Duplicate

PART A
Welcome to Max Life Insurance
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Date 30-Aug-2022
To MS. MALLIKA PAL PRAMANIK
W/O NAGENDRA PAL PRAMANIK
BEGAMPUR CHANDITALAII HOOGHLY
HOOGHLY 712306
WEST BENGAL INDIA

Branch: X2871
Policy no.: 610121311
Telephone: 7596855048
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Welcome Dear MS. MALLIKA PAL PRAMANIK,
Thank you for opting for Max Life Flexi Wealth Plus (A Unit Linked Non-Participating Individual Life Insurance Plan). We
request you to go through the enclosed policy contract.
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What to do in On examination of the Policy, 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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Free Look 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,
Cancellation stating the objections/reasons for such disagreement, to us within the Freelook period of 15 days from the date of receiving the
Policy 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 an amount which will be equal to unallocated Premium plus charges levied by cancellation of
Units plus Fund Value at the date of cancellation less mortality charges (including applicable GST) for the period of cover, rider
charges (including applicable GST), expenses incurred on medical examination of the Life Insured, if any and stamp duty.
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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 Company Limited

R Krishnakumar
Executive Vice President - Operations Digitally signed by DS MAX LIFE INSURANCE COMPANY LIMITED 1
Date: 2023.07.07 [Link] IST
Reason: Max Life Insurance
Location: 90C, Gurugram

AGENT NAME : M/S. AXIS BANK LTD KUMTA (57635A), PH

NO.: 08386-220151, ADDRESS: Axis Bank Limited,Sanman C/512,Nh
-66,Mangalore - Goa, Axis Bank Limited,Sanman C/512,Nh -66,Mangalore
- Goa, Axis Bank Limited,Sanman C/512,Nh -66,Mangalore - Goa, Uttar
Kannada,
NB13
Max Life Insurance Company Limited
Plot No. 90A, Sector 18, Gurugram, 122015, Haryana, India
Phone 4219090 Fax 4159397 (From Delhi and Other cities: 0124) Customer Helpline: 1860 120 5577
Regd. Office: 419, Bhai Mohan Singh Nagar, Railmajra, Tehsil Balachaur, District Nawanshahr, Punjab -144 533
Visit Us at: [Link] E-mail: [Link]@[Link]
IRDAI Registration No: 104 Corporate Identity Number: U74899PB2000PLC045626 .

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 Key Feature Document for Max Life Flexi Wealth Plus
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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 the Ms. Mallika Pal Pramanik Policyholder Name: (person in Ms. Mallika Pal Pramanik
person whose life is insured) whose name the policy is issued)
Policy No. (please use this for any 610121311 Premium Payment Due Date: 29th of Aug every year
communication with us)
Date of Commencement(date 29-Aug-2022 ECS Draw Date: 01st of Aug Every Year
when the policy starts):
Premium Payment Term in years 5 Policy Term: (period of coverage 10
(period for which premium is to be - in years)
paid):
Last Premium Due Date : 29th of Aug every year; Maturity Date: 29-Aug-2032
29-Aug-2026
Premium Amount(Annualised) : ` 50,000.00 Maturity Amount: Fund value as on maturity date
Sum Assured: (minimum amount ` 5,00,000.00 Investment Strategy opted for: SELF-MANAGED PORTFOLIO
payable if the life insured expires) STRATEGY
Variant: Wealth Funds invested in: Regular: High Growth Fund
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Important points of These are the important points of your policy:

your policy • A Unit Linked Non Participating Individual Life Insurance Plan
- is a long term life insurance and savings plan
- provides flexibility to invest in equity or debt or a combination based on your willingness to take risk, and
- gets you long term benefits and protection, so we encourage you to continue with the policy for the complete policy
term.
• Policy performance - The performance of your policy is related to the performance of markets; the total value of
your policy may fall, rise or remain constant, depending on the market ups and downs and the performance of the
fund(s). We do not assure guarantee of returns.
• Investment in funds - The entire premium amount is not invested in the markets. We invest the premium after
deducting the applicable charges, including the life insurance cover charge,
• Withdrawal of money - If you need, you will able to withdraw the money invested in this policy as follows:

If you wish to withdraw money Then you

in the initial 5 years cannot withdraw money.
after the initial 5 years can withdraw money.
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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, we will pay the sum of the following:
lives • the fund value* as on maturity date, or
• periodic payments, if you have chosen the settlement option.

*inclusive of all applicable Guaranteed Loyalty Additions, Guaranteed Wealth Boosters and Return of Mortality
Charges
Note: Settlement option allows you to continue to stay invested with us after maturity for a maximum period of 5 years.
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If the life insured If the life insured expires during the policy term and we have received all the due premiums, we will pay the highest
expires of the following values:
• sum assured*, or
• fund value as on the date of death, or
• 105% of premium(s) received up to the date of death*
*reduced by applicable partial withdrawals, if any from the fund value
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Policy Benefits, Continued
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If you stay invested Guaranteed Loyalty Additions - These are payable as a percentage of total fund value (as per below table) at the
for long term end of each policy year starting from 6th policy year and at the end of each policy year thereafter.
Band 1: Annualised Premium less than 1,00,000 N/A
Band 2: Annualised Premium 1,00,000 to
0.25% of Fund Value
1,99,999(both inclusive)
Band 3: Annualised/ Single Premium of 2,00,000 and
0.40% of Fund Value
above

Guaranteed Wealth Boosters - These are payable as an additional percentage of Fund Value (as per below table),
at the end of every 5 years starting from 10th policy year.
Base 1: Annualised Premium less than 1,00,000 N/A
Base 2: Annualised Premium 1,00,000 to 1,99,999(both
2% of Fund Value
inclusive)
Base 3: Annualised/ Single Premium of 2,00,000 and
above 2% of Fund Value

Return of Mortality Charges: At the end of the policy term, on the maturity date, the total amount of mortality
charges deducted in respect of life cover provided throughout the policy term, will be added back as ROMC, to the
Fund Value, as applicable.

Disclaimers: Guaranteed Loyalty Additions, Guaranteed Wealth Boosters and Return of Mortality Charges are
applicable only if all due premiums are paid.

Guaranteed Loyalty Additions and Guaranteed Wealth Boosters are subject to following:
• The additional units shall be created in different Fund (s) in proportion of Fund Value on the date when the
additions are due to be paid by the Company.
• In case your policy gets lapsed and You revive it at a later date, the additions for previous years will be paid based
on the fund value that existed when they were originally due.
• In case premium reduction option is exercised, the additions post premium reduction will be credited in a similar
manner as mentioned above, i.e. according to the band in which the reduced premium falls in.
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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 [Link].
• 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.
• periodically, review the investment fund(s) based on your willingness to take risks. In this policy, the market risks
of the funds you choose reside with you.
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Can you change the You can

fund(s) you have • you have an option to exercise switching option during the policy term or the settlement period
invested in? • switch fund(s) - change existing fund(s) to available fund(s): -
- the minimum amount of change should be 5,000, and
- you can switch funds unlimited number of times, at no cost, in a year, and
• redirect funds - allocate future premiums, in full or parts, to available fund(s):
- for a maximum of 6 times in a year, at no cost,
- while the existing money you invested would continue as per fund(s) you selected earlier.
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What are the charges These are the charges applicable to your policy:
applicable to your • Premium Allocation Charge - This charge is levied for the allocation of the premium to the fund(s). The charge
policy? is deducted before the premium is invested in the chosen fund.
• Policy Administration Charge - The charge is levied towards the management of the policy over the lifetime.
This charge is levied through deduction of units every month.
• Mortality Charge - This charge is deducted to provide life cover under the policy. This charge is levied through
deduction of units every month.
• Fund Management Charge - This is the charge levied for the management of funds. This charge is levied by
adjusting the Net Asset Value (NAV) of the fund on a daily basis.
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A. Managing Your Policy - Frequently asked questions, Continued
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How can you manage Manage your policy under the Customer Service section by visiting [Link] to get easy access
your policy? to the following self-service options:
• Access policy statements, receipts and premium due information
• Update your personal details
• Change the premium payment mode to any of these - annual, semi-annual, quarterly or monthly modes
• Pay renewal premiums online
• Switch existing fund(s)
• Redirect premium (allocation of future premium to another fund of your choice)
Option to reduce your annualized premium upto 50% once during the entire policy term post completion of 5
•
policy years

Note: For any support or claim-related query, you can reach us at 1860 120 5577 or (0124) 4219090 or
[Link]@[Link]
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How can you cancel If your Policy does not meet your objective, you may contact us to understand the Policy benefits. If you still feel
your policy? the need to cancel your Policy, you have an option to cancel it within the free look period of 15 days from the day
you receive the Policy documents.
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What happens if you To ensure continuous life insurance cover, please pay your premium on time.
delay your premium
payment? Non-payment by the due date
If for any reason, you are unable to pay by the due date, you have a grace period within which you can pay without
any late fee or interest.

Note: During the grace period, the insurance cover continues and your fund(s) will continue to participate in the
market. If the life insured dies during this period, we will pay the due amount.

Non-payment within the grace period for Limited/ Regular premium policies

If you are unable to pay the premium by the grace period, the fund value after deducting the applicable discontinuance
charges shall be credited to the discontinued policy fund. You can choose as follows:

If, during the lock-in period, you wish to opt for Then
Reviving the policy within three years You need to
• Give a written request to the company
• Pay all due premiums; and
• Produce evidence of insurability of the life
insured
In case you choose to revive but don't revive the Policy within • The proceeds of the Discontinuance Policy Fund
revival period will be paid at the end of the revival period or
lock-in period, whichever is later
If you don't choose to revive the policy • The policy shall continue without any risk cover
• Policy fund shall remain invested in the
Discontinuance Policy Fund
• At the end of the lock-in period, the proceeds of
the Discontinuance Policy Fund will be paid to
You. Policy shall terminate.
Withdraw/surrender completely from the policy • The proceeds of the Discontinuance Policy Fund
shall be payable at the end of lock-in period or
date of surrender whichever is later.

For Single premium policies

In case of Single Premium policies in case of Surrender request within the lock-in period, the fund value, after
deducting the applicable discontinuance charges shall be credited to the discontinued policy fund. The policy shall
continue to be invested in the Discontinuance Policy Fund and the proceeds from the discontinuance fund shall be
paid at the end of lock-in period.
Note: There will be no risk cover once your fund(s) move to the discontinuance policy fund.

After the lock-in period

In case of discontinuance of policy, the policy shall be converted into a reduced paid up policy with the paid up
sum assured.

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A. Managing Your Policy - Frequently asked questions, Continued
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You can choose as follows Then

Reviving the policy within three years You need to
• Give a written request to the company
• Pay all due premiums; and
• Produce evidence of insurability of the life insured
In case you choose to revive but don't revive the Policy • The fund value shall be paid to you at the end of the
within revival period revival period.
Surrender/ Completely withdraw the policy • Proceeds of the Policy Fund shall be payable
If you do not exercise any of the above options, • Your policy will continue to remain in reduced paid
up state and proceedings will be paid at the end of 3
years revival period

Note: Your policy has a lock-in period of 5 (five) years.

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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 In the event of death of the life insured due to suicide within twelve months from the date of commencement or
exclusions under revival of the policy:
the policy? • all risks and benefits under this policy shall cease and no benefits will be payable under this policy, and
• we will pay you the fund value prevailing on the date of intimation of death of the life insured and terminate the
policy.
• Further any charges other than Fund Management Charges (FMC) recovered subsequent to the date of death shall
be added back to the fund value as available on the date of intimation of death
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Disclaimers Please read the following carefully:

• The actual returns of the policy may be different from what is shown in the benefit illustration, enclosed in the
policy document. In the benefit illustration, the benefits are illustrated at investment returns of 4% and 8% p.a,
which are not guaranteed.
• The past performance of a fund is no indicator of future performance.
• 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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 PREAMBLE TO THE POLICY

MAX LIFE INSURANCE COMPANY LIMITED

Regd. Office: 419, Bhai Mohan Singh Nagar, Railmajra, Tehsil Balachaur, District Nawanshahr, Punjab -144533

Max Life Flexi Wealth Plus

(A Unit Linked Non-Participating Individual Life Insurance Plan)
UIN [104L115V01]

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 : Gurugram, Haryana

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POLICY SCHEDULE
In this Policy, the investment risk in the investment portfolio is borne by You.

Policy - Max Life Flexi Wealth Plus Type of Policy - A Unit Linked Non-Participating Individual Life
Insurance Plan
UIN - 104L115V01 Office - AXIS BANK LTD Kumta
Policy No./ Proposal No.:610121311 Client ID: 5015316518
Date of Proposal: 16-Aug-2022
Policyholder/Proposer : Age Admitted: Yes/No
Ms. Mallika Pal Pramanik
Gender: Female
PAN: DFLPP9846A
Tel No./Mobile No.: / 7596855048
Identification Source & I.D No.:
Relationship with Life Insured: Same Person Email: BINKERPAUL011@[Link]

Date of Birth: 05-Aug-1992

Address (For all communication purposes):
W/O NAGENDRA PAL PRAMANIK
BEGAMPUR CHANDITALAII HOOGHLY
HOOGHLY 712306
WEST BENGAL INDIA
Life Insured: Age Admitted: Yes/No
Ms. Mallika Pal Pramanik
Identification Source & ID No.: Gender: Female

Date of Birth: 05-Aug-1992

Age: 30
Address (For all communication purposes):
W/O NAGENDRA PAL PRAMANIK
BEGAMPUR CHANDITALAII HOOGHLY
HOOGHLY 712306
WEST BENGAL INDIA

Nominee details: Guardian/Appointee (if Nominee is minor):

Nominee (s)Name Relationship Date of Birth: Age: % KALIPADA PRAMANIK
of Nominee(s) Of Nominee share
with
Policyholder:
Mr. Binkar Paul Son 30-Mar-2011 11 100
Date of Commencement of Risk/ Inception of Policy: Variant: Wealth
29-Aug-2022
Investment Strategy: SELF-MANAGED PORTFOLIO
Date of Issuance of Policy: 29-Aug-2022 STRATEGY
Details of the riders, if any:
Premium Payment Method: ECS Bill Draw Date: 01ST
Bank Name: Axis Bank
Bank Account Number: 920010007283145
Bank Account Details for Pay outs Bank Name: Axis Bank
Bank Account Number: 920010007283145
Agent's name/Intermediary name: M/S. AXIS BANK LTD Agent's code / Intermediary code: 57635A
KUMTA
Agent's / Intermediary License No.: MAX57635A
Email:
Mobile / Landline Telephone Number: 08386-220151,
Address:
Axis Bank Limited,Sanman C/512,Nh -66,Mangalore - Goa, Axis
Bank Limited,Sanman C/512,Nh -66,Mangalore - Goa, Axis Bank
Limited,Sanman C/512,Nh -66,Mangalore - Goa
Uttar Kannada 581343

Details of Sales Personnel (for direct sales only): N/A

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 List of Maturity Insured Sum Assured Policy Premium Premium Annualised Single Premium Due Date
coverage Date Event (INR) Term Payment Payment Premium Premium payable as when
Term Mode (INR) (INR) per Premium
Premium is
payment payable/
mode Date
selected when the
(INR) Last
Premium
is payable
BASE POLICY
29th of
Max As per
29-Aug- Aug every
Life Flexi Section 2 5,00,000.00 10 5 Annual 50,000.00 NA 50,000.00
2032 year; 29-
Wealth Plus of Part C
Aug-2026

ALLOCATION PROPORTION AT THE DATE OF COMMENCEMENT OF RISK

(Applicable only if Self-Managed Portfolio Strategy is chosen)
ALLOCATION PROPORTION
FUND NAME
(as a % of the Single/Regular/ Limited Premium)
High Growth Fund 100
Diversified Equity Fund
Growth Super Fund
Growth Fund
Balanced Fund
Conservative Fund
Dynamic Bond Fund
Secure Fund
Secure Plus Fund
Money Market II Fund

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PART B received by Us divided by the total number of Premiums payable by You during the
DEFINITIONS AND INTERPRETATIONS Premium Payment Term;
The words and phrases listed below shall have the meaning attributed to them wherever 31. "Policy" means the contract of insurance entered into between You and Us as
they appear in the Policy unless the context otherwise requires. evidenced by this document, the Proposal Form, the Schedule and any additional
1. "Age" means the Life Insured's age on last birthday as on the Date of information/document(s) provided to Us in respect of the Proposal Form along with
Commencement of Risk or on the previous Policy Anniversary, as the case may be; any written instructions from You, subject to Our acceptance of the same and any
2. "Annualised Premium" is the amount specified in the Schedule, and means endorsement issued by Us;
Premium amount payable in a Policy Year, excluding any rider premiums, 32. "Policy Administration Charge" means a charge, if any, levied by Us for
underwriting extra premium on riders and applicable taxes, cesses or levies, if any; administration of the Policy during the Policy Term, starting from the Date of
3. "Appointee"/ "Guardian" means the person named by the Policyholder, registered Commencement of Risk on each Monthly Anniversary by cancelling an appropriate
with us and specified in the Schedule, who is authorised to receive and hold in trust number of Units in the Unit Account at the prevailing NAV and is specified in Part E;
the benefits under this Policy on behalf of the Nominee/(s), if the Nominee/(s) is/are 33. "Policy Anniversary" means the annual anniversary of the Date of Commencement
less than 18 years, on the date of payment. of Risk;
4. "Business Day" shall mean days other than holidays where stock exchanges with 34. "Policy Term" means the term of the Policy as specified in the Schedule;
national wide terminals are open for trade or any day declared by the IRDAI as 35. "Policy Year" means a period of 12 (Twelve) months commencing from the Date
business day; of Commencement of Risk and every Policy Anniversary thereafter;
5. "Claimant" means You, Life Insured (if You are not the Life Insured), Nominee(s) (if 36. "Premium" means an amount as specified in the Schedule;
valid nomination is effected), assignee(s) or their heirs, legal representatives or holders of a 37. "Premium Allocation Charge" means a charge, if any, as specified in Part E which
succession certificate in case Nominee(s) or assignee(s) is/are not alive at the time of claim; is levied by Us and calculated as a percentage of the Premium and deducted from
6. "Date of Commencement of Risk / Date of Inception" means the date as specified the Premium received by Us before the same is allocated to the Unit Account;
in the Schedule, on which the insurance cover/risk under this Policy commences; 38. "Premium Payment Term" means the term as specified in the Schedule, during
7. "Date of Discontinuance" means the date on which We receive a written intimation which the Premiums are payable by You;
from You about the surrender of the Policy or on expiry of the Grace Period, 39. "Proposer" is a person, who proposes for insurance on and has an insurable interest
whichever is earlier; in the life of the Life Insured. However, in case the Life Insured is a minor, the
8. "Discontinuance" means the state of the Policy arising out of the surrender of the Proposer can only be either a parent or a legal guardian.
Policy or on non-payment of the Premium due before the expiry of the Grace Period; 40. "Proposal Form" means the form filled in and completed by You, for the purpose
9. "Discontinuance/ Surrender Charge" means a charge levied by Us on the of obtaining insurance coverage under this Policy;
Discontinuance/ surrender of the Policy in accordance with the rates as specified in 41. "Regular Premium" means the Premium payable to Us in regular instalments
Part E; throughout the Policy Term in the manner and at the intervals specified in the
10. "Discontinuance Policy Fund" means Our segregated fund that is set aside and is Schedule.
constituted by the Fund Value of all policies discontinued during the Lock in Period 42. "Revival Period" means a period of 3 (Three) consecutive years from the date of
on which a minimum guaranteed interest rate of 4% (Four percent) per annum (or as first unpaid Premium during which You are entitled to revive the Policy which was
mandated by IRDAI from time to time) is payable by Us; discontinued due to non-payment of Premium;
11. "Freelook" means a period during which, subject to the Clause 9 Part D of the 43. "Schedule" means the policy schedule and any endorsements attached to and
Policy, You have an option to return the original Policy to Us by stating the forming part of the Policy and if an updated Schedule is issued, then, the Schedule
objections/reasons for such disagreement in writing; which is latest in time;
12. "Force Majeure Event" means an event by which performance of any of Our 44. "Single Premium" means the Premium payable to Us only once throughout the
obligations is prevented or hindered as a consequence of any act of God, State, Policy Term as specified in the Schedule;
strike, lock-out, legislation or restriction by any government or other authority or 45. "Sum Assured" means an amount as specified in the Schedule that is payable on the Life
any circumstance beyond Our anticipation or control, during continuance whereof Insured's death as calculated below in terms of the Policy;
the performance of Our obligations under this Policy shall remain wholly or partially For Single Premium:
suspended; • For Age less than or equal to 45 years-
13. "Funds" means the segregated investment funds established and managed by Us; a. 1.25 times the Single Premium; or
14. "Fund Management Charge" means a charge levied by Us for management of the b. 10 times the Single Premium only for Policy Term of 10 years, and
Funds and calculated as a percentage of the Fund Value and appropriated by adjusting • For Age greater than 45 years - 1.25 times the Single Premium.
the NAV. The Fund Management Charge shall be levied on each Valuation Date For Limited Premium and Regular Premium: 10 times the Annualised Premium
throughout the Policy Term and shall not change during the Policy Term; 46. "Sum at Risk" means an amount which is positive and is highest of the following:
15. "Fund Value" means the total number of Units in Fund(s) multiplied by the a. Sum Assured less (partial withdrawals made during the two years immediately
respective NAV of the Fund(s); preceding the date of calculation of sum at risk and Fund Value); or
16. "Grace Period" means a period of 15 (Fifteen) days from the due date of the first b. 105% (Hundred and Five percent) of the total Premium received less (Fund
unpaid Premium for monthly premium payment mode and 30 (Thirty) days from Value as on the date of calculation of Sum at Risk and partial withdrawals made
the due date of the first unpaid Premium for annually, semi-annually or quarterly during the two years immediately preceding the date of calculation of Sum at
premium payment modes; Risk and Fund Value)
17. "Guaranteed Loyalty Additions" means the additional Units added to the Fund c. Zero.
Value in accordance with Clause 2.2.2 of Part C of this Policy; Note: During the settlement period 'Sum at Risk' shall be higher of 105% (Hundred
18. "Guaranteed Wealth Boosters" means the additional Units added to the Fund and Five percent) of the total Premium received less Fund Value as on the date of
Value in accordance with Clause 2.2.3 of Part C of this Policy; death of the Life Insured or zero.
19. "Insurance Act" means the Insurance Act, 1938; 47. "Surrender Value" means the value payable on the surrender of the Policy which
20. "IRDAI" means the Insurance Regulatory and Development Authority of India is calculated by Us in accordance with the terms of the Policy;
established under the Insurance Regulatory and Development Authority Act, 1999 48. "Underwriting Policy" means an underwriting policy approved by Our board of
21. "Life Insured" means the person named in the Schedule, on whose life the Policy directors;
is effected; 49. "Unit" means a specific portion of the underlying Fund, which is representative of
22. "Limited Premium" means the Premium payable to Us during the Premium Your entitlement in such Funds;
Payment Term which is limited compared to the Policy Term and is paid in regular 50. "Unit Account" means a notional account opened and managed by Us for You, in
instalments in the manner and at the intervals specified in the Schedule a variant of which the Units are allocated following the receipt of the Premium from You and in
the Policy where the premium is payable for a term which is less than the Policy term. which the Units are cancelled by Us for the purpose of paying the benefits and for
23. "Lock in Period" means a period of 5 (Five) consecutive years from the Date of recovering the applicable charges;
Commencement of Risk; 51. "Valuation Date" means every Business Day on which We value the assets to which
24. "Maturity Date" means the date specified in the Schedule on which the Policy Term each of the Funds is referenced for the purpose of declaring the NAV;
expires; 52. "We", "Us" or "Our" or "Company" means Max Life Insurance Company
25. "Mortality Charge" means a charge levied by Us on every monthly anniversary Limited;
by canceling Units from the Unit Account on the basis of Sum at Risk for providing 53. "Wealth Variant" means all policies other than Whole Life Variant;
life insurance cover to the Life Insured during the Policy Term/settlement period on 54. "Whole Life Variant" means Policy where life cover is available till the Life
the basis of his attained Age during the Policy Term in accordance with the rates as Insured turns 100 years of Age; and
specified in Part E; 55. "You" or "Your" or "Policyholder" means the policyholder as named in the
26. "Monthly Anniversary" means the date in every month corresponding with the Schedule.
Date of Commencement of Risk; PART C
27. "Net Asset Value" or "NAV" or "Unit Price" means the net asset value which 1. ELIGIBILITY CONDITIONS
is the price at which the Units are allocated to the Unit Account or cancelled from 1.1. The Policy has been written on a single life basis only.
the Unit Account as per the terms and conditions specified in Part E and determined 1.2. The minimum Age of the Life Insured on the Date of Commencement of Risk
on each Valuation Date. should be
28. "Nominee" means the person nominated by You in case You are Life Insured as 1.2.1. For Wealth Variant- 91 (Ninety-One) days.
well, in accordance with Part F to receive the benefits under the Policy and whose 1.2.2. For Whole Life Variant- 18 (Eighteen) years.
name is mentioned in the Schedule; 1.3. The maximum Age of the Life Insured on the Date of Commencement of Risk
29. "Paid Up Policy" means the Policy under which the due Premiums have been cannot exceed:
discontinued after the completion of the Lock-in Period; 1.3.1. For Policy with Single Premium - 70 (Seventy) years;
30. "Paid-up Sum Assured" means the amount payable under a Paid-up Policy which is 1.3.2. For Policy with Limited /Regular Premium -
equal to the Sum Assured multiplied by the resultant of the total number of Premiums [Link]. For Wealth Variant - 60 (Sixty) years

9 of 33
 [Link]. For Whole Life Variant - 55 (Fifty-Five) years [Link]. The applicable Guaranteed Wealth Boosters differs for various
1.4. The minimum Age of the Life Insured on the Maturity Date shall not be less than: Premium bands in which the Policy falls as below:
1.4.1. For Wealth Variant - 18 (Eighteen) years a) If the Annualised Premium is less than Rs. 100,000 then, We
1.4.2. For Whole Life Variant - 100 (Hundred) years will not pay any Guaranteed Wealth Boosters.
1.5. The maximum Age of the Life Insured on the Maturity Date shall not exceed: b) If the Annualised Premium is equal to or greater than Rs.
1.5.1. For Wealth Variant - 80 (Eighty) years 100,000 then, We will add 2.00% of the Fund Value to the
1.5.2. For Whole Life Variant - 100 (Hundred) years Fund(s) by creation of additional Units.
2. BENEFITS [Link]. In case of revival of Policy, the Guaranteed Wealth Boosters for
2.1. Death Benefit previous years will be paid based on the Fund Value at the time
2.1.1. In the event of the Life Insured's death during the Policy Term, provided when the Guaranteed Wealth Boosters were originally due.
the Policy is in force, We shall pay to the Claimant highest of the following [Link]. In case Premium reduction option is exercised as per Clause 4.6 of
death benefits: Part C, Guaranteed Wealth Boosters post Premium reduction will
i. Sum Assured (reduced by all partial withdrawals, made during the two be credited in a similar manner as mentioned above, i.e. according
years' period immediately preceding the death of the Life Insured, if any, to the Premium band in which the reduced Premium falls.
from the Fund Value); or 3. PAYMENT OF BENEFITS
ii. 105% (Hundred and Five percent) of the total Premium received upto 3.1. The benefits under the Policy will be payable to the Claimant on submission of
the Life Insured's death (reduced by all partial withdrawals, if any satisfactory proof to Us.
made during the two years' period immediately preceding the death of 3.2. Once the benefits under the Policy are paid to the Claimant, the same will
the Life Insured, if any, from the Fund Value); or constitute a valid discharge of Our liability under the Policy.
iii. the total Fund Value (as on the date of death of the Life Insured). 4. PAYMENT OF PREMIUMS
2.1.2. Settlement option will not be provided in respect of the amount to be [Note: The provisions of Clause 4 below are not applicable in case of Single
paid towards Death Benefit. Premium]
2.2. Maturity Benefit 4.1. The Premium is due and payable to Us during the Premium Payment Term by
Upon maturity, if the Life Insured is alive and the Policy is in force or if this the due date specified in the Schedule. If the Premium is not paid by the due
Policy is a Paid-Up Policy, then, We will pay the Fund Value applicable on the date, You may pay the same during the Grace Period. During the Grace Period
Maturity Date to You, unless You have opted for the settlement option. In case the insurance cover will continue and all charges under the Policy will continue
you have opted settlement option, provisions under Clause 10 of Part D shall to apply.
apply. In case the Maturity Date is not on Business Day, then the NAV of next 4.2. The Premium can be paid by You annually, semi-annually, quarterly or monthly,
Business Day will be applicable. as per the Premium payment mode chosen by You. You may change the Premium
2.2.1. Return of Mortality Charge payment mode by submitting a written request to Us, provided that such change
[Link]. Upon maturity, if the Life Insured is alive and all due Premiums in Premium payment mode will be effective only on the Policy Anniversary
have been received by Us, We will add an amount equal to the following the receipt of such request.
Mortality Charge (in terms of absolute amount) deducted during 4.3. You may pay the Premium at any of Our offices or through Our website
the Term of the Policy to the Fund Value. [Link] or by any other means as informed by Us from time
[Link]. Amount of Mortality Charge will be returned on the Maturity Date to time. Any Premium paid by You will be deemed to have been received by Us
by means of converting the amount into Units into proportionate only after the same has been realised and credited to Our bank account.
fashion of Fund Value as on Maturity Date. 4.4. The Premium payment receipt shall be issued in Your name and shall be subject
[Link]. As this return of Mortality Charge is an integral part of the to realisation of the cheque or any other instrument/medium.
Maturity Benefit, return of Mortality Charge will not be allowed 4.5. We will not accept any additional premium or top-up premium under this Policy.
if the Policy has been surrendered, discontinued or is a Paid-Up 4.6. Premium Reduction
Policy. 4.6.1. Upon payment of full Premiums for the first five Policy Years, You have
[Link]. In case You opt for maturity payout through settlement option, an option to decrease the Premium upto 50% of the original Annualised
the Units obtained through return of Mortality Charge would be Premium subject to the minimum Premium limit as approved by the
treated the same as the Units in Policy otherwise. Authority under the product. To opt for such decrease, an intimation
[Link]. Return of Mortality Charge will be excluding any extra Mortality should be given to Us 15 days prior to the Premium due date.
Charge & or any applicable taxes, cesses and levies on the 4.6.2. The Sum Assured under the Policy will be also be reduced proportionately
Mortality Charge deducted, subject to changes in tax laws. and all the applicable charges will be deducted accordingly.
2.2.2. Guaranteed Loyalty Additions 4.6.3. This option may be exercised only once during the Policy Term and once
[Link]. Guaranteed Loyalty Additions are additional Units added to the reduced, the Premium cannot be subsequently increased.
Fund which shall be credited only if the Life Insured is alive 4.6.4. The Sum Assured of attached rider (if any) and the rider premium will also
and all due Premiums have been received by Us. No Guaranteed be reduced proportionately, subject to the regulatory boundary conditions
Loyalty Additions will be payable if the Policy is a Paid-Up Policy for riders. If the revised rider benefit is not within the prescribed limits,
or in Discontinuance mode. Guaranteed Loyalty Additions shall the rider benefit will be terminated and termination conditions of the rider
be payable along with the maturity benefit only. shall apply.
[Link]. Guaranteed Loyalty Additions shall be credited as a percentage 5. GRACE PERIOD
of total Fund Value at the end of each Policy Year starting from 5.1. The Premium is due and payable by the due date specified in the Schedule. If
end of 6th Policy Year till the end of Policy Term. The additional the due Premium is not paid by the due date, You may pay the same during the
Units shall be credited in different Funds in proportion of the Grace Period without any interest.
Fund Value on the due date of payment of Guaranteed Loyalty 5.2. During the Grace Period all charges under the Policy will continue to apply.
Additions. 5.3. During the Grace Period, if the overdue Premium is not paid and the insured event
[Link]. The applicable Guaranteed Loyalty Additions differs for various happens, then, We will pay the benefits only after deducting the said overdue
Premium bands in which the Policy falls as below: Premium.
a) If the Annualised Premium is less than Rs. 1,00,000 then, We 6. INCREASE OR DECREASE IN POLICY TERM / PREMIUM PAYMENT
will not pay any Guaranteed Loyalty Additions. TERM
b) If the Annualised Premium is between Rs. 1,00,000 to Rs. After completion of Lock-In Period, You may be allowed to increase or decrease the
1,99,999 then, We will add 0.25% of the Fund Value to the Policy Term (in multiples of one Policy Year) or the Premium Payment Term (in
Fund(s) by creation of additional Units. multiples of one Policy Year), as the case may be, under this Policy, by notifying Us,
c) If the Annualised Premium is equal to or greater than Rs. provided all due Premiums have been paid.
200,000 then, We will add 0.40% of the Fund Value to the 6.1. Increase or decrease in Policy Term:
Fund(s) by creation of additional Units. 6.1.1. This feature shall be subject to the Policy Term options available under
[Link]. In case of revival of Policy, the Guaranteed Loyalty Addition for the variant chosen by You.
previous years will be paid based on the Fund Value at the time 6.1.2. You may avail this facility only once during the Policy Term and any
when the Guaranteed Loyalty Addition were originally due. increase in the Policy Term, shall be subject to Our Underwriting Policy.
[Link]. In case Premium reduction option is exercised as per Clause 4.6 of 6.1.3. This feature shall not be available for Single Premium Policy and Whole
Part C, Guaranteed Loyalty Addition post Premium reduction will Life Variant.
be credited in a similar manner as mentioned above, i.e. according 6.2. Increase or decrease in Premium Payment Term:
to the Premium band in which the reduced Premium falls. 6.2.1. This feature shall be subject to the Premium Payment Term options
2.2.3. Guaranteed Wealth Boosters available under the variant chosen by You.
[Link]. Guaranteed Wealth Boosters are additional Units added to the 6.2.2. You may avail this facility only once during the Policy Term.
Fund Value which shall be made available only if the Life Insured 6.2.3. This feature shall not be available for Single Premium Policy.
is alive and all due Premiums have been received by Us. No 7. RISK COVERAGE FOR MINOR AND VESTING ON ATTAINING
Guaranteed Wealth Booster will be payable if the Policy is a MAJORITY
Paid-Up Policy or in Discontinuance mode. Guaranteed Wealth The risk coverage for the minors will start from the Date of Commencement of Risk.
Boosters shall be payable along with the maturity benefit only. In case the Life Insured is a minor, the Policy will automatically vest in him/her on
[Link]. Guaranteed Wealth Boosters will be credited at the end of every his/her attaining the age of majority. However, the Life Insured on attaining the age
5th Year starting from the 10th Policy Year till the end of the of majority, will be required to provide all the requisite information (including his
Policy Term. The additional Units shall be credited in different address, contact details, bank account details, etc.) and other documents as specified
Funds in proportion of the Fund Value on the due date of payment by Us to enable Us to pay the benefits under this Policy.
of Guaranteed Wealth Boosters.

10 of 33
PART D 1. Revive the Policy:
1. DISCONTINUANCE OF PAYMENT OF PREMIUMS/ NON-FORFEITURE Revive the Policy, subject to the following conditions:
BENEFITS i) You give Us a written request to revive the Policy or the Policy along
[Note: The provisions of Clause 1 below are not applicable in case of Single with rider cover; and
Premium] ii) Life Insured produces an evidence of insurability (in form of
1.1. Discontinuance of Payment of Premium during the Lock in Period
declaration of health condition and/or relevant medical reports)
a. If the Premium is not received before the expiry of the Grace Period, We will,
at Your own cost, acceptable to Us as per Our board approved
within 3 (Three) months of the first unpaid Premium, give a written notice
underwriting policy; and
to You informing You the status of the Policy and provide You the option to
iii) You pay Us all overdue Premiums in full.
revive the Policy within the Revival Period;
b. Upon expiry of the Grace Period, in case of Discontinuance of the Policy due The amount of Premium paid on revival, less any Premium Allocation
to non-payment of Premium, on the Date of Discontinuance, We will credit Charge attributable to the Premium paid on revival in accordance
the Fund Value, by creation of Units, into the Discontinuance Policy Fund with the ratio in which the Premium should be allocated in the Funds
after deducting applicable Discontinuance/Surrender Charge. The risk cover specified by You on the Date of Commencement of Risk or last
under the Policy and any applicable riders will cease and no further charges Premium redirection date, if any, whichever is later, will be used to
will be levied by Us other than the Fund Management Charge applicable on purchase Units at the Unit Price as on the date of revival.
the Discontinuance Policy Fund.
c. In the event that You opt to revive the Policy but do not revive the Policy We shall credit all the Guaranteed Loyalty Additions (if any) and
during the Revival Period, We will close the Unit Account and pay the Guaranteed Wealth Boosters (if any) that would otherwise have been
proceeds of the Discontinuance Policy Fund to You at the end of the Revival payable for the Revival Period in accordance with this Clause at the
Period or Lock in Period, whichever is later. Fund Value prevailing on which they were originally due.
d. If You do not exercise the above option to revive the Policy during the During the period up to the expiry of the Revival Period or the
Revival Period, the Policy shall continue without any risk cover (and rider earlier exercise of any of the above options, the Policy will continue
cover, if any) and the Funds shall remain invested in the Discontinuance with reduced risk cover and all applicable charges i.e. Policy
Policy Fund, and at the end of the Lock in Period, We will close the Unit Administration Charge, Mortality Charge and Fund Management
Account and pay the proceeds of the Discontinuance Policy Fund to You, Charge will be levied during the Revival Period.
and terminate the Policy.
e. If the Policy is surrendered by You, any time before the proceeds under the 2. Complete Withdrawal from the Policy without any risk cover:
Policy are paid out, the provisions as mentioned in Clause 2 of Part D relating If You exercise the option of complete withdrawal, then, on such date,
to surrender of the Policy within the Lock in Period will be applicable. the provisions relating to surrender of the Policy after the Lock in Period
f. If You have chosen in writing the option to revive the Policy within the as per Clause 2 of Part D shall be applicable.
Revival Period, You may exercise the option to revive the Policy during the 2. SURRENDER
Revival Period, subject to the following conditions: At any time during the Policy Term, You have the right to surrender the Policy by
1. You give Us a written request to revive the Policy or the Policy along giving Us a written notice:
with rider cover; and 2.1. Surrender within the Lock in Period
2. Life Insured produces an evidence of insurability (in form of declaration 2.1.1. If You surrender the Policy within the Lock in Period, We will credit the
of health condition and/or relevant medical reports) at Your own cost, Fund Value by creation of Units into the Discontinuance Policy Fund after
acceptable to Us as per Our board approved underwriting policy; and deducting applicable Discontinuance/Surrender Charge.
3. You pay Us all overdue Premiums in full. 2.1.2. On the expiry of the Lock in Period, whichever is later, We will close the
g. On revival, the insurance cover under the Policy as at the Date of Unit Account and the value of Units in the Discontinuance Policy Fund as
Discontinuance will be restored and the Fund Value of the Units in the at that date shall be paid to You and the Policy will terminate.
Discontinuance Policy Fund as on the date of the revival shall be credited 2.1.3. From the Date of Discontinuance, the risk cover under the Policy will stop
back to the Fund(s) chosen by You. The Discontinuance/Surrender Charge and only the Fund Management Charge applicable on the Discontinuance
deducted will also be added back to the Unit Account. Policy Fund shall be levied and no other charges will be levied by Us.
h. The amount of Premium paid on revival, less any Premium Allocation 2.1.4. If the Life Insured dies anytime within the Lock in Period after the Fund
Charge attributable to the Premium paid on revival in accordance with the Value has been transferred to the Discontinuance Policy Fund, We will
ratio in which the Premium should be allocated in the Funds specified by close the Unit Account and the value of Units in the Discontinuance Policy
You on the Date of Commencement of Risk or last Premium redirection date, Fund on the date of death of Life Insured shall be paid to the Claimant.
if any, whichever is later, will be used to purchase Units at the Unit Price as 2.2. Surrender after the completion of the Lock in Period
on the date of revival. If You surrender the Policy after the completion of the Lock in Period, We shall
i. An amount equal to the Policy Administration Charge falling due between close the Unit Account and pay the Surrender Value which is equal to the Fund
the Date of Discontinuance and the date of revival will be levied on revival Value prevailing on the date of receipt of a valid request for surrender.
by cancelling Units in the Unit Account at their Unit Price. 2.3. No guaranteed Surrender Value is applicable under this Policy.
j. In case the Life Insured dies during the period of Discontinuance, We shall 3. LOANS
pay the Fund Value as on the date of death and any Discontinuance/Surrender You are not entitled to loans under the Policy.
Charge deducted by Us shall be added back to the Fund Value in case the 4. PREMIUM REDIRECTION
Policyholder has exercised the option to revive the Policy. 4.1. You may redirect the Premium between available Funds by giving Us written
k. During the period of Discontinuance, You shall not be allowed to exercise notice before Premium due date. We will redirect the Premiums, provided
switches or partial withdrawals. the amount/ proportion of Premium to be paid into each Fund at the time of
1.2. Discontinuance of Payment of Premium after the Lock in Period redirection is specified by You in such request.
a. If the Premium is not received in full by the expiry of the Grace Period, 4.2. We will not permit more than 6 (Six) Premium redirections in any Policy Year.
the Policy shall be immediately and automatically converted into a Paid-up 5. SWITCH
Policy. On such Discontinuance, We will, within 3 (Three) months of the 5.1. You may switch Units from one Fund to another Fund by giving Us a written
first unpaid Premium, give a written notice to You informing the status of the request. We will cancel Units from the Fund from which You wish to switch out
Policy and provide You the option to exercise one of the following options and purchase Units in the Fund in which You have chosen to reinvest, provided
in writing : that the minimum amount to be switched is at least Rs. 5,000 (Rupees Five
1. revive the Policy within the Revival Period; Thousand).
2. complete withdrawal (surrender) of the Policy without any risk cover; 5.2. You may switch any number of times without any charges.
b. If the complete withdrawal option is exercised by You, the provisions 5.3. We may, in Our discretion and with the prior approval of the IRDAI, impose a
relating to surrender of the Policy after the Lock in Period as per Clause 2 partial or complete ban on switches for a period not exceeding 30 (Thirty) days,
of Part D will be applicable. if in Our view it is appropriate in order to maintain the stability of a Fund or if it is
c. In the event that You opt to revive the Policy but do not revive the Policy necessary to protect the interests of the policyholders. This ban may be imposed
during the Revival Period, We will pay the Fund Value to You at the end of under extraordinary circumstances such as non-availability of market prices or
the Revival Period. the occurrence of any catastrophe where the declaration of the Unit Price is not
d. If You do not exercise any of the above options, the Policy will continue to possible.
be a Paid-up Policy and at the end of the Revival Period, We will pay the 5.4. Switches will not be allowed during the period of Discontinuance.
Fund Value to You, and terminate the Policy. 5.5. You will be allowed to switch during the settlement period.
e. During the Revival Period, the risk cover under a Paid-up Policy shall be 6. PARTIAL WITHDRAWALS
restricted to the Paid-up Sum Assured and all applicable Charges i.e. Policy 6.1. You may make a partial withdrawal by giving Us a written request. We will allow
Administration Charge, Mortality Charge and Fund Management Charge partial withdrawal, which will be effected by cancelling Units, provided that:
will continue to be levied. During this period, the rider cover, if any, will 6.1.1. The amount to be withdrawn is at least Rs. 5,000 (Rupees Five Thousand);
cease. 6.1.2. Partial withdrawals are allowed only if the Life Insured is at least 18 years
f. If You have chosen in writing the option to revive the Policy within the of age at the date of request.
Revival Period, You may exercise any of the following options in writing 6.1.3. You may make a maximum of 12 (Twelve) partial withdrawals in a Policy
during the Revival Period: Year such that the total Fund Value withdrawn is not more than 25%
(Twenty Five percent) of the Fund Value as on the date of the partial
withdrawal(s) and subject to the Fund Value immediately after the partial
withdrawal(s) being at least equal to one Annualised Premium and 25%
(Twenty-Five percent) in case of Single Premium, as applicable;

11 of 33
 6.1.4. You shall not be allowed to make any partial withdrawal before the PART E
commencement of the 6th (Sixth) Policy Year; and 1. FUNDS
6.1.5. The Sum Assured shall be reduced by all partial withdrawals made with 1.1. The Funds currently available for investment under this Policy and the
respect to the Fund Value from the base Premium during the 2 (Two) investment objectives of each Fund are as below.
Policy Years immediately preceding the Life Insured's death. Risk
6.2. We may, in Our discretion and with the prior approval of the IRDAI, impose Name of the fund Investment objectives Investment mix
Rating
a partial or complete ban on partial withdrawals for a period not exceeding 30 High Growth Fund
(Thirty) days, if in Our view it is appropriate in order to maintain the stability is a multi-cap fund
of a Fund or if it is necessary to protect the interests of the policyholders. This with a focus on mid
ban may be imposed under extraordinary circumstances such as non-availability cap equities, where
of market prices or the occurrence of any catastrophe where the declaration of predominant investments
the Unit Price is not possible. are equities of companies Government
7. TERMINATION with high growth Securities:0-30%
The Policy shall terminate upon happening of the earliest of the following events: potential in the long term Corporate
7.1. on the date on which We receive a valid Free Look cancellation request from High Growth
(to target high growth bonds:0-30%
You; Fund
in capital value assets). Money Very
7.2. on payment of death benefit as per Clause 2.1 of Part C or on the date of SFIN:
At least 70% of the market & cash High
intimation of repudiation of the claim in accordance with the provisions of the ULIF01311/02/08
Fund corpus is invested instruments:0-
Policy; LIFEHIGHGR104
in equities at all times. 30%
7.3. on the date of surrender of the Policy after the Lock in Period; However, the remaining Equities:
7.4. on the Maturity Date, except in cases where settlement option has been is invested in government 70-100%
exercised; securities, corporate
7.5. upon the Fund Value becoming equal to or less than zero in accordance with bonds and money market
Clause 6 of Part E; instruments; hence the
7.6. in case You have chosen the settlement option, on receipt of Your request for risk involved is relatively
complete withdrawal during settlement period or on the expiry of the settlement higher.
period chosen by You.
The investment objective
8. UPON DEATH OF POLICYHOLDER AND CHANGE IN POLICYHOLDER
of the fund is to invest
8.1. If You and the Life Insured are different then, upon Your death, no benefits shall
at least 70% of the fund
become payable under the Policy. Your legal heirs may continue by paying the
corpus in a diversified
due Premiums to Us and by submitting the requisite documents as specified by Government
basket of equity
Us and subject to other conditions prescribed by Us from time to time. Securities:0-20%
stocks over the entire
8.2. You may request Us to make the Life Insured, the Policyholder under the Diversified Equity Corporate
market capitalisation
Policy by giving Us prior written notice provided that the Life Insured shall not Fund Bonds:0-20%
range, primarily focusing
become the Policyholder unless the Life Insured meets all our eligibility criteria SFIN: Money market & High
on large and mid-cap
in accordance with Our guidelines and policies and We have issued a written ULIF02201/01/20 cash instruments:
companies covering a
endorsement under the Policy confirming the change in Policyholder. LIFEDIVEQF104 0-30%
wide variety of
8.3. From the date of Our written endorsement confirming the Life Insured as the Equities:
sectors to provide
Policyholder, You shall automatically cease to have any rights, benefits or 70-100%
investors with long term
obligations under the Policy and all rights, benefits and obligations shall vest
growth opportunities
entirely with the Life Insured.
while ensuring liquidity
9. FREELOOK CANCELLATION
of investments.
"Free Look" means a period of fifteen (15) days, or thirty (30) days (for policies
This is primarily an
obtained through distance marketing modes) from the date of receipt of the Policy, Government
equity oriented fund. At
to review the terms and conditions of the Policy, where if You disagree with any Securities: 0-20%
least 70% of the fund
of those terms and conditions, You have the option to return the Policy stating the Growth Super Corporate
corpus is invested in
reasons for objection. Upon return, the Policy will terminate forthwith and all rights, Fund bonds:0-20%
equities at all times. The
benefits and interests under the Policy will cease immediately. You shall be entitled SFIN: Money Market & High
remaining is invested in
to an amount which will be equal to non-allocated Premium plus charges levied ULIF01108/02/07 Cash Instruments:
debt instruments across
by cancellation of Units plus Fund Value at the date of cancellation less Mortality LIFEGRWSUP104 0-30%
Government, corporate
Charge (including applicable GST) for the period of cover, rider charges, if applicable, Equities:
and money market
(including applicable GST), expenses incurred on medical examination of the Life 70-100%
papers.
Insured, if any, and stamp duty.
10. SETTLEMENT OPTION This fund invests in
10.1. You may opt to exercise the settlement option by giving a written request to various asset classes such
Us at least 15 (Fifteen) days before the Maturity Date. On Our acceptance of as Equities, Government
Your request for the settlement option: Securities, Corporate
Government
i. You will receive the value of Units, as per the prevailing NAV, in periodic Bonds and Money
Securities: 0-30%
instalments as may be chosen by You (i.e. annually, semi-annually, Market Instruments. The
Corporate
quarterly or monthly) for a maximum period of 5 (Five) years from the Growth Fund equities exposure in the
bonds:0-30%
Maturity Date. We will pay the first instalment under the settlement option SFIN: Fund will at all times be
Money High
on the Maturity Date. Under the settlement option, the Units payable ULIF00125/06/04 at a minimum of 20%
market & cash
towards each installment will be equal to the number of Units available LIFEGROWTH104) but not more than 70%.
instruments:0-
before payment of the installment divided by the number of remaining The fund invests the
40%
installments. remaining fund corpus in
Equities: 20-70%
ii. Your written request to apply for the settlement option shall specify the debt instruments across
proposed duration for payment and the frequency of payment of each Government, corporate
instalment; and money market
iii. During the period when the settlement option is in force: papers.
a. the Policy will continue after the Maturity Date as given below; This fund invests
b. We will only deduct the applicable Fund Management Charge, primarily in debt
switching charges (if any) and Mortality Charge; instruments such as
c. You shall not be permitted to make any partial withdrawals Government Securities,
d. You may switch Units between the Funds upon which applicable Corporate Bonds, Money Government
switching charges will be deducted; and Market Instruments Securities:20-
e. You shall continue to bear all inherent risks in the investment portfolio. etc. issued primarily 50%
Balanced Fund
10.2. During the settlement period, if You wish to opt for complete withdrawal by by Government of Corporate
SFIN:
giving a written notice to Us, We shall pay the Fund Value prevailing on the India/State Governments bonds:20-40% Medium
ULIF00225/06/04
date of receipt of such notice and terminate the Policy; and and to some extent Money market &
LIFEBALANC104
10.3. If Life Insured dies when the settlement option is in force, We will pay the in Corporate Bonds Cash instruments:
Fund Value prevailing as on the date of death of the Life Insured minus any and Money Market 0-40%
instalments paid between the date of death and date of intimation of death, Instruments. The fund Equities: 10-40%
subject to a minimum of 105% of total Premiums received and terminate the invests minimum of 10%
Policy. and up to maximum of
40% of fund corpus in
equities.
This fund invests Government
Conservative
primarily in debt Securities:50- Low
Fund
instruments such as 80%

12 of 33
 Government securities, Discontinuance Policy
corporate bonds, money Fund over and above
market instruments etc. the minimum guaranteed
Corporate
issued primarily by interest rate shall also
bonds:0-50%
Government of India be apportioned to the
SFIN: Money market
/ State Governments Discontinuance Policy
ULIF00325/06/04 & Cash
and to some extent Fund and shall not be
LIFECONSER104 instruments:0-
in corporate bonds made available to Our
40%
and money market shareholders.
Equities: 0-15%
instruments. The fund
invests up to 15% of fund *Cannot be chosen as a part of any of the investment strategies mentioned below
corpus in equities. and is only applicable in case the policy is discontinued.
The investment objective 1.2. We may add, close, combine or modify any Fund with the prior approval of the
of the fund is to IRDAI. We will send You prior written notice of at least 60 (Sixty) days of Our
generate superior returns intention to add, close, combine or modify any Fund.
Government
by investing in high 1.3. Although the Funds are open ended, We may, subject to prior approval from the
Securities And
Dynamic Bond quality debt instruments IRDAI, completely close any of the Funds on the happening of any event, which
Corporate
Fund including Government in Our sole discretion requires the said Fund to be closed. In case of complete
bonds:60-100%
SFIN: securities, corporate Low closure of a Fund, on and from the date of such closure, We shall cease to issue
Money market &
ULIF02401/01/20 bonds and money market and cancel units of the said Fund and cease to carry on activities in respect of
cash instruments:
LIFEDYNBOF104 instruments with an the said Fund, except such acts as are required to complete the closure. We shall
0-40%
objective to maximize send a prior written notice to You, at least 60 (Sixty) days prior informing You
Equities: 0%
returns keeping in mind about Our intention to close any Fund except in Force Majeure Event, where We
safety and liquidity of the may give a shorter notice. During such notice period, You shall be allowed to
portfolio. switch to any other available fund in the product and no switching charges shall
This fund invests in be levied. In such event, the Units are not switched to another Fund by You, We
debt instruments such as will switch the said Units in that Fund and apply any future Premiums which
Government securities, would have been applied to that Fund, to any other appropriate Fund with similar
Government characteristics and closest investment objectives to the original Fund, subject to
corporate bonds, money
Securities:50- prior approval from the IRDAI. Such switch shall be done without any switching
market instruments etc.
Secure Fund 100% charges being levied.
issued primarily by
SFIN: Corporate 2. INVESTMENT STRATEGIES
Government of
ULIF00425/06/04 Bonds:0-50% Low You shall have the option to choose only one investment strategy from the following
India/State
LIFESECURE104 Money Market five available investment strategies, there is no extra cost applicable for any of the
Governments, corporate
& Cash available strategies chosen by You.
and banks. The fund also
Instruments:0-40 Please note that if You have chosen 'Self-Managed Portfolio Strategy' at inception then
invests in money market
Equities: 0% You cannot switch to any other investment strategy as all other investment strategies
instruments as prescribed
by IRDA. No investment are available at inception only.
is made in equities. From the other four investment strategies You can switch to 'Self-Managed Portfolio
The investment objective Strategy' only.
of the Fund is 2.1. SELF-MANAGED PORTFOLIO STRATEGY
to provide higher 2.1.1. You will have an option to choose the allocation into and out of any
security of investment of the Funds mentioned in the table in Clause 1.1 of Part E above,
by way of higher except Secure Plus fund (SFIN: ULIF01628/04/09LIFESECPLS104) and
proportion of investment Discontinuance Policy Fund (SFIN: ULIF02021/06/13LIFEDISCON104)
in sovereign papers as mentioned above.
Secure Plus Fund that carry an implicit 2.1.2. Switching and premium redirection facility can be availed anytime under
SFIN: guarantee for repayment this strategy.
ULIF01628/04/09 of principal and Government 2.2. SYSTEMATIC TRANSFER PLAN
LIFESECPLS104 interest from the securities: 2.2.1. You may opt to exercise the systematic transfer plan only prior to the Date
Government of India. 60-100% of Commencement of Risk where You have opted for Single Premium or
(This Fund is This Fund invests in Corporate annual mode for Premium payment; and
available only debt instruments such as bonds:0-40% Low 2.2.2. If the systematic transfer plan is in force, then We will automatically
under 'Systematic Government Securities, Money market & allocate the Premiums received (after deducting Premium Allocation
Transfer Plan', Corporate Bonds, Money cash instruments: Charge and applicable taxes, cesses and levies) to purchase Units in
'Lifecycle Based Market Instruments etc. 0-40% the Secure Plus Fund at the applicable NAV at that time. Immediately
Portfolio Strategy issued primarily by Equities: 0% thereafter and on each subsequent Monthly Anniversary, the Fund Value
and Trigger Based Government of of the Units available in Secure Plus Fund will be systematically
Portfolio Strategy') India/State transferred to the Growth Super Fund (as per the below formula) by
Governments, Corporate cancelling Units in the Secure Plus Fund, and purchasing Units in the
and banks. The Fund Growth Super Fund on the applicable NAV at that time till the availability
also invests in money of Units in Secure Plus Fund as per the below formula:
market instruments as
prescribed by IRDAI. No [1/(13 less month number in the Policy Year)]
investment is made in
equities. For example:
Policy month 1: 1/(13-1) = 1/12th of the Units to be switched
The investment objective
Government Policy month 2: 1/(13-2) = 1/11th of the Units to be switched
of the fund is to deliver
securities: 0% Policy month 11: 1/(13-11) = 1/2 of the Units to be switched
Money Market II returns linked to Money
Corporate bonds: Policy month 12: 1/(13-12) = balance Units to be switched
Fund Market levels through a
0%
SFIN: portfolio with minimal Low
Money market & 2.2.3. You shall not be permitted to make partial withdrawals from the Secure
ULIF02301/01/20 interest rate and credit
cash instruments: Plus Fund during the period when this option is in force.
LIFEMONMK2104 risk so as to provide a
100% 2.2.4. You shall not be allowed to redirect Premiums and effect switching of
high level of safety of
Equities: 0% Units during the period when 'Systematic Transfer Plan' is in force.
capital.
2.2.5. You may opt out of the systematic transfer plan option anytime by giving
The minimum
Us a prior written request in which case the systematic transfer plan will
guaranteed interest rate Government
cease to be effective from the subsequent Policy Anniversary upon which
on this Fund is 4.0% securities: 60% to
You will automatically be transferred to 'Self-Managed Portfolio Strategy'
(Four percent) per annum 100%
*Discontinuance with choice of Your funds. Once You opt out of Systematic Transfer Plan,
(or as mandated by Corporate bonds:
Policy Fund You may not opt for 'Systematic Transfer Plan' during the Policy Term.
the IRDAI from time 0%
SFIN: Low 2.2.6. For Single Premium variant, systematic transfer plan is applicable only for
to time). The Fund Money
ULIF02021/06/13 the first year and thereafter the Fund will remain invested in Growth Super
Management Charge market & cash
LIFEDISCON104 Fund unless switched by You.
for the Discontinuance instruments:0-
2.2.7. In case of revival of the Policy, the Premium received and the Fund Value
Policy Fund is 0.5% 40%
in Discontinuance Policy Fund, if any, shall be allocated in Growth Super
per annum. The excess Equities: 0%
Fund. Upon receipt of next Premium, Systematic Transfer Plan will be
income earned in the
applicable as stated hereinabove.

13 of 33
2.3. LIFECYCLE PORTFOLIO STRATEGY available options as described below, however, once chosen, the Fund
2.3.1. You may opt to exercise the 'Lifecycle Portfolio Strategy' option only options cannot be changed throughout the Policy Term.
prior to the Date of Commencement of Risk. If this investment strategy 2.4.2. This trigger event is defined as an upward movement of x% in NAV of
is in force, the investments will be distributed between fund 1 and fund fund 1, since the previous rebalancing. For determining the first trigger
2 with their proportions varying as per the different life stages. Fund 1 event, the movement of x% in NAV of Fund 1 will be measured vis-a-vis
would essentially be an equity oriented fund whereas fund 2 would be a the NAV at the inception of the strategy in the Policy; where 'x' can be
debt oriented fund. You may choose fund 1 and fund 2 from the available 10% or 15% or 20% as may chosen by You. The trigger event once chosen,
options as described below. Once chosen, the Fund cannot be changed cannot be changed during the Policy Term. On the occurrence of the trigger
throughout Policy Term. event, any Fund Value of Fund 1 which is in excess of three times the
Fund Value of Fund 2 is considered as gains and is switched to the Fund
Fund options for fund 1: 2. Such rebalancing ensures that gains are capitalized and protected from
a. Diversified Equity Fund (SFIN: ULIF02201/01/20LIFEDIVEQF104) future equity market fluctuations, while maintaining the asset allocation
b. Growth Super Fund (SFIN: ULIF01108/02/07LIFEGRWSUP104) between Fund 1 and Fund 2 in the proportion of 75%:25%. Fund 1 would
c. Growth Fund (SFIN: ULIF00125/06/04LIFEGROWTH104) essentially be an equity oriented fund whereas fund 2 would be a debt
oriented fund. You may choose Fund 1 and Fund 2 from the available
Fund options for fund 2: options as described below, however, once chosen, the fund options cannot
a. Conservative Fund (SFIN: ULIF00325/06/04LIFECONSER104) be changed throughout the Policy Term.
b. Secure Fund (SFIN: ULIF00425/06/04LIFESECURE104)
c. Secure Plus Fund (SFIN: ULIF01628/04/09LIFESECPLS104) Fund options for fund 1:
• Diversified Equity Fund (SFIN: ULIF02201/01/20LIFEDIVEQF104)
2.3.2. At the inception, the Premium (reduced by the Premium Allocation Charge • Growth Super Fund (SFIN: ULIF01108/02/07LIFEGRWSUP104)
and applicable taxes, cesses and levies) will be distributed between the two • Growth Fund (SFIN: ULIF00125/06/04LIFEGROWTH104)
Funds as opted by you based on Age of the Life Insured. Thereafter, as
per the Age of the Life Insured (as reckoned on each Policy Anniversary),
Fund options for fund 2:
on attainment of next Age band as per the table below, the Funds will be
• Conservative Fund (SFIN: ULIF00325/06/04LIFECONSER104)
re-distributed accordingly:
• Secure Fund (SFIN: ULIF00425/06/04LIFESECURE104)
Age last birthday Proportion in Fund 1 Proportion in Fund 2 • Secure Plus Fund (SFIN: ULIF01628/04/09LIFESECPLS104)
Up to 25 85% 15%
26-30 80% 20%
2.4.3. On the occurrence of the trigger event, any Fund Value of fund 1 which is
31-35 75% 25% in excess of three times the Fund Value of fund 2 is switched to the fund 2.
36-40 70% 30% 2.4.4. You may opt out of the strategy option during the Policy Term by giving
41-45 65% 35% Us a prior written request, in which case this option will cease to be
46-50 50% 50% effective from the subsequent Policy Anniversary upon which You will
51-55 35% 65% automatically be transferred to 'Self-Managed Portfolio Strategy' with
56 and above 30% 70% choice of Your funds. Once You have opted out, You cannot opt for this
strategy again during the Policy Term.
2.4.5. No switches or Premium redirections would be allowed under this strategy.
2.3.3. On an annual basis (i.e. every Policy Anniversary), the Fund Value shall
2.4.6. If Premium is received on any date later than Premium due date or other
be rebalanced, if necessary, to achieve above proportions even if there
than Policy Anniversary but before the expiry of Grace Period, it shall be
is no change in the Age band. The rebalancing will be done on each
allocated into the two chosen funds Fund 1 and Fund 2 in a 75%: 25%
Policy Anniversary except for the last year Policy Anniversary i.e. (Policy
proportion.
Term-1)th year.
2.4.7. In case You opt for a partial withdrawal, withdrawal will happen from all
2.3.4. In the last year of the Policy Term, the remaining investments from Fund
underlying funds in the same proportion as the total Fund Value at that
1 will be systematically transferred to Fund 2, in 12 installments to obtain
time. You will not have any choice to opt for the Fund from which the
fund conservation towards maturity. Units in the fund 1 will be transferred
partial withdrawal of Units is to be done.
to Fund 2 on each subsequent monthly anniversary, by cancelling the Units
2.4.8. At the time of revival of the Policy, the Premium(s) received and the Fund
in Fund 1 and purchasing the Units in Fund 2 (based on the applicable
Value in Discontinuance Policy Fund, if any, will be allocated into the two
NAV at that time) and this shall continue till the availability of units in
chosen Funds - Fund 1 and Fund 2- in a 75%: 25% proportion.
Fund 1, as per the below formula:
2.5. DYNAMIC FUND ALLOCATION
[1/(13 less month number in the Policy Year)] 2.5.1. You may opt to exercise the dynamic fund allocation option only prior
to the Date of Commencement of Risk. If this investment strategy is in
For instance: force, switching of the existing Fund Value shall happen on the Policy
In the last Policy Year of the Policy starting from 1st month: Anniversary and We will automatically allocate the Premium received
Policy Month 1: 1/(13-1)= 1/12th of the Units to be switched on the later of the date of receipt of the Premium or the due date of
Policy Month 2: 1/(13-2)= 1/11th of the Units to be switched Premium and switch Units in the Funds on each Policy Anniversary, in a
Policy Month 11: 1/(13-11)= 1/2 of the Units to be switched pre-determined proportion specified in the table below:
Policy Month 12: 1/(13-12)= Balance Units to be switched Policy Years to Proportion under Proportion under
the Maturity Date Growth Super Fund Secure Fund
2.3.5. If Premium is received on any date later than Premium due date or 16 and above 80% 20%
other than Policy Anniversary but before the expiry of Grace Period, it 11-15 60% 40%
shall be allocated in the same proportion as applicable as per last Policy 6-10 40% 60%
Anniversary.
0-5 20% 80%
2.3.6. You may opt out of this strategy option during the Policy Term by giving
Us a prior written request, in which case this option will cease to be
effective from the subsequent Policy Anniversary upon which You will 2.5.2. If Premium is received on any date later than premium due date or other
automatically be transferred to 'Self-Managed Portfolio Strategy' with than policy Anniversary but before the expiry of Grace Period, it shall be
choice of Your funds. Once You have opted out, You cannot opt for this allocated as per the proportion applicable on the last Policy Anniversary.
strategy again during the Policy Term. 2.5.3. You shall not be permitted to make Premium redirections or switch Units
2.3.7. No switches or premium redirections would be allowed under this strategy. between the Funds during the period when this option is in force.
2.3.8. In case You opt for a partial withdrawal, withdrawal will happen from all 2.5.4. In case You opt for a partial withdrawal, withdrawal will happen from all
underlying funds in the same proportion as the total Fund Value. You will underlying Funds in the same proportion as the total Fund Value at that
not have any choice to opt for any specific Fund from which the partial time. You will not have any choice to opt for the Fund from which the
withdrawal of Units is to be done. partial withdrawal of Units is to be done.
2.3.9. In case of the Revival of the Policy, the Premium received and the 2.5.5. You may opt out of the strategy option during the Policy Term by giving
Fund Value in Discontinuance Policy Fund, if any, will be allocated Us a prior written request, in which case this option will cease to be
in the proportion applicable, in Fund 1 and Fund 2, on the last Policy effective from the subsequent Policy Anniversary upon which You will
Anniversary. automatically be transferred to 'Self-Managed Portfolio Strategy' with
2.4. TRIGGER BASED PORTFOLIO STRATEGY choice of Your funds. Once You have opted out, You shall not be permitted
2.4.1. You may opt to exercise the trigger based portfolio strategy option only to recommence the strategy during the Policy Term.
prior to the Date of Commencement of Risk. If this investment strategy 2.5.6. In case of revival of the Policy, the Premium received and the Fund Value
is in force, any Premium received will be initially allocated between in Discontinuance Policy Fund, if any, will be allocated in the proportion
fund 1 and fund 2 in a 75%: 25% proportion. The Fund allocation may as per the Age of the Life Insured as on the last Policy Anniversary.
subsequently fluctuate due to market movements. In such case, Your 3. ALLOCATION OF PREMIUM
portfolio will be re-balanced and the funds would be re-allocated based We will allocate the Premium on the later of the date of receipt of the Premium or
on a pre-defined trigger event which would be checked at every Monthly the Premium due date, as the case may be, to the Funds chosen by You and in the
Anniversary of the Policy. You may choose fund 1 and fund 2 from the allocation proportion specified in the Schedule (or as modified from time to time) after
deduction of the Premium Allocation Charge, if any.

14 of 33
4. UNITS & UNIT PRICE 5.1.3. Policy Administration Charge: This charge is levied for
4.1. We will initially open a Unit Account as on the Date of Commencement of Risk. administration of this Policy starting from the Date of Commencement
4.2. Units will be purchased and cancelled at the Unit Price/NAV. The number of of Risk and on each Monthly Anniversary by cancelling an appropriate
Units shall be expressed up to 3 (Three) decimal places. number of Units in the Unit Account at the prevailing NAV. The Policy
4.3. Units will be cancelled from the Unit Account for recovering applicable charges Administration Charge is as follows:
and for payment of benefit amounts and other amounts which are payable from POLICY ADMINISTRATION
the Fund Value. Premium Payment Mode/ CHARGE
4.4. The underlying assets in all Funds belong to Us. Units are purely notional and Premium Frequency (as a % of the Single Premium/
are only for the purpose of determining the charges recoverable and amounts Annualised Premium)
payable under the Policy. Neither the Units nor the Unit Account gives rise or 0.10% per month increasing at 5%
shall be deemed to give rise to any legal or beneficial ownership or right to You, p.a. (compounded annually) from 13th
the Life Insured, Nominee or the Claimant in either the assets to which the Funds Single Premium
month onwards for first 10 Policy
are referenced or the income from those assets or any surpluses in any Funds or Years.
in Our profits or assets. 0.20% per month increasing at 5%
4.5. The price of a Unit shall be calculated as per the following formula: Annual mode for
p.a. (compounded annually) from 13th
"Market value of investments held by the segregated fund plus value of Limited Premium and
month onwards for first 10 Policy
current assets minus (value of current liabilities and provisions, if any) Regular Premium
Years.
divided by number of Units on Valuation Date (before creation/redemption
Mode other than Annual
of Units)." 0.12% per month increasing at 5%
mode for Limited
4.6. The NAV shall be determined on each Valuation Date. The NAV in respect of p.a. (compounded annually)from 13th
Premium and Regular
each Fund will be determined by dividing the value of the Fund with the number month onwards for first 10 Policy Years
Premium
of Units on the Valuation Date subject to rounding up or down by not more than
1% (One percent) of a Rupee.
4.7. You can, through a secured login, access the value of Policy wise Units held by From Policy Year 11 onwards, Policy Administration Charge is equal
you and Fund wise NAV on Our website 4.8 Unit Encashment. to zero.
4.8. Unit Encashment
4.8.1. For Premium received by a local cheque or a demand draft payable at 5.1.4. Rider Charge: Nil
par at the place where Premium is received, in cash, before 3:00 p.m. on 5.1.5. Switch Charge: Nil
a Business Day, the closing NAV of the day on which the Premium is 5.1.6. Partial Withdrawal Charge: Nil
received by Us shall be applicable. 5.1.7. Premium Redirection Charge: Nil
4.8.2. For Premium received by a local cheque or a demand draft payable at 5.1.8. Alteration Charge: No charge is applicable for any alteration in
par at the place where the Premium is received, in cash, after 3:00 p.m. Premium Paying Term or Policy Term.
on a Business Day, the closing NAV of the next Business Day shall be 5.1.9. Miscellaneous charge: Nil
applicable. 5.1.10. Mortality Charge: The Mortality Charge shall be levied in accordance
4.8.3. For Premium received through an outstation cheque/demand draft, the with the table specified below:
closing NAV of the Business Day on which such cheque/demand draft is
realized shall be applicable Mortality Charge per 1000 Sum at Risk
4.8.4. For valid requests for maturity, switching, partial withdrawal, redirection (excluding GST &extra mortality charge)
or surrender received up to 3.00 p.m. on a Business Day, the closing NAV Attained Males Females Attained Males Females
of the same day shall be applicable. Age Age
4.8.5. For valid requests for maturity, switching, partial withdrawal, redirection 0 0.82 0.66 59 9.35 7.39
or surrender received after 3.00 p.m. on a Business Day or in case of any 1 0.82 0.66 60 10.05 8.03
request received on a day which is not a Business Day, the closing NAV 2 0.82 0.66 61 10.77 8.69
of the next Business Day shall be applicable.
3 0.42 0.34 62 11.55 9.35
4.8.6. For all transactions including death benefit or maturity benefit payments
that arise on a day which is not a Business Day, the closing NAV of the 4 0.24 0.20 63 12.39 10.05
next Business Day shall be applicable. 5 0.17 0.13 64 13.31 10.77
5. CHARGES 6 0.14 0.11 65 14.34 11.55
5.1. The following charges shall be levied by Us under this Policy during the Policy 7 0.13 0.11 66 15.49 12.39
Term: 8 0.15 0.12 67 16.77 13.31
5.1.1. Premium Allocation Charge: This Charge is calculated as a 9 0.19 0.14 68 18.22 14.34
percentage of the Premiums payable and shall be deducted from the 10 0.24 0.13 69 19.84 15.49
Premium received before the same are allocated to the Unit Account.
11 0.31 0.15 70 21.65 16.77
The Premium Allocation Charge is as follows:
12 0.39 0.19 71 23.68 18.22
For Policies where the Premium payment mode is other than Single
Premium: 13 0.47 0.24 72 25.95 19.84
PREMIUM 14 0.55 0.31 73 28.47 21.65
POLICY 15 0.63 0.39 74 31.28 23.68
ALLOCATION CHARGE
YEAR 16 0.69 0.47 75 34.40 25.95
(as a % of the Premium)
1 6.0% 17 0.75 0.55 76 37.85 28.47
2 5.0% 18 0.79 0.63 77 41.68 31.28
3 4.5% 19 0.81 0.69 78 45.92 34.40
4-10 4.0% 20 0.83 0.75 79 50.61 37.85
11 onwards (if applicable) NIL 21 0.84 0.79 80 55.79 41.68
22 0.84 0.81 81 61.50 45.92
For Single Premium, Premium Allocation Charge is 4% (Four percent) 23 0.84 0.83 82 67.82 50.61
of the Single Premium paid to Us. 24 0.84 0.84 83 74.77 55.79
5.1.2. Fund Management Charge: Fund Management Charge shall be levied
25 0.84 0.84 84 82.44 61.50
at rates equal to the annual rate, as given below, levied by cancelling
Units from the Unit Account divided by 365 (Three Hundred Sixty Five) 26 0.84 0.84 85 90.88 67.82
and multiplied by the number of days that have elapsed since previous 27 0.84 0.84 86 100.16 74.77
Valuation Date: 28 0.85 0.84 87 110.35 82.44
ALLOCATION PROPORTION 29 0.86 0.84 88 121.53 90.88
FUND NAME (levied as a % per annum 30 0.88 0.84 89 133.78 100.16
of the Fund Value) 31 0.90 0.85 90 147.16 110.35
High Growth Fund 1.25% 32 0.94 0.86 91 161.75 121.53
Diversified Equity Fund 1.25% 33 0.98 0.88 92 177.64 133.78
Growth Super Fund 1.25% 34 1.03 0.90 93 194.89 147.16
Growth Fund 1.25% 35 1.08 0.94 94 213.57 161.75
Balanced Fund 1.10% 36 1.15 0.98 95 233.74 177.64
Conservative Fund 0.90% 37 1.22 1.03 96 255.43 194.89
Dynamic Bond Fund 0.90% 38 1.31 1.08 97 278.69 213.57
Secure Fund 0.90% 39 1.40 1.15 98 303.54 233.74
Secure Plus Fund 0.90% 40 1.51 1.22 99 329.97 255.43
Money Market II Fund 0.90% 41 1.63 1.31 100 357.96 278.69
42 1.77 1.40 101 387.48 303.54

15 of 33
 43 1.93 1.51 102 418.46 329.97 6. AUTOMATIC TERMINATION /FORECLOSURE OF THE POLICY
44 2.11 1.63 103 450.81 357.96 7.1. At any time during the Policy Term or the settlement period, when the Fund
45 2.32 1.77 104 484.45 387.48 Value becomes equal to or less than zero, the Policy will terminate even if all
46 2.57 1.93 105 519.25 418.46 due Premium(s) have been paid.
47 2.85 2.11
PART F
48 3.18 2.32 GENERAL TERMS & CONDITIONS
49 3.56 2.57 1. TAXES
50 3.99 2.85 1.1. All Premiums are subject to applicable taxes, cesses and levies which will
51 4.47 3.18 entirely be borne by You and will always be paid by You along with the Premium.
52 5.00 3.56 If any imposition (tax or otherwise) is levied by any statutory or administrative
53 5.56 3.99 body under the Policy, We reserve the right to claim the same from You by
54 6.15 4.47 cancelling the Units. Alternatively, We have the right to deduct the amount from
the benefits payable by Us under the Policy.
55 6.76 5.00
1.2. Tax benefits and liabilities under the Policy are subject to prevailing tax laws. Tax
56 7.39 5.56 laws and the benefits arising thereunder are subject to change. You are advised to
57 8.03 6.15 seek an opinion from Your tax advisor in relation to the tax benefits and liabilities
58 8.69 6.76 applicable to You.
2. RISK FACTORS
During the Policy Term and/ or settlement period, a proportionate You understand and agree that:
Mortality Charge shall be levied by Us on the basis of 'Sum at Risk' 2.1. "Max Life Insurance Company Limited" is the name of the insurance
on every Monthly Anniversary by cancelling an appropriate number company and Max Life Flexi Wealth Plus is a unit linked non participating
of Units from the Unit Account at the prevailing NAV. The mortality individual life insurance plan. Unit linked life insurance products are different
charge will be on an attained Age basis over the Policy Term/ settlement from traditional life insurance products and are subject to investment risks.
period, as the case may be. 2.2. Max Life Flexi Wealth Plus is only the name of the Policy and does not in any
way indicate the quality of the Policy, its future prospects or returns.
Please note that We may charge extra Mortality Charge from You 2.3. The names of the Funds do not in any manner indicate the quality of the Funds,
based on Our Underwriting Policy. their future prospects or returns.
2.4. We do not guarantee the Fund Value or Unit Price. Depending on market risk and
5.1.11. Discontinuance/Surrender Charge: This charge shall be levied on the performance of the Funds to which the Units are referenced, the Fund Value
the Discontinuance/ surrender of the Policy in accordance with the may fall, rise or remain unchanged and You are responsible for Your decisions.
following table: There can be no assurance that the objectives of any Fund will be achieved and
i. For Limited Premium or Regular Premium: none is given by Us.
2.5. the past performance of any Fund is not necessarily indicative of the future
Discontinuance Charge for the performance of any Funds.
Policies having Annualised Premium: 2.6. the Funds do not offer a guaranteed or assured return except in case of
Policy Up to Rs. 50,000/-, Above Rs. 50,000/-, Discontinuance Policy Fund which offers minimum guarantee of 4% (Four
Year are lower of are lower of percent) currently or as prescribed by IRDAI from time to time during the Lock
in which in Period.
As a As a Fixed As a As a Fixed
surrender perce- perce- amount perce- perce- amount 3. CLAIM PROCEDURE
/Discont- ntage ntage (in Rs.) ntage ntage (in Rs.) 3.1. For processing a claim request under the Policy, We will require all of the
inuance following documents:
of of of of
occurs Annual- Fund 3.1.1. Death claim documents:
Annual- Fund
a. Claimant's statement in the prescribed form;
ised Value ised Value
b. original Policy document;
Premium Premium
c. a copy of police complaint/ first information report (only in the case
1st Policy
20% 20% 3,000 6% 6% 6,000 of death by accident of the Life Insured);
Year
d. a copy of duly certified post mortem report (only in the case of death
2nd by accident of the Life Insured);
Policy 15% 15% 2,000 4% 4% 5,000 e. death certificate issued by the local/municipal authority (only in the
Year case of death of the Life Insured);
3rd Policy f. identity proofs of the Claimants bearing their photographs and
10% 10% 1,500 3% 3% 4,000
Year signatures (only in case of death of the Life Insured);
4th Policy g. Copy of Bank Passbook / Cancelled Cheque of the Claimant; and;
5% 5% 1,000 2% 2% 2,000
Year h. any other documents or information required by Us for assessing and
5th Policy Nil Nil Nil Nil Nil Nil approving the claim request.
Year 3.1.2. Maturity claim documents:
onwards a. NEFT Form (if not provided earlier)
b. a cancelled cheque or copy of passbook with pre-printed name and
ii. For Single Premium: bank account number, for payout through NEFT (if not provided
earlier)
Discontinuance Charge for c. a self-attested photo ID proof
the Single Premium Policy: 3.2. A Claimant can download the claim request documents from Our website
Policy [Link] or can obtain the same from any of Our branches.
Up to Rs. 3,00,000/- Above Rs. 3,00,000/-
Year 3.3. Subject to provisions of Section 45 of the Insurance Act 1938 as amended
, are lower of , are lower of
in which from time to time, We shall pay the benefits under the Policy subject to Our
surrender As a As a Fixed As a As a Fixed satisfaction:
/Discont- perce- perce- amount perce- perce- amount 3.3.1. that the benefits have become payable as per the terms and conditions of
inuance ntage ntage (in Rs.) ntage ntage (in Rs.) the Policy; and
occurs of of of of 3.3.2. of the bonafides and credentials of the Claimant.
Single Fund Single Fund 3.4. Subject to Our discretion and satisfaction, in exceptional circumstances such as
Premium Value Premium Value on happening of a Force Majeure Event, We may decide to waive all or any of
1st Policy the requirements set out in Section 3.1 of Part F.
2.00% 2.00% 3,000 1.00% 1.00% 6,000
Year 4. DECLARATION OF THE CORRECT AGE
2nd Declaration of the correct Age and/ or gender of the Life Insured is important for Our
Policy 1.50% 1.50% 2,000 0.70% 0.70% 5,000 underwriting process and calculation of Premiums payable under the Policy. If the Age
Year and/or gender declared in the Proposal Form is found to be incorrect at any time during
3rd Policy the Policy Term or at the time of claim, We may exercise Our rights under Section
1.00% 1.00% 1,500 0.50% 0.50% 4,000
Year 45 of the Insurance Act, 1938 or revise the Premium with interest and/or applicable
4th Policy benefits payable under the Policy in accordance with the Premium and benefits that
0.5% 0.5% 1,000 0.35% 0.35% 2,000 would have been payable, if the correct Age and/ or gender would have made the Life
Year
5th Policy Nil Nil Nil Nil Nil Nil Insured eligible to be covered under the Policy on the Date of Commencement of Risk.
Year 5. FRAUD, MISREPRESENTATION AND FORFEITURE
onwards Fraud, misrepresentation and forfeiture would be dealt with in accordance with
provisions of Section 45 of the Insurance Act, 1938 as amended from time to time.
5.1.12. Taxes: All Charges are subject to applicable taxes, cesses and levies, as [A leaflet containing the simplified version of the provisions of the above section is
may be applicable from time to time. enclosed in Annexure - (1) for reference]"

16 of 33
6. SUICIDE EXCLUSION PART-G
Notwithstanding anything stated herein, if the Life Insured commits suicide, whether GRIEVANCE REDRESSAL MECHANISM AND OMBUDSMAN DETAILS
sane or insane, within 12 (Twelve) months from the Date of Commencement of Risk 1. DISPUTE REDRESSAL PROCESS UNDER THE RIDER
or from the date of revival of the Policy, all risks and benefits under the Policy will 1.1. All consumer grievances and/or queries may be first addressed by the
immediately cease and no benefits will be payable. In such an event, We will terminate complainant to the agent or Our customer helpdesk as mentioned below:
the Policy by paying only the Fund Value prevailing on the date of intimation of the a. Max Life Insurance Company Limited, Plot No. 90A, Sector 18, Gurugram,
Life Insured to Claimant. For avoidance of any doubt, any charges other than Fund 122015, Haryana, India, Helpline No.- 1860 120 5577 or (0124) 4219090,
Management Charge recovered subsequent to the date of death of the Life Insured Email: [Link]@[Link], Or
shall be added back to the Fund Value as available on the date of intimation of death. b. Any office of Max Life Insurance Company Limited.
7. TRAVEL AND OCCUPATION 1.2 . If Our response is not satisfactory or there is no response within 15 (Fifteen) days:
There are no restrictions on travel or occupation under the Policy. 1.2.1. the complainant may file a written complaint with full details of the
8. NOMINATION complaint and the complainant's contact information to the following
Nomination is allowed as per Section 39 of the Insurance Act, 1938 as amended from official for resolution:
time to time. [A leaflet containing the simplified version of the provisions of the above Grievance Redressal Officer,
section is enclosed in Annexure - (2) for reference] Max Life Insurance Company Limited
9. ASSIGNMENT Plot No. 90A, Sector 18
Assignment is allowed as per Section 38 of the Insurance Act, 1938 as amended from Gurugram, 122015, Haryana, India
time to time. [A leaflet containing the simplified version of the provisions of the above Helpline No - 1860 120 5577 or (0124) 4219090
section is enclosed in Annexure - (3) for reference] Email - [Link]@[Link]
10. POLICY CURRENCY 1.2.2. the complainant may approach the Grievance Cell of the IRDAI on the
The Policy is denominated in Indian Rupees. Any benefit/claim payments under the following contact details:
Policy will be made in Indian Rupees by Us or in any other currency in accordance IRDAI Grievance Call Centre (IGCC)
with the applicable guidelines issued by the Reserve Bank of India from time to time. Toll Free No:155255 or 1800 4254 732
11. ELECTRONIC TRANSACTIONS Email ID: complaints@[Link]
You will comply with all the terms and conditions with respect to all transactions 1.2.3. the complainant can also register Your complaint online at
effected by or through facilities for conducting remote transactions including the [Link]
internet, world wide web, electronic data interchange, call centre, tele-service 1.2.4. the complainant can also register Your complaint through by submitting
operations or by other means of telecommunication established by Us or on Our Your complaint to:
behalf, for and in respect of the Policy or services, which will constitute legally binding Consumer Affairs Department
and valid transactions when executed in adherence to and in compliance with the terms Insurance Regulatory and Development Authority of India
and conditions for such facilities. Sy No. 115/1, Financial District,
12. AMENDMENT Nanakramguda,Gachibowli, Hyderabad - 500032
No amendments to the Policy will be effective, unless such amendments are expressly Ph: (040) 20204000
approved in writing by Us and/or by the IRDAI (wherever applicable). 1.3. If the complainant are not satisfied with the redressal or there is no response
13. REGULATORY AND JUDICIAL INTERVENTION within a period of 1 (One) month or within 1 year after rejection of complaint
If any competent regulatory body or judicial body imposes any condition on the Policy by Us, the complainant may approach Insurance Ombudsman at the address
for any reason, We are bound to follow the same which may include suspension of all mentioned in Annexure A, or on the IRDAI website [Link] or on
benefits and obligations under the Policy. Council of Insurance Ombudsmen website at [Link], if the grievance
14. FORCE MAJEURE pertains to:
14.1. We shall derive the NAV on each Business Day. However, We may do so less 1.3.1 delay in settlement of a claim beyond the time specified in the regulations,
frequently in case of a Force Majeure Event, where the value of the assets is framed under the Insurance Regulatory and Development Authority of
too uncertain. In such circumstances, We may defer the valuation of assets for India Act, 1999;
up to 30 days until we are certain that the valuation of Funds can be resumed. 1.3.2. any partial or total repudiation of a claim by Us;
In which case, We shall inform IRDAI of such deferment in the valuation. 1.3.3. disputes over Premium paid or payable in terms of the Policy; or
14.2. During the continuance of the Force Majeure events, all requests for servicing 1.3.4. misrepresentation of Policy terms and conditions at any time in the Policy
the Policy including Policy related payment shall be kept in abeyance. We shall document or Policy contract;
continue to invest as per the Fund mandates submitted with IRDAI. However, 1.3.5. legal construction of the Policy in so far as the dispute relates to claim;
We reserve Our right to change the exposure of all or any part of the Funds to 1.3.6 Policy servicing by Us, our agents or intermediaries;
Money Market Instruments [as defined under IRDAI (Investment) Regulations, 1.3.7. issuance of Policy, which is not in conformity with the proposal form
2016] in circumstances mentioned under above. The exposure of the Fund submitted by You;
as per the Fund mandates submitted with IRDAI, shall be reinstated within 1.3.8. non issuance of any insurance document after receipt of the Premium.
reasonable timelines once the Force Majeure Event ends. 1.3.9 Any other matter resulting from non-observance of or non-adherence to
14.3. Some of the examples of the Force Majeure Event circumstances as mentioned the provisions of any regulations made by the IRDAI with regard to
are: protection of policyholders' interests or otherwise, or of any circulars,
14.3.1. when one or more stock exchanges which provide a basis for valuation guidelines or instructions issued by the IRDAI or of the terms and
of the assets of the fund are closed otherwise than for ordinary conditions of the Policy contract, in so far as they relate to issues
holidays. mentioned in this para 1.3 above.
14.3.2. when, as a result of political, economic, monetary or any 1.4. As per Rule 14 of the Insurance Ombudsman Rules, 2017, a complaint to the
circumstances which are not in Our control, the disposal of the assets Insurance Ombudsman can be made only within a period of 1 (One) year after
of the fund would be detrimental to the interests of the continuing receipt of Our rejection of the representation or after receipt of Our decision
policyholders. which is not to the satisfaction or if We fail to furnish reply after expiry of a
14.3.3. in the event of natural calamities, strikes, war, civil unrest, riots and period of one month from the date of receipt of the written representation of the
bandhs. Complainant, provided the complaint is not on the same matter, for which any
14.3.4. in the event of any force majeure or disaster that affects Our normal proceedings before any court, or consumer forum or arbitrator is pending.
functioning.
14.4. In such an event, an intimation of Force Majeure Event shall be uploaded on
Our website for information.
15. COMMUNICATION AND NOTICES ENDORSEMENT
a) All notices meant for Us should be in writing and delivered to Our address as
mentioned in Part G or such other address as We may notify from time to time.
You should mention the correct Policy number in all communications including STAMP DUTY AMOUNT : `100
communications with respect to Premium remittances made by You.
b) 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 Paid by e-Stamps Certificate no. 175/Issue Date: 07-06-2022/Vide Treasury
(E-CHALLAN) GRN NO.91074706 for Rs. 50000000
may send You notices by post, courier, hand delivery 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. Failure in
timely notification of change of address could result in a delay in processing of
benefits payable under the Policy.
c) For any updates, please visit Our website [Link].
16. GOVERNING LAW AND JURISDICTION
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 R Krishnakumar
arising out of the Policy. Authorized Signatory
17. ISSUANCE OF DUPLICATE POLICY
You may request for a duplicate copy of the Policy to Us along with relevant
documents. Additional charges, not exceeding Rs.250/- may be applicable for
issuance of the duplicate Policy.

17 of 33
 Annexure 1
Section 45 - Policy shall not be called in question on the ground of mis-statement death, his nominee(s) shall be entitled to the proceeds and benefit of the policy. 17. The
after three years provisions of Section 39 are not applicable to any life insurance policy to which Section 6
Provisions regarding policy not being called into question in terms of Section 45 of the of Married Women's Property Act, 1874 applies or has at any time applied except where
Insurance Act, 1938, as amended from time to time are as follows: 1. No Policy of Life before or after Insurance Act, 1938 as amended from time to time, a nomination is made
Insurance shall be called in question on any ground whatsoever after expiry of 3 yrs from in favour of spouse or children or spouse and children whether or not on the face of the
a. the date of issuance of policy or b. the date of commencement of risk or [Link] date of policy it is mentioned that it is made under Section 39. Where nomination is intended
revival of policy or d. the date of rider to the policy, whichever is later. 2. On the ground to be made to spouse or children or spouse and children under Section 6 of MWP Act,
of fraud, a policy of Life Insurance may be called in question within 3 years from [Link] it should be specifically mentioned on the policy. In such a case only, the provisions of
date of issuance of policy or [Link] date of commencement of risk or [Link] date of revival of Section 39 will not apply.
policy or d. the date of rider to the policy, whichever is later. For this, the insurer should
communicate in writing to the insured or legal representative or nominee or assignees of [Disclaimer: This is only a simplified version prepared for general information. You are
insured, as applicable, mentioning the ground and materials on which such decision is advised to refer to the Insurance Act, 1938 as amended from time to time for complete
based. 3. Fraud means any of the following acts committed by insured or by his agent, with and accurate details.]
the intent to deceive the insurer or to induce the insurer to issue a life insurance policy: a. Annexure 3
The suggestion, as a fact of that which is not true and which the insured does not believe Section 38 - Assignment and Transfer of Insurance Policies
to be true;b. The active concealment of a fact by the insured having knowledge or belief Assignment or transfer of a policy should be in accordance with Section 38 of the
of the fact; [Link] other act fitted to deceive; and [Link] such act or omission as the law Insurance Act, 1938 as amended from time to time. The extant provisions in this regard are
specifically declares to be fraudulent. 4. Mere silence is not fraud unless, depending on as follows: [Link] policy may be transferred/assigned, wholly or in part, with or without
circumstances of the case, it is the duty of the insured or his agent keeping silence to speak consideration. 2. An Assignment may be effected in a policy by an endorsement upon
or silence is in itself equivalent to speak. 5. No Insurer shall repudiate a life insurance the policy itself or by a separate instrument under notice to the Insurer. 3. The instrument
policy on the ground of fraud, if the insured / beneficiary can prove that the misstatement of assignment should indicate the fact of transfer or assignment and the reasons for the
was true to the best of his knowledge and there was no deliberate intention to suppress the assignment or transfer, antecedents of the assignee and terms on which assignment is
fact or that such mis-statement of or suppression of material fact are within the knowledge made. 4. The assignment must be signed by the transferor or assignor or duly authorized
of the insurer. Onus of disproving is upon the policyholder, if alive, or beneficiaries. 6. agent and attested by at least one witness. 5. The transfer or assignment shall not be
Life insurance Policy can be called in question within 3 years on the ground that any operative as against an insurer until a notice in writing of the transfer or assignment and
statement of or suppression of a fact material to expectancy of life of the insured was either the said endorsement or instrument itself or copy there of certified to be correct
incorrectly made in the proposal or other document basis which policy was issued or by both transferor and transferee or their duly authorised agents have been delivered to
revived or rider issued. For this, the insurer should communicate in writing to the insured the insurer. 6. Fee to be paid for assignment or transfer can be specified by the Authority
or legal representative or nominee or assignees of insured, as applicable, mentioning the through Regulations. 7. On receipt of notice with fee, the insurer should Grant a written
ground and materials on which decision to repudiate the policy of life insurance is based.7. acknowledgement of receipt of notice. Such notice shall be conclusive evidence against
In case repudiation is on ground of mis-statement and not on fraud, the premium collected the insurer of duly receiving the notice. 8. If the insurer maintains one or more places
on policy till the date of repudiation shall be paid to the insured or legal representative or of business, such notices shall be delivered only at the place where the policy is being
nominee or assignees of insured, within a period of 90 days from the date of repudiation.8. serviced. 9. The insurer may accept or decline to act upon any transfer or assignment or
Fact shall not be considered material unless it has a direct bearing on the risk undertaken endorsement, if it has sufficient reasons to believe that it is a. not bonafide; b. not in the
by the insurer. The onus is on insurer to show that if the insurer had been aware of the interest of the policyholder; [Link] in public interest; or d. is for the purpose of trading
said fact, no life insurance policy would have been issued to the insured.9. The insurer of the insurance policy.10. Before refusing to act upon endorsement, the insurer should
can call for proof of age at any time if he is entitled to do so and no policy shall be deemed record the reasons in writing and communicate the same in writing to policyholder within
to be called in question merely because the terms of the policy are adjusted on subsequent 30 days from the date of policyholder giving a notice of transfer or assignment.11. In case
proof of age of life insured. So, this Section will not be applicable for questioning age or of refusal to act upon the endorsement by the insurer, any person aggrieved by the refusal
adjustment based on proof of age submitted subsequently. may prefer a claim to IRDAI within 30 days of receipt of the refusal letter from the insurer.
12. The priority of claims of persons interested in an insurance policy would depend on the
[Disclaimer: This is only a simplified version prepared for general information. You are date on which the notices of assignment or transfer is delivered to the insurer; where there
advised to refer to the Insurance Act, 1938 as amended from time to time for complete are more than one instruments of transfer or assignment, the priority will depend on dates
and accurate details.] of delivery of such notices. Any dispute in this regard as to priority should be referred to
Annexure 2 the Authority. 13. Every assignment or transfer shall be deemed to be absolute assignment
Section 39 - Nomination by Policyholder or transfer and the assignee or transferee shall be deemed to be absolute assignee or
Nomination of a life insurance policy is as below in accordance with Section 39 of transferee, except [Link] assignment or transfer is subject to terms and conditions of
the Insurance Act, 1938 as amended from time to time. The extant provisions in this transfer or assignment OR [Link] the transfer or assignment is made upon condition that
regard are as follows: [Link] policyholder of a life insurance policy on his own life may i. the proceeds under the policy shall become payable to policyholder or nominee(s) in
nominate a person or persons to whom money secured by the policy shall be paid in the the event of assignee or transferee dying before the insured; or ii. the insured surviving
event of his death. [Link] the nominee is a minor, the policyholder may appoint any the term of the policy. Such conditional assignee will not be entitled to obtain a loan on
person to receive the money secured by the policy in the event of policyholder's death policy or surrender the policy. This provision will prevail notwithstanding any law or
during the minority of the nominee. The manner of appointment is to be laid down by custom having force of law which is contrary to the above position.14. In other cases, the
the insurer. [Link] can be made at any time before the maturity of the policy. 4. insurer shall, subject to terms and conditions of assignment, recognize the transferee or
Nomination may be incorporated in the text of the policy itself or may be endorsed on assignee named in the notice as the absolute transferee or assignee and such persona shall
the policy communicated to the insurer and can be registered by the insurer in the records be subject to all liabilities and equities to which the transferor or assignor was subject to at
relating to the policy.5. Nomination can be cancelled or changed at any time before policy the date of transfer or assignment;[Link] institute any proceedings in relation to the policy;
matures, by an endorsement or a further endorsement or a will as the case may be. 6. A [Link] loan under the policy or surrender the policy without obtaining the consent
notice in writing of change or cancellation of nomination must be delivered to the insurer of the transferor or assignor or making him a party to the proceedings.15. Any rights and
for the insurer to be liable to such nominee. Otherwise, insurer will not be liable if a remedies of an assignee or transferee of a life insurance policy under an assignment or
bonafide payment is made to the person named in the text of the policy or in the registered transfer effected before commencement of the Insurance Laws (Amendment) Act, 2015
records of the insurer. 7. Fee to be paid to the insurer for registering change or cancellation shall not be affected by this section.
of a nomination can be specified by the Authority through Regulations. 8. On receipt of
notice with fee, the insurer should grant a written acknowledgement to the policyholder [Disclaimer: This is only a simplified version prepared for general information. You are
of having registered a nomination or cancellation or change thereof. 9. A transfer or advised to refer to the Insurance Act, 1938 as amended from time to time for complete
assignment made in accordance with Section 38 shall automatically cancel the nomination and accurate details.
except in case of assignment to the insurer or other transferee or assignee for purpose of
loan or against security or its reassignment after repayment. In such case, the nomination
will get affected to the extent of insurer's or transferee's or assignee's interest in the policy.
The 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 [Link]
or [Link] or [Link] or [Link] and [Link] 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 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 be payable to the heirs or legal representative of the nominee or holder
of succession certificate of such nominee(s). 15. The provisions of sub-section 7 and 8
(13 and 14 above) shall apply to all life insurance policies maturing for payment after the
commencement of Insurance Laws (Amendment) Act 2015. 16. If policyholder dies after
maturity but the proceeds and benefit of the policy has not been paid to him because of his

18 of 33
Annexure A: List of Insurance Ombudsman

AHMEDABAD - Office of the Insurance Ombudsman, 6th Floor, Jeevan Prakash Bldg, Tilak Marg, Relief Road,Ahmedabad-380
001. Tel.:- 079-25501201/02/05/06 Email: [Link]@[Link] (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.:- 080-26652049/26652048 Email: [Link]@[Link] (State of Karnataka)
BHOPAL - Office of the Insurance Ombudsman, 2nd Floor, Janak Vihar Complex, 6, Malviya Nagar, Opp. Airtel Office, Near New Market, Bhopal(M.P.)-462
003. Tel.: 0755 - 2769201 / 2769202 Email: [Link]@[Link] (States of Madhya Pradesh and Chhattisgarh)
BHUBANESHWAR - Office of the Insurance Ombudsman, 62, Forest park, Bhubneshwar - 751 009. Tel.: 0674 - 2596461 /2596455 Email:
[Link]@[Link] (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 - 2706468 / 2706196 Email: [Link]@[Link] [States of Punjab, Haryana (excluding 4 districts viz, Gurugram, Faridabad, Sonepat
and Bahadurgarh) Himachal Pradesh, Union Territories of Jammu & Kashmir, Ladakh and Chandigarh]
CHENNAI - Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, Chennai - 600 018. Tel.: 044
- 24333668/ 24335284 Email: [Link]@[Link] (State of Tamil Nadu, and Union Territories - Puducherry 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.:- 011-23232481/23213504 Email:
[Link]@[Link] (State of Delhi, 4 districts of Haryana viz, Gurugram, Faridabad, Sonepat and Bahadurgarh)
ERNAKULAM - Office of the Insurance Ombudsman, 2nd Floor, Pulinat Bldg., Opp. Cochin Shipyard, M. G. Road, Ernakulam - 682015. Tel.: 0484 - 2358759
/ 2359338 Email: [Link]@[Link] (States of Kerala and Union Territory of (a) Lakshadweep (b) Mahe - a part of Union Territory of
Puducherry)
GUWAHATI - Office of the Insurance Ombudsman, "Jeevan Nivesh", 5th Floor, Nr. Panbazar over bridge, S.S. Road, Guwahati-781
001(ASSAM) Tel.:- 0361-2632204/2602205 Email: [Link]@[Link] (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 - 23312122 Email: [Link]@[Link] (State of Andhra Pradesh, Telangana and Yanam and part of the Union
Territory of Pondicherry.)
JAIPUR - Office of the Insurance Ombudsman, Ground Floor, Jeevan Nidhi II Bldg, Bhawani Singh Marg, Jaipur - 302005 Tel.: 0141 - 2740363 Email:
[Link]@[Link] (State of Rajasthan)
KOLKATA - Office of the Insurance Ombudsman, Hindustan Building. Annexe, 7th Floor, 4, C.R. Avenue, Kolkata-700 072. Tel :
033-22124339/22124340 Email: [Link]@[Link] (States of West Bengal, Sikkim, and Union Territories of Andaman & Nicobar Islands)
LUCKNOW - Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-2, Nawal Kishore Road, Hazaratganj, Lucknow-226 001. Tel : 0522
-2231331/2231330 Email: [Link]@[Link] (Following Districts of Uttar Pradesh: Laitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot,
Allahabad, Mirzapur, Sonbhadra, 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 - 400054. Tel :
022- 69038821/23/24/25/26/27/28/29/30/31 Email: [Link]@[Link] (State of Goa and Mumbai Metropolitan Region excluding areas of Navi
Mumbai and Thane)
NOIDA - Office of the Insurance Ombudsman, 4th Floor, Bhagwan Sahai Palace,Main Road, Naya Bans, Sector-15, Distt: Gautam Buddh Nagar, U.P.
- 201301. Tel : 0120-2514252/2514253 Email: [Link]@[Link] (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, 2nd floor, North Wing, Lalit bhawan, Bailey Road, Patna - 800001 Tel : 0612-2547068 Email:
[Link]@[Link] (State of Bihar, Jharkhand.)
PUNE - Office of the Insurance Ombudsman,3rd Floor, Jeevan Darshan Bldg, C.T.S. No.s. 195 to 198, N.C. Kelkar Road, Narayan peth, Pune - 411030 Tel :
020-41312555 Email: [Link]@[Link] (State of Maharashtra including Navi Mumbai and Thane and excluding Mumbai Metropolitan Region.)

19 of 33
 MAX LIFE INSURANCE COMPANY LIMITED
Regd. Office : 419, Bhai Mohan Singh Nagar, Railmajra, Tehsil Balachaur,
District Nawanshahr, Punjab- 144533
Head Office: 11th & 12th Floor, DLF Square, Jacaranda Marg, DLF City
Phase-II, Gurugram Haryana, 122 002.

For Unit linked Plans, THE INVESTMENT RISK IN

Unit Linked Proposal
INVESTMENT PORTFOLIO IS BORNE BY THE
Form POLICYHOLDER
PROPOSAL NUMBER: 610121311
SSN
Combo Proposal Number:
GO/CA/Broker Code: X2871 Customer ID: 858458655 Code:
N/A
271373
For Traditional Insurance Plans this proposal is solicited by Axis Bank a Corporate
Agent of Max Life Insurance Co. Ltd.
Do you have a Max Life Insurance Policy or have currently applied simultaneous policies? If yes give Policy/Proposal number? -(344507306)

Purpose of Insurance: WEALTH ACCUMULATION/INVESTMENT

Objective of Insurance: INDIVIDUAL POLICY
Product Solution: NA Existing Customer: YES

A. Personal Details

Proposer Life to be Insured(if other than proposer)

1. Title MS

First MALLIKA

2. Name Middle PAL

Last PRAMANIK

First KALIPADA
3. Father's / Husband's
Name
Last PRAMANIK

4. Date of Birth 05-08-1992

5. Gender FEMALE

6. Nationality INDIAN

6a. Residential country

Residence for Tax purposes in Jurisdiction(s) outside India : NO

(If Yes then FATCA & CRS-Self Certification Form to be mandatorily completed)

7. Marital Status WIDOW

8. Education Qualification PRIMARY SCHOOL

9. Relationship with Proposer SELF

10. Industry Type OTHERS

11. Organisation Type PARTNER/PROP

12. Occupation/Job Title SELF EMPLOYED

13. Name of Entity / Employer NA

14. Annual Income(Rs.) 450000

15. Is the Life Insured / Proposer / Nominee / Payor a Politically Exposed Person ? : NO

16. Nominee Details

Title MR

First BINKAR

Name Middle

Last PAUL

Page 1 of 6 20 of 33
Date of Birth 30-03-2011

Gender MALE

Percentage 100

Relationship with Proposer SON

Guardian Name (If nominee is under age 18) KALIPADA PRAMANIK

Guardian relationship to Nominee PARENT

17. Current Residential Address

House No./Apt. Name: W/O NAGENDRA PAL PRAMANIK

Society Road/Area/Sector: BEGAMPUR CHANDITALAII HOOGHLY
Village/Town:
Landmark:
City: HOOGHLY
Pin Code: 712306 State/UT: WEST BENGAL Country: INDIA
Mobile No. 1: 7596855048 Mobile No. 2: 9999999999 STD Code: Landline:
Email: BINKERPAUL011@[Link]

18. Permanent Residential Address (Optional)

House No./Apt. Name: W/O NAGENDRA PAL PRAMANIK

Society Road/Area/Sector: BEGAMPUR CHANDITALAII
Village/Town:
Landmark:
City: HOOGHLY
Pin Code: 712306 State/UT: WEST BENGAL Country: INDIA

19. Preferred Mailing Address. Current Residential

20. Do you wish to hold this Policy electronically under e-lnsurance ? NO

B. Coverage Information-Type of Coverage

Coverage Coverage Premium Annual Target Modal GST

a. Base Plan
Term Multiple Payment Term Premium (Rs.) Premium (Rs.) (Rs.)

MAX LIFE FLEXI WEALTH PLUS PLAN 10 10 5 50000 50000 0

Modal Premium without GST* and Cess:

GST* and Applicable Cess: 0 Total Premium Paid: 50000
50000
(*GST shall comprise of CGST, SGST/UTGST or IGST (whichever is applicable) including cesses and levies, if any. All applicable taxes, cesses and levies, as per
prevailing laws, shall be borne by you)
You can either opt for one of the below mentioned automated strategies or choose
c. INVESTMENT OPTIONS: to manage your funds on your own through self-managed Portfolio Strategy. Please
tick if any of the below Strategy is applicable.

i. Systematic Transfer Plan: NO iii. Dynamic Fund Allocation Strategy: NO v. Self-Managed Portfolio Strategy : YES

ii. Lifecycle Based Portfolio Strategy: NO iv. Trigger Based Portfolio Strategy: NO

Growth Diversified High Sustainable Growth Secure Money Dynamic bond

Balanced Secure Conservative
Super equity Growth Equity Fund Fund Plus* Market II fund
0% 0% 100 % 0% 0% 0% 0% 0% 0% 0% 0%

*Secure Plus fund is not applicable with Self-Managed Portfolio Strategy

d. Would you like to opt for Smart Withdrawal Option? No
e. When would you like your Smart Withdrawal Payouts to begin from? Please specify the policy year here. NA

f. Please state your required frequency of Smart Withdrawal Payouts.

g. Please state the % of Fund Value that you would require in an year NA %

2. NEFT Bank A/C Details of Proposer:

All Payouts will be credited to this account through Electronic mode of payment. (This will be applicable at select cities as per facilities/
arrangements of Max Life Insurance).
MICR Code: 700211071 Bank Account Number: 920010007283145

IFSC Code: UTIB0001574 Account Holder's Name: MALLIKA

Type of Bank A/C: Savings Account Bank Name & Branch: Axis Bank VIVEKANANDA ROAD,KOLKATA WB

Page 2 of 6 21 of 33
Banking Since: 01-01-2020

3. Permanent Account Number (PAN): DFLPP9846A

TDS may be applicable, in accordance with Income Tax Act Form 60 required: NO
1961, as amended from time to time.
4. Mode of Payment: ANNUAL 5. Renewal premium by: DIRECT DEBIT 6. Source of Funds: SELF-EMPLOYED

7. Is payor different from proposer/insured ? NO

8. Are you a Max Life Agent or an employee of a Max group company/ Corporate Agents? NO

9. Premium Payment Details

Amount in Words: FIFTY THOUSAND

Paid Rs: 50000 Payment by DIRECT DEBIT

Cheque / Draft No. / Online Transaction MAXCRM2112871160822054954 Date: 16-08-2022

Bank Name & Branch:

C. Information of Life Insured

1. Do you have any life or Critical Illness insurance policy issued, pending approval from any other insurance companies or
has your application for Life/Health/Critical illness insurance or its reinstatement ever been offered at modified NO
terms,rejected or postponed ?

Life to be
Proposer
Insured

2. In the next 12 months do you intend to travel or reside abroad other than on holiday of less than 4 weeks? NO NA

3. Do you participate or do you intend to participate in any hazardous activities as part of your Occupation/ Sports/
NO NA
Hobby?

4. Have you ever been convicted or are you under investigation for any criminal charges ? NO NA

5. For Female Life Insured YES

Life to be
Proposer
Insured

SELF
a. Spouse Occupation NA
EMPLOYED

b. Spouse Annual Income 5000000 NA

c. Spouse Insurance Amount NA NA

e. Full Name Prior to Marriage (If there is a name change post marriage): NA NA

f. Are you pregnant? NO NA

6. For Minor Life To Be Insured (Age < 18 yrs.) NO

D. Medical Information

1. Family Details Proposer Life Insured

Has any two (2) or more of your family members (parents & Siblings) ever been diagnosed with diabetes or
NA NA
hypertension or kidney failure or cancer or heart Attack or any Hereditory Disorder before the age of 60 ?

2.

Proposer Life To Be Insured

Height 152 cm NA
Weight 65 kg NA

Life to be
3. Have you ever been investigated, treated or diagnosed with any of the following conditions. Proposer
Insured

i) Diabetes /High blood sugar levels NO NA

ii) Hypertension/ High Blood Pressure, High Cholesterol or Thyroid disorder NO NA

iii) Heart or vascular disorder including chest pain, stroke, heart attack or Angioplasty, CABG or any other heart surgery. NO NA

iv) Breathing or lung disorders including asthma, emphysema, tuberculosis. NO NA

v) Liver or digestive system related disorder including jaundice ,gall bladder, pancreas or Hepatitis B/C. NO NA

Page 3 of 6 22 of 33
 vi) Any abnormal growth like tumour,lump,cancer or blood disorder, including anemia or thalassaemia or Sexually transmitted
NO NA
disease ( STD ) including HIV or AIDS.

vii) Any kind of Kidney or bladder disorder, including kidney failure, renal stone, nephritis or prostrate disorder. NO NA

viii) Any neurological or mental health problem like paralysis, multiple sclerosis, Parkinson's, epilepsy, depression or anxiety. NO NA

ix) Muscular-skeletal or joint disorders, including any kind of arthritis, gout, osteoporosis. NO NA

x) Are you having history of any hospitalization, treatment or investigation? NO NA

xi) Have you advised now or in last 5 yrs tests like X-Ray/CT scan/MRI/ Ultrasonography/ ECG/Blood test or any other investigatory
NO NA
or diagnostic tests, or any type of surgery.

Xii) Have you ever been diagnosed with any form of internal or external congenital anomaly or defect i.e. any condition(s) which is
NO NA
present since birth, and which is abnormal with reference to form, structure or position?

Xiii) Have you had any genetic testing before? NO NA

[Link]/Alcohol/Drugs
Do you consume any of the following ?
Consumption:

Proposer Life Insured

i) Tobacco ( Smoking /Chewing) currently or even occasionally in last 1 year ? NO NA

ii) Alcohol (ML) - Beer/Wine/Hard Liquor. NO NA

iii) Are you taking drugs like Cannabis/Marijuana,Ecstacy,Heroin,LSD,Amphetamines or any other illegal drugs? NO NA

E. Declaration And Authorisation

1. DECLARATION BY PROPOSER
I/We hereby declare that I/We fully understand the meaning and scope of the Proposal form and the questions contained above and I am submitting the completed
proposal form of my/our own volition, and confirm that I/We have not been induced by anyone to make the Proposal. I/We have been explained the nature of
questions and the importance of disclosing all material information.

I/We further declare that all the statements and declarations herein shall be the basis of a contract between me/us and the Company and that I/We have made
complete, true and accurate disclosure of all the facts and circumstances and have not withheld any information that may be relevant to enable the Company to
make an informed decision about the acceptability of the Proposal. I agree that in case of any fraud or misstatement, action will be initiated as per Section 45 of
Insurance Act, 1938, as amended from time to time. I/We undertake to notify the Company, forthwith in writing, of any change in any of the statements made in the
Proposal subsequent to the signing of this proposal and before acceptance of risk and issuance of the Policy by the Company. The first and subsequent year
premium will be paid out of legally acquired source of income. I will provide information as and when required by the Company, acting on its own or under any order
or instruction received from Statutory Authorities, as regards to the sources of funds or utilizations or withdrawals. I agree that the Company may provide any
information related to me as available to the Company at any time, to any Statutory Authority in relation to the any laws including the laws governing prevention of
money laundering, applicable in the country. To enable the Company to assess the risk under my/our proposal or for any other purpose in relation to the policy, l/we,
my/our heirs, administrators or executors or assignees hereby authorize my past or present employer(s)/business association/medical practitioners /other agencies
or governmental and/or any regulatory bodies, insurance repositories, CERSAI/ UIDAI, reinsurers / hospitals or diagnostic centres/ other insurance companies/
service providers to disclose and make available to the Company such details/records, as may be requested by the Company. I understand that I have disclosed my
personal information with Max life and I hereby provide consent to Max Life to share, store my information with its authorized service providers for servicing this
policy/proposal such as issuance, underwriting renewal and claims process with respect to this policy as per the regulation applicable from time to time. I/We submit
the mandate to credit My / Our account towards all payments against the above policy and agree and understand that payouts would be processed through
electronic mode of payment and will be affected at select cities as per facilities/ arrangements of Max Life Insurance. I/We authorize Max Life to send all
communications by letter, E-mail, SMS. I/We agree to receive regular reminders, updates / alerts from Max life from time to time.

I/ We authorize Max Life to send all communication by electronic means.

OTP Confirmation Date: 16-08-2022 [Link] Place: HOOGHLY

2. DECLARATION BY PRINCIPAL OFFICER/AGENT ADVISOR/SPECIFIED PERSON

I do declare and confirm that I have met and explained the Product features, benefits, premium paying term, nature of the questions contained in this Proposal form
and other relevant terms and conditions to the Proposer and the Life Insured. I have also explained that the answers to the questions forms the basis of the contract
of the Insurance between the Company and the Proposer / Life Insured, and if any untrue statement is contained therein and / or any information that may be
relevant to enable the Company make an informed decision, the Company shall have the right to vary the benefits which may be payable and / or treat the policy
voidable at the option of the Company subject to section 45 of the Insurance Act, 1938 as amended from time to time. I confirm that to the best of my knowledge the
Life Insured does not suffer from any physical or mental abnormality or handicap or has / had been hospitalised, undergone any surgery or treatment, or he /she is
involved in activities including any hazardous avocation or occupation or any other information material for underwriting this proposal form, unless expressly stated
in this Proposal. I also declare and represent to the Company that I am in full compliance with the regulatory requirements applicable to agent / corporate agent /
specified person / broker prescribed by the Insurance Act 1938, as amended from time to time and any other regulation, circular, instruction issued by IRDAI from
time to time. I confirm that I have verified the identity, current / permanent residential address of the Proposer/ Life Insured, the nature of his/her business and his /
her financial status basis the Max Life AML moral hazard checklist.

Is this a Replacement Sale? If yes, I have adequately explained

YES
the consequences of replacement sale to the customer.
Relationship of Principal Officer/Agent Advisor/Specified Person with the
Name of Principal Officer/Agent Advisor/Specified Person
Proposer/Life Insured

Customer MS. JYOTI BHAGAT

Page 4 of 6 23 of 33
Signature / OTP Confirmation Date / Thumb Impression / Electronic
Signature of Proposer:- 16-08-2022 [Link]
Specified Person License Number: SP0069456773
This system generated benefit Proposal form shall be treated as signed by
me.

Phone No. with STD Code:- 0

We confirm that we have made joint efforts in soliciting the prospect and will be jointly responsible for performing the service related to the policy. We further confirm
that the objective of sharing the commission is not for qualifying for any contest and/or reward & recognition programs of the company.

(Applicable only if more than one Agent Advisors share the commission)

Name(s) of Principal Officer/AA/Spec Person Principal Officer/AA/Spec Person Code % Share

Ms. Jyoti Bhagat 57635A 100

Important Notes: (1) Any payment/s including initial payment accompanying this proposal, cash or by bearer instrument must be made at any of the Company's
General Office only. (2) Crossed cheque or bank drafts must be made in favour of MAX LIFE INSURANCE COMPANY LIMITED ACCOUNT (Proposal No. as
above) maybe handed over to the Agent Advisor. (3} Receipt of the Completed Proposal and initial payment does not create any obligations upon the Company to
underwrite the risk. The Company shall not be liable until it has underwritten the risk and issued the Policy. If the Policy is sent by post it shall be deemed to have
been delivered to and received by you in the ordinary course within 3 (three) days of posting. We draw your attention to Section - 39, Section - 45 and Section - 41
of the Insurance Act 1938 which reads as follows-

Section 39: In case nomination facility is availed, section 39 of the Insurance Act, 1938 as amended from time to time shall apply.

Section 45: No policy of life insurance shall be called in question on any ground whatsoever after the expiry of three years from the date of issuance of policy, from
the date of the Commencement of Risk or Revival of the policy or the date of the rider to the policy, whichever is later. However, Insurer may question the Policy at
any time within three years from the date of issuance of policy, from the date of Commencement of Risk or Revival of the policy or the date of the rider to the policy,
whichever is later, on the ground of fraud, in which case insurer shall inform Proposer/Life Insured/legal representatives in writing specifying the grounds and
materials on which such decision is based. For other details please referto Section 45 of the Insurance Act, 1938 as amended from time to time.

Section 41: (1) No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take 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.

ULIP_STD_1221_5.5

Additional Declaration:

I hereby authorize AXIS BANK to share my last 6 months bank statement/ One Glance Statement (which includes savings, investments and liabilities in Savings
account, Current account, Deposits, Overdraft account, Demat Accounts, Investments, Insurance, Credit Cards etc. or other similar document and personal KYC
details/documents with Max Life for the purpose of insurance and confirm that the said details can be substantiated with adequate proofs as and when required.

I / we understand that this is not a Fixed Deposit but a life insurance plan. I confirm that this proposal for insurance has being solicited independently and not as
consideration for any other service provided by AXIS BANK.

I have opted for the Combination Solution voluntarily (wherever applicable) as it would assist me in planning my finances. I also understand that these are
different products and can also be purchased separately

I am submitting my Electronic Application of my own volition and have understood the contents of the Electronic Application, and the relevant sales literature
including product features, benefits, applicable charges and am aware of the investment risk under the Policy.

I / We are aware that suitability information has been collected from me/us and recommendation on purchase of life insurance product has been made only basis
such information and any product selected by me/us that differs from such recommendation is on the basis of my/our personal choice. I / we have seen and
understood the benefit illustration shown to me / us on the screen electronically or provided to me / us in physical form, as the case may be. I / we have disclosed
all material information and not withheld any information that may be relevant to enable Max Life to take an informed decision about the acceptability of the
Electronic Application. I also confirm that the information in the Electronic Application, including the state of health and lifestyle habits of the life to be insured is
true and complete. I / we have submitted the confirmation number sent on my mobile number/ email id as a confirmation of the contents of the Electronic
Application and the benefit illustration and agreement to the terms therein.

I/We understand and agree that by submitting the Electronic Application, I / we will be bound by the statements / disclosures of material facts made therein in the
same manner, as if I / we have signed and submitted a written proposal for insurance to the Company and these shall be the basis of a contract between me/us
and the Company. I / we undertake to notify the Company of any change in statements made in the Electronic Application subsequent to its submission and
before acceptance of risk and issuance of the policy by the Company. I / we understand that in case the Company detects any fraud or mis-statement or
suppression of fact material to my/our life expectancy, the Company reserves the right to take appropriate action in accordance with Section 45 of the Insurance
Act.

I / we hereby declare and confirm that details provided in Form 60 attached to this Electronic Application (wherever applicable) are true and correct to the best of
my knowledge and belief. I declare that I do not have a Permanent Account Number and my/ our estimated total income (including income of spouse, minor child
etc. as per section 64 of Income-tax Act, 1961) computed in accordance with the provisions of Income-tax Act, 1961 for the financial year in which the above
transaction is held will be less than maximum amount not chargeable to tax.

I / we understand that the Company will not be liable unless the premium is received and realized by it within the time period stipulated for the same subject to
underwriting by it. I / we hereby authorize the Company to conduct screening / confirmation of my / our health status through medical examinations on the basis
of which, the Company may accept, decline or offer alternate terms on my proposal. I/we hereby authorize my past and present employer(s) / associate(s) /
medical practitioner(s) / any insurer or any other organization to disclose and make available to the Company my/our information.

Page 5 of 6 24 of 33
I / We have filled the proposal electronically and have received the benefit illustration and filled up proposal form on email and registered mobile OR reviewed it
on tablet / desktop and after observing the said copy, I /we confirm that all the content / information therein is correct to the best of my / our knowledge.

I have opted for the Combination Solution voluntarily (wherever applicable) as it would assist me in planning my finances. I also understand that these are
different products and can also be purchased separately.

I do hereby certify that above stated information regarding the nationality and tax residential status is correct in all respects and may be used for all purposes,
including reporting to statutory authorities & compliances, and understand that it is my responsibility to report the changes, if any, to Max Life within 2 weeks of
occurrence of such change.

Signature / OTP Confirmation Date / Thumb Impression / Electronic Signature of Sales

Signature / OTP Confirmation Date / Thumb Impression / Manager :57635A
Electronic Signature of Proposer: 16-08-2022 [Link]
Specified Person License Number: SP0069456773

Phone No. with STD Code :0

Page 6 of 6 25 of 33
 BENEFIT ILLUSTRATION
[Date and Time of Illustration – 16 August 2022, 04:28 PM]

Proposal No: 610121311

Name of the Prospect/Policyholder: Ms. MALLIKA Name of the Product: Max Life Flexi Wealth Plus
Tag Line: A Unit-Linked Non-Participating Individual Life Insurance Plan
Age & Gender: 30 Years, Female
Policy Option: NA
Name of the Life Assured: Ms. MALLIKA Unique Identification No: 104L115V01
GST Rate (Base Policy, First Year): 18.00%
GST Rate (Base Policy, Subsequent Year): 18.00%
GST Rate (Rider, First Year): NA
Age & Gender: 30 Years, Female
GST Rate (Rider, Subsequent Year): NA
Max Life State: Karnataka
Policyholder Residential State: West Bengal
Sum Assured: `5,00,000 Investment Strategy Opted for: Self Managed Portfolio Strategy
Policy Term & Premium Payment Term: 10 Years & 5 Years
Funds opted for along with their risk level
Amount of Installment Premium: `50,000 [Please specify the customer specific fund
Mode of payment of premium: Annual option): High Growth Fund (Risk Rating-Very High) : 100%

How to read and understand this benefit illustration?

This benefit illustration is intended to show what charges are deducted from your premiums and how the unit fund, net of charges and taxes, may grow over the years of the policy term if the fund earns a gross
return of 8% p.a. or 4% p.a. These rates, i.e., 8% p.a. and 4% p.a. are assumed only for the purpose of illustrating the flow of benefits if the returns are at this level. It should not be interpreted that the returns
under the plan are going to be either 8% p.a. or 4% p.a.
Net Yield mentioned corresponds to the gross investment return of 8% p.a., net of all charges but does not consider mortality, morbidity charges, underwriting extra, if any, guarantee charges and cost of riders, if
deducted by cancellation of units. It demonstrates the impact of charges exclusive of taxes on the net yield. Please note that the mortality charges per thousand sum assured in general, increases with age.
The actual returns can vary depending on the performance of the chosen fund, charges towards mortality, morbidity, underwriting extra, cost of riders, etc. The investment risk in this policy is borne by the
policyholder, hence, for more details on terms and conditions please read sales literature carefully.
Part A of this statement presents a summary view of year-by-year charges deducted under the policy, fund value, surrender value and the death benefit, at two assumed rates of return. Part B of this statement
presents a detailed break-up of the charges, and other values.
Note: Some benefits are guaranteed and some benefits are variable with returns based on the future performance of your insurer carrying on life insurance business. If your policy offers guaranteed benefits then
these will be clearly marked “guaranteed” in the illustration table on this page. If your policy offers variable benefits then the illustration on this page will show two different rates of assumed future investment
returns. These assumed rates of return are not guaranteed and they are not the upper or lower limits of what you might get back, as the value of your policy is dependent on a number of factors including actual
future investment performance.

Rider Details

Critical Illness and Disability-Secure Rider - Rider Premium Critical Illness and Disability-Secure Rider - Coverage Variant NA
NA
Payment Term and Rider Term Critical Illness and Disability-Secure Rider - Rider Sum Assured NA

Premium Summary
Base Plan Max Life Critical Illness and Disability-Secure Rider Total Installment Premium
Installment Premium without GST (in Rs.) 50,000 0 50,000
Installment Premium with first year GST (in Rs.) 50,000 0 50,000
Installment Premium with GST 2nd year onwards (in Rs.) 50,000 0 50,000

26 of 33
UIN: 104L115V01 Page 1 of 4
 Part A
(Amount in Rupees.)
At 4% p.a. Gross Investment Return At 8% p.a. Gross Investment Return
Commission
Policy Annualized
payable to
Year Premium Mortality, Morbidity Fund at End Surrender Mortality, Fund at End Surrender
Other Charges* GST Death Benefit Other Charges* GST Death Benefit intermediary
Charges of Year Value Morbidity Charges of Year Value

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 50,000 381 4,780 929 45,716 42,176 5,00,000 381 4,792 931 47,508 43,968 5,00,000 6,000

2 50,000 346 4,930 950 93,134 90,774 5,00,000 343 4,978 958 98,661 96,301 5,00,000 500

3 50,000 309 5,352 1,019 1,41,995 1,40,225 5,00,000 302 5,461 1,037 1,53,380 1,51,610 5,00,000 500

4 50,000 272 5,795 1,092 1,92,328 1,91,148 5,00,000 259 5,993 1,125 2,11,891 2,10,711 5,00,000 500

5 50,000 233 6,506 1,213 2,43,867 2,43,867 5,00,000 211 6,824 1,266 2,74,126 2,74,126 5,00,000 500

6 - 239 4,628 876 2,47,767 2,47,767 5,00,000 206 5,086 953 2,89,573 2,89,573 5,00,000 -

7 - 246 4,753 900 2,51,664 2,51,664 5,00,000 199 5,364 1,001 3,05,925 3,05,925 5,00,000 -

8 - 254 4,883 925 2,55,552 2,55,552 5,00,000 192 5,656 1,053 3,23,235 3,23,235 5,00,000 -

9 - 262 5,016 950 2,59,424 2,59,424 5,00,000 182 5,966 1,107 3,41,564 3,41,564 5,00,000 -

10 - 275 5,153 977 2,66,088 2,66,088 5,00,000 172 6,292 1,164 3,63,417 3,63,417 5,00,000 -
*Other Charges includes all charges except Mortality, Morbidity Charges on the policy. See Part B for details

IN THIS POLICY, THE INVESTMENT RISK IS BORNE BY THE POLICYHOLDER AND THE ABOVE INTEREST RATES ARE ONLY FOR ILLUSTRATIVE PURPOSE.

I, Ms. Jyoti Bhagat (name), have explained the premiums, charges and benefits under the policy I, MALLIKA (name), having received the information with respect to the above, have understood
fully to the prospect / policyholder. the above statement before entering into the contract.

Place:
Date: 8/16/22 Signature / OTP Confirmation Date / Thumb Impression / Date:8/16/22 Signature / OTP Confirmation Date / Thumb Impression /
Electronic Signature of Agent/ Intermediary / Official Electronic Signature of Prospect/ Policyholder

This system generated benefit illustration shall be treated as signed by me.

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UIN: 104L115V01 Page 2 of 4
 Part B Gross Yield 8% p.a. Net Yield 5.32% Amount in Rupees
Premium Annualized Premium - Policy
Policy Annualized Mortality Guarantee Other Additions to the Fund before Fund at End of Surrender Death
Allocation Premium Allocation GST Admin. FMC
Year Premium (AP) Charge Charge Charges* fund* FMC the Year Value Benefit
Charge (PAC) Charges - GST on PAC Charge

1 50,000 3,000 46,460 381 931 1,200 - - - 47,567 592 47,508 43,968 5,00,000

2 50,000 2,500 47,050 343 958 1,260 - - - 98,783 1,218 98,661 96,301 5,00,000

3 50,000 2,250 47,345 302 1,037 1,323 - - - 1,53,570 1,888 1,53,380 1,51,610 5,00,000

4 50,000 2,000 47,640 259 1,125 1,389 - - - 2,12,154 2,604 2,11,891 2,10,711 5,00,000

5 50,000 2,000 47,640 211 1,266 1,459 - - - 2,74,466 3,365 2,74,126 2,74,126 5,00,000

6 - - - 206 953 1,532 - - - 2,89,932 3,555 2,89,573 2,89,573 5,00,000

7 - - - 199 1,001 1,608 - - - 3,06,304 3,755 3,05,925 3,05,925 5,00,000

8 - - - 192 1,053 1,689 - - - 3,23,635 3,968 3,23,235 3,23,235 5,00,000

9 - - - 182 1,107 1,773 - - - 3,41,987 4,193 3,41,564 3,41,564 5,00,000

10 - - - 172 1,164 1,862 - - 2,446 3,61,418 4,431 3,63,417 3,63,417 5,00,000

Gross Yield 4% p.a. Amount in Rupees

Premium Annualized Premium - Policy
Policy Annualized Mortality Guarantee Other Additions to the Fund before Fund at End of Surrender Death
Allocation Premium Allocation GST Admin. FMC
Year Premium (AP) Charge Charge Charges* fund* FMC the Year Value Benefit
Charge (PAC) Charges - GST on PAC Charge

1 50,000 3,000 46,460 381 929 1,200 - - - 45,772 580 45,716 42,176 5,00,000

2 50,000 2,500 47,050 346 950 1,260 - - - 93,249 1,170 93,134 90,774 5,00,000

3 50,000 2,250 47,345 309 1,019 1,323 - - - 1,42,170 1,779 1,41,995 1,40,225 5,00,000

4 50,000 2,000 47,640 272 1,092 1,389 - - - 1,92,566 2,405 1,92,328 1,91,148 5,00,000

5 50,000 2,000 47,640 233 1,213 1,459 - - - 2,44,169 3,047 2,43,867 2,43,867 5,00,000

6 - - - 239 876 1,532 - - - 2,48,074 3,096 2,47,767 2,47,767 5,00,000

7 - - - 246 900 1,608 - - - 2,51,976 3,145 2,51,664 2,51,664 5,00,000

8 - - - 254 925 1,689 - - - 2,55,868 3,194 2,55,552 2,55,552 5,00,000

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9 - - - 262 950 1,773 - - - 2,59,745 3,243 2,59,424 2,59,424 5,00,000

UIN: 104L115V01 Page 3 of 4

 Premium Annualized Premium - Policy
Policy Annualized Mortality Guarantee Other Additions to the Fund before Fund at End of Surrender Death
Allocation Premium Allocation GST Admin. FMC
Year Premium (AP) Charge Charge Charges* fund* FMC the Year Value Benefit
Charge (PAC) Charges - GST on PAC Charge

10 - - - 275 977 1,862 - - 2,817 2,63,597 3,292 2,66,088 2,66,088 5,00,000

*There are no charges included in other charges. Guaranteed Loyalty Additions and Wealth Boosters declared as per the product terms and conditions are included on Additions to the fund.
Notes: 1. Refer the sales literature for explanation of terms used in this illustration.
2. Fund management charge is based on the specific fund option(s) chosen.
3. In case rider charges are collected explicitly through collection of rider premium, and not by way of cancellation of units, then, such charges are not considered in this illustration. In other cases, rider charges are included in
other charges.

I, Ms. Jyoti Bhagat (name), have explained the premiums, charges and benefits under the policy I, MALLIKA (name), having received the information with respect to the above, have understood
fully to the prospect / policyholder. the above statement before entering into the contract.

Place:
Date: 8/16/22 Signature / OTP Confirmation Date / Thumb Impression / Date:8/16/22 Signature / OTP Confirmation Date / Thumb Impression /
Electronic Signature of Agent/ Intermediary / Official Electronic Signature of Prospect/ Policyholder

This system generated benefit illustration shall be treated as signed by me.

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UIN: 104L115V01 Page 4 of 4
80,30,10,500000,50000,N,N,N,N,F,l,100
 Premium Receipt
Receipt No.: 610121311 /2022-23/01 | Receipt Date: 29-AUG-2022
Personal Details
Policy Number: 610121311 Email ID: binkerpaul011@[Link]
Policyholder Name: Ms. Mallika Pal Pramanik PAN Number: DFLPP9846A
Address: W/O NAGENDRA PAL PRAMANIK
BEGAMPUR CHANDITALAII HOOGHLY
Hooghly-712306 West Bengal India
Mobile Number: 7596855048
Policy Details Connect for more details
Plan Name: Max Life Flexi Wealth Plus Name
Life Insured: Ms. Mallika Pal Pramanik Policy Commencement Date: 29-AUG-2022 M/S. Axis Bank Ltd Kumta
Premium Payment Term: 5 Years Policy Term: 10 Years Date of Maturity: 29-AUG-2032
(period of which premium to be paid) Contact Number
Modal Premium: ` 50,000.00 Rider Sum Assured: ` 0.00 Base Sum Assured: ` 5,00,000.00 1860 120 5577 or (0124) 4219090
Mudrank : Paid by e-Stamps Certificate no. 948/Issue Date: 4/04/2022/ Vide Treasury (E-CHALLAN) GRN NO.88821464
Fund Statement as on 29-AUG-2022
Closing Summary
Closing NAV/Market Market Value
Particulars
Units (A) (Nos) Price (B) (`) of fund (A x B) (`)
High Growth Fund - Premium Driven - ULIF01311/02/08LIFEHIGHGR104 814.07372 56.88002 46,304.52
Total 46,304.52

29-AUG-2022 to
Annual `50,000.00 28-AUG-2023 29-AUG-2023
*Important Note:
1. If the payment has been made other than in cash, this receipt is conditional upon realization of the amount in Max Life's account.
2. Amount received would be adjusted against the due premium as per the policy contract. In case policy contract is lapsed, the risk coverage is subject to the reinstatement as per terms
and conditions of policy.
3. Premiums may be eligible for tax benefits under section 80C/80CCC/80D/37(1) of the Income Tax Act 1961. You are advised to seek an opinion of a Tax advisor in relation to the applicable
tax benefits and liabilities. The above mentioned amount includes GST which is applicable as and when the charges are levied and shall comprise CGST, SGST / UTGST or IGST (whichever
is applicable) including cesses and levies, if any as per prevailing laws and shall be borne by you. Currently base GST rate is 18% apart from cess in some states.
4. You may request a detailed policy account statement by writing to us at the below mentioned details.
5. Applicable charges as per Part E of the Policy terms and conditions, would be charged from the Fund Value and Goods and Service Tax would be levied thereon @18%
This is an electronically generated receipt and does not require signature.
URM20 PRODUCT UIN:104L115V01
E.&O.E

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