Professional Documents
Culture Documents
80002850041
Policy Details
Classic Sum Assured (Rs.) 6,67,620
Policy Option Sum Assured on Death (at the inception of the
- 50,00,000
policy) Rs.
Premium Summary
Base Plan Riders Total Installment Premium
Instalment Premium without GST 22,254 0 22,254
Instalment Premium with First Year GST 23,255 0 23,255
Instalment Premium with GST 2nd Year onwards 22,755 0 22,755
Quotation No
Amounts in Rs.
Notes:
Quotation No
Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premium paid towards riders, if any, and Goods and Service Tax.
I, ___________________________ (name), have explained the premiums, and benefits under the I, ___________________________ (name), having received the informa on with respect to the
product fully to the prospect / policyholder. above, have understood the above statement before entering into the contract.
Place:
Date: Signature of Agent/ Intermediary/ Official Date: Signature of Prospect / Policyholder