RISK

ASSESSMENT

MEDICAL
UNDERWRITING

AML

FINANCIAL
KYC
UNDERWRITING

Version no Date of Issue Location of Change Changed By Description of change

1.0 22nd Nov 2018 Thane HO

2.0 16th July 2020 Thane HO

3.0 9th Sep 2020 Thane HO

UNDERWRITING
HANDBOOK
FOR AGENCY CHANNEL
Version History

Document Owner: Underwriting - Agency Team

Date of Implementation: Version: 1.0

Date of Implementation: 16th July 2020 Version: 2.0

Date of Implementation: 24th November 2020 Version: 3.0

Date of Implementation : 2nd February 2021 Version: 4.0

1
List of Contents

Index Page No

1. Age Proofs 3

2. KYC Guidelines 4

3. AML Guidelines 5

4. List of Mandatory documents 10

5. Non Term Underwriting 12

6. Term Underwriting 24

7. Business Insurance - Employer Employee, HUF, Key man Insurance 29

8. Annexure 1 - Acceptable Age Proofs 35

9. Annexure 2 - Acceptable ID/Address Proof for Individual Contract 36

10. Annexure 3 - List of Financial documents 39

11. Annexure 4 - COVID-19 Guidelines 40

12. Annexure 5 - List of questionnaires 41

13. Annexure 6 - Armed Forces and Paramilitary guidelines Term 43

14. Annexure 7 - Armed Forces Underwriting Savings 46

15. Annexure 8 - Exception Handling Scenarios for Term Plans 47

16. Annexure 9 - Param Rakshakaran Guidelines 47

2
AGE PROOF

Significance of Age Proof:

• Required to calculate age of life assured since mortality charges are age dependent
• Age determines
• Human Life Value/ Financial Eligibility
• Medical/Non-medical case
• Age at entry/ issue age
• Cover term that can be offered
• Policy premium payable

Types of Age Proof:

Standard Age Proof & Non Standard Age Proof

When is Standard age proof mandatory?

• Term Plans

• Minor Life Applications

• Term & Critical Illness Rider

• Products where extra mortality is not allowed.

• Non-Standard Age Proof – Document where date of birth or age on the proof is basis
self-declaration. Guidelines for Non-Standard Age Proof –
• Acceptable up to 10 Lakhs (including sum assured of CI and term rider)
• An extra premium of Rs. 2.50 per 1000 Sum Assured will be charged for all cases.
• Applications with nonstandard age proofs will be subjected to Medicals.

3
KYC GUIDELINES

KYC (Know your customer) – KYC is a process of knowing your customer OR Identifying
& verifying the identity of Life Assured / Payer / Proposer / Beneficial owner / Assignee etc.

Documents to be collected for KYC?

• Recent Photograph
• Proof of Identification/Constitution
• Residential Status and Proof of Residence.

*Please refer Annexure 2 for List of Acceptable KYC documents with criteria’s.

KYC needs to be done on -

• Payor
• Proposer (if proposer is different from payer),
• Insured (wherever required),
• Beneficiary, Assignee & Beneficial Owner

4
AML GUIDELINES

AML (Anti Money Laundering): Refers to a set of procedures, laws and regulations designed
to stop the practice of generating income through illegal actions.

Key Points:

• This has been prepared in accordance with Prevention of Money Laundering Act, 2002
(PMLA Act) and IRDAI Master Circular on AML dated 28th September, 2015.

• It is the primary responsibility of the Company to implement an effective AML/CFT

Program to mitigate the risks which may otherwise cause considerable damage to the
Company, employees, agents & intermediaries.

HIGH RISK and LOW RISK CUSTOMERS

Based on the individual's profile and product profile customer shall be classified as High risk
and Low risk.
Low Risk - entities whose identities and source of wealth can be easily identified and
transactions in whose accounts by and large conform to the known profile
High Risk - individuals and entities which require higher due diligence, especially those for
whom the sources of funds are not clear.

5
 Low Risk Customer
Salaried Individuals – Government, Public /
Private sector
Professionals e.g. Doctors, Lawyers,
Architects, Engineers, Pharmacist
Self-employed business owner (business
they are running is not categorized under
high risk category)
The total premium (paid/ payable to TATA
AIA in a financial year) to income ratio
should be Less than or equal to 50% basis
income disclosed on application form or
submitted financial
Individuals involved in agricultural/
horticulture/ sericulture/ fishing or any
similar business by person himself/ herself
High Risk Customer
Politically Exposed and& their close
relatives
Trusts/ Trustees/ Members of the Trust/
Owner of Trust
Charities / Owners and Members of
charities
NGO/ Owners and Members of NGO
Non-face to face customer
The total premium (paid / payable to TATA
AIA in a financial year) to income ratio
more than 50% basis income disclosed on
application form or submitted financial /
income evidence
Customer with dubious reputation as per
information available through public/
media/ internet/ social media. Also,
includes those who are not willing to
disclose the source of Income
Self-employed business owner engaged in
business activities defined below:
i. Construction business (Builder/ Property
Dealer/ Estate Agent/ Property Broker
etc.)
ii. Arms dealer
iii. Antique dealer
iv. Money exchanger
v. Jewelers
vi. Similar business where large cash
transactions are involved
6
AML GUIDELINES AND GRID

Based on Premium amount & type of customer it is mandatory to submit certain documents.
AML Grid for Low Risk Customers -

Total Annual Premium paid / payable Requirements

in a FY (including Top Up amount)

Up to ` 5 Lakhs 1. Proposal Form,

2. Client Confidential Report
3. KYC documents
4. PAN OR Form 60/61

Above ` 5 Lakhs 1. Proposal Form

2. Client Confidential Report
3. KYC documents
4. PAN OR Form 60/61
5. Proof of source of funds
OR 6 months Bank statement

AML Grid for High Risk Customers

Total Annual Premium paid / payable Requirements

in a FY (including Top Up amount)

Up to ` 3 Lakhs 1. Proposal Form

2. Client Confidential Report
3. KYC documents
4. PAN OR Form 60/61

Above ` 3 Lakhs 1. Proposal Form

2. Client Confidential Report
3. KYC documents
4. PAN OR Form 60/61
5. Proof of source of funds
OR 6 months Bank statement

7
AML Grid for NRI / OCI / PIO customers

Total Annual Premium paid / payable Requirements

in a FY (including Top Up amount)

Up to ` 5 Lakhs 1. Proposal Form,

2. Client Confidential Report
3. KYC documents
4. PAN OR Form 60/61
5. NRI/ OCI/ PIO Questionnaire

Above ` 5 Lakhs 1. Proposal Form,

2. Client Confidential Report
3. KYC documents
4. PAN OR Form 60/61
5. NRI/ OCI/ PIO Questionnaire
6. Proof of Source of fund OR 6 months
Bank Statement

8
PAN REQUIREMENT

Submission of PAN/Form 60 is now mandatory for all NB submission. The Guidelines are
applicable for below Entities:
(i) Proposer and/or Payor (ii) Beneficial Owners

Key Points:

• PAN Card photocopy is mandatory in assisted sales.

If PAN not available, then only Form 60 is required.
• The approach will also remain same for beneficial owners in Business Insurance
proposals such as Key man, Employer-Employee, MWP.
• Applicable for Rural/Micro
• Applicable irrespective of product, channel and premium amount

Exclusions:

The below individuals are excluded for submission of Pan Card subject to submission on
officially valid documents (OVD) only.
(i) NRI/PIO/OCI (ii) Foreign National
(iii) Indian Residents from the states of Assam, Meghalaya and J&K
(state of current residence)

OVD’s are listed below which are acceptable as Identity Proof and Address proof: -

Proof of Identity (POI) Proof of Address (POA)

PAN Aadhar

Aadhar Passport

Passport Driving License

Driving License Voter ID

Voter ID MNREGA Card

MNREGA Card BANK KYC (Only for Online Submission)

BANK KYC (Only for Online Submission)

9
MANDATORY DOCUMENTS
FOR SUBMISSION

• Completed Proposal Form / Application Form

• Proof of Age
• Sales Illustration (SIS)
• Premium Payment
• Know Your Customer (KYC) Documents
• Anti-Money Laundering (AML) Documents
• Income Proof & Financial Questionnaire as per requirement
• Any other Avocation / Occupation / Residence /Medical Questionnaire as per requirement
• CCR, COVID Questionnaires
• Customer Profile Report as applicable
Some applications might require additional documentation or might not qualify for Non-Medical/
Tele MER/ Financial Waiver, based on Underwriting assessment using Risk Scoring Models
Similarly some occupations depending on their exact nature may require relevant questionnaires to
be filled in to provide clarity of the occupation.

10
 NON TERM UNDERWRITING

FEMALE LIFE UNDERWRITING GUIDELINES

For financial eligibility, the female lives are grouped into three categories:

Type
Category 1

Employed in Govt organizations, Public & Pvt limited companies

Female lives who independently running their business.
Category 2

Female lives carrying out small business activity to support household but cannot
substantiate their income through valid proofs
Category 3

Female lives may have income through interest, investments, rent, capital gain, gift,
income from any other unearned sources, Housewives, Widow, Unmarried female lives

Documentation / Minimum Documentation / Minimum

Total Sum
Requirement - (Category 2 Lives, Requirement - (Category 3 Lives,
At Risk in INR#
Graduates only) Graduates only)

Up to 50 Lac Nil Nil

Above 50 Lac 1. Financial Questionnaire Nil

up to 2 Crore 2. Income Proof / Standard Income Proof

Above 2 Crore 1. Financial Questionnaire • The cover applied should be within

up to 5 Crore 2. Income Proof / Standard Income Proof 50% of Husbands insurance cover &
• Savings plan with 15 times premium
to sum assured ratio &
• The cover applied should be within
50% eligibility calculated as per
Husbands insurance eligibility using
income proof

11
 Documentation / Minimum Documentation / Minimum
Total Sum
Requirement - (Category 2 Lives, Requirement - (Category 3 Lives,
At Risk in INR#
Non-Graduates only) Non-Graduates only)

Up to 25 Lac Nil Nil

Above 25 Lac 1 Financial Questionnaire The cover applied should be equal to

up to 50 Lac 2.Income Proof / Standard Income Proof Husbands insurance cover

Underwriting guidelines for Juvenile / Minor and Major Student Lives:

1. Maximum Student Age is capped at 25 and Maximum cover
for Student is capped at INR 5 Crore (This includes insurance cover taken from all insurance
companies across the world).

Total Sum At Risk in ` Documentation / Minimum Requirement*

Up to 50 Lac Nil

Above 50 Lac up to 2 Crore • Equalinsurance cover on parents

(Combined insurance cover on father and
mother should be equal to the TSAR on
the proposed life)
• Equal insurance cover on all siblings
• Current
Academic Year Student Proof
(Above 5 Years) / Up to date
immunization record (Up to age 5)

Above 2 Crore and up to 5 Crore • Twicethe insurance cover on parents

(Combined insurance cover on father and
mother should be twice the TSAR on the
proposed life). Proof of insurance will be
required (Policy Schedule of Parents
Insurance cover)
• Equal insurance cover on all siblings
• CurrentAcademic Year Student Proof
(Above 5 Years) / Up to date immunization
record (Up to age 5)
• Standard Income proof of proposer (The
cover applied should be within 50%
eligibility calculated as per parents
insurance eligibility using income proof)

*Underwriters may call for Student ID Proof / Up to date immunization record / Income Proof /
Standard Income Proof from proposed insured based on the underwriting assessment.

12
AGRICULTURE GUIDELINES

Following grid is applicable for individuals engaged in agriculture (similar occupation) to

earn the income in order to support a certain standard of living however their income cannot
be verified with reasonable means (such as standard income proof).

Total Sum at Risk in ` Individual earning through agricultural /

Horticulture / Fishing or equivalent source

Up to 30 Lac Agriculture Questionnaire@

Above 30 Lac Agriculture Questionnaire + Latest land

records documents + Crop sale receipts or
alternate proof of agricultural income

@
Underwriters may call for Latest land records documents + Crop sale receipts or alternate
proof of agricultural income based on his / her assessment

13
NRI/PIO GUIDELINES

NRI PIO/OCI Foreign National

These are Indians Persons of “Indian origin” means a Foreign A Foreign National is a proposed
working abroad & citizen (not being a citizen of Pakistan, insured who is not of Indian origin but
holding Indian Bangladesh and other countries as may be either working in India or settled in
passport & specified by the Central Govt from time to India for a period of at least 3 yrs. and
nationality time) if: shows intent of indefinitely residing in
• He/she at any time held an Indian Passport or India or at least for the tenure of the
• He/she or rather his/her grandparents or policy.
great grandparents were born in and
permanently resident in India as defined in
the Govt of India Act 1935 and other
territories that became part of India,
thereafter provided neither was at any time
a citizen of any of the aforesaid countries or,
• They neither hold an Indian Passport nor
Indian nationality. These customers tend to
visit India as they have their relatives here
or may have relocated back to India.

Mandatory 1. Copies of the relevant pages in the Passport (include personal detail, address detail
documentation for page and current valid Work VISA from the country of residence)
NRIs: 2. Employment Card / Pass, Employment Contact, Business registration certificate, work
permit etc. along with proof of source of funds where a valid Work Visa is not available

1. OCI / PIO Questionnaire to be filled-in by the customer; to also include

Mandatory confirmation of source of fund
documentation for
PIO/OCI: 2. Copies of the relevant pages in the Passport (include personal detail, address detail
page and current valid Work VISA from the country of residence)
3. Details of overseas insurance
4. OCI / PIO card is mandatory. If not available valid Indian VISA copy is required.
5. Travel Questionnaire is required in case of life to be assured who travels to more
than one country

1. The reason of taking insurance and the proof for residing in India (Work
Mandatory
permit/Studies)
documentation for
Foreign National 2. Copies of the relevant pages in the Passport (include personal detail, address detail
page and valid Indian VISA pages)
3. Foreign National Questionnaire to be filled-in by the customer; to also include
confirmation of source of fund
4. Proof of employment / business / status in the country of current residence; Latest
and valid FRRO registration certificate.
5. Standard income proof is mandatory for Foreign Nationals irrespective of premium.

14
General Key Rules for NRI/PIO/OCI/FN:
• Indian Address to be mentioned on Proposal Form. For claiming GST waiver,
correspondence address must be a foreign address and premium payment must be
through NRE account
• Email ID of the prospect is mandatory to be mentioned in proposal form Address
• Proof of communication address mentioned on Proposal Form is mandatory.
• No repatriation of Funds allowed outside India
• Term plan, Term rider and Health products are not allowed to FN.

FATF: The Financial Action Task Force (FATF) is the global standard body for anti-money
laundering and combating the financing of terrorism (AML/CFT).

For all the cases

where the client is Mandatory KYC >> – Irrespective of Sum assured & Premium
residing / working or
is a foreign national
Mandatory AML >>- Standard Financial Evidences irrespective of sum assured and
from any of the
premium.
countries mentioned
in this list extra due
diligence must Source of Fund mandatory
be done

** FATF / UNSC country list is as per the FATF public statement and subject to change

Below is the current list of countries which are not complied with FATF

BOTSWANA CRMEA RUSSIA CUBA COMBODIA

DEMOCRATIC PEOPLES REPUBLIC OF KOREA GHANA ICELAND

IRAN IRAQ MONGOLIA PANAMA

PAKISTAN SYRIA THE BAHAMAS TRINIDAD & TOBAGO

YEMEN ZIMBABWE

POLITICALLY EXPOSED PERSON (PEP)

• PEP is an abbreviation for politically exposed person, a term that describes a person who
has been entrusted with a prominent public function, or an individual who is closely related
to such a person.
• Definition of politically exposed person is already present on the proposal form
• High risk and EDD (extra due diligence) for all the entities as applicable

15
NON TERM FINANCIAL WAIVER GUIDELINES

Financial Underwriting is done for following reason:

1) Need for insurance cover is present. This is established if there is financial loss to the
family / nominee in case of untimely death of the proposed life insured. This is termed as
“Need for Insurance”.
2) Cover proposed is commensurate with the financial loss. This is essential to avoid over
insurance as over insurance could lead to anti selection. This is termed as “Financial
Eligibility”.
3) Affordability of the insurance cover. This is required to ensure that the policy owner is
able to keep the policy in force to get the benefit for which the insurance is taken. This is
termed as “Premium Payment Capacity”.

Need for Insurance: -

For Insurance is established where the proposed insured is a earning through source such as
employment or self-employment or carrying out business. Certain individuals are engaged in
regular work however are not paid for their regular duties (such as housewife / home maker)
are eligible for insurance cover. However, those who are not earning are generally do not
qualify for taking insurance, except insurance on their lives is purely considered as future
financial planning through investment in long term insurance plan.

Standard Financial Eligibility: -

Those who satisfy the first criteria of “Need for Insurance” will be insured subject to a
maximum limit. No one can insure him / herself for unlimited amount and hence financial
eligibility is required to be established for each insurable life. This eligibility is derived
through a simple income multiplier factor. Maximum insurance cover (across all insurance
providers) is determines as per the following table.

Following table is used to calculate the Life Insurance eligibility and different tables / rules
are used to calculate the eligibility for additional benefits such as Accidental Death Benefit
rider, Critical Illness rider etc. The rider eligibility criteria are defined separately.

16
 Age Band (Age Last Birthday) Income Multiplier to arrive at “Standard Financial Eligibility”

18 – 40 25

41 – 45 20

46 – 50 15

> 60 5

Financial eligibility arrived using the above factor represent the maximum amount of life
insurance cover a person can obtain from all insurance providers across the world. All valid
policies$ taken throughout the lifetime of the insured where death benefit is payable in case
of claim are considered while arriving at the eligibility. This is referred as Total Sum At Risk
(TSAR).

Life to be insured shall be required to meet all of the following eligibility criteria to be
eligible for financial waiver with Credit report form Experian / CIBIL / CRIF.
1. Declared income minimum income 300,000 and above
2. Minimum Estimated income as per credit bureau report is equal to for Salaried and
Self-employed is INR 3 Lac. Estimated avg income from credit bureaus shall be taken for
financial evaluation.
3. Minimum Education Criteria: Graduate and above only
4. Credit score: CRIF: 650 & above; EXPERIAN: 750 & above; CIBIL * Not applicable
5. Maximum Financial TSAR including the current and simultaneous plan offered will be
INR 2 Crore per life basis CIBIL income & CRIF/Experian income

Calculation of HLV basis Credit bureau:-

Bureau Education Max FSAR^ allowed Credit score Income Revised HLV

CRIF / Graduate 2 Cr 650/750/N Avg bureau Average Bureau

Experian / A income s/t Income * Age
CIBIL * min 3 Lacs banded income
multiplier Max
capping to 2 cr

*For CIBIL – Credit score criteria is not applicable

^Financial TSAR includes total sum assured across all policies of life assured with the
Tata AIA and with other Life Insurance Companies

17
LIST OF STANDARD INCOME PROOF:

1. Recent Appointment Letter (Not more than 3 months old)

2. Latest salary revision letter (Not more than 3 months old)
3. Last 3 months salary slips
4. Last 6 months Bank statements reflecting salary credit at regular periodic interval
5. Latest Form 16 / Form 16 A
6. Income Tax Returns (ITR) along with CA certified (as applicable)
7. CA certified / Audited Profit and Loss (P&L) account & audited Balance Sheet
(for last two years). CA details need to be valid and the CA certificate should not be
based on the client’s declaration.

Please note, Income proof / Proof of Source of Fund is required under AML guidelines as
per defined matrix. Evidence received under AML guidelines will be used for financial
assessment as well.

Financial Underwriting Requirement:

Following grid is applicable for individuals engaged in full time employment or established
business to earn the income in order to support a certain standard of living and their income
can be reasonably verified through personal meeting and verification.

A) All MDRT / LP / DSF / DBS Assure Banking: For all plans except Fortune Guarantee (10 Pay).

Total Sum at Risk Age Band (Age Last Birthday)

in `
18-21 22 – 60 Above 60

Financial
Up to 5 Lac Nil Questionnaire*

Above 5 to 25 Lac Financial

Financial Questionnaire*
Nil Questionnaire*

Above 25 Lac to Standard Income Proof^

1 Crore Standard
Income Proof^
Above 1 Crore Standard
Income Proof^

18
B) Other Agents: For all plans except Fortune Guarantee (10 Pay).

Total Sum at Risk Age Band (Age Last Birthday)

in `
18-21 22 – 60 Above 60

Financial
Up to 5 Lac Nil Questionnaire*

Above 5 to 10 Lac Financial

Financial Questionnaire*
Nil Questionnaire*

Above 10 Lac to Standard Income Proof^

60 Lac Standard
Income Proof^
Above 60 Lac Standard
Income Proof^

C) Fortune Guarantee Plan Option (10 Pay Only)

Total Sum at Risk in ` Age above 21 years

Up to 1.5 Crore No Income Proof

Above 1.5 Crore Standard Income Proof

For Age Below 21 will be assessed as per Student Lives / Juvenile lives guidelines unless
income proof is provided for financial eligibility assessment. Students up to age 25 need to
submit current student proof. Student / Juvenile / Housewife guidelines will be applicable as
per current guidelines.

*Underwriters will call for Standard Income Proof from proposed insured based on the
underwriting assessment.

19
MEDICAL UNDERWRITING GUIDELINES

1) Non-Medical Limit (Differentiated basis type of Advisor, customer education and

Premium to Death Benefit ratio):

Note: 1) The below document is applicable if Standard Age Proof is provided. For
Non-Standard Age Proof, application will be subjected to medical as per medical grid. Term
Rider will not be allowed under Non-Standard Age Proof. 2) The above mentioned
Non-Medical limit apply to Advisors whose record do not reflect any repudiated claim or
suspicious claim (paid or not paid) from their portfolio or portfolio of their agent under
them. Such list is provided by claims team on regular basis and underwriter will use this for
assessment of eligibility of Non-Medical Limit at the time of underwriting. Not fulfilling this
criteria, the Basic Limit or SCC criteria (wherever applicable) will apply 3) Health Insurance
and Term Plan including any variation of term plan are excluded.

Non-Medical limits for all plans except Fortune Guarantee (10 Pay)

(Age in Medical Sum At Risk in INR

years)
Agent
MDRT/ COT/ TOT/LP Other Advisors and DSF
Category
Premium
to Death Upto 11 times >11 times Upto 11 times >11 times
benefit ratio
Non- Non- Non- Non-
Education Graduates Graduates Graduates Graduates
Graduates Graduates Graduates Graduates
0 – 17 3 Crore 2.5 Crore 2.5 Crore 1.25 Crore
18 – 35 3 Crore 2.5 Crore 2.5 Crore 1.25 Crore 2.5 Crore 1.25 Crore 1.25 Crore 50 Lac
36 – 45 2 Crore 1.5 Crore 1.5 Crore 1 Crore 1.5 Crore 1 Crore 1 Crore 35 Lac
46 – 50 1.5 Crore 1 Crore 1 Crore 75 Lac 1 Crore 75 Lac 75 Lac 20 Lac
51 – 55 1 Cr 75 Lac 75 Lac 50 Lac 75 Lac 50 Lac 50 Lac 15 Lac
56 – 60 50 Lac 50 Lac 50 Lac 30 Lac 50 Lac 30 Lac 30 Lac 10 Lac
61 – 65 50 Lac 30 Lac 30 Lac 20 Lac 30 Lac 20 Lac 20 Lac 10L

Medical limits for Fortune Guarantee Plan Option (10 Pay Only)
Also applicable for Juvenile lives and Students lives up to age 25

Age Band (Age Last Birthday) Medical Sum At Risk in INR

0 – 50 1.5 Crore

51 – 60 1.0 Crore

61 – 65 50 Lac

20
Agency Tele MER MDRT/ COT/ TOT/LP Other Advisors

Premium to Upto 11 times Upto 11 times

Death benefit ratio

Education Graduates Non Graduates Graduates

18 – 35 4 Crore 3 Crore 3 Crore

36 – 45 3 Crore 2 Crore 2 Crore

46 – 50 2 Crore 1.5 Crore 1.5 Crore

51 – 55 1.5 Crore 1 Crore 1 Crore

21
 Medical Grid for Non TERM Life Plans

Age Band (Age Last Birthday) in years

Medical Sum Up 14 - 18 -35 36 - 45 46 50 51 - 55 56-60

at risk in INR to 13 17

Up to JMR ME* ME* ME* ME* ME* ME*

1,000,000

1,000,001 - ME, BPB,

HBA1c,
1,500,000 ECG-R

1,500,001 - ME, BPB,

HBA1c,
2,000,000 ECG-R

2,000,001 - ME, BPB,

HBA1c,
3,000,000 ECG-R

3,000,001 - ME, BPB,

3,500,000 ME, BPB, CBC, HBA1c,
CBC, HBA1c, ECG-R
ECG-R
3,500,001 - ME, BPB, ME, BPB,
5,000,000 HBA1c,
CBC,
ECG-R
HBA1c,
ME, BPB, ME, BPB, ME, BPB,
5,000,001 - ME, ME, BPB, CBC, HBA1c, CBC, ECG-Exe
JMR HBA1c, ECG-R
HBA1c,
10,000,000 BPB ECG-R ECG-R HBA1c, ME, BPB,
ECG-R
CBC,
ME, BPB,
10,000,001 - ME, ME, BPB, ME, BPB, - ME, BPB, HBA1c,
CBC,
JMR HBA1c, ECG-R HBA1c, CBC, HBA1c,
20,000,000 BPB ECG-R ECG-R
HBA1c,
ECG-Exe
ECG-Exe
ME, BPB,
20,000,001- ME, ME, BPB, ME, BPB, ME, BPB,
CBC,
JMR HBA1c, CBC, HBA1c, CBC, HBA1c,
30,000,000 BPB ECG-R ECG-R ECG-Exe
HBA1c,
ECG-Exe

ME, BPB, ME, BPB, ME, BPB,

30,000,001 - ME, ME, BPB,
JMR HBA1c, ECG-R
CBC, HBA1c, CBC, HBA1c, CBC, HBA1c,
50,000,000 BPB ECG-Exe ECG-Exe ECG-Exe

50,000,001 – ME, ME, BPB, ME, BPB, ME, BPB, ME, BPB, ME, BPB,
JMR CBC, HBA1c, CBC, HBA1c, CBC, HBA1c, CBC, HBA1c, CBC, HBA1c,
49,999,999 BPB ECG-R ECG-Exe ECG-Exe ECG-Exe ECG-Exe

250,000,000 JMR ME, ME, BPB, ME, BPB, CBC, ME, BPB, ME, BPB, ME, BPB,
CBC, HBA1c, HBA1c, ECG-Exe, CBC, HBA1c, CBC, HBA1c, CBC,
and above BPB ECG-Exe , 2 D echo, USG ECG-Exe, ECG-Exe, HBA1c,
2 D echo, USG (KUB & Abd), 2 D echo, 2 D echo, ECG-Exe,
(KUB & Abd), Chest X ray, USG USG (KUB 2 D echo,
Chest X ray, Anti HCV, (KUB & Abd), & Abd), USG (KUB
Anti HCV, Urine Urine hest X ray, Chest X ray, & Abd),
microalbumin microalbumin Anti HCV, Anti HCV, Chest X ray,
Urine Urine Anti HCV,
microalbumin microalbumin Urine
microalbumin

Prostate-specific antigen (PSA) required for Male life above 55 years for SAR 10 Cr and
above

22
TERM UNDERWRITING

Parameter Resident Indian Non-Resident Indian

Age Proof Only standard age proof Passport is mandatory as age proof

Minimum Education HSC (10+2) passed HSC (10+2) passed

Occupation Salaried / Self-employed / Professionals in Life Assured should be gainfully employed

white and select blue collar job with class 1 occupation

Minimum Income Salaried – 3 Lakh and Self Employed – 4 Lakh Salaried – 3 Lakh and Self Employed – 4 Lakh
For TATA Group Employees – R.2.50 lakhs up Salary from own business or closely held
to age 30 years family business will not be considered under
Salary from own business or closely held Salaried.
family business will not be considered under
Salaried.

Financial evidence Financial waiver up to INR 1,50,00,000 Financial waiver up to INR 1,50,00,000

TELE MER Grid Refer to Tele MER part Refer Tele MER part

Additional docs NIL Passport, VISA, Employment Proof, Travel

Questionnaire, Passport showing entry into
India stamp by Airport authority, FATCA
evidence.

Only for MAHARAKSHA SUPREME following NML Limits, subject to fulfilment of below
mentioned criteria

Age in yrs Medical Sum at Risk

18 - 45 1 Cr

Above 45 Existing Tele MER / Med will apply

Minimum Education Graduate

Minimum Income* >=10 lacs

Occupation Salaried/Self Employed/Business Owner

Not applicable to Housewife

Health No Adverse health / BMI

Location Should not be from Negative pin codes (Existing Exception guidelines as applicable
for negative pin-codes will continue to be valid)

23
 Medical Sum at Risk

Existing Policies No Sub Standard policies including Borderline STD policies

Country^ NRI allowed from Standard countries only

Additional checks Internal risk checks and industry bureaus for existing policies with other insurance
companies will be applied

*Earned income as per bureau or standard income document as applicable

^Indicative List of Standard Countries as specified this document

Financial Underwriting Requirements:

Basis credit Bureau report:

• All cases by default would be eligible for Financial Waiver as Graduate & Min Income criteria being
default criteria
• If Income as per credit bureau- income estimator is lower than the 10Lac , then case will disqualify from
NML and standard Tele MER or medical grid will be applicable
• Also existing practice of considering lower of declared income or estimated income for financial eligibility
will continue as is

Standard Financial Underwriting:

• Income proof is mandatory for all cases not meeting the criteria for financial waiver as per credit bureau
• List of Standard Income Proof is given is as specified in the document
Existing Tele MER Limits and other criteria remain unchanged.

Revised Grid (Effective 14-Jan) with additional criteria specified below

Age Band Max MSAR Minimum Education Criteria: Graduate

Minimum Earned Income criteria
Premier
Gen Segment Salaried: R 5 Lakhs
Segment
Self Employed: R 7 Lakhs
18-35 1.5 CR 3 CR
No medical adversity disclosed & all previous medical reports
are within normal limit.
36-40 1 CR 3 CR All previous application are accepted at standard rate.
Applicable to all approved locations except those Pin codes
41-45 1 CR 2 CR which are marked as Negative Location.
Allowed for NRI’s from standard countries only.
46-50 75L 1 CR Premier Segment TELEMER limits will be allowed only to
Salaried Individuals having Minimum earned income - R 10 lakhs
> 50 NA NA and are sourced through Premier agents

All SR+ plans will be subject to Physical Grid medicals. No TELEMER limits for SR+ plans

24
Financial Underwriting Term Plans
• Life to be insured shall be required to meet all the following eligibility criteria to be eligible
for financial waiver with Credit report from TU - CIBIL
• Minimum Education Criteria: Graduate
• Minimum declared Annual income shall be INR 3 Lakhs for Salaried and INR 5 Lakhs for
Self - Employed.
• Verified income from mandatory documents is to be considered even if estimated income
is higher
• Further, if declared income is lower than the income estimator, the former should be used
for financial evaluation
• Maximum Financial TSAR including the current and simultaneous plan offered will be INR
1.5 Crore per life. (Financial TSAR includes total sum assured across all policies of life
assured with the Tata AIA and with other Life Insurance Companies)

LIST OF STANDARD INCOME PROOF:

1. Recent Appointment Letter (Not more than 3 months old) with at least 1 months’ salary
slip with Provident Fund deduction.

2. Latest salary revision letter (Not more than 3 months old) with at least 1 months’ salary
slip with Provident Fund deduction.

3. Last 3 months’ salary slips (With Provident Fund Deduction, average income will be
considered)

4. Last 6 months Bank statements reflecting salary credit at regular periodic interval

5. Latest Form 16 / Form 16 A

6. Income Tax Returns (ITR) along with CA certified (as applicable) Computation of income
for last three years – Average Income of 3 years will be considered for computing
eligibility

7. CA certified / Audited Profit and Loss (P&L) account & audited Balance Sheet for last
three years. (average income will be considered)

• Please note, Income proof / Proof of Source of Fund is required under AML guidelines as
per defined matrix. Evidence received under AML guidelines will be used for financial
assessment as well.

25
FINANCIAL SURROGATES
1. To be used only to bridge the financial eligibility gap in case of professional and
self-employed individuals.
2. The income derived through use of surrogates is to be capped to maximum 50% of the
verified income subject to a maximum sum assured of INR 30,000,000
Sr No Type of Surrogate
Investment portfolio
1 consolidated statement of
2 Monthly SIP
3 Car ownership
4 Credit Card limits
5 Home loan statement
6 Last 6 months [preceding date
Bank statement
Document Required Calculation Logic
Copies of the details Annual Income = 1.5 X total
invested value
investment in all instruments
should as of prior to insurance
application date. Investment
should be in the name of LA only
Copies of the monthly SIP for Annual Income =
past 12 months in the name of Monthly SIP * 60
the insurance applicant as of
prior to insurance application
date. Investment should be in
the name of LA
1. Copy of the ownership Annual Income = 1.5X of Value
document/purchase document of Car
2. The vehicle registration
should be in the name of the
Life Assured (with RC Book) &
Copy of Car Insurance.
3. Should be in single name of
the applicant
Car should not be more than 5
years old.
Credit Card statement of recent Annual Income = 5X monthly
6 months showing monthly Credit Limit
credit limits
Credit card should be in LA
name only [No joint owners /
No defaults]
Only one card with highest limit
to be used
1. Repayment statement for last Annual Income = 20 x Monthly
12 months along with bank EMI
statement showing debits for
the same period.
2. Loan approval letter from the
financial authority showing the
EMI [ only for recent loan
procurement]
Annual income = Average
of application] Bank statement monthly balance *10 (If 6
for savings account held in months’ statement is available)
individual name (not a joint
account)
26
Income Multiple for all Term Plans

Income Multiplier to arrive

Age Band (Age Last Birthday)
at “Standard Financial Eligibility”

18 – 35 25

36 – 45 20

46 – 50 15

51 – 60 10

Above 60 5

LIST OF STANDARD COUNTRIES FOR TERM

Indicative List of standard countries

1 Australia 22 Luxembourg
2 Austria 23 Mauritius
3 Belgium 24 Netherlands
4 Brunei 25 New Zealand
5 Bulgaria 26 Norway
6 Canada 27 Oman
7 China (including Hong Kong) 28 Poland
8 Czech Republic 29 Portugal
9 Denmark 30 Romania
10 Finland 31 Sardinia
11 France 32 Sicily
12 Germany 33 Singapore
13 Greece 34 Slovak Republic
14 Greenland 35 Slovenia
15 Hungary 36 Spain
16 Iceland 37 Sweden
17 Ireland 38 Switzerland
18 Italy 39 United Arab Emirates
19 Japan 40 United Kingdom
& Northern Ireland
20 Korea (Republic of Korea)
41 United States of America
21 Vatican City

27
Indicative List of Completely Non-Acceptable (Decline) Countries / Region
Important Note: Countries not covered above are either accepted with / without loading or
declined. You are requested to check with underwriting team for the latest update before
sourcing application

Indicative List of Non standard Countries

1 Afghanistan 10 Nigeria
2 Burundi 11 Pakistan
3 Casamance 12 Sierra Leone
4 Gaza Somalia
13
5 Iraq
14 South Sudan
6 Israel (Including West Bank
and Gaza Strip) 15 Syria

7 Liberia 16 Western Sahara Region

8 Libya 17 Yemen
9 Niger 18 Ukraine

Medical grid for all Term plans

Medical TSAR Age band (Age Last Birthday) in years

in INR
18 – 35 36 – 45 Above 45

50,00,000 ME, BPB, Hba1c ME, BPB, HBA1c, ECG-R ME, BPB, CBC, HBA1c,
ECG-Exe

5,000,001 ME, BPB, HBA1c, ECG-R ME, BPB, HBA1c, ECG-R ME, BPB, CBC, HBA1c,
-20,000,000 ECG-Exe

20,000,001 ME, BPB, HBA1c, ECG-R ME, BPB, CBC, HBA1c, ME, BPB, CBC, HBA1c,
-49,999,999 ECG-Exe ECG-Exe

5,00,00,000 - ME, BPB, CBC, HBA1c, ME, BPB, CBC, HBA1c, ME, BPB, CBC, HBA1c,
24.99 Crore ECG-Exe ECG-Exe ECG-Exe

25 Crore and ME, BPB, HBA1c, ECG-X, 2 ME, BPB, HBA1c, ECG-X, 2 ME, BPB, HBA1c, ECG-X, 2
above D Echo, USG (Pelvis & Abd), D Echo, USG (Pelvis & Abd), D Echo, USG (Pelvis & Abd),
Chest X ray, Chest X ray, Anti HCV, Chest X ray, Anti HCV,
Anti HCV, Urine microalbumin Urine microalbumin Urine microalbumin

Prostate-specific antigen (PSA) required for male life above 55 years for SAR 25 Cr and above
Urine Cotinine test shall be compulsory for all medically examined proposals where Life Assured has declared to be
non-consumer of tobacco or tobacco products. In case, where Life Assured declares as a tobacco consumer, then this
test is not required
If non fasting blood sugar sample is used, then HbA1c will be needed to be done.

28
Business Insurance –
Employer Employee

Purpose

• At times employer wishes to take life insurance cover on its employees as a welfare measure so
that in case of early demise of employee certain sum of money is made available to the
dependents/ legal heirs of the insured employee.
• The employer may also use insurance as one of the means to reward/ retain high performing
individuals.
• Employers have an insurable interest in their employees and vice versa.
• An employer may desire to give additional benefit to employees as a reward of good services by
paying the life insurance premium on behalf of its employees.

Type of Employer – Employee Schemes

• OPTION NO.1: - (SCHEME ‘A’)

a) The Employer is the ‘Proposer’ (policyholder) while the individual Employee(s) is the ‘Life insured’.
b) Employer appoints ‘Authorized Person’ who will sign/ provide documents and other necessary
requirements on behalf of the Employer – such as proposal form, assigment letter etc.
c) The Employer provides a declaration stating the intent to take insurance policies on individual
employees and agreeing to pay the premiums, along with list of employees to be covered under
individual life insurance policies.

OPTION NO.2: - (SCHEME ‘B’)

a) The Employee is both the ‘Proposer’ (policyholder) and the ‘Life Insured’ under this scheme
b) Since the Employee is the Policyholder, no assignment is required by the employer however the
individual employee is free to assign the policy as per existing rules

Products Offered

Savings, ULIP, Term can be offered under both the Schemes

29
Scheme A:

Parameter Details Special Conditions, if any

Proposer Employer Employer will appoint ‘Authorized Person’

to sign & provide documents on behalf
of the Employer

Eligible • Partnership Firms

Employers • Private Ltd Companies
• Public Ltd Companies

Life Insured Individual Employees As stated above

Proposal Form Employee’s details in the Life Assured

Section, while Employer’s details in the
Proposer’s Section.

Benefit • To be signed both by Authorized

Illustration Person as well as Individual Employee

Products • Only Savings/ Investment / Term No Micro Product

Allowed based products will be allowed

Riders Allowed • No Riders will be allowed

Policy Term • Policy term should be chosen such that Maturity age of policy should be earlier of:
• Retirement age of employee.
• Employee attaining age 60 years exceptionally we may consider higher ages

Sum Assured Sum assured will be subject maximum Minimum sum assured & premium
limits for individual employee conditions should be satisfied.
depending upon age, annual income,
existing insurance cover etc.

Income Proofs • Employee: Last three months’ salary slips of employees or Employer’s declaration
of annual salary of the insured
• Employer: ITR with computation of income with audited profit & loss account and
balance sheet of employer for last 3 financial years

AML As per AML Guidelines

Financial Normal Financial underwriting guidelines applicable

underwriting

KYC • Employee: ID, Age, Address proof and recent photograph

Documents • Employer: AOA, MOA, COI, Company’s PAN Card & Address Proof
• KYC of the beneficial Owner

Additional Along with application form, also require certain annexure’s

Documents

30
List of Annexures

Particulars Annexure

1. Covering Letter from Employer Format as per EE2

2. Undertaking to be taken on the letter head of the Company signed by Annex A

the person signing the proposal form as the authorized signatory.

3. Board resolution granting the permission to apply for an insurance Annex B

policy under the Employer-Employee Scheme

4. Format of details of the Employees covered Annex C

5. Beneficiary appointment form Annex D

6. The declaration of the employee Annex E

7. Format of Absolute Assignment to be executed by the Employer upon Annex F

the employee continuing beyond the stipulated working period

8. Special conditions endorsed on the policy Document. Annex G

Scheme B

Parameter Details Special Conditions, if any

Proposer / Life Insured Employee is the proposed insured and policy Format as per EE2
holder

Eligible Employers • Partnership Firms

• Private Ltd Companies
• Public Ltd Companies

Benefit Illustration To be signed both by Individual Employee

Products Allowed All plans are allowed No Micro Product

Riders Allowed No restriction

31
Parameter Details Special Conditions, if any

Sum Assured Sum assured will be subject maximum limits for Minimum sum assured &
individual employee depending upon age, premium conditions
annual income, existing insurance cover etc. should be satisfied.

AML As per AML Guidelines

Financial
Normal Financial underwriting guidelines applicable
underwriting

Income Proofs • Employee: Last three months’ salary slips of employees or Employer’s
declaration of annual salary of the insured
• Employer: ITR with computation of income with audited profit & loss
account and balance sheet of employer for last 3 financial years

• Employee: ID, Age, Address proof and recent photograph

KYC Documents • Employer: AOA, MOA, COI, Company’s PAN Card & Address Proof
• KYC of Beneficial owner

Additional Employer Employee Scheme B addendum form

Documents

Institution Guidelines – HUF

Who is a HUF • A Hindu Joint Family or Hindu undivided family (HUF) or a Joint Hindu
Family is an extended family arrangement prevalent among Hindus,
consisting of many generations living under the same roof.
• All the male members are blood relatives and all the women are either
mothers or wives or unmarried daughters or widowed relatives, all joint in
food, worship and estate.

Members of HUF • Karta: The head/ senior most male member of the family is the Karta. He
is responsible for all the affairs of the family. He represents the HUF as the
Manager
• Co-partners: All male decedents of a common male ancestor are the
Co-partners. Male children of the Co-partners acquire interest in the
family by birth and are admitted to the benefits of the family but are not
liable to commitments of the HUF during their minority. Every co-parcener
has joint possession and joint interest in the HUF property.
• Female members: This includes wife of Karta, wives and un-married
daughters of Co-partners

Financials eligibility • Last 3 years ITRs of HUF (as per Financial Grid is applicable)
• Financial eligibility for cover will be basis HUF income only

Products Offered • All products can be offered

Proposal Form • Only Karta can be the Proposer

• Proposer details column of proposal form should comprise HUF details
• Proposer signature space of Proposal Form / CDF should bear HUF
Karta’s stamp and signature

Documents required HUF addendum/ HUF Pan card required

32
INSTITUTION GUIDELINES – KEY MAN INSURANCE

WHO IS A KEY MAN?

• A person whose services have significant effect on the profitability of the company.
• Key Person could be an employee/director of the company with technical background,
experience, entrepreneurial vision and/or market image whose death, will have a bearing
on the profitability of the Company. There can be more than one Key Person within a
Company of the requisite background, knowledge, experience etc.
• It is not necessary for a Key Person to hold the highest position.
• Key man cannot be a sole proprietor of the firm.

Institution Guidelines – Key Man Insurance

Purpose To protect the company from possible loss which the company might
suffer due to the death of the Key man.

Examples of CEO, Managing Director, Top Executives at strategic levels like

Key man Executive Directors, General Managers, etc.

Financials • 3 times of Average Gross Profit of the company for last 3 years.
eligibility • 5 times of Average Net Profit of the company for last 3 years.
• 10 times of the annual compensation for the Key person including
salary, bonus and all other perquisites.

Products • Only term plan (Protection Plan) will be allowed.

Offered

Proposal • Proposal Form to be filled by Key man in the Life Assured Section,
Form while the Proposer’s details to be filled by the Employer (Company).
• Proposal Form to be signed by the Life Assured as well as an
Authorized Signatory as mentioned in the Board Resolution, along
with the Company’s Seal.

Beneficial Mandatory for all cases along with KYC documents of the
Ownership Beneficial Owner

Sales Authorized Signatory as mentioned in the Board Resolution, along

Illustration with the Company’s Seal.

33
Examples of Type of Plan Allowed Only Term plan, No SR +
Key man Riders Not Allowed

Illiterate Not Allowed

Nomination Not Allowed

Company incurring Not Allowed

consistent losses

1. Application form signed by insured and the authorized person on

Document behalf of the company
Required
2. The company is Payor and Proposer in policy
3. Age proof of insured
4. Medicals as per age and sum assured
5. Board resolution of the company allowing for the purchase of a Key
man insurance on the Key man and appointment of an authorized
signatory
6. Key man Questionnaire
7. ITRs/ P & L accounts/ Balance sheets of last 3 years
8. Personal ITRs of Key man
9. MoA/ AoA of the Company
10. Key man endorsement

34
PARTNERSHIP INSURANCE

Partnership insurance is an instrument that provides financial stability that ensures business’
buoyancy. The remaining partners in a business can buy the business interest of a deceased
partner from the legal heirs using proceeds from partnership
Partnership firm proposes the policy and is the policy owner, with partners as life assured.
All partners are covered as per their respective insurability and get individual policy.
In case only one/two partners out of three are insured , we need to know the reason for not
insuring the third partner. Premiums are paid by the partnership firm
In case of a partner’s death, the firm gets the death benefit.
Only Term Plan is allowed under Partnership Insurance
Following documentation required:

Proposer Insured
PAN copy KYC Proof
Address Proof Address Proof
Last 3 years ITR* & COI Last 2 years ITR & COI
Last 3 years P/L account statement*
Last 3 years Balance Sheet*
Partnership Deed/Agreement
Beneficial ownership declaration along
with his/her KYC

Financial eligibility
• 3 times of Average Gross Profit of the company for last 3 years.
• 5 times of Average Net Profit of the company for last 3 years.

ANNEXURE 1 - ACCEPTABLE AGE PROOFS

Standard Age Proofs

Defense ID Card Marriage Certificate showing Date of Birth
Baptism Certificate Bonafide Certificate showing Date of Birth
Employers PF Statement LIC Policy with specified codes
Service Extract Govt Employer ID Card
School Certificate Municipal Birth Certificate
Driving License Issued < 1 year Pan Card
Passport Domicile Certificate
Aadhar Card with DOB other than Hospital Discharge card up to 5 years.
01/01/YYYY OR 01/07/YYYY OR YYYY

35
 Non-Standard Age Proofs

Voter ID Card ESIS Card

LIC with only age admitted as YES & no codes Health Schemes (CGHS) Certificate

Aadhar Card with DOB 01/01/YYYY OR 01/07/YYYY OR YYYY

ANNEXURE 2 - ACCEPTABLE ID/ADDRESS PROOF FOR INDIVIDUAL CONTRACT

Photo ID Proof

Valid Passport

Pan Card

Voter ID Card

Driving License Valid driving license having photograph

Job Card Issued by NREGA
Aadhar Card/letter issued by UIDAI
(should not be expired);
Learners license not acceptable
Job Card should be signed by an officer
of the state government

Identity Card by Regulatory Authorities Identity card with applicants Photograph

or Government bodies issued by Central/State Govt, Statutory/
Regulatory Authorities, Public Sector
Undertakings, Scheduled Commercial Banks
and Public Financial Institutions

Letter with Photo attested

by Gazette Officer

36
 Address Proof

Name of Document Remark

Utility Bills Utility bill not older than 2 months

from application date

Valid Passport

Voter ID Card

Driving License Valid driving license having photograph

(should not be expired); Learners license
not acceptable

Job Card Issued by NREGA Job Card should be signed by an officer

of the state government

Aadhar Card/letter issued by UIDAI

Identity Card by Regulatory Authorities Identity card with applicants Photograph

or Government bodies issued by Central/State Govt, Statutory/
Regulatory Authorities, Public Sector
Undertakings, Scheduled Commercial Banks
and Public Financial Institutions

Property/Municipal Tax Receipt Property/Municipal Tax Receipt not

older than 1 year

Name of Document Remark

Bank account or Post Office savings Bank passbook OR Post office book with
account statement detail address updated up to
the previous month

Pension/Family Pension Payment Issued by Government Department OR

Orders of retired Govt/PSU employees Public sector if it contains address

Letter of Allotment of Accommodation Issued by Government Department OR

issued by Central/State Govt, Statutory/ Public sector if it contains address
Regulatory Authorities, Public Sector
Undertakings, Scheduled Commercial
Banks, Public Financial Institutions and
listed companies

Leave and license agreements with such employers allotting official accommodation

Documents by Foreign Embassy In case the officially valid document

presented by a foreign national does not
contain the details of address, in such case
the documents issued by Government
departments of foreign jurisdiction
and letter issued by Foreign Embassy or
Mission in India is acceptable

37
 KYC documents other than Individual

Insurance Contracts with Companies 1. Certificate of Incorporation and

Memorandum & Articles of Association;

2. Resolution of the Board of Directors

3. Power of Attorney granted to

its managers, officers or employees to
transact business on its behalf;

4. An officially valid document in respect of

managers, officers or employees holding
an attorney to transact on its behalf

5. Aadhar Numbers and Permanent

Account Numbers or Form 60 of the
managers, officers or employees holding
an attorney to transact on the
Company’s behalf.

Insurance Contracts with Partnership firms 1. Registration certificate, if registered

2. Partnership deed;
3. Any officially valid document in respect
of the person holding an attorney to
transact on its behalf
IRAN
4. Aadhar Numbers and Permanent
Account Numbers or Form 60 of the
person holding an attorney to transact
on its behalf.

Insurance Contracts with Trusts 1. Certificate of registration;

& Foundations 2. Trust Deed;

3. Any officially valid document to

identify the trustees, settlers, beneficiaries
and those holding Power of Attorney,
founders/managers/directors

4. Aadhar number and Permanent Account

Number or Form 60 of the person holding
an attorney to transact on its behalf.

Insurance Contracts with unincorporated 1. Resolution of the managing body

association or a body of individuals of such association or body of individuals
2. Power of Attorney granted to him to
transact on its behalf

3. Aadhar number and Permanent Account

Number or Form 60 of the person holding
an attorney to transact on its behalf.

38
ANNEXURE 3 - LIST OF FINANCIAL DOCUMENTS
A. SALARIED INDIVIDUAL FORM 16

1. Form 16A
2. Latest Appointment Letter / Latest Salary Revision Letter not more than 3 months old
from date of application sign date
3. Latest Employment Contract
4. Bank Statement showing Salary credits for last six months
5. Latest Three Months’ Salary Slips
6. Form 26 AS

B. BUSINESS
1. Income Tax Return (Includes Respective Tax Return Formed in Countries other than India)
2. Self-Attested Balance Sheet and Profit & Loss Account Statement for latest years with corre
sponding ITR's (Latest Partnership Deed in case of partnership firm)
3. Audited Balance Sheet and Profit & Loss Account Statement for latest years (Audited as per
prevailing Tax Norms)
4. Government Contract Letter / Government Work Order reflecting the value of the contract

C. RETIRED AND DRAWING PENSION

1. Pension Order received at the time of retirement in case of Government Employees / Final
Settlement Letter in case of Private Sector Employees if Pension is not provided + Bank
Statement reflecting monthly pension credit

D. AGRICULTURE

1. Agricultural Land Holding Records + Crop Sales receipts

2. Agricultural Land Holding Records + Income Certificate Issued by Tehsildar / Sub Divisional
Revenue Office / Deputy Collector / Collector (for 2 years).

E. SURROGATE INCOME PROOF

1. Fixed / Term Deposits/ FCNR Deposits**

2. Rent Agreement / Land or Property Sale Agreement

F. MUTUAL FUNDS/ STRUCTURES**

**Declaration by the customer that the premiums will be funded through the "surrogate income
proof" mentioned.

39
ANNEXURE 4 - COVID-19 Guidelines (Subject to regular updates)
a. Guidelines for Non Term Plans

No limit on cover amount or product for sourcing from : -Singapore, Hong Kong, Mauritius ,
UAE, Oman, Qatar, Saudi Arabia, Sri Lanka, New Zealand, Australia Thailand & Taiwan
Papua New Guinea, Fiji, Brunei, Maldives, Vietnam, South Korea, Bahrain , Kuwait, China
COVID Q, Video MER mandatory for all cases and other routine requirement
[Further medicals may be necessitated basis disclosures]; other routine requirement
South America, Russia, United Kingdom, Spain, Italy, France, Netherland, Turkey, Iran and
Substandard Residential Rating Countries.
Normal [pre-COVID standard residential guidelines] UW guidelines for NRIs for:
a. GRIP Joint-Life Single-Premium plan with 5 year term: up to a cover of INR. 3 Cr.
b. Savings plan with 20 times Premium to Sum Assured ratio: up to cover INR. 2 Cr (total new
cover issued after 1/4/2020)
All other countries with Standard Residential Rating:
No Pre-login is required, SA restriction as per point 1b applicable
Applications made within 15 days after first port of entry to India May not be postponed
however acceptance only after completing 15 days from entry can login [ allow as per point 2b]
All applicants with travel plans to International location/s within 3 months of date of
application Minimum requirement COVID Q, MER/ VMER and other routine requirements
4) All applications with
a. EMR equal to and above +150 – Postpone for 3 months
b. Age above 60:
i. Maximum sum assured- 50,000,000
ii. Any case with EMR above +75 - Postpone for 3 months

b. Guidelines for Term Plans

Term policies can now be offered to customers from all countries.

The rest of the COVID-19 related UW guidelines continue

40
ANNEXURE 5 - LIST OF QUESTIONNAIRE
Medical Questionnaire
1. Accident or Injury questionnaire
2. Alcohol Usage Questionnaire
3. Anxiety Depression Questionnaire
4. Arthritis Questionnaire
5. Asthma Questionnaire
6. Back and Neck Disorder Questionnaire
7. Chest pain Questionnaire
8. Diabetes Questionnaire
9. Epilepsy Questionnaire
10. Gastrointestinal and digestive disorders_ including ulcers
11. General Attending Physician Statement
12.Gynecological Disorder Questionnaire
13. Height Weight Confirmation Form
14. Hepatitis or Liver Condition Questionnaire
15. Hypertension Questionnaire
16. Kidney Disorder Questionnaire
17. Medical Checkup Questionnaire
18. Neurological Disorder APS
19. Polio or Deformity Questionnaire
20. Pregnancy Questionnaire
21. Respiratory Disorder Questionnaire
22. Smoking Questionnaire
23. Tumor Cyst Lump or Growth Questionnaire
24. Vague Chest Pain or Ischemic Heart Disease

41
Occupation
1. Agriculture Questionnaire Form
2. Civil Aviation Questionnaire
3. Defence Questionnaire
4. Diving Questionnaire
5. Driver Questionnaire
6. Fishing Questionnaire
7. Housewife Questionnaire
8. Marine Questionnaire
9. Micro lighting Questionnaire
10. Mining Questionnaire
11. Occupation Questionnaire
12. Oil and Rig questionnaire
13. Service Aviation Questionnaire

Travel/Residence

1. Foreign Nationals Questionnaire

2. NRI Questionnaire
3. PIO, OCI Questionnaire
4. Residence and Travel Questionnaire

Sports/Avocation
1. Diving Questionnaire
2. Gliding Questionnaire
3. Hang gliding Questionnaire
4. Hazardous Sports Questionnaire
5. Mountaineering Questionnaire
6. Parachuting Questionnaire
7. Scuba Diving Questionnaire

42
ANNEXURE 6 - ARMED FORCES AND PARAMILITARY GUIDELINES

Notes
Proposed below are general guidelines for proposals received from various armed forces
and para-military establishments. The assessment will be subject to nature of duties, current
posting, designation and type of benefit opted.

These are base ratings and additional loading may apply if the applicant is involved in other
hazardous activities like bomb disposal, diving, aviation etc.
Armed/Military questionnaire should be provided in all cases for risk assessment.

Rating Method:
1. Assess applicant's profile basis the information provided in proposal form &
Armed/military questionnaire. Indicative description of the profiles is provided in Table 1.
2. If the applicant's profile is administrative or non-combative in nature, use Table 1 for
rating guideline. However, if the applicant's profile is of combative nature, use Table 2 for
rating.

Table 1
Applicant's profile Description Rating

Administrative No exposure to field, only desk job e.g. Life Standard, Accident/disability
Clerical riders Std

Non-combative Includes profiles like cooks, medical Life Standard, Accident/disability

personnel, engineers, painters, barbers riders IC
etc. who have limited exposure to field and
primarily work in-doors

Combative Includes profiles who have significant field Refer Table 2 below
exposure e.g. gunners, infantry, armour,
artillery

43
Table 2
ARMY
Rank Current posting Rating

Non-sensitive location Sensitive location

Officer Rank Life Std, Riders Decline Life 2 p.m., Riders Decline
Non-officer rank Life 2 p.m., Riders Decline Life 4 p.m., Riders Decline
AIR FORCE
Rank Current posting Rating

Non-sensitive location Sensitive location

Officer Rank Life Std, Riders Decline Life 2 p.m., Riders Decline
Non-officer rank Life 2 p.m., Riders Decline Life 4 p.m., Riders Decline
NAVY
Rank Current posting Rating

Non-sensitive location Sensitive location

Officer Rank Life Std, Riders Decline Life 2 p.m., Riders Decline
Non-officer rank Life 2 p.m., Riders Decline Life 4 p.m., Riders Decline
OTHER ESTABLISHMENTS
Rank Current posting Rating

Non-sensitive location Sensitive location

RPF, CISF, Indian Home Life Std, Riders Rate as mentioned under Life Std, Riders Decline
Guards, Defence Police Force in LG
Security Guards

State Police Life Std, Riders per LG Life 2 per mille, Riders Decline

BSF, CRPF, RAF, SSB, Life 2 p.m., Riders Decline Decline

DSC, SFF, SAP

Black Cat commando, Life 5 p.m. Riders Decline Decline

NSG, SPG, COBRA

Coastal guards Life 2 p.m., Riders Decline Life 2 p.m., Riders Decline

Note: 1. If the applicant is posted overseas or under orders to relocate overseas, the proposal should be declined.
2. Refer LG for further guidance if the applicant is involved in any specialised duties like flying, diving, bomb disposal.

44
Definitions

Sensitive Location Defence personnel deployed or currently under orders of being deployed
to border areas of J&K, North East, Maoist prone areas of Chhattisgarh, Jharkhand.

Non-sensitive location All areas of the country excluding those specified as sensitive.

Abbreviations:

RPF Railway Protection Force

CISF Central Industrial Security Force

SAP State Armed Police

COBRA Commando Battalion for Resolute Action

SPG Special Protection Group

CRPF Central Reserve Police Force

RAF Rapid Action Force

SFF Special Frontier Force

SSB Sahastra Seema Bal

DSC Defense Security Corps.

NSG National Security Guard

BSF Border Security Force

Officer rank Non-officer rank

Army Lieutenant, Captain, Major, Lt. Col, Sepoys, Lance Naik, Naik, Hawaldar,
Colonel, Brigadier, Maj. Gen., Lt. Gen, Naib Subedar, Subedar, Subedar Major

Army Sublieutenant, Lieutenant, Lieutanant Master Chief Petty Officer, Chief Petty
Commander, Commander, Captain, Oifficer, Petty Officer, Seaman
Commodore, Rear Admiral, Vice
Admiral, Admiral

Army Pilot officer, Flying officer, Flight Aircraftsman, Corporal, Sergeant,

Liutenant, Squadron Leader, Wing Warrant officer
Commander, Group Captain, Air
Commodore, Air Vice Marshal, Air
Marshal, Air Chief Marshal

45
ANNEXURE 7 - ARMED FORCES UNDERWRITING SAVINGS

Following matrix is suggested to indicate possible acceptance terms

Rank / Nature of Duties Non-sensitive Location Non-sensitive Location

Life Riders/Benefits Life Riders/Benefits

BSF, CRPF, RAF, COBRA, 2% Decline 4% Decline

ITBP, SSB, AR, ICG

CRPF- Central Reserve Police Force

• For Non-sensitive areas: -

TATA AIA Life would allow offering all products to the serving personnel, restricting total
sum assured to INR 3,000,000, subject to complete underwriting. No Riders are allowed.

• For Sensitive areas:

TATA AIA Life would allow offering all products to the serving personnel, restricting total
sum assured to INR 1,000,000 per Life subject to complete underwriting. No Riders are
allowed.

^ - Kindly note since Sensitive Locations or Disturbed Areas cannot be defined in terms of
specific geographical location as this may change depending upon the prevailing
situations. Underwriter will use discretion and judgment while assessing the occupational
risk arising out of insurgency, politically unstable areas, war or civil unrest for acceptance or
decline such cases as well

Acceptance till maximum sum at risk of 10 Lac is restricted to below locations only.
Orrisa | Assam | Manipur | Nagaland | Mizoram | Chhattisgarh | Jharkhand | Bihar | Jammu
Gadchiroli

• Armed Forces Questionnaire with details of exact nature of day-to-day duties of the
should be specified very clearly. This is a mandatory requirement.
• Risks wherein applicant participates in hazardous Sports & Pastimes or partakes Military
Flying, Deep Sea Diving, Parachuting, Participation in Record Attempts or Competitions
etc. Will be assessed separately and may attract additional loading
• Pre-Submission Calling Wavier : PSC will not be done for these cases as most of the times
CRPF/ BSF / OR ANY OTHER SPECIAL ARMED FORCES personnel are placed at remote
areas where phone is not reachable or there is any issue in contactability.
• Random Medicals Wavier: If a Random Medical is called for , in lieu thereof the copy of
medical report done in last 6 months is submitted – the same will be acceptable.

46
ANNEXURE 8 - EXCEPTION HANDLING SCENARIOS FOR TERM PLANS

a. Education - SSC/10th pass cases will be considered subject to meeting the

following conditions:
1. Applicable to all approved locations except those PIN CODES which are marked as
‘Negative Location’
2. Minimum Earned Income for Salaried and Self-employed is INR 10 Lac
3. Mandatory Standard income proof required Financial waiver OR any kind of Financial
surrogate income shall not be accepted
4. Mandatory Medicals required
5. The Risk Score of TALIC is within acceptable limit
6. Video PSC Mandatory / Video MER &/ or PIV as per underwriter’s discretion
7. Final decision is subject to underwriting

b. Negative Locations cases will be considered subject to meeting the following

conditions:
1. Minimum Education Criteria: HSC or above
2. Minimum average annual earned Income >=INR 10 Lac (Avg. annual earned income
basis standard Income proofs)
3. Mandatory Standard income proof required
4. Financial waiver or any kind of Financial surrogate income shall not be accepted
5. The Risk Score of TALIC is within acceptable limit
6. Mandatory Medicals required
7. Video PSC Mandatory/Video MER &/or PIV as per underwriter’s discretion
8. Final decision is subject to underwriting

ANNEXURE 9: PARAM RAKSHAK GUIDELINES

Product Features
Product SSR ADB ATPD Criticare Plus Hospicare
Min Age 18 years
Max Age 60 years
Max Maturity Age 100 85 years 85 years 75 years 75 years
Minimum Policy Term 30 years 30 subject to Max.Maturity Age
Maximum Policy Term 40 years 40 subject to Max.Maturity Age
Premium Mode Annual
Premium Payment Term Limited Pay – 5 / 10 / 12 years; Regular Pay
Min SA 50L 50L 50L 20L 10L
Max SA No Limit 2Cr 2Cr 1Cr 40L

• Tata AIA Life Insurance Smart Sampoorna Raksha (SSR)

• Accidental Total and Permanent Disability Benefit (ATPD)
• Accidental Death Benefit (ADB)

47
Param Rakshak and Param Rakshak plus UW guidelines
Non Medical Limits Applicable (Subject to Qualifying criteria)
Tele-Medical Limits As per existing Term guidelines of respective channels & As per
Rider Tele limits
Medical Requirement As per Medical Underwriting table given in below pages
Financial Underwriting As per existing Term Product guidelines
Medical Loading Sub standard lives i.e Lives with medical adversity will not be
allowed. Only Standard lives allowed
Occupation Loading Occupations attracting loading are not allowed as per occupation.
Only Standard lives allowed
Residential Loading Sub standard countries not allowed as loading is not allowed . Only
Standard countries allowed Kindly Refer to annexure 1
Housewives Not Allowed
Students Not Allowed
NRI/PIO/FN Param Rakshak :- Allowed NRI/ PIO/OCI from Standard countries*,
FN – Not allowed Param Rakshak Plus:- Not Allowed.
Backdating Not allowed
Age Proof Mandatory Standard Age proof required , NSAP will not be
allowed.
Business Insurance Allowed under HUF, and Employer-Employee scheme A/B (as per
existing Term Plan guidelines) Not allowed to Partnership/ Keyman

Sum Assured Selection for Packages

Packages SA option
• SSR, ADB & ATPD Sum Assured should be equal.
i.e. If customer wants to opt for 50L SSR then ADB & ATPB will also
be automatically selected as 50L.
Param Rakshak
• Since ADB & ATPD Max. SA is 2 Cr, beyond 2Cr of Base (SSR)
cover, ADB & ATPD must be 2 Cr.
i.e. If customer wants to opt for 5Cr SSR then ADB & ATPB will also
be automatically selected as 2Cr.
• SSR, ADB & ATPD Sum Assured should be equal. Criticare Plus &
Hospicare can be opted as per customer’s preference.
i.e. If customer wants to opt for 1.5Cr SSR then ADB & ATPB will
also be automatically selected as 1.5Cr.
Customer can choose Criticare Plus from 20L upto 1Cr & Hospicare
Param Rakshak Plus from 10L to 40L.
• Since ADB & ATPD Max. SA is 2 Cr, beyond 2Cr of Base (SSR)
cover, ADB & ATPD must be 2 Cr. Criticare Plus & Hospicare can
be opted as per customer’s preference.
i.e. If customer wants to opt for 5Cr SSR then ADB & ATPB will also
be automatically selected as 2Cr. Customer can choose Criticare
Plus from 20L upto 1Cr & Hospicare from 10L to 40L.

48
Risk Aggregation
Product Risk Aggregation With
Tata AIA Life Insurance Smart All Term plans. For Term plans also SSR-
Sampoorna Raksha (SSR) SA would be aggregated.
All accidental disability plans (ATPD)
Accidental Total and Permanent Disability
[Max Accidental Disability Benefit per life
Benefit (ATPD)
is 2Cr]
All accidental Death plans (ADB, ADDL)
Accidental Death Benefit (ADB)
[Max Accidental Death Benefit per life is 2Cr]
All Critical Illness plans ( CPB, Existing CI
CritiCare Plus Benefit (CPB) plans) [Max Critical Illness Benefit per life
is 1Cr]
All Hospitalisation Benefit Plans (Hospicare)
HospiCare Benefit
[Max Hospitalisation Benefit per life is 40L]

Examples of Aggregation
1) Customer with existing MRS Plan wants to purchase Param Rakshak Plus.
Maximum SA
Plan Name Cover MSAR Maximum under FSAR
Rider Benefit
MRS 1Cr - - -
Existing Plan
ADDL 1Cr - - -
SSR 1Cr 2Cr 2Cr 2Cr
New Plan
ADB 1Cr NA 2Cr NA
Param Rakshak
ATPD 1Cr NA 1Cr NA

2) Customer with existing Param Rakshak Plus wants to purchase SR+ Plan.
Maximum SA
Plan Name Cover MSAR Maximum under FSAR
Rider Benefit
SSR 1Cr - - -
Existing Plan ADB 1Cr - - -
ATPD 1Cr - - -
SR+ 1Cr 2Cr 2Cr 2Cr
New Plan
ADDL 1Cr NA 2Cr NA

Rider Underwriting
Rider Underwriting Type
Accidental Total and Rules as applicable to ADDL. No Separate underwriting required
Permanent Disability medically/financially.
Benefit (ATPD)

Accidental Death Rules as applicable to ADDL. No Separate underwriting required

Benefit (ADB) medically/financially.

49
Rider Underwriting Type
CritiCare Plus Separate medical Grid Applicable. NML & Tele limits applicable.
Benefit (CPB) Financial Multiple Grid Different than Base.

HospiCare Benefit Separate medical Grid Applicable. NML & Tele limits applicable.
Financial Multiple Grid Different than Base.

Medical Underwriting
Base Criticare Hospicare Medical Decision
(SSR) Plus
NML NML NML NML
NML NML Tele-Eligible Tele-Eligible
NML Tele-Eligible NML Tele-Eligible
Tele-Eligible Tele-Eligible NML Tele-Eligible
Tele-Eligible NML Tele-Eligible Tele-Eligible
Tele-Eligible NML NML Tele-Eligible
Tele-Eligible Tele-Eligible Tele-Eligible Tele-Eligible
Tele-Eligible Medical NML Medical of Rider Grid Applicable
Tele-Eligible NML Medical Medical of Rider Grid Applicable
Tele-Eligible Medical Medical Medical of Rider Grid Applicable
Medical NML NML Medical of Base Grid Applicable
Medical of Base Grid + Rider Grid Applicable.
Medical Medical NML Unique set will be shared with TPA for medicals.
If ECG- R & ECG-X both are applicable only ECG-X
will be shared with TPA for medicals.
Medical of Base Grid + Rider Grid Applicable.
Medical NML Medical Unique set will be shared with TPA for medicals.
If ECG- R & ECG-X both are applicable only ECG-X
will be shared with TPA for medicals.
Medical of Base Grid + Rider Grid Applicable.
Medical Medical Medical Unique set will be shared with TPA for medicals.
If ECG- R & ECG-X both are applicable only ECG-X
will be shared with TPA for medicals.

Smart Sampoorna Raksha NML Limits

Age Band : 18-40 NML (Subject to below qualifying Criteria) : 1 Cr

Education Minimum Graduate

Declared Income >=10 lacs
Occupation Salaried/Self Employed/Business Owner
Location Top 50 cities only (As per Annexure 2)
Health No Adverse health
Existing Policies No Sub-Standard policies including Borderline
STD policies

50
 Age Band : 18-40 NML (Subject to below qualifying Criteria) : 1 Cr
No Adverse Risk Score
Country NRI allowed from Standard countries only

Tele-Medical Limits for Term Plans

(Applicable to SSR as well)
Tele UW Limits Medical Sum at Risk (INR)
Age in Years Premier segment General segment
18 – 35 30,000,000 20,000,000
36 - 40 30,000,000 20,000,000
41 - 45 30,000,000 20,000,000
46 – 50 20,000,000 15,000,000
Premier segment includes Premier Agency Agents like HDFC Bank, HDFC Securities, CITI
bank, Indus Ind bank, DBS (TRM), Blue Chip, NJ, Bajaj Finance, Policy Bazaar, Tata Capital, IEP,
Premier agency group [MDRT, COT, TOT, All Life Planners & NGPA] and Tata group employees.
General Segment: (All those who do not classify under premier segment ie Web Aggregator,
CoBI, DSF, Other agents etc)

NML & TELE MER Grid Riders

Criticare Plus Hospicare
Age Band NML TMER NML TMER
18-35 20L 50L 10L 40L
36-40 20L 50L 10L 40L
41-45 NA NA 10L NA
* Tele-limits to be applied manually till the time these are built in system

Term Plan Medical Grid

(Applicable to SSR as well)

Medical grid for all Term plans

Medical TSAR Age band (Age Last Birthday) in years

in INR
18 – 35 36 – 45 Above 45

50,00,000 ME, BPB, Hba1c ME, BPB, HBA1c, ECG-R ME, BPB, CBC, HBA1c,
ECG-Exe

5,000,001 ME, BPB, HBA1c, ECG-R ME, BPB, HBA1c, ECG-R ME, BPB, CBC, HBA1c,
-20,000,000 ECG-Exe

20,000,001 ME, BPB, HBA1c, ECG-R ME, BPB, CBC, HBA1c, ME, BPB, CBC, HBA1c,
-49,999,999 ECG-Exe ECG-Exe

5,00,00,000 - ME, BPB, CBC, HBA1c, ME, BPB, CBC, HBA1c, ME, BPB, CBC, HBA1c,
24.99 Crore ECG-Exe ECG-Exe ECG-Exe

51
 25 Crore and ME, BPB, HBA1c, ECG-X, 2 ME, BPB, HBA1c, ECG-X, 2 ME, BPB, HBA1c, ECG-X, 2
above D Echo, USG (Pelvis & Abd), D Echo, USG (Pelvis & Abd), D Echo, USG (Pelvis & Abd),
Chest X ray, Chest X ray, Anti HCV, Chest X ray, Anti HCV,
Anti HCV, Urine microalbumin Urine microalbumin Urine microalbumin

Prostate-specific antigen (PSA) required for male life above 55 years for SAR 25 Cr and above

Urine Cotinine test shall be compulsory for all medically examined proposals where Life Assured has declared to be
non-consumer of tobacco or tobacco products. In case, where Life Assured declares as a tobacco consumer, then this
test is not required
If non fasting blood sugar sample is used, then HbA1c will be needed to be done.

Rider Medical Grid

Criticare Plus
Medical Sum at Risk 18 to 40 Years 41 to 50 years 51 to 65 years
MER, ECG-R,
Upto 5,00,000
MER, ECG-R, MER, ECG-R, CBC, BPB
5,00,001 to 10,00,000 CBC, BPB CBC, BPB
10,00,001 to 15,00,000 MER, ECG-R,
15,00,001 to 20,00,000 MER, ECG-Exe, CBC, BPB

20,00,001 & Above MER, ECG-Exe, CBC, BPB

CBC, BPB

Hospicare
Medical Sum at Risk 18-45 Above 45
All Sum Assured MER, ECG-R, CBC, BPB MER, ECG-Exe, CBC,BPB

Examples of Medical grid applicability working

Scenario 1:- Param Rakshak Plus Solution opted by Customer of 35 years
Plan Name SSR SA ADB ATPD Criticare Plus Hospicare
Sum Assured 5Cr 2Cr 2Cr 1Cr 40L
ME, BPB, HBA1c, ME, BPB, ME, BPB,
Grid Applicable NA NA
ECG-X, Cotinine CBC, ECG-X CBC, ECG-R
Final Grid Applicable:- ME, BPB, HBA1c, ECG-X, Cotinine, CBC

Scenario 2:- Param Rakshak Plus Solution opted by Customer of 40 years with Premium
Segment channel
Plan Name SSR SA ADB ATPD Criticare Plus Hospicare
Sum Assured 5Cr 2Cr 2Cr 1Cr 40L
ME, BPB, HBA1c, ME, BPB, ME, BPB,
Grid Applicable NA NA
ECG-X, Cotinine CBC, ECG-X CBC, ECG-R
Final Grid Applicable :- ME, BPB, CBC, ECG-X

52
Financial Multiplier Applicable
Age Group Income Multiplier Income Multiplier
(in years) (Smart Sampoorna Raksha) (Criticare Plus/Hospicare)
18-35 25 12
36-45 20 10
46-50 15 7.5
51-60 10 5

E.g.51 Years Customer with income 10L wants to Purchase Param Rakshak Plus Solution.
Eligibility would be calculated as :-

Eligibility Income Income Coverage Max Allowed for the plan

Multiplier Eligibility

SSR 10L 10 1Cr No Limit

ADB 10L NA 1Cr As per Base upto 2Cr
ATPD 10L NA 1Cr As per Base upto 2Cr
Criticare Plus 10L 5 50L 50L
Hospicare 10L 5 40L 40L

Important Points to Remember

Smart Sampoorna Raksha is ULIP Plan.

Term Plan Guidelines would be applicable for Smart Sampoorna Raksha.

Gating Criteria, Tele medical Guidelines, Financial Waiver limit & other Term plan rules
applicable.

Differential rates for Smoker & Non-Smoker as per Term plan.

Any type of loading is not allowed. (i.e. Medical, Occupation, Residential)

For Param Rakshak Plus, medicals are mandatory above Age 40 as NML limits for Criticare
Plus rider restricted beyond that age.

53
ANNEXURE 9.1: INDICATIVE LIST OF STANDARD COUNTRIES
Sr.No. Countries Sr.No. Countries
1 Australia 18 Romania
2 Luxembourg 19 Finland
3 Austria 20 Hungary
4 Mauritius 21 France
5 Belgium 22 Spain
6 Netherlands 23 Germany
7 New Zealand 24 Singapore
8 Bulgaria 25 Greece
9 Norway 26 Iceland
10 Canada 27 Sweden
11 Oman 28 Ireland
12 Poland 29 Switzerland
13 Slovenia 30 Italy
14 Vatican City 31 United Arab Emirates
15 Czech Republic 32 Japan
16 Portugal 33 United Kingdom & Northern Ireland
17 Denmark 34 United States of America

ANNEXURE 9.2: TOP CITIES LIST

MUMBAI HISAR
DELHI AMRITSAR
BANGALORE BHUBANESWAR
HYDERABAD FARIDABAD
AHMEDABAD VISAKHAPATNAM
PUNE JAMSHEDPUR
KOLKATA KANPUR
THANE HOWRAH
CHENNAI RANCHI
SURAT AURANGABAD
JAIPUR RAIPUR
GURGAON BHOPAL
VADODARA CUTTACK
INDORE HOOGHLY
NAGPUR JALANDHAR
LUCKNOW CHANDIGARH
GHAZIABAD ERNAKULAM
PATNA THRISSUR

54
 NASHIK CHITTOOR
BENGALURU UDAIPUR
GUWAHATI GANDHINAGAR
RAJKOT BALESHWAR TOWN
NOIDA GUNTUR
COIMBATORE JABALPUR
LUDHIANA NORTH PARGANAS

55
Tata AIA Life Insurance Company Limited (IRDAI Regn. No.110) CIN: U66010MH2000PLC128403. Registered & Corporate Office: 14th Floor, Tower A, Peninsula Business Park,
Senapati Bapat Marg, Lower Parel, Mumbai - 400013. Trade logo displayed above belongs to Tata Sons Ltd and AIA Group Ltd. and is used by Tata AIA Life Insurance Company Ltd
under a license. For any information including cancellation, claims and complaints, please contact our Insurance Advisor / Intermediary or visit Tata AIA Life’s nearest branch office or call
1-860-266-9966 (local charges apply) or write to us at customercare@tataaia.com. Visit us at: www.tataaia.com. • For internal circulation only.

BEWARE OF SPURIOUS/ IRDAI is not involved in activities like selling insurance policies, announcing bonus or investment of premiums. Public receiving such phone calls are requested
FRAUD PHONE CALLS! to lodge a police complaint.