Dear Mr.

VIJAY THAMBAN S,

As you rush through life, it is the time you spend with your near and dear ones that make
the entire journey happy & deeply satisfying. Make these moments extra special with
Kotak LifeXL which provides lump sum payouts at important stages of your life and also
financial protection in case of unfortunate events.

Pay Money Back Risk Cover

Money back
Pay premium just for 10 years. High Risk Cover
at regular interval of your choice

LifeXL Solution is a combination of two or more policies of Kotak Premier Endowment Plan.
Page 1 of 5
 How this plan works?
Payout of Payout of
Pay premium of Rs. 258,530** Rs. 685,642**
Rs. 75,005/-* per annum at the end of 15th policy at the end of 25th policy
for only 10 years. year. year.

1st 10th 15th 20th 25th 30th

policy policy policy policy policy policy
year year year year year year

Payout of Payout of
Rs. 364,202** Rs. 1,204,355**
at the end of 20th at the end of 30th
policy year. policy year.

First Payout
You will receive a lump sum
payout of Rs.258,530** at the
end of 15th policy year
Second Payout
You will receive a lump sum
payout of Rs.364,202** at the
end of 20th policy year

Third Payout
This plan not only gives you
Mr.VIJAY THAMBAN S, you need
You will receive a lump sum money back at periodical
to invest Rs. 75,005/-* per
payout of Rs.685,642** at the intervals, but also provide your
annum for only 10 years. No
end of 25th policy year dear ones a financial safety
premium to be paid from 11th
in case of an unforeseen
policy year to 30th policy year
Fourth Payout eventuality

You will receive a lump sum

payout of Rs.1,204,355** at the
end of 30th policy year

** The above illustration is for a 31 year old healthy male, and the total benefit is illustrated assuming investment return of 8% p.a.

Page 2 of 5
MySolutions : LifeXL Report Date : 12/02/2017

Life Insured's Name : Mr. VIJAY THAMBAN S Life Insured's Age : 31 yrs.

Benefit Illustration

Policy Age Annual * Minimum Payout @ 4% Payout @ 8%

Year Premium Death Benefit Rate of Return Rate of Return
1 32 75,005 876,761 - -

2 33 75,005 876,761 - -

3 34 75,005 876,761 - -

4 35 75,005 876,761 - -

5 36 75,005 876,761 - -

6 37 75,005 876,761 - -

7 38 75,005 876,761 - -

8 39 75,005 876,761 - -

9 40 75,005 876,761 - -

10 41 75,005 876,761 - -

11 42 - 876,761 - -

12 43 - 876,761 - -

13 44 - 876,761 - -

14 45 - 876,761 - -

15 46 - 876,761 184,995 258,530

16 47 - 711,750 - -

17 48 - 711,750 - -

18 49 - 711,750 - -

19 50 - 711,750 - -

20 51 - 711,750 220,021 364,202

21 52 - 546,739 - -

22 53 - 546,739 - -

23 54 - 546,739 - -

24 55 - 546,739 - -

25 56 - 546,739 347,657 685,642

26 57 - 319,140 - -

27 58 - 319,140 - -

28 59 - 319,140 - -

29 60 - 319,140 - -

30 61 - 319,140 508,909 1,204,355

Page 3 of 5
 Combination
Products behind
behind
thethe
solution
solution

Policy Payment Payment Modal Premium* Basic Sum

Product Term Term Mode Assured

Kotak Premier Endowment Plan 15 10 Yearly 15,001 135,144

Kotak Premier Endowment Plan 20 10 Yearly 15,001 151,909

Kotak Premier Endowment Plan 25 10 Yearly 20,001 227,599

Kotak Premier Endowment Plan 30 10 Yearly 25,001 319,140

Tax Saving

u/s 80 C
Policy Basic Eligible Tax Benefit @
Year Premium* Amount 30.9% Net Premium

1 75,005 75,005 23,176 51,828

2 75,005 75,005 23,176 51,828
3 75,005 75,005 23,176 51,828
4 75,005 75,005 23,176 51,828
5 75,005 75,005 23,176 51,828
6 75,005 75,005 23,176 51,828
7 75,005 75,005 23,176 51,828
8 75,005 75,005 23,176 51,828
9 75,005 75,005 23,176 51,828
10 75,005 75,005 23,176 51,828
Total 750,050 518,280

Advertisement Disclaimers:
This advertisement is designed for combination of benefits of two or more policies of Kotak Premier Endowment Plan. The customer has the choice of
purchasing any one or more policies asper his/her need and choice and there is no compulsion whatsoever that these policies are to be taken together as
suggested by the insurer and presented in this advertisement. The customer is expected to ask questions, understand and satisfy himself that the
combination meets his/her specific needs better before deciding to purchase the combination. This benefit illustration is the arithmetic combination and
chronological listing of combined benefits of individual policies. The customer is advised to refer the detailed sales brochure of Kotak Premier Endowment
Plan.
Other Disclaimers
1) This combination solution comprises of set of policies of Kotak Premier Endowment Plan (UIN No.: 107N079V01). This product also available individually
with the Company and it is not mandatory for you to apply for this combination only. Kotak Premier Endowment Plan is a non-linked limited premium paying
savings-cum-protection oriented participating endowment Plan.
2) The benefits available under the combination solution shall be as per the product policies terms and conditions..
3) The benefit of this combination solution shall become payable only if all premiums for the entire premium payment term is paid in full and the policy is in
force.
4) *The Above premium figures are exclusive of Service Tax. Service tax and Cess thereon, shall be charged as per the prevalent tax laws over and above
the said premiums
5) Tax Benefits are subject to change in tax laws. You are advised to consult your tax advisor to details.
Page 4 of 5
5) Tax Benefits are subject to change in tax laws. You are advised to consult your tax advisor to details.
6) Insurance is the subject matter of solicitation.
7) Based on the combination option selected, after paying all premiums for the full premium payment term, the payout for each policy term will be paid as per
the intervals selected by the policyholder.
8) For more details on risk factors, terms and conditions please read the sales brochure of Kotak Premier Endowment Plan before concluding a sale.

9) These assumed rates return are not guaranteed and they are not 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.

10) Trade Logos displayed above belongs to Kotak Mahindra Old Mutual Life Insurance Limiteds promoting partners Kotak Mahindra Bank
Limited and Old Mutual plc and used by Kotak Mahindra Old Mutual Life Insurance Limited under license.

To know the details of this combination solution, please go through the benefit illustrations of Kotak Premier Endowment Plan as provided to you.

"BEWARE OF SPURIOUS PHONE CALLS AND FICTITIOUS/FRAUDULENT OFFERS

IRDAI clarifies to public that

IRDAI or its officials do not involve in activities like sale of any kind of insurance or financial products nor invest premiums.

IRDAI does not announce any bonus.

Public receiving such phone calls are requested to lodge a police complaint along with details of phone call, number."

Kotak Premier Endowment Plan UIN No.: 107N079V01, Form No. N079.
Ref No.: KLI/14-15/E-PL/173

Kotak Mahindra Old Mutual Life Insurance Ltd.,

CIN: U66030MH2000PLC128503
Regn. No.: 107, Regd. Office: 2nd Floor, Plot # C- 12, G- Block, BKC, Bandra (E), Mumbai- 400 051
Website: http://insurance.kotak.com | Email: clientservicedesk@kotak.com | Toll Free No. - 1800 209 8800

Page 5 of 5
 Customer Declaration Letter Cum Proposal Form Addendum

I VIJAY THAMBAN S declare & understand that I have opted for the MySolutions LifeXL, a combination solution offered by Kotak Life Insurance.
This combination solution consists of 4 policies of Kotak Premier Endowment plan UIN (107N079V01). I have filled the proposal application form
No. _______________________ & submitted all required documents.

Sr. Product Proposal Premium Policy Sum Frequency Modal Service Total
No. Name No. Payment Term Assured of Premium Tax on Premium
Term (Yrs.) (Rs.) Payment (Rs.) Modal
(Yrs.) Premium

1 Kotak Premier Endowment 10 15 135144 Yearly 15001 563 15564

Plan
2 Kotak Premier Endowment 10 20 151909 Yearly 15001 563 15564
Plan
3 Kotak Premier Endowment 10 25 227599 Yearly 20001 750 20751
Plan
4 Kotak Premier Endowment 10 30 319140 Yearly 25001 938 25939
Plan

I understand that this combination solution comprises of a set of policies across one or more products of the Company. I have been made aware
that these products are also available individually and separately with the company and it is not mandatory for me to apply for this combination
only.

I have separately gone through the product brochure of the above products and have taken the decision to opt for this combination solution after
having fully understood the risk factors, product terms and conditions.

I understand that the benefit of this combination solution are guaranteed provided all policies are in force and all premiums are paid upto date.

I declare that I have answered the questions in the proposal form to which this addendum is attached, after fully understanding the nature of the
questions and the importance of disclosing all information while answering such questions. I further declare that the details given by me to all the
questions in this addendum to the proposal form are true and complete in every respect and that I have not withheld any material information or
suppressed any fact. I further understand that the details given in the addendum shall form part of the proposal form. I understand that all polices
of this combination solution will either be converted or declined collectively, as per the underwriting rules of the company.

I declare that the contents in the proposal form, this addendum to the proposal form and documents forming part of this proposal form have been
fully explained to me and I have fully understood the significance of the proposed contract for each plan.

Date: ___________________________

Place: ___________________________
Signature / thumb impression of Life Assured Signature / thumb impression of the Proposer
(If different from Proposer)

Section 41 of the Insurance Act, 1938 states:

1. No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take or renew or continue an
insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or
any rebate of the premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate,
except such rebate as may be allowed in accordance with the published prospectuses or tables of the insurer.
2. Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakhs
rupees.

Section 38, 39 & 45 of the Insurance Act, 1938 states:

The above Proposal will be governed by the provisions of Section 38, Section 39 and Section 45 of the Insurance Act, 1938 and amendments
thereto from time to time.

Kotak Mahindra Old Mutual Life Insurance Ltd.,

CIN: U66030MH2000PLC128503. Regn. No.: 107, Regd. Office: 2nd Floor, Plot # C- 12, G- Block, BKC, Bandra (E), Mumbai- 400 051.
Website: http://insurance.kotak.com Email: clientservicedesk@kotak.com. Toll Free No. - 1800 209 8800.
Insurance is subject matter of solicitation.