Date & Time : 2022-08-25 12:45 PM

Quotation No : 678111 - 2
Branch : Beruwala
Agent Name : A.A.M. Madumantha
Agent Code : 13365
Contact No : 0701768487

ARPICO RELIEF PLAN

Main Life Details Occupation DOB Age Gender

MR M N M AMIR Business Man 12-03-1979 44 Male

Spouse Details
MRS M M F SHYAMA Business Partner 09-01-1979 44 Female

Plan Details
Term Paying Term Premium Payment Basic Sum Assured
Frequency
25 15 33,126 Monthly 2,770,000

Monthly Quarterly Half Yearly Yearly

33,126 98,453 195,294 386,895

Benefits

Main Life Spouse Children

Living Benefits
Amount Premium Amount Premium Amount Premium

Guaranteed Maturity 4,501,250 0 - - - -

Critical illness Benefit with cash back protector 500,000 1,008 - - - -

Super Healthcare Benefit Individual 600,000 4,466 600,000 5,936 600,000 1,423

Hospitalization per Day Benefit 15,000 1,545 15,000 1,545 - -

Waiver of Premium Benefit (WPB) Applied 685 - - - -

Main Life Spouse Children

Additional Benefits
Amount Premium Amount Premium Amount Premium

Natural Death Cover 2,770,000 12,698 2,500,000 3,744 - -

Accidental Death Benefit - - - - - -

Funeral Expenses - - - - - -

* Sum assured increase every year by 2.5%

Year Premium per year for Total Premium Paid per Minimum Life Benefits
Basic Policy year
Protection against Protection against
Natural Death Accident Death

1 152,376.00 397,512.00 2,839,250.00 2,839,250.00

2 304,752.00 795,024.00 2,908,500.00 2,908,500.00

3 457,128.00 1,192,536.00 2,977,750.00 2,977,750.00

4 609,504.00 1,590,048.00 3,047,000.00 3,047,000.00

5 761,880.00 1,987,560.00 3,116,250.00 3,116,250.00

6 914,256.00 2,385,072.00 3,185,500.00 3,185,500.00

7 1,066,632.00 2,782,584.00 3,254,750.00 3,254,750.00

8 1,219,008.00 3,180,096.00 3,324,000.00 3,324,000.00

9 1,371,384.00 3,577,608.00 3,393,250.00 3,393,250.00

10 1,523,760.00 3,975,120.00 3,462,500.00 3,462,500.00

11 1,676,136.00 4,372,632.00 3,531,750.00 3,531,750.00

12 1,828,512.00 4,770,144.00 3,601,000.00 3,601,000.00

13 1,980,888.00 5,167,656.00 3,670,250.00 3,670,250.00

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 14 2,133,264.00 5,565,168.00 3,739,500.00 3,739,500.00

15 2,285,640.00 5,962,680.00 3,808,750.00 3,808,750.00

16 Relief Relief 3,878,000.00 3,878,000.00

17 Relief Relief 3,947,250.00 3,947,250.00

18 Relief Relief 4,016,500.00 4,016,500.00

19 Relief Relief 4,085,750.00 4,085,750.00

20 Relief Relief 4,155,000.00 4,155,000.00

21 Relief Relief 4,224,250.00 4,224,250.00

22 Relief Relief 4,293,500.00 4,293,500.00

23 Relief Relief 4,362,750.00 4,362,750.00

24 Relief Relief 4,432,000.00 4,432,000.00

25 Relief Relief 4,501,250.00 4,501,250.00

Guranteed Maturity : 4,501,250

Medical Requirements

Main Life : Not Applied

Financial Requirements : Not Applied

Special Notes

1. Premiums are on standard rates and could differ based on health/medical/occupational grounds.

2. All amounts are in Sri Lankan Rupees (LKR).

3. Initial policy processing fee of Rs 300 (Payable only with initial deposit).

4. This is only an indicative quote. Valid for 30 days from date of issue.

5. If the above Benefits table includes any benefit with Cash back protector benefit the company will return the total premiums paid in respect of the
same benefit ,Subject to no calims paid under any circumstances during the tenor of the policy.

Declaration of Life to be Assured:

I hereby certify that I have read and understood the information stated in this quotation to the best of my knowledge

....................................... .......................................
Signature of Life to be Assured Date .

Sales Officer:
I declare that I have explained the above quotation and benefits to the Life to be Assured.

....................................... .......................................
Signature of Sales officer Date .

This is a system generated report, therefore signature not required. Page 2 of 2