BENEFIT ILLUSTRATION

[Date and Time of Illustration – 09 July 2021, 04:43 PM]

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

Age & Gender: 26 Years, Male Name of the Product: Max Life Smart Secure Plus Plan
Name of the Primary Life Assured: Mr. dfs fs Tag Line: Non-Linked Non-Participating Individual Life Insurance Pure Risk Premium Plan
Age & Gender: 26 Years, Male Unique Identification No: 104N118V02
Risk Class: Non Smoker GST Rate (Base Policy, First Year): 18.00%
Name of the Secondary Life Assured, if applicable: NA GST Rate (Base Policy, Subsequent Year): 18.00%
Age & Gender: NA GST Rate (Rider, First Year): 18.00%
Risk Class: NA GST Rate (Rider, Subsequent Year): 18.00%
Policy Term: 59 Years
Premium Payment Term: 10 Years Max Life State: Null
Amount of Installment Premium: `1,30,365 Policyholder Residential State: Telangana
Mode of payment of premium: Annual

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

Policy Details
Policy Option Life Cover Sum Assured (in Rs.) 2,50,00,000
Return of Premium Option No Sum Assured on Death (at inception of the policy) (in Rs.) 2,50,00,000

Optional Benefit Details

Optional Benefit Name Applicability/ Opted Sum Assured Coverage Term Payment Term
Accelerated Critical Illness Cover No NA NA NA
Accident Cover Yes 1,00,00,000 59 Years 10 Years
Joint Life Benefit No NA NA NA
Premium Break No NA NA NA

Rider Details

Rider Name Applicability/ Opted Sum Assured Coverage Term Payment Term

Waiver of Premium (WOP) Plus Rider Yes NA 10 Years 10 Years

Critical Illness and Disability Rider_Platinum Plus Yes 10,00,000 49 Years 10 Years

Premium Summary
Accelerated Critical Waiver of Premium
Accidental Cover Critical Illness and Total Installment
Base Plan Joint Life Illness Cover Benefit Plus Rider
Benefit Disability Rider Premium

Installment Premium without GST (in Rs.) 80,470 0 0 14,600 779 14,630 1,10,479
Installment Premium with first year GST (in Rs.) 94,955 0 0 17,228 919 17,263 1,30,365
Installment Premium with GST 2nd year onwards (in Rs.) 94,955 0 0 17,228 919 17,263 1,30,365

UIN: 104N118V02 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 1 of 4
 (Amount in Rupees)

Guaranteed Non Guaranteed

Single/ Annualized Premium
Policy Year Min Guaranteed Surrender
Survival Benefits/ Loyalty Special Surrender Value/
Other Benefits, if any Maturity Benefit Death Benefit Value/ Exit Value
Additions Special Exit Value

1 95,070 - - NA 2,50,00,000 - -
2 95,070 - - NA 2,50,00,000 - -
3 95,070 - - NA 2,50,00,000 - -
4 95,070 - - NA 2,50,00,000 - -
5 95,070 - - NA 2,50,00,000 - -
6 95,070 - - NA 2,50,00,000 - -
7 95,070 - - NA 2,50,00,000 - -
8 95,070 - - NA 2,50,00,000 - -
9 95,070 - - NA 2,50,00,000 - -
10 95,070 - - NA 2,50,00,000 5,52,695 5,52,695
11 - - - NA 2,50,00,000 5,41,416 5,41,416
12 - - - NA 2,50,00,000 5,30,136 5,30,136
13 - - - NA 2,50,00,000 5,18,857 5,18,857
14 - - - NA 2,50,00,000 5,07,577 5,07,577
15 - - - NA 2,50,00,000 4,96,298 4,96,298
16 - - - NA 2,50,00,000 4,85,018 4,85,018
17 - - - NA 2,50,00,000 4,73,739 4,73,739
18 - - - NA 2,50,00,000 4,62,459 4,62,459
19 - - - NA 2,50,00,000 4,51,180 4,51,180
20 - - - NA 2,50,00,000 4,39,900 4,39,900
21 - - - NA 2,50,00,000 4,28,621 4,28,621
22 - - - NA 2,50,00,000 4,17,341 4,17,341
23 - - - NA 2,50,00,000 4,06,062 4,06,062
24 - - - NA 2,50,00,000 3,94,782 3,94,782
25 - - - NA 2,50,00,000 3,83,503 3,83,503
26 - - - NA 2,50,00,000 3,72,223 3,72,223
27 - - - NA 2,50,00,000 3,60,944 3,60,944
28 - - - NA 2,50,00,000 3,49,664 3,49,664
29 - - - NA 2,50,00,000 3,38,385 3,38,385
30 - - - NA 2,50,00,000 3,27,105 8,04,700
UIN: 104N118V02 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 2 of 4
 Guaranteed Non Guaranteed
Single/ Annualized Premium
Policy Year Min Guaranteed Surrender
Survival Benefits/ Loyalty Special Surrender Value/
Other Benefits, if any Maturity Benefit Death Benefit Value/ Exit Value
Additions Special Exit Value

31 - - - NA 2,50,00,000 3,15,826 3,15,826

32 - - - NA 2,50,00,000 3,04,546 3,04,546
33 - - - NA 2,50,00,000 2,93,267 2,93,267
34 - - - NA 2,50,00,000 2,81,987 2,81,987
35 - - - NA 2,50,00,000 2,70,708 2,70,708
36 - - - NA 2,50,00,000 2,59,428 2,59,428
37 - - - NA 2,50,00,000 2,48,149 2,48,149
38 - - - NA 2,50,00,000 2,36,869 2,36,869
39 - - - NA 2,50,00,000 2,25,590 2,25,590
40 - - - NA 2,50,00,000 2,14,310 2,14,310
41 - - - NA 2,50,00,000 2,03,031 2,03,031
42 - - - NA 2,50,00,000 1,91,751 1,91,751
43 - - - NA 2,50,00,000 1,80,472 1,80,472
44 - - - NA 2,50,00,000 1,69,192 1,69,192
45 - - - NA 2,50,00,000 1,57,913 1,57,913
46 - - - NA 2,50,00,000 1,46,633 1,46,633
47 - - - NA 2,50,00,000 1,35,354 1,35,354
48 - - - NA 2,50,00,000 1,24,074 1,24,074
49 - - - NA 2,50,00,000 1,12,795 1,12,795
50 - - - NA 2,50,00,000 1,01,515 1,01,515
51 - - - NA 2,50,00,000 90,236 90,236
52 - - - NA 2,50,00,000 78,956 78,956
53 - - - NA 2,50,00,000 67,677 67,677
54 - - - NA 2,50,00,000 56,397 56,397
55 - - - NA 2,50,00,000 45,118 45,118
56 - - - NA 2,50,00,000 33,838 33,838
57 - - - NA 2,50,00,000 22,559 22,559
58 - - - NA 2,50,00,000 11,279 11,279
59 - - - NA 2,50,00,000 - -

UIN: 104N118V02 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 3 of 4
Notes:
• Annualized Premium includes base policy and additional benefits premium, if opted. It excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any, and Goods and
Service Tax.
• Guaranteed Death Benefit will be paid to the beneficiary, immediately on death of the Life Insured or diagnosis of terminal illness (capped at sum assured of 1 crore) on the Life Insured, whichever is earlier.

Refer Sales literature (Prospectus) for explanation of terms used in this illustration.

I, Mr. Saikiran Thatipamula (name),have explained the premiums, and benefits under the I, dfs fs (name), having received the information with respect to the above, have understood the
product fully to the prospect / policyholder. above statement before entering into the contract.

Place: Signature / Thumb Impression / Electronic Signature of Date:7/9/21 Signature / Thumb Impression / Electronic Signature of
Date: 7/9/21 Agent / Intermediary / Official Prospect / Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N118V02 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 4 of 4