LOLC LIFE ASSURANCE LIMITED

Company Registration No PB-3807

No.481, T.B. Jayah Mawatha, Colombo 10. SRI LANKA
Tel 011-5889488 Fax 011-5931881  
E mail : enquiry@lolclife.com
Web : www.lolclife.com

 Financial Plan For
 Plan
 Date of Birth of Life Assured
 Date of Birth of Spouse
 Period of cover (Years)
 Occupation of Spouse
Life Insurance Quotation
: MISS  RENUKA PATHIRANA Date : 26/08/2021
: LOLC   LIFE PROTECT PLUS Mode of Payment : MONTHLY
: 14/06/1972 Life Assured Age : 49 YEARS
: 24/09/1962 Spouse Age : 59 YEARS
: 16 Occupation of Life Assured : NA
: NA

Main Life Assured Spouse

1  Additional Life Benefit
2  Accidental Death Benefit
3  Total & Permanent Disability
4  Partial Permanent Disability
5  Critical Illness Benefit
6  Hospitalization Benefit per Day
7  Heath Indemnity Rider
8  Family Income Benefit per Month
Benefits payable on Natural Death
Benefits payable on Accidental Death
Special Provisions
Benefit (Rs) Premium (Rs.) Benefit (Rs) Premium (Rs.)
  200,000  703.00
600,000  58.00 600,000  58.00
200,000  136.00 200,000  179.00
400,000  42.00 200,000  21.00
100,000  272.00 100,000  619.00
2,000  188.00 1,700  216.00
   
 
: Basic Sum Assured of Rs. 200,000 or Investment account value, which ever is higher
Basic Sum Assured of Rs. 200,000 or Investment account value, which ever is higher , plus Accidental
:
Death Benefit of Rs. 600,000
Basic Sum Assured increases by 10% every year without any addition to Basic Annual Premium.
:
Claim Value with respect to above will be increased accordingly.

Assumed Annual Dividend Rate Assumed Annual Dividend Rate Assumed Annual Dividend Rate of
of 6% of 8% 10%
Illustrated Maturity Value based on the Monthly premium
812,726 954,796 1,124,919
payment method

Premium (Rs)
Date of Birth Gender Age HB per Day Critical Illness Health Indemnity HB CIB Health
Benefit Indemnity
Child 1 08/01/2003 19
Child 2 26/07/2006 Male 15 1,700 100,000 80.00 41.00
Child 3
Child 4

  Yearly Half Yearly Quarterly Monthly

 Basic Premium (Rs.) 38,412 19,206 9,603 3,201
 Premium for Protection Benefits (Rs.) 28,959 15,065 7,535 2,613
 Total Premium (Rs.) 67,371 34,271 17,138 5,814

 Rs. 500 will be charged as Policy Fee with 1st Premium in addition to above mentioned Total Installment Premium
Premiums in the quotation is valid for standard lives only.

 User    :   AGENTNAME Page     1/3     V 1.2.8

 Assumed Annual Assumed Annual Assumed Annual
Premium Mode
Dividend Rate of 6% Dividend Rate of 8% Dividend Rate of 10%
 Illustrative Maturity Benefit Yearly 834,687 989,136 1,175,457
 (Illustrative Investment Account Value at Maturity) Half Yearly 822,718 970,352 1,147,769
Quaterly 816,714 961,017 1,134,048
Monthly 812,726 954,796 1,124,919

Annual 6% Illustration 8% Illustration 10% Illustration

Year
Premium Amount Payable on Death Investment Account Value Amount Payable on Death Investment Account Value Amount Payable on Death Investment Account Value
1 38,412 200,000 10,291 200,000 10,396 200,000 10,502
2 38,412 220,000 34,949 220,000 35,517 220,000 36,086
3 38,412 240,000 67,768 240,000 69,396 240,000 71,045
4 38,412 260,000 109,216 260,000 112,709 260,000 116,287
5 38,412 280,000 152,785 280,000 159,118 280,000 165,676
6 38,412 300,000 198,613 300,000 208,881 300,000 219,646
7 38,412 320,000 246,860 320,000 262,297 320,000 278,690
8 38,412 340,000 297,703 340,000 319,701 343,372 343,372
9 38,412 360,000 351,347 381,448 381,448 414,141 414,141
10 38,412 407,954 407,954 447,667 447,667 491,325 491,325
11 38,412 467,476 467,476 518,537 518,537 575,480 575,480
12 38,412 529,978 529,978 594,383 594,383 667,235 667,235
13 38,412 595,601 595,601 675,549 675,549 767,275 767,275
14 38,412 664,495 664,495 762,406 762,406 876,347 876,347
15 38,412 736,816 736,816 855,348 855,348 995,266 995,266
16 38,412 812,726 812,726 954,796 954,796 1,124,919 1,124,919
- - - - - - - -
Note 1. The Dividend rates assumed above are only for illustration of three different scenarios and do not represent the upper or lower limit of what you might receive.
: 2. The Investment account values mentioned is only an illustration and is subject to change depending on the declared dividend rates based on prevailing market conditions. Dividend rate will be     declared
at the beginning of each year.
3. Fund accumulations are based on Monthly premium payment method (Actual Maturity value will depend on the actual dividends declared & date of premium payment)
Year 2014 2015 2016 2017 2018 2019
Declared Dividend Rate (per annum) 7% 9% 9% 9% 9% 8.50%
Additional Notes applicable to this Quotation
 1. Please note that additional covers 2,3,4 and 5 are valid up to age 70 and 6 and 7 are valid up to age 65 of Life assured and spouse.
 2. If Total Permanent Disability is obtained, in the event of Total Permanent Disability (Accident or Sickness) Waiver of Premium Benefit will be available for the main Life Assured for Basic Premium for free     of
charge.
 3. Age of the Life Assured / Spouse on the date of commencement of the policy shall be less than 55 years to qualify for 40 - Critical Illness Benefit, age of the Life Assured / Spouse over 55 years will be      qualify
for 39 - Critical Illness (Excluding Angioplasty).
 4. For full details and conditions applicable to the policy please refer the policy document.
 5. For any alterations made on this Quotation – Illustration will not be valid.
 6. In the event of Death or TPD (due to sickness or accident) Family Income Benefit will be activated until policy gets maturity.
 7. Please refer the 3rd page for required basic medicals (If applicable).
 8. This quotation is valid for 60 days from the date of issuance, unless the age doesn't change within 60 days.
 Customer Declaration:
 I hereby certify that I have read and understood the information stated in this quotation to the best of my knowledge.

  Sales Officer:  
Customer Signature I declare that I have explained the above quotation and benefits to the customer. Signature
 Date :  26/08/2021 Agent Code  :
 User :  AGENTNAME Page               :   2/3 V 1.2.8
 Financial Plan For : MISS  RENUKA PATHIRANA Date : 26/08/2021
 Plan : LOLC   LIFE PROTECT PLUS Mode of Payment : MONTHLY
 Date of Birth of Life Assured : 14/06/1972 Life Assured Age : 49 YEARS
 Date of Birth of Spouse : 24/09/1962 Spouse Age : 59 YEARS
 Period of cover (Years) : 16 Occupation of Life Assured : NA
 Occupation of Spouse : NA
 

Life Assured   Spouse

MER RUA   MER RUA

FBS -   FBS HbA1c

- -   ECG -

- -   - -

- -   - -

- -   - -
12 hours fasting is required for FBS
and Lipid Profile - -   - -
(If Applicable only).
- -   - -

- -   - -

- -   - -

- -   - -

- -   - -

- -   - -

- -   - -

- -   - -

 * Medicals only for the above quotation

 Date :  26/08/2021 Page               :  3/3 V 1.2.8

 User :  AGENTNAME