Professional Documents
Culture Documents
80000788045
Policy Details
Policy Option Annual Income Payout Mode Sum Assured (Rs.) 1,89,989
Guaranteed Death Benefit Payout Option Sum Assured on Death (at inception of the policy) 3,60,000
Rs.
Premium Summary
Base Plan Riders Total Installment Premium
Instalment Premium without GST 18,000 0 18,000
Instalment Premium with First Year GST 18,810 0 18,810
Instalment Premium with GST 2nd Year onwards 18,405 0 18,405
Quotation No
Notes: 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
policy 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