For Office Use Only (w.e.f. Sep 24/ Ver 1.
0)
Illustration No: KET-2540M-8882-Y19
Quotation Number: 01231224181716257
Proposal No:
Policy No:
Name of the Prospect/Policyholder Name of the Product Kotak e-Term
DOB of the Prospect/Policyholder 09 January 1999 Tag Line A Non-Participating Non-Linked
Life Insurance Individual Pure Risk
Age of the Prospect/Policyholder 25
Product
(in yrs)
Unique Identification No UIN: 107N129V03
Name of Life Assured
Goods and Services Tax and Cess 18%
DOB of Life Assured 09 January 1999
Rate (GST)
Age of the Life Assured (in yrs) 25
Rider Goods and Services Tax and 18%
Gender of Life Assured Male Cess Rate (GST)
Tobacco User No Salaried Customer No
Policy Term (in yrs) 40 Existing Customer No
Premium Payment Term (in yrs) 40 Existing Policy number Not Applicable
Amount of Installment Premium (in 18,600 Kotak Group Employee No
Rs.)
Backdation Date Chosen Not Applicable
Mode of Payment of Premium Yearly
Channel Name Corporate Agents
Agent's Branch Location Maharashtra
Prospect/Policyholder's Current Maharashtra
Location
POLICY DETAILS
Plan Option : Life Base Sum Assured (Rs.) : 2,00,00,000
Payout Option : Immediate Payout Sum Assured on Death (at inception of the policy) Rs. : 2,00,00,000
Step Up Option : No
Yearly Step Up Fee (Rs.) : Not Applicable
Page 1 of 5
Quotation Number:01231224181716257
Rider Details
Rider Sum Rider Premium
Rider Name Option Availed Rider Term Rider Premium
Assured Payment Term
Kotak Critical Illness Plus Benefit Rider
No Not Selected
(UIN: 107B020V02)
Kotak Permanent Disability Benefit Rider
No Not Selected
(UIN: 107B002V03)
PREMIUM SUMMARY
Base Plan Riders Total Installment Premium
Installment First Year Premium <<including Step-Up Option
18,600 0 18,600
fee, if any>> without GST (Rs.) :
Installment Second Year Premium <<including Step-Up
18,600 0 18,600
Option fee, if any>> without GST (Rs.) :
Installment First Year Premium <<including Step-Up Option
21,948 0 21,948
fee, if any>> with GST (Rs.) :
Installment Second Year Premium <<including Step-Up
21,948 0 21,948
Option fee, if any>> with GST (Rs.) :
Page 2 of 5
Quotation Number:01231224181716257
BENEFIT ILLUSTRATION TABLE
Guaranteed Benefits
Voluntary Termination
End of Policy Year Age of Life Assured Annualized Premium (Rs.) Death Benefit(Rs.)
Value(Rs.)
1 26 18,600 2,00,00,000 0
2 27 18,600 2,00,00,000 0
3 28 18,600 2,00,00,000 0
4 29 18,600 2,00,00,000 0
5 30 18,600 2,00,00,000 0
6 31 18,600 2,00,00,000 0
7 32 18,600 2,00,00,000 0
8 33 18,600 2,00,00,000 0
9 34 18,600 2,00,00,000 0
10 35 18,600 2,00,00,000 0
11 36 18,600 2,00,00,000 0
12 37 18,600 2,00,00,000 0
13 38 18,600 2,00,00,000 0
14 39 18,600 2,00,00,000 0
15 40 18,600 2,00,00,000 0
16 41 18,600 2,00,00,000 0
17 42 18,600 2,00,00,000 0
18 43 18,600 2,00,00,000 0
19 44 18,600 2,00,00,000 0
20 45 18,600 2,00,00,000 0
21 46 18,600 2,00,00,000 0
22 47 18,600 2,00,00,000 0
23 48 18,600 2,00,00,000 0
24 49 18,600 2,00,00,000 0
25 50 18,600 2,00,00,000 0
26 51 18,600 2,00,00,000 0
27 52 18,600 2,00,00,000 0
28 53 18,600 2,00,00,000 0
29 54 18,600 2,00,00,000 0
30 55 18,600 2,00,00,000 0
31 56 18,600 2,00,00,000 0
32 57 18,600 2,00,00,000 0
33 58 18,600 2,00,00,000 0
34 59 18,600 2,00,00,000 0
35 60 18,600 2,00,00,000 0
36 61 18,600 2,00,00,000 0
37 62 18,600 2,00,00,000 0
Page 3 of 5
38 63 18,600 2,00,00,000 0
39 64 18,600 2,00,00,000 0
40 65 18,600 2,00,00,000 0
Notes: Annualized Premium excludes underwriting extra Premium, Step-up Option fee, if any, frequency loadings on premiums, the premiums
paid towards the riders, if any and Goods and Services Tax.
Page 4 of 5
Quotation Number:01231224181716257
Terms & Conditions:
1. This is A Non-Participating non-linked life insurance individual pure risk Product. The illustration stated is for a healthy individual and would be
subject to underwriting.
2. Premium payable in a policy year including Extra Premium (if any), but excluding Goods and Services Tax and Cess and Rider Premium, if any.
3. There is no maturity benefit payable under this plan.
4. The above illustrated benefits are derived on the basis of details of life insured provided at the time of filling the proposal form.If the details are
found inaccurate or there are any changes before or at the time of the policy issuance for eg: change in Age, The illustrated benefits will be
subject to revision
5. Goods and Services Tax and Cess as applicable shall be levied at the applicable Tax rates in accordance with the prevailing Tax Laws. Prevailing
Tax Laws will be applicable on this policy which may vary from time to time.
6. TDS at prevailing rate will be deducted from any amount paid under a life insurance policy subject to the provisions of prevailing tax laws.In case
of non-availability of valid PAN, TDS will be deducted at higher rate. Tax laws are subject to changes from time to time. Kindly consult your tax
advisor for tax implication of your policy.
7. The values shown are for illustrative purposes only. for more details on risk factors, terms and conditions please read Sales Brochure carefully
before concluding a sale.
I, _____________________________(Name), have explained the I, ____________________________(Name), having received the
premiums and benefits under the product fully to the prospect / information with respect to the above, have understood the above
policyholder. statement before entering into the contract.
Place :_____________ __________________________________
Date :_____________ Signature of Agent /Intermediary/Official Place :_____________ ______________________________
of the Insurer Date :_____________ Signature of Prospect / Policyholder
[ ] Digitally Accepted for Prospect / Policyholder
Kotak Mahindra Life Insurance Company Limited.
CIN: U66030MH2000PLC128503
Regd. Office: 8th Floor, Plot# C-12, G-Block, BKC, Bandra (E), Mumbai - 400 051
Regn. No: 107. Toll Free No.: 1800 209 8800. WhatsApp:9321003007. Website: https://www.kotaklife.com
Page 5 of 5
