For Office Use Only (w.e.f. June 22/ Ver 1.

11)

Illustration No: KASP-3920M-1205-Y100

Quotation Number:01270223090848809

Proposal No:

Policy No.:

Name of the Name of the Product Kotak Assured Savings Plan

Prospect/Policyholder
Tag Line A Non-Participating Endowment
Age of the 39 Assurance Plan
Prospect/Policyholder (in yrs)
Unique Identification No UIN : 107N081V04
DOB of the 10 January 1984
Base Goods and Services Tax and Cess Rate 4.5%
Prospect/Policyholder
(GST) (1st Year)
Name of Life Assured
Base Goods and Services Tax and Cess Rate 2.25%
DOB of Life Assured 10 January 1984 (GST) (2nd Year)

Age of Life Assured (in yrs) 39 Rider Goods and Services Tax and Cess Rate 18%
(GST)
Gender of Life Assured Male
Channel Name Individual Agents
Policy Term (in yrs) 20

Premium Payment Term (in 10

yrs)
Agent's Branch Location Himachal Pradesh
Amount of Installment 1,00,000
Prospect/Policyholder's Current Location Gujarat
Premium (in Rs.)

Mode of Payment of Premium Yearly

This Benefit Illustration is intended to show year-wise premiums payable and benefits under the policy.

POLICY DETAILS

Policy Option : Not Applicable Base Sum Assured (Rs.) : 15,14,394

Base Sum Assured on Death (at

: 18,17,273
inception of the policy) Rs.

Rider Details

Rider Premium Paying

Rider Name Rider Sum Assured Rider Policy Term Rider Premium (Rs.)
Term

Kotak Term Benefit Rider (UIN: 107B003V03) Not Selected

Kotak Accidental Death Benefit Rider

Not Selected
(UIN:107B001V03)

Kotak Permanent Disability Benefit Rider

Not Selected
(UIN:107B002V03)

Kotak Life Guardian Rider (UIN: 107B012V02) Not Selected

Kotak Accidental Disability Guardian Rider (UIN

Not Selected
107B011V02)

Kotak Critical Illness Plus Benefit Rider (UIN

Not Selected
107B020V01)

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Quotation Number:01270223090848809

PREMIUM SUMMARY

Base Plan Riders (Please refer Rider Details table) Total Installment Premium

Installment Premium (without GST) 1,00,000 0 1,00,000

Installment Premium (with First Year GST) 1,04,500 0 1,04,500

Installment Premium (with GST, Second Year onwards) 1,02,250 0 1,02,250

BENEFIT ILLUSTRATION TABLE

Non-Guaranteed
Guaranteed Benefits
Benefits
Annualised
End of Policy Year Age of Life Insured Accrued
Premium Guaranteed Yearly Guaranteed Loyalty Guaranteed Special Surrender
Basic Sum Assured Guaranteed Yearly Maturity Benefit4 Death Benefit3
Addition Additions Surrender Value5 Value6
Additions

1 40 100000 15,14,394 10,000 10,000 0 0 18,27,273 0 0

2 41 100000 15,14,394 20,000 30,000 0 0 18,47,273 65,229 61,087

3 42 100000 15,14,394 30,000 60,000 0 0 18,77,273 1,16,460 1,02,576

4 43 100000 15,14,394 40,000 1,00,000 0 0 19,17,273 2,20,950 1,53,206

5 44 100000 15,14,394 50,000 1,50,000 0 0 19,67,273 2,84,515 2,14,489

6 45 100000 15,14,394 60,000 2,10,000 0 0 20,27,273 3,53,109 2,88,340

7 46 100000 15,14,394 70,000 2,80,000 0 0 20,97,273 4,27,896 3,76,776

8 47 100000 15,14,394 80,000 3,60,000 0 0 21,77,273 5,18,268 4,82,157

9 48 100000 15,14,394 90,000 4,50,000 0 0 22,67,273 6,37,785 6,07,467

10 49 100000 15,14,394 1,00,000 5,50,000 0 0 23,67,273 7,64,490 7,55,630

11 50 0 15,14,394 0 5,50,000 0 0 23,67,273 8,25,445 8,25,861

12 51 0 15,14,394 0 5,50,000 0 0 23,67,273 8,78,655 9,02,780

13 52 0 15,14,394 0 5,50,000 0 0 23,67,273 9,54,395 9,87,317

14 53 0 15,14,394 0 5,50,000 0 0 23,67,273 10,22,830 10,80,029

15 54 0 15,14,394 0 5,50,000 0 0 23,67,273 11,04,345 11,81,845

16 55 0 15,14,394 0 5,50,000 0 0 23,67,273 11,99,215 12,93,322

17 56 0 15,14,394 0 5,50,000 0 0 23,67,273 12,97,825 14,15,576

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 18 57 0 15,14,394 0 5,50,000 0 0 23,67,273 14,00,505 15,49,720

19 58 0 15,14,394 0 5,50,000 0 0 23,67,273 15,17,750 16,96,684

20 59 0 15,14,394 0 5,50,000 3,02,879 23,67,273 23,67,273

Notes: Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any and Goods and Services Tax.

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Quotation Number:01270223090848809

Terms & Conditions:

1. This is a limited pay non-participating endowment plan. The Illustration stated is for a healthy individual and would be subject to underwriting.

2. High Premium Benefit is available for annual premiums of Rs.30,000 and above by way of increase in the Basic Sum Assured Rates. For details,
please refer to Sales Brochure.

3. Death Benefit shall be Basic Death Benefit Plus Guaranteed Yearly Additions accrued as on the date of death where Basic Death Benefit will be
higher of
11 times Annualized Premium for entry ages less than 50 years or 7 times Annualized Premium for entry ages 50 and above or
Guaranteed Minimum Death Benefit* or,
105% of total premiums paid (excluding any extra premiums)
* Guaranteed Minimum Death Benefit will be 110% for PPT of 5 years, 112% for PPT of 6 years, 114% for PPT of 7 years and 120% for PPT of
10 years.

4. Guaranteed Maturity benefit is Basic Sum Assured plus Accrued Guaranteed Yearly Additions plus Guaranteed Loyalty Addition.

5. The policy will acquire Guaranteed Surrender Value provided premiums due for at least 2 policy years have been paid in full.
The Guaranteed Surrender Value shall be a 'X' percent of total Premiums paid (excluding Goods and Services tax and Cess, Rider premium and
Extra Premium, if any) Plus the value of accrued Guaranteed Yearly Additions where 'X' percent varies by year of surrender, Premium Payment
Term and Policy Term and is mentioned in the table below:

Policy Year: 1 2 3 4 5 6 7
N.A 30% 35% 50% 50% 50% 50%
Policy Year: 8 9 10 11 12 13 14
51% 54% 56% 60% 63% 68% 72%
Policy Year: 15 16 17 18 19 20
77% 83% 89% 95% 102% 110%

6. Once policy acquires Surrender Value, the Company may consider paying a Special Surrender Value and the same will be quoted in writing by
the Company, on receipt of a written request from the policyholder. In any case, higher of the Guaranteed Surrender Value or Special Surrender
Value will be payable. For more details, please refer the sales brochure.

7. The policy is automatically made Reduced Paid-Up where policy has acquired Surrender Value and due premiums are not received within the
grace period. Paid-Up policies shall not be eligible for future Guaranteed Yearly Additions and Guaranteed Loyalty Additions.
The Maturity Benefit is reduced to Reduced Paid-Up Basic Sum Assured PLUS accrued Guaranteed Yearly Additions; where Reduced Paid-Up
Basic Sum Assured = (Total Premiums paid / Total premiums payable over the term) * Basic Sum Assured
On death of the life insured during the policy term after being Reduced Paid-Up, the benefit payable will be the sum of Reduced Paid-Up Basic
Death Benefit and accrued Guaranteed Yearly Additions. For more details, please refer to Sales Brochure.
Rider benefit will be available as per Reduced Paid-Up Sum Assured of Rider (if applicable).

8. A lapsed or Paid-Up policy can be revived with or without riders within 5 years from the date of the first unpaid premium. Revival can be done
without evidence of good health on payment of the outstanding premiums and revival charges, if the payment is made within six months from the
date of the first unpaid premium. Thereafter to revive the policy, evidence of good health would be required along with payment of the outstanding
premiums and revival charges. On revival, all benefits under the policy will be reinstated.

9. The above illustrated benefits are derived on the basis of details of life insured provided at the time of filling the proposal form. If the details are
found inaccurate or there are any changes before or at the time of the policy issuance for eg: change in age, the illustrated benefits will be subject
to revision.

10. Goods and Services Tax & Cess, as applicable are levied at the applicable Tax rates in accordance with the prevailing Tax Laws. Prevailing tax
laws are applicable on this policy which may vary from time to time.

11. The values shown are for illustrative purposes only. For more details on risk factors, terms and conditions please read sales brochure carefully
before concluding a sale.

12. TDS at prevailing rate will be deducted from any amount paid under a life insurance policy subject to the provisions of prevailing tax laws. In case
of non-availability of valid PAN, TDS will be deducted at higher rate. Tax laws are subject to changes from time to time. Kindly consult your tax
advisor for tax implication of your policy.

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Quotation Number:01270223090848809

Section 41 of the Insurance Act, 1938 states as amended from time to time

(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:

(2) Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakh rupees.

I, _____________________________(Name), have explained the I, ____________________________(Name), having received the

premiums and benefits under the product fully to the prospect / information with respect to the above, have understood the above

policyholder. statement before entering into the contract.

Place :_____________ __________________________________ Place :_____________ ______________________________

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

Kotak Mahindra Life Insurance Company Limited.

CIN: U66030MH2000PLC128503
Regd. Office: 8th Floor, Plot# C-12, G-Block, BKC, Bandra (E), Mumbai - 400 051
Regn. No: 107. Toll Free No.: 1800 209 8800.WhatsApp: 9321003007 Website: https://www.kotaklife.com

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