Fortune Guarantee Plus (2)

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Name of the Prospect / Bhushan patil Proposal No: 12678345

Policyholder:
Name of the Product: Tata AIA Life Insurance Fortune Guarantee
Age (years) : 18 Gender: Male Plus

Tag Line : Individual, Non-Linked Non-Participating


Name of the Life Assured 1 : Bhushan patil Life Insurance Savings Plan
Age (years) : 18 Gender: Male Unique Identification No.: 110N158V11

i GST Rate: 4.5% for first year


Name of the Life Assured 2 : NA
am
red 2.25% second year onwards
Age (years) : NA Gender: NA

Policy Term (years) : 11

Premium Payment Term (years) : 10

Amount of Instalment Premium 2214


(Rs.):

Mode of Payment of Premium : Monthly

This benefit illustration is intended to show year-wise premiums payable and


benefits under the policy.

Policy Details
Basic Sum Assured (First Death) Rs. 328800
Policy Option Regular Income
Basic Sum Assured (Second Death, if any) Rs. NA

Income Period (years) 35


Sum Assured on First Death (at inception of the policy) Rs. 328800
Income starts from Year 12

Income ends on Year 46


Sum Assured on Second Death, if any (at inception of the policy) Rs. NA
Guaranteed Annual Income (GAI)* Monthly

*GAI shall commence from the end of the Policy Year, following Date of Maturity of Policy. In case of monthly frequency, GAI shall commence from the end
of the policy month following Date of Maturity of Policy.

Rider Details

Tata AIA Vitality


(Wellness No
Program)

Details of Life
Rider Name/UIN^ Insured/Partner under the Benefit Payout
Benefit Option Return of Benefit Premium Sum Premium p.a. Year 1
(Benefit
premium Option Payment Assured without GST Discount
Option/Benefit Income option Term Term (Rs.) (Rs.) (Rs.)
Payout Option) Name Age(yrs) Gender Lumpsum Income Duration
(Rs.) p.a.(Rs.)
(yrs)

Premium Summary
Base Plan Riders Total Instalment Premium

Instalment Premium without GST (Rs.) 2119 0 2119

Instalment Premium with First year GST (Rs.) 2214 0 2214

Instalment Premium post applicable discount with First year GST


2214 0 2214
(Rs.)

Instalment Premium with GST 2nd year onwards (Rs.) 2167 0 2167
(Amount in Rupees)
Guaranteed Non - Guaranteed
Death
Policy Single/ Annualised Survival Death
Other Maturity Benefit
Year Premium Benefit / Benefit #Min Guaranteed #Special Surrender
Benefits, if (Second
Loyalty
any Benefit ## (First
Death,
Surrender Value Value
Additions Death)
if any)
1 24000 NA NA 0 328800 NA 0 0

2 24000 NA NA 0 328800 NA 14400 24983

3 24000 NA NA 0 328800 NA 25200 40597

4 24000 NA NA 0 328800 NA 48000 59334

5 24000 NA NA 0 328800 NA 60000 79372

6 24000 NA NA 0 328800 NA 72000 104615

7 24000 NA NA 0 328800 NA 84000 131159

8 24000 NA NA 0 328800 NA 120960 162387

9 24000 NA NA 0 328800 NA 166320 199080

10 24000 NA NA 0 328800 NA 216000 239417

11 0 NA NA 0 328800 NA 216000 260236

12 0 NA NA 21089 0 NA 0 0

13 0 NA NA 21089 0 NA 0 0

14 0 NA NA 21089 0 NA 0 0

15 0 NA NA 21089 0 NA 0 0

16 0 NA NA 21089 0 NA 0 0

17 0 NA NA 21089 0 NA 0 0

18 0 NA NA 21089 0 NA 0 0

19 0 NA NA 21089 0 NA 0 0

20 0 NA NA 21089 0 NA 0 0

21 0 NA NA 21089 0 NA 0 0

22 0 NA NA 21089 0 NA 0 0

23 0 NA NA 21089 0 NA 0 0

24 0 NA NA 21089 0 NA 0 0

25 0 NA NA 21089 0 NA 0 0

26 0 NA NA 21089 0 NA 0 0

27 0 NA NA 21089 0 NA 0 0

28 0 NA NA 21089 0 NA 0 0

29 0 NA NA 21089 0 NA 0 0

30 0 NA NA 21089 0 NA 0 0

31 0 NA NA 21089 0 NA 0 0

32 0 NA NA 21089 0 NA 0 0

33 0 NA NA 21089 0 NA 0 0

34 0 NA NA 21089 0 NA 0 0

35 0 NA NA 21089 0 NA 0 0

36 0 NA NA 21089 0 NA 0 0

37 0 NA NA 21089 0 NA 0 0

38 0 NA NA 21089 0 NA 0 0

39 0 NA NA 21089 0 NA 0 0

40 0 NA NA 21089 0 NA 0 0

41 0 NA NA 21089 0 NA 0 0

42 0 NA NA 21089 0 NA 0 0

43 0 NA NA 21089 0 NA 0 0

44 0 NA NA 21089 0 NA 0 0

45 0 NA NA 21089 0 NA 0 0

46 0 NA NA 261089 0 NA 0 0
Note: "Annualised Premium" shall be the premium payable in a year under a non-single pay option chosen by the policyholder, excluding the taxes, rider
premiums, underwriting extra premiums, loading for modal premiums, if any.
"Single Premium" shall be the premium payable under a single pay option chosen by the policyholder, excluding the taxes, rider premiums, underwriting
extra premiums, if any.
##The policyholder shall also be given the option to receive the Guaranteed Annual Income (GAI) on a monthly basis. This option has to be chosen at
inception and cannot be altered once chosen. The GAI illustrated above is the total amount payable in a year on selection of monthly mode.

#Surrender value illustrated above is the end of the policy year value.

#Special Surrender Value may be revised depending upon the prevailing marketing conditions.
#Surrender value will be higher of Guaranteed Surrender Value and Special Surrender Value

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

Place: i am red
Date: Signature of Agent/ Intermediary/ Official Date: Signature of Prospect/ Policyholder

Unique Reference Number - L&C/Advt/2023/Aug/2727 (Rider - L&C/Advt/2022/Sep/2271)


Tata AIA Life Insurance Company Ltd. (IRDA of India Regn No. 110) (CIN: U66010MH2000PLC128403)
Registered and Corporate Office: 14th Floor, Tower A, Peninsula Business Park, Senapati Bapat Marg, Lower Parel, Mumbai- 400013
Trade logo displayed above belongs to Tata Sons Ltd and AIA Group Ltd. and is used by Tata AIA Life Insurance Company Ltd under a license.
For more information, Call the Tata AIA Life Insurance Company Ltd Helpline number1860-266-9966 (local charges apply) or Visit us at: www.tataaia.com

(I)V.99.00/FY2023-2024_Q4/RELEASE 01-01-24/EXPIRY 31-03-2024 005754234Y9FGPSLV8N1 08-02-2024,05:15 PM

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