BENEFIT ILLUSTRATION

[Date and Time of Illustration – 15 October 2020, 05:36 PM]

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

Age & Gender: 29 Years, Male Name of the Product: Max Life Smart Wealth Plan
Name of the Life Assured: Mr. Tag Line: A Non-Linked Non Participating Individual Life Insurance Savings Plan
Age & Gender: 29 Years, Male Unique Identification No: 104N116V03
Policy Term: 11 Years GST Rate (Base Policy, First Year): 4.50%
Premium Payment Term: 10 Years GST Rate (Base Policy, Subsequent Year): 2.25%
Amount of Installment Premium: `1,04,500 GST Rate (Rider, First Year): NA
Mode of payment of premium: Annual
GST Rate (Rider, Subsequent Year): NA
Annual Income Amount: `92,200
Income Period, if applicable: 25 Years Max Life State: Punjab
Mode of Income, if applicable: Annual Policyholder Residential State: Punjab

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
Sum Assured on Death (at inception of the policy) (in Rs.) 11,00,000

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
COVID19 One Year Term Rider Term NA COVID19 One Year Term Rider Sum Assured (in Rs.) NA

Premium Summary
Accidental Death & Dismemberment Waiver of Premium Plus COVID19 One Year Term Total Installment
Base Plan Rider
Term Plus Rider Rider Rider Premium
Installment Premium without GST (in Rs.) 1,00,000 0 0 0 0 1,00,000
Installment Premium with first year GST (in Rs.) 1,04,500 0 0 0 0 1,04,500
Installment Premium with GST 2nd year onwards (in Rs.) 1,02,250 0 0 0 0 1,02,250

UIN: 104N116V03 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 1,00,000 1,00,000 - - - 11,00,000 - -

2 1,00,000 1,00,000 - - - 11,00,000 60,000 66,000
3 1,00,000 1,00,000 - - - 11,00,000 1,05,000 1,15,500
4 1,00,000 1,00,000 - - - 11,00,000 2,00,000 2,20,000
5 1,00,000 1,00,000 - - - 11,00,000 2,50,000 2,88,150
6 1,00,000 1,00,000 - - - 11,00,000 3,00,000 3,80,340
7 1,00,000 1,00,000 - - - 11,00,000 3,50,000 4,88,110
8 1,00,000 1,00,000 - - - 11,48,720 5,06,640 6,13,600
9 1,00,000 1,00,000 - - - 13,48,650 6,90,030 7,59,330
10 1,00,000 1,00,000 - - - 15,64,500 9,00,000 9,28,100
11 - - - - - 16,89,700 9,00,000 10,20,900
12 - - 92,200 - - - - -
13 - - 92,200 - - - - -
14 - - 92,200 - - - - -
15 - - 92,200 - - - - -
16 - - 92,200 - - - - -
17 - - 92,200 - - - - -
18 - - 92,200 - - - - -
19 - - 92,200 - - - - -
20 - - 92,200 - - - - -
21 - - 92,200 - - - - -
22 - - 92,200 - - - - -
23 - - 92,200 - - - - -
24 - - 92,200 - - - - -
25 - - 92,200 - - - - -
26 - - 92,200 - - - - -
27 - - 92,200 - - - - -
28 - - 92,200 - - - - -
29 - - 92,200 - - - - -
30 - - 92,200 - - - - -
31 - - 92,200 - - - - -
32 - - 92,200 - - - - -
UIN: 104N116V03 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 - - 92,200 - - - - -
34 - - 92,200 - - - - -
35 - - 92,200 - - - - -
36 - - 92,200 10,00,000 - - - -

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

Place: Signature / Thumb Impression / Electronic Signature of Date:10/15/20 Signature / Thumb Impression / Electronic Signature of
Date: 10/15/20 Agent/ Intermediary / Official Prospect/ Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N116V03 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
88,29,36,100000,0,100000,M,c88