[Date and Time of Illustration – 23 December 2024, 11:10 AM]
Name of the Prospect/Policyholder: Mr. Proposal No:
Age & Gender: 32 Years, Male Name of the Product: Max Life Smart Total Elite Protection Term Plan Tag Line: A Non-Linked Non-Participating Individual Pure Risk Premium Life Insurance Plan Name of the Life Insured: Mr. Unique Identification No: 104N125V06 Age & Gender: 32 Years, Male GST Rate (Base Policy, First Year): 18.00% Risk Class: Non Smoker GST Rate (Base Policy, Subsequent Year): 18.00%
Policy Term: 48 Years GST Rate (Rider, First Year): NA
Premium Payment Term: 10 Years GST Rate (Rider, Subsequent Year): NA
Amount of Installment Premium: `54,957 Max Life State: Haryana
Mode of payment of premium: Annual Policyholder Residential State: Haryana
This benefit illustration is intended to show year-wise premiums payable and benefits under the policy. Policy Details Sum Assured (in Rs.) 1,00,00,000 Sum Assured on Death (at inception of the policy) (in Rs.) 1,00,00,000
Optional Benefit Details
Optional Benefit Name Applicability/ Opted Sum Assured Coverage Term Payment Term
Accident Cover No NA NA NA
Rider Details
Rider Name Applicability/ Opted Sum Assured Coverage Term Payment Term
Waiver of Premium (WOP) Plus Rider No NA NA NA
Critical Illness and Disability Rider No NA NA NA
Premium Summary
Accelerated Critical Accidental Cover Waiver of Premium Critical Illness and Total Installment Base Plan Illness Cover Benefit Benefit Plus Rider Disability Rider Premium
Installment Premium without GST (in Rs.) 46,574 0 0 0 0 46,574
Installment Premium with first year GST (in Rs.) 54,957 0 0 0 0 54,957 Installment Premium with GST 2nd year onwards (in Rs.) 54,957 0 0 0 0 54,957
UIN: 104N125V06 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 1 of 3 (Amount in Rupees)
Guaranteed Benefits Non Guaranteed
Single/ Annualized Premium Policy Year Survival Benefits/ Other Benefits, if Special Exit Guranteed Special Surrender Surrender Value Maturity Benefit Death Benefit Exit Value Loyalty Additions any Value* Surrender Value Value Payable EOY
1 46,574 - - NA 1,00,00,000 - - NA NA NA
2 46,574 - - NA 1,00,00,000 - - NA NA NA
3 46,574 - - NA 1,00,00,000 - - NA NA NA
4 46,574 - - NA 1,00,00,000 - - NA NA NA
5 46,574 - - NA 1,00,00,000 - - NA NA NA
6 46,574 - - NA 1,00,00,000 - - NA NA NA
7 46,574 - - NA 1,00,00,000 - - NA NA NA
8 46,574 - - NA 1,00,00,000 - - NA NA NA
9 46,574 - - NA 1,00,00,000 - - NA NA NA
10 46,574 - - NA 1,00,00,000 2,58,098 - NA NA NA
11 - - - NA 1,00,00,000 2,51,306 - NA NA NA
12 - - - NA 1,00,00,000 2,44,514 - NA NA NA
13 - - - NA 1,00,00,000 2,37,721 - NA NA NA
14 - - - NA 1,00,00,000 2,30,929 - NA NA NA
15 - - - NA 1,00,00,000 2,24,137 - NA NA NA
16 - - - NA 1,00,00,000 2,17,345 - NA NA NA
17 - - - NA 1,00,00,000 2,10,553 - NA NA NA
18 - - - NA 1,00,00,000 2,03,761 - NA NA NA
19 - - - NA 1,00,00,000 1,96,969 - NA NA NA
20 - - - NA 1,00,00,000 1,90,177 - NA NA NA
21 - - - NA 1,00,00,000 1,83,385 - NA NA NA
22 - - - NA 1,00,00,000 1,76,593 - NA NA NA
23 - - - NA 1,00,00,000 1,69,801 - NA NA NA
24 - - - NA 1,00,00,000 1,63,009 - NA NA NA
25 - - - NA 1,00,00,000 1,56,217 - NA NA NA
26 - - - NA 1,00,00,000 1,49,425 - NA NA NA
27 - - - NA 1,00,00,000 1,42,633 - NA NA NA
28 - - - NA 1,00,00,000 1,35,841 - NA NA NA
29 - - - NA 1,00,00,000 1,29,049 - NA NA NA
30 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
UIN: 104N125V06 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 2 of 3 Guaranteed Benefits Non Guaranteed Single/ Annualized Premium Policy Year Survival Benefits/ Other Benefits, if Special Exit Guranteed Special Surrender Surrender Value Maturity Benefit Death Benefit Exit Value Loyalty Additions any Value* Surrender Value Value Payable EOY
31 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
32 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
33 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
34 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
35 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
36 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
37 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
38 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
39 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
40 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
41 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
42 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
43 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
44 - - - NA 1,00,00,000 - 4,65,740 NA NA NA
45 - - - NA 1,00,00,000 20,376 - NA NA NA
46 - - - NA 1,00,00,000 13,584 - NA NA NA
47 - - - NA 1,00,00,000 6,792 - NA NA NA
48 - - - NA 1,00,00,000 - - NA NA NA
Notes: • Annualized Premium includes base policy and additional benefits premium, if opted. It excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any, and Goods and Service Tax. • *Special Exit Value - The policyholder has an option to terminate the policy and get back all the premiums they have paid till date, excluding taxes. This option can be exercised in any policy year starting 30th Policy year, but not during the last 4 policy years. This shall be allowed to policyholders who have opted for a Policy Term of 40 years and above. • Refer Sales literature (Prospectus) for explanation of terms used in this illustration.
I, ……………………………………………. (name), have explained the premiums, and benefits I, ……………………………………………. (name), having received the information with respect under the product fully to the prospect / policyholder. to the above, have understood the above statement before entering into the contract.
Place: Signature / Thumb Impression / Electronic Signature of Date:12/23/24 Signature / Thumb Impression / Electronic Signature of Date: 12/23/24 Agent / Intermediary / Official of the insurer Prospect / Policyholder This system generated benefit illustration shall be treated as signed by me.
UIN: 104N125V06 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 3 of 3
