BENEFIT ILLUSTRATION

[Date and Time of Illustration – 13 August 2020, 01:11 PM]

Name of the Prospect/Policyholder: Mr. Ravindar Proposal No:

Age & Gender: 30 Years, Male Name of the Product: Max Life Smart Wealth Plan
Name of the Life Assured: Mr. Ravindar Tag Line: A Non-Linked Non Participating Individual Life Insurance Savings Plan
Age & Gender: 30 Years, Male Unique Identification No: 104N116V02
Policy Term: 7 Years GST Rate (Base Policy, First Year): 4.50%
Premium Payment Term: 6 Years GST Rate (Base Policy, Subsequent Year): 2.25%
Amount of Installment Premium: `52,250 GST Rate (Rider, First Year): NA
Mode of payment of premium: Annual
GST Rate (Rider, Subsequent Year): NA
Annual Income Amount: `18,520
Income Period, if applicable: 30 Years Max Life State: Tamil Nadu
Mode of Income, if applicable: Annual Policyholder Residential State: Tamil Nadu

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

Policy Details
Policy Option Long Term Income Sum Assured (in Rs.) Not Applicable

Rider Details
Accidental Death & Dismemberment (ADD) Rider Term NA Accidental Death & Dismemberment (ADD) Rider Sum Assured (in Rs.) NA
Term Plus Rider Term NA Term Plus Rider Sum Assured (in Rs.) NA
Waiver of Premium (WOP) Plus Rider Term NA

Premium Summary
Accidental Death & Waiver of Premium Plus Rider
Base Plan Term Plus Rider Total Installment Premium
Dismemberment Rider
Installment Premium without GST (in Rs.) 50,000 0 0 0 50,000
Installment Premium with first year GST (in Rs.) 52,250 0 0 0 52,250
Installment Premium with GST 2nd year onwards (in Rs.) 51,125 0 0 0 51,125

UIN: 104N116V02 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 3
 (Amount in Rupees)

Guaranteed Non Guaranteed

Single/ Annualized
Policy Year Total Annual Premium
Premium Other Benefits, if any Min Guaranteed Special Surrender Value
Income Benefit Maturity Benefit Death Benefit
(Terminal Benefit) Surrender Value

1 50,000 50,000 - - - 5,50,000 - -

2 50,000 50,000 - - - 5,50,000 30,000 33,000
3 50,000 50,000 - - - 5,50,000 52,500 57,750
4 50,000 50,000 - - - 5,50,000 1,00,000 1,10,000
5 50,000 50,000 - - - 5,50,000 1,25,000 1,47,075
6 50,000 50,000 - - - 5,50,000 2,70,000 1,87,980
7 - - - - - 5,50,000 2,70,000 2,25,570
8 - - 18,520 - - - - -
9 - - 18,520 - - - - -
10 - - 18,520 - - - - -
11 - - 18,520 - - - - -
12 - - 18,520 - - - - -
13 - - 18,520 - - - - -
14 - - 18,520 - - - - -
15 - - 18,520 - - - - -
16 - - 18,520 - - - - -
17 - - 18,520 - - - - -
18 - - 18,520 - - - - -
19 - - 18,520 - - - - -
20 - - 18,520 - - - - -
21 - - 18,520 - - - - -
22 - - 18,520 - - - - -
23 - - 18,520 - - - - -
24 - - 18,520 - - - - -
25 - - 18,520 - - - - -
26 - - 18,520 - - - - -
27 - - 18,520 - - - - -
28 - - 18,520 - - - - -
29 - - 18,520 - - - - -
30 - - 18,520 - - - - -
31 - - 18,520 - - - - -
32 - - 18,520 - - - - -
UIN: 104N116V02 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 3
 Guaranteed Non Guaranteed
Single/ Annualized
Policy Year Total Annual Premium
Premium Other Benefits, if any Min Guaranteed Special Surrender Value
Income Benefit Maturity Benefit Death Benefit
(Terminal Benefit) Surrender Value

33 - - 18,520 - - - - -
34 - - 18,520 - - - - -
35 - - 18,520 - - - - -
36 - - 18,520 - - - - -
37 - - 18,520 3,00,000 - - - -

Notes:
• Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any, and Goods and Service Tax.
• Total Annual Premium includes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any but excludes Goods and Service Tax.
• Refer Sales literature (Prospectus) for explanation of terms used in this illustration.

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

Place: Signature / Thumb Impression / Electronic Signature of Date:8/13/20 Signature / Thumb Impression / Electronic Signature of
Date: 8/13/20 Agent/ Intermediary / Official Prospect/ Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N116V02 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 3
88,30,37,50000,0,50000,M,b88