Proposal No:

Name of the Prospect/Policyholder: Mr. Aman Name of the Product: Max Life Online Savings Plan
A Unit Linked Non Participating Individual Life
Age & Gender: 20 Years, Male Tag Line:
Insurance Plan
Name of the Life Assured: Mr. Aman Policy Option: Variant 1
Unique Identification No: 104L098V06
Age & Gender: 20 Years, Male GST Rate: 18.00%
Max Life State: Haryana
Sum Assured: `3,60,000 Policyholder Residential
Haryana
Policy Term & Premium Payment 10 Years & 5 Years State/Country:
Amount of Installment Premium: `3,000 Investment Strategy Opted for: NA
Mode of payment of premium: Monthly Funds opted for along with their Midcap Momentum Index Fund (Risk Rating-Very
risk level (Please specify the High) : 100%
customer specific fund option):

How to read and understand this benefit illustration?

This benefit illustration is intended to show what charges are deducted from your premiums and how the unit fund, net of charges and taxes, may grow over the years of
the policy term if the fund earns a gross return of 8% p.a. or 4% p.a. These rates, i.e., 8% p.a. and 4% p.a. are assumed only for the purpose of illustrating the flow of
benefits if the returns are at this level. It should not be interpreted that the returns under the plan are going to be either 8% p.a. or 4% p.a.
Net Yield mentioned corresponds to the gross investment return of 8% p.a., net of all charges but does not consider mortality, morbidity charges, underwriting extra, if
any, guarantee charges and cost of riders, if deducted by cancellation of units. It demonstrates the impact of charges exclusive of taxes on the net yield. Please note that
the mortality charges per thousand sum assured in general, increases with age.
The actual returns can vary depending on the performance of the chosen fund, charges towards mortality, morbidity, underwriting extra, cost of riders, etc. The
investment risk in this policy is borne by the policyholder, hence, for more details on terms and conditions please read sales literature carefully.
Part A of this statement presents a summary view of year-by-year charges deducted under the policy, fund value, surrender value and the death benefit, at two assumed
rates of return. Part B of this statement presents a detailed break-up of the charges, and other values.
Note: Some benefits are guaranteed and some benefits are variable with returns based on the future performance of your insurer carrying on life insurance business. If
your policy offers guaranteed benefits then these will be clearly marked “guaranteed” in the illustration table on this page. If your policy offers variable benefits then the
illustration on this page will show two different rates of assumed future investment returns. These assumed rates of return are not guaranteed and they are not the
upper or lower limits of what you might get back, as the value of your policy is dependent on a number of factors including actual future investment performance.

UIN: 104L098V06 Page 1 of 6

 Rider Details
Critical Illness and Disability Rider - Coverage
NA
Critical Illness and Disability-Secure Rider - Rider Premium Payment Variant
NA
Term and Rider Term Critical Illness and Disability Rider - Rider Sum
NA
Assured

Premium Summary
Max Life Critical Illness and Disability-
Base Plan Total Installment Premium
Secure Rider

Installment Premium without GST (in Rs.) 3,000 0 3,000

Installment Premium with first year GST (in Rs.) 3,000 0 3,000

Installment Premium with GST 2nd year onwards

3,000 0 3,000
(in Rs.)

UIN: 104L098V06 Page 2 of 6

 Part A
(Amount in Rupees.)
At 4% p.a. Gross Investment Return At 8% p.a. Gross Investment Return
Policy Annualized Mortality, Mortality,
Year Premium Fund at Surrender Death Fund at Surrender Death
Morbidity Other Charges* GST Morbidity Other Charges* GST
End of Year Value Benefit End of Year Value Benefit
Charges Charges

1 2 3 4 5 6 7 8 9 10 11 12 13 14

1 36,000 242 246 88 36,190 32,650 3,60,000 242 249 88 36,943 33,403 3,60,000

2 36,000 225 708 168 73,294 70,934 3,60,000 224 731 172 76,275 73,915 3,60,000

3 36,000 200 1,181 249 1,11,343 1,09,573 3,60,000 196 1,243 259 1,18,161 1,16,391 3,60,000

4 36,000 175 1,667 332 1,50,360 1,49,180 3,60,000 168 1,789 352 1,62,766 1,61,586 3,60,000

5 36,000 147 2,164 416 1,90,374 1,90,374 3,60,000 135 2,370 451 2,10,270 2,10,270 3,60,000

6 - 132 2,427 461 1,94,913 1,94,913 3,60,000 114 2,737 513 2,23,607 2,23,607 3,60,000

7 - 130 2,485 471 1,99,567 1,99,567 3,60,000 104 2,911 543 2,37,810 2,37,810 3,60,000

8 - 127 2,545 481 2,04,340 2,04,340 3,60,000 92 3,096 574 2,52,938 2,52,938 3,60,000

9 - 124 2,605 491 2,09,234 2,09,234 3,60,000 81 3,293 607 2,69,049 2,69,049 3,60,000

10 - 123 2,668 502 2,14,249 2,14,249 3,60,000 69 3,503 643 2,86,207 2,86,207 3,60,000
*See Part B for details

IN THIS POLICY, THE INVESTMENT RISK IS BORNE BY THE POLICYHOLDER AND THE ABOVE INTEREST RATES ARE ONLY FOR ILLUSTRATIVE PURPOSE.

I ALSO UNDERSTAND THAT WHILST 100% OF MY FIRST YEAR PREMIUM WILL BE INVESTED IN UNIT LINKED INVESTMENT FUNDS THERE ARE CHARGES DURING THE FIRST POLICY
YEAR AS GIVEN IN THE BENEFIT ILLUSTRATION.

UIN: 104L098V06 Page 3 of 6

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

Place
Signature / OTP Confirmation Date / Thumb
Date: 11/24/24
Impression / Electronic Signature of Agent/ Date: 11/24/24 Signature / OTP Confirmation Date / Thumb
Intermediary / Official Impression / Electronic Signature of Prospect/
Policyholder
This system generated benefit illustration shall be treated as signed by me.

Part B
Gross Yield 8% p.a. Net Yield 6.65% Amount in Rupees
Annualized
Annualized Premium Premium - Policy
Policy Mortality Guarantee Other Additions to Fund before Fund at End Surrender Death
Premium Allocation Premium GST Admin. FMC
Year Charge Charge Charges* the fund* FMC of the Year Value Benefit
(AP) Charge (PAC) Allocation Charge
Charges

1 36,000 - 36,000 242 88 - - - - 36,989 249 36,943 33,403 3,60,000

2 36,000 - 36,000 224 172 - - - - 76,369 731 76,275 73,915 3,60,000

3 36,000 - 36,000 196 259 - - - - 1,18,307 1,243 1,18,161 1,16,391 3,60,000

4 36,000 - 36,000 168 352 - - - - 1,62,967 1,789 1,62,766 1,61,586 3,60,000

5 36,000 - 36,000 135 451 - - - - 2,10,530 2,370 2,10,270 2,10,270 3,60,000

6 - - - 114 513 - - - - 2,23,884 2,737 2,23,607 2,23,607 3,60,000

7 - - - 104 543 - - - - 2,38,105 2,911 2,37,810 2,37,810 3,60,000

UIN: 104L098V06 Page 4 of 6

 Annualized
Annualized Premium Premium - Policy
Policy Mortality Guarantee Other Additions to Fund before Fund at End Surrender Death
Premium Allocation Premium GST Admin. FMC
Year Charge Charge Charges* the fund* FMC of the Year Value Benefit
(AP) Charge (PAC) Allocation Charge
Charges

8 - - - 92 574 - - - - 2,53,251 3,096 2,52,938 2,52,938 3,60,000

9 - - - 81 607 - - - - 2,69,382 3,293 2,69,049 2,69,049 3,60,000

10 - - - 69 643 - - - - 2,86,561 3,503 2,86,207 2,86,207 3,60,000

Gross Yield 4% p.a. Amount in Rupees

Annualized
Annualized Premium Premium - Policy
Policy Mortality Guarantee Other Additions to Fund before Fund at End Surrender Death
Premium Allocation Premium GST Admin. FMC
Year Charge Charge Charges* the fund* FMC of the Year Value Benefit
(AP) Charge (PAC) Allocation Charge
Charges

1 36,000 - 36,000 242 88 - - - - 36,235 246 36,190 32,650 3,60,000

2 36,000 - 36,000 225 168 - - - - 73,384 708 73,294 70,934 3,60,000

3 36,000 - 36,000 200 249 - - - - 1,11,481 1,181 1,11,343 1,09,573 3,60,000

4 36,000 - 36,000 175 332 - - - - 1,50,546 1,667 1,50,360 1,49,180 3,60,000

5 36,000 - 36,000 147 416 - - - - 1,90,609 2,164 1,90,374 1,90,374 3,60,000

6 - - - 132 461 - - - - 1,95,154 2,427 1,94,913 1,94,913 3,60,000

7 - - - 130 471 - - - - 1,99,814 2,485 1,99,567 1,99,567 3,60,000

8 - - - 127 481 - - - - 2,04,593 2,545 2,04,340 2,04,340 3,60,000

9 - - - 124 491 - - - - 2,09,493 2,605 2,09,234 2,09,234 3,60,000

UIN: 104L098V06 Page 5 of 6

 Annualized
Annualized Premium Premium - Policy
Policy Mortality Guarantee Other Additions to Fund before Fund at End Surrender Death
Premium Allocation Premium GST Admin. FMC
Year Charge Charge Charges* the fund* FMC of the Year Value Benefit
(AP) Charge (PAC) Allocation Charge
Charges

10 - - - 123 502 - - - - 2,14,514 2,668 2,14,249 2,14,249 3,60,000

*There are no charges included in other charges. There are no additions included on Additions to the fund.
Notes: 1. Refer the sales literature for explanation of terms used in this illustration.
2. Fund management charge is based on the specific fund option(s) chosen.
3. In case rider charges are collected explicitly through collection of rider premium, and not by way of cancellation of units, then, such charges are not considered in this illustration. In
other cases, rider charges are included in other charges.

I, ……………………………………………. (name), have explained the

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

Place
Date: 11/24/24 Signature / OTP Confirmation Date / Thumb
Impression / Electronic Signature of Agent/
Intermediary / Official Date: 11/24/24 Signature / OTP Confirmation Date / Thumb
Impression / Electronic Signature of Prospect/
Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104L098V06 Page 6 of 6