For Office Use Only (w.e.f. Nov 19/ Ver 1.

0)

Illustration No: KAIA-5215M-4916-Y1221

Quotation Number:BB091220125721776

Proposal No:

Policy No.:

Name of the Mr. pradeep gill Name of the Product Kotak Assured Income Accelerator
Prospect/Policyholder
Tag Line A Non-Participating Guaranteed
Age of the 52 Income Anticipated Endowment
Prospect/Policyholder (in yrs) Insurance Plan

DOB of the 04 January 1968 Unique Identification No UIN : 107N089V02

Prospect/Policyholder
Base Goods and Services Tax and Cess Rate 4.50%
Name of Life Assured Mr. pradeep gill (GST) (1st Year)

DOB of Life Assured 04 January 1968 Base Goods and Services Tax and Cess Rate 2.25%
(GST) (2nd Year)
Age of Life Assured (in yrs) 52
Rider Goods and Services Tax and Cess Rate 18.00%
Gender of Life Assured Male
(GST)
Policy Term (in yrs) 15
Channel Name Individual Agent
Premium Payment Term (in 7
yrs)

Amount of Installment 10,00,000 Agent's Branch Location Delhi

Premium (in Rs.)
Prospect/Policyholder's Current Location Haryana
Mode of Payment of Premium Yearly

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

POLICY DETAILS

Policy Option : Not Applicable Base Sum Assured (Rs.) : 1,00,00,000

Income Benefit Payout Option : Yearly Base Sum Assured on Death : 1,00,00,000
(at inception of the policy) Rs.

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Quotation Number:BB091220125721776

Rider Details

Rider Premium Paying

Rider Name Rider Sum Assured Rider Policy Term Rider Premium (in Rs.)
Term

Kotak Term Benefit Rider (UIN: 107B003V03) 30,50,000 15 7 71523

Kotak Accidental Death Benefit Rider

50,00,000 15 7 5,650
(UIN:107B001V03)

Kotak Permanent Disability Benefit Rider

50,00,000 15 7 3,400
(UIN:107B002V03)

Kotak Life Guardian Rider (UIN: 107B012V02) Not Selected

Kotak Accidental Disability Guardian Rider (UIN

Not Selected
107B011V02)

Kotak Critical Illness Plus Rider

50,00,000 15 7 1,40,245
(UIN:107B020V01)

PREMIUM SUMMARY

Riders (Please refer Rider Details

Base Plan Total Installment Premium
table)

Installment Premium (without GST) 10,00,000 2,20,818 12,20,818

Installment Premium (with First Year

10,45,000 2,60,565 13,05,565
GST)

Installment Premium (with GST,

10,22,500 2,60,565 12,83,065
Second Year onwards)

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Quotation Number:BB091220125721776

BENEFIT ILLUSTRATION TABLE

Non-
Guaranteed Benefits Guaranteed
End of Policy Age of Life Annualized Benefits
Year Assured Premium Guaranteed Special
Basic Sum Guaranteed Maturity
Death Benefit3 Surrender Surrender
Assured Income$ Benefit4
Value5 Value6

1 53 10,00,000 1,00,00,000 0 0 1,00,00,000 0 0

2 54 10,00,000 1,00,00,000 0 0 1,00,00,000 6,00,000 0

3 55 10,00,000 1,00,00,000 0 0 1,00,00,000 10,50,000 0

4 56 10,00,000 1,00,00,000 0 0 1,00,00,000 20,00,000 10,00,000

5 57 10,00,000 1,00,00,000 0 0 1,00,00,000 25,00,000 21,00,000

6 58 10,00,000 1,00,00,000 0 0 1,00,00,000 30,00,000 33,00,000

7 59 10,00,000 1,00,00,000 0 0 1,00,00,000 35,00,000 46,20,000

8 60 0 1,00,00,000 7,50,000 0 1,00,00,000 39,20,000 50,40,000

9 61 0 1,00,00,000 7,87,500 0 1,00,00,000 35,20,000 47,10,000

10 62 0 1,00,00,000 8,25,000 0 1,00,00,000 31,52,500 42,72,500

11 63 0 1,00,00,000 8,62,500 0 1,00,00,000 27,47,500 37,97,500

12 64 0 1,00,00,000 9,00,000 0 1,00,00,000 23,05,000 32,15,000

13 65 0 1,00,00,000 9,37,500 0 1,00,00,000 17,55,000 25,25,000

14 66 0 1,00,00,000 9,75,000 0 1,00,00,000 12,37,500 17,97,500

15 67 0 1,00,00,000 10,12,500 18,25,000 1,00,00,000 2,62,500 9,62,500

Notes: Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any and
Goods and Services Tax.

$The Guaranteed Income Benefit shall be payable annually on completion of one policy year from the end of premium paying term to the end of policy
term.

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Quotation Number:BB091220125721776

Terms & Conditions:

1. This is a non-linked, non-participating anticipated Endowment Assurance Plan. The illustration stated is for a healthy individual and is under the
assumption that this is the only policy the client has with Kotak Life Insurance and would be subject to underwriting.

2. The benefits under this product are guaranteed for inforce premium paying policy.

3. Death Benefit shall be Sum Assured on death, where Sum Assured on death will be higher of

(i) 11 times Annualized Premium for entry ages less than or equal to 50 years or 7 times Annualized Premium for entry ages 51 and above or
(ii) Basic Sum Assured, or
(iii) 105% of total premiums paid (excluding any extra premiums)
(iv) Guaranteed Maturity Benefit

Due Premiums and Outstanding premiums for the year in which death occurs (applicable for non-annual premium paying policies) will be adjusted
from the Death Benefit mentioned above.

4. Guaranteed Maturity Benefit is paid at maturity and expressed as a % of Basic Sum Assured that varies based on Age and Policy Term. For more
information please refer Sales Brochure.

5. The policy acquires surrender value provided the premiums have been paid for at least two consecutive years. The Surrender Value shall be
higher of Guaranteed Surrender Value or Special Surrender Value and it is prior to the payment of Guaranteed Income due in that policy year.
The Guaranteed Surrender Value will be 'X' percent of total Premiums paid (excluding Goods and Services Tax and Cess, Rider premium and
Extra Premium, if any) less Guaranteed Income already paid, where 'X' percent varies by year of surrender and is mentioned in the table below:

1 2 3 4 5 6 7 8 9
Policy Year:
0% 30% 35% 50% 50% 50% 50% 56% 61%
10 11 12 13 14 15 16 17 18
Policy Year:
67% 73% 79% 84% 90% 90% 0% 0% 0%
19 20 21 22 23 24 25 26 27
Policy Year:
0% 0% 0% 0% 0% 0% 0% 0% 0%
28 29 30
Policy Year:
0% 0% 0%

6. Once policy acquires Surrender Value, the Company shall pay a Special Surrender Value and the same will be quoted in writing by the Company,
on receipt of a written request from the policyholder.In any case, higher of the Guaranteed Surrender Value or Special Surrender Value will be
payable. For more details, please refer the sales brochure.

7. The policy is automatically made Reduced Paid-Up where policy has acquired Surrender Value and due premiums are not received within the
grace period. The Guaranteed Maturity Benefit and Guaranteed income will be based on Reduced Paid-Up Basic Sum Assured where Reduced
Paid-Up Basic Sum Assured = Basic Sum Assured × (Total Premiums paid / Total premiums payable over the term)

On death of the life insured during the policy term after being Reduced Paid-Up, Reduced Paid-Up Sum Assured on death will be paid.
Where Reduced Paid-Up Sum Assured on death = Sum Assured on death × (Total Premiums paid / Total premiums payable over the term)

For more details, please refer to Sales Brochure.

Rider benefit will be available as per Reduced Paid-Up Sum Assured of Rider (if applicable).

8. A lapsed or a Reduced Paid-Up policy can be revived with or without riders within 5 years from the date of the first unpaid premium. Revival can
be done without evidence of good health on payment of the outstanding premiums and late payment charges, if the payment is made within six
months from the date of the first unpaid premium. Thereafter to revive the policy, evidence of good health would be required along with payment
of the outstanding premiums and late payment charges. On revival, only future benefits shall be reinstated to their original level.

9. 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.

10. Goods and Services Tax & Cess, as applicable are levied at the applicable Tax rates in accordance with the prevailing Tax Laws. Prevailing tax
laws are applicable on this policy which may vary from time to time

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Quotation Number:BB091220125721776

11. 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.

12. 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.

Section 41 of the Insurance Act, 1938 states

(1) No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take or renew or continue an insurance in
respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the
premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebate as may be
allowed in accordance with the published prospectuses or tables of the insurer:

(2) Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakh rupees.

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 :_____________ __________________________________ Place :_____________ ______________________________

Date :_____________ Signature of Agent /Intermediary/Official Date :_____________ Signature of Prospect / Policyholder

Kotak Mahindra Life Insurance Company Limited.

CIN: U66030MH2000PLC128503
Regd. Office: 2nd Floor, Plot# C-12, G-Block, BKC, Bandra (E), Mumbai - 400 051
Regn. No: 107. Toll Free No.: 1800 209 8800. Website: http://insurance.kotak.com

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