Duplicate

PART A
Welcome to Max Life Insurance
-----------------------------------------------------------------------------------------------------------------------------------------------------------
Date 23-Mar-2024
To Mr. Awanish Kumar Mandal
S/O Yogendra Nath Mandal
Karsi
Nawanagar, Ballia, Nawa Nagar
Ballia 221717
Uttar Pradesh India
Branch: EBRL1
Policy no.: 158948752
Telephone: 7307571031
-----------------------------------------------------------------------------------------------------------------------------------------------------------
Welcome Dear Mr. Awanish Kumar Mandal,
Thank you for opting for Max Life Smart Secure Plus Plan (A Non-Linked Non-Participating Individual Pure Risk Premium
Life Insurance Plan). We request you to go through the enclosed policy contract.
-----------------------------------------------------------------------------------------------------------------------------------------------------------
What to do in On examination of the Policy, if you notice any mistake or error, proceed as follows:
case of errors 1. Contact our customer helpdesk or your agent immediately at the details mentioned below.
2. Return the Policy to Us for rectifying the same.
-----------------------------------------------------------------------------------------------------------------------------------------------------------
Cancelling the In case you are not satisfied with the policy, you have the option to cancel it by returning the original copy with a written request,
Policy stating the objections/reasons for such disagreement, to us within the Free Look Period of 15 days from the date of receiving the
Policy document.

Result: Upon return, the Policy will terminate forthwith and all rights, benefits and interests under the Policy will cease
immediately. We will refund only the Premiums received by us after deducting the proportionate risk premium for the period of
cover, stamp duty paid and the expenses incurred on medical examination of the Life Insured, if any.
-----------------------------------------------------------------------------------------------------------------------------------------------------------
Long term We are committed to giving you honest advice and offering you long-term savings, protection and retirement solutions backed by
protection the highest standards of customer service. We will be delighted to offer you any assistance or clarification you may require about
your Policy or claim-related services at the address mentioned below. We look forward to being your partner for life.
Yours Sincerely,
Max Life Insurance Company Limited

Krishnakumar Ramasubramanian
Executive Vice President - Head of Operations

Digitally signed by DS MAX LIFE INSURANCE COMPANY LIMITED 1

Date: 2024.04.25 12:17:52 IST
Reason: Max Life Insurance
Location: 90C, Gurugram

Relationship Manager Name & Code: Rishabh Sarin (909174)

Contact Number: 8077624761, Address: Max Life Insurance Co. Ltd., 2nd
Floor,Main Commercial, Plot No. 54, Civil Lines, Ayub Khan Chauraha,
Chaupla Road, Bareilly - 243001
NB13
Max Life Insurance Company Limited
Plot No. 90 C, Sector 18, Udyog Vihar, Gurugram-122015, Haryana, India
Phone 4219090 Fax 4159397 (From Delhi and Other cities: 0124) Customer Helpline: 1860 120 5577
Regd. Office: 419, Bhai Mohan Singh Nagar, Railmajra, Tehsil Balachaur, District Nawanshahr, Punjab -144 533
Visit Us at: www.maxlifeinsurance.com E-mail: service.helpdesk@maxlifeinsurance.com
IRDAI Registration No: 104 Corporate Identity Number: U74899PB2000PLC045626 .

1 of 33
 Key Feature Document for Max Life Smart Secure Plus Plan
- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --
Introduction This document is the summary of important points in your policy. You must read this to understand your policy
better.
- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --
Your policy details The table below gives an overview of the details of this policy:
Life Insured Name: (name of Mr. Awanish Kumar Mandal Policyholder Name: (person, Mr. Awanish Kumar Mandal
the person whose life is to be in whose name the policy is
insured) issued)
Policy No.: (please use this for 158948752
any communication with us)
Date of Commencement of 22-Mar-2024 ECS Draw Date: 23rd of Mar Every Year
Risk: (date when the policy
starts)
Premium Payment Term: 27 Policy Term: (period of 42
(period, in years, for which coverage in years)
premium is to be paid)
Premium Payment Mode: Annual Due Date when Premium is 22nd of Mar every year
payable:
Date when the Last Premium 22-Mar-2050 Premium Amount (`): 17,070.50
is payable: (applicable taxes extra)
Cover Option chosen: Life cover Sum Assured (`): 50,00,000.00
Accelerated Critical Illness No Accelerated Critical Illness
Benefit Option: Sum Assured (`):
Accidental Death Benefit Yes Accidental Death Benefit Sum 50,00,000.00
Option: Assured(`):
Return of Premium Option: No Premium Break Option: No
Joint Life Cover: No
Secondary Life Insured N.A Secondary Life Age: N.A
Name:

Policy Benefits
- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --
If the life insured expires We will pay 100% of the Sum Assured as per the Payout Option chosen by the Claimant.
during the policy term
and we have received
all due premiums till
the date of death of Life
Insured
If the life insured is We will pay 100% of the Guaranteed Death Benefit (subject to maximum of Rs. 1 Crore) as accelerated Terminal
diagnosed with Terminal Illness Benefit to the Claimant.
Illness during the
policy term and we
have received all due
premiums till such date
- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --

Accidental Death Benefit Since you have chosen the Accidental Death Benefit Option, if the Policy is in force at the time of the death of
Option the Life Insured and the Life Insured dies due to an Accident, 100% of Accidental Death Benefit Sum Assured
will be payable as lump sum in addition to the Death Benefit option chosen by You.
- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --

Continued on next page

2 of 33
 - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --

Managing Your Policy - Frequently Asked Questions

- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --

What you need to do? You need to:

• pay premiums on time for the entire premium payment term. There are various easy and convenient payment
options for you to choose from. To know more about payment options, log on to www.maxlifeinsurance.com,
and
• read the details of the policy document, including the proposal form, to ensure the accuracy of information. For
any error you observe, contact us for correction
- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --

How can you manage Register your policy at www.maxlifeinsurance.com to get easy access to the following self-service options:
your policy? • Access policy statements, receipts and premium due information
• Update your contact details
• Pay renewal premiums online
Note: For any support or claim-related query, you can reach us at 1860 120 5577 or (0124) 4219090 or
service.helpdesk@maxlifeinsurance.com
- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --

What happens if you To ensure continuous life insurance cover, please pay your premium on time. If for any reason, you are unable to
delay your premium pay by the due date, you have a grace period, within which you can pay without any late fee or interest.
payment?
If you are unable to pay the Premium by the end of grace period:
Where your Policy has In that case your
Not acquired a Surrender/ Early Exit Policy shall lapse and no benefit will be payable.
Value
Acquired a Surrender/ Early Exit Value Policy will be in reduced paid up mode.
Note:The insurance cover will be reduced as per the terms of the
Policy Contract.

Note: During the grace period, the insurance cover continues. If the life insured dies during this period, we will
pay the death benefit after deducting the unpaid due premium, if any.
- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --

How can you revive You may revive your policy within 5 years from the due date of the first unpaid premium, once you
your policy? • provide us with a written request to revive the policy
• pay all due premiums along with late fee / interest, and
• produce evidence of insurability of the life insured.
- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --

How can you cancel If your Policy does not meet your objective, you may contact us to understand the Policy benefits. If you still feel
your policy? the need to cancel your Policy, you have an option to cancel it within the free look period of 15 days from the
day you receive the Policy documents.
- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --

Taxes and Others - Frequently asked questions

- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --

Tax benefits Premium under the policy are tax deductible subject to fulfilling conditions prescribed under the Section
80C/80CCC/80D of Income Tax Act 1961. The benefits you receive in the policy will be exempt, subject to
fulfilling conditions prescribed under the Section 10(10D) else it will subject to TDS as per applicable rate. Please
note that tax benefits are as per prevailing provisions of Income Tax Act 1961 at the time of payment of premium
or receipt of benefits by you. Consult your tax advisor for further details
Taxes on Premium - Premium you pay would be subject to applicable taxes, cesses and levies, as imposed by
the Government from time to time.
- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --

Exclusions In the event of death of the life insured due to suicide within twelve months from the date of start or revival of
the policy,
• all risks and benefits under this policy shall cease and no benefits will be payable under this policy, and
• we will pay you the Total Premiums Paid plus underwriting extra premium paid plus loading for modal premiums
paid (but exclusive of taxes, cesses & levies as imposed by the Government from time to time), to the nominee
and terminate the policy.
• Other exclusions with respect to the Accelerated Critical Illness Option and Accident Cover Option shall be as
mentioned in the Policy Contract.
• In certain scenarios the benefits under this Policy will not be payable. You are requested to refer to the policy
contract for details.
- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --

Disclaimers The aim of this document is to summarize the key features of your policy and does not replace the policy, in any
way. In case of any discrepancy between the policy contract and this document, the terms and conditions of the
policy contract shall prevail.
- -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- - -- -- - -- - -- - -- - -- - -- - -- -- - --

3 of 33
POLICY PREAMBLE

MAX LIFE INSURANCE COMPANY LIMITED

Regd. Office: 419, Bhai Mohan Singh Nagar, Railmajra, Tehsil Balachaur, District Nawanshahr, Punjab -144 533

Max Life Smart Secure Plus Plan

A Non-Linked Non-Participating Individual Pure Risk Premium Life Insurance Plan

UIN - 104N118V07

Max Life Insurance Company Limited has entered into this contract of insurance on the basis of the information given in the Proposal Form
together with the Premium deposit, statements, reports or other documents and declarations received from or on behalf of the proposer for
effecting a life insurance contract on the life of the person named in the Schedule.

We agree to pay the benefits under the Policy on the happening of the insured event, while the Policy is in force subject to the terms and
conditions stated herein.

Max Life Insurance Company Limited

Place of Issuance: Gurugram, Haryana

4 of 33
POLICY SCHEDULE

Policy: Max Life Smart Secure Plus Plan Type of Policy: A Non-Linked Non-Participating Individual Pure
Risk Premium Life Insurance Plan
UIN: 104N118V07 Office: Max Life Agency Distribution Bareilly 1
Policy No./ Proposal No.: 158948752 Client ID: 6004747541
Date of Proposal: 19-Mar-2024
Policyholder/Proposer : Mr. Awanish Kumar Mandal Date of Birth: 01-Dec-1990
Identification Source & I.D No.: PAN , BIXPM9361E Gender: Male
PAN: BIXPM9361E Tel No./Mobile No.: / 7307571031
Relationship with Life Insured: Same Person Email: Awanishpassion32@Gmail.Com
Address (For all communication purposes):
S/O Yogendra Nath Mandal
Karsi Nawanagar, Ballia, Nawa Nagar
Ballia 221717
Uttar Pradesh India
Life Insured: Mr. Awanish Kumar Mandal Age: 33 years
Identification Source & I.D No.: PAN , BIXPM9361E Gender: Male
Date of Birth: 01-Dec-1990 Underwriting Category: Non Smoker
Address:
S/O Yogendra Nath Mandal
Karsi Nawanagar, Ballia, Nawa Nagar
Ballia 221717
Uttar Pradesh India
Secondary Life: N.A Age: N.A
Date of Birth: N.A Gender: N.A
Address: Underwriting Category: N.A
Nominee(s):
Nominee(s)Name Relationship of Date of Birth Gender Age %
Nominee(s) with of Nominee share
Policyholder:
Ms. Lalit Devi Mother 01-Jan-1954 Female 70 100
Appointee (if Nominee is minor): N.A.
Date of Commencement of Risk: 22-Mar-2024 Cover Option chosen: Life cover
Date of Issuance of Policy: 22-Mar-2024 Premium payment variant: Pay till 60
Date on which Survival Benefit is payable: N.A. Premium payment mode: Annual
Details of Rider attached: N.A Return of Premium Option: No
Accelerated Critical Illness Benefit Option: No
Accidental Death Benefit Option: Yes
Joint Life Cover Option: No
Premium Break Option: No
Voluntary Sum Assured Top-up option: Yes, after end of 1st
Policy Year
Point of sale policy: No
Premium Payment Method: ECS Cheque Draw Date: 23RD
Bank Name: HDFC BANK LTD
Bank Account Number: 50100543023326
Bank Name: HDFC BANK LTD
Bank Account Details for Pay-outs
Bank Account Number: 50100543023326
Relationship Manager Name & Code: Rishabh Sarin (909174) Intermediary License No.: MAX909174
Address: Contact Number: 8077624761
Max Life Insurance Co. Ltd., 2nd Floor,Main Commercial, Plot No. Email: rishabh.sarin@maxlifeinsurance.com
54, Civil Lines, Ayub Khan Chauraha, Chaupla Road
Bareilly 243001
Details of Sales Personnel (for direct sales only): Email: rishabh.sarin@maxlifeinsurance.com
Employee discount (applicable to agents of Max Life/ employees of Max group and corporate agents of Max Life): No
Corporate or existing customer discount (available for first Policy Year only): No

5 of 33
 List of Maturity Insured Sum Policy Premium Annualised Underwriting GST** and any Modal Factors Total Premium Due Date
coverage Date Event Assured Term Payment Premium Extra other taxes, D along with when
(INR) Term A Premium cesses & levies applicable Premium
B C taxes, cesses is payable;
(INR) (INR) (INR) Date
and levies when the
payable as Last
per Premium Premium
payment is payable
mode selected
E=
[(A+B+C)*D]
(INR)
BASE POLICY
Max Life Smart As per Clause 22nd of Mar
Secure Plus 22-Mar-2066 1.1 and 1.2 50,00,000.00 42 27 13,520.50 NA 2,433.70 1 15,954.20 every year;
Plan of Part C 22-Mar-2050
Max Life 22nd of Mar
Accidental 22-Mar-2066 50,00,000.00 42 27 3,550.00 NA 639.00 1 4,189.00 Every Year;
Cover Option 22-Mar-2050

*Applicable Premium rates for the Accelerated Critical Illness Benefit are guaranteed only for a period of five (5) years and may be revised thereafter by Us basis experience under the product by
seeking prior approval from IRDAI. Once revised, the applicable Premium rates for the Accelerated Critical Illness Benefit shall be guaranteed for the next five (5) years.
**GST includes IGST, SGST, CGST, UGST (whichever is applicable) and applicable cesses

6 of 33
PART B
DEFINITIONS
The words and phrases listed below will have the meaning attributed to them wherever
they appear in the Policy unless the context otherwise requires.
1. "Accident" means sudden, unforeseen and involuntary event caused by external,
visible, violent means;
2. "Accidental Death Benefit Sum Assured" means an Accident cover amount
chosen by You, as specified in the Schedule, which is payable in accordance with
Clause 1.4 of Part C of the Policy;
3. "Accidental Death" means death which is caused by an Accident as revealed by an
autopsy provided such death was caused directly by such Accident and independent
of any physical or mental illness within 180 days of the date of Accident;
4. "Accidental Death Benefit Term" shall mean the term as specified in the
Schedule, during which the Accidental Death benefit (defined above) will be
available under the Policy. Accidental Death Benefit Term shall be same as the
Policy Term or remaining Policy Term, as the case may be;
5. "Accelerated Critical Illness Benefit" shall have the meaning assigned to it in
Clause 1.3.1 of Part C;
6. "Accelerated Critical Illness Benefit Term" shall mean the term as specified in
the Schedule, during which the Accelerated Critical Illness Benefit will be available
under the Policy;
7. "Accelerated Critical Illness Benefit Sum Assured" means a Critical Illness
benefit amount chosen by You as a part of the Sum Assured as specified in the
Schedule, which is payable in accordance with Clause 1.3 of Part C of the Policy;
8. "Age" means Life Insured's age on last birthday as on the Date of Commencement
of Risk or on the previous Policy Anniversary, as the case may be;
9. "Annualised Premium" is the amount specified in the Schedule, and means
Premium payable during a Policy Year chosen by You, excluding Underwriting
Extra Premium, loadings for modal premiums, Rider Premiums and applicable
taxes, cesses or levies, if any;
10. "Appointee" means the person named by You (as applicable and registered with
Us in the Schedule who is authorised to receive and hold in trust the benefits under
this Policy on behalf of the Nominee/(s), if the Nominee/(s) is/are less than 18 years
on the date of payment of the such benefit;
11. "Assignment" is the process of transferring the rights and benefits to an assignee,
in accordance with the provisions of Section 38 of Insurance Act, 1938, as amended
from time to time;
12. "Claimant" means You, nominee(s) (if valid nomination is effected), assignee(s)
or their heirs, legal representatives or holders of a succession certificates in case
nominee(s) or assignee(s) is/are not alive at the time of claim;
13. "Cover Option" means one of the following death cover options chosen by You
on the Date of Commencement of Risk:
(i) "Level Cover Option"- wherein the Sum Assured to be paid on death of the
Life Insured, will remain level throughout the Policy Term.
(ii) "Increasing Cover Option"- wherein the Sum Assured to be paid on death
of the Life Insured increases by a simple rate of 5% per annum at each
policy anniversary, subject to maximum of 200% of Sum Assured chosen at
inception. The Sum Assured will increase only till completion of 21st Policy
Year. The Sum Assured will not increase from 22nd Policy Year onwards
and will be the same as increased Sum Assured effective as on the last Policy
anniversary. In case of Joint Life Cover Option, only the Sum Assured under
the Policy for Life Insured shall increase under Increasing Cover Option.
14. "Critical Illness"/ "CI" means the first time Diagnosis of the Life Insured with
any of the critical illnesses or undergoing any of the medical procedures/surgeries
for the first time, as enlisted in Clause 1.3.12 of Part C, to this Rider;
15. "Date of Commencement of Risk"/ "Date of Inception of Policy" means the
date as specified in the Schedule, on which the insurance coverage/risk under the
Policy commences;
16. "Date of Issuance of Policy" means the date as specified in the Schedule on which
this Policy is issued;
17. "Death Benefit Variant" means the option chosen by You at the time of the
proposal and as specified in the Schedule. Once You have chosen the Death Benefit
Variant at the time of proposal, the same cannot be changed by You during the
Policy Term;
18. "Diagnosis" or "Diagnosed" means the definitive diagnosis made by a Medical
Practitioner during Policy Term, based upon radiological, clinical, and histological
or laboratory evidence acceptable to Us provided the same is acceptable and
concurred by Our appointed Medical Practitioner. In the event of any doubt
regarding the appropriateness or correctness of the Diagnosis, We will have the
right to call for an examination of the Life Insured and/or the evidence used in
arriving at such Diagnosis, by an independent expert selected by Us. The opinion
of such an expert as to such Diagnosis shall be binding on both You and Us;
19. "Early Exit Value" shall have the meaning assigned to it in Clause 1 of part D
of the Policy;
20. "Freelook" means a period during which, subject to the Clause 6 Part D of the
Policy, You have an option to return the original Policy to Us by stating the
objections/reasons for such disagreement in writing;
21. "Grace Period" means the time granted by Us from the due date for the payment
of Premium, without any penalty or late fee, during which time the Policy is
considered to be inforce with the risk cover without any interruption, as per the
terms and conditions of the Policy. The Grace Period for payment of the premium
for this Policy shall be, 15 (Fifteen) days where You are paying on a monthly basis;
and 30 (Thirty) days in all other cases;
22. "Guaranteed Death Benefit" shall have the meaning assigned to it in Clause 1.1
of part C of the Policy;
23. "Guaranteed Surrender Value" shall have the meaning assigned to it in Clause
1 of part D of the Policy;
24. "Injury" means accidental physical bodily harm excluding illness or disease solely
and directly caused by external, violent, visible and evident means, which is verified
and certified by a Medical Practitioner;
25. "IRDAI" means the Insurance Regulatory and Development Authority of India;
26. "Joint Life Cover Option" means the option selected by You during the Proposal
Form fulfilment wherein You may choose to cover Your spouse by paying an
additional Premium as specified under Clause 1.7 of Part C;
27. "Lapsed Policy" means a Policy which has not acquired Surrender Value /Early
Exit Value and where the due Premium has not been received for any of the first
two full Policy Years by the end of the Grace Period;
28. "Life Insured" means the person named in the Schedule, on whose life the Policy
is effected;
29. "Limited Premium Payment Variant" means where the Premium Payment Term
which is either 5, 10, 12 or 15 years with Policy Term ranging from 10 years to 67
years' subject to the Policy Term being greater than the Premium Payment Term
by at least 5 years;
30. "Maturity Date" means the date specified in the Schedule, on which the Policy
Term expires;
31. "Medical Practitioner" means a person who holds a valid registration from
the Medical Council of any state or Medical Council of India or Council for
Indian Medicine or for Homeopathy set up by the Government of India or a State
Government and is thereby entitled to practice medicine within its jurisdiction
and is acting within its scope and jurisdiction of license, provided such Medical
Practitioner shall not include Your spouse, father (including step father), mother
(including step mother), son (including step son), son's wife, daughter, daughter's
husband, brother (including step brother) or sister (including step sister) or the Life
Insured or You or employed by You/the Life Insured;
32. "Modal Factor" means the applicable factor specified in the Schedule, which is
used by Us for determining the Premium. The Modal Factors for this Policy are as
follows: i) for annual Premium payment mode - (1.00); ii) for semi-annual Premium
payment mode - (0.513); iii) for quarterly Premium payment mode - (0.261); iv)
for monthly Premium payment mode - (0.088);
33. "Nomination" is the process of nominating a person(s) in accordance with
provisions of Section 39 of the Insurance Act, 1938 as amended from time to time;
34. "Nominee" means nominee nominated by You (only if You are the Life Insured)
in accordance with Section 39 of Insurance Act, 1938 as amended from time to
time, to receive the benefits under the Policy and whose name is mentioned in the
Schedule;
35. "Pay Till 60 Premium Payment Variant" means that the Premium payable to
Us during the Premium Payment Term shall be equal to 60 less Age, subject to
minimum Premium Payment Term of 16 years. For this variant, the Premium
Payment Term will always be lesser than Policy Term;
36. "Policy" means the contract of insurance entered into between You and Us as
evidenced by this document, the Proposal Form, the Schedule and any additional
information/document(s) provided to Us in respect of the Proposal Form along with
any written instructions from You subject to Our acceptance of the same and any
endorsement issued by Us;
37. "Policy Anniversary" means the annual anniversary of the Date of
Commencement of Risk;
38. "Policy Term" means the term of this Policy as specified in the Schedule;
39. "Policy Year" means a period of 12 (Twelve) months commencing from the Date
of Commencement of Risk and every Policy Anniversary thereafter;
40. "Premium" means an amount specified in the Schedule, payable by You, by the
due dates to secure the benefits under the Policy, excluding applicable taxes, cesses
and levies, if any;
41. ."Premium Break Option" means the option selected by You during the Proposal
Form fulfilment wherein You are allowed to take Premium waiver in accordance
with Clause 1.8 of Part C
42. "Premium Payment Term" means the term specified in the Schedule, during
which the Premiums are payable by You;
43. "Pre-Existing Diseases" means any condition, ailment or injury, disease:
a) That is/are Diagnosed by a Medical Practitioner within 48 months prior to the
Date of Commencement of Risk of the Policy issued by Us; or
b) For which medical advice or treatment was recommended by, or received
from, a Medical Practitioner within 48 months prior to the he Date of
Commencement of Risk or Date of Issuance of this Policy or date of Revival
of the Policy.
44. "Proposal Form" means the form filled in by You giving full particulars, for the
purpose of obtaining insurance coverage under the Policy;
45. "Regular Premium Payment Variant" means that the Premium payable to Us in
regular installments throughout the Premium Payment Term which is the same as
the Policy Term, in the manner and at the intervals specified in the Schedule;
46. "Reduced Paid-Up Mode" means the Policy with reduced paid up benefits as
specified under Clause 1.9 of Part C;
47. "Reduced Paid-Up Sum Assured" means the Policy with reduced paid up Sum
Assured as specified under Clause 1.9 of Part C;
48. "Reduced Paid-Up Terminal Illness Benefit" means the Policy with reduced paid
up Terminal Illness Benefit as specified under Clause 1.9 of Part C;
49. "Reduced Paid-Up Maturity Benefit" means the Policy with reduced paid up
maturity benefit as specified under Clause 1.9 of Part C;
50. "Reduced Paid-Up Surrender Value" means the Policy with reduced paid up
Surrender Value or Early Exit Value as specified under Clause 1.9 of Part C;
51. "Return of Premium Option" means the option available under the Policy to be
chosen by You at the time of Date of Inception of Policy, as per Clause 1.5 of Part
C;
52. "Revival" means restoration by Us of the Policy, which was discontinued due to
non-payment of Premium, by Us with all the benefits stated in the Policy, upon the
7 of 33
 receipt of all the due Premiums and other charges / late fee as provided in Clause
3 of Part D of the Policy;
53. "Revival Period" means a period of 5 (Five) consecutive years from the due date
of the first unpaid Premium, during which period You are entitled to revive the
Policy which was discontinued due to the non-payment of Premium;
54. "Rider" means benefits, which are in addition to basic/optional benefits under this
Policy;
55. "Rider Premium" means the premium amount payable in respect of a Rider
applicable under the Policy and is the amount specified in the Schedule;
56. "Schedule" means the Policy schedule and any endorsements attached to and
forming part of the Policy and if any updated Schedule is issued, then, the Schedule
latest in time;
57. "Secondary Life" means Your spouse, in case You have opted for the Joint Life
Cover Option as per Clause 1.7 of Part C of this Policy;
58. "Single Premium Payment Variant" means where the Premium is received in
full in advance of the Date of Commencement of Risk;
59. "Special Exit Value" shall have the meaning assigned to it in Clause 1 of Part D
of the Policy;
60. "Special Surrender Value" shall have the meaning assigned to it in Clause 1 of
Part D of the Policy;
61. "Sum Assured" means an amount under the Death Benefit Variant under Clause
1.1 of Part C, as specified in the Schedule:
62. "Surrender Value" shall have the meaning assigned to it in Clause 1 of Part D;
63. "Terminal Illness" means a disease with which the Life Insured is Diagnosed with
and in the opinion of a Medical Practitioner and Our appointed Medical Practitioner
is likely to lead to the death of the Life Insured within 6 (Six) months from the date
of such certification by the Medical Practitioner;
64. "Terminal Illness Benefit" shall have the meaning assigned to it in Clause 1.2
of Part C;
65. "Total Premiums Paid" means the total of all Premium received under the
Policy, excluding Underwriting Extra Premium, loadings for modal premiums,
Rider Premium and applicable taxes, cesses or levies, if any;
66. "Underwriting Extra Premium" means an additional amount mentioned in the
Schedule and charged by Us, as per Underwriting Policy, which is determined on
the basis of disclosures made by You in the Proposal Form or any other information
received by Us including medical examination report of the Life Insured;
67. "Underwriting Policy" means an underwriting policy approved by Our board of
directors;
68. "Voluntary Sum Assured Top-Up" means voluntary top-up to the Sum Assured
by You to increase the Sum Assured at a later stage in the Policy Term;
69. "Voluntary Sum Assured Top-Up Option" means an option available to You to
do Voluntary Sum Assured Top-Up at a later stage during the Policy Term as per
Clause 1.6 of Part C;
70. "Waiting Period" means a period 90 (Ninety) days, starting from the Date of
Commencement of Risk or Date of Issuance of Policy or date of Revival, whichever
is later;
71. "We", "Us" or "Our" means Max Life Insurance Company Limited; and
72. "You" or "Your" means the policyholder as named in the Schedule.
PART C
POLICY FEATURES, BENEFITS AND PREMIUM PAYMENT
1. BENEFITS
1.1. DEATH BENEFIT
1.1.1. If the Policy is in force and is not under Reduced Paid Up Mode,
then, upon death of the Life Insured, during the Policy Term, We
will pay "Guaranteed Death Benefit" to the Claimant which will be
highest of the following:
a. For Single Premium Payment Variant - 1.25 times of the sum of
single Premium and Underwriting Extra Premium, if any;
For all other Premium payment variants - 10 times the sum of
Annualised Premium and Underwriting Extra Premium, if any;
or
b. 105% of sum of Total Premiums Paid, Underwriting Extra
Premium and loadings for modal premiums, if any, received till
the date of death of the Life Insured; or
c. "Absolute Amount Assured to be Paid on Death" which shall
be the Sum Assured payable as per the Cover Option chosen by
You.
1.1.2. The Claimant will have the option to choose from one of the
following payout options at claims stage. In case no payout option
is selected by the Claimant, then the payout option 1 (lump sum
Guaranteed Death Benefit) will be considered as the default payout
option:
a. Payout option 1 - lump sum Guaranteed Death Benefit - 100%
of the Guaranteed Death Benefit will be paid as lump sum.
b. Payout option 2 - monthly income - monthly payment for a fixed
period of 10 years starting from the next monthly anniversary
following the date of intimation of death ("Payout Period") shall
be calculated as per the formula below:
Monthly Income = Guaranteed Death Benefit x i
(1- 1 ) x (1+i)
(1+i)120
Where interest ("i") equals to (1+ (Bank Rate -1%))1/12 - 1
For the purpose of the above calculation Bank Rate shall mean
the prevailing RBI Bank Rate as declared by the Reserve Bank
of India. The monthly income shall be determined basis the
prevailing RBI Bank Rate on the date of intimation of death,
less 1% p.a.. The interest rate will be revised only if the RBI
Bank Rate changes by 50 bps or more from the RBI Bank rate
used to determine the prevailing interest rate (reviewed on 1st
day of every quarter). As the interest rate will be reviewed at
the beginning of each quarter, any change in interest rate will be
applicable from 1st day of the next quarter to allow sufficient
time for making necessary system changes.
c. Payout option 3 - partial Guaranteed Death Benefit plus
part monthly income- If the Claimant chooses this payment
option, We will pay the proportion as may be selected by the
Claimant of the Guaranteed Death Benefit as lump sum and
the remaining Guaranteed Death Benefit would be payable as
monthly income.
Note: In case monthly payout option has been selected whether
under (b) or (c), above then during the Payout Period, the
Claimant may commute the outstanding monthly income. In
such case We will pay the present value of the outstanding
monthly income at the same interest rate used to determine the
monthly income.
1.1.3. In case an Accelerated Critical Illness Benefit or Terminal Illness
Benefit claim has been paid, then the Guaranteed Death Benefit
shall be reduced to the extent of the Accelerated Critical Illness
Benefit or Terminal Illness Benefit already paid.
1.1.4. Point of Sale Policy
In case this Policy is sourced as a point of sale Policy, the following
conditions shall apply:
a. In case of death of the Life Insured, death benefit will be payable
as noted in Clause 1.1.1 above. However, in case the Life
Insured dies during the waiting period of 90 days from Date
of Commencement of Risk due to any reason other than an
Accident, We will refund 100% of the Total Premiums Paid till
the date of death of the Life Insured and no other benefit will be
payable and the Policy will terminate.
b. In the event of death of Life Insured due to an Accident,
the waiting period of 90 days as specified above shall not be
applicable and the death benefit shall be payable in accordance
with Clause 1.1.1.
1.2. TERMINAL ILLNESS BENEFIT
1.2.1. If the Policy is in force and is not under Reduced Paid Up Mode,
then, upon Diagnosis of Life Insured with a Terminal Illness, during
the Policy Term, We will pay 100% of the Guaranteed Death Benefit
(subject to maximum of Rs. 1 Crore) as accelerated Terminal Illness
Benefit to the Claimant. Only one valid Terminal Illness Benefit is
payable during the Policy Term and once a Terminal Illness claim
is paid, the sum of Guaranteed Death Benefit and Voluntary Sum
Assured Top-Up, if opted, will be reduced by the Terminal Illness
Benefit paid and the Policy will continue..
1.2.2. The Terminal Illness Benefit does not provide additional benefit but
only accelerates the Guaranteed Death Benefit payable under this
Policy, subject to maximum of Rs. 1 Crore.
1.2.3. The claim payout under the Terminal Illness Benefit would be made
in lump sum only. The Claimant shall not have the options to receive
or convert the lump sum claim amount into monthly income
1.2.4. In case the claim against the Terminal Illness has been raised, We
may request the Life Insured to undertake a medical examination or
test at Our cost, which in Our opinion, is reasonable to determine the
Terminal Illness. We shall not accept a claim if the Member does
not undertake any medical examination or test which We consider
reasonable or necessary to determine the Terminal Illness.
1.2.5. After the payment of the claim in respect of Terminal Illness of the
Life Insured, all Premiums (including the Premium for base Policy
and optional benefits i.e. Premium Break Option, Joint Life Cover
Option and/or Voluntary Sum Assured Top-Up Option) falling due
from the date of Diagnosis of Terminal Illness would be waived off
and the Policy shall continue till death of the Life Insured or the end
of the Policy Term, whichever is earlier. However, in case You have
opted for Joint Life Cover Option and the Secondary Life survives
on the date of Diagnosis of Terminal Illness of the Life Insured then
the Policy will continue till Death or Diagnosis of Terminal illness of
the Secondary Life or end of the Policy Term, whichever is earlier.
1.2.6. Accelerated Critical Illness Benefit and Accidental Death benefit
shall terminate post Diagnosis of Terminal Illness.
1.2.7. Terminal Illness Benefit will be available in case of Policy is sourced
as a point of sale policy.
1.3. ACCELERATED CRITICAL ILLNESS BENEFIT OPTION
1.3.1. If You have chosen Accelerated Critical Illness Benefit option then
upon completion of the Waiting Period and provided the Policy is
in force, if the Life Insured is Diagnosed with a specified Critical
Illness (as mentioned in the Table below) for the first time during his
lifetime, then, We will pay the Accelerated Critical Illness Benefit
Sum Assured ("Accelerated Critical Illness Benefit").
1.3.2. For the sake of clarity, no Accelerated Critical Illness Benefit will
be payable if the Critical Illness is Diagnosed within the Waiting
Period. In such case the Accelerated Critical Illness Benefit will
terminate and We will only refund the Premium received till the date
8 of 33
 of death of the Life Insured corresponding to Accelerated Critical h) On the Policy Anniversary immediately after Life Insured
Illness Benefit. It may be noted that no Waiting Period shall be attaining the Age of 75 years.
applicable if any of the listed Critical Illnesses occurs due to an 1.3.12. List of Critical Illnesses and exclusions applicable for the Accelerated
Accident. Accelerated Critical Illness Benefit will not be available in Critical Illness Benefit:
case of Policy is sourced as a point of sale policy.
1.3.3. The Accelerated Critical Illness Benefit does not provide additional Sl Name of Details
benefit but only accelerates the part of the death benefit payable under no. the Illness
this Policy. A malignant tumour characterised by the
1.3.4. The Accelerated Critical Illness Benefit is payable only once during uncontrolled growth & spread of malignant cells
the Accelerated Critical Illness Benefit Term and only one valid with invasion & destruction of normal tissues.
Accelerated Critical Illness Benefit claim will be admissible and This Diagnosis must be supported by histological
payable under the Policy. However, in case of confirmed Diagnosis evidence of malignancy. The term cancer includes
of angioplasty, the Accelerated Critical Illness Benefit is limited leukemia, lymphoma and sarcoma.
to Rs. 5 lacs or Accelerated Critical Illness Benefit Sum Assured, The following are excluded -
whichever is lower, with the remaining Accelerated Critical Illness
Benefit (if any) payable on subsequent Diagnosis of any one of the
other specified Critical Illnesses. It is clarified that only one claim is a. All tumors which are histologically
admissible due to angioplasty. described as carcinoma in situ, benign,
1.3.5. If the first claim under the Policy is for one of the insured pre-malignant, borderline malignant, low
Critical Illness conditions other than angioplasty, then 100% of malignant potential, neoplasm of unknown
the Accelerated Critical Illness Sum Assured will be paid and behavior, or non-invasive, including but not
Accelerated Critical Illness Benefit would terminate and no further limited to: Carcinoma in situ of breasts,
Critical Illness claim shall be accepted or payable. However, if the Cervical dysplasia CIN-1, CIN -2 and
first claim under the Policy is for angioplasty, then We will pay the Cancer of CIN-3.
claim on angioplasty as detailed above and the Accelerated Critical Specified b. Any non-melanoma skin carcinoma unless
Illness Benefit will continue with reduced Accelerated Critical Illness 1 Severity there is evidence of metastases to lymph
Benefit Sum Assured, if any, for other insured Critical Illness (malignant nodes or beyond;
conditions. tumor) c. Malignant melanoma that has not caused
1.3.6. Upon payment of 100% of the Accelerated Critical Illness Benefit invasion beyond the epidermis;
Sum Assured, the Accelerated Critical Illness Benefit will terminate d. All tumors of the prostate unless
and Premium payment on account of Accelerated Critical Illness histologically classified as having a Gleason
Benefit will cease. Accordingly, future Premiums payable under the score greater than 6 or having progressed to
Policy will reduce proportionately in accordance with the following at least clinical TNM classification T2N0M0
formula and the Policy will continue till Maturity Date with reduced e. All Thyroid cancers histologically classified
Guaranteed Death Benefit and other benefits (if any), provided the as T1N0M0 (TNM Classification) or below;
Policy is in force and all applicable Premiums are paid in full. It is f. Chronic lymphocytic leukaemia less than
clarified that in case of payment of an angioplasty claim, the Premium RAI stage 3
shall not change, unless it terminates the Accelerated Critical Illness g. Non-invasive papillary cancer of the
Benefit itself. bladder histologically described as
TaN0M0 or of a lesser classification,
Premium on account of base Sum Assured x (reduced base Sum h. All Gastro-Intestinal Stromal Tumors
Assured post payout of Accelerated Critical Illness Benefit Sum histologically classified as T1N0M0 (TNM
Assured claim) / (base Sum Assured chosen at inception) Classification) or below and with mitotic
count of less than or equal to 5/50 HPFs.
1.3.7. Unless otherwise provided under this Policy, the amount of the Coronary Angioplasty is defined as percutaneous
Accelerated Critical Illness Benefit payable under the Policy is coronary intervention by way of balloon
chosen by You and cannot be changed throughout the Policy Term. angioplasty with or without stenting for treatment
In the event You have not opted for the Accelerated Critical Illness of the narrowing or blockage of minimum 50
Benefit at the time of proposal, We may offer the same at a later % of one or more major coronary arteries. The
date during the Premium Payment Term, subject to Our Underwriting intervention must be determined to be medically
Policy and remaining Policy Term being 10 years or more. necessary by a cardiologist and supported by a
1.3.8. You may at any time during the Policy Term choose to opt 2 Angioplasty
coronary angiogram (CAG).
out of/discontinue the Accelerated Critical Illness Benefit, upon Coronary arteries herein refer to left main stem, left
which, the total Premium to be paid will be reduced by the anterior descending, circumflex and right coronary
Accelerated Critical Illness Benefit Premium and only the Premium artery.
corresponding to the death benefit or Riders/optional benefits (if any) Diagnostic angiography or investigation
will continued to be payable. It is clarified that once Accelerated procedures without angioplasty/stent insertion are
Critical Illness Benefit is discontinued, the Accelerated Critical excluded.
Illness Benefit cannot be again opted for.
The first occurrence of heart attack or myocardial
1.3.9. The Accelerated Critical Illness Sum Assured will always be paid as
infarction, which means the death of a portion of
a lump sum benefit.
the heart muscle as a result of inadequate blood
1.3.10. Subject to Clause 1.3.7 above, the Accelerated Critical Illness Benefit
supply to the relevant area. The Diagnosis for
option can be chosen anytime during the Policy Term, however:
Myocardial Infarction should be evidenced by all
a) Accelerated Critical Illness Benefit option is not available under
of the following criteria:
Single Premium Payment Variant and 5 Pay Premium payment
a. a history of typical clinical symptoms
variant under the Limited Premium Payment Variant.
consistent with the Diagnosis of Acute
b) Accelerated Critical Illness Benefit cannot be opted for if you
Myocardial Infarction (for e.g. typical chest
have chosen Increasing Cover Option under this Policy.
First Heart pain)
c) Accelerated Critical Illness Benefit is not available for the
Attack - of b. new characteristic electrocardiogram
Secondary Life Insured in case of Joint Life cover. 3
Specified changes
d) For Accelerated Critical Illness Benefit option, the Accelerated
Severity c. elevation of infarction specific enzymes,
Critical Illness Benefit Term cannot exceed the Premium
Troponins or other specific biochemical
Payment Term of the Policy.
markers.
e) In case Premium Break Option has been selected then
The following are excluded:
Accelerated Critical Illness Benefit option cannot be chosen after
a. Other acute Coronary Syndromes
the Date of Commencement of Risk.
b. Any type of angina pectoris
1.3.11. The Accelerated Critical Illness Benefit will terminate immediately
c. A rise in cardiac biomarkers or Troponin
upon the occurrence of any of the following events, whichever is
T or I in absence of overt ischemic
earliest:
heart disease OR following an intra-arterial
a) On the expiry of the Accelerated Critical Illness Benefit Term;
cardiac procedure
b) On payment of 100% of the Accelerated Critical Illness Sum
Assured; The actual undergoing of open-heart valve surgery
c) On expiry, cancellation or surrender of the Policy; to replace or repair one or more heart valves, as
d) On death of the Life Insured; Open Heart a consequence of defects in, abnormalities of, or
e) Life Insured being diagnosed with Terminal Illness; Replacement disease-affected cardiac valve(s). The Diagnosis of
4
f) On Your failure to revive the Policy within the Revival Period or Repair of the valve abnormality must be supported by an
of the Policy; Heart Valves echocardiography and the realization of surgery
g) You opting out or discontinuing the Accelerated Critical Illness has to be confirmed by a specialist Medical
Benefit; or; Practitioner.

9 of 33
 Catheter based techniques including but not limited
to balloon valvotomy/valvuloplasty are excluded.
Undergoing of a laporotomy or thoracotomy
to repair or correct an aneurysm, narrowing,
obstruction or dissection of the aortic artery.
Surgery For this definition, aorta means the thoracic and
5 3. Arterial blood gas analyses with partial
to Aorta abdominal aorta but not its branches. Surgery
performed using only minimally invasive or
intra-arterial techniques such as percutaneous
endovascular aneurysm repair are excluded.
The unequivocal diagnosis by a Consultant
Cardiologist of Cardiomyopathy causing
permanent impaired left ventricular function with
an ejection fraction of less than 25%. This must
result in severe physical limitation of activity to the
degree of class IV of the New York Heart
Classification and this limitation must be sustained
over at least six months when stabilized on
appropriate therapy. Cardiomyopathy directly
related to alcohol or drug misuse is excluded.
New York Heart Classification
Class I. Patients with cardiac disease but without
resulting limitation of physical activity. Ordinary
physical activity does not cause undue fatigue,
palpitation, dyspnea, or anginal pain.
6 Cardiomyopathy Class II. Patients with cardiac disease resulting
in slight limitation of physical activity. They are
comfortable at rest. Ordinary physical activity
results in fatigue, palpitation, dyspnea, or anginal
pain.
Class III. Patients with cardiac disease resulting
in marked limitation of physical activity. They are
comfortable at rest. Less than ordinary activity
causes fatigue, palpitation, dyspnea, or anginal
pain.
Class IV. Patients with cardiac disease resulting
in inability to carry on any physical activity
without discomfort. Symptoms of heart failure or
the anginal syndrome may be present even at rest.
If any physical activity is undertaken, discomfort
increases.
An unequivocal Diagnosis of Primary (Idiopathic)
Pulmonary Hypertension by a Cardiologist or
specialist in respiratory medicine with evidence of
right ventricular enlargement and the pulmonary
artery pressure above 30 mm of Hg on
Cardiac Cauterization. There must be permanent
irreversible physical impairment to the degree of at
least Class IV of the New York Heart Association
Classification (NYHA) of cardiac impairment.
The NYHA Classification of Cardiac Impairment
Primary are as follows:
7 Pulmonary a. Class III: Marked limitation of physical
Hypertension activity. Comfortable at rest, but less than
ordinary activity causes symptoms.
b. Class IV: Unable to engage in any physical
activity without discomfort. Symptoms may
be present even at rest.
Pulmonary hypertension associated with lung
disease, chronic hypoventilation, pulmonary
thromboembolic disease, drugs and toxins,
diseases of the left side of the heart, congenital
heart disease and any secondary cause are
specifically excluded.
The actual undergoing of heart surgery to correct
blockage or narrowing in one or more coronary
artery(s), by coronary artery bypass grafting done
via a sternotomy (cutting through the breast
bone) or minimally invasive keyhole coronary
Open Chest artery bypass procedures. The Diagnosis must be
8
CABG supported by a coronary angiography and the
realization of surgery has to be confirmed by a
cardiologist
The following are excluded:
a. Angioplasty and/or any other intra-arterial
procedures
Total, permanent and irreversible loss of all vision
in both eyes as a result of illness or accident.
The Blindness is evidenced by:
a. corrected visual acuity being 3/60 or less in
both eyes or;
9 Blindness
b. the field of vision being less than 10 degrees
in both eyes.
The Diagnosis of blindness must be confirmed
and must not be correctable by aids or surgical
procedure
End stage lung disease, causing chronic respiratory
End Stage
10 failure, as evidenced by all of the following:
Lung Failure
1. FEV1 test results consistently less than 1
litre measured on 3 occasions 3 months
apart; and
2. Requiring continuous permanent
supplementary oxygen therapy for
hypoxemia; and
oxygen pressures of 55mmHg or less (PaO2
< 55 mmHg); and
4. Dyspnea at rest.
Permanent and irreversible failure of liver
function that has resulted in all three of the
following:
End Stage 1. permanent jaundice; and
11
Liver Failure 2. ascites; and
3. hepatic encephalopathy.
Liver failure secondary to drug or alcohol abuse
is excluded.
End stage renal disease presenting as chronic
irreversible failure of both kidneys to function,
Kidney Failure
as a result of which either regular renal dialysis
12 requiring
(hemodialysis or peritoneal dialysis) is instituted or
regular dialysis
renal transplantation is carried out. Diagnosis has to
be confirmed by a specialist Medical Practitioner.
The actual undergoing of a transplant of:
1. One of the following human organs: heart,
lung, liver, kidney, pancreas, that resulted
from irreversible end-stage failure of the
relevant organ, or
Major Organ/ 2. Human bone marrow using haematopoietic
13 Bone Marrow stem cells. The undergoing of a transplant
Transplant has to be confirmed by a specialist Medical
Practitioner.
The following are excluded:
1. Other stem-cell transplants
2. Where only Islets of Langerhans are
transplanted
Universal necrosis of the brain cortex with the brain
stem remaining intact. The definite Diagnosis must
Apallic
14 be confirmed by a consultant neurologist and this
Syndrome
condition has to be medically documented for at
least one (1) month with no hope of recovery.
A life threatening, non-cancerous tumor in the
brain, cranial nerves or meninges within the skull.
The presence of the underlying tumor must be
confirmed by imaging studies such as CT scan or
MRI.
This brain tumor must result in at least one of the
following and must be confirmed by the relevant
specialist Medical Practitioner:
a. Permanent Neurological deficit with
Benign Brain
15 persisting clinical symptoms for a
Tumour
continuous period of at least 90 consecutive
days or
b. Undergone surgical resection or radiation
therapy to treat the brain tumor.
The following conditions are excluded:
Cysts, Granulomas, malformations in the arteries
or veins of the brain, hematomas, abscesses,
pituitary tumors, tumors of skull bones and tumors
of the spinal cord.
The actual undergoing of surgery to the brain under
general anesthesia during which a craniotomy
is performed. Keyhole surgery is included
however, minimally invasive treatment where no
surgical incision is performed to expose the
target, such as irradiation by gamma knife or
16 Brain Surgery
endovascular neuroradiological interventions such
as embolizations, thrombolysis and stereotactic
biopsy are excluded. Brain surgery as a result of
an Accident is also excluded. The procedure must
be considered necessary by a qualified specialist
Medical Practitioner.
A state of unconsciousness with no reaction or
response to external stimuli or internal needs. This
diagnosis must be supported by evidence of all of
the following:
1. No response to external stimuli
continuously for at least 96 hours;
Coma of
2. Life support measures are necessary to
17 specified
sustain life; and
Severity
3. Permanent neurological deficit which
must be assessed at least 30 days after the
onset of the coma.
The condition has to be confirmed by a specialist
Medical Practitioner. Coma resulting from alcohol
or drug abuse is excluded.
10 of 33
 Accidental head injury resulting in permanent
Neurological deficit to be assessed no sooner
than 3 months from the date of the Accident. This
Diagnosis must be supported by unequivocal
findings on Magnetic Resonance Imaging,
Computerized Tomography, or other reliable
imaging techniques. The Accident must be caused
solely and directly by accidental, violent, external
and visible means and independently of all other
causes.
The Accidental head injury must result in an
inability to perform at least three (3) of the
following Activities of Daily Living either with or
without the use of mechanical equipment, special
devices or other aids and adaptations in use for
disabled persons. For the purpose of this benefit,
the word "permanent" shall mean beyond the
scope of recovery with current medical knowledge
and technology.
Major Head The Activities of Daily Living are:
18
Trauma a. Washing: the ability to wash in the bath or
shower (including getting into and out of
the bath or shower) or wash satisfactorily by
other means;
b. Dressing: the ability to put on, take off,
secure and unfasten all garments and, as
appropriate, any braces, artificial limbs or
other surgical appliances;
c. Transferring: the ability to move from a bed
to an upright chair or wheelchair and vice
versa;
d. Mobility: the ability to move indoors from
room to room on level surfaces;
e. Toileting: the ability to use the lavatory
or otherwise manage bowel and bladder
functions so as to maintain a satisfactory
level of personal hygiene;
f. Feeding: the ability to feed oneself once
food has been prepared and made available.
The spinal cord injury is excluded.
Total and irreversible loss of use of two or more
limbs as a result of injury or disease of the brain
Permanent
or spinal cord. A specialist Medical Practitioner
19 Paralysis
must be of the opinion that the paralysis will be
of Limbs
permanent with no hope of recovery and must be
present for more than 3 months.
Any cerebrovascular incident producing permanent
neurological sequelae. This includes infarction
of brain tissue, thrombosis in an intracranial
vessel, haemorrhage and embolisation from an
extracranial source. Diagnosis has to be confirmed
by a specialist Medical Practitioner and evidenced
Stroke resulting by typical clinical symptoms as well as typical
20 in permanent findings in CT Scan or MRI of the brain.
symptoms Evidence of permanent neurological deficit lasting
for at least 3 months has to be produced.
The following are excluded:
1. Transient ischemic attacks (TIA)
2. Traumatic injury of the brain
3. Vascular disease affecting only the eye or
optic nerve or vestibular functions.
Progressive and permanent deterioration of
memory and intellectual capacity as evidenced by
accepted standardised questionnaires and cerebral
imaging. The diagnosis of Alzheimer's disease
must be confirmed by an appropriate consultant and
supported by Our appointed Medical Practitioner.
There must be significant reduction in mental
and social functioning requiring the continuous
supervision of the Life Insured. There must also be
an inability of the Life Insured to perform (whether
aided or unaided) at least 3 of the following 5
"Activities of Daily Living" for a continuous period
of at least 6 months.
Alzheimer's
21 Activities of Daily Living are defined as:
Disease
1. Washing - the ability to wash in the bath
or shower (including getting into and out of
the bath or shower) or wash satisfactorily by
other means;
2. Dressing - the ability to put on, take off,
secure and unfasten all garments and, as
appropriate, any braces, artificial limbs or
other surgical appliances;
3. Transferring - the ability to move from a bed
to an upright chair or wheelchair and vice
versa;
4. Toileting - the ability to use the lavatory
or otherwise manage bowel and bladder
functions so as to maintain a satisfactory
level of personal hygiene;
5. Feeding - the ability to feed oneself once
food has been prepared and made available.
Alcohol related brain damage are excluded.
Coverage for this impairment will cease at Age
sixty-five (65) or on maturity data/expiry date,
whichever is earlier.
Motor neuron disease diagnosed by a specialist
Medical Practitioner as spinal muscular atrophy,
progressive bulbar palsy, amyotrophic lateral
Motor Neurone sclerosis or primary lateral sclerosis. There must
Disease with be progressive degeneration of corticospinal tracts
22
Permanent and anterior horn cells or bulbar efferent neurons.
Symptoms There must be current significant and permanent
functional neurological impairment with objective
evidence of motor dysfunction that has persisted for
a continuous period of at least 3 months.
The unequivocal diagnosis of Definite Multiple
Sclerosis confirmed and evidenced by all of the
following:
1. investigations including typical MRI
Multiple
findings which unequivocally confirm the
Sclerosis with
23 diagnosis to be multiple sclerosis;
Persisting
2. there must be current clinical impairment of
Symptoms
motor or sensory function, which must have
persisted for a continuous period of at least
6 months,
Neurological damage due to SLE is excluded.
Muscular Dystrophy is a disease of the muscle
causing progressive and permanent weakening
of certain muscle groups. The Diagnosis of
muscular dystrophy must be made by a
consultant neurologist, and confirmed with the
appropriate laboratory, biochemical, histological,
and electromyographic evidence. The disease must
result in the permanent inability of the insured to
perform (whether aided or unaided) at least three
(3) of the five (5) "Activities of Daily Living".
Activities of Daily Living are defined as:
1. Washing - the ability to wash in the bath
or shower (including getting into and out of
Muscular the bath or shower) or wash satisfactorily by
24
Dystrophy other means;
2. Dressing - the ability to put on, take off,
secure and unfasten all garments and, as
appropriate, any braces, artificial limbs or
other surgical appliances;
3. Transferring - the ability to move from a bed
to an upright chair or wheelchair and vice
versa;
4. Toileting - the ability to use the lavatory
or otherwise manage bowel and bladder
functions so as to maintain a satisfactory
level of personal hygiene;
Feeding - the ability to feed oneself once food has
been prepared and made available
The unequivocal Diagnosis of idiopathic
Parkinson's Disease by a consultant neurologist.
This Diagnosis must be supported by all of the
following conditions:
1. The disease cannot be controlled with
medication; and
2. There are objective signs of progressive
deterioration; and
3. There is an inability of the Life Insured to
perform (whether aided or unaided) at least 3
of the following five (5) "Activities of Daily
Living" for a continuous period of at least 6
months:
Activities of Daily Living are defined as:
1. Washing - the ability to wash in the bath
Parkinson's
25 or shower (including getting into and out of
Disease
the bath or shower) or wash satisfactorily by
other means;
2. Dressing - the ability to put on, take off,
secure and unfasten all garments and, as
appropriate, any braces, artificial limbs or
other surgical appliances;
3. Transferring - the ability to move from a bed
to an upright chair or wheelchair and vice
versa;
4. Toileting - the ability to use the lavatory
or otherwise manage bowel and bladder
functions so as to maintain a satisfactory
level of personal hygiene;
Feeding - the ability to feed oneself once
5. food has been prepared and made available.
11 of 33
 Drug-induced or toxic causes of Parkinsonism are
excluded.
Coverage for this impairment will cease at Age
sixty-five (65) or on maturity data/expiry date,
whichever is earlier.
Loss of the physical ability through an illness or
injury to do at least 3 of the 6 tasks listed below
ever again.
The relevant specialists must reasonably expect
that the disability will last throughout life with no
prospect of improvement, irrespective of when the
cover ends or the Life Insured expects to retire. Our
appointed Medical Practitioner should also agree
that the disability will last throughout life with no
prospect of improvement, irrespective of when the
cover ends or the Life Insured expects to retire.
The Life Insured must need the help or supervision
of another person and be unable to perform the
task on their own, even with the use of special
equipment routinely available to help and having
taken any appropriate prescribed medication.
The tasks are:
1. Bathing - the ability to wash in the bath or
shower (including getting into and out of
the bath or shower) or wash satisfactorily by
other means;
2. Dressing - the ability to put on, take off,
secure and unfasten all garments and, as
Loss of appropriate, any braces, artificial limbs or
26 Independent other surgical appliances;
Existence 3. Getting in and out of bed - the ability to
move from a bed to an upright chair or
wheelchair and vice versa;
4. Maintaining personal hygiene - the ability
to maintain a satisfactory level of personal
hygiene by using the toilet or otherwise
managing bowel and bladder function.
5. Feeding oneself - the ability to feed oneself
once food has been prepared and made
available.
6. Getting between rooms - the ability to move
indoors from room to room on level surface.
Loss of independent living must be medically
documented for an uninterrupted period of at least
six months. Proof of the same must be submitted to
Us while the Life Insured is alive and permanently
disabled. We will have the right to evaluate the Life
Insured to confirm total and permanent disability.
Loss of Independent Existence due to an injury
should occur independently of any other causes
within ninety (90) days of such injury.
Coverage for this impairment will cease at Age
sixty-five (65) or on maturity data/expiry date,
whichever is earlier.
The physical separation of two or more limbs, at
or above the wrist or ankle level limbs as a result
of injury or disease. This will include medically
necessary amputation necessitated by injury or
27 Loss of Limbs disease. The separation has to be permanent
without any chance of surgical correction.
Loss of Limbs resulting directly or indirectly from
self-inflicted injury, alcohol or drug abuse is
excluded.
Total and irreversible loss of hearing in both ears
as a result of illness or Accident. This Diagnosis
must be supported by pure tone audiogram test
28 Deafness and certified by an Ear, Nose and Throat (ENT)
specialist. Total means "the loss of hearing to the
extent that the loss is greater than 90 decibels across
all frequencies of hearing" in both ears.
Total and irrecoverable loss of the ability to speak
as a result of injury or disease to the vocal cords.
The inability to speak must be established for a
29 Loss of Speech
continuous period of 12 months. This diagnosis
must be supported by medical evidence furnished
by an Ear, Nose, Throat (ENT) specialist.
Medullary Cystic Disease is a disease where the
following criteria are met:
1. The presence in the kidney of multiple cysts
in the renal medulla accompanied by the
presence of tubular atrophy and interstitial
fibrosis;
Medullary
30 2. Clinical manifestations of anaemia, polyuria
Cystic Disease
and progressive deterioration in kidney
function; and
The diagnosis of medullary cystic disease is
3. confirmed by renal biopsy
Isolated or benign kidney cysts are
specifically excluded from this benefit
The unequivocal Diagnosis by a Medical
Practitioner of systemic lupus erythematosus
(SLE) with evidence of malar rash, discoid
rash, photosensitivity, multi-articular arthritis, and
serositis. There must also be hematological and
immunological abnormalities consistent with the
diagnosis of SLE. There must also be a positive
antinuclear antibody test. There must also be
evidence of central nervous system or renal
impairment with either
1. Renal involvement with persistent
proteinuria greater than 0.5 grams per day
Systemic Lupus
31 or a spot urine showing 3+ or greater
Erythematosus
proteinuria
2. Central nervous system involvement with
permanent neurological dysfunction as
evidenced with objective motor or sensory
neurological abnormal signs on physical
examination by a neurologist and present for
at least 3 months. Seizures, headaches and
cognitive abnormalities are not considered
under this definition as evidence of
"permanent neurological dysfunction".
Discoid lupus and medication induced lupus are
excluded.
There must be third-degree burns with scarring
that cover at least 20% of the body's surface
Third Degree area. The diagnosis must confirm the total area
32
Burns involved using standardized, clinically accepted,
body surface area charts covering 20% of the body
surface area
Aplastic Anemia is chronic persistent bone marrow
failure. A certified hematologist must make the
diagnosis of severe irreversible aplastic anemia.
There must be permanent bone marrow failure
resulting in bone marrow cellularity of less than
25% and there must be two of the following:
1. Absolute neutrophil count of less than
500/mm3
Aplastic 2. Platelets count less than 20,000/mm3
33
Anaemia 3. Reticulocyte count of less than 20,000/mm3
The insured must be receiving treatment for more
than 3 consecutive months with frequent blood
product transfusions, bone marrow stimulating
agents, or immunosuppressive agents or the insured
has received a bone marrow or cord blood stem cell
transplant.
Temporary or reversible aplastic anemia is
excluded and not covered in this Policy.
The occurrence of Poliomyelitis where the
following conditions are met:
1. Poliovirus is identified as the cause; and
2. Paralysis of the limb muscles or respiratory
34 Poliomyelitis muscles must be present and persist for at
least 3 months as confirmed by a consultant
neurologist.
Other causes of paralysis such as Guillain-Barre
syndrome are specifically excluded.
Bacterial meningitis is a bacterial infection of the
meninges of the brain causing brain dysfunction.
There must be an unequivocal diagnosis by a
consultant physician of bacterial meningitis that
Bacterial
35 must be proven on analysis of the cerebrospinal
Meningitis
fluid. There must also be permanent objective
neurological deficit that is present on physical
examination at least 3 months after the diagnosis of
the meningitis infection.
Severe inflammation of the brain substance
(cerebral hemisphere, brainstem or cerebellum)
caused by viral infection and resulting in
36 Encephalitis permanent neurological deficit. This Diagnosis
must be certified by a consultant neurologist
and the permanent neurological deficit must be
documented for at least 6 weeks.
Progressive supranuclear palsy occurring
independently of all other causes and resulting in
permanent neurological deficit, which is directly
Progressive
responsible for a permanent inability to perform
37 supranuclear
at least two (2) of the Activities of Daily Living.
palsy
The Diagnosis of the progressive supranuclear
palsy must be confirmed by a registered Medical
Practitioner who is a neurologist
The unequivocal diagnosis of Rheumatoid Arthritis
Severe
must be made by a certified medical consultant
Rheumatoid
based on clinically accepted criteria. There must be
38 arthritis
imaging evidence of erosions with widespread joint
destruction in three or more of the following joint
12 of 33
 areas: hands, wrists, elbows, knees, hips, ankle,
cervical spine or feet. There must also be typical
rheumatoid joint deformities.
Degenerative osteoarthritis and all other forms of
arthritis are excluded.
There must be history of treatment or
current treatment with disease-modifying
anti-rheumatic drugs, or DMARDs. Non-steroidal
anti-inflammatory drugs such as acetylsalicylic
acid are not considered a DMARD drug under this
definition.
Creutzfeldt-Jacob disease is an incurable
brain infection that causes rapidly progressive
deterioration of mental function and movement.
Creutzfeldt - A neurologist must make a definite diagnosis
39
Jakob disease of Creutzfeldt-Jacob disease based on clinical
assessment, EEG and imaging. There must be
objective neurological abnormalities on exam
along with severe progressive dementia.
A submassive to massive necrosis of the liver by a
hepatitis virus, leading precipitously to liver failure
where the following criteria are met.
1. Rapid decrease in liver size associated with
Fulminant necrosis involving entire lobules;
40
Viral Hepatitis 2. Rapid degeneration of liver enzymes;
3. Deepening jaundice; and
4. Hepatic encephalopathy
Hepatitis infection or carrier status alone, does
not meet the diagnostic criteria.
1.3.13. Exclusions applicable for the Accelerated Critical Illness Benefit:
No Critical Illness benefit will be payable in respect of any listed
condition arising directly or indirectly from or in consequence of or
aggravated by any of the following:
a) Pre-Existing Diseases.
b) Self-inflicted injury, suicide, insanity and deliberate participation
of the Life Insured in an illegal or criminal act
c) Use of intoxicating drugs / alcohol / solvent, taking of drugs
except under the direction of a qualified Medical Practitioner.
d) War - whether declared or not, civil commotion, breach of Law
with criminal intent, invasion, hostilities (whether war is declared
or not), rebellion, revolution, military or usurped power or willful
participation in acts of violence.
e) Aviation other than as a fare paying passenger or crew in a
commercial licensed aircraft.
f) Treatment for injury or illness caused by avocations / activities
such as hunting, mountaineering, steeple-chasing, professional
sports, racing of any kind, scuba diving, aerial sports,
activities such as hand-gliding, ballooning, deliberate exposure
to exceptional danger.
g) Radioactive contamination due to nuclear Accident.
h) Any treatment of a donor for the replacement of an organ.
i) Any illness due to pandemics
j) A condition for which any symptoms and or signs are present
and have resulted in the Diagnosis of a Critical Illness or medical
condition within the initial Waiting Period of the issuance of the
Policy.
k) Any illness due to a congenital defect or disease which has
manifested or was Diagnosed before the date of commencement
of the policy
1.4. ACCIDENTAL DEATH BENEFIT
1.4.1. In case the Accidental Death benefit option is chosen, subject to the
Policy being in force and the Life Insured dies due to an Accident,
100% of Accidental Death Benefit Sum Assured will be payable
as lump sum irrespective of the Cover Option chosen by You,
whereupon the Accidental Death benefit option will terminate and
no further benefit shall be paid under this Accidental Death benefit
option. In a scenario where Accident happened during the Accidental
Death Benefit Term and death due to the same Accident happens after
the Accidental Death Benefit Term, but within 180 days from the date
of the Accident, the Accidental Death Benefit Sum Assured shall be
payable.
1.4.2. You may choose to opt for an Accidental Death benefit option
at the Date of Inception of Policy or at any point of time during
the Policy Term, subject to the Policy being Premium paying and
remaining Policy Term being more than 5 (Five Years), subject to
our Underwriting Policy. A pro-rata basis additional Premium for the
Accidental Death benefit option will be charged in case the benefit is
added during the middle of a Policy Year and full Premium for the
Accidental Death benefit option will be charged starting from next
Policy Anniversary. However, in case Premium Break Option has
been selected then Accidental Death benefit option cannot be chosen
after the Date of Commencement of Risk.
1.4.3. Maximum Accidental Death Benefit Sum Assured available under
Accidental Death benefit option is Rs. 1 Cr, however in no case shall
the Accidental Death Sum Assured be higher than Guaranteed Death
Benefit prevailing at the time of opting for the Accidental Death
benefit cover.
1.4.4. You may at any time during the Policy Term choose to opt out
of/discontinue the Accidental Death benefit option, upon which, the
total Premium to be paid will be reduced by the Accidental Death
benefit Premium and only the Premium corresponding to the death
benefit or Riders/optional benefits (if any) will continued to be
payable. It is clarified that, once Accidental Death benefit option is
discontinued, the benefit cannot be again opted for.
1.4.5. The Accidental Death benefit option is not available under Single
Premium Payment Variant.
1.4.6. The Accidental Death benefit will always be paid as a lump sum
benefit.
1.4.7. This benefit shall be available under any point of sale Policy only
when the Policyholder has selected this Accidental Death benefit
option.
1.4.8. Termination of Accidental Death benefit option: The Accidental
Death benefit option will terminate immediately upon the occurrence
of any of the following events, whichever is earliest:
a) On the expiry of the Accidental Death Benefit Term;
b) On payment of 100% of the Accidental Death Benefit Sum
Assured;
c) On cancellation or surrender of the Policy;
d) On death of the Life Insured;
e) Life Insured being diagnosed with Terminal Illness;
f) On Your failure to revive the Policy within the Revival Period
of the Policy; or;
g) You opting out of or discontinuing the Accidental Death benefit
option.
1.4.9. Exclusions applicable to Accidental Death benefit: In case the
death of the Life Insured has occurred directly or indirectly due
to or caused, occasioned, accelerated or aggravated by any of the
following, no Accidental Death benefit shall be payable:
a) Suicide or self-inflicted Injury, whether the Life Insured is
medically sane or insane.
b) War, terrorism, invasion, act of foreign enemy, hostilities, civil
war, martial law, rebellion, revolution, insurrection, military or
usurper power, riot or civil commotion. War means any war
whether declared or not.
c) Taking part in any naval, military or air force operation during
peace time.
d) Any condition that is pre-existing at the time of later of Date of
Commencement of Risk or Date of Inception of Policy
e) Committing an assault, a criminal offence, an illegal activity or
any breach of law with criminal intent.
f) Alcohol or solvent abuse or taking of drugs, narcotics or
psychotropic substances unless taken in accordance with the
lawful directions and prescription of a Medical Practitioner
g) Poison, gas or fumes (voluntary or involuntarily, accidentally or
otherwise taken, administered, absorbed or inhaled).
h) Service in the armed forces, or any police organization, of any
country at war or service in any force of an international body
i) Participation in aviation other than as a fare-paying passenger in
an aircraft that is authorised by the relevant regulations to carry
such passengers between established aerodromes.
j) Taking part in professional sport(s) or any adventurous pursuits
or hobbies including any kind of racing (other than on foot
or swimming), potholing, rock climbing (except on man-made
walls), hunting, mountaineering or climbing requiring the use of
ropes or guides, any underwater activities involving the use of
underwater breathing apparatus including deep sea diving, sky
diving, cliff diving, bungee jumping, paragliding, hand gliding
and parachuting.
k) Nuclear contamination; the radioactive, explosive or hazardous
nature of nuclear fuel materials or property contaminated by
nuclear fuel materials or Accident arising from such nature.
1.5. MATURITY BENEFIT
No maturity benefit is payable except where Return of Premium Option
has been chosen by You at Date of Inception of Policy. This option cannot
be selected at later stage during the Policy Term. Under this option, if the
Life Insured survives throughout the Policy Term, 100% of the sum of
Total Premiums Paid, Underwriting Extra Premiums and loadings for modal
premiums received under the Policy (corresponding to the Guaranteed Death
Benefit and any Voluntary Top Sum Assured) will be paid to You, on maturity
("Return of Premium Option"). Additional premium charged for optional
benefits such as Accelerated Critical Illness Benefit option, Accidental Death
benefit option, Secondary Life benefit under Joint Life Cover or towards
Riders, if any, will not be returned on maturity under the Return of Premium
Option. If there is a discount applicable under the Policy, only 100% of
the discounted Premiums received (corresponding to the Guaranteed Death
Benefit and any Voluntary Top Sum Assured) under the Policy would be
returned on maturity of the Policy. It is clarified that in case You have opted
for the Joint Life Cover Option the maturity benefit will be paid only if the
Life Insured is alive on the Maturity Date, irrespective of the Secondary Life
being alive or not.
1.6. VOLUNTARY SUM ASSURED TOP-UP
1.6.1. Post completion of waiting period of 1 year from the Date of
Commencement of Risk and subject to receipt of Your written request
and medical and financial underwriting by Us, We may allow You
13 of 33
 to increase the Sum Assured on Premium which will be determined
by Us basis the Age of the Life Insured at the time of exercising
Voluntary Sum Assured Top-Up Option, once during the Policy.
Such increase in the Sum Assured shall in no case exceed 100% of the
Sum Assured as on the Date of Commencement of Risk. Once this
Voluntary Sum Assured Top-Up Option is exercised, it shall remain
level throughout the remaining Policy Term. The Sum Assured can
be increased in multiples of Rs.10 lakh only.
1.6.2. The Voluntary Sum Assured Top-Up Option can be exercised only if
the Policy is in force and the following conditions are satisfied:
a) the Age of the Life Insured does not exceed 50 years;
b) Increasing Cover Option or Premium Break Option have not been
opted;
c) The Sum Assured under the Policy as chosen at Date of Inception
of Policy, is equal to or greater than Rs.50 Lacs; and
d) The minimum Premium Payment Term & Policy Term under for
this option are 5 years and 10 years respectively.
1.6.3. In case of death of the Life Insured, the Top Up Sum Assured shall
be payable alongwith the Guaranteed Death Benefit as per Clause 1.1
of Part C.
1.6.4. In case the Life Insured is Diagnosed with Terminal Illness, the Top
Up Sum Assured shall be payable alongwith the Terminal Illness
Benefit as per Clause 1.2 of Part C subject to total benefit payable
not exceeding Rs.1 Crore.
1.6.5. Voluntary Sum Assured Top-Up Option will not be allowed if any
Accelerated Critical Illness Benefit has already been claimed or if
Premium Break Option has been opted for.
1.6.6. Voluntary Sum Assured Top-Up will not impact the Accelerated
Critical Illness Benefit Sum Assured or Accidental Death Benefit
Sum Assured, if opted for.
1.6.7. For a Joint Life Cover Option, Voluntary Sum Assured Top-Up
Option will be applicable only for You i.e. top-up will not be allowed
on Secondary Life.
1.6.8. You shall be allowed to surrender the Top-Up Sum Assured anytime
as per Your convenience. The Surrender Value shall be different
for each Sum Assured and Top-Up Sum assured which shall be
determined basis the duration elapsed since the commencement of
first Premium payment for each Sum Assured.
1.6.9. Return of Premium Option at maturity shall also be available for the
Premium paid to enhance the Sum Assured under this Voluntary Sum
Assured Top-Up Option.
1.6.10. The Voluntary Sum Assured Top-Up Option shall be identical to the
base plan variant. i.e. If You have chosen Return of Premium Option,
the same shall also apply to Premium paid towards Voluntary Sum
Assured Top-Up Option. However, if You have not chosen Return of
Premium Option at Date of Inception of Policy, then the same cannot
be applied to Premium paid toward Voluntary Sum Assured Top-Up
Option.
1.6.11. The Premium rates for Voluntary Sum Assured Top-Up Option will
be determined basis the Sum Assured band of the Policy applicable
to the Sum Assured inclusive of the Voluntary Sum Assured Top-Up.
1.6.12. The minimum outstanding base Policy Term to exercise this option
is 10 years, subject to the other boundary condition of maximum
attained Age.
1.6.13. The Policy Term of this option shall be same as the outstanding Policy
Term of the base Policy cover and the Premium Payment Term shall
be the maximum Premium Payment Term available at the time of
opting for this option but not exceeding the base cover Premium
Payment Term.
1.6.14. Waiver of Premium Plus Rider will also be applicable for Voluntary
Sum Assured Top-Up i.e. if You have opted for Waiver of Premium
Plus rider and later exercise the Voluntary Sum Assured Top-Up
then Waiver of Premium Plus Rider benefit would be payable for
the additional Premium corresponding to the Voluntary Sum Assured
Top-Up.
1.6.15. Voluntary Sum Assured Top-Up will not be available in case of
Policy is sourced as a point of sale policy.
1.7. JOINT LIFE COVER OPTION
1.7.1. If You have opted for Joint Life Cover Option at Date of Inception of
Policy, to cover Your spouse ("Secondary Life") under this Policy,
then in case of either death or Diagnosis with Terminal Illness of the
Secondary Life:
i. Before the death or Diagnosis with Terminal Illness of Life
Insured, then, We will pay an amount of Rs. 10 (Ten) lacs to
You as guaranteed death benefit and cover on the life of the
Secondary Life will end, however the cover of life of the Life
Insured continues with Premium reduced to the extent to the
Premium payable with respect to Joint Life Cover Option and
with applicable Guaranteed Death Benefit.
After the death or Diagnosis with Terminal Illness of Life
Insured, We will pay an amount of Rs.50 (Fifty) lacs to the
ii. Claimant as guaranteed death benefit.
1.7.2. Premium payable under the Policy with respect to Joint Life Cover
Option including applicable of loadings for modal premiums and
taxes) will be waived off when the Life Insured dies or is Diagnosed
with Terminal Illness, whichever is earlier.
1.7.3. Joint Life Cover Option will be available only where You have taken
the Policy on your own life and the Guaranteed Death Benefit under
the Policy is greater than or equal to Rs.1 Crore.
1.7.4. Maximum Age at maturity of Secondary Life cannot be more than
85 years, accordingly the Joint Life Cover Option for Secondary Life
will automatically terminate on the Policy Anniversary immediately
following his/her 85th birthday irrespective of the cover in respect of
Life Insured still being in force.
1.7.5. In case You have chosen Increasing Cover Option, the Guaranteed
Death Benefit only in respect of the Life Insured shall increase and
it will not impact the life cover towards Secondary Life. Further
all other optional benefits under this Policy including Accelerated
Critical Illness, Accidental Death benefit cover, Voluntary Sum
Assured Top-Up Option and available Riders shall applicable only
on the life cover provided to the Life Insured and will not available
for Secondary Life.
1.7.6. In the event of simultaneous death or Diagnosis of Terminal Illness
of both the Life Insured and Secondary Life or death of Life Insured
and Diagnosis of Terminal Illness of Secondary Life or vice versa,
an amount of Rs.50,00,000 will be paid to the Claimant towards
Secondary Life in addition to the Guaranteed Death Benefit payable
in respect of the Life Insured.
1.7.7. In the earlier event of death of the Life Insured prior to Secondary
Life, the Secondary Life will become the policyholder under the
Policy.
1.7.8. The benefits under this Joint Life Cover Option can be surrendered
by You anytime during the Policy Term. However, the Secondary
Life cannot surrender benefits under this Joint Life Cover Option or
the Policy upon the death of the Life Insured.
1.7.9. In case of death of Secondary Life due to suicide within 12 months
from the Date of Commencement of Risk or Date of Inception
of Policy or the date of Revival of the Policy, whichever is later,
provisions as per Clause 6 of Part F will be applicable and Secondary
Life benefit will terminate. Cover for Life Insured will continue
with reduced Premium along with the other additional options
like Accelerated Critical Illness, Accidental Death benefit cover,
Voluntary Sum Assured Top-Up Option and available Riders, if any.
1.7.10. Joint Life Cover Option will not be available in case of Policy is
sourced as a point of sale policy.
1.8. PREMIUM BREAK OPTION
1.8.1. You shall be allowed to opt for the Premium Break Option on
payment of extra Premium on the Date of Inception of Policy only.
Once opted for, You are allowed to take two annual Premium breaks
(or its equivalent as per Clause 1.8.4 of Part C) from paying the
Premiums under the Policy after completion of 10 Policy Years
provided all due Premiums have been paid ("Premium Break").
The duration of one Premium Break shall be 12 Policy months
and the Premium which shall be waived shall include the Premium
to be paid towards base Policy cover, Accelerated Critical Illness
Benefit Premium and Accidental Death benefit Premium inclusive of
Underwriting Extra Premium, loadings for modal premiums, if any,
and any applicable taxes thereon. The second Premium Break can be
exercised only after a minimum gap of 10 years from end of the first
Premium Break period.
1.8.2. During the Premium Break, the Policy will remain in force with the
full risk cover as per terms and condition of the Policy.
1.8.3. This Premium Break Option is available only if you have opted for
Regular Premium Payment Variant or Pay Till 60 Premium Payment
Variant and where the Policy Term is greater than 30 years and
Premium Payment Term greater than 21 years.
1.8.4. Once the Premium Break Option is in force, it shall continue for
12 consecutive Policy months i.e. one Premium Break shall mean 1
annual Premium or 2 half-yearly Premiums or 4 quarterly Premium
or 12 monthly Premiums.
1.8.5. This Premium Break Option can be exercised from the next Premium
anniversary, independent of the Policy Anniversary. For example,
for a monthly mode Policy, a You after having paid 125 monthly
premiums may choose not to pay the next monthly Premium upto a
maximum of 12 month Premiums.
1.8.6. If You have exercised the first Premium Break in the last 10 years
of the Policy, then the second Premium Break shall be by default the
last Policy Year Premium as applicable.
1.8.7. In case You do not voluntarily exercise the Premium Break benefit
during the Premium Payment Term, We will waive off the last two
Policy Year Premiums (last Policy Year Premium if partly exercised
earlier) as applicable.
1.8.8. For exercising a Premium Break Option, You will be required to
intimate Us, at least 30 days (15 days in case of Premium payment
mode is monthly) before next Premium due date. Thus if a Premium
is unpaid with no prior intimation, then at the end of the Grace Period
the Policy shall become Lapsed Policy / Reduced Paid Up, as the case
may be.
1.8.9. If You discontinue Premium payment immediately post exercising
one or both the Premium Break, the Revival Period will be considered
to start from the due date of Premium payable after the end of the
Premium Break period.
1.8.10. You cannot opt for Premium Break Option if You have chosen Joint
Life Cover option.
14 of 33
 1.8.11. If Premium Break Option has been opted for then Accelerated Critical
Illness & Accidental Death benefit can only be opted at Date of
Inception of Policy and not later in the Policy Term.
1.8.12. Voluntary Sum Assured Top-Up option is not available with
Premium Break Option.
1.8.13. No Rider will be available with Premium Break Option.
1.8.14. You can surrender the Policy anytime along with this option even
during the Premium Break period, however, the surrender can be
done along with the base Policy only and not separately.
1.8.15. Premium Break Option will only be applicable on the base
Policy Premium (including Return of Premium Option), Accelerated
Critical Illness Benefit Premium and Accidental Death benefit
Premium.
1.8.16. Premium Break Option will not be available in case of Policy is
sourced as a point of sale policy.
1.9. REDUCED PAID-UP BENEFIT/ NON FORFEITURE OPTIONS
If Return of Premium Option was chosen by You at the Date of Inception of
Policy and Policy has acquired a Surrender Value as specified under Clause
1 of Part D, then, in the event of non-payment of the due Premiums by You to
Us, on the expiry of the Grace Period, this Policy will not become a Lapsed
Policy and by default will continue under Reduced Paid-Up Mode unless
revived. A Reduced Paid-Up Policy can be revived within a Revival Period,
subject to conditions, for revival of Lapsed Policy mentioned in Part D. If a
Reduced Paid-Up Mode Policy is not revived within Revival Period, then the
Policy cannot be revived and the Policy will continue as Reduced Paid-Up
Policy for the remaining Policy Term. Policy under the Reduced Paid-Up
Mode will be free from all liabilities of payment of future Premiums to Us. If
this Policy is under Reduced Paid-Up Mode, then, the benefits payable shall
be as follows:
1.9.1. Reduced Paid -Up Death Benefit
a. In the event of the death of the Life Insured during Policy Term
when the Policy is under Reduced Paid-Up Mode, the death
benefit, in case of Level Cover Option, will be reduced as per the
below formula:
Reduced Paid-Up Sum Assured= ((Total Premium Paid under
base Policy) / (total Premiums payable under base Policy
(excluding Underwriting Extra Premium, loadings for modal
premiums and Rider Premium, if any)) * Sum Assured applicable
before Policy moved to Reduced Paid-Up Mode.
b. In case of the Increasing Cover Option, the future increase in
Reduced Paid-Up death benefit post the Policy becomes Reduced
Paid-Up will also get reduced as per the below proportionate
Premiums formula:
5% * Sum Assured at the Date of Inception of Policy * ((Total
Premium Paid under base Policy) / (total Premiums payable
under base Policy (excluding Underwriting Extra Premium,
loadings for modal premiums and Rider Premium, if any))
c. It is clarified that for the purpose of above calculations Total
Premium Paid towards base death benefit would only be
considered.
1.9.2. Reduced Paid -Up Terminal Illness Benefit
In the event the Life Insured is Diagnosed with a Terminal Illness
during Policy Term, when the Policy is under Reduced Paid-Up
Mode, a benefit equal to the Reduced Paid-Up Mode death benefit as
noted in Clause 1.9.1 of Part C, subject to a maximum limit of Rs.1
Crore shall be payable. Upon payment of Reduced Paid-Up Terminal
Illness Benefit, the Reduced Paid-Up Death Benefit will be reduced
by the amount of the benefit paid.
1.9.3. Reduced Paid -Up Maturity Benefit
Under the Return of Premium Option, if the Life Insured has survived
until the Maturity Date, 100% of the Sum of Total Premiums Paid,
Underwriting Extra Premium and loadings for modal premiums, if
any (corresponding to base Policy cover, Premium Break Option
and Voluntary Sum Assured Top-Up Option) will be paid at end
of Policy Term. Please note that any additional Premium charged
for optional benefits (Accelerated Critical Illness Benefit option,
Accidental Death benefit cover option and Joint Life Cover) or
Riders, will not be returned back at maturity under this option.
1.9.4. Reduced Paid -Up Surrender Value
The Surrender Value of Reduced Paid-Up Policy will be as calculated
in accordance with Clause 1 of Part D (Surrender / Early Exit Value).
1.9.5. No benefit will be paid towards Accelerated Critical Illness Benefit,
Accidental Death benefit cover or Secondary Life (in case Joint
life Cover Option has been opted) once the Policy has moved into
Reduced Paid Up mode.
2. PREMIUMS
2.1. You shall have a choice between the Single Premium Payment Variant,
Limited Premium Payment Variant, Regular Premium Payment Variant
or Pay Till 60 Premium Payment Variant for Premium payments. Unless
otherwise allowed in the Policy, the Premium payment variant can only
be chosen at the Date of Inception of Policy and cannot be changed
subsequently. The Premium payment mode for Accelerated Critical Illness
Benefit, Accidental Death benefit cover and Voluntary Sum Assured Top-Up
Option shall be same as base Policy Premium payment mode.
2.2. You can pay the Premium annually, semi-annually, quarterly or on monthly
basis, as per the Premium payment mode chosen by You. However, Premium
payment mode applicable for base cover will be applicable Premium payable
towards any optional benefits/ Riders that You may have opted under this
Policy.
2.3. You have an option to change the Premium payment mode during the
Premium Payment Term by submitting a written request to Us. Any change
in the Premium payment mode will result in a change in the Premium amount
basis the applicable Modal Factors. A change in Premium payment mode
will be effective only on the modal Anniversary following the receipt of such
request, depending on the premium payment frequency chosen by You.
2.4. You can pay Premium at any of Our offices or through Our website
www.maxlifeinsurance.com or by any other means, as informed by Us. Any
Premium paid by You will be deemed to have been received by Us only after
the same has been realized and credited to Our bank account.
2.5. The Premium payment receipt will be issued in Your name, which will be
subject to realization of cheque or any other instrument/medium.
2.6. Premium rates for the death benefit and Accidental Death benefit cover option
are guaranteed for the entire Policy Term. However, for the Accelerated
Critical Illness Benefit, the Premium rates are guaranteed only for a period of
five (5) years and may be revised thereafter by Us basis experience under the
product by seeking prior approval from IRDAI. Once revised, the Premium
rates shall be guaranteed for the next five (5) years.
2.7. Under Accelerated Critical Illness Benefit, the Premium Payment Term shall
be equal to the Policy Term.
2.8. Under Accidental Death benefit cover, the Premium Payment Term and
Accidental Death Benefit Term will be subject to the remaining Premium
Payment Term and Policy Term of the base Policy benefit, such that:
1) At Date of Inception of Policy, the Accidental Death Benefit Term and
Premium Payment Term shall be same as that of the base Policy.
2) Post the Date of Inception of Policy, the Accidental Death Benefit Term
shall be same as the remaining Premium Payment Term of the base
Policy benefit. The Accidental Death Benefit Term shall be the maximum
Premium Payment Term available under Accidental Death benefit cover
at the time of opting for this option but not exceeding the base Policy
Premium Payment Term.
3. GRACE PERIOD
3.1. The Premium is due and payable by the due date specified in the Schedule.
If the Premium is not paid by the due date, You may pay the same during the
Grace Period without any penalty or late fee.
3.2. The insurance coverage continues during the Grace Period. However, if the
overdue Premium is not paid even in the Grace Period and the Life Insured
dies, then, We will pay the death benefit after deducting the unpaid premium
(if any) till date of death.
PART D
POLICY SERVICING CONDITIONS
1. SURRENDER/ EARLY EXIT VALUE
You may surrender the Policy any time after the Policy has acquired a Surrender
Value or Early Exit Value as below:
1.1. If You have not opted for Return of Premium Option:
1.1.1. The Policy shall acquire Early Exit Value ("Early Exit Value"),
subject to the following criteria :
a. For Single Premium Payment Variant: immediately after payment
of single Premium.
b. For Limited Premium Payment Variant including Pay Till 60
Variant: Upon completion of Premium Payment Term on receipt
of all due Premiums.
c. Regular Premium Payment Variant: No surrender benefit is
applicable or payable.
1.1.2. The Early Exit Value shall be determined basis the formula provided
below:
70% x (Sum of Total Premium Paid, Underwriting Extra Premium and
loadings for modal premiums, if any) x (unexpired Policy Term/ Policy
Term).
1.1.3. Special Exit Value: You shall be allowed a Special Exit Value,
wherein We will return sum of Total Premiums Paid, Underwriting
Extra Premiums and loadings for modal premiums, if any, only if You
surrender the Policy during:
• For Policy with Policy Term between 40-44 years: 25th Policy
Year or during the period when the attained Age of the Life
Insured is between 65th and 66th Year, whichever is earlier,
• For Policy with Policy Term greater than 44 years: 30th Policy
Year or during the period when the attained Age of the Life
Insured is between 65th and 66th Year, whichever is earlier.
The following conditions shall be applicable for Special Exit Value:
(i) The Policy has to be in force at the time of availing this Special
Exit Value.
(ii) The Policy shall be terminated after availing this Special Exit
Value.
(iii) Special Exit Value shall not be available with Policy with Return
of Premium Option.
(iv) Special Exit Value shall not be available for Policy Term less
than 40 years.
(v) Special Exit Value shall be applicable on the base Policy
Premium only and not to additional optional benefits like
Accelerated Critical Illness benefit, Accidental Death benefit,
Joint life cover or Voluntary Sum Assured Top-Up.
1.1.4. For optional benefits like Accidental Death benefit cover, Joint Life
Cover Option, Premium Break Option or Voluntary Sum Assured
Top-Up Option, Early Exit Value will be payable. However, no
15 of 33
 Early Exit Value will be paid in lieu of the Premium paid towards For further details and the Revival late fee applicable as on date, please refer
Accelerated Critical Illness benefit. to our website www.maxlifeinsurance.com. Any change in methodology to
1.2. If You have opted for Return of Premium Option and You discontinue derive the Revival rate of interest shall be with prior approval from IRDAI.
paying Premium or You surrenders the Policy, then: 3.4. The Revival of the Lapsed Policy will take effect only after We have approved
1.2.1. The Policy shall acquire Surrender Value ("Surrender Value"), the same in accordance with Our Underwriting Policy and communicated Our
subject to the following criteria: decision to You in writing. All benefits (except for the Accelerated Critical
a) For Single Premium Payment Variant: immediately after receipt Illness Benefit, if already claimed under the Lapsed Policy) including death
of single Premium. and monthly income which were originally payable will be restored on such
b) Limited Premium Payment Variant including Pay Till 60 Revival with effect from due date of the unpaid Premium.
Premium Payment Variant and Regular Premium Payment 3.5. If a Lapsed Policy is not revived within the Revival Period, this Policy will
Variant: on receipt of two full year Premium. terminate without value, on the expiry of the Revival Period.
1.2.2. The Surrender Value is the higher of Guaranteed Surrender Value or 3.6. The Policy cannot be revived beyond the Policy Term.
Special Surrender Value. For the purpose of this Policy the Special 3.7. Once the Policy has acquired Surrender/ Early Exit Value, if future Premiums
Surrender Value will be equal to the Guaranteed Surrender Value. are discontinued then the Policy shall not lapse and the following shall be
Guaranteed Surrender Value is defined as: applicable:
a. Under Return of Premium Option: The Policy will by default become
Guaranteed Surrender Value factor x (sum of Total Premium Paid, Reduced Paid-Up Policy. A Reduced Paid-Up Policy can be revived
Underwriting Extra Premium and loadings for modal premiums, if within the Revival Period, subject to conditions mentioned above for
any) Revival of Lapsed Policy. If a Reduced Paid-Up Policy is not revived
within the Revival Period, then the Policy cannot be revived and will
The Guaranteed Surrender Value factors are provided below: continue as Reduced Paid-Up Policy for the rest of its Policy Term.
b. Other than the Return of Premium Option: If the Policy is not revived
within a Revival Period from the due date of first unpaid Premium,
an Early Exit Value shall be paid to the You and the Policy shall be
terminated.
% of Total Premiums Paid, Underwriting 3.8. In case of non-receipt of Premium, the cover for Accelerated Critical Illness
Extra Premium including Premiums Benefit, Accidental Death benefit and Joint Life Cover Option will lapse and
for Voluntary Sum Assured Top-Up no benefits shall be payable. However, the cover for these benefit options
Policy Limited Premium can be reinstated during the Revival Period as per the applicable terms and
Year of Payment Variant, conditions for Revival of Policy.
Surrender Single Premium Pay Till 60 Premium 3.9. Once the Policy has been revived, all the benefits will get reinstated to original
Payment Variant Payment Variant and levels, which would have been the case had the Policy remained premium
Regular Premium paying including the optional benefits chosen.
Payment Variant 3.10. In addition to the revival provisions stated above and subject to Our sole
discretion, You may also be eligible to avail of one or more of the following
1 75% NIL
revival schemes to revive Your Policy:
2 75% 30%
i. Reduction in the Sum Assured: You may be eligible to revive your Policy
3 75% 35% by reducing the Sum Assured. Please contact Us for details on whether
4 90% 50% You are eligible for this Revival scheme and, if so, the extent to which
5 90% 52% the Sum Assured can be reduced, the total amount required to be paid
6 90% 54% by You to revive the Policy and the applicable terms and conditions for
7 90% 56% utilizing this revival scheme;
Graduating linearly from ii. Change in the Premium Payment Term: You may be eligible to revive
56% to 90% during the your Policy by changing the Premium Payment Term. Please contact Us
last two Policy Years for details on whether You are eligible for this revival scheme and if so,
8+ 90% Minimum [(56% + the extent to which the Premium Payment Term can be changed, the total
[(34% x (N-7)) / (Policy amount required to be paid by You to revive the Policy and the applicable
Term - 8)], or 90%] terms and conditions for utilizing this revival scheme;
N : Year of Surrender iii. Special Revival Schemes: We may also introduce special revival schemes
from time to time which are available for a particular period. Please
contact Us for details on whether such revival scheme is available and, if
1.2.3. Surrender Value for the Premium paid towards Premium Break and
You are eligible for the same, the total amount required to be paid by You
Voluntary Sum Assured Top Up Option will be calculated in the same
to revive the Policy and the applicable terms and conditions for utilizing
manner as for the Premium paid towards base cover under this Policy.
such revival scheme.
However, no Surrender Value will be paid in lieu of the Premium paid
iv. We may, from time to time, at Our sole discretion, introduce new
towards Accidental Death benefit cover, Joint Life Cover Option and
revival schemes or modify or terminate existing revival schemes.
Accelerated Critical Illness Benefit.
Please contact Us for details on 1860 120 5577 or visit Our website
2. LOANS
www.maxlifeinsurance.com.
You are not entitled to any loans under this Policy.
4. PAYMENT OF BENEFITS
3. REVIVAL OF POLICY
4.1. The benefits under this Policy will be payable only on submission of
A Lapsed Policy can be revived as per Our Underwriting Policy, within the Revival
satisfactory proof to Us. The benefits under this Policy will be payable to the
Period:
Claimant.
3.1. on receipt of Your written request to revive the Policy by Us; and
4.2. Once the benefits under this Policy are paid to the Claimant, the same will
3.2. if You produce an evidence of insurability (in form of declaration of health
constitute a valid discharge of Our liability under this Policy.
condition and/or relevant medical reports) of Life Insured at Your own cost
5. TERMINATION OF POLICY
which is acceptable to Us; and
This Policy will terminate upon the happening of any of the following events:
3.3. on payment of all overdue Premiums (along with the applicable taxes, cesses
5.1. on the date on which We receive Freelook cancellation request from You;
and levies, if any) to Us with late payment fee as may be determined by Us
5.2. the date of death of the Life Insured or Secondary Life, whichever is later;
from time to time (in the manner described hereinbelow) as on the date of
5.3. upon payment of the Sum Assured or 100% of the Guaranteed Death Benefit
Revival. Currently the applicable late fee is as below:
to Claimant;
No. of days 5.4. on the expiry of the Revival Period, if the Lapsed Policy has not been revived;
Currently
between date of 5.5. on the date of payment of Surrender Value as per the terms and conditions of
Revival Late Fee Basis Applicable
Revival and date the Policy;
Revival Late Fee*
of lapse of Policy 5.6. on the Maturity Date, upon the payment of the all maturity benefits, if any;
0-60 Nil 0.00% 5.7. upon payment of the commuted value of the future benefits; or
RBI Bank Rate + 5.8. upon payment of dues as per suicide clause (Clause 6 of Part-F);
61-180 1% p.a. compounded 5.65% 6. FREELOOK CANCELLATION
annually on due Premiums "Freelook" means a period of 15 days (30 days in case of electronic policies and
RBI Bank Rate + policies obtained through distance marketing mode) from the date of receipt of the
>180 3% p.a. compounded 7.65% Policy, to review the terms and conditions of the Policy, where if You disagree to
annually on due Premiums any of those terms and conditions, You have the option to return the Policy stating
the reasons for objection. Upon return, the Policy will terminate forthwith and all
*Note: The current applicable revival late fee effective as on 1st July 2020 rights, benefits and interests under the Policy will cease immediately. You shall be
is based on RBI Bank rate of 4.65% p.a. prevailing as at 31st March, 2020. entitled to a refund of the Premium received by Us after deducting the proportionate
The 'RBI Bank Rate' for the financial year ending 31st March (every year) risk premium for the period of cover, charges of stamp duty paid and the expenses
will be considered for determining the revival late fee and the same shall be incurred by Us on medical examination of the Life Insured, if any.
made effective w.e.f. 01st July every year. The revival late fee is revised only 7. LAPSATION OF POLICY
if the 'RBI Bank Rate' changes by 1% or more from the 'RBI Bank Rate' used In case of Lapsed Policy risk cover will cease and no benefits shall be payable. Once
to determine the prevailing revival late fee (reviewed on every 31st March). the Policy has acquired Surrender Value / Early Exit Value, the Policy shall not

16 of 33
 lapse at the end of the Grace period. You may revive a Lapsed Policy during the
Revival Period.
PART E
POLICY CHARGES
APPLICABLE FEES/ CHARGES UNDER THE POLICY
This Policy is a non-linked non participating individual pure risk premium life insurance
plan and therefore, Part E is not applicable to this Policy.
PART F
GENERAL TERMS AND CONDITIONS
1. ELIGIBILITY
1.1. The minimum Age of the Life Insured on the Date of Commencement of
Risk should be 18 (Eighteen) years.
1.2. The maximum Age of the Life Insured on the Date of Commencement of
Risk should be:
1.2.1. For Single Premium Payment Variant, Regular Premium Payment
Variant, Limited Premium Payment Variant - 65 (Sixty-Five) years
(except in case of the policies sourced through point of sales person
it will be 55 (Fifty-Five) years; and;
1.2.2. For Pay Till 60 Premium Payment Variant - 44 (Forty-Four) years.
1.2.3. For Voluntary Sum Assured Top-Up Option - 50 (Fifty) years.
1.3. The maximum Age of the Life Insured on the Maturity Date cannot exceed:
1.3.1. For Death/ Terminal Illness Benefit and Accidental Death benefit
option is 85 (Eighty-Five) years.
1.3.2. For Accelerated Critical Illness Benefit option is 75 (Seventy-Five)
years.
1.3.3. For policies sourced through point of sales person is 65 (Sixty-Five)
years.
1.4. In case the Return of Premium Option has been chosen by You, maximum
Policy Term for base death benefit and Accidental Death benefit option shall
in no case exceed 50 Years from the Date of Commencement of Risk.
2. TAXES
2.1. All Premiums are subject to applicable taxes, cesses, and levies, if any which
will entirely be borne by You and will always be paid by You along with
the payment of Premium. If any imposition (tax or otherwise) is levied by
any statutory or administrative body under the Policy, We reserve the right
to claim the same from You. Alternatively, We have the right to deduct the
amount from the benefits payable by Us under the Policy.
2.2. Tax benefits may be available as per the prevailing tax laws. Tax laws and
the benefits arising thereunder are subject to change. You are advised to seek
an opinion of Your tax advisor in relation to the tax benefits and liabilities
applicable to You.
3. CLAIM PROCEDURE
3.1. For processing a claim request under this Policy, We will require all of the
following documents:
3.1.1. In case of a Death claim:
a) Claimant's statement in the prescribed form;
b) original Policy document;
c) a copy of police complaint/ first information report (in the case
of unnatural death of the Life Insured/ Secondary Life);
d) a copy of duly certified post mortem report (in the case of
unnatural death of the Life Insured/ Secondary Life);
e) all medical/ hospital records (including diagnostic records)
f) a copy of death certificate issued by the local/municipal
authority duly attested by the Claimant;
g) a self-attested copy of admissible identity proof of the Claimant
including Nominee(s) bearing their photographs and signatures
(only in the case of the death of the Life Insured/ Secondary
Life);
h) Bank details of Claimant;
i) any other document or information required by Us for assessing
and approving the claim request.
3.1.2. In case of claim with towards Accelerated Critical Illness or Terminal
Illness:
a) Claimant's statement in the prescribed form;
b) a copy of police complaint/ first information report (wherever
applicable);
c) attending physician's statement;
d) certificate by a Medical Practitioner confirming Diagnosis
of Critical Illness or Terminal Illness of the Life
Insured/ Secondary Life;
e) All medical/ hospital records (including diagnostic records)
pertaining to Critical Illness or Terminal Illness and treatment.
f) a self-attested copy of identity proof of the Claimant including
Nominee(s), if any, bearing their photographs and signatures;
and
g) any other documents/information required by Us for assessing
and approving the claim request.
3.1.3. In case of Maturity claim:
a) NEFT Form (if not provided earlier)
b) a cancelled cheque or copy of passbook with pre-printed name
and bank account number, for payout through NEFT (if not
provided earlier)
c) a self-attested photo ID proof
3.2. A Claimant can download the claim request documents from Our website
www.maxlifeinsurance.com or can obtain the same from any of Our
branches.
3.3. Subject to provisions of Section 45 of the Insurance Act 1938 as amended
from time to time, We shall pay the benefits under this Policy subject to Our
satisfaction:
3.3.1. that the benefits have become payable as per the terms and conditions
of this Policy; and
3.3.2. of the bonafides and credentials of the Claimant.
3.4. Subject to Our sole discretion and satisfaction, in exceptional circumstances
such as on happening of a force majeure event, We may decide to waive all
or any of the requirements set out in Clause 3.1 of Part F.
4. DECLARATION OF THE CORRECT AGE
Declaration of the correct Age and/ or gender of the Life Insured is important for
Our underwriting process and calculation of Premiums payable under the Policy. If
the Age and/or gender declared in the Proposal Form is found to be incorrect at any
time during the Policy Term or at the time of claim, We may revise the Premium
with interest and/or applicable benefits payable under the Policy in accordance with
the premium and benefits that would have been payable, if the correct Age and/ or
gender would have made the Life Insured eligible to be covered under the Policy on
the Date of Commencement of Risk.
5. FRAUD, MIS-STATEMENT AND FORFEITURE
Fraud, mis-statement and forfeiture would be dealt with in accordance with
provisions of Section 45 of the Insurance Act, 1938 as amended from time to
time. [A leaflet containing the simplified version of the provisions of the above
section is enclosed in Annexure - (1) for reference]
6. SUICIDE EXCLUSION
Notwithstanding anything stated herein, if the Life Insured commits suicide, whether
minor/major, whether sane or insane, within 12 (Twelve) months from the Date of
Commencement of Risk of Policy or from the date of Revival of this Policy, as
applicable, all risks and benefits under this Policy shall cease and in such an event
We will only refund the sum of Total Premiums Paid, loading for modal premium
and Underwriting Extra Premium, if any, received under the Policy by Us till the
death of the Life Insured to the Claimant.
If You chose to increase Sum Assured under the Voluntary Sum Assured Top-Up
Benefit, the above suicide clause provisions will be applicable on the increased
Sum Assured as well. Hence, if the Life Insured commits suicide within 12 months,
whether minor or major, whether sane or insane, from the date of increase in
Sum Assured benefit due to Voluntary Sum Assured Top-Up Benefit Option, the
Claimant will receive the Sum Assured under the base Policy (subject to the Clause
above) plus return of sum of additional Total Premiums Paid, loading for modal
premium and Underwriting Extra Premium, that was received towards increase the
Sum Assured under Voluntary Sum Assured Top-Up Benefit Option. The increased
Sum Assured due to Voluntary Sum Assured Top-Up Benefit Option will not be
paid as suicide happened within 12 months of increase in Sum Assured.
7. TRAVEL AND OCCUPATION
There are no restrictions on travel or occupation under this Policy.
8. NOMINATION
Nomination is allowed as per Section 39 of the Insurance Act, 1938 as amended
from time to time. [A leaflet containing the simplified version of the provisions of
the above section is enclosed in Annexure - (2) for reference]
9. ASSIGNMENT
Assignment is allowed as per Section 38 of the Insurance Act, 1938 as amended
from time to time. [A leaflet containing the simplified version of the provisions of
the above section is enclosed in Annexure - (3) for reference]
10. POLICY CURRENCY
This Policy is denominated in Indian Rupees. Any benefit/claim payments under the
Policy will be made in Indian Rupees by Us or in any other currency in accordance
with the applicable guidelines issued by the Reserve Bank of India from time to time.
11. ELECTRONIC TRANSACTIONS
You will comply with all the terms and conditions with respect to all transactions
effected by or through facilities for conducting remote transactions including
the internet, world wide web, electronic data interchange, call center, tele-service
operations or by other means of telecommunication established by Us or on Our
behalf, for and in respect of the Policy or services, which will constitute legally
binding and valid transactions when executed in adherence to and in compliance
with the terms and conditions for such facilities.
12. AMENDMENT
No amendments to the Policy will be effective, unless such amendments are
expressly approved in writing by Us and/or by the IRDAI wherever applicable.
13. REGULATORY AND JUDICIAL INTERVENTION
If any competent regulatory body or judicial body imposes any condition on the
Policy for any reason, We are bound to follow the same which may include
suspension of all benefits and obligations under the Policy.
14. COMMUNICATION AND NOTICES
14.1. All notices meant for Us should be in writing and delivered to Our address
as mentioned in Part G or such other address as We may notify from time to
time. You should mention the correct Policy number in all communications
including communications with respect to Premium remittances made by
You.
14.2. All notices meant for You will be in writing and will be sent by Us to Your
address as shown in the Schedule or as communicated by You and registered
with Us. We may send You notices by post, courier, hand delivery, fax or
e-mail/electronic mode or by any other means as determined by Us. If You
change Your address, or if the address of the nominee changes, You must
notify Us immediately. Failure in timely notification of change of address
could result in a delay in processing of benefits payable under the Policy.
14.3. For any updates, please visit Our website www.maxlifeinsurance.com.
17 of 33
15. GOVERNING LAW AND JURISDICTION ENDORSEMENT
The Policy will be governed by and enforced in accordance with the laws of India.
The competent courts in India will have exclusive jurisdiction in all matters and
causes arising out of the Policy.
16. ISSUANCE OF DUPLICATE POLICY STAMP DUTY AMOUNT : `2000
You may request for a duplicate copy of the Policy to Us along with relevant
documents. Additional charges, not exceeding Rs.250/- may be applicable for
issuance of the duplicate Policy.
Paid by e-Stamps Certificate no. 1054/Issue Date: 06-03-2024/Vide Treasury
PART G
GRIEVANCE REDRESSAL MECHANISM AND OMBUDSMAN DETAILS (E-CHALLAN) GRN NO.113600639 for Rs. 50000000
1. DISPUTE REDRESSAL PROCESS UNDER THE POLICY
1.1. All consumer grievances and/or queries may be first addressed to Your agent
or Our customer helpdesk as mentioned below:
a. Max Life Insurance Company Limited, Plot No. 90 C, Sector 18, Udyog
Vihar, Gurugram-122015, Haryana, India, Helpline No.- 1860 120 5577 or
(0124) 4219090, Email: service.helpdesk@maxlifeinsurance.com, Or
b. To any office of Max Life Insurance Company Limited.
1.2 . If Our response is not satisfactory or there is no response within 15 (Fifteen)
days: Krishnakumar Ramasubramanian
1.2.1. the complainant may file a written complaint with full details of the
complaint and the complainant's contact information to the following Authorized Signatory
official for resolution:
Grievance Redressal Officer,
Max Life Insurance Company Limited
Plot No. 90 C, Sector 18, Udyog Vihar,
Gurugram-122015, Haryana, India
Helpline No - 1860 120 5577 or (0124) 4219090
Email - manager.services@maxlifeinsurance.com
1.2.2. the complainant may approach the Grievance Cell of the IRDAI on the
following contact details:
IRDAI Grievance Call Centre (IGCC)
Toll Free No:155255 or 1800 4254 732
Email ID: complaints@irdai.gov.in
1.2.3. the complainant can also register Your complaint online at
http://www.igms.irdai.gov.in/
1.2.4. the complainant can also register Your complaint through fax/paper by
submitting Your complaint to:
Consumer Affairs Department
Insurance Regulatory and Development Authority of India
Sy No. 115/1, Financial District,
Nanakramguda,Gachibowli, Hyderabad - 500032
Ph: (040) 20204000
1.3. If the complainant are not satisfied with the redressal or there is no response
within a period of 1 (One) month or within 1 year after rejection of complaint
by Us, the complainant may approach Insurance Ombudsman at the address
mentioned in Annexure A, or on the IRDAI website www.irdai.gov.in or on
Council of Insurance Ombudsmen website at www.cioins.co.in, if the grievance
pertains to:
1.3.1 delay in settlement of a claim beyond the time specified in the
regulations, framed under the Insurance Regulatory and Development
Authority of India Act, 1999;
1.3.2. any partial or total repudiation of a claim by Us;
1.3.3. dispute over Premium paid or payable in terms of the Policy; or
1.3.4. misrepresentation of Policy terms and conditions at any time in the Policy
document or Policy contract;
1.3.5. legal construction of the Policy in so far as the dispute relates to claim;
1.3.6 Policy servicing by Us, our agents or intermediaries;
1.3.7. issuance of insurance Policy, which is not in conformity with the
proposal form submitted by You;
1.3.8. non issuance of any insurance document after receipt of the Premium.
1.3.9 Any other matter resulting from non-observance of or non-adherence
to the provisions of any regulations made by the IRDAI with regard to
protection of policyholders' interests or otherwise, or of any circulars,
guidelines or instructions issued by the IRDAI or of the terms and
conditions of the Policy contract, in so far as they relate to issues
mentioned in this para 1.3 above.
1.4. As per Rule 14 of the Insurance Ombudsman Rules, 2017, a complaint to the
Insurance Ombudsman can be made only within a period of 1 (One) year after
receipt of Our rejection of the representation or after receipt of Our decision
which is not to Your satisfaction or if We fail to furnish reply after expiry of
a period of one month from the date of receipt of the written representation of
the Complainant, provided the complaint is not on the same matter, for which
any proceedings before any court, or consumer forum or arbitrator is pending.

18 of 33

Annexure 1
Section 45 - Policy shall not be called in question on the ground of mis-statement
after three years
Provisions regarding policy not being called into question in terms of Section 45 of the
Insurance Act, 1938, as amended from time to time are as follows: 1.No Policy of Life
Insurance shall be called in question on any ground whatsoever after expiry of 3 yrs from
a. the date of issuance of policy or b. the date of commencement of risk or c.the date of
revival of policy or d. the date of rider to the policy, whichever is later. 2.On the ground of
fraud, a policy of Life Insurance may be called in question within 3 years from a.the date
of issuance of policy or b.the date of commencement of risk or c.the date of revival of
policy or d. the date of rider to the policy, whichever is later. For this, the insurer should
communicate in writing to the insured or legal representative or nominee or assignees of
insured, as applicable, mentioning the ground and materials on which such decision is
based. 3. Fraud means any of the following acts committed by insured or by his agent,
with the intent to deceive the insurer or to induce the insurer to issue a life insurance
policy: a.The suggestion, as a fact of that which is not true and which the insured does not
believe to be true;b. The active concealment of a fact by the insured having knowledge or
belief of the fact; c.Any other act fitted to deceive; and d.Any such act or omission as the
law specifically declares to be fraudulent. 4.Mere silence is not fraud unless, depending
on circumstances of the case, it is the duty of the insured or his agent keeping silence
to speak or silence is in itself equivalent to speak. 5. No Insurer shall repudiate a life
insurance policy on the ground of fraud, if the insured / beneficiary can prove that the
misstatement was true to the best of his knowledge and there was no deliberate intention
to suppress the fact or that such mis-statement of or suppression of material fact are within
the knowledge of the insurer. Onus of disproving is upon the policyholder, if alive, or
beneficiaries. 6. Life insurance Policy can be called in question within 3 years on the
ground that any statement of or suppression of a fact material to expectancy of life of
the insured was incorrectly made in the proposal or other document basis which policy
was issued or revived or rider issued. For this, the insurer should communicate in writing
to the insured or legal representative or nominee or assignees of insured, as applicable,
mentioning the ground and materials on which decision to repudiate the policy of life
insurance is based.7.In case repudiation is on ground of mis-statement and not on fraud,
the premium collected on policy till the date of repudiation shall be paid to the insured or
legal representative or nominee or assignees of insured, within a period of 90 days from
the date of repudiation.8.Fact shall not be considered material unless it has a direct bearing
on the risk undertaken by the insurer. The onus is on insurer to show that if the insurer
had been aware of the said fact, no life insurance policy would have been issued to the
insured.9.The insurer can call for proof of age at any time if he is entitled to do so and no
policy shall be deemed to be called in question merely because the terms of the policy are
adjusted on subsequent proof of age of life insured. So, this Section will not be applicable
for questioning age or adjustment based on proof of age submitted subsequently.
[Disclaimer: This is only a simplified version prepared for general information. You are
advised to refer to the Insurance Act 1938 as amended from time to time for complete
and accurate details.]
Annexure 2
Section 39 - Nomination by Policyholder
Nomination of a life insurance policy is as below in accordance with Section 39 of the
Insurance Act, 1938 as amended from time to time. The extant provisions in this regard
are as follows:1.The policyholder of a life insurance policy on his own life may nominate
a person or persons to whom money secured by the policy shall be paid in the event of
his death.2.Where the nominee is a minor, the policyholder may appoint any person to
receive the money secured by the policy in the event of policyholder's death during the
minority of the nominee. The manner of appointment is to be laid down by the insurer.
3.Nomination can be made at any time before the maturity of the policy. 4.Nomination
may be incorporated in the text of the policy itself or may be endorsed on the policy
communicated to the insurer and can be registered by the insurer in the records relating to
the policy.5.Nomination can be cancelled or changed at any time before policy matures,
by an endorsement or a further endorsement or a will as the case may be. 6.A notice in
writing of change or cancellation of nomination must be delivered to the insurer for the
insurer to be liable to such nominee. Otherwise, insurer will not be liable if a bonafide
payment is made to the person named in the text of the policy or in the registered records
of the insurer.7.Fee to be paid to the insurer for registering change or cancellation of a
nomination can be specified by the Authority through Regulations.8.On receipt of notice
with fee, the insurer should grant a written acknowledgement to the policyholder of having
registered a nomination or cancellation or change thereof. 9.A transfer or assignment
made in accordance with Section 38 shall automatically cancel the nomination except in
case of assignment to the insurer or other transferee or assignee for purpose of loan or
against security or its reassignment after repayment. In such case, the nomination will
get affected to the extent of insurer's or transferee's or assignee's interest in the policy.
The nomination will get revived on repayment of the loan.10.The right of any creditor
to be paid out of the proceeds of any policy of life insurance shall not be affected by
the nomination.11.In case of nomination by policyholder whose life is insured, if the
nominees die before the policyholder, the proceeds are payable to policyholder or his
heirs or legal representatives or holder of succession certificate.12.In case nominee(s)
survive the person whose life is insured, the amount secured by the policy shall be paid to
such survivor(s). 13.Where the policyholder whose life is insured nominates hia.parents
or b.spouse or c.children ord.spouse and childrene.or any of them, the nominees are
beneficially entitled to the amount payable by the insurer to the policyholder unless it is
proved that policyholder could not have conferred such beneficial title on the nominee
having regard to the nature of his title.14. If nominee(s) die after the policyholder but
before his share of the amount secured under the policy is paid, the share of the expired
nominee(s) shall be payable to the heirs or legal representative of the nominee or holder
of succession certificate of such nominee(s). 15.The provisions of sub-section 7 and 8
(13 and 14 above) shall apply to all life insurance policies maturing for payment after the
commencement of Insurance Laws (Amendment) Act 2015.16.If policyholder dies after
maturity but the proceeds and benefit of the policy has not been paid to him because of
his death, his nominee(s) shall be entitled to the proceeds and benefit of the policy.17.The
provisions of Section 39 are not applicable to any life insurance policy to which Section 6
of Married Women's Property Act, 1874 applies or has at any time applied except where
before or after Insurance Act, 1938 as amended from time to time, a nomination is made
in favour of spouse or children or spouse and children whether or not on the face of the
policy it is mentioned that it is made under Section 39. Where nomination is intended
to be made to spouse or children or spouse and children under Section 6 of MWP Act,
it should be specifically mentioned on the policy. In such a case only, the provisions of
Section 39 will not apply.
[Disclaimer: This is only a simplified version prepared for general information. You are
advised to refer to the Insurance Act 1938 as amended from time to time for complete
and accurate details.]
Annexure 3
Section 38 - Assignment and Transfer of Insurance Policies
Assignment or transfer of a policy should be in accordance with Section 38 of the
Insurance Act, 1938 as amended from time to time. The extant provisions in this regard are
as follows:1.This policy may be transferred/assigned, wholly or in part, with or without
consideration.2.An Assignment may be effected in a policy by an endorsement upon the
policy itself or by a separate instrument under notice to the Insurer.3. The instrument
of assignment should indicate the fact of transfer or assignment and the reasons for the
assignment or transfer, antecedents of the assignee and terms on which assignment is
made.4.The assignment must be signed by the transferor or assignor or duly authorized
agent and attested by at least one witness.5.The transfer or assignment shall not be
operative as against an insurer until a notice in writing of the transfer or assignment and
either the said endorsement or instrument itself or copy there of certified to be correct
by both transferor and transferee or their duly authorised agents have been delivered to
the insurer.6.Fee to be paid for assignment or transfer can be specified by the Authority
through Regulations.7.On receipt of notice with fee, the insurer should Grant a written
acknowledgement of receipt of notice. Such notice shall be conclusive evidence against
the insurer of duly receiving the notice.8.If the insurer maintains one or more places
of business, such notices shall be delivered only at the place where the policy is being
serviced.9.The insurer may accept or decline to act upon any transfer or assignment or
endorsement, if it has sufficient reasons to believe that it is a.not bonafide;b.not in the
interest of the policyholder;c.not in public interest; or d.is for the purpose of trading of the
insurance policy.10.Before refusing to act upon endorsement, the insurer should record
the reasons in writing and communicate the same in writing to policyholder within 30 days
from the date of policyholder giving a notice of transfer or assignment.11.In case of refusal
to act upon the endorsement by the insurer, any person aggrieved by the refusal may prefer
a claim to IRDAI within 30 days of receipt of the refusal letter from the insurer.12.The
priority of claims of persons interested in an insurance policy would depend on the date
on which the notices of assignment or transfer is delivered to the insurer; where there are
more than one instruments of transfer or assignment, the priority will depend on dates of
delivery of such notices. Any dispute in this regard as to priority should be referred to
the Authority.13.Every assignment or transfer shall be deemed to be absolute assignment
or transfer and the assignee or transferee shall be deemed to be absolute assignee or
transferee, except a.where assignment or transfer is subject to terms and conditions of
transfer or assignment OR b.where the transfer or assignment is made upon condition
that i.the proceeds under the policy shall become payable to policyholder or nominee(s)
in the event of assignee or transferee dying before the insured; orii.the insured surviving
the term of the policy.Such conditional assignee will not be entitled to obtain a loan on
policy or surrender the policy. This provision will prevail notwithstanding any law or
custom having force of law which is contrary to the above position.14In other cases, the
insurer shall, subject to terms and conditions of assignment, recognize the transferee or
assignee named in the notice as the absolute transferee or assignee and such persona shall
be subject to all liabilities and equities to which the transferor or assignor was subject to at
the date of transfer or assignment;b.may institute any proceedings in relation to the policy;
andc.obtain loan under the policy or surrender the policy without obtaining the consent
of the transferor or assignor or making him a party to the proceedings15.Any rights and
remedies of an assignee or transferee of a life insurance policy under an assignment or
transfer effected before commencement of the Insurance Laws (Amendment) Act, 2015
shall not be affected by this section.
[Disclaimer: This is only a simplified version prepared for general information. You are
advised to refer to the Insurance Act, 1938 as amended from time to time for complete
and accurate details.
19 of 33
Annexure A: List of Insurance Ombudsman

AHMEDABAD - Office of the Insurance Ombudsman, 6th Floor, Jeevan Prakash Bldg, Tilak Marg, Relief Road, Ahmedabad-380
001. Tel.:- 079-25501201/02/05/06 Email: bimalokpal.ahmedabad@cioins.co.in. (State of Gujarat and Union Territories of Dadra & Nagar Haveli and Daman
and Diu.)
BENGALURU - Office of the Insurance Ombudsman, Jeevan Soudha Bldg., PID No. 57-27-N-19, Ground Floor, 19/19, 24th Main Road, JP Nagar, 1st Phase,
Bengaluru - 560 078. Tel.: 080-26652049/26652048 Email: bimalokpal.bengaluru@cioins.co.in. (State of Karnataka)
BHOPAL - Office of the Insurance Ombudsman, 1st Floor, Jeevan Shikha, 60-B,Hoshangabad Road, Opp. Gayatri Mandir, Bhopal-462
011. Tel.:- 0755-2769201/2769202 Email: bimalokpal.bhopal@cioins.co.in (States of Madhya Pradesh and Chhattisgarh.)
BHUBANESHWAR - Office of the Insurance Ombudsman, 62, Forest Park, Bhubaneswar - 751 009. Tel.:- 0674-2596461/2596455 Email:
bimalokpal.bhubaneswar@cioins.co.in (State of Odisha.)
CHANDIGARH - Office of the Insurance Ombudsman, S.C.O. No. 101, 102 & 103, 2nd Floor, Batra Building, Sector 17-D, Chandigarh-160017. Tel.:- 0172
- 4646394/2706468 Email: bimalokpal.chandigarh@cioins.co.in [States of Punjab, Haryana (excluding 4 districts viz, Gurugram, Faridabad, Sonepat and
Bahadurgarh) Himachal Pradesh, Union Territories of Jammu & Kashmir, Ladakh and Chandigarh]
CHENNAI - Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, Chennai-600 018. Tel.:- 044-24333668
/ 24333678 Email: bimalokpal.chennai@cioins.co.in [State of Tamil Nadu and Union Territories - Puducherry Town and Karaikal (which are part of Union
Territory of Puducherry).]
DELHI - Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi-110 002. Tel.:- 011 - 23237539 Email:
bimalokpal.delhi@cioins.co.in (State of Delhi, 4 districts of Haryana viz, Gurugram, Faridabad, Sonepat and Bahadurgarh)
ERNAKULAM - Office of the Insurance Ombudsman, 2nd Floor, Pulinat Bldg., Opp. Cochin Shipyard, M.G. Road, Ernakulam-682 011. Tel :
0484-2358759/2359338 Email: bimalokpal.ernakulam@cioins.co.in (State of Kerala and Union Territory of (a) Lakshadweep (b) Mahe-a part of Union Territory
of Puducherry.)
GUWAHATI - Office of the Insurance Ombudsman, "Jeevan Nivesh", 5th Floor, Nr. Panbazar over bridge, S.S. Road, Guwahati-781
001(ASSAM) Tel.:- 0361-2632204/2602205 Email: bimalokpal.guwahati@cioins.co.in (States of Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh,
Nagaland and Tripura.)
HYDERABAD - Office of the Insurance Ombudsman, 6-2-46, 1st Floor, Moin Court, Lane Opp. Saleem Function Palace, A.C. Guards, Lakdi-Ka-Pool,
Hyderabad-500 004. Tel : 040-23312122 Email: bimalokpal.hyderabad@cioins.co.in (State of Andhra Pradesh, Telangana and Yanam and part of the Union
Territory of Puducherry.)
JAIPUR - Office of the Insurance Ombudsman, Ground Floor, Jeevan Nidhi II Bldg, Bhawani Singh Marg, Jaipur - 302005 Tel : 0141-2740363/ 2740798 Email:
bimalokpal.jaipur@cioins.co.in (State of Rajasthan)
KOLKATA - Office of the Insurance Ombudsman, Hindustan Building. Annexe, 7th Floor, 4, C.R. Avenue, Kolkata-700 072. Tel :
033-22124339/22124341 Email: bimalokpal.kolkata@cioins.co.in (States of West Bengal, Sikkim, and Union Territories of Andaman and Nicobar Islands.)
LUCKNOW - Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-2, Nawal Kishore Road, Hazratganj, Lucknow-226 001. Tel.:
0522 - 4002082 / 3500613 Email: bimalokpal.lucknow@cioins.co.in (Following Districts of Uttar Pradesh: Lalitpur, Jhansi, Mahoba, Hamirpur, Banda,
Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur,
Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar,
Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharathnagar.)
MUMBAI - Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S.V. Road, Santacruz(W), Mumbai 400054. Tel :
022- 69038821/23/24/25/26/27/28/29/30/31 Email: bimalokpal.mumbai@cioins.co.in (State of Goa and Mumbai Metreturn of premiumolitan Region excluding
areas of Navi Mumbai and Thane)
NOIDA - Office of the Insurance Ombudsman, 4th Floor, Bhagwan Sahai Palace, Main Road, Naya Bans, Sector-15, Distt: Gautam Buddh Nagar,
U.P. - 201301. Tel: 0120-2514252/2514253 Email: bimalokpal.noida@cioins.co.in (State of Uttarakhand and the following Districts of Uttar Pradesh:
Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj, Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit,
Etawah, Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras,
Kanshiramnagar, Saharanpur.)
PATNA - Office of the Insurance Ombudsman, 2nd floor, Lalit Bhawan, Bailey Road, Patna - 800001 Tel No: 0612-2547068, Email id :
bimalokpal.patna@cioins.co.in (State of Bihar, Jharkhand.)
PUNE - Office of the Insurance Ombudsman, 3rd Floor, Jeevan Darshan Bldg, C.T.S. Nos. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune - 411030. Tel.:
020-24471175 Email: bimalokpal.pune@cioins.co.in (State of Maharashtra including Navi Mumbai and Thane and excluding Mumbai Metreturn of
premiumolitan Region.)

20 of 33
 MAX LIFE INSURANCE COMPANY LIMITED
Regd. Office : 419, Bhai Mohan Singh Nagar, Railmajra, Tehsil Balachaur, District Nawanshahr, Punjab-
144533
Head Office: 11th & 12th Floor, DLF Square, Jacaranda Marg, DLF City Phase-II, Gurugram - Haryana,
122002.

NON LINKED PROPOSAL FORM PROPOSAL NUMBER: 158948752

GO/CA/Broker Code: EBRL1

Do you have Max Life Insurance Policy or have currently applied for simultaneous policies? If yes give Policy/Proposal number NO

Purpose of Insurance PROTECTION

Objective of Insurance INDIVIDUAL POLICY

Product Solution N/A Affinity Customer: N/A Existing Customer: NO

A. PERSONAL DETAILS
PROPOSER/JOINT LIFE LIFE TO BE INSURED(if other than proposer)
1. Title MR

First AWANISH

2. Name Middle KUMAR

Last MANDAL

First YOGENDRA
3. Father's / Husband
Name
Last NATH MANDAL

4. Date of Birth 01-12-1990

5. Gender MALE
6. Nationality INDIAN
7. Marital Status SINGLE
8. Education GRADUATE
9. Relationship with Proposer/ Joint Life SELF

10. Industry Type OTHERS

11. Organisation Type GOVT

12. Occupation/Job Title SALARIED
13. Name of entity / employer UNION BANK OF INDIA
13a. Nature of Duties OFFICE WORK
14. Annual Income (Rs) 1200000

15. Is the Life to be Insured / Proposer / Joint Life / Nominee / Payor a Politically Exposed Person ? NO

16. NOMINEE DETAILS Nominee 1 (Mandatory) Nominee 2 (Optional) Nominee 3 (Optional)

a. Title MS NA NA

b. Name First Lalit NA NA

Middle NA NA

Last Devi NA NA

c. Date of Birth 01-01-1954 NA NA

d. Gender FEMALE NA NA
e. Percentage of Share 100 NA NA
f. Relationship with Proposer/ Joint
MOTHER NA NA
Life
g. Appointee Full Name (If nominee is
NA NA NA
under age 18)

h. Appointee relationship to
NA NA NA
Nominee

Page 1 of 5 21 of 33
 i. Appointee Gender NA NA NA
j. Appointee Date of Birth NA NA NA

17. CURRENT RESIDENTIAL ADDRESS

House No./Apt. Name S/O YOGENDRA NATH MANDAL

Society Road/Area/Sector KARSI

Landmark NAWANAGAR, BALLIA

Village/Town NAWA NAGAR City/District BALLIA
Pin Code 221717 State/UT UTTAR PRADESH Country INDIA
Mobile Std
Mobile No. 1 7307571031 9112169486 Telephone#
No. 2 Code
E-mail ID awanishpassion32@gmail.com

18. PERMANENT RESIDENTIAL ADDRESS (optional)

House No./Apt. Name S/O YOGENDRA NATH MANDAL

Society Road/Area/Sector KARSI
Landmark NAWANAGAR, BALLIA
Village/Town NAWA NAGAR City/District BALLIA
Pin Code 221717 State/UT UTTAR PRADESH Country INDIA

19. Preferred Mailing Address Current Residential

20. Do you wish to hold for this policy electronically under e-Insurance ? NO

B. COVERAGE INFORMATION -Type of Coverage

Sum Premium
Premium Income Payout Coverage Modal
a. Base Plan Variant Assured/Income Payment GST
Back Option Frequency Term Premium
Payout Term
MAX LIFE SMART SECURE
NA NO 5000000 NA 42 27 13521 2433.69
PLUS PLAN
Income
Income
Deferment Income Start Year
Period
Period

NA NA NA

Premium Back Sum Coverage Premium Payment Modal

b. Riders/Optional Benefits GST
Option Assured Term Term Premium
MAX LIFE ACCIDENTAL COVER RIDER NA 5000000 42 27 3550 639.00

Modal Premium without GST* and Cess 17070.5 GST* and Applicable Cess 3073 Total Premium Paid 20143

*GST shall comprise of CGST, SGST/UTGST or IGST (whichever is applicable) including cesses and levies, if any. All applicable taxes, cesses and levies, as per
prevailing laws, shall be borne by you.
c. Death Benefit Option Life Cover d. Life Stage Benefit NA
e. Policy Continuance Benefit (PCB) NA f. Avail Income on a Special Date No
Bonus Option NA
(Not Applicable for plans that offer reversionary Bonus)

2. NEFT BANK A/C DETAILS OF All Payouts will be credited to this account through Electronic mode of payment. (This will be applicable at select
PROPOSER/ JOINT LIFE cities as per facilities/arrangements of Max Life Insurance).

MICR Code: 276240002 Bank Account Number: 50100543023326

IFSC Code: HDFC0001884 Account Holder's Name: AWANISH KUMAR MANDAL

Type of Bank Account: SAVINGS

Bank Name & Branch: HDFC BANK LTD AZAMGARH
ACCOUNT

Banking Since: 11-04-2011

3. Permanent Account Number (PAN): BIXPM9361E Form 60 NO (for proposer/jointlife) Form 60 NA (for Insured)
TDS may be applicable, in accordance with Income Tax Act 1961, as amended from time to time.

4. Mode of Payment: ANNUAL 5. Renewal premium by: ECS 6. Source of Funds SALARY

7. IS PAYOR DIFFERENT FROM THE PROPOSER ? NO

8. Are you a Max Life Agent or an employee of a Max group company/ Corporate Agents? NO
9. Effective Date of Coverage: 18-03-2024

Page 2 of 5 22 of 33
 10. Premium Payment Details
Amount in Words: TWENTY THOUSAND ONE HUNDRED FORTY THREE
Paid Rs: 20143.19 Payment by ONLINE
Cheque / Draft No. / Instrument no YAX62275132374 Date: 19-03-2024
Bank Name & Branch: NA

C. INFORMATION OF LIFE TO BE INSURED

Proposer/Joint Life to be
Life Insured

1. Do you have any life or Critical Illness insurance policy issued, pending approval from any other insurance companies or has
your application for Life/Health/Critical illness insurance or its reinstatement ever been offered at modified terms,rejected or NO NA
postponed ?

2. Active Life Insurance Policy SA across all Insurance companies for Spouse and Children (in Crs.) NA NA

3. In the next 12 months do you intend to travel or reside abroad other than on holiday of more than 4 weeks? NO NA

4. Do you participate or do you intend to participate in any hazardous activities as part of your Occupation/ Sports/ Hobby? NO NA

5. Have you ever been convicted or are you under investigation for any criminal charges ? NO NA

6. FOR FEMALE LIFE TO BE INSURED NO

7. FOR MINOR LIFE TO BE INSURED (AGE < 18 YRS.) NO

D. MEDICAL INFORMATION

1. FAMILY HISTORY

Has any two (2) or more of your family members (parents & Siblings) ever been diagnosed with diabetes or
NO NA
hypertension or kidney failure or cancer or heart Attack or any Hereditary Disorder before the age of 60 ?

2. Proposer/Joint Life Life To Be Insured

Height 175 cm NA
Weight 78 kg NA

3. Has your weight changed more than 5 Kgs in past 1 year? NO NA

Please Provide Details

4. Have you ever been investigated, treated or diagnosed with any of the following conditions. Proposer/Joint Life to be
If yes, please provide details Life Insured

i) Diabetes /High blood sugar levels NO NA

ii) Hypertension/ High Blood Pressure, High Cholesterol or Thyroid disorder NO NA

iii) Heart or vascular disorder including chest pain, stroke, heart attack or Angioplasty, CABG or any other heart
NO NA
surgery.

iv) Breathing or lung disorders including asthma, emphysema, tuberculosis. NO NA

v) Liver or digestive system related disorder including jaundice ,gall bladder, pancreas or Hepatitis B/C. NO NA

vi) Any abnormal growth like tumour,lump,cancer or blood disorder, including anemia or thalassaemia or Sexually
NO NA
transmitted disease ( STD ) including HIV or AIDS.

vii) Any kind of Kidney or bladder disorder, including kidney failure, renal stone, nephritis or prostrate disorder. NO NA

viii) Any neurological or mental health problem like paralysis, multiple sclerosis, Parkinson's, epilepsy, depression or
NO NA
anxiety.

ix) Muscular-skeletal or joint disorders, including any kind of arthritis, gout, osteoporosis. NO NA

x) Are you having history of any hospitalization, treatment or investigation? NO NA

xi) Have you advised now or in last 5 yrs tests like X-Ray/CT scan/MRI/ Ultrasonography/ ECG/Blood test or any other
NO NA
investigatory or diagnostic tests, or any type of surgery.

Xii) Have you ever been diagnosed with any form of internal or external congenital anomaly or defect i.e. any
NA NA
condition(s) which is present since birth, and which is abnormal with reference to form, structure or position?

Xiii) Have you had any genetic testing before? NA NA

5. TOBACCO / ALCOHOL/ DRUGS CONSUMPTION: Do you consume any of the following ? NO NA

i) Tobacco ( Smoking /Chewing) currently or even occasionally in last 2 year ?

NO NA
If Yes, Please specify alcohol quantity (daily/Monthly/Occasionally)

Page 3 of 5 23 of 33
 QT. NA FR. QT. NA FR.
Smoking: Please specify the number of cigarette NA NA
QT. NA FR. QT. NA FR.
Tobacco Sachet/Gutka/Flavoured Pan Masala etc.: Please specify the number of pouches you chew NA NA

ii) Do you consume Alcohol? If yes, Please specify alcohol quantity (ml/ (daily/Monthly/Occasionally)) NO NA

QT. NA FR. QT. NA FR.

Wine NA NA
QT. NA FR. QT. NA FR.
Beer NA NA
QT. NA FR. QT. NA FR.
Hard Liquor NA NA

iii) Are you taking drugs like Cannabis/Marijuana/Ecstacy/Heroin/LSD/Amphetamines or any other illegal drugs? NO NA

E. DECLARATION AND AUTHORISATION

1. DECLARATION BY PROPOSER/ JOINT LIFE

I/We hereby declare that I/We fully understand the meaning and scope of the Proposal form and the questions contained above and I am submitting the completed
proposal form of my/our own volition, and confirm that I/We have not been induced by anyone to make the Proposal. I/We have been explained the nature of
questions and the importance of disclosing all material information.

I/We further declare that all the statements and declarations herein shall be the basis of a contract between me/us and the Company and that I/We have made
complete, true and accurate disclosure of all the facts and circumstances and have not withheld any information that may be relevant to enable the Company to make
an informed decision about the acceptability of the Proposal. I agree that in case of any fraud or misstatement, provisions of Section 45 of Insurance Act, 1938, as
amended from time to time will apply. I/We undertake to notify the Company, forthwith in writing, of any change in any of the statements made in the Proposal
subsequent to the signing of this proposal and before acceptance of risk and issuance of the Policy by the Company. The first and subsequent year premium will be
paid out of legally acquired source of income. I will provide information as and when required by the Company, acting on its own or under any order or instruction
received from Statutory Authorities, as regards to the sources of funds or utilizations or withdrawals. I agree that the Company may provide any information related to
me in respect of this proposal; as available to the Company at any time, to any Statutory Authority in relation to the any laws including the laws governing prevention
of money laundering, applicable in the country. To enable the Company to assess the risk under my/our proposal or for any other purpose in relation to the policy,
l/we, my/our heirs, administrators or executors or assignees hereby authorize my past or present employer(s)/business association/medical practitioners /other
agencies or governmental and/or any regulatory bodies, insurance repositories, CERSAI/ UIDAI, reinsurers / hospitals or diagnostic centres/ other insurance
companies/ service providers to disclose and make available to the Company such details/records, as may be requested by the Company. I understand that I have
disclosed my personal information with Max life and I hereby provide consent to Max Life to share, store my information with its authorized service providers for
servicing this policy/proposal such as issuance, underwriting renewal and claims process with respect to this policy as per the regulation applicable from time to time.
I/We submit the mandate to credit My / Our account towards all payments against the above policy and agree and understand that payouts would be processed
through electronic mode of payment and will be affected at select cities as per facilities/ arrangements of Max Life Insurance. I/We authorize Max Life to send all
communications by E-mail, SMS or any other communication mode. I/We agree to receive regular reminders, updates / alerts from Max life from time to time.

I do hereby certify that above stated information regarding the nationality and tax residential status is correct in all respects and may be used for all purposes,
including reporting to statutory authorities & compliances, and understand that it is my responsibility to report the changes, if any, to Max Life within 2 weeks of
occurrence of such change

Signature / Thumb Impression / Electronic

Signature of Proposer/ Joint Life

Place: BALLIA Date: 19-03-2024

VERNACULAR /ILLITERATE DECLARATION

(Declaration to be made by a person unconnected with Max life Insurance Company Limited but whose identify can be easily
established.) I hereby declare that I have fully explained the contents of this proposal to the proposer/Life to be Insured in
language, as understood by him/her and that the left thumb impression/signature of the
proposer/Life to be Insured has been appended/affixed after fully understanding the contents thereof. I have truthfully recorded the
answers given by the Proposer/Life to be Insured.I have understood the content of the proposal form as explained to me in
language by the declarant, Mr./Ms. ,filling in the
proposal form and after the same, I am affixing my signature/thumb-impression.

Name of the Declarant: Address of the Declarant:

I hereby certify that I have understood the content of the proposal

form as explained to me in
language by the
declarant, Mr./Ms. , filling
in the proposal form and after the same, I am affixing my
signature/thumb-impression.

Signature / Thumb Impression / Electronic Signature of Signature / Thumb Impression / Electronic Signature of
Declarant Proposer / Joint Life

2. DECLARATION BY PRINCIPAL OFFICER/AGENT ADVISOR/SPECIFIED PERSON

Page 4 of 5 24 of 33
I MR. RISHABH SARIN do declare and confirm that I have met and explained the Product features, benefits, premium paying
term, nature of the questions contained in this Proposal form and other relevant terms and conditions to the Proposer and the Life Insured. I have also explained that
the answers to the questions forms the basis of the contract of the Insurance between the Company and the Proposer / Life Insured, and if any untrue statement is
contained therein and / or any information that may be relevant to enable the Company make an informed decision, the Company shall have the right to vary the
benefits which may be payable and / or treat the policy voidable at the option of the Company subject to section 45 of the Insurance Act, 1938 as amended from time
to time. I confirm that to the best of my knowledge the Life Insured does not suffer from any physical or mental abnormality or handicap or has / had been
hospitalised, undergone any surgery or treatment, or he /she is involved in activities including any hazardous avocation or occupation or any other information
material for underwriting this proposal form, unless expressly stated in this Proposal. I also declare and represent to the Company that I am in full compliance with the
regulatory requirements applicable to agent / corporate agent / specified person / broker prescribed by the Insurance Act 1938, as amended from time to time and
any other regulation, circular, instruction issued by IRDAI from time to time. I confirm that I have verified the identity, current / permanent residential address of the
Proposer/Life Insured, the nature of his/her business and his / her financial status basis the Max Life AML moral hazard checklist.

Is this a Replacement Sale? If yes, I have adequately explained the consequences of replacement sale to the customer. NO

Relationship of Principal Officer/Agent Advisor/Specified Person with the Proposer/ Joint Life/ Life
Customer
Insured
Name of Principal Officer/Agent Advisor/Specified Person Mr. Rishabh Sarin
Principal Officer/Agent Advisor/Specified Person Code 909174
Phone No. with STD Code:-8077624761
Date:- 19-03-2024 Place:- BALLIA

Signature / Thumb Impression / Electronic Signature of Principal

Officer/Agent Advisor/Specified Person :- 18-03-2024 15:22:56
Signature / Thumb Impression / Electronic Signature of Sales Manager 18-
03-2024 15:22:56
This system generated benefit Proposal form shall be treated as signed by
me.

Phone No. with STD Code:-8077624761

Date:- 19-03-2024 Place:- BALLIA

We confirm that we have made joint efforts in soliciting the prospect and will be jointly responsible for performing the service related to the policy. We further confirm
that the objective of sharing the commission is not for qualifying for any contest and/or reward & recognition programs of the company.

(Applicable only if more than one Agent Advisors share the commission)

Name(s) of Principal Officer/AA/Spec Person Principal Officer/AA/Spec Person Code Principal Officer/AA/Spec Person's Signature % Share

Mr. Rishabh Sarin 909174 18-03-2024 15:22:56 100

Important Notes: (1) Any payment/s including initial payment accompanying this proposal, cash or by bearer instrument must be made at any of the Company's
General Office only. (2) Crossed cheque or bank drafts must be made in favour of MAX LIFE INSURANCE COMPANY LIMITED ACCOUNT (Proposal No. as
above) maybe handed over to the Agent Advisor. (3} Receipt of the Completed Proposal and initial payment does not create any obligations upon the Company to
underwrite the risk. The Company shall not be liable until it has underwritten the risk and issued the Policy. If the Policy is sent by post it shall be deemed to have
been delivered to and received by you in the ordinary course within 3 (three) days of posting. We draw your attention to Section - 39, Section - 45 and Section - 41
of the Insurance Act 1938 which reads as follows-

Section 39: In case nomination facility is availed, section 39 of the Insurance Act, 1938 as amended from time to time shall apply.

Section 45: No policy of life insurance shall be called in question on any ground whatsoever after the expiry of three years from the date of issuance of policy, from
the date of the Commencement of Risk or Revival of the policy or the date of the rider to the policy, whichever is later. However, Insurer may question the Policy at
any time within three years from the date of issuance of policy, from the date of Commencement of Risk or Revival of the policy or the date of the rider to the policy,
whichever is later, on the ground of fraud, in which case insurer shall inform Proposer/Life to be Insured/legal representatives in writing specifying the grounds and
materials on which such decision is based. For other details please refer to Section 45 of the Insurance Act, 1938 as amended from time to time.

Section 41: (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.

TERM_STD_1123_1.0

Page 5 of 5 25 of 33
Date : 19-Mar-2024

Reference Number: 4005607864

Dear awanish Kumar Mandal ,

Greetings from Max Life Insurance! Thank you for choosing us as your life insurance partner. We are committed to financially

protect you and your loved ones, because for them

You have completed the mandatory pre-issuance verification for your Max Life policy 158948752 with the following details:

S. No. Pre Issuance Verification Questions Your Responses

1 I have agreed to pay Annual premium of 20143* for _______. 27

*Note: This value is for Renewal Premium. Initial premium may vary due to Discount/GST.

Please refer Benefit Illustration.

2 Life Cover(Death Benefit) Yes

5000000

3 Annual Premium Yes

20143

*Note:This value is for Renewal Premium. Initial premium may vary due to Discount/GST.

Please refer Benefit Illustration

4 Policy maturity Yes

42yrs (Till 2066)

I am aware that suitability information has been collected from me and in person recommendation on purchase of life

insurance product has been made only basis such information and if product selected by me that differs from such

Our virtual assistant WhatsApp Login to manage your policy Write to us at

Chat with MILI on our website Send ‘Hi’ to +91 74283 96005 maxlifeinsurance.com/customer-service maxlifeinsurance.com/contact-us

Call us at 18601205577

Important: Do Not believe in calls, SMS, E-mail offering discounts. for NEFT Payments, please transfer only to HSBC Bank A/C No. 1165 158948752 IFS

Code: HSBC0110002. Max Life does not collect Premium in any other account.

Max Life Insurance Co. Ltd.: Plot No. 90C, Sector 18, Udyog Vihar, Gurugram (Haryana) - 122 015

Regd. Office: 419, Bhai Mohan Singh Nagar, Railmajra, Tehsil Balachaur, District Nawanshahr, Punjab - 144 533.

Fax:0124-4159397, CIN:U74899PB2000PLC045626 | Customer Helpline Number: 1860 120 5577

IRDAT Registration No. 104

BEWARE OF SPURIOUS / FRAUD PHONE CALLS!

IRDAI is not involved in activities like selling insurance policies. announcing bonus or investment of premiums Public receiving such phone calls are requested to lodge a police complaint

26 of 33
recommendation is on the basis of my personal choice. (If ULIP product) I have gone through the risk profiler and understood

the risks associated with investments in the above funds. Basis my financial goals and needs, I have made a conscious

decision to allocate premium as given information. I hereby agree, declare and confirm that I have read and understood the

benefit illustration, key feature document (if applicable as per regulation) and the proposal form sent on my registered

mobile number and email. I have filled up the verification, health & habit questions and agree for it to be part of the proposal

form. I hereby confirm that all the content / information therein is true and correct to the best of my knowledge and belief.

We value your association with us and assure you the best of our service always.

Regards,

Max Life Insurance Co. Ltd.

Please note:

- This letter does not confirm issuance of the insurance policy. Issuance of Policy is subject to realization of premium

and completion of underwriting requirements.

- Please ensure that all the information provided by you including the medical facts are accurate as per Pre Issuance

Verification Process completed by you. If in-case of non-disclosure or misrepresentation, company has the right to

reject the policy.

- Once the Policy is issued, you have a free-look period of 15 days from receipt of the insurance policy to review its terms

and conditions.

This is an electronically generated document

Our virtual assistant WhatsApp Login to manage your policy Write to us at

Chat with MILI on our website Send ‘Hi’ to +91 74283 96005 maxlifeinsurance.com/customer-service maxlifeinsurance.com/contact-us

Call us at 18601205577

Important: Do Not believe in calls, SMS, E-mail offering discounts. for NEFT Payments, please transfer only to HSBC Bank A/C No. 1165 158948752 IFS

Code: HSBC0110002. Max Life does not collect Premium in any other account.

Max Life Insurance Co. Ltd.: Plot No. 90C, Sector 18, Udyog Vihar, Gurugram (Haryana) - 122 015

Regd. Office: 419, Bhai Mohan Singh Nagar, Railmajra, Tehsil Balachaur, District Nawanshahr, Punjab - 144 533.

Fax:0124-4159397, CIN:U74899PB2000PLC045626 | Customer Helpline Number: 1860 120 5577

IRDAT Registration No. 104

BEWARE OF SPURIOUS / FRAUD PHONE CALLS!

IRDAI is not involved in activities like selling insurance policies. announcing bonus or investment of premiums Public receiving such phone calls are requested to lodge a police complaint

27 of 33
 BENEFIT ILLUSTRATION
[Date and Time of Illustration – 18 March 2024, 02:57 PM]

Name of the Prospect/Policyholder: Mr. Awanish Kumar Mandal Proposal No: 158948752
Age & Gender: 33 Years, Male Name of the Product: Max Life Smart Secure Plus Plan
Name of the Primary Life Assured: Mr. Awanish Kumar Mandal Tag Line: A Non-Linked Non-Participating Individual Pure Risk Premium Life Insurance Plan
Age & Gender: 33 Years, Male Unique Identification No: 104N118V07
Risk Class: Non Smoker GST Rate (Base Policy, First Year): 18.00%
Name of the Secondary Life Assured, if applicable: NA GST Rate (Base Policy, Subsequent Year): 18.00%
Age & Gender: NA GST Rate (Rider, First Year): NA
Risk Class: NA GST Rate (Rider, Subsequent Year): NA
Policy Term: 42 Years
Premium Payment Term: 27 Years Max Life State: Null
Amount of Installment Premium: `20,143 Policyholder Residential State: Uttar Pradesh
Mode of payment of premium: Annual
This benefit illustration is intended to show year-wise premiums payable and benefits under the policy.
Policy Details
Policy Option Life Cover Sum Assured (in Rs.) 50,00,000
Return of Premium Option No Sum Assured on Death (at inception of the policy) (in Rs.) 50,00,000

Optional Benefit Details

Optional Benefit Name Applicability/ Opted Sum Assured Coverage Term Payment Term
Accelerated Critical Illness Cover No NA NA NA
Accident Cover Yes 50,00,000 42 Years 27 Years
Joint Life Benefit* No NA NA NA
Premium Break No NA NA NA
*In case of either death or diagnosis with Terminal Illness of the Secondary Life before the death or diagnosis with Terminal Illness of Life Insured, then, an amount of Rs. 10 (Ten) lacs will be paid to the Claimant.
However, if the same happens after the death or diagnosis with Terminal Illness of Life Insured, an amount of Rs.50 (Fifty) lacs will be paid to the Claimant.
Rider Details

Rider Name Applicability/ Opted Sum Assured Coverage Term Payment Term

Waiver of Premium (WOP) Plus Rider No NA NA NA

Critical Illness and Disability Rider No NA NA NA

Premium Summary
Accelerated Critical Waiver of Premium
Accidental Cover Critical Illness and Total Installment
Base Plan Joint Life Illness Cover Benefit Plus Rider
Benefit Disability Rider Premium

Installment Premium without GST (in Rs.) 13,521 0 0 3,550 0 0 17,071

Installment Premium with first year GST (in Rs.) 15,954 0 0 4,189 0 0 20,143

28 of 33
Installment Premium with GST 2nd year onwards (in Rs.) 15,954 0 0 4,189 0 0 20,143

UIN: 104N118V07 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)

Guaranteed Non Guaranteed

Single/ Annualized Premium
Policy Year Min Guaranteed Surrender
Survival Benefits/ Loyalty Special Surrender Value/
Other Benefits, if any Maturity Benefit Death Benefit Value/ Exit Value
Additions Special Exit Value

1 17,071 - - NA 50,00,000 - -
2 17,071 - - NA 50,00,000 - -
3 17,071 - - NA 50,00,000 - -
4 17,071 - - NA 50,00,000 - -
5 17,071 - - NA 50,00,000 - -
6 17,071 - - NA 50,00,000 - -
7 17,071 - - NA 50,00,000 - -
8 17,071 - - NA 50,00,000 - -
9 17,071 - - NA 50,00,000 - -
10 17,071 - - NA 50,00,000 - -
11 17,071 - - NA 50,00,000 - -
12 17,071 - - NA 50,00,000 - -
13 17,071 - - NA 50,00,000 - -
14 17,071 - - NA 50,00,000 - -
15 17,071 - - NA 50,00,000 - -
16 17,071 - - NA 50,00,000 - -
17 17,071 - - NA 50,00,000 - -
18 17,071 - - NA 50,00,000 - -
19 17,071 - - NA 50,00,000 - -
20 17,071 - - NA 50,00,000 - -
21 17,071 - - NA 50,00,000 - -
22 17,071 - - NA 50,00,000 - -
23 17,071 - - NA 50,00,000 - -
24 17,071 - - NA 50,00,000 - -
25 17,071 - - NA 50,00,000 - 3,38,013
26 17,071 - - NA 50,00,000 - -
27 17,071 - - NA 50,00,000 1,15,226 1,15,226
28 - - - NA 50,00,000 1,07,544 1,07,544
29 - - - NA 50,00,000 99,862 99,862

29 of 33
30 - - - NA 50,00,000 92,181 92,181
UIN: 104N118V07 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
 Guaranteed Non Guaranteed
Single/ Annualized Premium
Policy Year Min Guaranteed Surrender
Survival Benefits/ Loyalty Special Surrender Value/
Other Benefits, if any Maturity Benefit Death Benefit Value/ Exit Value
Additions Special Exit Value

31 - - - NA 50,00,000 84,499 84,499

32 - - - NA 50,00,000 76,817 76,817
33 - - - NA 50,00,000 69,136 69,136
34 - - - NA 50,00,000 61,454 61,454
35 - - - NA 50,00,000 53,772 53,772
36 - - - NA 50,00,000 46,090 46,090
37 - - - NA 50,00,000 38,409 38,409
38 - - - NA 50,00,000 30,727 30,727
39 - - - NA 50,00,000 23,045 23,045
40 - - - NA 50,00,000 15,363 15,363
41 - - - NA 50,00,000 7,682 7,682
42 - - - NA 50,00,000 - -

Notes:
• Annualized Premium includes base policy and additional benefits premium, if opted. It excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any, and Goods and
Service Tax.
• Guaranteed Death Benefit will be paid to the beneficiary, immediately on death of the Life Insured or diagnosis of terminal illness (capped at sum assured of 1 crore) on the Life Insured, whichever is earlier.

Refer Sales literature (Prospectus) for explanation of terms used in this illustration.

I, Mr. Rishabh Sarin (name),have explained the premiums, and benefits under the product fully I, Awanish Kumar Mandal (name), having received the information with respect to the above,
to the prospect / policyholder. have understood the above statement before entering into the contract.

Place: Signature / Thumb Impression / Electronic Signature of Date:3/18/24 Signature / Thumb Impression / Electronic Signature of
Date: 3/18/24 Agent / Intermediary / Official Prospect / Policyholder
This system generated benefit illustration shall be treated as signed by me.

30 of 33
UIN: 104N118V07 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
 Premium Receipt
Receipt No.: 158948752MAR2401 | Receipt Date: 23-MAR-2024
Personal Details
Policy Number: 158948752 Email ID: awanishpassion32@gmail.com
Policyholder Name: Mr. Awanish Kumar Mandal PAN Number: BIXPM9361E
Address: S/o Yogendra Nath Mandal Karsi Customer GSTIN: Not Available
Nawanagar, Ballia, Nawa Nagar Current Residential State: Uttar Pradesh
BALLIA- 221717
Uttar Pradesh India
Mobile Number: 7307571031
Policy Details

Plan Name: Max Life Smart Secure Plus Plan Policy Commencement Date: 22-MAR-2024
Life Insured: Mr. Awanish Kumar Mandal Policy Term: 42 Years Premium Payment Term: 27 Years
Premium Payment Frequency: Annual Date of Maturity: 22-MAR-2066 Modal Premium (incl. GST): ` 20,143.20
Late Payment Fee (incl GST): ` 0.00 Premium Received (incl. GST): ` 20,143.20
GST Details Connect for more details
Coverage Taxable SGST/UTGST CGST IGST Name
Type Value (`) Rate Amount (`) Rate Amount (`) Rate Amount (`) Mr. Rishabh Sarin
Base 13,520.56 9% 1,216.85 9% 1,216.85 NA 0.00
Rider 3,550.00 9% 319.50 9% 319.50 NA 0.00
Contact Number
Late Payment 0.00 9% 0.00 9% 0.00 NA 0.00
8077624761
Total GST Value: ` 3,072.70
GSTIN: 09AACCM3201E1Z1 GST Regd. State: Uttar Pradesh SAC CODE: 997132

Mudrank: Paid by e-Stamps Certificate no. 826/Issue Date: 27/10/2023/ Vide Treasury (E-CHALLAN) GRN NO.108610615

Total Sum Assured of base

plan and term rider (if any)

22-MAR-2024 to
` 50,00,000.00 ` 20,143.20 21-MAR-2025 22-MAR-2025
*Important Note:
1.For payment mode other than in cash, this receipt is conditional upon the credit in our account. Payment of premium amount does not constitute commencement of risk. The risk
commencement starts after acceptance of risk by us.
2.Amount received would be adjusted against the due premium as per terms and conditions of the policy.
3.Premiums may be eligible for tax benefits under section 80C/80CCC/80D/37(1) of the income Tax Act 1961. Kindly consult your tax advisor for more information. Tax benefits are liable
to change due to changes in legislation or government notification.
4.GST shall comprise CGST, SGST / UTGST or IGST (whichever is applicable) including cesses and levies, if any as per prevailing laws and shall be borne by you. For GST purposes, this premium
receipt is Tax invoice. Assessable Value in GST is premium as reduced by amount allocated for investment (if applicable). In other scenarios, assessable value for Endowment First Year is
25%, Renewal Year is 12.5%, Single Premium Annuity is 10%, Term and Health is 100%. Currently base GST rate is 18% apart from Cess in some states.
5.I/We hereby declare that though our turnover is more than the turnover notified under sub-rule (4) of rule 48, we are not required to prepare an invoice in terms of the said sub-rule.

Authorised Signatory
PRM20 PRODUCT UIN: 104N118V07
E.&O.E

31 of 33
 158948752
---------------------------------------------------------------------------------------

** ACKNOWLEDGEMENT OF RECEIPT OF POLICY **

I hereby acknowledge the receipt of the Policy Document along with a copy of Proposal Form, Benefit Illustration
& Key Feature Document.
I am aware that the policy purchased by me is Max Life Smart Secure Plus Plan a traditional plan with below
mentioned plan details :-

Policy No. 158948752

Policy Holder Mr. Awanish Kumar Mandal
Sum Assured 50,00,000.00
Total Premium Payable*** 20,143.20
Premium Frequency Annual
Premium Payment Term (in years) 27
Policy Maturity (in years) 42
Policy Maturity Date 22-Mar-2066

***GST shall comprise of CGST, SGST/UTGST or IGST (whichever is applicable) including cesses and levies,
if any. All applicable taxes, cesses and levies, as per prevailing laws, shall be borne by you.

(Relationship with the Policy Holder)

Self

Spouse

Parents

Children (Only if above 18 years)

Others ___________________________ (please specify relationship)

___________ ___________________________
___________________________
Date Recipient's Signature Recipient's Full Name

c.c. : 909174 MR. RISHABH SARIN

Work Ph 1 : Home Ph 1 :
Work Ph 2 : Home Ph 2 :
Office : Max Life Agency Distribution Bareilly 1

"Note - Please submit this form within 10 days of receiving the Policy Pack to your nearby Max Life office/
Agent / Max Employee". Kindly submit self attested id proof of the receiver if signed by Spouse /Parents/ Major
Child/ Others."

32 of 33
33 of 33