18-Oct-2014

Mr VVN Murthy
Door No 7-75
4th Mile
Nuvalakula Gardens
Nellore 524002 Policy No 10170440
AndhraPradesh India
Mob No-9966802424 Client Id. 50847222
Ph. No- 0
Home No- 0
Proposal No. NNU75578265
Policy No:10170440 / Client ID:50847222

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Dear Mr VVN Murthy,

Welcome to the world of Aviva Life Insurance

Thank you for applying online and purchasing an Aviva Life Insurance Policy, the companion in your journey of creating wealth and
happiness.

As your preferred life insurance partner, it is our pleasure to ensure a brighter future for you and your near ones. You are now part of a
big family - one of the world's most trusted insurance group. The Aviva Group has over 300 years' experience in the global life
insurance business. Our wide range of insurance solutions ensures peace and prosperity throughout your life.

Please find your Policy Document designed to help you understand your Aviva Policy better. Please spend some time going through it
so you can make the most out of it. We have also enclosed a copy of the proposal form filled online by you on the basis of which this
policy has been issued.

In case you are not satisfied with the Policy's terms and conditions, you can reconsider your decision of purchasing it within 30 days of
receiving the Policy Document. Kindly refer to the 'Your Right to Reconsider' section of the document for more details.

At Aviva, we will be glad to assist you with our Customer Care services, designed for your convenience. You can get in touch with us for
any of your needs - be it for policy claim procedures or to get your complaints resolved.

We would also like to mention that your next premium is due on 13-Apr-2015. Do pay your premiums on time to enjoy the complete
Policy benefits.

If you wish to enquire about any aspect of your Policy, please feel free to contact any of our contact points mentioned below. We look
forward to a long and healthy relationship with you.

Yours Sincerely,

Vijayalakshmi Natarajan
Director - Operations

You can also reach us directly at the contact points mentioned below. We will be happy to provide you our best services always.
www.avivaindia.com| )1800-103-7766 / 0124-2709046|@customerservices@avivaindia.com

* Ver MPP_WL_V1
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Page:2/34
 Most Important Terms about your
Aviva i-Growth

Your Policy at a glance:

Type of Policy Unit Linked Insurance Plan (ULIP)

Name of the Life Insured Mr VVN Murthy Date of Birth 01-Aug-1965

Policy No. 10170440 Sum Assured / Insurance Cover ` 360,000

Policy Term 10 Years Premium Payment Term 10 Years

Premium Amount / Frequency ` 18,000 / Half Yearly Last Premium Payment Date 13-Apr-2024

Policy Start Date 13-Oct-2014 Date of Maturity 13-Oct-2024

Nominee Mrs Sarada Konda

What are the benefits of this Policy?

You will get an amount equal to the Fund Value along with loyalty
What do I get at the end of the Policy Term
additions as on 13-Oct-2024 (after 10 years).
(Maturity Benefit)?

Your Nominee Mrs Sarada Konda will get an assured payout of

What will my Nominee(s) get(Death Benefit)? Rs.360,000 or 105% of premiums paid or the Fund Value (whichever
is higher), in case of death of life Insured. The Policy will terminate
after the payout.

What do I need to pay to get these benefits?

For how long do I need to pay premium
10 years (up to year 2024).
(Premium Payment Term)?

How much premium do I need to pay?
Are there any charges in this Policy?
You need to pay a premium amount of Rs.18,000 in the month of
October & April every year.
Yes, charges apply in this Policy. For details, refer to the Terms &
Condition(enclosed) and the benefit illustration signed by you
(enclosed).These charges are deducted from your Fund Value and
need not be paid separately.

Are there any other critical points I need to know?

No, the returns will depend on the performance of the funds
Are the returns in this Policy guaranteed? selected by you. The investment risk in this Policy is borne by you.

In case of an emergency, can I withdraw money
from this Policy?
What happens if I stop paying premiums within the
first 5 years?
Yes . But this flexibility is available to you only after 5 years (lock-in
period).
Your money will be transferred to a specific (discontinuance) fund
after deduction of discontinuance charge. The funds are available
after 5 years and could be less than the total premiums paid by you.
You are advised to pay premium for all 10 years.Insurance benefits
will cease or reduce in case you stop paying premiums.

Smart Tip:
• Your benefit payout will get impacted in case any inaccurate information is filled by you in the Proposal
Form. Please read through the Proposal Form (enclosed) and inform us about inaccuracies, if any.
• In case you are not in agreement with any of the Terms and Conditions (enclosed), you have the option
to cancel the Policy within 30 days of receiving this Policy Document. You will get full refund after
deduction of applicable charges.

Note: These are not the detailed Terms and Conditions of the Policy. Please read the Policy Document for the same.

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This page is intentionally left blank

Page:4/34
Note: In this Policy, the investment risk in the investment portfolio is borne by the Policyholder.
10170440 Aviva I-Growth 122L106V01
Plan Type Non-Participating Unit Linked Plan
Allocation Proportion Balanced Fund-II 100% Bond Fund-II N/A Enhancer Fund-II N/A

Mr VVN Murthy 13/10/2014

01/08/1965 ` 360,000.00
49 Annualised Premium ` 36,000.00
Male
Minimum Sum Assured ` 360,000.00
Pan Card Regular Premium* ` 18,000.00
Door No 7-75 4th Mile Nuvalakula Gardens
` 18,000.00
Nellore 524002
AndhraPradesh India Half Yearly
10 Years
10 Years
13/10/2024
Self Due date for payment of last 13/04/2024
Regular Premium
Accidental Death Sum Assured ` 360,000.00
Accidental Death cover expiry date 13/10/2024

Mr VVN Murthy
01/08/1965
49 Mrs Sarada Konda
Male 100%
Pan Card Door No 7-75 4th Mile Nuvalak
Door No 7-75 4th Mile Nuvalakula Gardens Gardens AndhraPradesh 524002
Nellore 524002 Nellore India
AndhraPradesh India
Wife

N/A
Married
Y - Income Tax PAN Number

N/A
N/A

N/A N/A

N/A Policy Classification : Individual

Insured
Mr VVN Murthy
Whether Age Admitted : Y - Income Tax PAN Number
Benefits Extra Mortality Rating Flat Extra(per 1000 of sum assured)
Death Benefit N/A N/A
AVIVA Accidental Death Benefit N/A N/A

Page:5/34
 Table of Charges
Nature of Charge Rate applicable at the Commencement Date Maximum Limit
1) Premium Allocation Charge : Allocation Rate: This charge is
This is a percentage of the guaranteed not to
premium appropriated towards Policy Year Policy Term (in years) change during the
charges from the premium Policy Term.
received. This is a charge levied 10 & 15 20
at the time of receipt of premium.
(calculated as 100% minus the
st nd rd th
applicable Allocation Rate) 1 , 2 , 3 and - 4 95.0% 96%

5
th 95.5% 97%

th
6 onwards 100% 100%

2)Policy Administration Charge This charge is

(PAC): guaranteed not to
Policy Year PAC per month
change during the
This is a charge levied at the Policy Term.
1st to 5th 0.10% of Annualised Premium
beginning of each policy month
6 onwards 0.05% of Annualised Premium
from the unit account by
cancelling Units for equivalent
amount. The Policy Administration Charge is applicable throughout the Policy Term with a maximum
limit of Rs. 400 per month.
3) Mortality Charge: Mortality Charges are given in the enclosed table. The Mortality Charge
shall remain
This is the cost of life insurance guaranteed
cover under the Policy. This is throughout the
· The Mortality Charge will apply on the Sum at Risk (SAR) as defined below provided the
levied at the beginning of each Policy Term.
SAR works out to be greater than zero otherwise no mortality charge will be deducted.
policy month from the unit
account by cancelling Units of the SAR=”A” minus Fund Value
equivalent amount.
Where “A”= Higher (Sum Assured, 105% of Regular Premiums Received)
Rs.0.60 per annum per Rs. 1,000 of In-built Accidental Death Sum Assured
4) Fund Management Charge: This charge is
Fund M anagement Charge (FMC) of 1.35% per annum will be applied on the below given guaranteed not to
This is a charge levied at the time change during the
of computation of NAV and shall Funds while calculating the NAV on a daily basis: Policy Term.
be appropriated by adjusting the
NAV.
Fund
Balanced Fund-II
Bond Fund-II
Enhancer Fund-II

Discontinued Policy Fund Management Charge : 0.50% per annum or as per the guidelines
issued by the IRDA from time to time.
5) Switching Charge: First 12 switches in a Policy Year: Nil Rs.500 per switch.
This is a charge levied on
switching of monies from one On subsequent switches in that Policy Year, the Switching Charge will be 0.5% of the amount
Fund to another available Fund switched subject to a maximum of Rs.500 per switch.
under the Policy, beyond the free
switching transactions under the
Policy, if any.
6) Miscellaneous Charge: As notified by the Government from time to time. As notified by the
Service Tax Charge: Government from
time to time.
The above charge will be made
by cancellation of Units from the
Policy unit account.
7) Discontinuance Charge: The Discontinuance Charge will be applied on Units pertaining to Regular Premium on the This charge is
basis of completed Policy Years, premiums paid and the Date of Complete Withdrawal as per guaranteed not to
This is a charge which will be
the table below: change during the
recovered from value of Units
pertaining to Regular Premium at Where the Policy is Policy Term.
the time of Complete Withdrawal. discontinued during the Discontinuance charges
Policy Year
Lowest of the following amounts:
I. 6% of Annualised Premium
1
II. 6% of Fund Value
III. Rs. 6,000

2 Lowest of the following amounts:

I. 4% of Annualised Premium
II. 4% of Fund Value
III. Rs. 5,000

3 Lowest of the following amounts:

I. 3% of Annualised Premium
II. 3% of Fund Value
III. Rs. 4,000
Lowest of the following amounts:
I. 2% of Annualised Premium
4
II. 2% of Fund Value
III. Rs. 2,000

5 and onward Nil

8) Discontinuance Charge Nil This charge is

on Units pertaining to Top guaranteed not to
Up Premium change during the
Policy Term.

9) Alteration charges Rs.100* This charge is

This is a charge levied at the guaranteed not to
time of change in Premium change during the
Frequency Policy Term.

* Service tax or any other applicable taxes will be charged and/ or deducted on/ from the unit account at the prevailing rate. Tax laws are subject to change.
Page:6/34
Endorsements, if any: N/A

Stamp duty Of Rs 144.00

New Delhi
18/10/2014
Note: On examination of this Schedule, if You notice any mistake in the information related to you, this Policy Document is to be returned for correction to Us.

Page:7/34
 Aviva Life Insurance Aviva Tower, Sector Road, Opp Golf Course,DLF - Phase V, Sector - 43, Gurgaon - 122003
Phone No: Tel: +91 (0) 124 2709046 Fax: +91 (0) 124 2571210 www.avivaindia.com

Policy Account Statement Charges on your policy

Policy Details
Owner Name Mr VVN Murthy Date 13-Oct-2014

Product Name Aviva I-Growth Term 10 Years

Policy Number 10170440 Premium Amount (Rs.) ` 18,000.00

Life Assured Mr VVN Murthy Commencement Date 13-Oct-2014

Sum Assured (Rs.) ` 360,000.00 Frequency Half Yearly

Policy Charges

Effective Date Details Value

13-Oct-2014 Premium Received 18,000.00

13-Oct-2014 Premium Allocation Charge 900.00

13-Oct-2014 Premium Allocated (A) 17,100.00

13-Oct-2014 Mortality Charge** 200.00

13-Oct-2014 Policy Administration Charge** 40.00
13-Oct-2014 Service Tax on Premium Allocation 111.00
13-Oct-2014 Accidental Death Benefit Charge 20.00

13-Oct-2014 Total Charges (B) 371.00

Fund Value (A-B) 16,729.00

Closing Balance as on
For details on charges, please refer to Standard Terms & Conditions of the Policy Document.

** Inclusive of Service Tax (ST Regn. No. Delhi - III/ST/R-I/Insurance & Auxiliary/01/2002

Page:8/34
 Annexure 1

INVESTMENT OBJECTIVES & RISK PROFILES OF THE FUNDS

The Funds currently available to You under this Policy, their investment objectives and risk
profiles are:

(Funds offered with this Policy)

Balanced Fund-II[SFIN: ULIF01508/01/2010LIBALAN-II122] - (Risk Profile: Medium):

The investment objective of the Balanced Fund-II is to provide progressive capital growth with
relatively lower asset value fluctuations. The fund will aim to invest in equities to the extent of
0% to 45%, Debt to the extent of 25% to 100% and Money Market to the extent of 0% to 40%
in order to achieve the investment objective of this Fund.

Bond Fund-II [SFIN: ULIF01608/01/2010LIFDEBT-II122] - (Risk Profile: Low): The

investment objective of the Bond Fund-II is to provide a steady income through investment in
high quality fixed income securities. The fund will aim to invest 60% to 100% in Debt, Money
Market 0% to 40% and 0% in Equities order to achieve the investment objective of this Fund.

Enhancer Fund-II [SFIN: ULIF01708/01/2010LIFENHN-II122] - (Risk Profile: High): The

investment objective of the Enhancer Fund-II is to provide long term capital appreciation with
high equity exposure. The fund will aim to invest in equities to the extent of 60% to 100%,
Debt to the extent of 0% to 40% and Money Market to the extent of 0% to 40% in order to
achieve the investment objective of this Fund.

Kindly Note:

Discontinued Policy Fund [SFIN: ULIF03127/01/2011LIDISCPLCY122] – (Risk Profile:

Low): The investment objective of the Discontinued Policy Fund is to provide a minimum
guarantee rate as prescribed by IRDA from time to time. The Fund will aim to invest in Money
Market to the extent of 0 to 40% and Government Securities to the extent of 60% to 100% in
order to achieve the investment objective of this Fund.

The investment pattern for the Discontinued Policy Fund shall be in accordance with the
guidelines issued by the IRDA from time to time.

Money Market stands for Money Market and other cash instruments.

Page:9/34
 Right To Reconsider with respect to Policy Number 10170440

Dear Mr VVN Murthy

Your application for life insurance with Aviva Life Insurance has been accepted.

YOU HAVE 30 DAYS FROM THE RECEIPT OF THIS POLICY DOCUMENT TO RECONSIDER YOUR APPLICATION

Here are some questions to help you decide.

Do you understand what your policy will do for you?

Before you signed the proposal you would have received a key features document, and in case you chose to use our complimentary Financial Health Check service, you would have
received personalised details of how the Plan will work for you. If there is anything, which is still unclear, please contact our Customer Services Help Line on 1800-103-7766/0124-
2709046, or your Financial Planning Adviser.

If you do not agree with any of the terms and conditions of the policy, what should you do?
You have the option to cancel the policy. You would need to return the policy document, policy schedule and premium receipt, along with a letter clearly stating the “Terms and
Conditions” with which you disagree, within 30 days of receipt of the policy document, marked to "Customer Services" at the above mentioned address. Please refer to the “Policy
Information” details given below.

Will you lose anything by canceling?

Aviva Life Insurance will repay you the Fund Value on the date of cancellation plus the un-allocated premium (if any) plus any charge deducted by cancellation of units, after
deducting a proportionate risk charges till the date of cancellation and expenses incurred on your medical examination and stamp duty. In case the allocation rate under this policy is
more than 100%, then Aviva will also deduct the amount of extra allocation

If you wish to proceed with the policy, what should you do?
Ignore this notice.

Policy Information

Important Suggestions
Please:

§ Update your address, contact number and email id with Aviva in case of any change.
§ Ensure that all instructions and notifications are given in writing and signed by the Policy Holder.
§ Verify that all information on the Policy Schedule is correct. Revert in case of any discrepancy.
§ Note your Policy number & Client Id and quote in your communications.
§ Keep your policy documents including the Policy Schedule, Terms, Conditions and all correspondence from Aviva in a safe place.

Premium Payment Facilities

The following facilities are available for payment of premiums:

Periodicity Of Payment: You may opt for Annual , Half yearly, Quaterly, Monthly Payments.
Mode of Payment: You may pay premiums through convenient options like Cheque, Demand draft, Standing Instruction, Credit Card (both at the
branch as well as through our IVR),ECS (Electronic Clearance System), NEFT (National Electronic Fund Transfer), Online payment
through our website www.avivaindia.com or Cash.

Should you wish to avail of any of these facilities, please check with your advisor or call up on our customer services helpdesk on which options are available for you.

Please note that premium will be adjusted towards the unit allocation on the due date even if it has been received in advance. On receipt of premium, units shall be allocated as per
IRDA Guidelines.

Aviva Branch Offices are the “Official Places” for Acceptance of Premium/ Transaction Requests for determining Cut off Time for allocation/ surrender of units as per the IRDA
Guidelines. In respect of premiums paid by using the Drop Box or Free Cheque Pickup facility, the Cut off Time for allocation of units, shall be reckoned from time the premium is
actually received at the Official Places mentioned above.

Periodicity of Premium Receipt:

For Monthly, Half Yearly, Annual frequency the premium receipt will be issued as per the frequency of the premium payment.
In case of monthly frequency, for ease of documentation and your convenience, an Annual Premium Receipt (APR), featuring all the payments received would be provided at the end
of each financial year. Should you require details of premium payments made by you during the course of the financial year, a statement will be issued to you on request.

Customer Services
Helpline : Please call: Toll Free 1800-103-7766/0124-2709046 for any queries, clarifications or concerns or call our Branch Customer Services support.

Please write to us at:

Customer Services
Aviva Life Insurance Company India Limited
Aviva Tower, Sector Road, Opp Golf Course,DLF - Phase V, Sector - 43,Gurgaon - 122003.
Fax : +91 (0) 124 2571210 Email : customerservices@avivaindia.com

Complaints: You may contact our Customer Services Cell at the address given above or write to the Complaint Redressal Officer at:

Complaints Cell
Aviva Life Insurance Company India Limited
Aviva Tower, Sector Road, Opp Golf Course,DLF - Phase V, Sector - 43,Gurgaon - 122003.
In the unlikely event that we are not able to resolve your query /grievance satisfactorily, you may contact the Insurance Ombudsman of your region. The list of ombudsman is printed
overleaf.

Claims
Please notify the Aviva claims department in the event of any claim. A written intimation of claim must be sent by the proposer /beneficiary to the branch office or at:
The Claims department
Aviva Life Insurance Company India Limited
Aviva Tower, Sector Road, Opp Golf Course,DLF - Phase V, Sector - 43,Gurgaon - 122003.
The claim intimation must include the policy number the name of the Proposer & Life Insured, nature of claim (death, critical illness, hospitalization) date of death/accident
/hospitalization/critical illness (as applicable)

Page:10/34
 Complaint Redressal

Ÿ In case, you have any query, complaint or grievance, you can approach any of our branch offices or contact our Customer
Services Group at the head office at the following address:
Aviva Life Insurance Company India Limited, Aviva Tower, Sector Road, Opposite Golf Course, DLF- Phase V,
Sector- 43, Gurgaon-122003 (Haryana). Call our customer services helpline at 1800-103-7766 ,
E-mail: complaints@avivaindia.com

Ÿ In case you are not satisfied with the decision of the above office, or have not received any response within 10days, you may
contact the following official for resolution:
Complaint Redressal Officer (CRO): Aviva Life Insurance Company India Limited, Aviva Tower, Sector Road,
Opposite Golf Course, DLF – Phase V, Sector -43, Gurgaon - 122003 (Haryana). Call our CRO at 0-124-2709046,
Email: cro@avivaindia.com

Ÿ In case you are not satisfied with the decision/resolution of the company, you may approach the Insurance Ombudsman at the
address mentioned in the table below if your grievance pertains to:
- Insurance claim that has been rejected or dispute of a claim on legal construction of the Policy
- Delay in settlement of claim
- Dispute with regard to Premium
- Non-receipt of your insurance document

Ÿ The complaint should be made in writing duly signed by the complainant or by his/her legal heirs with full details of the
complaint and the contact information of complainant

Ÿ As per provision 13(3) of the Redressal of Public Grievances Rules 1998, the complaint to the ombudsman can be made:
- Only if the grievance has been rejected by the Grievance Redressal Machinery of the Insurer
- Within a period of one year from the date of rejection by the Insurer
- If it is not simultaneously under any litigation

Office of the Governing Body of Insurance Council

3rd Floor, Jeevan Seva Annexe, S.V. Road, Santacruz (W), MUMBAI -400021. Tel:- 022-26106245/ 022-26106980, Fax:- 022-
26106949, E mail: inscoun@gmail.com

Page:11/34
 Your Benefits Illustration

Illustration* - Benefits for Policy No: 10170440

THE LINKED INSURANCE PRODUCTS DO NOT OFFER ANY LIQUIDITY DURING THE FIRST FIVE YEARS OF THE CONTRACT. THE POLICY HOLDER WILL NOT BE ABLE TO SURRENDER/WITHDRAW THE
MONIES INVESTED IN LINKED INSURANCE PRODUCTS COMPLETELY OR PARTIALLY TILL THE END OF THE FIFTH YEAR.

Product Features : Name of the Life Insured (1) : MR VVN Murthy

1) Name Of the Product : Aviva I - Growth
Age of the Life Insured (1) : 49 Years
2) Unique Identification No. : 122L106V01
Gender of the Life Insured (1) : Male
3) Sum Assured : ` 360,000.00
4) Accidental Death Benefit Sum Assured : ` 360,000.00 Service Tax : 12.36%
6) Premium Paying Term : 10 Years
5) Amount of Installment Premium : ` 36,000 (Per Annum) 8) Policy Term : 10 Years
7) Frequency of Premium Payment : Half Yearly
9) Funds opted for:
Balanced Fund-II[SFIN:ULIF01508/01/2010LIBALAN-II122]: 100% Enhancer Fund-II[SFIN:ULIF01708/01/2010LIFENHN-II122]: 0% Bond Fund-II[SFIN:ULIF01608/01/2010LIFDEBT-II122]: 0%

Statement of various charges alongwith growth of the Fund expected over the duration of the policy with assumed rate of interest as mentioned is given under
Gross Yield 8% p.a. Net Yield 6.47% p.a. the table: (All charges are in Rupees)

Assuming gross investment return of 8 % p.a. Assuming gross investment return of 4% p.a.
investment (out of premium)
Amount of Annualised

Total charges inclusive of

Amount Available for
Amount of Premium

Loyalty Additions(if any)

Policy Administration

*Commission/ Brokerage
Allocation Charge

inclusive of inbuilt ADB

inclusive of inbuilt ADB

Total charges inclusive

Brokerage on premium
Policy Administration
on premium including
Loyalty Additions(if

Surrender Value ++
Fund Management

Surrender Value ++
Policy year

Death Benefit
Fund Management
Fund Before FMC

Fund Before FMC

Premium

Mortality Charge

Mortality Charge
Fund at the End
of Service Tax

**Service Tax
Death Benefit

*Commission/
Service Tax

Fund at the end

Service Tax
Charge

Charges

if payable
including
Charges
Charges
if payable
benefit

benefit
any)

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (22) (23) (24) (25) (25) (26)
1 36,000 1,800 34,200 2,305 432 602 0 32,453 331 5,470 32,412 30,468 360,000 0 2,307 432 601 0 31,518 326 5,465 31,478 29590 360,000 0

2 36,000 1,800 34,200 2,305 432 658 0 66,974 785 5,979 66,890 65,450 360,000 0 2,317 432 656 0 63,791 757 5,962 63,710 62270 360,000 0

3 36,000 1,800 34,200 2,259 432 712 0 103,748 1,267 6,470 103,617 102,537 360,000 0 2,295 432 708 0 96,873 1,199 6,433 96,751 95671 360,000 0

4 36,000 1,800 34,200 2,154 432 762 0 142,987 1,782 6,930 142,806 142,086 360,000 0 2,232 432 756 0 130,833 1,652 6,872 130,668 129948 360,000 0

5 36,000 1,620 34,380 1,975 432 786 0 185,147 2,333 7,146 184,913 184,913 360,000 0 2,117 432 777 0 165,956 2,119 7,066 165,746 165746 360,000 0

6 36,000 0 36,000 1,688 216 599 0 232,487 2,945 5,449 232,193 232,193 360,000 0 1,926 216 589 0 204,253 2,622 5,353 203,994 203994 360,000 0

7 36,000 0 36,000 1,279 216 631 0 283,318 3,610 5,737 282,960 282,960 360,000 0 1,654 216 620 0 243,791 3,148 5,639 243,483 243483 360,000 0

8 36,000 0 36,000 731 216 652 4,220 338,026 4,325 5,924 341,819 341,819 360,000 0 1,294 216 643 3,554 284,702 3,692 5,845 287,896 287896 360,000 0

9 36,000 0 36,000 216 216 690 5,010 401,317 5,153 6,276 405,820 405,820 400,810 0 779 216 655 4,130 330,840 4,305 5,955 334,552 334552 360,000 0

10 36,000 0 36,000 216 216 801 5,861 469,483 6,048 7,281 474,750 474,750 468,889 0 270 216 672 4,735 379,272 4,949 6,107 383,527 383527 378,792 0

Page:12/34
 Your Benefits Illustration
IN THIS POLICY, THE INVESTMENT RISK IS BORNE BY THE POLICYHOLDER AND THE ABOVE INTEREST RATES ARE ONLY FOR
Notes:
ILLUSTRATION PURPOSE.
1. This illustration assumes that all due premiums are paid as and when due
2. The Fund at the start shall be the amount available for investment in the first year and previous year's end fund for the rest of the years
3. Fund Management Charge is based on the weighted fund management charges applicable to the chosen fund
4. For more details on charges, risk factors, terms and conditions please read sales brochure carefully before concluding a sale
5. Some benefits are guaranteed and some benefits are variable with returns based on future performance of your Life Insurance Company. If your policy offers guaranteed returns then
these will be clearly marked "guaranteed" in the illustration table on this page. This illustration is based on assumed gross investment return at 4% and 8% scenario. 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 future
investment performance.
6. **Service Tax or any other applicable taxes will be charged and/or deducted on/from the premium/unit account at the prevailing rate. Tax laws are subject to change.
7. The projected net yield has been calculated after applying all charges except mortality charge, in-built accidental death benefit charge and service tax.
8. The illustration is based on basic mortality charge including in-built accidental death benefit charge but excluding any extra premium.
9. Past performance of the investment funds do not indicate the future performance of the same
10. The quantum of benefits in respect of non-guaranteed products may vary.
11. The sum assured is guaranteed upon death provided the premiums are paid regularly and the same is included in the "Death Benefit" column in the above Table.
12. In case of accidental death, in addition to the death benefit a benefit equal to the accidental death cover shall be payable subject to maximum limit of Rs.50 lacs.
13. When a policy is discontinued during the lock-in period, only discontinuance charge will be applicable.
14. ++: Surrender Value during the lock-in-period (i.e. first 5 years from the Commencement Date) is the Fund Value as per Unit Account after deducting the Discontinuance Charge.
Surrender Value is not payable during the lock-in-period. However, surrender value of such Policy will be transferred to the Discontinued Policy Fund. The minimum guaranteed
interest rate applicable to the Discontinued Policy Fund shall be declared by the Authority from time to time. The current minimum guaranteed rate of interest applicable to the
Discontinued Policy Fund shall be 4% per annum.
15. ++: Surrender Value after the lock-in-period: It is the Fund Value as per Unit Account without any discontinuance charge, payable in case of Complete Withdrawal.

Discontinuance Charge is as under:

Where the policy is Discontinuance charges
discontinued during
the policy year

1 Lower of 6% * (AP or FV) subject to maximum of ` 6000/-

2 Lower of 4% * (AP or FV) subject to maximum of ` 5000/-

3 Lower of 3% * (AP or FV) subject to maximum of `4000/-

4 Lower of 2% * (AP or FV) subject to maximum of `2000/-

5 and onwards NIL

AP - Annualised premium
FV - Fund value on the date of discontinuance

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 Insurance Terms Simplified

1. Annualised Premium means the total amount you have to pay in a year. For example, if your premium is 25,000 payable half
yearly, the Annualized premium will be 50,000.
2. Age - this is the age as per your last birthday. For e.g. your age is 35 years 10 months and 22 days. This will be considered as 35
years
3. Commencement Date means the policy start date or the date on which the Policy commenced. This is specified in the policy
scheduled.
4. Grace Period: This is an additional time given to each policy holder to pay their premium after the due date. During this period
the premium can be paid without any additional interest. The insurance cover also remains enforced/intact during this period
5. Insured means the person whose life is covered under the policy.
6. IRDA means the Insurance Regulatory and Development Authority established under the Insurance Regulatory and Development
Authority Act, 1999.
7. Maturity Benefit means the amount payable at the maturity date of the policy provided the insured is alive on such date.
8. Maturity Date means the date on which the Maturity Benefit becomes payable.
9. Nominee - Nominee is the person who will be paid the benefit amount in case of death of the Life Insured
10. Policyholder is the person who owns the life insurance policy. If your policy is self proposed, you will be the policyholder.
11. Discontinuance is the state of policy where Insurance Benefit stops because of non-payment of premiums during the lock-in
period.
12. Paid up policy - Policy with reduced benefits in case of non payment of premium after the lock-in period of 5 years
13. Paid-up Sum Assured means the reduced sum assured of the paid up policy
14. Policy Anniversary means the annual anniversary of your policy from the Commencement Date.
15. Policy Term means the period for which policy will run with the benefits contracted.
16. Policy Year means a period of twelve (12) months commencing from the Commencement Date or a Policy Anniversary.
17. Premium Payment Term means the period during the policy term for which you are committed to pay the premium.
18. Proposal Form: Proposal Form is an application form that is filled in and signed by you for taking the insurance plan. This
includes any declarations or statements annexed for obtaining insurance cover under this Policy.
19. Regular Premium means the amount of the instalment premium, excluding extra premium and taxes, if any payable during the
Premium Payment Term, at the intervals (Premium Frequency) as decided by you.
20. Reinstatement Period means the period during which a lapsed or paid-up policy can be started again (reinstated).
21. Schedule means the section of your policy document containing details of your policy and schedule of benefits as well as
obligations (including any annexures/tables attached to it and any endorsements).
22. Sum Assured means the minimum amount payable in case of death of Insured
23. Allocation Rate is the proportion of premium amount that gets invested after deducting the allocation charge.
24. Complete Withdrawal means the discontinuance of the Policy and withdrawal of proceeds before or after the lock-in period.
25. Date of Complete Withdrawal means the date on which you opt for Complete Withdrawal or the expiry of 30 days period from
the date you receive company’s notice sent on non-payment of regular premium.
26. Discontinued Policy Fund means the segregated fund of the company which is constituted by the funds of all discontinued
policies.
27. Loyalty additions are guaranteed addition to the fund to enhance benefits on continuing policy by paying all due premiums for a
certain period.
28. Fund Value means the total number of Units pertaining to Regular Premium and Top Up Premium under the policy multiplied by
their respective Unit Price.
29. Lock-In-Period means the period of five (5) consecutive Policy Years from the policy Commencement Date during which you
cannot withdraw any money from your policy.
30. Top Up Premium means additional premium contribution which is on an over to your regular premium, towards your insurance
policy to increase the investment value.
31. Top Up Sum Assured means the minimum amount of benefit payable on death with respect to the top-up premium paid

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 STANDARD TERMS & CONDITIONS

Aviva i-Growth (UIN :122L106V01)

Non-Participating Unit-Linked Plan

Note: In this Policy, the investment risk in the investment portfolio is borne by the
Policyholder.

Your Proposal Form is the basis of the insurance provided by, and is part of, the Policy Document,
which also consists of these Standard Terms & Conditions, the Schedule, annexures/ table and/or
unit statements attached to it, if any.

1. Interpretation & Definitions

1.1. The terms defined below have the meanings given to them below wherever they appear
in the Policy Document:

1.1.1. Accident means a sudden, unforeseen and involuntary event caused by

external, visible and violent means.

1.1.2. Accidental Death means the death of the Insured caused by an Accident (within
ninety (90) days of the occurrence of the Accident and which directly and
independently of any physical or mental Illness results in the Insured’s death.

1.1.3. Age means age at last birthday as specified in the Schedule.

1.1.4. Allocation Rate means the rate at which We allocate the Regular Premium
received from You into Units in the unit account, and is as specified in the
Schedule (at Item No. 1 of the Table of Charges).

1.1.5. Annualised Premium means the amount specified in the Schedule.

1.1.6. Appointee means the person named as such in the Schedule, to receive the
Death Benefit and give a valid discharge to Us on behalf of the Nominee, on
the occurrence of the Insured Event during the minority of the Nominee.

1.1.7. Commencement Date means the date on which this Policy commences, as
specified in the Schedule.

1.1.8. Complete Withdrawal means the discontinuance of the Policy in accordance

with Articles 3.3.1 or 5.

1.1.9. Date of Complete Withdrawal means the date on which We receive Your notice
for Complete Withdrawal of the Policy or the expiry of 30 days of Your receipt
of Our notice under Article 3.3.1, whichever is earlier.

1.1.10. Date of Revival means the date on which the Policy is revived by Us as per
Article 3.3.4.

1.1.11. Discontinuance Period is the period from the due date of first unpaid instalment
of Regular Premium till the Date of Revival.

1.1.12. Discontinued Policy Fund means Our segregated fund which is constituted by
the fund value of all discontinued linked insurance policies.

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 1.1.13. Funds means the internal unit linked funds established and managed by Us in
accordance with Articles 7 and 9

1.1.14. Fund Value means the total number of Units pertaining to Regular Premium
held in the unit account multiplied by their respective Unit Price.

1.1.15. Grace Period means a period of thirty (30) days (if the Premium Frequency is
annual, half yearly or quarterly) and fifteen (15) days (if the Premium
Frequency is monthly) from the due date of the first unpaid instalment of
Regular Premium.

1.1.16. Illness means a sickness or disease or pathological condition leading to the

impairment of normal physiological function, which manifests itself during the
Policy Term and requires medical treatment.

1.1.17. Insured means the person named as the insured in the Schedule, on whose life
this Policy is effected.

1.1.18. Insured Event means the Insured’s death.

1.1.19. IRDA means the Insurance Regulatory and Development Authority established
under the Insurance Regulatory and Development Authority Act, 1999.

1.1.20. Lock-In-Period means the period of five (5) consecutive Policy Years from the
Commencement Date.

1.1.21. Maturity Benefit means the amount payable in accordance with Article 2.3
(Maturity Benefit).

1.1.22. Maturity Date means the date specified in the Schedule on which the Maturity
Benefit becomes payable.

1.1.23. Medical Practitioner means person who holds a valid registration from the
Medical Council of any State of India or Medical Council of India or Council for
Indian Medicine or for Homeopathy set up by the Government of India or by a
State Government and is thereby entitled to practice medicine within its
jurisdiction and is acting within the scope and jurisdiction of his license. Medical
Practitioner shall not include:

a) Your or the Insured’s close relative; or

b) a person who resides with You or the Insured; or

c) You or the Insured.

1.1.24. Minimum Interest Rate means the minimum guaranteed rate of interest
applicable to the Discontinued Policy Fund as declared by the IRDA from time
to time. The current minimum guaranteed rate of interest applicable to the
Discontinued Policy Fund is four percent (4%) per annum.

1.1.25. Nominee means the person named in the Schedule who has been nominated
by You in accordance with Article 15.

1.1.26. Paid Up Policy means a Policy where the Sum Assured is reduced after We
have received a notice from You to convert the Policy into a paid up policy as
per Article 3.3.8.

1.1.27. Paid-up Sum Assured means the amount as calculated with Article 3.3.8.

1.1.28. Policy means the arrangements established by this Policy Document.

Policy Terms and Conditions Aviva i-Growth

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 1.1.29. Policy Anniversary means the annual anniversary of the Commencement Date.

1.1.30. Policy Term means the period between the Commencement Date and the
Maturity Date.

1.1.31. Policy Year means a period of twelve (12) months commencing from the
Commencement Date or any Policy Anniversary.

1.1.32. Premium Payment Term means the period specified in the Schedule, during
which Regular Premium is payable.

1.1.33. Proceeds of the Discontinued Policy Fund means the Fund Value as on the
Date of Complete Withdrawal.

1.1.34. Proposal Form means the signed, completed and dated proposal form
submitted by You to Us, including any declarations and statements annexed to
it or submitted to Us in connection with the proposal for obtaining insurance
cover under this Policy.

1.1.35. Regular Premium means the amount of the instalment premium as specified in
the Schedule payable by You during the Premium Payment Term, in the
manner and at the intervals (Premium Frequency) as specified in the Schedule.

1.1.36. Revival Period means a period of two (2) years commencing from the date of
the expiry of the notice period as per Article 3.3.1.

1.1.37. Schedule means the schedule (including any annexures/unit statements/tables

attached to it and any endorsements We have issued) in connection with this
Policy and, if more than one, then the latest in time.

1.1.38. Sum Assured means the amount specified in the Schedule.

1.1.39. Unit means a notional and proportionate part of the unit account created by the
allocation of the Regular Premium and created solely for the purpose of
determining the benefits under this Policy.

1.1.40. Unit Price means the price in accordance with Article 9 at which We allocate or
redeem Units in each of the Funds on that day.

1.1.41. Valuation Date shall have the meaning ascribed to it in Article 9.2.

1.1.42. We, Our and Us means Aviva Life Insurance Company India Limited.

1.1.43. You or Your or Policyholder means the person named in the Schedule who has
concluded this policy with Us.

1.2. In this Policy Document, where appropriate, references to the singular include references
to the plural, references to a gender include the other gender and references to any
statutory enactment includes any subsequent amendment to that enactment and
reference to days means calendar days only.

2. Benefits

2.1. Death Benefit

2.1.1. If the Insured Event occurs during the Policy Term when the Policy is in-force
for full Sum Assured, then, We shall pay the highest of the following amounts to
the Nominee, or if the Nominee has not attained the Age of eighteen (18)
years, to the Appointee to hold in trust for the Nominee :

a) the Sum Assured; or

Policy Terms and Conditions Aviva i-Growth

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 b) 105% of the total of the Regular Premiums received excluding taxes as
appliacle till the date of the Insured Event

c) the Fund Value as on the date of the notification of Insured Event along
with Loyalty Additions as applicable and in accordance with clause 2.2 ,

2.1.2. If the Accidental Death occurs while the Policy is in-force for full Sum Assured
and before the Accidental Death cover expiry date as specified in the Schedule,
then, in addition to any amounts payable under Article 2.1.1, We shall pay the
Accidental Death Sum Assured as specified in the Schedule, provided that the
Insured Event is not caused or aggravated directly or indirectly by :

a) Alcohol or drug abuse including drug taking other than prescribed by a

Medical Practitioner, any crime committed by the Insured, wilful self
inflicted injury, suicide or attempted suicide or unreasonable failure to seek
or follow medical advice.

b) Failure to seek and follow medical treatment and advice from a registered
and qualified Medical Practitioner.

c) Aviation other than as a passenger in a commercially licensed passenger

aircraft.

d) Engaging in racing of any kind other than athletics or swimming.

e) Any form of war, invasion, hostilities (whether war be declared or not), civil
war, rebellion, riots, social disorder, insurrection, military or usurped
power, or wilful participation in acts of violence.

f) Radioactive contamination due to a nuclear accident.

g) Participation in sports or pastimes of a hazardous nature including

parachuting, potholing, mountaineering and hot air ballooning.

h) Any condition, ailment or injury or related conditions for which Insured had
signs or symptoms, and/or were diagnosed, and/or received medical
advice/treatment within forty eight (48) months prior to the
Commencement Date or Date of Revival.

2.2. Loyalty Additions

2.2.1. We shall credit Your Unit account with loyalty additions from time to time during
the Policy subject to the following conditions:
a) All the due Regular Premiums have been received in full under the Policy

b) The loyalty addition rate is guaranteed and shall not be altered during the
Policy Term.

c) An amount equal to the applicable loyalty addition shall be credited in the

Funds at the allocation proportion that was applicable for Regular
Premium at the end of the relevant Policy Year.

The loyalty additions shall be credited as per the following table.

If the Policy Loyalty Amount of Loyalty
Term is Additions shall Addition
be credited on
th th th
10 Years 8 , 9 and 10 1.25% of Fund Value as
Policy Anniversary on Policy Anniversary
th th th
15 Years 13 , 14 and 15 2.70% of Fund Value as
Policy Anniversary on Policy Anniversary
th th th
20 Years 18 , 19 and 20 3.00% of Fund Value as
Policy Anniversary on Policy Anniversary

Policy Terms and Conditions Aviva i-Growth

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 2.3. Maturity Benefit

2.3.1. If the Policy is not terminated for any reason prior to the Maturity Date, then,
the Fund Value as at the Maturity Date along with Loyalty Additions as
applicable and in accordance with clause 2.2 shall be payable to You.

3. Payment of Regular Premium, Top-up Premium, Grace Period, Complete Withdrawal,

Revival and Dealings with the Policy

3.1. Regular Premium shall be paid by You to Us on every Policy Anniversary, if Your
Premium Frequency is annual. If Your Premium Frequency is half-yearly, quarterly or
monthly, then the Regular Premium shall be paid on the date corresponding with the
Commencement Date in every half-year, quarter or month respectively. If the
corresponding date does not exist in a particular month, then the last day of that month
shall be deemed to be the due date.

You may alter the Premium Frequency on any Policy Anniversary provided that Your
request for the change in Premium Frequency is received by Us at least ten (10) days
prior to Policy Anniversary and You pay the Alteration Charges as specified in the
Schedule.

3.2. If We do not receive the Regular Premium in full on due date then, We shall allow a
Grace Period for You to pay the unpaid Regular Premium to Us. If the Insured Event
occurs during this Grace Period, we will make payments in accordance with Article 2.1.

3.3. If We do not receive the due unpaid Regular Premium in full within the Grace Period,
then:

3.3.1. We shall send You a written notice within fifteen (15) days from the expiry of
the Grace Period. Within thirty (30) days of receipt of Our notice, You shall
give Us written notice to either:

a)revive the Policy; or

b)exercise Complete Withdrawal, or

c) convert the Policy into a Paid-up Policy provided the Lock-in-Period is over
on the date of discontinuance of the Regular Premium

Until the earlier of the receipt of Your notice under Article 3.3.1 and the expiry of 30
days of You receiving Our notice under Article 3.3.1 the Fund Value of the Policy
shall continue to be part of the Funds chosen by You and the benefits under Article
2 (Benefits) will continue to apply.

3.3.2. If the discontinuance of the Regular Premium payment happens before the
expiry of the Lock-in-Period and You give Us written notice to revive the Policy
under Article 3.3.4 but the Policy is yet to be revived, then the Fund Value (after
deduction of the Discontinuance Charge as specified in the Schedule) as on
the date of expiry of the notice period of 30 days as per Article 3.3.1 will be
transferred to the Discontinued Policy Fund.

3.3.3. If the Policy is not revived, then the Proceeds of the Discontinued Policy Fund
as on the date of expiry of the Lock-In-Period or the Revival Period, whichever
is later, will be payable to the You. In case the Lock-In-Period has ended before
the expiry of the Revival Period, then You will have the option to request for the
Proceeds of the Discontinued Policy Fund by giving Us written notice.

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 3.3.4. If You have given Us written notice to revive the Policy or the Paid-up Policy
under Article 3.3.8 the risk cover shall be restored from the Date of Revival
subject to:
a)Our board approved underwriting policy, as applicable from time to time, and
Our right to obtain additional information or documentation and/or impose
additional mortality charges before reviving the Policy.
b)You paying in full all the Regular Premiums that would have been payable
from the date of discontinuance of Regular Premium to the Date of Revival of
the Policy.
c) You bearing the cost of medical examination, if any.
d)You agreeing that even if You have submitted all the information and
documentation sought by Us there is no obligation on Us to revive the Policy
or We may restrict the terms upon which We may agree to revive, the
decision as to which shall be in Our sole and absolute discretion.
e)The revival of the Policy shall only be effective from the date on which We
have issued a written endorsement confirming the revival of the Policy.
f) We shall at the time of revival of the Policy
i. add back to the Proceeds of the Discontinued Policy Fund, if applicable, as
on the Date of Revival, an amount equal to the Discontinuance Charge
which was deducted from the Fund Value on the expiry of the notice period
of 30 days as per Article 3.3.2 and use this sum to allocate units to the
segregated Funds at the Net Asset Value (NAV) on the Date of Revival in
the proportion as chosen by You on the date of expiry of the notice period
of 30 days as per Article 3.3.1.
ii. levy Policy Administration Charge and Premium Allocation Charge as
applicable during the Discontinuance Period.

3.3.5. If You have given Us written notice for Complete Withdrawal under Article 3.3.1
b) then We shall pay the amount calculated in accordance with Article 5.

3.3.6. If You do not give Us written notice to revive the Policy in accordance with
3.3.1 within 30 days of You receiving Our notice under Article 3.3.1, You shall
be deemed to have opted for Complete Withdrawal and We shall pay the
amount calculated in accordance with Article 5.

3.3.7. The charges as specified in the Schedule shall continue to be deducted till
earlier of the Date of Complete Withdrawal or the end of the Policy Term

3.3.8. If You opt for option under Article 3.3.1 c), the Policy will become paid-up and
the Policy will acquire a Paid-up Sum Assured, which shall be calculated as
follows:.
Paid-up Sum Assured = Sum Assured X {total number of Regular Premiums
received / total number of Regular Premiums payable under the Policy}

3.3.9. . The Mortality Charges as specified in the Schedule will be applicable on the
Paid Up Sum Assured and all other applicable charges shall continue to remain
deducted as specified in the Schedule.

The Accidental Death Sum Assured specified in the Schedule will become
equal to the Paid Up Sum Assured, if the Paid Up Sum Assured becomes lower
than the Accidental Death Sum Assured as on at the Commencement Date.

3.4. No loan shall be available under this Policy.

3.5. Payment of any top-up premium is not allowed under this Policy.

3.6. Reduction in the Sum Assured

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 3.6.1. If You have opted for Sum Assured of 20 times of Annualised Premium as
specified in the Schedule You may reduce the Sum Assured to 10 times of the
Annualised Premium. Such Reduction in the Sum Assured shall be subject to
the following:

a) At least 3 Policy Years have been completed on the date when You give
Us request for reduction in the Sum Assured

b) You have given Us a written notice to reduce the Sum Assured at least
fifteen (15) days prior to the Policy Anniversary from which the Sum
Assured is proposed to be reduced;

c) the reduced Sum Assured shall be applicable from the Policy Anniversary
immediately succeeding the receipt of the said notice by Us and Our
acceptance of the reduced Sum Assured by sending a confirmation to You
in writing;

d) the reduction in Sum Assured shall not result in any change in the Regular
Premium due under the Policy;

e) Mortality Charges as specified in the Schedule would be deducted

according to the reduced Sum Assured;

f) the Sum Assured once reduced cannot be increased subsequently.

4. Partial Withdrawals
th
4.1. After commencement of the sixth (6 ) Policy Year, You may make upto four (4) partial
withdrawals in a Policy Year. The minimum amount of a partial withdrawal is rupees five
thousand (Rs. 5,000). Un-availed partial withdrawals in a Policy Year shall not be carried
forward to the next Policy Year.

4.2. Any partial withdrawal shall only be allowed to the extent that the Fund Value, after the
proposed partial withdrawal, does not fall below an amount equivalent to the Annualised
Premium for two (2) Policy Years.

4.3. Partial withdrawals made during the two (2) years prior to the date of Insured Event will
be deducted from the Sum Assured. However, on the occurrence of the Insured Event,
on or after attainment of age sixty (60) years of the Insured, all the partial withdrawals
made within two (2) years before attaining age sixty (60) years and all partial withdrawals
made after attaining age sixty (60) years will be deducted from the Sum Assured. .

5. Complete Withdrawal Proceeds

5.1. You may request Us for Complete Withdrawal at any time during the Policy Term by
giving Us a prior written notice.

5.2. If You opt for Complete Withdrawal under Article 3 or Article 5.1 before the completion of
the Lock-In-Period, then, the Fund Value as on the Date of Complete Withdrawal (after
deduction of the Discontinuance Charge specified in the Schedule) will be transferred to
the Discontinued Policy Fund. On the expiry of the Lock-In-Period, the Proceeds of the
Discontinued Policy Fund as on the expiry of the Lock-In-Period will be payable to You. If
the Insured Event occurs after the amount has been transferred to the Discontinued
Policy Fund but before it becomes payable, then, the Proceeds of the Discontinued
Policy Fund as on the date of the Insured Event will be payable to the Nominee or if the
Nominee has not attained the Age of eighteen (18) years to the Appointee to hold in trust
for the Nominee. On payment the Policy shall terminate immediately and automatically.
5.3. If You opt for Complete Withdrawal under Article 3 or Article 5.1 after the completion of
the Lock-In-Period, then, We shall pay the Fund Value as on the Date of Complete
Withdrawal along with Loyalty Additions,as applicable and in accordance with clause 2.2

Policy Terms and Conditions Aviva i-Growth

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 . On payment the Policy shall terminate immediately and automatically.
6. Units & Unit Account
6.1. On the Commencement Date, We will open a unit account. We will apply Your Regular
Premium, to the allocation of Units to that unit account by reference to the Funds chosen
by You, in the allocation proportion specified in the Schedule, after adjusting for the
applicable Allocation Rate.. The allocation of Units will be carried out at the next
available Unit Price.

6.2. You may request a premium re-direction by changing the allocation proportion upto two
(2) times in any Policy Year by informing Us in writing of the changes You wish to make.
The changed allocation proportion will only apply to premiums received after We are
satisfied that the proposed change is in line with Our rules applicable at that time. The
allocation proportion for any Fund chosen by You may range between ten percent (10%)
and one hundred percent (100%). Un-availed premium re-direction in a Policy Year shall
not be carried forward to the next Policy Year.

6.3. You can switch Units between available Funds at any time by informing Us in writing of
the switch proposed to be made. The first twelve (12) switches in a Policy Year shall be
free of any Switching Charge. Subsequent switches will attract the Switching Charge
specified in the Schedule. Un-availed free switches in a Policy Year shall not be carried
forward to any subsequent Policy Year. We will process a switch after receiving a written
request from You and only if We are satisfied that the proposed switch is in line with Our
rules applicable at that time for switching, and (unless You wish to switch one hundred
percent (100%) to another Fund) that the amount switched and the balance remaining in
the Fund from which Units are to be switched, after the proposed switch, are at least
rupees five thousand (Rs.5,000) each or such other minimum amounts We may specify
from time to time.

6.4. We will make the switch by redeeming Units from the Fund from which You wish to make
the switch out and allocating Units in the Fund You wish to switch in, equivalent to the
amount You wish to be switched. After first twelve (12) switches, We will redeem Units
for an amount equivalent to the Switching Charge as specified in the Schedule from the
Fund You have switched in. For each transaction, We will use the Unit Price of the
respective Fund that applies on the day of that transaction.

7. Funds

7.1. Subject to the approval of the IRDA, We reserve the right to add, close or amend any
Fund or its investment objectives. The only Funds available for You to invest in and the
investment objectives together with the risk profile of each Fund are described in the
Annexure 1 of the Schedule. We shall send You the details of any change We may
decide to make at least one (1) month prior to such change becoming effective.

7.2. Units are a proportionate part of a Fund and will be created in a Fund when assets of an
equivalent value are added to the portfolio of assets to which the Fund is referenced. The
unit account, the Units and the allocation of Units to the unit account are notional and are

designed for the sole purpose of determining the benefits under the Policy.

7.3. Assets may only be withdrawn from the portfolio of assets to which the Fund is
referenced when Units of equal value to those assets are redeemed in the Fund. Income
received from assets referenced to a Fund will be added to these assets. The amount
after allowing for tax, if any, will alter the value of each existing unit of the respective
Fund.

7.4. We do not guarantee the price or value of the Units. The price or value of any Unit and
Fund will fluctuate depending upon the performance of the underlying assets. The assets
and any income arising from these assets shall remain Our property at all times. The
Policy does not confer on You or any other person any title to or any beneficial interest in
any of Our assets, or to any income from these assets.

Policy Terms and Conditions Aviva i-Growth

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8. Conditions for Payment

It is a condition precedent to Our liability to make payment that:

8.1. We are given a written notice immediately and in any event within ninety (90) days of the
occurrence of an Insured Event. If We are not given a written notice of the claim within
ninety (90) days of the occurrence of the Insured Event, We may accept the claim if We
are given reasons in writing for the delay which in Our view are reasonable.

8.2. Upon occurrence of the Insured Event, We are given such information and/or
documentation that We may request in order to establish the fact of, date of,
circumstances relating to and cause of the Insured Event and/or Our liability in respect of
it, including but not limited to:

8.2.1. Original or certified copy of the death certificate issued by the municipal
authorities.

8.2.2. Original Policy Document.

8.2.3. Our claim form duly filled in, signed by the claimant and attested by the
authorities as mentioned in the claim form.

8.2.4. Certified proof of cause of death of the Insured from a Medical Practitioner.

8.2.5. Last medical attendant/ Medical Practitioner’s report, if applicable.

8.2.6. Employer’s questionnaire, if applicable.

8.2.7. Medical records related to admission to a hospital/medical facility or

consultation with a Medical Practitioner within the last three (3) years.

8.2.8. Identification proof of the Nominee & Appointee issued by a governmental

authority.

8.2.9. Any document, which establishes the Nominee & Appointee’s relationship with
the Insured.

8.2.10. Address proof of the claimant for the address mentioned in the claim form.

8.2.11. If the Insured Event was caused due to un-natural or non– medical reasons,
then, in addition to the above documents the following additional documents
also need to be submitted to Us:

a) Certified copies of First Information Report (FIR), Post Mortem Report

(PMR), Final Police Inquest Report (FPIR).

b) Newspaper articles/ cutting, if any.

8.3. For payment of Maturity Benefit, We are given such information and/ or documentation
that We may request in order to establish the fact of Our liability in respect of it, including
but not limited to:

8.3.1. Original Policy Document.

8.3.2. Payout form duly filled in by You and/or the assignee, if any.

8.3.3. Your and/or the assignee’s (if any) identification proof issued by a
governmental authority.

8.3.4. Your and/or the assignee’s (if any) address proof.

Policy Terms and Conditions Aviva i-Growth

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 8.3.5. Cancelled cheque for National Electronic Funds Transfer NEFT payment
issued by You and/or the assignee (if any).

8.4. We receive all co-operation and assistance in any investigation that We may decide to
carry out in respect of the Insured Event.

8.5. We may agree to accept minimum required documents on a case to case basis.

9. Valuation of Funds, Unit Price & Charges

9.1. We will deduct Policy charges from the unit account. The Schedule contains the list of
charges and the manner in which they will be deducted.

9.2. The Unit Price of Units of each Fund shall be determined daily as per the
regulations/guidelines issued by the IRDA from time to time (the ‘Valuation Date’). As per
the current guidelines issued by the IRDA, We will determine the Unit Price of each Fund
daily as per the following formula:

Market value of investment held by the Fund + Value of current assets – Value of
current liabilities and provisions, if any

Number of Units existing on the Valuation Date (before creation / redemption of

Units)

The Unit Price of a Fund will be rounded by not less than three (3) decimal places.

9.3. We shall deduct all expenses, costs and duties related to the purchase and sale of
assets of the Funds.

9.4. We will make all decisions about the selection and valuation of the assets to which a
Fund is referenced.

10. Unit Encashment Conditions

10.1. Units will be redeemed or created at their Unit Price on the date of redemption or
creation of those Units.

10.2. Subject to the IRDA Regulations, receipt of premium or valid requests for unit switching
or benefit payments (excluding outstation cheques or demand drafts) received at Our
address specified in the Schedule or at any of Our branch offices:

10.2.1. at or before 3:00 p.m. on a particular day will be processed at the closing Unit
Price on that day, and

10.2.2. after 3:00 p.m. on a particular day will be processed at the closing Unit Price on
the next business day,

Unless in either case if the payment comprises outstation cheques or demand drafts, in
which case the payment will be processed at the closing Unit Price on the day of
realisation.

10.3. Any Regular Premium received by Us in advance of the due date shall be invested in the
Funds only on the due date.

11. Termination

11.1. This Policy will immediately and automatically terminate on the earliest of:

11.1.1. Insured Event

11.1.2. Maturity Date

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 11.1.3. Complete Withdrawal of the Policy in accordance with Article 5

12. Suicide

12.1. If the Insured Event occurs due to suicide within twelve (12) months of the
Commencement Date or the Date of Revival of the Policy,

12.2. We shall pay only the Fund Value as available on date of Insured Event.

12.3. Any charges recovered subsequent to the date of Insured Event shall also be payable.

Policy will terminate immediately and automatically after the payment as per Article 12.1.

13. Freelook period

You have the right to review the terms and conditions of this Policy, within the freelook period
which is 30 days from the date of receipt of the Policy Document. If You disagree to any of the
terms or conditions, You have the option to return the Policy stating the reasons for Your
objection. If You cancel the Policy during the free look period, We will refund the Regular
Premium received, subject only to a deduction of the expenses incurred by the Us on medical
examination, if any and stamp duty charges.

14. Taxation

14.1. We shall deduct or charge any taxes or levies (including Service Tax) as applicable from
time to time from and/or on the premium payable or the fee/charge payable or benefit
receivable under the Policy. We shall not be liable for any tax liability on income of You,
Insured or the Nominee. You shall be solely responsible to assess, claim and /or ensure
admissibility, or otherwise, of deductions under the tax laws in respect of the amount
contributed or accrued/received. We do not hold any responsibility for Your claim to any
deduction/s under the tax laws in respect of the amount contributed or accrued/received.

14.2. Tax laws are subject to amendments from time to time and We are not responsible to
inform You and/or the Nominee of any change/s in tax laws.

15. Nomination and Assignment

15.1. You may nominate a Nominee or change an existing Nominee in accordance with
Section 39 of the Insurance Act, 1938, by giving Us a written notice.

15.2. Any nomination and any change in nomination will take effect only when We register the
same in Our records and We send an endorsement confirming the identity of the
Nominee.

15.3. If there are no Nominees, then, We will pay Your legal heirs or legal representatives, as
the case maybe.

15.4. You may assign this Policy in accordance with Section 38 of the Insurance Act, 1938. An
assignment of the Policy shall automatically cancel all nominations. No assignment shall
be effective against Us, until We have received a written notice of the assignment.

15.5. The assignment of the policy shall only be effective from the date on which we have
issued a written endorsement confirming the assignment of the Policy.

15.6. In registering an assignment, We do not accept any responsibility or express any opinion
as to its validity or legality.

16. Entire Contract

This Policy constitutes the entire contract of insurance between You and Us. We may amend

Policy Terms and Conditions Aviva i-Growth

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 this Policy, if We consider this to be either necessary or desirable (to be evidenced by and
effective from the date of an endorsement on the Schedule) but agree not to do so without first
having obtained the consent of the IRDA.

17. Due Observance

The due observance of and compliance with the terms, provisions and conditions of the Policy
insofar as they relate to anything to be done or complied with by You shall be a condition
precedent to Our liability under this Policy.

18. Fraud

Subject to the provisions of Section 45 of the Insurance Act, 1938, If You or anyone acting on
Your behalf or at Your direction, or with Your knowledge is proved to have made any
misrepresentation or made/advanced any claim under this Policy knowing it to be dishonest,
misleading, false or fraudulent in any respect, then, this Policy shall be immediately cancelled
by paying the Surrender Value.

19. Territorial Limits and Currency

All Regular Premium, taxes, levies and benefits etc. are payable only within India and in Indian
Rupees.

20. Misstatement

In accordance with Section 45 of the Insurance Act, 1938, “No policy of life insurance effected
before the commencement of this Act shall after the expiry of two years from the date of
commencement of this Act and no policy of life insurance effected after the coming into force of
this Act shall, after the expiry of two years from the date on which it was effected be called in
question by an insurer on the ground that statement made in the proposal or in any report of a
medical officer, or referee, or friend of the insured, or in any other document leading to the issue
of the policy, was inaccurate or false, unless the insurer shows that such statement was on a
material matter or suppressed facts which it was material to disclose and that it was fraudulently
made by the policy holder and that the policy holder knew at the time of making it that the
statement was false or that it suppressed facts which it was material to disclose:

Provided that nothing in this section shall prevent the insurer from calling for proof of age at any
time if he is entitled to do so, and no policy shall be deemed to be called in question merely
because the terms of the policy are adjusted on subsequent proof that the age of the life
insured was incorrectly stated in the proposal.”

21. Loss of the Policy Document

21.1. We will replace a lost Policy Document when satisfied that it is lost. However, We
reserve the right to make such investigations into and/or to call for such evidence of the
loss of the Policy Document, at the Your expense, as We consider necessary before
issuing a duplicate Policy Document. We reserve the right to charge a fee for the issue of
a duplicate Policy Document.

21.2. If We agree to issue a duplicate Policy Document, it is hereby understood and agreed
that the original Policy Document shall cease to be of any legal effect and You shall
indemnify and keep Us indemnified and hold Us harmless from and against any claims,
costs, expenses, awards or judgments arising out of or howsoever connected with the
original Policy Document or arising out of the issuance of a duplicate Policy Document.

22. Notices & Correspondence

22.1. You shall give Us all notices, instructions and correspondence in writing at Our address
specified in the Schedule or at any of Our branch offices.

22.2. All notices and correspondence meant for You will be in writing and will be sent by Us to

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 Your address shown in the Schedule through speed post or courier or any other legally
recognized mode of posting. Any change of Your address or Your Nominee’s address
must be notified to Us immediately, failing which the notices or correspondence will be
sent to the last recorded address and hence, We will not take any responsibility of any
loss/ damage owing to this.

22.3. Any Policy Document or any other communication shall be sent to You by Us through
speed post or courier or any other legally recognized mode of posting, at the address
provided in the Schedule.

23. Agent’s Authority

23.1. The insurance agent is only authorised by Us to arrange the completion and submission
of the Proposal Form.

23.2. No insurance agent is authorised to amend the Policy Document, or to accept any notice
on Our behalf or to accept payments on Our behalf. If any payment meant for Us in any
form is paid to an insurance agent, then, such payment is made at Your risk and the
agent will be acting only as Your representative.

24. Governing Law

This Policy shall be governed by Indian laws. Any disputes or differences arising out of or under this
Policy shall be governed and determined in accordance with Indian law and shall be subject to the
jurisdiction of the Indian Courts.

Policy Terms and Conditions Aviva i-Growth

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 Annual Mortality Charge per 1000 Sum at Risk

Age Male Life Female Life Age Male Life Female Life
2 0.7418 0.7418 39 2.2529 1.9056
3 0.6268 0.7418 40 2.4725 2.0620
4 0.5118 0.7418 41 2.6830 2.2529
5 0.4600 0.6268 42 2.8865 2.4725
6 0.4485 0.5118 43 3.1246 2.6830
7 0.4600 0.4600 44 3.4167 2.8865
8 0.4600 0.4485 45 3.7651 3.1246
9 0.4485 0.4600 46 4.1711 3.4167
10 0.4773 0.4600 47 4.6345 3.7651
11 0.5635 0.4485 48 5.1532 4.1711
12 0.6785 0.4773 49 5.7293 4.6345
13 0.7843 0.5635 50 6.3618 5.1532
14 0.8533 0.6785 51 7.0507 5.7293
15 0.9166 0.7843 52 7.7970 6.3618
16 0.9752 0.8533 53 8.5997 7.0507
17 1.0304 0.9166 54 9.4588 7.7970
18 1.0810 0.9752 55 10.3753 8.5997
19 1.1270 1.0304 56 11.3436 9.4588
20 1.1684 1.0810 57 12.2590 10.3753
21 1.2052 1.1270 58 13.2112 11.3436
22 1.2386 1.1684 59 14.3888 12.2590
23 1.2673 1.2052 60 15.7918 13.2112
24 1.2915 1.2386 61 17.4202 14.3888
25 1.3110 1.2673 62 19.2717 15.7918
26 1.3260 1.2915 63 21.3486 17.4202
27 1.3375 1.3110 64 23.6509 19.2717
28 1.3432 1.3260 65 25.4955 21.3486
29 1.3455 1.3375 66 27.7967 23.6509
30 1.3467 1.3432 67 31.3030 25.4955
31 1.3639 1.3455 68 35.1877 27.7967
32 1.4076 1.3467 69 39.4830 31.3030
33 1.4686 1.3639 70 44.2279 35.1877
34 1.5502 1.4076 71 49.4592 39.4830
35 1.6503 1.4686 72 55.2184 44.2279
36 1.7687 1.5502 73 61.5503 49.4592
37 1.9056 1.6503 74 68.5009 55.2184
38 2.0620 1.7687 75 76.1208 61.5503

i) Ages given above are age last birthday.

ii) In addition to above mortality charge, Re.0.60 per 1000 Sum Assured will be charged for inbuilt Accidental
Death Benefit, if applicable.

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 Endorsement

*Update your address, contact number and email id with Aviva in case of any change * Ensure that all instructions and notifications are given in writing and signed by the policy holder

*Verify that all information on the policy schedule is correct. Revert in case of any discrepancy *Note your policy number and client id and quote in your communications

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Your Proposal Form

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Your Proposal Form

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Your Proposal Form

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Your Proposal Form

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 *

Branch Gurgaon 1 Unit Manager Code N/A Date 18/10/2014

Policy No. 10170440 Risk Commencement Date 13/10/2014 Agent Code 60150001
UIN 122L106V01 Plan Aviva I-Growth

Name of Policy holder Mr VVN Murthy Date of Birth 01/08/1965

Address Door No 7-75

4th Mile
Nuvalakula Gardens
Nellore 524002
AndhraPradesh India
Client ID 50847222

Sum Assured ` 360,000.00 Date of Maturity 13/10/2024 Frequency Half Yearly

Premium Amount (in figures) ` 18,000.00 Mode Online Policies Payment Gatewy
Premium Amount (words) Rupees Eighteen Thousand only. Funds Summary as on 13/10/2014
Funds/Values Units NAV * Fund Value as on 13/10/2014
Balanced Fund II 1,137.718 14.704 16,729.000
Name of Life Assured Mr VVN Murthy * Total Fund Value 16,729
Client ID 50847222
Name of Nominee (1) : Mrs Sarada Konda
Name of Nominee (2) : N/A
Name of Nominee (3) : N/A

Tax benefits available as per applicable sections of the Income Tax Act 1961, as amended from time to time.
Information on NAV is published daily on our website www.avivaindia.com and in leading financial newspaper.
We have received the amount noted in the schedule being the First Premium on the policy assurance for the plan and amount indicated therein.
*The fund value has been rounded off to nearest rupee
per IRDA Guidelines, units are allocated on the day the proposal is completed and results into a policy by adjustment of application money towards premium.
**Service tax or any other applicable taxes will be charged and/ or deducted on/ from the unit account at the prevailing rate. Tax laws are subject tochange.(ST Regn. No. Delhi-
III/ST/R-I/Insurance & Auxiliary/01/2002.)

Aviva i-Growth : A Unit Linked Insurance Plan that offers a minimal charge structure to maximise your returns and also provides protection to you and your family.

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