Benefit Illustration

(This shall form a part of the policy document)

Na me of Pros pect/Policyholder: Hs hs Bbhs Pro p o s a l N o :

Age: 28 N a m e o f th e Pro d u ct: S U D Li f e Pro te ct S h i e l d
Na me of Life As s ured: Hs hs Bbhs Ta g Li n e : PlI nadni vi d u a l N o n - Li n k e d N o n - Pa r ci p a n g Te rm
Age: 28
U n i q u e I d e n fica o n N u m b e r: 142 N 085 V01
Policy Term: 40
Premium Pa yment Term: Regula r Pa y 1s t Yea r 4.50%
GST Ra te a nd a pplica ble Ces s , if a ny
Amount of Ins ta lment Premium: 16,388 2nd Yea r Onwa rds 2.25%
Mode of Premium Pa yment: Annua l

This benefit illustration is intended to show year-wise premiums and benefits under the policy.
Policy Details
Sum Assured Rs. 50,00,000
Policy Option Life Cover with Return of Premium Base Plan
Sum Assured on Death(at inception of the policy) Rs. 50,00,000
Death Payout Option Lump Sum SUD Life Accidental Death and Total & Permanent Disability Benefit Rider - Traditional (UIN: 142B005V01) Rider Sum Assured Rs. 0

Premium Summary
Base Plan Riders Total Instalment Premium
Instalment Premium w ithout GST 16,388 0 16,388
Instalment Premium w ith First Year GST 17,125 0 17,125
Instalment Premium w ith GST 2nd year Onw ards 16,757 0 16,757

(Amount in Rupees.)

Guaranteed Non Guaranteed

Single/
Policy Year Annualized Guaranteed Special
Premium Critical Illness Maturity Policy Cancellation Surrender Benefit
Survival Benefits Death Benefit Surrender Surrender
Benefit if any Benefit Value Max(GSV, SSV)
Value(GSV) Value (SSV)

1 16,388 0 0 0 50,00,000 0 0 0 0
2 16,388 0 0 0 50,00,000 0 9,833 98 9,833
3 16,388 0 0 0 50,00,000 0 17,207 221 17,207

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 (Amount in Rupees.)

Guaranteed Non Guaranteed

Single/
Policy Year Annualized Guaranteed Special
Premium Critical Illness Maturity Policy Cancellation Surrender Benefit
Survival Benefits Death Benefit Surrender Surrender
Benefit if any Benefit Value Max(GSV, SSV)
Value(GSV) Value (SSV)

4 16,388 0 0 0 50,00,000 0 32,776 393 32,776

5 16,388 0 0 0 50,00,000 0 41,789 615 41,789
6 16,388 0 0 0 50,00,000 0 51,131 885 51,131
7 16,388 0 0 0 50,00,000 0 60,799 1,205 60,799
8 16,388 0 0 0 50,00,000 0 70,796 1,573 70,796
9 16,388 0 0 0 50,00,000 0 81,121 2,323 81,121
10 16,388 0 0 0 50,00,000 0 91,773 3,278 91,773
11 16,388 0 0 0 50,00,000 0 1,02,753 4,462 1,02,753
12 16,388 0 0 0 50,00,000 0 1,14,060 5,900 1,14,060
13 16,388 0 0 0 50,00,000 0 1,25,696 7,616 1,25,696
14 16,388 0 0 0 50,00,000 0 1,37,659 9,636 1,37,659
15 16,388 0 0 0 50,00,000 0 1,49,950 11,984 1,49,950
16 16,388 0 0 0 50,00,000 0 1,62,569 14,684 1,62,569
17 16,388 0 0 0 50,00,000 0 1,75,515 17,760 1,75,515
18 16,388 0 0 0 50,00,000 0 1,88,790 21,239 1,88,790
19 16,388 0 0 0 50,00,000 0 2,02,392 25,143 2,02,392
20 16,388 0 0 0 50,00,000 0 2,16,322 29,498 2,16,322
21 16,388 0 0 0 50,00,000 0 2,30,579 34,329 2,30,579
22 16,388 0 0 0 50,00,000 0 2,45,164 41,642 2,45,164
23 16,388 0 0 0 50,00,000 0 2,60,078 49,848 2,60,078
24 16,388 0 0 0 50,00,000 0 2,75,318 58,997 2,75,318
25 16,388 0 0 0 50,00,000 0 2,90,887 69,137 2,90,887
26 16,388 0 0 0 50,00,000 0 3,06,783 80,318 3,06,783
27 16,388 0 0 0 50,00,000 0 3,23,007 92,588 3,23,007
28 16,388 0 0 0 50,00,000 0 3,39,559 1,09,210 3,39,559
29 16,388 0 0 0 50,00,000 0 3,56,439 1,27,486 3,56,439
30 16,388 0 0 0 50,00,000 0 3,73,646 1,47,492 3,73,646

2
 (Amount in Rupees.)

Guaranteed Non Guaranteed

Single/
Policy Year Annualized Guaranteed Special
Premium Survival Benefits Critical Illness Maturity Death Benefit Policy Cancellation Surrender Surrender Surrender Benefit
Benefit if any Benefit Value Value(GSV) Value (SSV) Max(GSV, SSV)

31 16,388 0 0 0 50,00,000 0 3,91,182 1,69,300 3,91,182

32 16,388 0 0 0 50,00,000 0 4,09,044 1,97,180 4,09,044
33 16,388 0 0 0 50,00,000 0 4,32,643 2,27,543 4,32,643
34 16,388 0 0 0 50,00,000 0 4,51,326 2,60,487 4,51,326
35 16,388 0 0 0 50,00,000 0 4,76,071 3,01,130 4,76,071
36 16,388 0 0 0 50,00,000 0 4,95,573 3,45,131 4,95,573
37 16,388 0 0 0 50,00,000 0 5,21,466 3,98,224 5,21,466
38 16,388 0 0 0 50,00,000 0 5,41,787 4,55,537 5,41,787
39 16,388 0 0 0 50,00,000 0 5,75,219 5,23,449 5,75,219
40 16,388 0 0 6,55,520 50,00,000 0 5,89,968 6,03,078 6,03,078

Notes:Annualized Premium excludes Underwriting extra premium ,frequency loadings on premiums ,the premiums paid towards the riders ,if any and Goods and Service Tax
Terms and Conditions
1. Surrender Benefit (Applicable only for Benefit Option 2 Life Cover with Return of Premium)
Surrender of the policy is allowed after 2 consecutive full years’ premiums have been paid. During the Policy Term, Surrender Value payable will be higher of Guaranteed Surrender Value and
Special Surrender Value.
2. Policy Cancellation Value.
Policy Cancellation Value acquires if at least two consecutive full policy years’ premiums are paid,During the Policy Term.The Same is applicable only for Benefit option1 & Benefit Option3
except Regular Pay Premium Option.
3. Payout Options: Below Payout Options are available under this Plan:
1. Lump Sum: Under this option, the Death Benefit will be paid in lump sum immediately.

2. Monthly Income: Under this option, Monthly Income Benefit of 1% of the Death Benefit will be paid every month for a fixed period of 125 months, starting from next policy month
anniversary following the date of death.

3. Lump Sum plus Monthly income: Under this option, 50% of the death benefit will be paid as lump sum immediately and Monthly Income Benefit of 0.50% of the Death Benefit will
be paid every month for a fixed period of 125 months, starting from next policy month anniversary following the date of death.
4. The Rider available under the plan.(For Life Cover with Critical Illness, no rider will be available.)
Presently,the following riders are available under this product on payment of additional premium over and above the Base premium provided conditions on riders (Entry Age, Policy Term,
Premium Paying Term, Sum Assured etc) are satisfied.
a. SUD Life Accidental Death and Total & Permanent Disability Benefit Rider - Traditional (UIN: 142B005V01)
5. Policy values are as of year end.

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6. Tax Benefits
Premiums payable and benefits receivable under this plan are eligible for tax benefits as per the prevailing tax laws. w.e.f. from April 01, 2012, to qualify for tax benefit on premium(s) paid under
section 80 C & for tax benefit on maturity/survival proceeds under section 10 (10 D) of the IT Act, 1961, the sum assured should not be less than 10 times the annualised/single premium. Please
consult your tax advisor for details
7. Proposal Deposit
The proposal deposit receipt given in respect of the consideration amount paid to the company does not bind the company to accept the risk on the life of the life proposed under the proposal for
insurance.
The above premium is for a healthy individual and would be subject to underwriting.
Any extra premiums charged are subject to underwriting of proposal, and may change based on the Board approved underwriting policy. The extra premium to be charged for Non Standard Age
Proof cases (NSAP) is Rs. 1.5 per thousand Sum Assured.
8. About Star Union Dai-ichi Life Insurance Company Limited
Star Union Dai-ichi Life insurance is the name of the company and 'SUD Life Protect Shield' is only the name of the Plan and does in no way indicate the quality of the policy, its future
prospects or returns.
9. Goods & Services Tax and applicable cess,if any will be charged on premiums as per prevailing tax laws.This is subject to any change in the tax rate.
10. For more details on risk factor, terms and conditions, please read the Sales brochure of the plan carefully before concluding a sale.
In case you require any clarification, please consult your insurance advisor or call our office.

I, ___________________________ (Name), have explained the I, ___________________________ (Name), having received the
premiums, and benefits under the product fully to the prospect / informa on with respect to the above, have understood the above
policyholder. statement before entering into the contract.

Place:
Date: Signature of Agent/ Intermediary/ Official Date: Signature of Prospect / Policyholder