BENEFIT ILLUSTRATION

[Date and Time of Illustration – 21 February 2025, 03:45 PM]

Name of the Prospect/Policyholder: Mr. Proposal No:

Age & Gender: 37 Years, Male Name of the Product: Axis Max Life Smart Term Plan Plus
Name of the Life Assured: Mr. Ankit Ji Tag Line: A Non-Linked Non-Participating Individual Pure Risk Life Insurance Plan
Age & Gender: 37 Years, Male Unique Identification No: 104N127V01
Risk Class: Non-Smoker GST Rate (Base Policy, First Year): 18.00%
Policy Term: 48 Years GST Rate (Base Policy, Subsequent Year): 18.00%
Premium Payment Term: 23 Years GST Rate (Rider, First Year): NA
Amount of Installment Premium: Rs.56199 GST Rate (Rider, Subsequent Year): NA
Mode of payment of premium: Annual
Axis Max Life State: Rajasthan
Discount Applicable: NA
Policyholder Residential State: Rajasthan
Female Discount (throughout PPT): NA
First Year Discount%: NA
First Year Discount: NA
Second Year & Onwards Discount%: NA
Second Year & Onwards Discount: NA

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

Policy Details
Plan Variant Smart Cover Sum Assured (in Rs.) 1,00,00,000
Sum Assured on Death (at inception of the policy) (in Rs.) 1,50,00,000

Optional Benefit Details

Optional Benefit Name Applicability/ Opted Sum Assured Coverage Term Payment Term

Maternity 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
Accidental Death And DIsmemberment Rider No NA NA NA

UIN: 104N127V01 Axis 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 4
 Premium Summary
Accidental Death And
Dismemberment Waiver of Premium Critical Illness and Total Installment
Type Base Plan Maternity Cover
Rider Plus Rider Disability Rider Premium

Installment Premium without GST (in Rs.) 47,626 0 0 0 0 47,626

Installment Premium with first year GST (in Rs.) 56,199 0 0 0 0 56,199
Installment Premium with GST 2nd year onwards (in Rs.) 56,199 0 0 0 0 56,199

(Amount in Rupees)

Guaranteed Non Guaranteed

Single/ Annualized Premium
Policy Year
Survival Benefits/ Other Benefits, if Early Exit Special Exit Guaranteed Special Surrender Surrender Value
Maturity Benefit Death Benefit Payable (EOY)
Loyalty Additions any Value Value Surrender Value Value

1 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
2 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
3 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
4 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
5 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
6 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
7 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
8 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
9 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
10 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
11 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
12 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
13 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
14 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
15 47,626 0 0 0 1,50,00,000 0 0 NA NA NA
16 47,626 0 0 0 1,00,00,000 0 0 NA NA NA
17 47,626 0 0 0 1,00,00,000 0 0 NA NA NA
18 47,626 0 0 0 1,00,00,000 0 0 NA NA NA
19 47,626 0 0 0 1,00,00,000 0 0 NA NA NA
20 47,626 0 0 0 1,00,00,000 0 0 NA NA NA
21 47,626 0 0 0 1,00,00,000 0 0 NA NA NA
22 47,626 0 0 0 1,00,00,000 0 0 NA NA NA
23 47,626 0 0 0 1,00,00,000 3,99,364 0 NA NA NA

UIN: 104N127V01 Axis 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 4
 Guaranteed Non Guaranteed
Single/ Annualized Premium
Policy Year
Survival Benefits/ Other Benefits, if Early Exit Special Exit Guaranteed Special Surrender Surrender Value
Maturity Benefit Death Benefit Payable (EOY)
Loyalty Additions any Value Value Surrender Value Value

24 0 0 0 0 1,00,00,000 3,83,389 0 NA NA NA
25 0 0 0 0 1,00,00,000 3,67,415 0 NA NA NA
26 0 0 0 0 1,00,00,000 3,51,440 0 NA NA NA
27 0 0 0 0 1,00,00,000 3,35,466 0 NA NA NA
28 0 0 0 0 1,00,00,000 3,19,491 0 NA NA NA
29 0 0 0 0 1,00,00,000 3,03,517 0 NA NA NA
30 0 0 0 0 1,00,00,000 2,87,542 10,95,398 NA NA NA
31 0 0 0 0 1,00,00,000 2,71,567 10,95,398 NA NA NA
32 0 0 0 0 1,00,00,000 2,55,593 10,95,398 NA NA NA
33 0 0 0 0 1,00,00,000 2,39,618 10,95,398 NA NA NA
34 0 0 0 0 1,00,00,000 2,23,644 10,95,398 NA NA NA
35 0 0 0 0 1,00,00,000 2,07,669 10,95,398 NA NA NA
36 0 0 0 0 1,00,00,000 1,91,695 10,95,398 NA NA NA
37 0 0 0 0 1,00,00,000 1,75,720 10,95,398 NA NA NA
38 0 0 0 0 1,00,00,000 1,59,746 10,95,398 NA NA NA
39 0 0 0 0 1,00,00,000 1,43,771 10,95,398 NA NA NA
40 0 0 0 0 1,00,00,000 1,27,796 10,95,398 NA NA NA
41 0 0 0 0 1,00,00,000 1,11,822 10,95,398 NA NA NA
42 0 0 0 0 1,00,00,000 95,847 10,95,398 NA NA NA
43 0 0 0 0 1,00,00,000 79,873 10,95,398 NA NA NA
44 0 0 0 0 1,00,00,000 63,898 10,95,398 NA NA NA
45 0 0 0 0 1,00,00,000 47,924 0 NA NA NA
46 0 0 0 0 1,00,00,000 31,949 0 NA NA NA
47 0 0 0 0 1,00,00,000 15,975 0 NA NA NA
48 0 0 0 0 1,00,00,000 0 0 NA NA NA

Notes:
1. 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.

UIN: 104N127V01 Axis 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 4
I, …………………………………………….(name),have explained the premiums, and benefits I, Mr.(name), having received the information with respect to the above, have understood the
under the product fully to the prospect / policyholder. above statement before entering into the contract.

Place: Signature / Thumb Impression / Electronic Signature of Date:2/21/25 Signature / Thumb Impression / Electronic Signature of
Date: 2/21/25 Agent / Intermediary / Official of the insurer Prospect / Policyholder

This system generated benefit illustration shall be treated as signed by me.

UIN: 104N127V01 Axis Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 4 of 4