viuh i‚fylh dk çcU/ku fuEufyf[kr Lo&lsok fodYiksa rd ljy ,Dlsl çkIr djus ds fy, viuh i‚fylh dk www.maxlifeinsurance.com ij
dSls dj ldrs gSa\
iathdj.k djok,aA
• i‚fylh fooj.k] çkfIr;ksa vkSj ns; çhfe;e tkudkjh dks ,Dlsl djsa
• vius laidZ C;kSjs dks viMsV djsa
• v‚uykbu uohdj.k çhfe;e dk Hkqxrku djsaA

uksV% fdlh Hkh lgk;rk ;k nkos ls lacaf/kr ç'uksa ds fy,] vki gels 1800 200 4006 ;k axis.helpdesk@maxlifeinsurance.com ij laidZ
dj ldrs gSaA
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D;k gksxk ;fn vki fujarj thou chek lqj{kk dks lqfuf'pr djus ds fy,] le; ij vius çhfe;e dk Hkqxrku djsaA
viuk çhfe;e Hkqxrku
le; ij u djsa\
;fn vki ns; frfFk rd çhfe;e dk Hkqxrku djus esa vleFkZ gSa
;fn fdlh Hkh dkj.k ls] vki ns; frfFk rd Hkqxrku djus esa vleFkZ gSa] rks vki ds ikl 30 fnu dh ,d xzsl vofèk gksrh gS ftlesa
vki fcuk fdlh nsjh 'kqYd ;k C;kt ds Hkqxrku dj ldrs gSaA

uksV% xzsl vofèk ds nkSjku] chek lqj{kk tkjh jgrh gSA ;fn chfer O;fä dh bl vofèk ds nkSjku e`R;q gks tkrh gS] rks ge vnÙk
çhfe;e] ;fn gks rks] ?kVkus ds ckn e`R;q ykHk dk Hkqxrku dj nsaxsA

;fn vki xzsl vofèk ds var rd çhfe;e dk Hkqxrku djus esa vleFkZ jgrs gSa
xzsl vofèk ds var rd çhfe;e dk Hkqxrku u djus ls fuEu gksxk
tgk¡ vkidh i‚fylh us--- rks vkidh---
ljsUMj ewY; çkIr ugha fd;k gS i‚fylh jí gks tk,xh vkSj dksbZ Hkh ykHk ns; ugha gksxkA
ljsUMj ewY; çkIr fd;k gS i‚fylh de Hkqxrku eksM esa jgsxhA
uksV% chek lqj{kk dqy ns; çhfe;e ls çkIr çhfe;e ds vuqikr
esa ?kVk fn;k tk,xkA
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vki viuh i‚fylh dks dSls vki igys vnÙk çhfe;e dh ns; frfFk ls nks o"kksZa ds Hkhrj viuh i‚fylh dks iqu: pkyw dj ldrs gSa] tc vki
iqu: pkyw dj ldrs gSa\ • lkjs ns; çhfe;e dk Hkqxrku dj nsrs gSa] vkSj
• chfer O;fä dh chek ;ksX;rk ds lcwr nsrs gSaA
ijarq] ;fn nks o"kksZa ds Hkhrj ,d de Hkqxrku okyh i‚fylh dks iqu: pkyw ugha fd;k tkrk gS] rks oks de Hkqxrku eksM esa jgsxhA
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vki viuh i‚fylh dks ;fn vkidh i‚fylh vkids mís'; dks iwjk ugha djrh] rks vki i‚fylh ykHkksa dks le>us ds fy, gels laidZ dj ldrs gSaA ;fn
jí dSls dj ldrs gSa\ fQj Hkh vki viuh i‚fylh dks jí djus dh t+:jr eglwl djrs gSa] rks vkids ikl i‚fylh nLrkost çkIr gksus ds fnu ls iaæg
fnu dh Qzh&yqd vofèk ds Hkhrj mls jí djus dk fodYi gksrk gSA
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[k½ dj vkSj vU; & vDlj iwNs tkus okys ç'u

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dj ykHk vk;dj vf/kfu;e 1961 dh /kkjk 80C/80CCC/80D ds rgr mYysf[kr 'krksaZ dks iwjk djus ds v/khu jgrs gq, i‚fylh ds rgr
çhfe;e esa ls dj dh dVkSrh dh tk,xhA /kkjk 10(10D) ds rgr mYysf[kr 'krksaZ dks iwjk djus ds v/khu jgrs gq, i‚fylh esa
vkidks çkIr gksus okys ykHk ij NwV nh tk,xh vU;Fkk ykxw nj ds vuqlkj TDS nsuk gksxkA —i;k /;ku nsa fd dj ykHk çhfe;e
ds Hkqxrku ;k vkids }kjk ykHk dh çkfIr ds le; vk;dj vf/kfu;e 1961 ds ekStwnk çko/kkuksa ds vuqlkj gksaxsA vf/kd tkudkjh
ds fy, vius dj lykgdkj ls ijke'kZ ysaA
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D;k i‚fylh ds rgr i‚fylh ds vkjaHk dh frfFk ;k i‚fylh ds iqu: pkyw gksus dh frfFk ls ckjg eghuksa ds vUnj chfer O;fä dh vkRegR;k ds dkj.k gksus
dksbZ viokn gSa\
okyh e`R; dh fLFkfr esa] bl i‚fylh ds rgr lHkh tksf[ke vkSj ykHk jí dj fn, tk,axs vkSj dksbZ Hkh ykHk ns; ugha gksaxsA ,slh fLFkfr esa%
;fn vkidh i‚fylh us--- rks ge vnk djsaxs---
ljsUMj ewY; çkIr ugha fd;k gS dqy çkIr çhfe;eA
ljsUMj ewY; çkIr dj fy;k gS ljsUMj ewY; ;k dqy çkIr çhfe;e esa ls tks Hkh vfèkd gksA
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[kaMu • bl nLrkost+ dk mís'; vkidh i‚fylh dh eq[; fo'ks"krkvksa dk lkj çnku djuk gS vkkSj ;s fdlh Hkh çdkj ls i‚fylh dk
LFkku ugha ysrkA i‚fylh vuqcaèk vkSj bl nLrkost+ ds chp fdlh Hkh varj dh fLFkfr esa] i‚fylh vuqcaèk dh fu;e vkSj 'krZsa ekuh
tk,axhA

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POLICY PREAMBLE

MAX LIFE INSURANCE COMPANY LIMITED

Regd. Office: 419, Bhai Mohan Singh Nagar, Railmajra, Tehsil Balachaur, District Nawanshahr, Punjab -144 53

Max Life Guaranteed Income Plan

A Non-Linked Non-Participating Savings Insurance Plan

UIN [104N085V02]

Max 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.

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

Max Life Insurance Company Limited

Place of Issuance : New Delhi

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 SCHEDULE

Policy - Max Life Guaranteed Income Plan Type of Policy - A Non-Linked Non-Participating Savings
Insurance Plan
UIN - 104N085V02 Office - AXIS BANK LTD South Extn
Policy No./ Proposal No.: 310978457 Client ID: 5009319825

Date of Proposal: 05-Dec-2017

Policyholder/Proposer : Age Admitted: Yes/No
MS. AMITA FRANCIS
Gender: Female
PAN: ABWPF7665B
Tel No./Mobile No.: / 9868737860
Identification Source & I.D No.:
Email: HENRYSAMEER19@GMAIL.COM
Relationship with Life Insured: Same Person

Date of Birth: 13-Mar-1965

Address:
7A/401 TOP FLOOR GAUTAM NAGAR
NEW DELHI 110049
DELHI

Life Insured: Age Admitted: Yes/No

MS. AMITA FRANCIS
Gender: Female
Identification Source & ID No.:
Appointee (if nominee is minor):
Date of Birth: 13-Mar-1965

Age: 52

Nominee(s):
MR.ANIKET CHARLES FRANCIS

Relationship of Nominee with Policyholder:

Date of Birth:
01-Feb-1991
Date of Commencement of Policy: 05-DEC-17 Premium Payment mode: Annual
Premium Payment Method: Two-stage autopay Bill Draw Date: 08TH

Bank Name:

Bank Account Number: 917010080836410

Agent's name/Broker's name: AXIS BANK LTD SOUTH EXTN Agent's code / Broker's code: 598996

Email: Broker's License No.:

CA0069
Address:
Axis Bank Ltd., Ground Floor, Shop no. G-24, G-25, G-26, G-27,G28
Property No. D-15, South, Lower Ground Floor Shop no. LGF-13, Mobile / Landline Telephone Number: 9654004152,
LGF-14, LGF-15, LGF-16,
Delhi 110049

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 List of Maturity Insured Death Guaranteed Income Income Policy Premium Annualised Extra GST** Premium Premium Due Date Date when
Coverage Date Event Benefit Sum Benefit Benefit Term Payment Premium Premium and any (INR) payable when the Last
Assured on payable payable (years) Term (INR) (INR) other taxes, on the Premium Premium
Maturity monthly monthly (years) cesses & due date is payable is payable
(INR) in the first in the last levies (INR) alongwith
5 years of 5 years of GST**
the Payout the Payout and any
Period Period other taxes,
(INR) (INR) cesses &
levies
(INR)
BASE POLICY
Max Life 05-Dec- Death of 1147500.26 5,63,698.00 3,682.50 7,365.00 6 6 90,000.02 NA 2,025.00 90,000.02 92,025.02 5th of Dec 05-Dec-
Guaranteed 2033 the Life Every Year 2022
Income Plan Insured
during
the Policy
Term/
Survival
of the Life
Insured
till the
end of the
Policy Term
**GST includes IGST, SGST, CGST, UGST (whichever is applicable) and applicable cesses

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PART B
DEFINITIONS APPLICABLE TO YOUR POLICY 24. "Premium Payment Term" means the term as specified in the Schedule,
The words and phrases listed below shall have the meanings attributed to them during which the Premiums are payable by You, which is same as the Policy
wherever they appear in this Policy, unless the context otherwise requires. Term under this Policy;
1. "Age" means the Life Insured's age on last birthday as on the Date of 25. "Proposal Form" means the form filled in and completed by You for the
Commencement/Inception of Policy or on the previous Policy Anniversary, purpose of obtaining insurance coverage under this Policy;
as the case may be; 26. "Reduced Paid Up Mode" means the Policy with reduced paid up benefits
2. "Annualised Premium" means an amount of premium payable in annual as specified under Clause 2.4 of Part C;
mode excluding Extra Premium, rider premium and applicable taxes, cesses 27. "Revival" means restoration of the Policy, which was discontinued due to
or levies, if any, specified in the Schedule, which is utilised for the purpose nonpayment of Premium, by Us with all the benefits stated in the Policy, upon
of calculating the benefits payable under the Policy; the receipt of all the due Premiums and other charges / late fee as provided
3. "Claimant" means You (in case of maturity), Nominee(s) (if valid in Clause 3 of Part D of the Policy;
nomination is effected), assignee(s) or their heirs, legal representatives or 28. "Revival Period" means a period of 2 (Two) years from the due date of the
holders of a succession certificates in case Nominee(s) or assignee(s) is/are first unpaid Premium;
not alive at the time of claim; 29. "Schedule" means the Policy schedule and any endorsements attached to and
4. "Date of Commencement/Inception of Policy" means the date as specified forming part of this Policy and if any updated Schedule is issued, then, the
in the Schedule, on which the insurance coverage under this Policy Schedule latest in time;
commences; 30. "Surrender Value" means an amount payable as per Clause 1 of Part D on
5. "Death Benefit" means amount payable to the Claimant upon the death of surrender of this Policy, which will be the higher of the Guaranteed Surrender
the Life Insured during the Policy Term; Value or the Special Surrender Value;
6. "Extra Premium" means an additional amount charged by Us, as per Our 31. "Terminal Benefit" means a one time amount payable on completion of the
board approved underwriting policy, which is determined on the basis of Payout Period. Terminal Benefit shall be equal to:
disclosures made by You in the Proposal Form or on the basis of any other a) 125% (One Hundred Twenty Five percent) of Annualised Premium,
information received by Us including through medical examinations of the where the Policy Term is 6 (Six) years; or
Life Insured in relation to this Policy and as mentioned in the Schedule;
b) 200% (Two Hundred percent) of Annualised Premium, where the
7. "Force Majeure Event" means an event by which performance of any of Policy Term is 12 (Twelve) years;
Our obligations are prevented or hindered as a consequence of any act of God,
State, strike, lock-out, legislation or restriction by any government or other 32. "We", "Us" or "Our" means Max Life Insurance Company Limited; and
authority or any circumstance beyond Our control; 33. "You", "Your", "Proposer" or "Policyholder" means the policyholder as
8. "Free Look" means a period of 15 days (30 days if the Policy is sourced named in the Schedule.
through distance marketing modes) from the date of receipt of the Policy, to PART C
review the terms and conditions of the Policy, where if You disagree to any of 1. ELIGIBILITY
those terms and conditions, You have the option to return the Policy stating
the reasons for objection. Upon return, the Policy will terminate forthwith and 1.1. This Policy has been written on a single life basis.
all rights, benefits and interests under the Policy will cease immediately. You 1.2. The minimum Age of the Life Insured on the Date of
shall be entitled to a refund of the Premium received by Us after deducting Commencement/Inception of Policy should be 25 (Twenty Five) years.
the proportionate risk premium for the period of cover, charges of stamp duty 1.3. The maximum Age of the Life Insured on the Date of
paid and the expenses incurred by Us on medical examination, if any; Commencement/Inception of Policy cannot exceed:
9. "Grace Period" means a period of 30 (Thirty) days from the due date for i. 60 (Sixty) years for the Policy where the Policy Term is of 6 (Six) years;
payment of Premium, for paying the overdue Premium to Us; and
10. "Guaranteed Sum Assured on Death" means a lump sum amount equal to ii. 55 (Fifty Five) years for the Policy where the Policy Term is of 12
12.75 times the Annualised Premium, where the Policy Term is 6 years and (Twelve) years
18.50 times the Annualised Premium, where the Policy Term is 12 years ;
1.4. The maximum Age of the Life Insured on the Maturity Date cannot exceed:
11. "Guaranteed Sum Assured on Maturity" means a guaranteed amount
specified in the Schedule and will be equal to the present value of the Survival i. 66 (Sixty Six) years for the Policy where the Policy Term is of 6 (Six)
Benefit calculated at a discounted rate of 5.3% (Five and three tenths percent) years; and
per annum; Guaranteed Sum Assured on Maturity is always higher than the ii. 67 (Sixty Seven) years for the Policy where the Policy Term is of 12
sum of the Annualised Premium payable over the Policy Term; (Twelve) years.
12. "Income Benefit" means an amount payable monthly during the Payout 2. BENEFITS
Period as specified in the Schedule;
2.1. Survival Benefit
13. "IRDAI" means the Insurance Regulatory and Development Authority of
India; 2.1.1. If the Life Insured has survived upto the Maturity Date and We
have received all the due Premiums, then, We shall pay the Survival
14. "Lapsed Policy" means a Policy which has not acquired the Surrender Value
Benefit as defined below:
and where the due Premium has not been received till the expiry of the Grace
Survival Benefit = Income Benefit + Terminal Benefit
Period;
2.1.2. Under this Policy, the Income Benefit shall become payable in the
15. "Life Insured" means the person named in the Schedule, on whose life this
manner specified in the Schedule, during the Payout Period. The
Policy is effected;
Income Benefit shall accrue on the Policy Anniversary after the end
16. "Maturity Date" means the date specified in the Schedule, on which the of the Policy Term. The Income Benefit will be payable on a payout
Policy Term expires; date, once per month, as specified by Us in writing to You.
17. "Nominee" means the person named by You and registered with Us in 2.1.3. Under this Policy, You have an option to receive the Guaranteed
accordance with Clause 7 of Part F, who is authorized to receive the Death Sum Assured on Maturity as a lump sum amount at the end of the
Benefit, on the death of the Life Insured; Policy Term, instead of receiving the Survival Benefit, by submitting
18. "Payout Period" means a period of 10 (Ten) years after the completion of a written request to Us before commencement of the Payout Period.
the Policy Term; Upon payment of the Guaranteed Sum Assured on Maturity, this
19. "Policy" means the contract of insurance entered into between You and Us Policy will terminate.
as evidenced by this document, the Proposal Form, the Schedule and any 2.2. Death Benefit
additional information/document(s) provided to Us in respect of the Proposal
2.2.1. If Life Insured dies during the Policy Term provided the Policy is in
Form along with any written instructions from You subject to Our acceptance
force and not under lapsed or Reduced Paid Up Mode, We shall pay
of the same and any endorsement issued by Us;
lump sum amount called "Death Benefit" which will be highest of
20. "Policy Anniversary" means the annual anniversary of the Date of the following:
Commencement/Inception of Policy;
a) 10 (Ten) times the Annualised Premium;
21. "Policy Term" means the term of this Policy specified in the Schedule,
during which the Policy coverage continues; b) 105% (One Hundred Five percent) of all the Premiums received
from You as on the date of death of the Life Insured;
22. "Policy Year" means a period of 12 (Twelve) months commencing from the
Date of Commencement/Inception of Policy and every Policy Anniversary c) Guaranteed Sum Assured on Maturity; or
thereafter; d) Any absolute amount assured to be paid on death. The absolute
23. "Premium" means sum of Annualised Premium and Extra Premium (an amount guaranteed to be paid on death is equal to the Guaranteed
amount specified in the Schedule), payable by You, by the due dates and in Sum Assured on Death.
the manner specified in the Schedule, to secure the benefits under this Policy, 2.2.2. The Claimant also has an option to receive the Death Benefit in
excluding applicable tax, cesses or levies, if any; monthly installments for a period of 10 (Ten) years following the

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 date of death of the Life Insured. On exercising this option, the Death PART D
Benefit will be paid as follows: POLICY SERVICING CONDITIONS
Policy Term Death Benefit 1. SURRENDER
(as % of Annualised 1.1 This Policy shall acquire a Surrender Value provided all the due Premiums
Premium, payable monthly) for the first 2 (Two) Policy Years (if the Policy Term under this Policy is 6
6 years 162% / 12 (Six) years) or for the first 3 (Three) Policy Years (if the Policy Term under
this Policy is 12 (Twelve) years) have been received and accounted by Us.
12 years 236% / 12
1.2 You may request in writing to surrender this Policy only if this Policy has
2.2.3. If the Claimant has chosen to receive the Death Benefit in monthly acquired the Surrender Value. On receipt of such request, We will terminate
installments in accordance with Clause 2.2.2 of Part C above, this Policy and the Surrender Value prevailing on the date of request for
then, such a person(s) can at a future date choose to commute the surrender of this Policy, shall become payable by Us to You.
outstanding monthly installments in accordance with Clause 2.3 of 1.3 The Surrender Value payable will be subject to the condition that there are no
Part C. statutory or other restrictions to the contrary. Upon surrender of this Policy,
2.2.4. Under this Policy no Death Benefit shall be payable if the Life no further benefits under this Policy shall become payable and this Policy will
Insured dies during the Payout Period. If the Life Insured dies during terminate.
the Payout Period, then the Claimant shall continue to receive the 1.4 The Guaranteed Surrender Value will be determined in the Policy Year in
outstanding Survival Benefit for the remaining Payout Period. If the which the surrender is effected, as a percentage of the total Annualised
Claimant is receiving the Survival Benefit in monthly installments, Premiums received by Us, in accordance with the table below ("Guaranteed
then such a person(s) can choose to commute the outstanding monthly Surrender Value"):
installments in accordance with Clause 2.3 of Part C.
2.3. Commutation Option Guaranteed Surrender Value as a percentage of total Annualised
Premium [subject to the condition that Premiums for the first 2 (Two)
2.3.1 The Claimant has an option to receive at a future date the present value Policy Years {if the Policy Term under this Policy is 6 (Six) years}
of the outstanding monthly installments of the Death Benefit or the or for the first 3 (Three) Policy Years {if the Policy Term under this
present value Survival Benefit by submitting a written request to Us. Policy is 12 (Twelve) years} have been received and accounted by Us
2.3.2 We shall derive the commuted value by using a discount rate of 5.3% in accordance with Clause 1.1 of Part D]
(Five and Three Tenths percent) per annum from the date of receipt
of the written request by Us. The discount rate can be changed by Us Policy Term
from time to time subject to receipt of the prior approval of the IRDAI 6 years 12 years
basis changing investment returns. Policy Year of surrender
2.3.3 Once the Claimant has exercised the commutation option, then, all 1 0.00% 0.00%
future Death Benefit or Survival Benefit, as the case may be, payable
under this Policy will cease and a lump sum amount shall become 2 30.00% 0.00%
payable to such person. The lump sum payment on commutation of 3 30.00% 30.00%
the Survival Benefit shall at least be equal to the Guaranteed Sum
4 50.00% 50.00%
Assured on Maturity less monthly installments already paid by Us.
In case of commutation of the Death Benefit, the lump sum payment 5 90.00% 52.00%
shall at least be equal to the Death Benefit less monthly installments 6 90.00% 54.00%
already paid by Us.
7 NA 56.00%
2.4. Reduced Paid Up Benefit
8 NA 64.50%
2.4.1 If this Policy has acquired a Surrender Value then in the event of
non-payment of due Premiums till the expiry of the Grace Period, this 9 NA 73.00%
Policy will not lapse and will continue with reduced paid up benefits. 10 NA 81.50%
A Policy under the Reduced Paid Up Mode will thereafter be free
from all liabilities of payment of the future Premiums to Us. 11 NA 90.00%
2.4.2 If this Policy is under Reduced Paid Up Mode, then, the benefits 12 NA 90.00%
payable shall be as follows:
1.5 Special Surrender Value
i. Reduced Paid Up Death Benefit
1.5.1 The Special Surrender Value will be determined by Us in the Policy
In the event of the death of the Life Insured during Policy Term, Year in which the surrender is effected, as a percentage of the total
We will pay: Annualised Premiums received by Us ("Special Surrender Value").
Reduced Paid Up Death Benefit = [Total Annualised Premiums
1.5.2 The Special Surrender Value will always be equal to or higher than
paid / Total Annualised Premiums payable] X Death Benefit
the Guaranteed Surrender Value and shall be determined by Us from
ii. Reduced Paid Up Survival Benefit time to time, as approved by the IRDAI. The Special Surrender Value
If the Life Insured has survived until the Maturity Date, then, We is not guaranteed and the same may be changed by Us provided We
shall pay: have received the prior approval of the IRDAI.
Reduced Paid Up Survival Benefit = [Total Annualised Premiums
2. LOANS
paid / Total Annualised Premiums payable] X Survival Benefit
2.1 You are not entitled to any loans under this Policy.
3. PREMIUMS
3. REVIVAL OF POLICY
3.1. You can pay the Premiums under this Policy only on an annual mode basis.
3.1 A Lapsed Policy or a Policy under Reduced Paid Up Mode can be revived as
3.2 You can pay Premium at any of Our offices or through Our website per Underwriting Policy, within the Revival Period:
www.maxlifeinsurance.com or by any other means, as informed by Us. Any
Premium paid by You will be deemed to have been received by Us only after 3.1.1 on receipt of Your written request to revive this Policy by Us;
the same has been realized and credited to Our bank account. if You produce an evidence of insurability of the Life Insured at Your
3.1.2
3.3. The Premium payment receipt will be issued in Your name, which will be own cost which is acceptable to Us; and
subject to realization of cheque or any other instrument/medium.. 3.1.3. on payment of all overdue Premiums (along with the applicable
4. GRACE PERIOD taxes, cesses or levies, if any) to Us with late fee at such a rate as
may be determined by Us from time to time. Currently the applicable
4.1 The Premium is due and payable by the due date specified in the Schedule. late fee rates are as below:
If the Premium (along with applicable taxes, cesses or levies, if any) is not
paid by the due date, You may pay the same during the Grace Period without No. of days between
any late fee. date of Revival and Late Payment Fee (in Rs.)
date of lapse of Policy
4.2 During the Grace Period, if the overdue Premium is not paid and the Life
Insured dies, then, We will pay the Death Benefit under this Policy after 0-60 Nil
deducting the due Premium (if any) till the date of death. RBI Bank Rate +
5. LAPSATION OF POLICY 61-180 1% p.a. compounded
5.1 If You discontinue the payment of Premium before paying Premiums for first annually on due Premiums
two Policy Years, the Policy will lapse on the expiry of the Grace Period and RBI Bank Rate + 3% p.a.
no benefits under the Policy will be payable >180 compounded annually
on due Premiums

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 3.2 The revival of the Lapsed Policy or a Policy under reduced paid up mode (a) that the benefits have become payable as per the terms and conditions of
shall take effect only after We have approved the same in accordance with Our this Policy; and
board approved underwriting policy and communicated to You in writing. (b) of the bonafides and credentials of the Claimant.
All original benefits such as Death Benefit and Maturity Benefit which were
originally payable will be restored on such Revival. However, no interest shall 2.4. Subject to Our sole discretion and satisfaction, in exceptional circumstances
be payable by Us on such restoration. such as on happening of a Force Majeure Event, We may decide to waive all
or any of the requirements set out in Clause 2.1 of Part F.
3.3 If a Lapsed Policy is not revived within the Revival Period, this Policy shall
terminate on the expiry of the Revival Period. 3. DECLARATION OF THE CORRECT AGE
3.1. Declaration of the correct Age and/ or gender of the Life Insured is important
3.4 If a Policy under Reduced Paid Up Mode is not Revived within the Revival for Our underwriting process and calculation of Premiums payable under
Period then, the Policy under Reduced Paid Up Mode cannot be revived and the Policy. If the Age and/or gender declared in the Proposal Form is found
will continue to be under Reduced Paid Up Mode for the remaining part of to be incorrect at any time during the Policy Term or at the time of claim,
the PolicyTerm. We may revise the Premium with interest and/or applicable benefits payable
3.5 The Policy cannot be revived beyond the Policy Term. under the Policy in accordance with the premium and benefits that would
have been payable, if the correct Age and/ or gender would have made
4. PAYMENT OF BENEFITS the Life Insured eligible to be covered under the Policy on the Date of
4.1 The benefits under this Policy will be payable only on submission of Commencement/Inception of Policy.
satisfactory proof to Us. The benefits under this Policy will be payable to the 4. FRAUD, MISREPRESENATION AND FORFEITURE
Claimant.
4.1. Fraud, misrepresentation and forfeiture would be dealt with in accordance
4.2 Once the benefits under this Policy are paid to the Claimant, the same will with provisions of Section 45 of the Insurance Act, 1938 as amended from
constitute a valid discharge of Our liability under this Policy. time to time. [A leaflet containing the simplified version of the provisions of
5. TERMINATION OF POLICY the above section is enclosed in Annexure - (1) for reference]
5.1 This Policy shall terminate upon the happening of any of the following 5. SUICIDE EXCLUSION
events: 5.1. Notwithstanding anything stated herein, if the Life Insured commits suicide,
5.1.1 on the date on which We receive Free Look cancellation request whether sane or insane, within 12 (Twelve) months from the Date of Inception
5.1.2 upon payment of the Death Benefit or the Survival Benefit or of Policy or from the date of Revival of this Policy, all risks and benefits under
Guaranteed Sum Assured on Maturity to the Claimant, or the date this Policy shall cease and We shall only pay the following to the Claimant:
of intimation of repudiation of the death benefit claim by Us in 5.1.1. higher of the Surrender Value or total Premiums received by Us, if
accordance with the provisions of this Policy; the Policy has acquired a Surrender Value; or
5.1.3 the date of death of the Life Insured; 5.1.2. total Premiums received by Us, if the Policy has not acquired a
on the expiry of the Revival Period, if the Lapsed Policy has not Surrender Value.
5.1.4
been Revived; 6. TRAVEL AND OCCUPATION
5.1.5 on the date of payment of Surrender Value;
6.1. There are no restrictions on travel or occupation under this Policy.
5.1.6 on the Maturity Date subject to payment applicable benefits; or
7. NOMINATION
5.1.7 upon payment of the benefits under the commutation option.
7.1. Nomination is allowed as per Section 39 of the Insurance Act, 1938 as
PART E amended from time to time. [A leaflet containing the simplified version of the
APPLICABLE FEES/ CHARGES UNDER THIS POLICY provisions of the above section is enclosed in Annexure - (2) for reference]
This Policy is a Non-Linked Non-Participating Savings Insurance Plan and 8. ASSIGNMENT
therefore, Part E is not applicable to this Policy.
8.1. Assignment is allowed as per Section 38 of the Insurance Act, 1938 as
PART F amended from time to time. [A leaflet containing the simplified version of the
GENERAL TERMS AND CONDITIONS provisions of the above section is enclosed in Annexure - (3) for reference]
1. TAXES 9. POLICY CURRENCY
1.1. All Premiums are subject to applicable taxes, cesses and levies, which shall 9.1. This Policy is denominated in Indian Rupees. Any benefit/claim payments
be entirely borne by You and will be paid by You along with the Premium. If under the Policy will be made in Indian Rupees by Us or in any other currency
any imposition (tax or otherwise) is levied by any statutory or administrative in accordance with the applicable guidelines issued by the Reserve Bank of
body under the Policy, We reserve the right to claim the same from You. India from time to time.
Alternatively, We have the right to deduct the amount from the benefits
10. ELECTRONIC TRANSACTIONS
payable by Us under the Policy.
1.2. Tax benefits and liabilities under the Policy are subject to prevailing tax laws. 10.1. You will comply with all the terms and conditions with respect to
Tax laws and the benefits arising thereunder are subject to change. You are all transactions effected by or through facilities for conducting remote
advised to seek an opinion of Your tax advisor in relation to the tax benefits transactions including the internet, world wide web, electronic data
and liabilities applicable to You. interchange, call centre, tele-service operations or by other means of
telecommunication established by Us or on Our behalf, for and in respect
2. CLAIM PROCEDURE of the Policy or services, which will constitute legally binding and valid
2.1. For processing a claim request under this Policy, We will require all of the transactions when executed in adherence to and in compliance with the terms
following documents: and conditions for such facilities.
(a) Claimant's statement in the prescribed form; 11. DUPLICATE POLICY
(b) original Policy document; 11.1. In case of loss of this Policy document, You may contact Our nearest
(c) a copy of police complaint/ first information report (only in the case of branch office to know the requirements for issuance of a duplicate Policy.
death by accident of the Life Insured); The duplicate Policy shall be issued without any charge.
(d) a copy of duly certified post mortem report (only in the case of death by 12. AMENDMENT
accident of the Life Insured); No amendments to the Policy will be effective, unless such amendments
(e) death certificate issued by the local/municipal authority (only in the 12.1. are expressly approved in writing by Us and/or by the IRDAI wherever
case of death of the Life Insured); applicable.
(f) identity proof of the Claimant including Nominee(s) bearing their 13. REGULATORY AND JUDICIAL INTERVENTION
photographs and signatures (only in the case of the death of the Life
13.1 If any competent regulatory body or judicial body imposes any condition
Insured); and
on the Policy for any reason, We are bound to follow the same which may
(g) any other documents or information required by Us for assessing and include suspension of all benefits and obligations under the Policy.
approving the claim request.
14. FORCE MAJEURE
2.2. A Claimant can download the claim request documents from Our website
www.maxlifeinsurance.com or can obtain the same from any of Our branches 14.1. The performance of the Policy may be wholly or partially suspended
or offices. during the continuance of such Force Majeure Event under an intimation
to or approval of the IRDAI. We will resume Our obligations under the
2.3. Subject to Section 45 of the Insurance Act, 1938 as amended from time Policy after the Force Majeure Event ceases to exist.
to time, We reserve the right to scrutinize the documents submitted by the
Claimant and/or investigate the cause of death of the Life Insured and deny the 15. COMMUNICATION AND NOTICES
claim partially or completely on the basis of Our scrutiny of the documents or 15.1. All notices meant for Us should be in writing and delivered to Our address
investigation, as the case may be. We shall pay the benefits under this Policy as mentioned in Part G or such other address as We may notify from time to
subject to Our satisfaction: time. You should mention the correct Policy number in all communications

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 including communications with respect to Premium remittances made by
You.
15.2. All notices meant for You will be in writing and will be sent by Us to
Your address as shown in the Schedule or as communicated by You
and registered with Us. We may send You notices by post, courier,
hand delivery, fax or e-mail/electronic mode or by any other means as
determined by Us. If You change Your address, or if the address of the
Nominee changes, You must notify Us immediately.
15.3. For any updates, please visit Our website www.maxlifeinsurance.com.
16. GOVERNING LAW AND JURISDICTION
16.1. The Policy will be governed by and enforced in accordance with the laws
of India. The competent courts in India will have exclusive jurisdiction in
all matters and causes arising out of the Policy.
PART G
GRIEVANCE REDRESSAL MECHANISM & OMBUDSMAN DETAILS
1. DISPUTE REDRESSAL PROCESS UNDER THE POLICY ENDORSEMENT
1.1. All consumer grievances and/or queries may be first addressed to Your agent
or Our customer helpdesk as mentioned below:
Max Life Insurance Company Limited STAMP DUTY AMOUNT : `229.62
Plot No. 90A, Sector 18, Gurugram, 122015, Haryana, India
Tel No: 0124-4219090
Email : axis.helpdesk@maxlifeinsurance.com 663 Date: 16/11/17
1.2. If Our response is not satisfactory or there is no response within 15 (Fifteen)
days:
1.2.1. the complainant or his legal heirs may file a written complaint with full
details of the complaint and the complainant's contact information to
the following official for resolution: Indeevar Krishna
Head Operations and Customer Services Authorized Signatory
Max Life Insurance Company Limited
Plot No. 90A, Sector 18,
Gurugram, 122015, Haryana, India,
Toll Free No. - 1800 200 4006
Email: manager.services@maxlifeinsurance.com;
1.2.2. the complainant or his legal heirs may approach the Grievance Cell of
the IRDAI on the following contact details:
IRDAI Grievance Call Centre (IGCC)
Toll Free No:155255 or 1800 4254 732
Email: complaints@irda.gov.in
1.2.3. You can also register Your complaint online at
http://www.igms.irda.gov.in.
1.2.4. You can also register Your complaint through fax/paper by submitting
Your complaint to:
Consumer Affairs Department
Insurance Regulatory and Development Authority of India
9th floor, United India Towers, Basheerbagh
Hyderabad - 500 029, Andhra Pradesh
Fax No: 91- 40 - 6678 9768
1.3. If You are not satisfied with the redressal or there is no response within a
period of 1 (One) month, the complainant or his legal heirs may approach
the Insurance Ombudsman at the address mentioned in Annexure A or at the
IRDAI website www.irda.gov.in, if the grievance pertains to:
1.3.1 any partial or total repudiation of claims by Us;
1.3.2 any dispute on the legal construction of this Policy in so far as such
disputes relates to a claim;
1.3.3 delay in settlement of a claim;
1.3.4 any dispute with regard to the Premium paid or payable in terms of
this Policy; or
1.3.5 non issuance of any insurance document after receipt of the Premium.
1.4. As per Rule 13(3) of the Redressal of Public Grievances Rules 1998, a
complaint to the Insurance Ombudsman can be made only within a period of
1 (One) year after Our rejection of the representation or the date of Our final
reply on the representation of the complainant, provided the complaint is not
on the same matter, for which any proceedings before any court, or consumer
forum or arbitrator is pending.

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 of his title.14.If nominee(s) die after the policyholder but before his share of the
amount secured under the policy is paid, the share of the expired nominee(s) shall
Annexure 1 be payable to the heirs or legal representative of the nominee or holder of succession
Section 45 - Policy shall not be called in question on the ground of certificate of such nominee(s). 15.The provisions of sub-section 7 and 8 (13 and
mis-statement after three years 14 above) shall apply to all life insurance policies maturing for payment after the
Provisions regarding policy not being called into question in terms of Section 45 of commencement of Insurance Laws (Amendment) Act 2015.16.If policyholder dies
the Insurance Act, 1938, as amended from time to time are as follows: 1.No Policy after maturity but the proceeds and benefit of the policy has not been paid to him
of Life Insurance shall be called in question on any ground whatsoever after expiry because of his death, his nominee(s) shall be entitled to the proceeds and benefit of
of 3 yrs from a. the date of issuance of policy or b. the date of commencement of the policy.17.The provisions of Section 39 are not applicable to any life insurance
risk or c.the date of revival of policy or d. the date of rider to the policy, whichever policy to which Section 6 of Married Women's Property Act, 1874 applies or has
is later. 2.On the ground of fraud, a policy of Life Insurance may be called in at any time applied except where before or after Insurance Act, 1938 as amended
question within 3 years from a.the date of issuance of policy or b.the date of from time to time, a nomination is made in favour of spouse or children or spouse
commencement of risk or c.the date of revival of policy or d. the date of rider to the and children whether or not on the face of the policy it is mentioned that it is made
policy, whichever is later. For this, the insurer should communicate in writing to the under Section 39. Where nomination is intended to be made to spouse or children
insured or legal representative or nominee or assignees of insured, as applicable, or spouse and children under Section 6 of MWP Act, it should be specifically
mentioning the ground and materials on which such decision is based. 3. Fraud mentioned on the policy. In such a case only, the provisions of Section 39 will not
means any of the following acts committed by insured or by his agent, with the apply.
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 insured does Annexure 3
not believe to be true;b. The active concealment of a fact by the insured having Section 38 - Assignment and Transfer of Insurance Policies
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. 4.Mere silence is not Assignment or transfer of a policy should be in accordance with Section 38 of
fraud unless, depending on circumstances of the case, it is the duty of the insured the Insurance Act, 1938 as amended from time to time. The extant provisions
or his agent keeping silence to speak or silence is in itself equivalent to speak.5. No in this regard are as follows:1.This policy may be transferred/assigned, wholly
Insurer shall repudiate a life insurance policy on the ground of fraud, if the insured or in part, with or without consideration.2.An Assignment may be effected in a
/ beneficiary can prove that the misstatement was true to the best of his knowledge policy by an endorsement upon the policy itself or by a separate instrument under
and there was no deliberate intention to suppress the fact or that such mis-statement notice to the Insurer.3.The instrument of assignment should indicate the fact of
of or suppression of material fact are within the knowledge of the insurer. Onus transfer or assignment and the reasons for the assignment or transfer, antecedents
of disproving is upon the policyholder, if alive, or beneficiaries. 6. Life insurance of the assignee and terms on which assignment is made.4.The assignment must
Policy can be called in question within 3 years on the ground that any statement of be signed by the transferor or assignor or duly authorized agent and attested by at
or suppression of a fact material to expectancy of life of the insured was incorrectly least one witness.5.The transfer or assignment shall not be operative as against an
made in the proposal or other document basis which policy was issued or revived insurer until a notice in writing of the transfer or assignment and either the said
or rider issued. For this, the insurer should communicate in writing to the insured or endorsement or instrument itself or copy there of certified to be correct by both
legal representative or nominee or assignees of insured, as applicable, mentioning transferor and transferee or their duly authorised agents have been delivered to the
the ground and materials on which decision to repudiate the policy of life insurance insurer.6.Fee to be paid for assignment or transfer can be specified by the Authority
is based.7.In case repudiation is on ground of mis-statement and not on fraud, the through Regulations.7.On receipt of notice with fee, the insurer should Grant a
premium collected on policy till the date of repudiation shall be paid to the insured written acknowledgement of receipt of notice. Such notice shall be conclusive
or legal representative or nominee or assignees of insured, within a period of 90 evidence against the insurer of duly receiving the notice.8.If the insurer maintains
days from the date of repudiation.8.Fact shall not be considered material unless it one or more places of business, such notices shall be delivered only at the place
has a direct bearing on the risk undertaken by the insurer. The onus is on insurer where the policy is being serviced.9.The insurer may accept or decline to act upon
to show that if the insurer had been aware of the said fact, no life insurance policy any transfer or assignment or endorsement, if it has sufficient reasons to believe
would have been issued to the insured.9.The insurer can call for proof of age at that it is a.not bonafide;b.not in the interest of the policyholder;c.not in public
any time if he is entitled to do so and no policy shall be deemed to be called in interest; ord.is for the purpose of trading of the insurance policy.10.Before refusing
question merely because the terms of the policy are adjusted on subsequent proof to act upon endorsement, the insurer should record the reasons in writing and
of age of life insured. So, this Section will not be applicable for questioning age or communicate the same in writing to policyholder within 30 days from the date
adjustment based on proof of age submitted subsequently. of policyholder giving a notice of transfer or assignment.11.In case of refusal to
act upon the endorsement by the insurer, any person aggrieved by the refusal may
prefer a claim to IRDAI within 30 days of receipt of the refusal letter from the
Annexure 2 insurer.12.The priority of claims of persons interested in an insurance policy would
Section 39 - Nomination by Policyholder depend on the date on which the notices of assignment or transfer is delivered to
Nomination of a life insurance policy is as below in accordance with Section 39 the insurer; where there are more than one instruments of transfer or assignment,
of the Insurance Act, 1938 as amended from time to time. The extant provisions the priority will depend on dates of delivery of such notices. Any dispute in this
in this regard are as follows:1.The policyholder of a life insurance policy on regard as to priority should be referred to the Authority.13.Every assignment or
his own life may nominate a person or persons to whom money secured by the transfer shall be deemed to be absolute assignment or transfer and the assignee or
policy shall be paid in the event of his death.2.Where the nominee is a minor, the transferee shall be deemed to be absolute assignee or transferee, except a.where
policyholder may appoint any person to receive the money secured by the policy in assignment or transfer is subject to terms and conditions of transfer or assignment
the event of policyholder's death during the minority of the nominee. The manner OR b.where the transfer or assignment is made upon condition that i.the proceeds
of appointment is to be laid down by the insurer. 3.Nomination can be made at under the policy shall become payable to policyholder or nominee(s) in the event
any time before the maturity of the policy. 4.Nomination may be incorporated of assignee or transferee dying before the insured; orii.the insured surviving the
in the text of the policy itself or may be endorsed on the policy communicated term of the policy.Such conditional assignee will not be entitled to obtain a loan on
to the insurer and can be registered by the insurer in the records relating to policy or surrender the policy. This provision will prevail notwithstanding any law
the policy.5.Nomination can be cancelled or changed at any time before policy or custom having force of law which is contrary to the above position.14In other
matures, by an endorsement or a further endorsement or a will as the case may be. cases, the insurer shall, subject to terms and conditions of assignment, recognize the
6.A notice in writing of change or cancellation of nomination must be delivered transferee or assignee named in the notice as the absolute transferee or assignee and
to the insurer for the insurer to be liable to such nominee. Otherwise, insurer will such persona shall be subject to all liabilities and equities to which the transferor
not be liable if a bonafide payment is made to the person named in the text of the or assignor was subject to at the date of transfer or assignment;b.may institute
policy or in the registered records of the insurer.7.Fee to be paid to the insurer for any proceedings in relation to the policy; andc.obtain loan under the policy or
registering change or cancellation of a nomination can be specified by the Authority surrender the policy without obtaining the consent of the transferor or assignor or
through Regulations.8.On receipt of notice with fee, the insurer should grant a making him a party to the proceedings15.Any rights and remedies of an assignee
written acknowledgement to the policyholder of having registered a nomination or or transferee of a life insurance policy under an assignment or transfer effected
cancellation or change thereof. 9.A transfer or assignment made in accordance with before commencement of the Insurance Laws (Amendment) Act, 2015 shall not be
Section 38 shall automatically cancel the nomination except in case of assignment affected by this section.
to the insurer or other transferee or assignee for purpose of loan or against security [Disclaimer: This is only a simplified version prepared for general information.
or its reassignment after repayment. In such case, the nomination will get affected You are advised to refer to the Insurance Act, 1938 as amended from time to time
to the extent of insurer's or transferee's or assignee's interest in the policy. The for complete and accurate details.]
nomination will get revived on repayment of the loan.10.The right of any creditor
to be paid out of the proceeds of any policy of life insurance shall not be affected by
the nomination.11.In case of nomination by policyholder whose life is insured, if
the nominees die before the policyholder, the proceeds are payable to policyholder
or his heirs or legal representatives or holder of succession certificate.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). 13.Where the policyholder whose life is
insured nominates his a.parents or b.spouse or c.children or d.spouse and children
e.or any of them, the nominees are beneficially entitled to the amount payable
by the insurer to the policyholder unless it is proved that policyholder could not
have conferred such beneficial title on the nominee having regard to the nature

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 Annexure A: Names of Ombudsman and addresses of Ombudsman Centres

AHMEDABAD - Office of the Insurance Ombudsman,6th Floor, Jeevan Prakash Bldg, Tilak Marg, Relief Road, Ahmedabad - 380001 Tel nos:
079-25501201/02/05/06 email: bimalokpal.ahmedabad@ecoi.co.in (State of Gujarat and Union Territories of Dadra & Nagar Haveli and Daman and Diu.)
BENGALURU -Office of the Insurance Ombudsman, Jeevan Soudha Bldg. ,PID No. 57-27-N-19, Ground Floor 19/19, 24th Main Road, JP Nagar, Ist Phase,
Bengaluru - 560 078. Tel.:080-26652048/26652049 Email: bimalokpal.bengaluru@ecoi.co.in. (State of Karnataka)
BHOPAL - Office of the Insurance Ombudsman, Janak Vihar Complex, 2nd Floor, 6, Malviya Nagar, Opp. Airtel Office, Near New Market, Bhopal - 462 003.
Tel.: 0755 - 2769201 / 2769202 Fax: 0755 - 2769203 Email: bimalokpal.bhopal@ecoi.co.in (States of Madhya Pradesh and Chattisgarh)
BHUBANESHWAR - Office of the Insurance Ombudsman, 62, Forest park, Bhubneshwar - 751 009. Tel.: 0674 - 2596461 /2596455 Fax: 0674 - 2596429
Email: bimalokpal.bhubaneswar@ecoi.co.in (State of Orissa).
CHANDIGARH - Office of the Insurance Ombudsman, S.C.O. No. 101, 102 & 103, 2nd Floor, Batra Building, Sector 17 - D, Chandigarh- 160 017. Tel.:
0172 - 2706196 / 2706468 Fax: 0172 - 2708274 Email: bimalokpal.chandigarh@ecoi.co.in (States of Punjab, Haryana, Himachal Pradesh, Jammu & Kashmir,
Union territory of Chandigarh)
CHENNAI- Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, CHENNAI - 600 018. Tel.: 044
- 24333668/ 24335284 Fax: 044- 24333664 Email: bimalokpal.chennai@ecoi.co.in (State of Tamil Nadu, and Union Territories - Pondicherry Town and Karaikal
(which are part of Union Territory of Pondicherry)).
DELHI- Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi - 110 002. Tel.: 011 - 23239633 / 23237532
Fax: 011 - 23230858Email: bimalokpal.delhi@ecoi.co.in (States of Delhi).
GUWAHATI - Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Nr. Panbazar over bridge, S.S. Road, Guwahati- 781001(ASSAM). Tel.:
0361 - 2132204 / 2132205 Fax: 0361 - 2732937 Email: bimalokpal.guwahati@ecoi.co.in (States of Assam, Meghalaya, Manipur, Mizoram, Arunachal
Pradesh,Nagaland and Tripura)
HYDERABAD - Office of the Insurance Ombudsman, 6-2-46, 1st floor, "Moin Court", Lane Opp. Saleem Function Palace, A. C. Guards, Lakdi-Ka-Pool,
Hyderabad - 500 004. Tel.: 040 - 65504123 / 23312122 Fax: 040 - 23376599 Email: bimalokpal.hyderabad@ecoi.co.in (State of Andhra Pradesh, Telangana,
and Union Territory of Yanam - a part of the Territory of Pondicherry)
JAIPUR- Office of the Insurance Ombudsman, Jeevan Nidhi - II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur - 302 005. Tel.: 0141 - 2740363
Email:Bimalokpal.jaipur@ecoi.co.in (State of Rajasthan)
ERNAKULAM - Office of the Insurance Ombudsman, 2nd Floor, Pulinat Bldg., Opp. Cochin Shipyard, M. G. Road, Ernakulam - 682015. Tel.: 0484 - 2358759
/ 2359338 Fax: 0484 - 2359336 Email: bimalokpal.ernakulam@ecoi.co.in (State of Kerala and Union Territory of (a) Lakshadweep (b) Mahe-a part of Union
Territory of Pondicherry)
KOLKATA - Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 4th Floor, 4, C.R. Avenue, KOLKATA - 700 072. Tel.: 033 - 22124339 / 22124340
Fax : 033 - 22124341 Email: bimalokpal.kolkata@ecoi.co.in (States of West Bengal, Sikkim, and Union Territories of Andaman & Nicobar Islands)
LUCKNOW - Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001. Tel.: 0522
- 2231330 / 2231331 Fax:0522 - 2231310 Email: bimalokpal.lucknow@ecoi.co.in (Following Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur,
Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur,
Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar,
Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar)
MUMBAI- Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai - 400 054. Tel.: 022 - 26106552 / 26106960
Fax: 022 - 26106052 Email:bimalokpal.mumbai@ecoi.co.in (State of Goa, Mumbai Metropolitan Region excluding Navi Mumbai & Thane)
PUNE - Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune - 411 030. Tel.:
020-41312555 Email: bimalokpal.pune@ecoi.co.in (State of Maharashtra, Area of Navi Mumbai and Thane excluding Mumbai Metropolitan Region)
NOIDA - Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor, Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301.
Tel.: 0120-2514250 / 2514252 / 2514253 Email: bimalokpal.noida@ecoi.co.in (State of Uttaranchal and the following Districts of Uttar Pradesh: Agra, Aligarh,
Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kanooj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad,
Firozbad, Gautambodhanagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar, Saharanpur)
PATNA - Office of the Insurance Ombudsman, 1st Floor,Kalpana Arcade Building, Bazar Samiti Road, Bahadurpur, Patna 800 006.Tel.: 0612-2680952 Email:
bimalokpal.patna@ecoi.co.in (State of Bihar, Jharkhand)

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 Max Life Guaranteed Income Plan
UIN No: 104N085V02
Non Participating Non-Linked Savings Insurance Plan
Policy/Proposal No: [ _________________ ]
Date of Illustration - Dec 7, 2017 11:58:04 PM
Personal Details Product Features

Name of Policyholder AMITA FRANCIS 310978457 Policy Term 6 Years

Age of Policyholder as at last birthday on the date of 52 Years Premium Payment Term 6 Years
commencement

Gender of Policyholder Female Premium Payment Mode Annual

Name of Life Insured AMITA FRANCIS 310978457

Age of Life Insured as at last birthday on the date of 52 Years

commencement

Gender of Life Insured Female

Policyholder Residential State Delhi

Max Life State Delhi

PREMIUM SUMMARY

First Year Premium Renewal Year Premium

Annualised Premium Rs 90,000.02 Rs 90,000.02

Premium payable on Due Date Rs 90,000.02 Rs 90,000.02

GST on Premium payable on Due Date Rs 4,050.00 Rs 2,025.00

Premium payable on Due Date along with GST Rs 94,050.02 Rs 92,025.02

Refer Description of Goods and Service Tax (GST) under Important Notes section.

Max Life Insurance Company Limited having its corporate office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram 122 002
Page 1 of 4

YEARLY ILLUSTRATIVE DETAILS

(This shall form a part of the policy document)

(All cash flows are in Rs )

General Details Guaranteed Benefit Non Guaranteed

Benefit

Year Premium Payment Payout Period Age of life Assured Premium (BOY) Income Benefit Terminal Benefit Guaranteed Total Lump sum Sum of Income Special Surrender
Term (BOY) payable in a Year * (EOY) Surrender Value** Death Benefit for the benefits on Death Value** (EOY)
(BOY) for the year year*** payable over 10
years****

1 1 0 52 90,000 0 0 0 11,47,500 14,58,000 0

2 2 0 53 90,000 0 0 54,000 11,47,500 14,58,000 1,07,082

3 3 0 54 90,000 0 0 81,000 11,47,500 14,58,000 1,93,104

4 4 0 55 90,000 0 0 1,80,000 11,47,500 14,58,000 3,05,064

5 5 0 56 90,000 0 0 4,05,000 11,47,500 14,58,000 4,25,880

6 6 0 57 90,000 0 0 4,86,000 11,47,500 14,58,000 5,63,698

7 0 1 58 0 44,190 0 0 0 0 0

8 0 2 59 0 44,190 0 0 0 0 0

9 0 3 60 0 44,190 0 0 0 0 0

10 0 4 61 0 44,190 0 0 0 0 0

11 0 5 62 0 44,190 0 0 0 0 0

12 0 6 63 0 88,380 0 0 0 0 0

13 0 7 64 0 88,380 0 0 0 0 0

14 0 8 65 0 88,380 0 0 0 0 0

15 0 9 66 0 88,380 0 0 0 0 0

16 0 10 67 0 88,380 1,12,500 0 0 0 0

(BOY) - Beginning of Year

(EOY) - End of Year

Max Life Insurance Company Limited having its corporate office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram 122 002
Page 2 of 4
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* The Income Benefit is distributed in equal installments each month

** The illustrated surrender values are applicable assuming that all the due premiums have been received as on the date of surrender.

In case of death of the Life Insured within the Policy Term, the beneficiary shall receive the following death benefit:
The lump sum death benefit payable is equal to the death sum assured, which is defined as the higher of:
i) 10 times the Annualised Premium;
ii) 105% of total premiums paid as on the date of death of life insured;
iii) Guaranteed Sum Assured on Maturity (GSAM)
iv) Any absolute amount assured to be paid on death#
# Absolute amount assured to be paid on death is equal to the Guaranteed Sum Assured on Death (GSAD) under this product.

***Total Lump sum Death Benefit: The Death Benefit is payable as a lump sum benefit to the beneficiary. It is the maximum of mentioned amount at any given point of time during the policy term.

****Sum of Income Benefits on Death: The beneficiary has the option to avail the death benefit in monthly instalments for a period of 10 years post the date of death in lieu of lump sum death benefit. On exercising the option, the Death Benefit is paid as
follows:

Period Death Income Benefit (as % of Annualised Premium, payable monthly)

10 Years following the date of death of the Life Insured 162%/12

Extra premium, rider premium, GST , cesses(if any) and any statutory levies are excluded from total Annualised premiums used for calculating the death benefit, income benefit and terminal benefit.

Important Notes:

Section A
-- Guaranteed Surrender Value (GSV): Guaranteed Surrender Value is the guaranteed amount that will be payable to the Policyholder on surrender of the policy.
-- Special Surrender Value (SSV): Special surrender value is the non guaranteed amount that will be payable to the Policyholder on surrender of the policy. SSV will be determined from time to time in consultation and with approval of IRDAI and is not
guaranteed. The SSV will always be equal to or higher than GSV.

Section B
-- This document does not purport to be a contract of insurance and does not in any way create any rights and/or obligations.
-- Please refer to the product brochures, for the understanding the product features and explanation of the terms used in this illustration.
-- GST and other applicable taxes, cess (if any) would be levied as per applicable laws and would be borne by the Policyholder. Tax laws and the benefits arising under the Policy are as per prevailing provisions of law and subject to change.
-- Tax benefits are subject to the changes in tax laws. You may be entitled to certain applicable tax benefits on your premiums and policy benefits. Please note that all the tax benefits are subject to the tax laws prevailing at the time of payment of premiums
or receipt of benefits by you. You may seek an independent advice on tax benefits from your tax advisor.
-- Guaranteed Sum Assured on Death (GSAD) is defined as 12.75 times Annualised Premium for 6 years Policy Term variant and 18.5 times Annualised Premium for 12 years Policy Term variant.
-- Guaranteed Sum Assured on Maturity (GSAM) is defined as the present value of survival benefits and is expressed in terms of one Annualised Premium.
-- Instead of taking the Survival Benefit as a series of monthly payments along with the terminal benefit at the end of payout period, the policyholder also has the option to avail the survival benefit in lump sum at the end of the policy term, before the
commencement of the payout period. On exercising this option, the GSAM is paid to the policyholder. The policy shall terminate on the payment of the GSAM.
-- The GST shall comprise - CGST, SGST/UTGST or IGST whichever may applicable and cesses, if any. The applicability of appropriate components will be determined subject to policyholder communication address (state) and state of insurance
provider.

Max Life Insurance Company Limited having its corporate office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram 122 002
Page 3 of 4

I ________________________________________________________ (Name), have explained the terms and conditions and the benefits of the policy to the prospect/policyholder.

Signature of Agent/Specified Person:

Name and ID:
Place:
Date:
Company Seal:

I ________________________________________________________ (Name), having received the information with respect to the above, have understood the above statement before entering into the contract. I understand and intend to continue paying the

6 Years
above said premium amount for the complete Premium Payment Term of ___________________ and as per the opted frequency. I also understand that only the Special Surrender Value, as specified in illustration table above, is non
______________
guaranteed.
Policyholders Signature:
Policyholders Name:
Date:

Max Life Insurance Company Limited having its corporate office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram 122 002

2010.1.2.8.6.63.22 5215625000111373 600 100000180000 0 2

Page 4 of 4
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 Date: 07-Dec-2017
Receipt No.: 310978457 DEC201701

Life Insurance Premium Receipt

Duration For Which the Premium is Received: 05-DEC-2017 to 04-DEC-2018
Personal Details
Policy Number: 310978457 Current residential state: Delhi
Policyholder Name: Ms. Amita Francis Mobile No. 9868737860
Commuinication Address: 7A/401 TOP FLOOR GAUTAM Landline no. Please inform us for regular updates
NAGAR Life Insured Name: MS. AMITA FRANCIS
New Delhi - 110049 PAN Number: ABWPF7665B
Email ID: HENRYSAMEER19@GMAIL.COM
Policy Details
Plan Name: Max Life Guaranteed Income Plan - 104N085V02
Policy Term 16 Years Premium Payment Frequency Annual
Date of Commencement 05-DEC-2017 Date of Maturity 05-DEC-2033
Last Premium Due Date 05-DEC-2017 Next Due Date 05-DEC-2018
Reinstatement Interest (incl. GST) ` 0.00 Model Premium (incl. GST) ` 92,025.02
Total Premium Received (incl. GST)* ` 94,050.02 Minimum Guaranteed Death Benefit / ` 11,47,500.26
Death Benefit of base plan and term rider
(if any)
Agent's Name Axis Bank Ltd South Extn Agent's Contact No.

GST Details
Coverage Type SAC Code GST (INR) GSTIN 07AACCM3201E1Z5
Base 997132 ` 4,050.00 GST Regd. State Delhi
Rider 997132 ` 0.00 Affix
Reinstatement Interest ` 0.00 Re1
revenue
Total ` 4,050.00
stamp

Important Note:
*For payment mode other than in cash, this receipt is conditional upon the credit in our account. Payment of premium amount does not constitute commencement of risk. The risk
commencement starts after acceptance of risk by us. *Amount received would be adjusted against the due premium as per terms and conditions of the policy. *Premium paid would be
eligible for deduction as per the provision of Income Tax Act, 1961. Kindly consult your tax advisor for more information. Tax benefits are liable to change due to changes in legislation
or government notification. *Applicable Taxes, Cesses and Levies, as per prevailing laws, shall be borne by you. *For GST purposes,this premium receipt is Tax Invoice.Assessable
Value in GST for Endowment First Year is 25%, Renewal Year is 12.5%; Single Premium Annuity is 10%; Term and Health is 100%. In case of unit linked product GST is applicable
on charges.

Authorised signatory

PRM20

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