BENEFIT ILLUSTRATION

[Date and Time of Illustration – 11 March 2023, 02:44 PM]

Name of the Prospect/Policyholder: Ms. lakshmi M Proposal No: 141881425

Age & Gender: 39 Years, Female Name of the Product: Max Life Smart Wealth Income Plan
Name of the Life Assured: Ms. lakshmi M Tag Line: A Non-Linked Participating Individual Life Insurance Savings Plan
Age & Gender: 39 Years, Female Unique Identification No: 104N120V02
Policy Term: 36 Years GST Rate (Base Policy, First 4.50%
Premium Payment Term: 12 Years GST Rate (Rider, First Year): 18.00%
Amount of Installment Premium: `53,818 Max Life State: Karnataka
Mode of payment of premium: Annual Policyholder Residential State: Karnataka

How to read and understand this benefit illustration?

This benefit illustration is intended to show year-wise premiums payable and benefits under the policy, at two assumed rates of interest i.e., 8% p.a. and 4% p.a.
Some benefits are guaranteed and some benefits are variable with returns based on the future performance of your Insurer carrying on life insurance business. If your policy offers guaranteed returns benefits then
these will be clearly marked “guaranteed” in the illustration table on the next this page. If your policy offers variable returns benefits then the illustration on the next this page will show two different rates of
assumed future investment returns, of 8%p.a. and 4% p.a.. These assumed rates of return are illustrative, not guaranteed and they are not the upper or lower limits of what you might get back, as the value of your
policy is dependent on a number of factors including future investment performance.

Policy Details
Policy Option Early Income Sum Assured (in Rs.) 8,00,684
Policy Continuance Benefit Option Yes Sum Assured on Death (at inception of the policy) (in Rs.) 5,66,500
Payment Frequency for Guaranteed Income/Cash Bonus Annual

Rider Details
Accidental Death & Dismemberment (ADD) Rider Premium
NA Accidental Death & Dismemberment (ADD) Rider Sum Assured (in Rs.) NA
Payment Term and Rider Term
Term Plus Rider Term NA Term Plus Rider Sum Assured (in Rs.) NA
Waiver of Premium (WOP) Plus Rider Term NA
Critical Illness and Disability Rider - Rider Premium Payment Term
NA Critical Illness and Disability Rider - Coverage Variant NA
and Rider Term
Critical Illness and Disability Rider - Rider Sum Assured NA

Premium Summary

Accidental Death & Waiver of Premium Critical Illness and Total Installment
Base Plan Term Plus Rider
Dismemberment Rider Plus Rider Disability Rider Premium

Installment Premium without GST (in Rs.) 51,500 0 0 0 0 51,500

Installment Premium with first year GST (in Rs.) 53,817 0 0 0 0 53,818
Installment Premium with GST 2nd year onwards (in Rs.) 52,659 0 0 0 0 52,659

UIN: 104N120V02 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)

Non-Guaranteed Benefits Non-Guaranteed Benefits Total Benefits including Guaranteed and Non- Guaranteed Benefits
Guaranteed Benefits
@ 4% p.a. @ 8% p.a.
Survival Benefit Surrender Benefit Death Benefit Maturity Benefit
Single/ Total Total
Surrender Surrender
Annualiz Survival Total Total
Policy Benefit, Benefit, Total Total Total Total
ed Benefit Surrender Surrender Survival Survival incl. of TB, if incl.of TB, if Death
Year Death Maturity Maturity
Premium (Guaranteed Survival Benefit (SSV Death Maturity Survival Benefit (SSV Death Maturity Benefit, Benefit, any @ 4% any @ 8%
Surrender Benefit, Benefit, Benefit, Benefit,
Income/Gua Death Maturity Benefit Including TB Benefit Benefit Benefit Including TB Benefit Benefit incl. of incl. of (Higher of (Higher of
Benefit (4 - Cash (4 - Cash
incl. of TB, incl. of TB, incl. TB, if incl. TB, if
ranteed Benefit Benefit (Cash on (TB on (TB at (Cash on (TB on (TB at Cash Cash
(GSV)* Bonus, if bonus bonus if any @ if any @ any @ 4% any @ 8%
Money Bonus) Surrender) Death) Maturity) Bonus) Surrender) Death) Maturity) Bonus, if
any @ 8% applicable applicable 4% (5+9) 8% (5+13) (6+10) (6+14)
Back) any @ 4%
(3+11) till date) or till date) or
(3+7) 8) 12)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
5,66,5
1 51,500 - - - - - - - - - - - - - - - 5,66,500 5,66,500 - -
00
5,66,5
2 51,500 3,923 26,977 - 480 31,646 - - 11,690 20,437 - - 4,404 15,613 31,646 20,437 5,66,500 5,66,500 - -
00
5,66,5
3 51,500 3,923 46,228 - 480 60,717 - - 11,690 38,298 - - 4,404 15,613 60,717 38,298 5,66,500 5,66,500 - -
00
5,66,5
4 51,500 3,923 91,230 - 480 1,00,089 - - 11,690 66,460 - - 4,404 15,613 1,00,089 66,460 5,66,500 5,66,500 - -
00
5,66,5
5 51,500 3,923 1,13,057 - 480 1,33,022 - - 11,690 88,184 - - 4,404 15,613 1,33,022 88,184 5,66,500 5,66,500 - -
00
5,66,5
6 51,500 3,923 1,34,883 - 480 1,69,561 - - 11,690 1,15,158 - - 4,404 15,613 1,69,561 1,15,158 5,66,500 5,66,500 - -
00
5,66,5
7 51,500 3,923 1,56,710 - 480 2,09,705 - - 11,690 1,55,065 - - 4,404 15,613 2,09,705 1,55,065 5,66,500 5,66,500 - -
00
5,66,5
8 51,500 3,923 2,02,062 - 480 2,53,454 - - 11,690 2,02,161 - - 4,404 15,613 2,53,454 2,02,161 5,66,500 5,66,500 - -
00
5,66,5
9 51,500 3,923 2,53,341 - 480 3,09,716 - - 11,690 2,56,222 - - 4,404 15,613 3,09,716 2,56,222 5,66,500 5,66,500 - -
00
5,66,5
10 51,500 3,923 3,10,461 - 480 3,76,228 - - 11,690 3,17,897 - - 4,404 15,613 3,76,228 3,17,897 5,66,500 5,66,500 - -
00
5,94,8
11 51,500 3,923 3,73,518 - 480 4,49,781 - - 11,690 3,88,294 - - 4,404 15,613 4,49,781 3,88,294 5,94,825 5,94,825 - -
25
6,48,9
12 51,500 3,923 4,42,406 - 480 5,30,418 - - 11,690 4,67,951 - - 4,404 15,613 5,30,418 4,67,951 6,48,900 6,48,900 - -
00
6,48,9
13 - 3,923 4,73,832 - 480 5,73,230 - - 11,690 5,11,110 - - 4,404 15,613 5,73,230 5,11,110 6,48,900 6,48,900 - -
00
6,48,9
14 - 3,923 5,05,196 - 480 5,89,075 - - 11,690 5,30,303 - - 4,404 15,613 5,89,075 5,30,303 6,48,900 6,48,900 - -
00
6,48,9
15 - 3,923 5,01,273 - 480 6,00,516 - - 11,690 5,46,009 - - 4,404 15,613 6,00,516 5,46,009 6,48,900 6,48,900 - -
00
6,48,9
16 - 3,923 4,97,350 - 480 6,12,176 - - 11,690 5,62,932 - - 4,404 15,613 6,12,176 5,62,932 6,48,900 6,48,900 - -
00

UIN: 104N120V02 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
 Non-Guaranteed Benefits Non-Guaranteed Benefits Total Benefits including Guaranteed and Non- Guaranteed Benefits
Guaranteed Benefits
@ 4% p.a. @ 8% p.a.
Survival Benefit Surrender Benefit Death Benefit Maturity Benefit
Single/ Total Total
Surrender Surrender
Annualiz Survival Total Total
Policy Benefit, Benefit, Total Total Total Total
ed Benefit Surrender Surrender Survival Survival incl. of TB, if incl.of TB, if Death
Year Death Maturity Maturity
Premium (Guaranteed Survival Benefit (SSV Death Maturity Survival Benefit (SSV Death Maturity Benefit, Benefit, any @ 4% any @ 8%
Surrender Benefit, Benefit, Benefit, Benefit,
Income/Gua Death Maturity Benefit Including TB Benefit Benefit Benefit Including TB Benefit Benefit incl. of incl. of (Higher of (Higher of
Benefit (4 - Cash (4 - Cash
incl. of TB, incl. of TB, incl. TB, if incl. TB, if
ranteed Benefit Benefit (Cash on (TB on (TB at (Cash on (TB on (TB at Cash Cash
(GSV)* Bonus, if bonus bonus if any @ if any @ any @ 4% any @ 8%
Money Bonus) Surrender) Death) Maturity) Bonus) Surrender) Death) Maturity) Bonus, if
any @ 8% applicable applicable 4% (5+9) 8% (5+13) (6+10) (6+14)
Back) any @ 4%
(3+11) till date) or till date) or
(3+7) 8) 12)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
6,48,9
17 - 3,923 4,93,426 - 480 6,24,076 - - 11,690 5,81,155 - - 4,404 15,613 6,24,076 5,81,155 6,48,900 6,48,900 - -
00
6,48,9
18 - 3,923 4,89,503 - 480 6,36,196 - - 11,690 6,00,792 - - 4,404 15,613 6,36,196 6,00,792 6,48,900 6,48,900 - -
00
6,48,9
19 - 3,923 4,85,580 - 480 6,48,557 - - 11,690 6,21,910 - - 4,404 15,613 6,48,557 6,21,910 6,48,900 6,48,900 - -
00
6,48,9
20 - 3,923 4,81,656 - 480 6,61,149 - - 11,690 6,44,640 - - 4,404 15,613 6,61,149 6,44,640 6,48,900 6,48,900 - -
00
6,48,9
21 - 3,923 4,77,733 - 480 6,73,970 - - 11,690 6,69,081 - - 4,404 15,613 6,73,970 6,69,081 6,48,900 6,48,900 - -
00
6,48,9
22 - 3,923 4,73,810 - 480 6,87,021 - - 11,690 6,95,347 - - 4,404 15,613 6,87,021 6,95,347 6,48,900 6,48,900 - -
00
6,48,9
23 - 3,923 4,69,886 - 480 7,00,313 - - 11,690 7,23,587 - - 4,404 15,613 7,00,313 7,23,587 6,48,900 6,48,900 - -
00
6,48,9
24 - 3,923 4,65,963 - 480 7,13,814 - - 11,690 7,53,917 - - 4,404 15,613 7,13,814 7,53,917 6,48,900 6,48,900 - -
00
6,48,9
25 - 3,923 4,62,040 - 480 7,27,512 - - 11,690 7,86,451 - - 4,404 15,613 7,27,512 7,86,451 6,48,900 6,48,900 - -
00
6,48,9
26 - 3,923 4,58,116 - 480 7,41,385 - - 11,690 8,21,353 - - 4,404 15,613 7,41,385 8,21,353 6,48,900 6,48,900 - -
00
6,48,9
27 - - 4,58,116 - 641 7,58,857 - - 15,613 8,57,933 - - 641 15,613 7,58,857 8,57,933 6,48,900 6,48,900 - -
00
6,48,9
28 - - 4,58,116 - 641 7,76,526 - - 15,613 8,97,096 - - 641 15,613 7,76,526 8,97,096 6,48,900 6,48,900 - -
00
6,48,9
29 - - 4,58,116 - 641 7,94,360 - - 15,613 9,38,956 - - 641 15,613 7,94,360 9,38,956 6,48,900 6,48,900 - -
00
6,48,9
30 - - 4,58,116 - 641 8,12,281 - - 15,613 9,83,662 - - 641 15,613 8,12,281 9,83,662 6,48,900 6,48,900 - -
00
6,48,9 10,31,37
31 - - 4,58,116 - 641 8,30,235 - - 15,613 10,31,378 - - 641 15,613 8,30,235 6,48,900 6,48,900 - -
00 8
6,48,9 11,00,89
32 - - 4,58,116 - 641 8,61,305 - - 15,613 11,00,890 - - 641 15,613 8,61,305 6,48,900 6,48,900 - -
00 0
6,48,9 11,75,15
33 - - 4,58,116 - 641 8,92,496 - - 15,613 11,75,155 - - 641 15,613 8,92,496 6,48,900 6,48,900 - -
00 5

UIN: 104N120V02 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
 Non-Guaranteed Benefits Non-Guaranteed Benefits Total Benefits including Guaranteed and Non- Guaranteed Benefits
Guaranteed Benefits
@ 4% p.a. @ 8% p.a.
Survival Benefit Surrender Benefit Death Benefit Maturity Benefit
Single/ Total Total
Surrender Surrender
Annualiz Survival Total Total
Policy Benefit, Benefit, Total Total Total Total
ed Benefit Surrender Surrender Survival Survival incl. of TB, if incl.of TB, if Death
Year Death Maturity Maturity
Premium (Guaranteed Survival Benefit (SSV Death Maturity Survival Benefit (SSV Death Maturity Benefit, Benefit, any @ 4% any @ 8%
Surrender Benefit, Benefit, Benefit, Benefit,
Income/Gua Death Maturity Benefit Including TB Benefit Benefit Benefit Including TB Benefit Benefit incl. of incl. of (Higher of (Higher of
Benefit (4 - Cash (4 - Cash
incl. of TB, incl. of TB, incl. TB, if incl. TB, if
ranteed Benefit Benefit (Cash on (TB on (TB at (Cash on (TB on (TB at Cash Cash
(GSV)* Bonus, if bonus bonus if any @ if any @ any @ 4% any @ 8%
Money Bonus) Surrender) Death) Maturity) Bonus) Surrender) Death) Maturity) Bonus, if
any @ 8% applicable applicable 4% (5+9) 8% (5+13) (6+10) (6+14)
Back) any @ 4%
(3+11) till date) or till date) or
(3+7) 8) 12)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
6,48,9 12,54,37
34 - - 4,58,116 - 641 9,23,653 - - 15,613 12,54,372 - - 641 15,613 9,23,653 6,48,900 6,48,900 - -
00 2
6,48,9 13,38,75
35 - - 4,58,116 - 641 9,54,603 - - 15,613 13,38,754 - - 641 15,613 9,54,603 6,48,900 6,48,900 - -
00 4
6,48,9 8,00,68 10,95,73 16,44,92
36 - - - 641 - - 2,95,052 15,613 - - 8,44,241 641 15,613 - - 6,48,900 6,48,900
00 4 6 5

Notes:
1. Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any, and Goods and Service Tax. Refer Sales literature for explanation of terms used in
this illustration.
2. The survival benefits are payable at the end of the policy year.
3. The surrender benefit, death benefit and maturity benefit shown above are at the end of the Policy Year.
4. The Surrender Value is higher of the Guaranteed Surrender Value (GSV) and the Special Surrender Value (SSV).
*GSV is shown after deducting the total Guaranteed Survival Benefit applicable till date. In addition, the Total Cash Bonus applicable till date shall also be deducted from the GSV shown above.
5. For details on the Surrender Benefit refer Sales Literature and Policy Document.
6. TB - Terminal Bonus

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

Place: Signature / Thumb Impression / Electronic Signature of Date:3/11/23 Signature / Thumb Impression / Electronic Signature of
Date: 3/11/23 Agent / Intermediary / Official Prospect / Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N120V02 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