Personalised proposal for securing your family

with

Hi ,
Thank you for choosing ICICI Prudential
Life Insurance to secure your loved ones
financially.
 Snapshot of your plan

Details of the Life Assured (person covered under the policy):

Name Age Gender

41 Male

You pay

You pay premium for 15 years

Year
Dec 2024 Dec 2038 Dec 2039

You get

Coverage Coverage details Coverage term

15 years
In your absence, your nominee
Life cover from Dec 2024
will receive a lump sum of ` 50,00,000/-
to Dec 2039

On diagnosis of any of the covered 15 years

Accelerated
critical illnesses, you will receive from Dec 2024
critical illness cover to Dec 2039
a lump sum payout of ` 25,00,000/-
 Detailed break-up of premium amount incl. of taxes

Yearly Applicable Tax benefit

Premium taxes under

`
Life cover ` 10,262/- ` 1,848/- Section 80C

Accelerated critical illness cover ` 12,602/- ` 2,268/- Section 80D

Total Yearly Premium ` 22,864/- + ` 4,116/- =` 26,980/-

The above premium is payable for 15 years.

Why choose us:

` 9.84 Cr ` 2.87 Lakh Cr

Lives covered as on Benefits paid till
June 30, 2024 June 30, 2024

` 3.08 Lakh Cr Quick claim settlement

Assets under management as on Quick claim settlement
June 30, 2024 process available

Tax Saving
Tax benefits may be applicable on
premiums paid & benefits received

ICICI Prudential Life Insurance Company. IRDAI Regn No. 105.CIN:L66010MH2000PLC127837.

ICICI Prudential Life Insurance Company Limited. Registered Address:1089 Appasaheb Marathe Marg, Prabhadevi, Mumbai - 400025.ICICI Pru iProtect Smart,
UIN: 105N151V13 . For more details on the risk factors, term & conditions please read the policy document. COMP/DOC/Sep/2023/279/4230.
 Benefit Illustration of ICICI Pru iProtect Smart Date: 26-Dec-2024 11:31:08
IP :0:0:0:0:0:0:0:1
(UIN:105N151V13) - A Non-Participating Non-Linked
Life Individual pure risk insurance product
Name of the Prospect/Policyholder : Mr. Name of the Product : ICICI Pru iProtect Smart
Age of the Policyholder at policy : 11-Jul-1983 (41 years) Tag Line : A Non-Participating
inception Non-Linked Life Individual
Pure Risk Insurance Product
Gender of the Policyholder : MALE
Is Proposer an existing employee? : No Unique Identification No. : 105N151V13
Name of the Life Assured : Mr. GST Rate : 18%
Age of the Life Assured at policy : 11-Jul-1983 (41 years)
inception
Gender of the Life Assured : MALE Sales Channel : BOL
Is Life Assured Smoker / Non- : Non-Smoker
Smoker?
Policy Term : 15 years
Premium Payment Term : 15 years
Frequency of premium payment : yearly
Amount of Instalment Premium for : Rs. 22,864/-
Year 1*(without GST)
*Please refer the section Premium Summary for a detailed break-up of premium payable

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

Policy Details
Benefit Option Life and Health
Death benefit payout option Lump Sum

Sum Assured on Death or Terminal Illness (A + B*C*12) 5000000

Accelerated Critical Illness (ACI) Benefit 2500000
Accelerated Critical Illness (ACI) Benefit period 15 years

Premium Summary
Death Benefit/ Terminal Accidental Death Benefit Accelerated Critical Illness Total (1+2+3)
Illness Benefit and Waiver (2) Benefit (3)
of Premium on Permanent
Disability due to
Accident(1)
Instalment Premium without GST Rs. 10,262/- 0 Rs. 12,602/- Rs. 22,864/-
Instalment Premium with GST Rs. 12110/- 0 Rs. 14870/- Rs. 26980/-

Important points to note:

i. The above illustration is applicable to a standard life from medical, life style and occupation point of view.
ii. In case of permanent disability due to accident, all future premiums payable under this policy will be waived off.
iii. In the event of Accelerated Critical Illness, the Death Benefit is reduced to the extent of Accelerated Critical Illness
Benefit paid. Please refer to the policy terms & conditions for complete details.
iv. The surrender values may be different than those illustrated above on account of multiple factors such as surrender
taking place before the end of the policy year, non-payment of all the instalment premiums payable in that policy year,
etc. The policyholder is advised to check the surrender value payable with the company before surrendering.
v. Tax benefits may be available as per the prevailing Income Tax laws.
Please refer to your sales brochure and policy document for more details.
I __________________________________,(Name) have explained the I ______________________________(Name), having received
premiums, and benefits under the product fully to the the information with respect to the above, have understood the
prospect / policyholder. above statement before entering into the contract.

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

ICICI Prudential Life Insurance Company Limited.

1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai - 400025
Email: lifeline@iciciprulife.com
www.iciciprulife.com
 CUSTOMER INFORMATION SHEET/KNOW
YOUR POLICY
This document provides key information about your policy. You are also advised to
go through your policy document.

Sl Title Description Policy

No Clause
(Please refer to applicable Policy Clause
Number in next column) Number
1 Name of Insurance ICICI Pru iProtect Smart Policy
Product and Unique schedule
Identification Number UIN: 105N151V13
(UIN)
2 Application number/ Policy
Policy Number schedule
3 Type of Insurance A Non-Participating Non-Linked Life Policy
Policy Individual Pure Risk Insurance Product schedule
4 Basic Policy details Sum Assured (Insurance Cover Amount) (in Policy
₹) : 50,00,000/- schedule
Premium Instalment in first policy year (in
₹) : 10,262/-
Premium Instalment from second policy
year onwards (in ₹) : 10,262/-
Payment frequency: Yearly
You need to pay premiums for: 15 in years
Policy Term : 15 years

5 Policy Benefits payable on maturity- Part C -Clause

Coverage/benefits Not applicable 1 ,1.6
payable Part D clause
Benefits payable on death- 3
In case of Regular/Limited Pay,Death benefit
will be higher of
7 times the annualized premium or
105% of the total premiums received
up to the date of death or diagnosis of
terminal illness or
the sum assured chosen by
You ,as stated on your policy schedule.

In case of single pay, Death benefit will be

higher of
125% of the single premium or
Sum Assured chosen by You, as
stated on your policy schedule.
 For more information, refer to Part C ,
Clause 1 of policy document.

Surrender benefits- On policy surrender,

Surrender Value equal to Unexpired risk
premium value will be payable

For more information related to surrender,

refer to Part D Clause 3 of policy document.

Lock-in period for Linked Insurance

products-
Not applicable

Survival Benefits excluding that payable on

maturity-Not Applicable

Options to policyholders for availing

benefits, if any, covered under the policy-
Life stage protection: Under Regular pay,
You can choose to increase the Sum
Assured at the key milestones of Life
Assured such as marriage and child birth/
adoption of child, provided no claim has
been admitted for any benefits under the
policy and the policy is in force.
For more details ,refer to Part C, Clause 1.6
of policy document

Other benefits/options payable, specific to

the policy, if any- Not Applicable

6 Options available (in Not Applicable

case of Linked
Insurance Products)
7 Option available (in Not Applicable
case of Annuity
product)
8 Riders opted, if any Not Applicable

9 Exclusions (events There are certain Exclusions for Waiver of Part D Clause
where insurance Premium on Permanent Disability due to 5
coverage is not accident, For Accidental Death Benefit, For
payable), if any ACI Benefit where we will not be liable to pay Part F, Clause
the respective benefit. 11
For more information, refer to Part D, Clause 5
of policy document

Suicide

If the Life Assured, whether sane or insane,

commits suicide within 12 months from the
date of commencement of risk of this Policy,
We will refund higher of 80% of the total
premiums paid, if any till the date of death or
unexpired risk premium value as available on
the date of death, provided the policy is in
force. For more information, refer to Part F,
Clause 11 of policy document
10 Waiting /lien Period, There is waiting period for Accelerated Part C ,Clause
if any Critical illness Benefit if opted . 1.5
For more information please refer Part C
,Clause 1.5 of policy document.
11 Grace Period 15 days-For monthly frequency of Part C-Clause
premium payment 4
30 days- For other frequencies of premium
payment

For more information, refer to Part C,

Clause 4 of policy document
12 Free Look Period 30 days Part D -Clause
1
For more information, refer to Part D,
Clause 1 of policy document
13 Lapse, paid-up and Lapse: If any premium instalment is not Part D-Clause
revival of the Policy paid within the grace period, then the 4,Clause 8
Policy shall lapse, and the cover will cease.
If the Policy is not revived within the revival
period, then the surrender value
(computed as on date of premium
discontinuance), if any, shall become
payable on the earliest of the following
events:
•Event of death or diagnosis of terminal
illness (whichever happens first) of the Life
Assured within the revival period,
•End of the revival period, and
 •Date of maturity .
For more details on Lapse ,refer to Part D,
Clause 4 of policy document

Revival: A Policy which has lapsed for

nonpayment of premium within the grace
period may be revived subject to
underwriting and other conditions. The
application for revival should be made
within 5 years from the due date of the first
unpaid premium and before the Date of
Maturity of the Policy. Revival will be
based on the prevailing Board approved
underwriting policy.
For more details on revival ,refer to Part D,
Clause 8 of policy document

14 Policy Loan, if Not applicable

applicable
15 Claims/Claims Turn around Time – For TAT details for Part F ,Clause
Procedure death claim refer to 10
https://www.iciciprulife.com/contact-
us/our-services-turn-around-times.html

For any assistance on Claims, you can call

Us on 18002660 (for calls within India) or
+91 8069385555 (for calls outside India).
You can also register a health or a death
claim by sending us an email at
claimsupport@iciciprulife.com

The claim form can be downloaded from

the following links:
Digital Claim Form Link:
https://buy.iciciprulife.com/buy/Claim-
Intimation.htm?execution=e2s1

Physical Claim Form Link:

https://www.iciciprulife.com/insurance-
library/life-insurance-claims-related-
faqs.html#linked_content

For information on documents required to

process claims, please refer to the policy
document (Part F, Clause 10) under the
 section ‘Specimen Policy Document’
available on our website at
https://www.iciciprulife.com/services/dow
nload-centre.html
16 Policy Servicing Turn around Time – For TAT details for Part G ,Clause
policy servicing - refer to 1
https://www.iciciprulife.com/contact-
us/our-services-turn-around-times.html

For any clarification or assistance, You

may contact Our advisor or call Our
customer service representative (between
10.00 a.m. to 7.00 p.m, Monday to
Saturday; excluding national holidays) on
18002660 or visit Our website:
www.iciciprulife.com.
Alternatively, You may communicate with
Us at any of our branches or the customer
service helpline number 18002660 or email
at lifeline@iciciprulife.com. For updated
contact details, We request You to
regularly check Our website.
17 Grievances 1. You may write to gro by visiting the Part G
/Complaints grievance redressal page of our
website:
https://www.iciciprulife.com/services/g
rievance-redressal.html. Alternatively,
you can contact the Grievance
redressal officer at our branches or
write to us at gro@iciciprulife.com

2. https://www.iciciprulife.com/services/g
rievance-redressal.html

3. Kindly refer the Insurance Ombudsman

details under part G under the
‘Specimen Policy Document’ available
at Download Centre | ICICI Prulife . This
is subject to change from time to time
Additionally, the contact details of
Ombudsman can be accessed
through
 https://www.cioins.co.in/Ombudsm
an

Note: In case of any conflict, the terms and conditions mentioned in the policy
document shall prevail
Declaration by the Policyholder

I have read the above and confirm having noted the details.

Place: (Signature of the Policyholder)

Date