QuotationNo : 100001791100067

Dear Ms. DEVADASAN V P

Thank you for your interest in our Canara HSBC Life Insurance Jeevan Nivesh. Based on the details provided by you, and reproduced below, the illustration customized to your requirements is appended.

Date : 08/04/2024 Proposal No: NA

Name of the Prospect/ Policyholder: DEVADASAN V P Name of the Product: Canara HSBC Life Insurance Jeevan Nivesh
Age 57 An Individual Non-Linked Par Life Insurance
Tag Line:
Savings cum Protection Plan
Gender Male
Unique Identification Number: 136N047V02
Name of the Life Assured: ANUSREE V P
GST Rate(First Year): 4.50%
Age 27
GST Rate(2nd Year onwards): 2.25%
Gender Female
Policy Term 10
Premium Payment Term 5
Amount of Instalment Premium Year 1 1,22,813
Amount of Instalment Premium Year 2
1,22,813
onwards
Mode of payment of Premium Annual

How to read and understand this benefit illustration?

This benefit illustration is intented to show year-wise premiums payable and benefits under the policy, at two assumed rates of interest i.e., 8% p.a. and 4% p.a.

Some benefits are guaranteed and some benefits are variable with returns based on the future performance of your insurer carrying on life insurance business. If your policy
offers guaranteed benefits then these will be clearly marked "guaranteed" in the illustration table on this page. If your policy offers variable benefits then the illustrations on this
page will show two different rates of assumed future investment returns, of 8% p.a. and 4% p.a. These assumed rates of return are not guaranteed and they are not the upper or
lower limits of what you might get back, as the value of your policy is dependent on a number of factors including future investment performance.

Policy Details

Policy Option Endowment Sum Assured Rs 6,25,000

Sum Assured on Death (at inception of the

Bonus Type Simple Reversionary & Terminal Bonus 12,28,120
policy) Rs
Set-off Option No

Premium Summary

Total Installment
Base Plan Riders
Premium

Instalment Premium Year 1 without GST 1,22,813 - 1,22,813

Instalment Premium Year 2 onwards without GST 1,22,813 - 1,22,813

Instalment Premium Year 1 with GST 1,28,340 - 1,28,340

Instalment Premium Year 2 onwards with GST 1,25,576 - 1,25,576

Page No. Production Release Channel Name : Kerala Gramin Bank Proc hub : Mallapuram Curr Res State : KERALA Version 1.0.0 N Illustration Number : 100001791100067
 (Amount in Rupees)
Total Benefits including Guaranteed and Non
Guaranteed Benefits
Guaranteed Benefits Non Guaranteed Benefits @ 4% Non Guaranteed Benefits @ 8%
Maturity Benefit Death Benefit

Total
Total
Total Death
Maturity Total Death
Maturity Benefit,
Single/ Benefit, Benefit, incl
Policy Guraranteed Survival Surrender Death Maturity Reversionary Cash Surrender Reversionary Cash Surrender Benefit, incl incl
Annualized incl Terminal
Year Additions Benefit Benefit Benefit Benefit Bonus Bonus Benefit* Bonus Bonus Benefit* Terminal Terminal
Premium Terminal Bonus*, if
Bonus, if Bonus*,
Bonus, if any @8%
any @8% if any
any @4%
@4%

1 2 3 4 5 6 7 8 9 10 11 12 13 14=7+8+9 15=7+11+12 16=6+8+9 17=6+11+12

1 1,22,812 0 0 0 12,28,120 0 0 0 0 12,500 0 0 0 0 12,28,120 12,40,620

2 1,22,812 0 0 73,688 12,28,120 0 0 0 0 25,000 0 6,250 0 0 12,28,120 12,53,120
3 1,22,812 0 0 1,28,953 12,28,120 0 0 0 0 37,500 0 10,500 0 0 12,28,120 12,65,620
4 1,22,812 0 0 2,45,625 12,28,120 0 0 0 0 50,000 0 16,000 0 0 12,28,120 12,78,120
5 1,22,812 0 0 3,56,155 12,28,120 0 0 0 0 62,500 0 23,125 0 0 12,28,120 12,90,620
6 0 0 0 4,05,280 12,28,120 0 0 0 0 75,000 0 32,250 0 0 12,28,120 13,03,120
7 0 0 0 4,54,405 12,28,120 0 0 0 0 87,500 0 42,875 0 0 12,28,120 13,15,620
8 0 0 0 5,03,530 12,28,120 0 0 0 0 1,00,000 0 57,000 0 0 12,28,120 13,28,120
9 0 0 0 5,52,655 12,28,120 0 0 0 0 1,12,500 0 73,125 0 0 12,28,120 13,40,620
10 0 0 0 5,52,655 12,28,120 6,25,000 0 0 0 1,25,000 0 93,750 7,00,000 8,93,750 12,28,120 13,53,120

Important Notes:

1.Annualized Premium mentioned excludes rider premiums, underwriting extra premiums, frequency loadings on premiums if any, as well as excludes Goods and Services Tax & applicable cess (es)/other
levy, if any.

2.Maturity Benefit payable under this plan is Guaranteed Sum Assured on Maturity plus Accrued Annual Bonuses and Final Bonus, if any.

3.Installment premium mentioned is inclusive of underwriting extra premiums, if any.

4.A Policy shall acquire lapse state if the Policyholder fails to pay due premium within the Grace Period in the first 2 consecutive Policy Years. In such case your Policy will lapse at the expiry of the grace
period and the insurance cover will cease immediately. No benefit shall be payable upon death or upon your request for termination of the Policy or on the expiry of the revival period.

5.The Death Benefit is the benefit payable on death of the Life Assured, which is higher of 1. Sum Assured on Death plus Accrued Annual Bonus, Interim Bonus and Final Bonus (if any) accrued till the
date of death. 2. 105% of {the Total Premiums Paid till the date of death less underwriting extra premiums, if any}, where Sum Assured on Death is defined as Higher of (10 times the Annualized
Premium or Guaranteed Sum Assured on Maturity or Absolute amount assured to be paid on death).

Other Points to Note:

1.The Policy will be eligible for bonuses from the profits emerging out of the with-profit fund managed by the Company by way of Annual bonuses and Final bonus, if any. The Company will declare the
Annual bonus at the end of each financial year and once declared, the annual bonus will get accrued to the Policy and is guaranteed to be payable.

2.This is a traditional plan intended for long term savings and benefits. It is strongly advised that the Policy should be continued throughout the defined Policy term to realize the full benefits. Early exit
should not be opted for unless there is no other alternative available, as it will impact the Policy value. If premiums are discontinued after payment of at least first 2 years’ consecutive premiums then the
Policy will acquire a Paid-up value. You will receive this Paid-up value on death or on maturity, provided you have not surrendered or revived the Policy.

3.Your Policy will acquire a guaranteed surrender value (GSV) after payment of atleast 2 consecutive Policy years' premiums. However, the Company may offer a special surrender value (SSV), and higher
of {GSV or SSV} will be paid on surrender. The Illustration above only shows the GSV payable on surrender of the Policy under the two assumed rates, of 4% p.a. and 8% p.a.

4.Premiums payable and benefits receivable under this plan are eligible for tax benefits as per the prevailing tax laws subject to amendments from time to time.

5.The premium is for a healthy individual. Your application will be assessed as per board approved underwriting guidelines of the company. Basis underwriting, it may result in an extra premium to be
paid, which shall be borne by you.

6.Minimum guaranteed amount payable on Surrender is payable at the end of the Policy year.

7.The illustration takes into account currently applicable service tax & cess. However, the applicable taxes may change from time to time and premium payable will change accordingly.

8.Settlement option will not be available if the prevailing 10-Year G-Sec yield is below 4%.For more details on Settlement option please read sales brochure or sample policy contract carefully before
concluding a sale.

9.For more details on product features and terms and conditions please read sales brochure or sample Policy contract carefully before concluding a sale.

Risk Factors

There is no guarantee on the amount of bonuses and these will be declared at the sole discretion of the company. Hence, the bonuses in this plan may vary from time to time.

Page No. Production Release Channel Name : Kerala Gramin Bank Proc hub : Mallapuram Curr Res State : KERALA Version 1.0.0 N Illustration Number : 100001791100067
I, _____________________________________(name), have explained the premiums, charges and benefits under the I, _____________________________ (name), having received the information with respect to the above, have understood
product fully to the prospect / policyholder. the above statement before entering into the contract.

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

Page No. Production Release Channel Name : Kerala Gramin Bank Proc hub : Mallapuram Curr Res State : KERALA Version 1.0.0 N Illustration Number : 100001791100067
Version 2

Jeevan Nivesh Plan:

Key Information Document (KID)
There is no compulsion or requirement to take this Life
Insurance Policy as a condition/part of a bank loan.

Other important aspects that you must know:

*In the unfortunate event of death of the Life

You have the

1. Sum Assured on Death plus accrued annual

2
choose from
multiple premium bonuses
payment terms
(i.e. 5/7/10/ 2. 105% of Total Premiums Paid till the date of
Takes care of Regular payment)
with policy term death less underwriting extra premiums (if any)
your saving cum

1
ranging from 10 to
protection needs Guaranteed Benefit Where: Sum A
through either 30 years.
- 100% of Guaranteed

3
Endowment option of a) 10 times Annualized Premium b) Guaranteed
Sum Assured on Maturity
or Endowment with is paid on maturity. Under Sum Assured on Maturity c) Sum Assured (i.e. the
Whole Life Option Endowment with Whole Life
(i.e. life coverage till option, additional amount
absolute amount assured to be paid on death.)
age 100 years) equal to Sum Assured on Only applicable in Endowment with Whole Life
Maturity is payable on life
assured surviving till age Option: If the death of the Life Assured occurs after
100 years. the Maturity Date and before attaining Age 100,

7
while the Policy is in-force, We shall pay an amount
Under Endowment
Option you have an Important equal to Guaranteed Sum Assured on Maturity.
option to choose ‘Settlement
aspects

7
option#’. It allows you to *In case you stop paying the premiums after paying
convert your Guaranteed
Sum Assured on Maturity about Jeevan Bonus payout on
maturity - Accrued
into annual payouts which are
Nivesh Plan become Paid-up and continue but with reduced

4
paid over next 15 year period. Annual Bonuses
These annual payouts also
increase by 5% any) are payable on
compounded maturity. *Policy acquires a Guaranteed Surrender Value(GSV)
every year. No bonuses are
payable beyond
the policy term.
Special Surrender Value (SSV), and higher of GSV
Loans - Provides
and SSV will be paid on surrender.
liquidity once the

6
policy acquires In case of *Premiums
Surrender Value. Surrender/

5
Non-payment of
beyond the policy premiums, the
subject to change in tax laws. Please consult your
term in case of
Endowment with will be reduced tax advisor for details.
Whole life that you would
Cover Option. have otherwise *Applicable taxes including Goods and Services
received on policy tax, as per government regulations, will be levied
continuance.
additionally and are to be borne by the Policyholder

#
Pleases refer to the sample policy document/sales brochure for more details on settlement option

Policy Discontinuance & Revival:

• AP
in such cases.
• R
the product features, please refer to the product brochure.

IMPORTANT DISCLOSURE REQUIREMENT:

Please provide correct and complete details, including information on all medical ailments such as diabetes, hypertension, heart diseases, cancer, etc. in the
proposal form, otherwise, there is a risk of your policy benefit/ claim being denied.
I have been briefed on the benefits and features of Canara HSBC Life Insurance Jeevan Nivesh Plan. I have understood the information and risks associated
with this plan. I confirm that my selection of the above policy is in keeping with my life insurance/investment objectives I have briefed
__________________________________________ in ______________________________________ language on the benefits and features of this
insurance plan.

Name: Signature: Date:

Code: Proposal Number:

IMPORTANT INFORMATION:
This is the Key Information document about the Jeevan Nivesh Plan and it doesn’t replace the full policy terms and conditions (which you should read carefully on receipt).
Jeevan Nivesh Plan is an Individual Non-Linked Par Life Insurance Savings cum Protection plan intended for regular savings and
strongly advise that the policy should be continued throughout surrender, the surrender
value available may be lower than the premiums paid. Hence, we recommend that you pay your premiums regularly and continue the policy till maturity.
Early surrender should not be opted for unless there is no other alternative available, as it will impact the policy value and intended goals may not be
realised.
Purchase of any insurance products by a bank’s customer is purely voluntary and is not linked to availment of any other facility from the bank.
For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale. You can also speak to your sales representative, or
visit our website www.canarahsbclife.com.
There are restrictions on requests of Revival of Policies, any request that results in change of premium or policy feature while the customer is in the US. The Company
reserves the right to restrict any other policy servicing request basis the applicable US Laws.

understanding of the proposed Life Insurance plan.

Canara HSBC Life Insurance Jeevan Nivesh Plan (UIN:136N047V02)

The information provided here is indicative of your policy terms and conditions. The Insurance products are offered and underwritten by
Canara HSBC Life Insurance Company Limited (formerly known as Canara HSBC Oriental Bank of Commerce Life Insurance Company Ltd)
(IRDAI Regn. No. 136) having its head office at 139 P, Sector 44, Gurugram – 122003, Haryana (India).