QuotationNo :100004404300009

Dear Poornima Vishwanath Putran,

Thank you for showing interest in our Canara HSBC Life Insurance Guaranteed Fortune Plan. Based on the details provided by you, and reproduced below, th
illustration customised to your requirements is appended.

Date: 04-07-2024

Name of the Prospect/ Policyholder: Poornima Vishwanath Putran

Age & Gender: 27|Female

Name of the Prospect / Policyholder Poornima Vishwanath Putran

Age & Gender: 27 Female
Name of the Life Assured Poornima Vishwanath Putran
Age & Gender: 27 Female
Premium Payment Term 7 years
Policy Term 12 years
Amount Of Installment Premium Rs. 25,000
Mode of payment of Premium Annual
Staff No

Proposal number

Name of the product: Canara HSBC Life Insurance Guaranteed Fortune Plan

Tagline A Non-Linked Non-Participating Individual Savings Life Insurance Plan

Unique Identification No: 136N084V03

GST Rate (Year 1) 4.50%

GST Rate (Year 2 onwards) 2.25%

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

Policy Details

Policy Option Guaranteed Savings Sum Assured on Death (at inception of the policy in Rs.) 3,25,000

Benefit Details (in Rs.)

Guaranteed Sum Assured on Maturity 1,75,000

Total Accrued Guaranteed Yearly Additions till Maturity 60,165

Premium Summary (in Rs.)

Base Plan Premium without

Staff Discount Rider Total Instalment Premium
discount

Page No. Production Release Channel Name : Canara Bank Proc hub : Mumbai Curr Res State : MAHARASHTRA Version 1.0.0 N Illustration Number : 100004404300009
 Instalment Premium without GST 25,000 0 0 25,000

Instalment Premium in First Year with GST 26,125 0 0 26,125

Instalment Premium 2nd year onwards with GST 25,563 0 0 25,563

(Amount in Rs.)

Guaranteed Non Guaranteed

Policy Annualized
Year Premium Survival Guaranteed Yearly Maturity Death Minimum Guaranteed Surrender Special Surrender
Benefits Additions* Benefit# Benefit# Value Value
1 25,000 0 0 0 3,25,000 0 0
2 25,000 0 0 0 3,25,000 15,000 19,000
3 25,000 0 0 0 3,25,000 26,250 31,500
4 25,000 0 0 0 3,25,000 50,000 45,000
5 25,000 0 0 0 3,25,000 70,000 62,500
6 25,000 0 0 0 3,25,000 91,500 81,000
7 25,000 0 0 0 3,25,000 1,17,250 1,05,000
8 0 0 0 0 3,25,000 1,27,750 1,13,750
9 0 0 0 0 3,25,000 1,38,250 1,26,000
10 0 0 20,055 0 3,45,055 1,53,017 1,54,093
11 0 0 20,055 0 3,65,110 1,69,533 1,84,995
12 0 0 20,055 2,35,165 3,85,165 1,75,550 2,23,407

*Guaranteed Yearly Additions is the additional benefit which will accrue at the start of each Policy Year in the last three years of the Policy Term, provided all due premiums have been
paid (as displayed in the illustration above). Accrued Guaranteed Yearly Additions are payable in case of death of the Life Assured during the Policy Term or at Maturity.

#The Death Benefit and Maturity Benefit displayed above are inclusive of accrued Guaranteed Yearly Additions.

Notes:

1.Annualized Premium excludes underwriting extra premium, frequency loading on premiums, the premiums paid towards the riders, if any and Goods & Services Tax.

2.Surrender values and death benefit have been calculated assuming the event occurring at the end of the policy year

Important Notes
1. Maturity Benefit is the benefit payable on survival of Life Assured till maturity, which is sum of Guaranteed Sum Assured on Maturity plus accrued Guaranteed Yearly Additions.

2. Death Benefit payable in case of death of the Life Assured - Sum Assured on Death less CARE Pay Benefit already paid, if any, plus accrued Guaranteed Yearly Additions, if any.
No other benefit will be payable and policy will terminate on payment of death benefit. Where, Sum Assured on Death is defined as higher of a) 11 times the Annualized
Premium b)105% of the Total Premiums Paid c) Guaranteed Sum Assured on Maturity d) Absolute amount assured to be paid on death (Sum Assured)

3. Installment premium mentioned is inclusive of loadings for modal premiums and underwriting extra premium, if any.

4. Total Premiums Paid means total of all the premiums received, excluding rider premiums, underwriting extra premiums and taxes.

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

Other points to note:

1. This is a traditional plan intended for long term savings and benefits. It is strongly advised that the Policy should be continued throughout the defined Policy term to realise the
full benefits. If premiums are discontinued after payment of at least first 2 consecutive Policy years’ premiums then the Policy will acquire a Paid-up value. You will receive this
Paid-up value on death or on maturity, provided you have not surrendered or revived the Policy.

2. Your Policy will acquire a guaranteed surrender value (GSV) after payment of at least first 2 consecutive Policy years’ premiums. However, the Company may offer a special
surrender value (SSV), and higher of {GSV or SSV} will be paid on surrender. The Illustration shows both the GSV as well as the current SSV payable on surrender of the Policy.
SSV scales may be revised in the future by the Company with the prior approval of the Authority

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

4. The illustrated premium is for a healthy individual with standard premium rates. Your application will be assessed as per Board approved underwriting Policy of the Company.
Basis underwriting, it may result in extra premium to be paid, which shall be borne by you.

5. The illustration takes into account currently applicable Goods and Services Tax & applicable cess (es)/other levy, if any. However, the applicable taxes may change from time to
time and total premium payable will change accordingly.

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

7. Insurance is the subject matter of solicitation.

Page No. Production Release Channel Name : Canara Bank Proc hub : Mumbai Curr Res State : MAHARASHTRA Version 1.0.0 N Illustration Number : 100004404300009
I, ___________________________ (name), have explained the premiums, charges and I, ___________________________ (name), having received the information with
benefits under the product fully to the prospect / policyholder respect to the above, have understood the above statement before entering into the
contract

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

Page No. Production Release Channel Name : Canara Bank Proc hub : Mumbai Curr Res State : MAHARASHTRA Version 1.0.0 N Illustration Number : 100004404300009
Version 3

GUARANTEED FORTUNE PLAN

KEY INFORMATION DOCUMENT (KID)
There is no compulsion or requirement to take this

2
Life Insurance Policy as a condition / part of bank Loan

Guaranteed
Other important aspects that you must know:

1 Payout at the
end of the PLAN OPTIONS

3
Term
1. Guaranteed Savings Option: Sum Assured on Death less CARE Pay Benefit
Dual benefit of
Life Cover and already paid, if any, plus accrued Guaranteed Yearly Additions, if any shall be
Savings Claims
paid to the nominee on death of the Life Assured and the policy will
Accelerated for terminate. In case the Life Assured outlives the policy term, Guaranteed
Relief & Ease Sum Assured on Maturity plus accrued Guaranteed Yearly Additions, shall be
(C.A.R.E.) Pay paid. On payment of this benefit, the Policy will terminate and no further

7 7
Important benefit shall be payable.
aspects about 2. Guaranteed Cash Back Option: Sum Assured on Death less CARE Pay
Benefit already paid, if any, plus Deferred Survival Benefits, if any, plus

4
Tax Benefits available
Guaranteed
accrued Guaranteed Yearly Additions, if any shall be paid to the nominee on
as per prevailing tax Fortune Plan death of the Life Assured and the policy will terminate. 15% of Guaranteed
laws amended from
time to time Option to receive Sum Assured on Maturity shall be paid at the end of each 5th Policy Year,
Guaranteed Cash Back falling before the end of the Policy Term as survival benefit. On outliving the
at the end of every policy term, Guaranteed Sum Assured on Maturity less Survival Benefits

6
5th Policy Year already paid, if any, plus Deferred Survival Benefits, if any, plus accrued
Guaranteed Yearly Additions, shall be paid. On payment of this benefit, the

Guaranteed Yearly
Additions to boost
Maturity Benefit
5
Option for
Policy will terminate and no further benefit shall be payable.
Sum Assured on Death is defined as the higher of:
• 11 times the Annualized Premium
payout Deferring the
• 105% of Total Premiums Paid
Survival Benefit
• Guaranteed Sum Assured on Maturity
• Absolute amount assured to be paid on death (Sum Assured)
Guaranteed Sum Assured on Maturity is equal to the sum of the Annualized
Premiums payable under the Policy during the Premium Payment Term (i.e.
Annualized Premium x Premium Payment Term).
CARE Pay Benefit: On occurrence of death, the product will pay 100% of Total Premiums Paid till date of death on intimation of death of the Life Assured, established basis the Death
Certificate issued by competent authority and the rights of claimant established basis applicable documents as may be required by the Company from time to time. This will be applicable
with both the plan options. CARE Pay benefit is an accelerated cover and the amount paid for this benefit will be deducted from the Sum Assured on Death payable.
Deferment of Survival Benefit: (Available under Guaranteed Cash Back plan option): Under this option, the Policyholder can choose to defer the payout of Survival Benefits i.e. the
guaranteed cash backs.

Revival: A request for revival of the policy can be raised anytime during the revival period of 5 years from the due date of first unpaid premium subject to the terms and conditions as
specified in the Policy Contract. Post revival of the policy, all benefits would be reinstated to the applicable full level.
Paid-Up: After payment of at least first 2 consecutive years’ Premiums, if any subsequent due Premium is not paid within the grace period, the Policy shall acquire a Paid-up status. Once
the Policy is in Paid-up status and provided the Policy is not surrendered, the policyholder will receive the Paid-Up benefits.
Surrender: Surrender Value is defined as the higher of {Guaranteed Surrender Value (GSV) and Special Surrender Value (SSV)} subject to a minimum of zero.
Please refer the terms and conditions for the Surrender Value Payable.

IMPORTANT DISCLOSURE REQUIREMENT:

Please provide correct and complete details, including information on all medical ailments such as diabetes, hypertension, heart diseases, cancer, etc. in the proposal form, otherwise, there
is a risk of your policy benefit / claim being denied.

I have been briefed on the benefits and features of Canara HSBC Life Insurance Guaranteed Fortune Plan. I have understood the information and risks associated with this plan. I confirm
that my selection of the above policy is in keeping with my life insurance / investment objectives
I have briefed ________________________________________________________ in ________________________________ language on the benefits and features of this insurance
plan.
Name: _________________________________________________________________ Signature: ________________________________________ Date: __________________________
Code: ________________________________________________________________ Proposal Number: ___________________________________

IMPORTANT INFORMATION:
This is the Key Information document about the Guaranteed Fortune Plan and it doesn’t replace the full policy terms and conditions (which you should read carefully on receipt).
Guaranteed Fortune Plan is a Non-Linked Non-Participating Individual Savings Life Insurance Plan.
Purchase of any insurance products by a bank’s customer is purely voluntary and is not linked to availment of any other facility from the bank.
For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale. You can also speak to your sales representative, or visit our
website www.canarahsbclife.com
You will shortly receive a call to verify the details filled up by you in the Proposal Form. Kindly attend the call to confirm your understanding of the proposed Life Insurance plan.
Canara HSBC Life Insurance Guaranteed Fortune Plan (UIN: 136N084V03)

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