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Benefit Illustration: Death Benefit Multiple Policy Continuance Benefit Option Special Date Option
Benefit Illustration: Death Benefit Multiple Policy Continuance Benefit Option Special Date Option
This benefit illustration is intended to show year-wise premiums payable and benefits under the policy.
Policy Details
Policy Option Wealth for Milestones Sum Assured on Maturity (in Rs.) 24,78,800
Death Benefit Multiple NA Sum Assured (at inception of the policy) upon Death (in Rs.) 22,00,000
Policy Continuance Benefit Option No Sum Assured (Inbuilt Additional Accidental Death Benefit) (in Rs.) 11,00,000
Special Date Option No Opted Special Date NA
Rider Details
Accidental Death & Dismemberment (ADD) Rider Term NA Accidental Death & Dismemberment (ADD) Rider Sum Assured (in Rs.) NA
Term Plus Rider Term NA Term Plus Rider Sum Assured (in Rs.) NA
Waiver of Premium (WOP) Plus Rider Term NA
Critical Illness and Disability Rider - Rider Premium Payment
NA Critical Illness and Disability Rider - Coverage Variant NA
Term and Rider Term
Critical Illness and Disability Rider - Rider Sum Assured NA
Premium Summary
Accidental Death & Waiver of Premium Plus Critical Illness and Total Installment Premium
Base Plan Dismemberment Rider
Term Plus Rider Rider Disability Rider
Installment Premium without GST (in Rs.) 2,00,000 0 0 0 0 2,00,000
Installment Premium with first year GST (in Rs.) 2,09,000 0 0 0 0 2,09,000
Installment Premium with GST 2nd year onwards (in Rs.) 2,04,500 0 0 0 0 2,04,500
UIN: 104N124V04 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 1 of 3
(Amount in Rupees)
Non Guaranteed
Guaranteed
Single/
Total Annual Other Benefits, if Inbuilt
Policy Annualized Money Back Accrued Minimum
Premium (BOY) Auto Debit any (Sum Additional Special
Year Premium (BOY) Base Income Loyalty Income (In case of Life Total Survival Guaranteed Total Maturity Guaranteed
Booster Assured on Death Benefit Accidental Surrender Value
(EOY) (EOY) Long Income) Benefit (EOY) Additions (if Benefit (EOY) Surrender Value
(EOY) Maturity) (EOY) Death Benefit (EOY)
any) (EOY) (EOY)
UIN: 104N124V04 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 2 of 3
I, ……………………………………………. (name),have explained the premiums, and benefits I, ……………………………………………. (name), having received the information with respect
under the product fully to the prospect / policyholder. to the above, have understood the above statement before entering into the contract.
Place: Signature / Thumb Impression / Electronic Signature of Date:9/22/23 Signature / Thumb Impression / Electronic Signature of
Date: 9/22/23 Agent/ Intermediary / Official Prospect/ Policyholder
This system generated benefit illustration shall be treated as signed by me.
UIN: 104N124V04 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 3 of 3