Max Life Life Gain Premier (UIN No:104N079V01)

Savings - Traditional Participating Endowment Insurance Plan

Policy/Proposal No: [ _________________ ]
Date of Illustration - Jan 18, 2014 8:18:50 PM
Personal Details

Product Features
Guaranteed Maturity Sum Assured

Rs 3,00,269.00

Age of Policyholder as at last birthday on the Effective Date

32 Years

Policy Term

20 Years

Gender of Policyholder

Male

Premium Payment Term

10 Years

Bonus Option

Paid Up Additions

Name of Policyholder

Name of Life Insured

Age of Life Insured as at last birthday on the Effective Date

26 Years

Payment Mode

Annual

Gender of Life Insured

Female

State

Other

PREMIUM SUMMARY
First Year Premium

Renewal Year Premium

Base Modal Premium

Rs 25,000.40

Rs 25,000.40

Payor Rider Modal Premium

Rs 502.41

Rs 502.41

Service Tax including Cess on Base and Payor Rider Modal Premium, if opted

Rs 834.61

Rs 448.35

Total Premium Payable on Due Date along with Service Tax & Cess

Rs 26,337.42

Rs 25,951.16

Total Premium Payable for the policy year

Rs 25,502.81

Rs 25,502.81

Total Premium Payable for the policy year along with Service Tax and Cess

Rs 26,337.42

Rs 25,951.16

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

This is only an Illustrative document. The Benefits if guaranteed, are clearly marked so. For variable benefits, investment growth rates of 4% and 8% are used as an illustration.
MAX LIFE INSURANCE CO. LTD, 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurgaon 122 002

Page 1 of 3

YEARLY ILLUSTRATIVE DETAILS

(This shall form a part of the policy document)
All cash flows are in Rs
General Details
Policy Year

Guaranteed

Non Guaranteed (Assumed rate of return on investment is 4% p.a.)

Non Guaranteed (Assumed rate of return on investment is 8% p.a.)

Age of life
Assured

Premium

Death
Benefit (
Including
Rider
Benefit ( If
Any ) )

Guaranteed
Surrender
Value

Survival/
Maturity
Benefit

Cash Bonus

Net Outlay

Death
Benefit

Surrender
Value of
PUA

Terminal
Bonus

Special
Surrender
Value

Cash Bonus

Net Outlay

Death
Benefit

Surrender
Value of
PUA

Terminal
Bonus

Special
Surrender
Value

(BOY)

(BOY)

(BOY)

(EOY)

(EOY)

(EOY)

(BOY)

(BOY)

(EOY)

(EOY)

(EOY)

(EOY)

(BOY)

(BOY)

(EOY)

(EOY)

(EOY)

26

25,503

3,00,269

25,503

3,00,269

25,503

3,00,269

27

25,503

3,00,269

973

25,503

3,00,269

3,825

25,503

3,00,269

28

25,503

3,00,269

22,953

1,012

25,503

3,02,034

2,017

40,508

4,133

25,503

3,09,389

8,146

41,492

29

25,503

3,00,269

51,006

1,051

25,503

3,03,811

3,136

61,121

4,466

25,503

3,18,784

13,012

63,646

30

25,503

3,00,269

63,757

1,094

25,503

3,05,597

4,335

82,435

4,828

25,503

3,28,461

18,479

87,337

31

25,503

3,00,269

76,508

1,137

25,503

3,07,396

5,617

1,10,990

5,219

25,503

3,38,432

24,607

1,19,716

32

25,503

3,00,269

89,260

1,181

25,503

3,09,206

6,987

1,35,195

5,639

25,503

3,48,704

31,457

1,48,496

33

25,503

3,00,269

1,08,132

1,229

25,503

3,11,024

8,450

1,60,225

6,097

25,503

3,59,282

39,104

1,79,274

34

25,503

3,00,269

1,30,829

1,276

25,503

3,12,854

10,010

1,86,105

6,589

25,503

3,70,183

47,621

2,12,180

10

35

25,503

3,00,269

1,53,017

1,328

25,503

3,14,693

11,675

7,914

2,18,546

7,121

25,503

3,81,411

57,094

9,824

2,53,419

11

36

3,00,269

1,60,668

1,380

3,24,459

13,447

7,960

2,38,083

7,698

4,02,797

67,613

10,122

2,84,956

12

37

3,00,269

1,70,869

1,436

3,26,366

15,336

8,007

2,47,701

8,324

4,15,007

79,282

10,429

3,05,915

13

38

3,00,269

1,78,520

1,493

3,28,287

17,346

8,054

2,57,686

8,998

4,27,587

92,206

10,745

3,28,353

14

39

3,00,269

1,86,171

1,553

3,30,218

19,483

8,102

2,68,059

9,726

4,40,543

1,06,500

11,070

3,52,371

15

40

3,00,269

1,96,372

1,614

3,32,162

21,754

8,149

2,78,827

10,517

4,53,887

1,22,302

11,406

3,78,082

16

41

3,00,269

2,04,022

1,679

3,34,116

24,168

8,197

2,90,011

11,369

4,67,634

1,39,745

11,751

4,05,592

17

42

3,00,269

2,11,673

1,748

3,36,082

26,733

8,245

3,01,630

12,296

4,81,791

1,58,992

12,107

4,35,029

18

43

3,00,269

2,21,874

1,817

3,38,061

29,456

8,294

3,13,698

13,293

4,96,377

1,80,205

12,473

4,66,520

19

44

3,00,269

2,29,525

1,891

3,40,053

32,346

8,343

3,26,235

14,379

5,11,398

2,03,575

12,851

5,00,210

20

45

3,00,269

2,29,525

3,00,269

1,966

3,42,058

35,412

8,392

3,44,072

15,549

5,26,874

2,29,303

13,239

Rs 3,00,269

Maturity Value:

Rs 3,44,072

(BOY) - Beginning of Year Value (EOY) - End of Year value

This is only an Illustrative document. The Benefits if guaranteed, are clearly marked so. For variable benefits, investment growth rates of 4% and 8% are used as an illustration.
MAX LIFE INSURANCE CO. LTD, 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurgaon 122 002

Page 2 of 3

5,42,811
Rs 5,42,811

Important Notes:
-- This is only an illustrative document. It does not purport to be a contract of insurance and does not in any way create any rights and/or obligations. Bonuses (if applicable and shown in the illustration) are not guaranteed, and bonus rates will be based on
the actual company experience from time to time.
-- PUA withdrawals (if any) shown are illustrative. In case you wish to withdraw the money, then you will have to give a request at that point of time.
-- Benefits secured under your Policy shall become payable provided all contractual premiums are paid as and when they are due. The illustrative benefits above assume that all the contractual premiums will be paid on the due dates.
-- Please refer to the product brochures, for understanding the product features and explanation of the terms used in this illustration.
-- Service Tax and Education Cess would be levied as per applicable laws.
-- You may be entitled to certain applicable tax benefits on your premiums and Policy benefits. Please note that all the tax benefits are subject to tax laws prevailing at the time of payment of premium or receipt of benefits by you/ your nominee.
-- Guaranteed Death Benefit is defined as higher of 11 times the annualised premium, 105% of all premiums paid as on the date of death or Guaranteed Maturity Sum Assured. Please note that here annualised premium includes extra premium, if any, but
does not include loading for modal premium.
I ________________________________________________________ (Name), have explained the terms and conditions and the benefits of the policy to the prospect/policyholder.
Signature of Agent/Specified Person:
Name and ID:
Place:
Date:
Company Seal:
I _____________________________________________________________________________________ (Name), having received the information with respect to the above, have understood the above statement before entering into the contract. I understand
and intend to continue paying the above said premium amount for the complete Premium Payment Period and as per the opted frequency.
Policy Holders Signature:
Policy Holders Name:
Date:
MAX LIFE INSURANCE CO. LTD, 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurgaon 122 002
2010.1.2.8.6.59.2149172526.000001300269.000001.00000121183 100000001000000 10000018001000000 10000 2

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