Policy Document 20240798

Download as pdf or txt
Download as pdf or txt
You are on page 1of 24

PART A

INDIAFIRST LIFE INSURANCE COMPANY LIMITED


Regd. & Corporate Office: 12th and 13th Floor, North [C] Wing,Tower 4, Nesco IT Park, Nesco Center,Western Express
Highway,Goregaon (East),Mumbai – 400063
CIN : U66010MH2008PLC183679
T41 14601/338228/SpeedPost/B9612/0

Date : Mar 07, 2022

AX270716274IN
To, Agency code : 50000001
Mr. Siddharthkumar Sahay Agency Name : BANK OF BARODA
Flat no 402
A Block Monarch Residency 4 Branch Name : KESHOD
Rayji baug Junagadh
Junagadh Contact No : 2871236044
Gujarat - 362001 Email ID : [email protected]
Mobile No: 9840266139
Policy No: 20240798
Branch Address IndiaFirst Financial Planning Center Address
KRISHNA KRIPA 206/207, Zodiac Plaza
BHAVSAR VAD DARWAJA Nr / Nabard Flats
GUJARAT Opp: Shambhu Coffee Bar
Gujarat - 387810 H L Comm. Clg Rd Ahmedabad
India Gujarat - 380009
India

This page is intentionally left blank. IndiaFirst Life Guaranteed Protection Plan – UIN: 143N058V01
A Non-Linked, Non-Participating, Individual Term Insurance Plan
Dear Customer,

Congratulations! You have taken a step towards insuring your ‘Happy Family’ and we are glad to be part of this journey with you.

All our products have been designed to be simple and easy to understand, providing true value for money.

We have provided you the relevant information about your policy in this policy document. This document is simple to understand.
Please read it carefully to ensure that this is the right policy for your financial needs.

You have a free look period of 15 days from the date of receipt of the policy document and a period of 30 days in case of electronic
policies and policies obtained through Distance Marketing, to review the terms and conditions of the policy and in case you disagree to
any of those terms or conditions, you shall have the option to return the policy to us for cancellation, stating the reasons for your
objection, then you shall be entitled to a refund of the premium paid subject only to a deduction of a proportionate risk premium for the
period of cover and the expenses incurred by us on medical examination of the life to be assured and stamp duty charges. Such a
request received by us for free look cancellation of the policy shall be processed and premium refunded within 15 days of receipt of the
request.

In case of any communication in respect of the policy; You may contact Us at IndiaFirst Life Insurance Company Ltd, 12th & 13th floor,
North [C] Wing, Tower 4, Nesco IT Park, Nesco Center, Western Express Highway, Goregaon (East), Mumbai – 400 063. You can also
write to Us at [email protected] or contact us on 1800 209 8700. IRDAI Regn No. 143. CIN:
U66010MH2008PLC183679.

Thank you once again for choosing IndiaFirst.


Yours truly,

Atri Chakraborty
Chief Operating Officer

Insurance Intermediary Details

Name: BANK OF BARODA

Intermediary Code : CA0004

Telephone No.: 022-66985000-04


Address: Baroda Coporate Centre C26, G Block,Bandra Kurla Complex Bandra East, Mumbai .. 400051

E-mail ID : [email protected]

1 of 45
14601/338228
T41

Policy Preamble
IndiaFirst Life Guaranteed Protection Plan
A Non-Linked Non-Participating Term Insurance Plan
143N058V01
The Policyholder and the Life Assured named in the Policy Schedule have submitted the Proposal Form together with a personal
statement and paid the first instalment of Premium specified herein to the Company for grant of the benefits specified in the
Policy Schedule. It is agreed by the Policyholder, the Life Assured and the Company that the Proposal Form and the personal
statement together with any report or other documents shall form the basis for issuance of this Policy and that the grant of the
benefits under this Policy are subject to due receipt of subsequent instalments of Premiums and due compliance with the terms
and conditions contained in this document.

Subject to the terms and conditions of this Policy, the Company agrees that the benefits under this Policy shall become payable
on the death of the Life Assured during the Policy Term or on occurrence of the covered event during the Policy Term, as the
case may be.

It is further hereby declared that every endorsement issued on this Policy by the Company shall be deemed to be a part of this
Policy

Signed by and on behalf of


IndiaFirst Life Insurance Company Limited

This page is intentionally left blank.


Atri Chakraborty
Chief Operating Officer

2 of 45
14601/338228
FirstPremiumReceipt
Mr.SiddharthkumarSahay
Flat no 402
A Block Monarch Residency 4
Rayji baug Junagadh
Junagadh
Gujarat - 362001
Mobile No: 9840266139

Premium Payment Details


Policy number 20240798
Name of the Policyholder Mr. Siddharthkumar Sahay
Basic plan IndiaFirst Life Guaranteed Protection Plan
Premium Received (In INR): 33,579.26
Payment mode Yearly
Next Premium due 28/02/2023

Pleasenote:
This page is intentionally left blank. n If you are an individual, your premiums paid under the plan, are eligible for tax deductions under Section 80 C as applicable
under Income Tax Act, 1961

n Tax laws are subject to change from time to time. Please refer to the ‘Policy Schedule’ available with the Plan Documents for
further details.

n
This is a computer generated receipt and does not require a signature

n
This receipt is issued subject to the clearance of the payment

Please contact us for any further information, on 1800-209-8700 or email us at [email protected] or visit us at
www.indiafirstlife.com

Consolidated Revenue Mudrank paid vide certificate No. CSD/171/2019/4521 Dt. 3rd October 2019.

3 of 45
14601/338228
This page is intentionally left blank.

4 of 45 45 of 45
14601/338228 14601/338228
Policy Schedule

I. Policyholder and Life Assured Details


Policyholder’s Name: Mr. Siddharthkumar Sahay
Date of Birth: 01/03/1989
Age (In Years): 33
Relationship with Life Assured: Self
Flat no 402
Policyholder’s Address: A Block Monarch Residency 4 Rayji baug Junagadh
Junagadh
Gujarat - 362001

Telephone No./ Mobile No: 9840266139


Email Address: [email protected]
Life Assured’s Name: Mr. Siddharthkumar Sahay
Date of Birth: 01/03/1989
Age (In Years) : 33
Client ID: 64124589
Gender (Male / Female): M
Flat no 402
Life Assured’s Address: A Block Monarch Residency 4 Rayji baug Junagadh
Junagadh
Gujarat 362001
Telephone No./ Mobile No: 9840266139
Email Address: [email protected]

Secondary Life Assured (spouse) Details (in case Joint Life Option or Better-Half Benefit is selected)
Secondary Life Assured’s (spouse) Name:
Date of Birth:
Age :
Client ID:
Gender: (Male/ Female/ Transgender):

Secondary Life Assured’s Address:

Telephone No./ Mobile No:


Email Address:

I.Policy details
Company Name: IndiaFirst Life Insurance Company Limited
Product Name: IndiaFirst Life Guaranteed Protection Plan
UIN: 143N058V01
Policy Number: 20240798
Proposal Form Number: P03423434
Policy Commencement Date: 28/02/2022
Risk Commencement Date : 28/02/2022
Maturity Date : 28/02/2075

44 of 45 5 of 45
14601/338228 14601/338228
II.Premium and Benefit Details

Plan Option : Life Benefit Base Sum Assured: 10,000,000.00

Payout Option: LUMPSUM


<< Lumpsum Payout %
(in case any of the Lumpsum and Level Income option or 100
Lumpsum and Increasing Income option are selected)>>
Accidental Death Benefit Sum Assured (in case Accidental Death
Cover (Additional) plan variant is chosen under Incidence Coverage Waiver of Premium Benefit N
Option): 0.00
Critical Illness Sum Assured (in case Critical Illness Cover
(Accelerated) plan variant is chosen under Incidence Coverage
Option): 0.00
Income Period (in case Long Term Care Option is chosen):
ROP % : 000
Maturity Benefit: (in case Return of Premium Option is chosen) :
0.00
Age at which the Survival Benefit shall commence (in case Dual
Protect Option is chosen):

Joint Life Option : N Better-Half Benefit : N


Sum Assured for Secondary Life
0.00
Assured (spouse):
Policy Term (In Years) 53 Premium Paying Term (In Years) 10
Premium Payment Mode: Yearly Premium Due Dates : 28/02/2023
Due Date for Payment of Last
28/02/2031
Regular Premium :
Annualized Premium (in INR) : 28,457.00 Installment Premium (in INR) : 33,579.26
Applicable Taxes (in INR)
Extra Premium, if any (in INR): 0.00 Policy Year 1 : 5,122.26
Policy Year 2 onwards: 5,122.26
Total Premium (including Applicable Taxes) in INR:
Policy Year 1 : 33,579.26
Policy Year 2 onwards:

III.Nominee(s) details as per Section 39 of the Insurance Act, 1938 as amended from time to time
Nominee Name Percentage Share Age of Nominee Relationship of Nominee Appointee’s Name*
Mrs. Prerna Priya 100% 28 Wife
*If any of the Nominees is a minor, then, the Appointee will be the person named as the Appointee in the Proposal Form and
shall be entitled to receive the death benefit from us for and on behalf of the Nominee under this Policy.

6 of 45 43 of 45
14601/338228 14601/338228
VI. Insurance Distributor Details
Name: BANK OF BARODA
License Number : CA0004
Telephone No.: 022-66985000-04
Address: Baroda Coporate Centre C26, G Block,Bandra Kurla Complex Bandra East, Mumbai .. 400051

E-mail ID : [email protected]

VII. Special Conditions


NIL
The Stamp Duty of Rs. 2,000.00/- (Rupees Two Thousand Rupees . only) paid vide certificate No. CSD/253/2022/1382 dated 21st Jan 2022.
Government Notification Revenue and Forest Department No. Mudrank CSD/227/2021/6305, dated Dt. 28th Dec 2021.

Note: ON EXAMINATION OF THIS POLICY, if you notice any mistake, then, you may contact us for correction of the same.

The Premium payable under this Policy may differ on the basis of the Extra Premiums, if any, the Premium payment mode chosen by you and the
applicable Modal Factor.

Please read the terms and conditions of this Policy carefully to understand the terms referred to in this Policy Schedule.

42 of 45 7 of 45
14601/338228 14601/338228
PART B

Definitions
We have listed below a few words, terms and phrases which have been used in this Policy along with their meaning for your easy reference.

Word Meaning
Age of the Life Assured as at the last birthday on the Policy Commencement Date and on any subsequent
Age
Policy Anniversary.
Annexure Any annexure, endorsement attached to this Policy as changed/ modified and issued by us from time to time.
Annualized premium shall be the premium payable in a year chosen by the Policyholder, excluding the
Annualized Premium
applicable taxes, rider premiums, underwriting extra premiums and loadings for modal premiums, if any.
The person appointed by you to receive the benefits under this Policy, if the Nominee is less than 18
Appointee
(Eighteen) years of Age.
Assignment is the process through which Policyholder can assign the rights and benefits under the policy to
Assignment any other person / entity by virtue of an assignment clause under section 38 of the Insurance Act, 1938 as
amended from time to time.
Distance Marketing includes every activity of solicitation (including lead generation) and sale of insurance
products through the following modes: (i) Voice mode, which includes telephone-calling; (ii) Short Messaging
Distance Marketing service (SMS); (iii) Electronic mode which includes e-mail, internet and interactive television (DTH); (iv)
Physical mode which includes direct postal mail and newspaper & magazine inserts; and, (v) Solicitation
through any means of communication other than in person
An additional amount payable by you, which is determined by us in accordance with our board approved
underwriting policy. This is determined on the basis of information provided by you in the Proposal Form or on
Extra Premium
the basis of any other information submitted to us or through medical examination of the Life Assured subject
to your consent.
A period of 15 days (30 days if the policy is sourced through distance marketing or electronic mode) from the
Free Look Period date of receipt of the Policy, during this period you can return the policy if you disagree to any of the terms and
conditions of your policy.
A period of one month but not less than 30 (Thirty) days from the due date for payment of Premium for yearly,
Grace Period half yearly and quarterly Premium payment mode and 15 (Fifteen) days for monthly Premium payment mode.
During this period the policy will be considered to be in-force.
The minimum amount payable by us on Surrender of this Policy for applicable plan options as specified in
Guaranteed Surrender Value
PART D.
Income Tax Act Income Tax Act, 1961, as amended from time to time
An amount that you pay us during the Premium Paying Term at regular intervals for securing the benefits
under this Policy. The Premium payable under this Policy will be determined by us on the basis of the Premium
Installment Premium
payment mode chosen by you and the applicable Modal Factor. Your Premium is specified in the Policy
Schedule.
Insurance Act Insurance Act, 1938 and as amended from time to time
Non-payment of premium within the expiry of grace period and provided Policy has not acquired any Paid-Up
Lapse
value.
Life Assured The person on whose life this Policy has been issued by us.
Limited Premium Policy Limited Premium Policy is any Policy where the Premium Paying Term is less than Policy Term
This is the amount you receive on the Maturity Date, if any, provided the Life Assured is alive, as specified in
Maturity Benefit
PART C of this Policy Document.
A factor used by us for calculating the instalment Premium payable by You under this Policy, if you have opted
Modal Factor
to pay the Premium other than yearly mode.
Nominee is the person nominated by the Life Assured under this Policy who is authorized to receive the claim
Nominee
benefit payable under this Policy and to give a valid discharge to the Company on settlement of the claim
Nomination Nomination is as per section 39 of the Insurance Act, 1938 as amended from time to time
Under this Policy, if we have received all the due Premiums from you for the first 2 (Two) full Policy Years then,
Paid-Up Mode this Policy will not terminate on non-payment of due premium(s) but continue under paid up mode. This is only
applicable for Return of Premium Option and Dual Protect Option.
This IndiaFirst Life Guaranteed Protection Plan, which includes this Policy wording (as may be changed/
modified by us subject to receipt of prior approval of the Regulatory Authority, from time to time), the Proposal
Policy
Form, Annexures, the Policy Schedule, any tables, information and documents which form a part of this Policy.
This Policy includes the entire contract of insurance between you and us.
Policy Anniversary The annual anniversary of the Policy Commencement Date.
Policy Commencement Date The date on which this Policy is issued by us. This is specified in the Policy Schedule.
The schedule attached to this Policy and if we have issued a revised Policy Schedule, then, such revised
Policy Schedule
Policy Schedule.
Policy Term The period which starts on the Policy Commencement Date and ends on the Maturity Date.
A period of 12 (Twelve) consecutive months starting from the Policy Commencement Date and ending on the
Policy Year day immediately preceding its annual anniversary and each subsequent period of 12 (Twelve) consecutive
months thereafter during the Policy Term.
Premium An amount that you pay us for securing the benefits under this Policy. This is specified in the Policy Schedule.
The time period during which you need to pay your Premiums regularly to us for securing the benefits under
Premium Paying Term
this Policy. Your Premium Paying Term is specified in the Policy Schedule.
Proposal Form The proposal form completed and submitted by you based on which we have issued this Policy to you.
Risk Cover Benefit The benefit payable on occurrence of any covered event, as specified in PART C of this Policy Document.

8 of 45 41 of 45
14601/338228 14601/338228
Risk Commencement Date The date on which the insurance coverage starts under this Policy. This is specified in the Policy Schedule.
The Insurance Regulatory and Development Authority of India or such other authority or authorities, as may be
Regulatory Authority designated/ appointed under the applicable laws and regulations as having the authority to oversee and
regulate life insurance business in India.
Revival is the process of restoring all the benefits under the Policy due to the nonpayment of premiums on due
Revival
dates, resulting in the Policy getting lapsed or paid-up as the case may be.
The period of 5 (Five) consecutive years from the date of first non-payment of premium during which you may
revive the policy by paying all the arrears premium with (under Return of Premium Option and Dual Protect
Revival Period
Option) or without (under plan options other than Return of Premium Option and Dual Protect Options) any
interest to us and comply with the conditions specified in Part D, as the case may be for reviving the Policy.
Single Premium Policy Single Premium Policy means a Policy where the Policy Premium is payable as lumpsum in one-go
The Special Surrender Value will be used by us for determining the Surrender Value payable under this Policy
Special Surrender Value
upon Surrender of this Policy, for applicable plan options as specified in PART D.
Surrender Termination or cancellation of this Policy prior to the Maturity Date.
The amount payable by us on Surrender of this Policy before the Maturity Date, which is higher of the
Surrender Value Guaranteed Surrender Value or the Special Surrender Value, for applicable plan options as specified in PART
D.
The amount payable by us at the time of termination of policy by the policyholder either after completion of
premium paying term under limited premium policy or after completion of three years under single premium
Termination Value
policy. This amount is payable so as to provide benefits on termination when policyholder has paid all due
premiums.
Total Premiums Paid Total Premiums paid shall be (Annualized premium*number of years for which premiums have been paid)
We or us or our or Insurer or
IndiaFirst Life Insurance Company Limited.
Company
You or your or Policyholder or
The person named as the Policyholder in the Policy Schedule, who has taken this Policy from us.
Proposer
Plan option specific Definitions - Details of the benefits are provided in Part C
Accident An accident is a sudden, unforeseen and involuntary event caused by external and visible means.
Accidental Total Permanent Disability means disablement of the Life Assured as a result of an accident during
the term of the policy, which meets one or both of the two definitions:

Definition 1: Loss of use of limbs or visual loss


As a result of accidental bodily injury the Life Assured has suffered
 Loss of the use of both limbs; or
 Loss of the sight in both eyes ( Blindness ) ; or
 Loss of the use of one limb and the sight of one eye

The loss of a limb means the physical separation of a limb, at or above the wrist or ankle level as a result of
injury. This will include medically necessary amputation necessitated by injury. The separation has to be
permanent without any chance of surgical correction. Loss of a limb resulting directly or indirectly from self-
inflicted injury, alcohol or drug abuse is excluded. The loss of use of the particular limb must be certified by a
relevant Medical Practitioner and documented for an uninterrupted period of at least six months.

1. The total loss of vision in one eye means total, permanent and irreversible loss of all vision in an eye as a
result of accident.

2. Loss of sight in both eyes – (Blindness) evidenced by:

Accidental Total Permanent I. Total, permanent and irreversible loss of all vision in both eyes as a result of accident
Disability i. corrected visual acuity being 3/60 or less
in both eyes or;
ii. the field of vision being less than 10
degrees in both eyes
II. The diagnosis of blindness or the total loss of vision in one eye must be confirmed and must not be
correctable by aids or surgical procedure

Definition 2:
Loss of independent living
Permanent Loss of ability through an injury caused solely by an accident, to do at least 3 of the 6 tasks listed
below ever again. Total and Permanent Disability should occur within Ninety 90 days of the accident
independent of any other causes.
For the purpose of this benefit, the word “permanent” shall mean beyond the scope of recovery with current
medical knowledge and technology.
The insured person must need the help or supervision of another person and be unable to perform the task on
their own, even with the use of special equipment routinely available to help and having taken any appropriate
prescribed medication. Loss of independent living must be medically documented for an uninterrupted period
of at least six months.

The tasks are:


i. Washing: the ability to wash in the bath or shower (including getting into and out of the bath or shower) or
wash satisfactorily by other means;

40 of 45 9 of 45
14601/338228 14601/338228
ii. Dressing: the ability to put on, take off, secure and unfasten all garments and, as appropriate, any braces,
artificial limbs or other surgical appliances;
iii. Transferring: the ability to move from a bed to an upright chair or wheelchair and vice versa;
iv. Mobility: the ability to move indoors from room to room on level surfaces
v. Toileting: the ability to use the lavatory or otherwise manage bowel and bladder functions so as to maintain a
satisfactory level of personal hygiene;
vi. Feeding: the ability to feed oneself once food has been prepared and made available
Medical Practitioner means a person who holds a valid registration from the Medical Council of any State or
Medical Council of India or Council for Indian Medicine or for Homeopathy set up by the Government of India
or a State Government and is thereby entitled to practice medicine within its jurisdiction; and is acting within its
scope and jurisdiction of license.
Medical Practitioner The Medical practitioner should not be the policyholder/insured person himself/herself; or an authorized
insurance intermediary (or related persons) involved with selling or servicing the insurance contract in question;
or employed by or under contractual engagement with the insurance company; related to the policyholder/insured
person by blood or marriage.
A Life Assured shall be regarded as Terminally Ill only if that Life Assured is diagnosed as suffering from a
condition which, in the opinion of two independent medical practitioners specializing in treatment of such illness,
Terminal Illness is highly likely to lead to death within 6 months. The Terminal Illness must be diagnosed and confirmed by
medical practitioners registered with the Indian Medical Association and approved by the Company. The
Company reserves the right for independent assessment.
1. Cancer of specified severity

I. A malignant tumor characterized by the uncontrolled growth and spread of malignant cells with invasion and
destruction of normal tissues. This diagnosis must be supported by histological evidence of malignancy. The
term cancer includes leukemia, lymphoma and sarcoma.

II. The following are excluded –

i. All tumors which are histologically described as carcinoma in situ, benign, pre-malignant, borderline
malignant, low malignant potential, neoplasm of unknown behavior, or non-invasive, including but not limited
to: Carcinoma in situ of breasts, Cervical dysplasia CIN-1, CIN -2 and CIN-3.
ii. Any non-melanoma skin carcinoma unless there is evidence of metastases to lymph nodes or beyond;
iii. Malignant melanoma that has not caused invasion beyond the epidermis;
iv. All tumors of the prostate unless histologically classified as having a Gleason score greater than 6 or having
progressed to at least clinical TNM classification T2N0M0
v. All Thyroid cancers histologically classified as T1N0M0 (TNM Classification) or below;
vi. Chronic lymphocytic leukaemia less than RAI stage 3
vii. Non-invasive papillary cancer of the bladder histologically described as TaN0M0 or of a lesser
classification,
viii.All Gastro-Intestinal Stromal Tumors histologically classified as T1N0M0 (TNM Classification) or below and
with mitotic count of less than or equal to 5/50 HPFs;

Critical Illnesses Covered 2. Open Chest CABG

I. The actual undergoing of heart surgery to correct blockage or narrowing in one or more coronary artery(s),
by coronary artery bypass grafting done via a sternotomy (cutting through the breast bone) or minimally
invasive keyhole coronary artery bypass procedures. The diagnosis must be supported by a coronary
angiography and the realization of surgery has to be confirmed by a cardiologist.

II. The following are excluded:


i. Angioplasty and/or any other intra-arterial procedures

3. Myocardial Infarction (First Heart Attack of specific severity)

I. The first occurrence of heart attack or myocardial infarction, which means the death of a portion of the heart
muscle as a result of inadequate blood supply to the relevant area. The diagnosis for Myocardial Infarction
should be evidenced by all of the following criteria:

i. A history of typical clinical symptoms consistent with the diagnosis of acute myocardial infarction (For e.g.
typical chest pain)
ii. New characteristic electrocardiogram changes
iii. Elevation of infarction specific enzymes, Troponins or other specific biochemical markers.
II. The following are excluded:
i. Other acute Coronary Syndromes
ii. Any type of angina pectoris

10 of 45 39 of 45
14601/338228 14601/338228
iii. A rise in cardiac biomarkers or Troponin T or I in absence of overt ischemic heart disease OR following an
intra-arterial cardiac procedure
4. Open Heart Replacement or repair of heart valves

I. The actual undergoing of open-heart valve surgery is to replace or repair one or more heart valves, as a
consequence of defects in, abnormalities of, or disease affected cardiac valve(s). The diagnosis of the valve
abnormality must be supported by an echocardiography and the realization of surgery has to be confirmed by a
specialist medical practitioner.

Catheter based techniques including but not limited to, balloon valvotomy / valvuloplasty are excluded.

5. Primary (Idiopathic)Pulmonary Hypertension

I. An unequivocal diagnosis of Primary (Idiopathic) Pulmonary Hypertension by a Cardiologist or specialist in


respiratory medicine with evidence of right ventricular enlargement and the pulmonary artery pressure above
30 mm of Hg on Cardiac Cauterization. There must be permanent irreversible physical impairment to the
degree of at least Class IV of the New York Heart Association Classification of cardiac impairment.

II. The NYHA Classification of Cardiac Impairment are as follows:


i. Class III: Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes
symptoms.
ii. Class IV: Unable to engage in any physical activity without discomfort. Symptoms may be present even at
rest.
III. Pulmonary hypertension associated with lung disease, chronic hypoventilation, pulmonary thromboembolic
disease, drugs and toxins, diseases of the left side of the heart, congenital heart disease and any secondary
cause are specifically excluded

6. Kidney Failure requiring regular dialysis

I. End stage renal disease presenting as chronic irreversible failure of both kidneys to function, as a result of
which either regular renal dialysis (haemodialysis or peritoneal dialysis) is instituted or renal transplantation is
carried out. Diagnosis has to be confirmed by a specialist medical practitioner.

7. Major Organ/ Bone Marrow Transplant

I. The actual undergoing of a transplant of:


i. One of the following human organs: heart, lung, liver, kidney, pancreas ,that resulted from irreversible end-
stage failure of the relevant organ, or
ii. Human bone marrow using haematopoietic stem cells. The undergoing of a transplant has to be confirmed
by a specialist medical practitioner.
II. The following are excluded:
i. Other stem-cell transplants
ii. Where only islets of langerhans are transplanted

8. Stroke resulting in Permanent symptoms

I. Any cerebrovascular incident producing permanent neurological sequelae. This includes infarction of brain
tissue, thrombosis in an intracranial vessel, haemorrhage and embolisation from an extracranial source.
Diagnosis has to be confirmed by a specialist medical practitioner and evidenced by typical clinical symptoms
as well as typical findings in CT Scan or MRI of the brain. Evidence of permanent neurological deficit lasting for
at least 3 months has to be produced.

II. The following are excluded:


i. Transient ischemic attacks (TIA)
ii. Traumatic injury of the brain
iii. Vascular disease affecting only the eye or optic nerve or vestibular functions.

9. Benign Brain Tumour

I. Benign brain tumor is defined as a life threatening, non-cancerous tumor in the brain, cranial nerves or
meninges within the skull. The presence of the underlying tumor must be confirmed by imaging studies such as
CT scan or MRI.

II. This brain tumor must result in at least one of the following and must be confirmed by the relevant medical
specialist.

38 of 45 11 of 45
14601/338228 14601/338228
i. Permanent Neurological deficit with persisting clinical symptoms for a continuous period of at least 90
consecutive days or
ii. Undergone surgical resection or radiation therapy to treat the brain tumor.
III. The following conditions are excluded:
Cysts, Granulomas, malformations in the arteries or veins of the brain,hematomas, abscesses, pituitary
tumors, tumors of skull bones and tumors of the spinal cord.

10. Coma of specified severity

I. A state of unconsciousness with no reaction or response to external stimuli or internal needs. This diagnosis
must be supported by evidence of all of the following:
i. no response to external stimuli continuously for at least 96 hours;
ii. life support measures are necessary to sustain life; and
iii. permanent neurological deficit which must be assessed at least 30 days after the onset of the coma.
II. The condition has to be confirmed by a specialist medical practitioner. Coma resulting directly from alcohol or
drug abuse is excluded.

11. End Stage Liver Disease

I. Permanent and irreversible failure of liver function that has resulted in all three of the following:
i. Permanent jaundice; and
ii. Ascites; and
iii. Hepatic encephalopathy.
II. Liver failure secondary to drug or alcohol abuse is excluded.

12. End Stage Lung Disease

I. End stage lung disease, causing chronic respiratory failure, as confirmed and evidenced by all of the
following:
i. FEV1 test results consistently less than 1 litre measured on 3 occasions 3 months apart; and
ii. Requiring continuous permanent supplementary oxygen therapy for hypoxemia; and
iii. Arterial blood gas analysis with partial oxygen pressure of 55mmHg or less (PaO2 < 55mmHg); and
iv. Dyspnea at rest.

13. Loss of Limbs

The physical separation of two or more limbs, at or above the wrist or ankle level limbs as a result of injury or
disease. This will include medically necessary amputation necessitated by injury or disease. The separation has
to be permanent without any chance of surgical correction. Loss of Limbs resulting directly or indirectly from self-
inflicted injury, alcohol or drug abuse is excluded.

14. Blindness

I. Total, permanent and irreversible loss of all vision in both eyes as a result of illness or accident.
II. The Blindness is evidenced by:
i. corrected visual acuity being 3/60 or less in both eyes or ;
ii. the field of vision being less than 10 degrees in both eyes.
III. The diagnosis of blindness must be confirmed and must not be correctable by aids or surgical procedure

15. Third Degree Burns

I. There must be third-degree burns with scarring that cover at least 20% of the body’s surface area. The
diagnosis must confirm the total area involved using standardized, clinically accepted, body surface area charts
covering 20% of the body surface area

16. Major Head Trauma

I. Accidental head injury resulting in permanent Neurological deficit to be assessed no sooner than 3 months
from the date of the accident. This diagnosis must be supported by unequivocal findings on Magnetic
Resonance Imaging, Computerized Tomography, or other reliable imaging techniques. The accident must be
caused solely and directly by accidental, violent, external and visible means and independently of all other
causes.

II. The Accidental Head injury must result in an inability to perform at least three (3) of the following Activities of
Daily Living either with or without the use of mechanical equipment, special devices or other aids and

12 of 45 37 of 45
14601/338228 14601/338228
adaptations in use for disabled persons. For the purpose of this benefit, the word “permanent” shall mean
beyond the scope of recovery with current medical knowledge and technology.

III. The Activities of Daily Living are:


i. Washing: the ability to wash in the bath or shower (including getting into and out of the bath or shower) or
wash satisfactorily by other means;
ii. Dressing: the ability to put on, take off, secure and unfasten all garments and, as appropriate, any braces,
artificial limbs or other surgical appliances;
iii. Transferring: the ability to move from a bed to an upright chair or wheelchair and vice versa;
iv. Mobility: the ability to move indoors from room to room on level surfaces;
v. Toileting: the ability to use the lavatory or otherwise manage bowel and bladder functions so as to maintain a
satisfactory level of personal hygiene;
vi. Feeding: the ability to feed oneself once food has been prepared and made available.

IV. The following are excluded:


i. Spinal cord injury;

17. Permanent Paralysis of limbs

Total and irreversible loss of use of two or more limbs as a result of injury or disease of the brain or spinal cord.
A specialist medical practitioner must be of the opinion that the paralysis will be permanent with no hope of
recovery and must be present for more than 3 months.

18. Motor Neurone Disease with Permanent Symptoms

Motor neuron disease diagnosed by a specialist medical practitioner as spinal muscular atrophy,progressive
bulbar palsy, amyotrophic lateral sclerosis or primary lateral sclerosis. There must be progressive degeneration
of corticospinal tracts and anterior horn cells or bulbar efferent neurons. There must be current significant and
permanent functional neurological impairment with objective evidence of motor dysfunction that has persisted
for a continuous period of at least 3 months.

19. Multiple Sclerosis with Persistent Symptoms

I. The unequivocal diagnosis of Definite Multiple Sclerosis confirmed and evidenced by all of the following:
i. investigations including typical MRI findings which unequivocally confirm the diagnosis to be multiple
sclerosis and
ii. there must be current clinical impairment of motor or sensory function, which must have persisted for a
continuous period of at least 6 months.
II. Other causes of neurological damage such as SLE are excluded.

20. Deafness

I. Total and irreversible loss of hearing in both ears as a result of illness or accident. This diagnosis must be
supported by pure tone audiogram test and certified by an Ear, Nose and Throat (ENT) specialist. Total means
“the loss of hearing to the extent that the loss is greater than 90decibels across all frequencies of hearing” in
both ears.

21. Loss of Speech

I. Total and irrecoverable loss of the ability to speak as a result of injury or disease to the vocal cords. The
inability to speak must be established for a continuous period of 12 months. This diagnosis must be supported
by medical evidence furnished by an Ear, Nose, Throat (ENT) specialist.

II. All psychiatric related causes are excluded.

22. Surgery to Aorta

Undergoing of a laporotomy or thoracotomy to repair or correct an aneurysm, narrowing, obstruction or dissection


of the aortic artery. For this definition, aorta means the thoracic and abdominal aorta but not its branches. Surgery
performed using only minimally invasive or intra-arterial techniques such as percutaneous endovascular
aneurysm repair are excluded

23. Apallic Syndrome

36 of 45 13 of 45
14601/338228 14601/338228
Universal necrosis of the brain cortex with the brain stem remaining intact. The definite diagnosis must be
confirmed by a consultant neurologist and this condition has to be medically documented for at least one (1)
month with no hope of recovery

24. Loss of Independent Existence

Loss of the physical ability through an illness or injury to do at least 3 of the 6 tasks listed below ever again.

The relevant specialists must reasonably expect that the disability will last throughout life with no prospect of
improvement, irrespective of when the cover ends or the insured person expects to retire. The company’s
appointed doctor should also agree that the disability will last throughout life with no prospect of improvement,
irrespective of when the cover ends or the insured person expects to retire.

The insured person must need the help or supervision of another person and be unable to perform the task on
their own, even with the use of special equipment routinely available to help and having taken any appropriate
prescribed medication.

The tasks are


i. Washing: the ability to wash in the bath or shower (including getting into and out of the bath or shower) or
wash satisfactorily by other means;
ii. Dressing: the ability to put on, take off, secure and unfasten all garments and, as appropriate, any braces,
artificial limbs or other surgical appliances;
iii. Transferring: the ability to move from a bed to an upright chair or wheelchair and vice versa;
iv. Mobility: the ability to move indoors from room to room on level surfaces;
v. Toileting: the ability to use the lavatory or otherwise manage bowel and bladder functions so as to maintain
a satisfactory level of personal hygiene;
vi. Feeding: the ability to feed oneself once food has been prepared and made available

Loss of independent living must be medically documented for an uninterrupted period of at least six months.
Proof of the same must be submitted to the Company while the Person Insured is alive and permanently disabled.
The company will have the right to evaluate the insured person to confirm total and permanent disability.

Loss of Independent Existence due to an injury should occur independently of any other causes within ninety
(90) days of such injury.
Coverage for this impairment will cease at age sixty-six (66) or on maturity data/expiry date, whichever is
earlier.

25. Cardiomyopathy

The unequivocal diagnosis by a Consultant Cardiologist of Cardiomyopathy causing permanent impaired left
ventricular function with an ejection fraction of less than 25%. This must result in severe physical limitation of
activity to the degree of class IV of the New York Heart
Classification and this limitation must be sustained over at least six months when stabilized on appropriate
therapy. Cardiomyopathy directly related to alcohol or drug misuse is excluded.
New York Heart Classification
Class I. Patients with cardiac disease but without resulting limitation of physical activity. Ordinary physical
activity does not cause undue fatigue, palpitation, dyspnea, or anginal pain.
Class II. Patients with cardiac disease resulting in slight limitation of physical activity. They are comfortable at
rest. Ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain.
Class III. Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable
at rest. Less than ordinary activity causes fatigue, palpitation, dyspnea, or anginal pain.
Class IV. Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort.
Symptoms of heart failure or the anginal syndrome may be present even at rest. If any physical activity is
undertaken, discomfort increases.

26. Brain Surgery

The actual undergoing of surgery to the brain under general anaesthesia during which a craniotomy is
performed. Keyhole surgery is included however, minimally invasive treatment where no surgical incision is
performed to expose the target, such as irradiation by gamma knife or endovascular neuroradiological
interventions such as embolizations, thrombolysis and stereotactic biopsy are excluded. Brain surgery as a
result of an accident is also excluded. The procedure must be considered necessary by a qualified specialist.”

27. Alzheimer`s Disease

14 of 45 35 of 45
14601/338228 14601/338228
Progressive and permanent deterioration of memory and intellectual capacity as evidenced by accepted
standardised questionnaires and cerebral imaging. The diagnosis of Alzheimer’s disease must be confirmed by
an appropriate consultant and supported by the Company's appointed doctor. There must be significant
reduction in mental and social functioning requiring the continuous supervision of the life assured. There must
also be an inability of the Life Assured to perform (whether aided or unaided) at least 3 of the following 5
“Activities of Daily Living” for a continuous period of at least 6 months:

Activities of Daily Living are defined as:


1. Washing - the ability to wash in the bath or shower (including getting into and out of the bath or shower) or
wash satisfactorily by other means;
2. Dressing - the ability to put on, take off, secure and unfasten all garments and, as appropriate, any braces,
artificial limbs or other surgical appliances;
3. Transferring - the ability to move from a bed to an upright chair or wheelchair and vice versa;
4. Toileting - the ability to use the lavatory or otherwise manage bowel and bladder functions so as to maintain
a satisfactory level of personal hygiene;
5. Feeding - the ability to feed oneself once food has been prepared and made available.

Psychiatric illnesses and alcohol related brain damage are excluded.


Coverage for this impairment will cease at age sixty-six (66) or on maturity data/expiry date, whichever is
earlier.

28. Muscular dystrophy

Muscular Dystrophy is a disease of the muscle causing progressive and permanent weakening of certain
muscle groups. The diagnosis of muscular dystrophy must be made by a consultant neurologist, and confirmed
with the appropriate laboratory, biochemical, histological, and electromyographic evidence. The disease must
result in the permanent inability of the insured to perform (whether aided or unaided) at least three (3) of the
five (5) “Activities of Daily Living”.

Activities of Daily Living are defined as:

1. Washing - the ability to wash in the bath or shower (including getting into and out of the bath or shower) or
wash satisfactorily by other means;
2. Dressing - the ability to put on, take off, secure and unfasten all garments and, as appropriate, any braces,
artificial limbs or other surgical appliances;
3. Transferring - the ability to move from a bed to an upright chair or wheelchair and vice versa;
4. Toileting - the ability to use the lavatory or otherwise manage bowel and bladder functions so as to maintain
a satisfactory level of personal hygiene;
5. Feeding - the ability to feed oneself once food has been prepared and made available

29. Parkinson`s Disease

The unequivocal diagnosis of idiopathic Parkinson’s Disease by a consultant neurologist. This diagnosis must
be supported by all of the following conditions:

1) The disease cannot be controlled with medication; and


2) There are objective signs of progressive deterioration; and
3) There is an inability of the Life Assured to perform (whether aided or unaided) at least 3 of the following five
(5) “Activities of Daily Living” for a continuous period of at least 6 months:

Activities of Daily Living are defined as:

1. Washing - the ability to wash in the bath or shower (including getting into and out of the bath or shower) or
wash satisfactorily by other means;
2. Dressing - the ability to put on, take off, secure and unfasten all garments and, as appropriate, any braces,
artificial limbs or other surgical appliances;
3. Transferring - the ability to move from a bed to an upright chair or wheelchair and vice versa;
4. Toileting - the ability to use the lavatory or otherwise manage bowel and bladder functions so as to maintain
a satisfactory level of personal hygiene;
5. Feeding - the ability to feed oneself once food has been prepared and made available.

Drug-induced or toxic causes of Parkinsonism are excluded.


Coverage for this impairment will cease at age sixty-six (66) or on maturity data/expiry date, whichever is earlier

34 of 45 15 of 45
14601/338228 14601/338228
30. Medullary Cystic Disease

Medullary Cystic Disease is a disease where the following criteria are met: Annexure of List of Ombudsmen
Office of the Insurance Ombudsman - Ahmedabad Office of the Insurance Ombudsman – Bhopal
1. The presence in the kidney of multiple cysts in the renal medulla accompanied by the presence of tubular Jeevan Prakash Building , 06th Floor, Tilak Marg, Relief Road, Janak Vihar Complex, 2nd Floor, 6, Malviya Nagar, Opp. Airtel
atrophy and interstitial fibrosis; AHMEDABAD- 380001 Tel. 079- 25501201/02/05/06 Office, Near New Market,
Email: [email protected] BHOPAL – 462 003.Tel.: 0755 - 2769201 / 2769202 Fax: 0755 -
2. Clinical manifestations of anaemia, polyuria and progressive deterioration in kidney function; and Area of Jurisdiction - Gujarat, Dadra & Nagar Haveli, Daman and 2769203
3. The diagnosis of medullary cystic disease is confirmed by renal biopsy. Diu Email: [email protected]
Area of Jurisdiction - Madhya Pradesh & Chhattisgarh
Isolated or benign kidney cysts are specifically excluded from this benefit Office of the Insurance Ombudsman - Bhubaneshwar Office of the Insurance Ombudsman – Chandigarh
62, Forest Park, S.C.O. No. 101, 102 & 103, 2nd Floor, Batra Building, Sector 17 –
31. Systemic Lupus Erythematosus BHUBNESHWAR – 751 009. Tel.: 0674 - 2596461 /2596455 Fax: D,
0674 – 2596429 Email: [email protected] CHANDIGARH – 160 017. Tel.: 0172 - 2706196 / 2706468 Fax:
Area of Jurisdiction - Odisha 0172 – 2708274 Email: [email protected]
The unequivocal diagnosis by a consultant physician of systemic lupus erythematosus (SLE) with evidence of
Area of Jurisdiction - Punjab, Haryana, Himachal Pradesh,
malar rash, discoid rash, photosensitivity, multi-articular arthritis, and serositis. There must also be Jammu & Kashmir, Chandigarh
hematological and immunological abnormalities consistent with the diagnosis of SLE. There must also be a Office of the Insurance Ombudsman - Chennai Office of the Insurance Ombudsman – New Delhi
positive antinuclear antibody test. There must also be evidence of central nervous system or renal impairment Fatima Akhtar Court, 4th Floor, 453, Anna Salai, Teynampet, 2/2 A, Universal Insurance Building, Asaf Ali Road,
with either CHENNAI – 600 018. Tel.: 044 - 24333668 / 24335284 Fax: 044 - NEW DELHI – 110 002. Tel.: 011 - 23239633 / 23237532 Fax: 011
24333664 – 23230858 Email: [email protected]
a) Renal involvement is defined as either persistent proteinuria greater than 0.5 grams per day or a spot urine Email: [email protected] Area of Jurisdiction – Delhi
showing 3+ or greater proteinuria Area of Jurisdiction - Tamil Nadu, –Pondicherry Town and Karaikal
(which are part of Pondicherry)
b) Central nervous system involvement with permanent neurological dysfunction as evidenced with objective Office of the Insurance Ombudsman - Guwahati Office of the Insurance Ombudsman – Hyderabad
motor or sensory neurological abnormal signs on physical examination by a neurologist and present for at least Jeevan Nivesh, 5th Floor, Nr. Panbazar over bridge, S.S. Road, 6-2-46, 1st floor, "Moin Court", Lane Opp. Saleem Function
3 months. Seizures, headaches, cognitive and psychiatric abnormalities are not considered under this GUWAHATI – 781001 (ASSAM). Tel.: 0361 - 2132204 / 2132205 Palace, A. C. Guards, Lakdi-Ka-Pool,
definition as evidence of “permanent neurological dysfunction”. Fax: 0361 – 2732937 Email: [email protected] HYDERABAD - 500 004. Tel.: 040 - 65504123 / 23312122
Area of Jurisdiction - Assam, Meghalaya, Manipur, Mizoram, Fax: 040 – 23376599 Email: [email protected]
Discoid lupus and medication induced lupus are excluded Arunachal Pradesh,Nagaland and Tripura Area of Jurisdiction - Andhra Pradesh, Telangana,
Yanam and part of Territory of Pondicherry
Office of the Insurance Ombudsman - Ernakulam Office of the Insurance Ombudsman – Kolkata
32. Aplastic Anaemia
2nd Floor, Pulinat Bldg., Opp. Cochin Shipyard, M. G. Road, Hindustan Bldg. Annexe, 4th Floor, 4, C.R. Avenue,
ERNAKULAM - 682 015. Tel.: 0484 - 2358759 / 2359338 KOLKATA - 700 072. Tel.: 033 - 22124339 / 22124340
Aplastic Anemia is chronic persistent bone marrow failure. A certified hematologist must make the diagnosis of Fax: 0484 – 2359336 Email: [email protected] Fax : 033 – 22124341 Email: [email protected]
severe irreversible aplastic anemia. There must be permanent bone marrow failure resulting in bone marrow Area of Jurisdiciton - Kerala, Lakshadweep, Mahe – a part of Area of Jurisdiction - West Bengal, Sikkim, Andaman & Nicobar
cellularity of less than 25% and there must be two of the following: Pondicherry Islands
Office of the Insurance Ombudsman - Lucknow Office of the Insurance Ombudsman – Noida
1. Absolute neutrophil count of less than 500/mm³ 6th Floor, Jeevan Bhawan, Phase-II, Bhagwan Sahai Palace, 4th Floor, Main Road,
2. Platelets count less than 20,000/mm³ Nawal Kishore Road, Hazratganj, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar,
LUCKNOW - 226 001. Tel.: 0522 - 2231330 / 2231331 UTTAR PRADESH (U.P.) - 201301. Tel.: 0120-2514250 / 2514252
3. Reticulocyte count of less than 20,000/mm³
Fax: 0522 – 2231310 Email: [email protected] / 2514253 Email: [email protected]
The insured must be receiving treatment for more than 3 consecutive months with frequent blood product Area of Jurisdiction - Districts of Uttar Pradesh : Laitpur, Jhansi, Area of Jurisdiction - State of Uttaranchal and the following
transfusions, bone marrow stimulating agents, or immunosuppressive agents or the insured has received a Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor,
bone marrow or cord blood stem cell transplant. Sonbhabdra, Fatehpur, Budaun, Bulandshehar, Etah, Kanooj, Mainpuri, Mathura, Meerut,
Pratapgarh, Jaunpur,Varanasi,Gazipur, Jalaun, Kanpur, Lucknow, Moradabad,
Temporary or reversible aplastic anemia is excluded and not covered in this policy. Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli,Sravasti, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad,
Gonda, Faizabad, Amethi,Kaushambi, Balrampur, Basti, Gautam Buddh Nagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur,
33. Poliomyelitis Ambedkarnagar, Sultanpur,Maharajgang, Santkabirnagar, Shamli, Rampur, Kashganj,Sambhal, Amroha, Hathras,
Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Kanshiramnagar, Saharanpur
Chandauli, Ballia, Sidharathnagar
The occurrence of Poliomyelitis where the following conditions are met: Office of the Insurance Ombudsman - Jaipur Office of the Insurance Ombudsman – Pune
Jeevan Nidhi – II Bldg., Gr. Floor, Bhawani Singh Marg, Jeevan Darshan Bldg., 3rd Floor, C.T.S. Nos. 195 to 198,
 Poliovirus is identified as the cause; and JAIPUR - 302 005. Tel.: 0141 - 2740363 N.C. Kelkar Road, Narayan Peth, PUNE – 411 030.
 Paralysis of the limb muscles or respiratory muscles must be present and persist for at least 3 Email: [email protected] Tel.: 020-41312555 Email: [email protected]
months as confirmed by a consultant neurologist. Area of Jurisdiction – Rajasthan Area of Jurisdiction - Maharashtra, Area of Navi Mumbai and
Other causes of paralysis such as Guillain-Barre syndrome are specifically excluded Thane excluding Mumbai Metropolitan Region
Office of the Insurance Ombudsman - Bengaluru Office of the Insurance Ombudsman – Mumbai
Jeevan Soudha Building, PID No. 57-27-N-19 3rd Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W),
34. Bacterial Meningitis Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, MUMBAI - 400 054. Tel.: 022 - 26106552 / 26106960 Fax: 022 -
BENGALURU – 560 078. Tel.: 080 - 26652048 / 26652049 26106052
Bacterial meningitis is a bacterial infection of the meninges of the brain causing brain dysfunction. There must Email: [email protected] Email: [email protected]
be an unequivocal diagnosis by a consultant physician of bacterial meningitis that must be proven on analysis Area of Jurisdiction – Karnataka Area of Jurisdiction – Goa, Mumbai Metropolitan Region excluding
of the cerebrospinal fluid. There must also be permanent objective neurological deficit that is present on physical Navi Mumbai & Thane
examination at least 3 months after the diagnosis of the meningitis infection Office of the Insurance Ombudsman – Patna
1st Floor, Kalpana Arcade Building,
Bazar Samiti Road, Bahadurpur,
35. Encephalitis
PATNA – 800006 Tel No: 0612-2680952
Email id : [email protected].
Severe inflammation of the brain substance (cerebral hemisphere, brainstem or cerebellum) caused by viral Area of Jurisdiction - Bihar, Jharkhand
infection and resulting in permanent neurological deficit. This diagnosis must be certified by a consultant
neurologist and the permanent neurological deficit must be documented for at least 6 weeks.

16 of 45 33 of 45
14601/338228 14601/338228
36. Progressive Supra nuclear Palsy

Progressive supranuclear palsy occurring independently of all other causes and resulting in permanent
Year of neurological deficit, which is directly responsible for a permanent inability to perform at least two (2) of the
Surrender / 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Activities of Daily Living. The diagnosis of the Progressive Supranuclear Palsy must be confirmed by a registered
Plan Term Medical Practitioner who is a neurologist
1 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75%
37. Severe Rheumatoid Arthritis
2 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75%
3 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% The unequivocal diagnosis of Rheumatoid Arthritis must be made by a certified medical consultant based on
4 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% clinically accepted criteria. There must be imaging evidence of erosions with widespread joint destruction in
5 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% three or more of the following joint areas: hands, wrists, elbows, knees, hips, ankle, cervical spine or feet.
There must also be typical rheumatoid joint deformities.
6 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%
7 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% Degenerative osteoarthritis and all other forms of arthritis are excluded.
8 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%
9 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% There must be history of treatment or current treatment with disease-modifying anti-rheumatic drugs, or
DMARDs. Non-steroidal anti-inflammatory drugs such as acetylsalicylic acid are not considered a DMARD drug
10 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%
under this definition.
11 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%
12 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 38. Creutzfeldt- Jakob Disease
13 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%
Creutzfeldt-Jacob disease is an incurable brain infection that causes rapidly progressive deterioration of mental
14 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%
function and movement. A neurologist must make a definite diagnosis of Creutzfeldt-Jacob disease based on
15 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% clinical assessment, EEG and imaging. There must be objective neurological abnormalities on exam along with
16 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% severe progressive dementia
17 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%
39. Fulminant Viral Hepatitis
18 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%
19 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% A submassive to massive necrosis of the liver by any virus, leading precipitously to liver failure. This diagnosis
20 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% must be supported by all of the following:
21 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%
 rapid decreasing of liver size;
22 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%
 necrosis involving entire lobules, leaving only a collapsed reticular framework;
23 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%
 rapid deterioration of liver function tests;
24 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%  deepening jaundice; and
25 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%  hepatic encephalopathy.
26 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% Acute Hepatitis infection or carrier status alone, does not meet the diagnostic criteria
27 NA 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%
40. Pneumonectomy
28 NA NA 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%
29 NA NA NA 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% The undergoing of surgery on the advice of a consultant medical specialist to remove an entire lung for any
30 NA NA NA NA 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% physical injury or disease
1. Stroke resulting in Permanent symptoms
31 NA NA NA NA NA 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%
I. Any cerebrovascular incident producing permanent neurological sequelae. This includes infarction of
32 NA NA NA NA NA NA 90% 90% 90% 90% 90% 90% 90% 90% 90% brain tissue, thrombosis in an intracranial vessel, haemorrhage and embolisation from an extracranial
33 NA NA NA NA NA NA NA 90% 90% 90% 90% 90% 90% 90% 90% source. Diagnosis has to be confirmed by a specialist medical practitioner and evidenced by typical
34 NA NA NA NA NA NA NA NA 90% 90% 90% 90% 90% 90% 90% clinical symptoms as well as typical findings in CT Scan or MRI of the brain. Evidence of permanent
neurological deficit lasting for at least 3 months has to be produced.
35 NA NA NA NA NA NA NA NA NA 90% 90% 90% 90% 90% 90%
II. The following are excluded:
36 NA NA NA NA NA NA NA NA NA NA 90% 90% 90% 90% 90%
i. Transient ischemic attacks (TIA)
37 NA NA NA NA NA NA NA NA NA NA NA 90% 90% 90% 90% ii. Traumatic injury of the brain
38 NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 90% iii. Vascular disease affecting only the eye or optic nerve or vestibular functions.
39 NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% Degenerative Diseases covered
2. Permanent Paralysis of limbs
40 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90%
Total and irreversible loss of use of two or more limbs as a result of injury or disease of the brain or spinal
cord. A specialist medical practitioner must be of the opinion that the paralysis will be permanent with no
hope of recovery and must be present for more than 3 months.

3. Alzheimer`s Disease
Progressive and permanent deterioration of memory and intellectual capacity as evidenced by accepted
standardised questionnaires and cerebral imaging. The diagnosis of Alzheimer’s disease must be
confirmed by an appropriate consultant and supported by the Company's appointed doctor. There must
be significant reduction in mental and social functioning requiring the continuous supervision of the life

32 of 45 17 of 45
14601/338228 14601/338228
assured. There must also be an inability of the Life Assured to perform (whether aided or unaided) at least 79 NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89%
80 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90%
3 of the following 5 “Activities of Daily Living” for a continuous period of at least 6 months:
81 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90%
Activities of Daily Living are defined as:
1. Washing - the ability to wash in the bath or shower (including getting into and out of the bath or shower) B. Single Premium
or wash satisfactorily by other means;
2. Dressing - the ability to put on, take off, secure and unfasten all garments and, as appropriate, any
braces, artificial limbs or other surgical appliances; Year of
3. Transferring - the ability to move from a bed to an upright chair or wheelchair and vice versa; Surrend
5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
4. Toileting - the ability to use the lavatory or otherwise manage bowel and bladder functions so as to er / Plan
Term
maintain a satisfactory level of personal hygiene;
75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75
5. Feeding - the ability to feed oneself once food has been prepared and made available. 1
% % % % % % % % % % % % % % % % % % % % %
Psychiatric illnesses and alcohol related brain damage are excluded. 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75
Coverage for this impairment will cease at age sixty-six (66) or on maturity data/expiry date, whichever is 2
% % % % % % % % % % % % % % % % % % % % %
earlier. 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75 75
3
% % % % % % % % % % % % % % % % % % % % %
4. Parkinson`s Disease 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90
4
The unequivocal diagnosis of idiopathic Parkinson’s Disease by a consultant neurologist. This diagnosis % % % % % % % % % % % % % % % % % % % % %
90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90
must be supported by all of the following conditions: 5
% % % % % % % % % % % % % % % % % % % % %
1) The disease cannot be controlled with medication; and 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90
2) There are objective signs of progressive deterioration; and 6 NA
% % % % % % % % % % % % % % % % % % % %
3) There is an inability of the Life Assured to perform (whether aided or unaided) at least 3 of the following 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90
7 NA NA
five (5) “Activities of Daily Living” for a continuous period of at least 6 months: % % % % % % % % % % % % % % % % % % %
Activities of Daily Living are defined as: 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90
8 NA NA NA
1. Washing - the ability to wash in the bath or shower (including getting into and out of the bath or shower) % % % % % % % % % % % % % % % % % %
or wash satisfactorily by other means; 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90
9 NA NA NA NA
% % % % % % % % % % % % % % % % %
2. Dressing - the ability to put on, take off, secure and unfasten all garments and, as appropriate, any
90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90
braces, artificial limbs or other surgical appliances; 10 NA NA NA NA NA
% % % % % % % % % % % % % % % %
3. Transferring - the ability to move from a bed to an upright chair or wheelchair and vice versa; 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90
4. Toileting - the ability to use the lavatory or otherwise manage bowel and bladder functions so as to 11 NA NA NA NA NA NA
% % % % % % % % % % % % % % %
maintain a satisfactory level of personal hygiene; 90 90 90 90 90 90 90 90 90 90 90 90 90 90
12 NA NA NA NA NA NA NA
5. Feeding - the ability to feed oneself once food has been prepared and made available. % % % % % % % % % % % % % %
Drug-induced or toxic causes of Parkinsonism are excluded. 90 90 90 90 90 90 90 90 90 90 90 90 90
13 NA NA NA NA NA NA NA NA
Coverage for this impairment will cease at age sixty-six (66) or on maturity data/expiry date, whichever is % % % % % % % % % % % % %
earlier 90 90 90 90 90 90 90 90 90 90 90 90
14 NA NA NA NA NA NA NA NA NA
% % % % % % % % % % % %
90 90 90 90 90 90 90 90 90 90 90
5. Any other form of Dementia 15 NA NA NA NA NA NA NA NA NA NA
% % % % % % % % % % %
Dementia is a syndrome – usually of a chronic or progressive nature – in which there is deterioration in 90 90 90 90 90 90 90 90 90 90
cognitive function (i.e. the ability to process thought) beyond what might be expected from normal ageing. 16 NA NA NA NA NA NA NA NA NA NA NA
% % % % % % % % % %
It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and 90 90 90 90 90 90 90 90 90
17 NA NA NA NA NA NA NA NA NA NA NA NA
judgement. Consciousness is not affected. The impairment in cognitive function is commonly % % % % % % % % %
accompanied, and occasionally preceded, by deterioration in emotional control, social behavior, or 90 90 90 90 90 90 90 90
18 NA NA NA NA NA NA NA NA NA NA NA NA NA
motivation. % % % % % % % %
90 90 90 90 90 90 90
19 NA NA NA NA NA NA NA NA NA NA NA NA NA NA
% % % % % % %
90 90 90 90 90 90
20 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA
% % % % % %
90 90 90 90 90
21 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA
% % % % %
90 90 90 90
22 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA
% % % %
90 90 90
23 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA
% % %
90 90
24 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA
% %
90
25 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA
%

18 of 45 31 of 45
14601/338228 14601/338228
PART C shall be notified to you in writing about the change and you shall have
Year of Surrender / Policy Term 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 an option not to pay the revised premium. If you are not willing to
1 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1. Benefits under the policy continue the Policy with the revised Premium rates, the Policy will
2 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 1.1 Risk Cover Benefit terminate and no policy benefits shall be applicable thereafter.
3 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35%
4 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% A. Plan Options The Critical Illnesses covered under this policy are:
5 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50%
Sr.
6 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% Critical Illness
You have to select any of the below given plan options at the inception No.
7 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50%
8 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51%
of the policy. Plan option once selected cannot be changed at a later 1 Cancer of specified severity
9 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% date. 2 Open Chest CABG
10 52% 52% 52% 52% 52% 52% 52% 52% 52% 52% 52% 52% 52% 52% 52% 52% Kidney Failure requiring regular
1) Life Option 3
11 53% 53% 53% 53% 53% 53% 53% 52% 52% 52% 52% 52% 52% 52% 52% 52% dialysis
12 53% 53% 53% 53% 53% 53% 53% 53% 53% 53% 53% 53% 53% 53% 53% 53% On death of the life assured or diagnosis of terminal illness whichever 4 Permanent paralysis of limbs
13 54% 54% 54% 54% 54% 54% 54% 54% 54% 54% 54% 53% 53% 53% 53% 53% is earlier, during the term of the policy, Sum Assured is payable and Primary (Idiopathic) Pulmonary
14 55% 55% 55% 55% 55% 54% 54% 54% 54% 54% 54% 54% 54% 54% 54% 54% the policy terminates once the full amount of benefit is paid on 5
Hypertension
15 56% 55% 55% 55% 55% 55% 55% 55% 55% 55% 55% 55% 55% 55% 54% 54% occurrence of either of the events. Myocardial Infarction (First Heart
16 56% 56% 56% 56% 56% 56% 56% 56% 55% 55% 55% 55% 55% 55% 55% 55% 6
17 57% 57% 57% 57% 56% 56% 56% 56% 56% 56% 56% 56% 56% 56% 56% 55% Attack Of Specific Severity)
2) Life Plus Option
18 58% 57% 57% 57% 57% 57% 57% 57% 57% 57% 56% 56% 56% 56% 56% 56% Stroke Resulting in Permanent
On death of the life assured or diagnosis of terminal illness whichever 7
19 58% 58% 58% 58% 58% 58% 58% 57% 57% 57% 57% 57% 57% 57% 57% 57% Symptoms
is earlier, during the term of the policy, Enhanced Sum Assured is
20 59% 59% 59% 59% 58% 58% 58% 58% 58% 58% 58% 58% 57% 57% 57% 57% Major organ / bone marrow
payable and the policy terminates once the full amount of benefit is paid 8
21 60% 59% 59% 59% 59% 59% 59% 59% 58% 58% 58% 58% 58% 58% 58% 58% transplant
22 60% 60% 60% 60% 60% 60% 59% 59% 59% 59% 59% 59% 59% 58% 58% 58%
on occurrence of either of the events.
Multiple Sclerosis with persisting
23 61% 61% 61% 60% 60% 60% 60% 60% 60% 60% 59% 59% 59% 59% 59% 59% 9
symptoms
24 62% 62% 61% 61% 61% 61% 61% 60% 60% 60% 60% 60% 60% 60% 59% 59% Enhanced Sum Assured is calculated as initial base Sum Assured +
5% of Sum Assured increasing every year (simple interest) 10 Surgery to Aorta
25 62% 62% 62% 62% 62% 61% 61% 61% 61% 61% 61% 60% 60% 60% 60% 60%
commencing from 2nd policy year onwards. This increase in Sum 11 Apallic Syndrome
26 63% 63% 63% 62% 62% 62% 62% 62% 62% 61% 61% 61% 61% 61% 61% 60%
27 64% 64% 63% 63% 63% 63% 63% 62% 62% 62% 62% 62% 61% 61% 61% 61% Assured will cease at 200% of initial base Sum Assured or at the end 12 Benign Brain Tumour
28 64% 64% 64% 64% 64% 63% 63% 63% 63% 63% 62% 62% 62% 62% 62% 62% of policy term, whichever is earlier. 13 Coma of specified severity
29 65% 65% 65% 64% 64% 64% 64% 64% 63% 63% 63% 63% 63% 62% 62% 62% 14 End Stage Liver Failure
30 66% 66% 65% 65% 65% 65% 64% 64% 64% 64% 64% 63% 63% 63% 63% 63% 3) Incidence Coverage Option 15 End Stage Lung Failure
31 67% 66% 66% 66% 65% 65% 65% 65% 65% 64% 64% 64% 64% 64% 63% 63% Open Heart Replacement or
32 67% 67% 67% 66% 66% 66% 66% 65% 65% 65% 65% 64% 64% 64% 64% 64% 16
You can choose from any one of the variants mentioned below: Repair of Heart Valves
33 68% 68% 67% 67% 67% 67% 66% 66% 66% 66% 65% 65% 65% 65% 64% 64% 17 Loss of Limbs
34 69% 68% 68% 68% 67% 67% 67% 67% 66% 66% 66% 66% 65% 65% 65% 65%
A. Accidental Death Cover (Additional) 18 Blindness
35 69% 69% 69% 68% 68% 68% 67% 67% 67% 67% 66% 66% 66% 66% 66% 65%
36 70% 70% 69% 69% 69% 68% 68% 68% 68% 67% 67% 67% 67% 66% 66% 66% On death of the life assured or diagnosis of terminal illness whichever 19 Third degree Burns
37 71% 70% 70% 70% 69% 69% 69% 68% 68% 68% 68% 67% 67% 67% 67% 66% is earlier, during the term of the policy, Sum Assured is payable and 20 Major Head Trauma
38 71% 71% 71% 70% 70% 70% 69% 69% 69% 69% 68% 68% 68% 67% 67% 67% the policy terminates once the full amount of benefit is paid on 21 Loss of Independent Existence
39 72% 72% 71% 71% 71% 70% 70% 70% 69% 69% 69% 69% 68% 68% 68% 68% occurrence of either of the events. 22 Cardiomyopathy
40 73% 72% 72% 72% 71% 71% 71% 70% 70% 70% 69% 69% 69% 69% 68% 68% 23 Brain Surgery
41 73% 73% 73% 72% 72% 72% 71% 71% 71% 70% 70% 70% 69% 69% 69% 69% On accidental death of the life assured, additional Accidental Death 24 Alzheimer’s Disease
42 74% 74% 73% 73% 73% 72% 72% 72% 71% 71% 71% 70% 70% 70% 69% 69% Benefit Sum Assured chosen at inception by the policyholder (as Motor Neurone Disease with
43 75% 74% 74% 74% 73% 73% 72% 72% 72% 71% 71% 71% 71% 70% 70% 70% mentioned in the policy schedule), shall also be payable along with the 25
44 76% 75% 75% 74% 74% 73% 73% 73% 72% 72% 72% 71% 71% 71% 71% 70%
permanent symptoms
base Sum Assured and the policy terminates once the full amount of 26 Muscular Dystrophy
45 76% 76% 75% 75% 75% 74% 74% 73% 73% 73% 72% 72% 72% 71% 71% 71%
benefit is paid. 27 Parkinson’s Disease
46 77% 76% 76% 76% 75% 75% 74% 74% 74% 73% 73% 73% 72% 72% 72% 71%
47 78% 77% 77% 76% 76% 75% 75% 75% 74% 74% 74% 73% 73% 73% 72% 72% 28 Deafness
48 78% 78% 77% 77% 76% 76% 76% 75% 75% 74% 74% 74% 73% 73% 73% 72% B. Disability Cover (Accelerated) 29 Loss of Speech
49 79% 78% 78% 78% 77% 77% 76% 76% 75% 75% 75% 74% 74% 74% 73% 73% On death of the life assured or diagnosis of terminal illness whichever
30 Medullary Cystic Disease
50 80% 79% 79% 78% 78% 77% 77% 76% 76% 76% 75% 75% 75% 74% 74% 74% is earlier, during the term of the policy, Sum Assured is payable and
31 Systemic Lupus Erythematosus
51 80% 80% 79% 79% 78% 78% 77% 77% 77% 76% 76% 76% 75% 75% 74% 74% the policy terminates once the full amount of benefit is paid on
32 Aplastic Anaemia
52 81% 81% 80% 80% 79% 79% 78% 78% 77% 77% 76% 76% 76% 75% 75% 75% occurrence of either of the events.
53 82% 81% 81% 80% 80% 79% 79% 78% 78% 77% 77% 77% 76% 76% 76% 75% 33 Poliomyelitis
54 82% 82% 81% 81% 80% 80% 79% 79% 78% 78% 78% 77% 77% 76% 76% 76% On accidental total permanent disability, 50% of Sum Assured at 34 Bacterial Meningitis
55 83% 83% 82% 81% 81% 80% 80% 80% 79% 79% 78% 78% 77% 77% 77% 76% inception of policy, is paid and the balance Sum Assured is paid on 35 Encephalitis
56 84% 83% 83% 82% 82% 81% 81% 80% 80% 79% 79% 78% 78% 78% 77% 77% death of the life assured or diagnosis of terminal illness whichever is 36 Progressive Supra nuclear Palsy
57 84% 84% 83% 83% 82% 82% 81% 81% 80% 80% 79% 79% 79% 78% 78% 77% earlier, during the term of the policy, and the policy terminates once the 37 Severe Rheumatoid Arthritis
58 85% 85% 84% 83% 83% 82% 82% 81% 81% 80% 80% 80% 79% 79% 78% 78% 38 Creutzfeldt – Jakob Disease
full amount of benefit is paid on occurrence of either of the events.
59 86% 85% 85% 84% 84% 83% 83% 82% 82% 81% 81% 80% 80% 79% 79% 78%
. 39 Fulminant Viral Hepatitis
60 87% 86% 85% 85% 84% 84% 83% 83% 82% 82% 81% 81% 80% 80% 79% 79%
61 87% 87% 86% 85% 85% 84% 84% 83% 83% 82% 82% 81% 81% 80% 80% 80%
C. Critical Illness Cover (Accelerated) 40 Pneumonectomy
62 88% 87% 87% 86% 85% 85% 84% 84% 83% 83% 82% 82% 81% 81% 81% 80% On death of the life assured or diagnosis of terminal illness whichever
63 89% 88% 87% 87% 86% 86% 85% 84% 84% 83% 83% 82% 82% 82% 81% 81% is earlier, during the term of the policy, Sum Assured is payable and There will be a waiting period of 180 days from policy inception or from
64 89% 89% 88% 87% 87% 86% 86% 85% 85% 84% 84% 83% 83% 82% 82% 81% the policy terminates once the full amount of benefit is paid on any subsequent reinstatement, whichever is later. No Critical Illness
65 90% 89% 89% 88% 87% 87% 86% 86% 85% 85% 84% 84% 83% 83% 82% 82% occurrence of either of the events. Benefit shall be payable during this waiting period.
66 90% 90% 89% 89% 88% 87% 87% 86% 86% 85% 85% 84% 84% 83% 83% 82% There will be a survival period of 14 days applicable from the date of
67 NA 90% 90% 89% 89% 88% 88% 87% 86% 86% 85% 85% 84% 84% 83% 83% On diagnosis of any of the covered Critical Illnesses, Critical Illness diagnosis of a critical illness for eligibility of critical illness benefit
68 NA NA 90% 90% 89% 89% 88% 88% 87% 86% 86% 85% 85% 84% 84% 83% Sum Assured selected at inception of policy (as mentioned in the policy payment.
69 NA NA NA 90% 90% 89% 89% 88% 88% 87% 86% 86% 85% 85% 84% 84% schedule), is paid and the balance Sum Assured is paid on death of the
70 NA NA NA NA 90% 90% 89% 89% 88% 88% 87% 87% 86% 85% 85% 85% life assured or diagnosis of terminal illness whichever is earlier, during 4) Long Term Care Option
71 NA NA NA NA NA 90% 90% 89% 89% 88% 88% 87% 87% 86% 86% 85% the term of the policy, and the policy terminates once the full amount of On death of the life assured or diagnosis of terminal illness whichever
72 NA NA NA NA NA NA 90% 90% 89% 89% 88% 88% 87% 87% 86% 86% benefit is paid on occurrence of either of the events. is earlier, during the term of the policy, Sum Assured is payable and
73 NA NA NA NA NA NA NA 90% 90% 89% 89% 88% 88% 87% 87% 86%
the policy terminates once the full amount of benefit is paid on
74 NA NA NA NA NA NA NA NA 90% 90% 89% 89% 88% 88% 87% 87%
75 NA NA NA NA NA NA NA NA NA 90% 90% 89% 89% 88% 88% 87%
Critical illness premium is guaranteed for a period of five years from the occurrence of either of the events.
76 NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 89% 88% 88% date of commencement of the policy and reviewable thereafter.
77 NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 89% 88% Upon the completion of five policy years, the Premiums may be revised On diagnosis of any of the covered degenerative disease, 50% of Sum
78 NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 89% by us subject to IRDAI’s approval. Any revision in the Premium rates Assured at inception of policy, will be payable as a monthly income over

30 of 45 19 of 45
14601/338228 14601/338228
next 5, 10 or 15 years as chosen at the inception of policy and the balance policy terminates once the full amount of benefit is paid on occurrence 40 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 88% 87% 86%
Sum Assured on death of the life assured or diagnosis of the terminal of the event. 41 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 88% 87%
illness whichever is earlier during the term of the policy. The policy 42 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 88%
terminates once the full amount of benefit is paid on occurrence of either 43 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89%
No maturity benefit is applicable in any of the options other than Return 44 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90%
of the events. The income starts on the end of the monthly policy
of Premium Option. 45 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90%
anniversary immediately after the diagnosis of the degenerative disease.
The degenerative diseases covered are:
1) Stroke resulting in Permanent symptoms 1.3 Life Stage Benefit
 This benefit is only applicable only under Life Option. Year of
2) Alzheimer’s Disease Surrender / 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
3) Parkinson’s Disease  Sum Assured can be increased without any medical underwriting Plan Term
4) Permanent Paralysis of limbs on any of the below specified events during the life of the Life 1 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
5) any other form of Dementia Assured. The total increase in Sum Assured shall be subject to 2 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30%
overall limit of 100% of initial Sum Assured. 3 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35%
In case of diagnosis of degenerative diseases, monthly instalment 4 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50%
amount will be calculated as dividing lump sum amount (say, S) by Maximum Maximum 5 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50%
annuity factor ( i.e. a(n)(12)) i.e. S/a(n)(12) where n is the instalment Additional % of Additional 6 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50%
Events 7 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50%
Base Sum Sum Assured
period either 5, 10 or 15 years as chosen at inception of the policy. 8 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51%
Assured allowed
The prevailing SBI savings bank interest rate will be used to calculate Marriage 9 52% 52% 52% 52% 52% 52% 52% 52% 52% 52% 52% 52% 52% 52% 52% 52% 51% 51% 51% 51%
the annuity factor. Once the instalment payment starts, this payment 10 53% 53% 53% 53% 53% 53% 53% 53% 53% 53% 53% 52% 52% 52% 52% 52% 52% 52% 52% 52%
(only one instance 50% 50 Lakh
11 54% 54% 54% 54% 54% 54% 54% 54% 53% 53% 53% 53% 53% 53% 53% 53% 53% 53% 53% 53%
remains level throughout the instalment period. The current rate of during Policy Term) 12 55% 55% 55% 55% 55% 55% 55% 54% 54% 54% 54% 54% 54% 54% 54% 54% 54% 54% 54% 54%
interest is 2.7% and the interest rate used to calculate annuity factor Birth/ Legal adoption 13 56% 56% 56% 56% 56% 56% 55% 55% 55% 55% 55% 55% 55% 55% 55% 55% 54% 54% 54% 54%
25% 25 Lakh
is subject to review at the end of every financial year and will be of 1st child 14 57% 57% 57% 57% 57% 57% 56% 56% 56% 56% 56% 56% 56% 55% 55% 55% 55% 55% 55% 55%
changed in case of change in SBI savings bank interest rate. Birth/ Legal adoption 15 58% 58% 58% 58% 58% 57% 57% 57% 57% 57% 57% 57% 56% 56% 56% 56% 56% 56% 56% 56%
25% 25 Lakh
of 2nd child 16 59% 59% 59% 59% 59% 58% 58% 58% 58% 58% 58% 57% 57% 57% 57% 57% 57% 57% 56% 56%
There will be a waiting period of 180 days from policy inception or from Home loan taken by 50% or loan 17 61% 60% 60% 60% 60% 59% 59% 59% 59% 59% 58% 58% 58% 58% 58% 58% 57% 57% 57% 57%
Life Assured amount 18 62% 61% 61% 61% 60% 60% 60% 60% 60% 59% 59% 59% 59% 59% 58% 58% 58% 58% 58% 58%
any subsequent reinstatement, whichever is later. No Degenerative 50 Lakh 19 63% 62% 62% 62% 61% 61% 61% 61% 60% 60% 60% 60% 60% 59% 59% 59% 59% 59% 59% 58%
disease Benefit shall be payable during this waiting period. (only one instance (whichever is
during Policy Term) lower) 20 64% 63% 63% 63% 62% 62% 62% 62% 61% 61% 61% 61% 60% 60% 60% 60% 60% 59% 59% 59%
There will be a survival period of 14 days applicable from the date of 21 65% 64% 64% 64% 63% 63% 63% 62% 62% 62% 62% 61% 61% 61% 61% 61% 60% 60% 60% 60%
diagnosis of a degenerative disease for eligibility of degenerative 22 66% 65% 65% 65% 64% 64% 64% 63% 63% 63% 63% 62% 62% 62% 62% 61% 61% 61% 61% 61%
disease benefit payment.  The option to increase Sum Assured can be availed within a period 23 67% 66% 66% 66% 65% 65% 65% 64% 64% 64% 63% 63% 63% 63% 62% 62% 62% 62% 61% 61%
of six months from the date of the specified events. The increase 24 68% 67% 67% 67% 66% 66% 65% 65% 65% 64% 64% 64% 64% 63% 63% 63% 63% 62% 62% 62%
5) Return of Premium Option in Sum Assured will be effective from the annual policy anniversary 25 69% 68% 68% 68% 67% 67% 66% 66% 66% 65% 65% 65% 64% 64% 64% 64% 63% 63% 63% 63%
On death of the life assured or diagnosis of terminal illness whichever falling immediately after the date of notification and an additional 26 70% 69% 69% 69% 68% 68% 67% 67% 67% 66% 66% 66% 65% 65% 65% 64% 64% 64% 64% 63%
is earlier, during the term of the policy, Sum Assured is payable and premium will be charged for an increase in the Sum Assured. 27 71% 71% 70% 70% 69% 69% 68% 68% 67% 67% 67% 66% 66% 66% 65% 65% 65% 65% 64% 64%
the policy terminates once the full amount of benefit is paid on  This option is not allowed in Single Premium policies. 28 72% 72% 71% 70% 70% 70% 69% 69% 68% 68% 67% 67% 67% 66% 66% 66% 66% 65% 65% 65%
occurrence of either of the events.  To exercise the above options life assured’s proposal should have 29 73% 73% 72% 71% 71% 70% 70% 70% 69% 69% 68% 68% 68% 67% 67% 67% 66% 66% 66% 65%
been underwritten at standard rate at policy inception, the policy 30 74% 74% 73% 72% 72% 71% 71% 70% 70% 70% 69% 69% 68% 68% 68% 67% 67% 67% 66% 66%
31 75% 75% 74% 73% 73% 72% 72% 71% 71% 70% 70% 70% 69% 69% 68% 68% 68% 67% 67% 67%
On survival of the life assured till the end of the policy term, Maturity should be premium paying at the time of exercising the option and
32 76% 76% 75% 74% 74% 73% 73% 72% 72% 71% 71% 70% 70% 70% 69% 69% 69% 68% 68% 68%
Benefit shall be paid to the customer (as mentioned in the policy age of the policyholder must be less than 45 years. 33 77% 77% 76% 75% 75% 74% 74% 73% 73% 72% 72% 71% 71% 70% 70% 70% 69% 69% 69% 68%
schedule). The policy terminates once the full amount of benefit is paid  The premium rate corresponding to the additional Sum Assured 34 78% 78% 77% 76% 76% 75% 75% 74% 73% 73% 72% 72% 72% 71% 71% 70% 70% 70% 69% 69%
on occurrence of the event. shall be based on the age attained and outstanding policy term on 35 79% 79% 78% 77% 77% 76% 75% 75% 74% 74% 73% 73% 72% 72% 72% 71% 71% 70% 70% 70%
the prevailing premium rates at the time of the exercise of this 36 81% 80% 79% 78% 78% 77% 76% 76% 75% 75% 74% 74% 73% 73% 72% 72% 71% 71% 71% 70%
6) Dual Protect Option benefit. This shall be subject to the minimum premium paying term 37 82% 81% 80% 79% 79% 78% 77% 77% 76% 76% 75% 74% 74% 74% 73% 73% 72% 72% 71% 71%
If the life assured attains the age 55/60/65/70 years as chosen at available under the product at the time of exercising this option. 38 83% 82% 81% 80% 80% 79% 78% 78% 77% 76% 76% 75% 75% 74% 74% 73% 73% 73% 72% 72%
inception (to be selected such that Survival Benefit commences only after 39 84% 83% 82% 81% 80% 80% 79% 78% 78% 77% 77% 76% 76% 75% 75% 74% 74% 73% 73% 72%
end of premium paying term if the policy is in force, for limited premium Option to Decrease Sum Assured 40 85% 84% 83% 82% 81% 81% 80% 79% 79% 78% 78% 77% 76% 76% 75% 75% 74% 74% 74% 73%
policies and after completion of 5 years for single premium policies), 41 86% 85% 84% 83% 82% 82% 81% 80% 80% 79% 78% 78% 77% 77% 76% 76% 75% 75% 74% 74%
 Sum Assured can be reduced in future if it had been increased 42 87% 86% 85% 84% 83% 83% 82% 81% 80% 80% 79% 79% 78% 77% 77% 76% 76% 75% 75% 75%
following Survival Benefit shall be payable: during an event beforehand and post attaining age 45 years
- A lumpsum payout of 5% of Sum Assured shall be paid on annual 43 88% 87% 86% 85% 84% 83% 83% 82% 81% 81% 80% 79% 79% 78% 78% 77% 77% 76% 76% 75%
 The decrease will be allowed to the extent of Sum Assured 44 89% 88% 87% 86% 85% 84% 84% 83% 82% 81% 81% 80% 80% 79% 78% 78% 77% 77% 76% 76%
policy anniversary after life assured attains the Survival Benefit increased under the specified event in the life of the Life Assured. 45 90% 89% 88% 87% 86% 85% 85% 84% 83% 82% 82% 81% 80% 80% 79% 79% 78% 78% 77% 77%
commencement age
 The reduction in Sum Assured will be effective from the annual 46 90% 90% 89% 88% 87% 86% 85% 85% 84% 83% 83% 82% 81% 81% 80% 79% 79% 78% 78% 77%
- 0.1% of Sum Assured shall be paid as monthly income from the next 47 NA 90% 90% 89% 88% 87% 86% 86% 85% 84% 83% 83% 82% 81% 81% 80% 80% 79% 79% 78%
policy anniversary falling immediately after the date of notification
monthly policy anniversary after lumpsum payout has been paid till 48 NA NA 90% 90% 89% 88% 87% 86% 86% 85% 84% 83% 83% 82% 82% 81% 80% 80% 79% 79%
and the premium will be decreased at the same time.
death or diagnosis of terminal illness of the life assured or end of 49 NA NA NA 90% 90% 89% 88% 87% 87% 86% 85% 84% 84% 83% 82% 82% 81% 81% 80% 79%
 The decrease in premium corresponding to the specified event of
policy term whichever is earlier 50 NA NA NA NA 90% 90% 89% 88% 87% 87% 86% 85% 84% 84% 83% 82% 82% 81% 81% 80%
increase will be equal to the additional premium charged at the time
51 NA NA NA NA NA 90% 90% 89% 88% 87% 87% 86% 85% 85% 84% 83% 83% 82% 81% 81%
of increase in Sum Assured benefit corresponding to that specific
On death of the life assured or diagnosis of terminal illness whichever 52 NA NA NA NA NA NA 90% 90% 89% 88% 88% 87% 86% 85% 85% 84% 83% 83% 82% 82%
event as mentioned in the option to Increase Sum Assured.
is earlier, during the term of the policy, Sum Assured less Survival 53 NA NA NA NA NA NA NA 90% 90% 89% 88% 88% 87% 86% 85% 85% 84% 83% 83% 82%
Benefit already paid under the policy (if any), is payable and the policy  The option to decrease sum assured benefit cannot be availed by 54 NA NA NA NA NA NA NA NA 90% 90% 89% 88% 88% 87% 86% 85% 85% 84% 84% 83%
terminates once the full amount of benefit is paid on occurrence of the policyholder during the last 5 policy years. 55 NA NA NA NA NA NA NA NA NA 90% 90% 89% 88% 88% 87% 86% 86% 85% 84% 84%
either of the events.  Once sum assured is decreased it cannot be increased in future. 56 NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 88% 88% 87% 86% 86% 85% 84%
57 NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 88% 88% 87% 86% 86% 85%
The written request for reduction in Sum Assured should be sent at 58 NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 88% 88% 87% 86% 86%
7) COVID Cover least two months prior to the annual policy anniversary. 59 NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 89% 88% 87% 86%
On death of the life assured due to positive diagnosis of COVID-19 or
60 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 89% 88% 87%
death due to co-morbid conditions provided the life assured has tested 1.4 Pay-out Options 61 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 89% 88%
positive for COVID-19, during the term of the policy, Sum Assured is 62 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 89%
payable and the policy terminates once the full amount of benefit is paid You have to select any of the below given payout options at the 63 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89%
on occurrence of the event. inception of the policy. 64 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90%
65 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90%
1.2 Maturity Benefit A. Lumpsum Option
Maturity Benefit is only applicable in case Return of Premium Option is The benefit on death or diagnosis of terminal illness, whichever is
chosen. On survival of the life assured till the end of the policy term earlier, is payable as lumpsum and the policy terminates.
Maturity Benefit as mentioned in the Policy Schedule is payable. The

20 of 45 29 of 45
14601/338228 14601/338228
B. Lumpsum and Level Income Option This option is chosen at the inception of policy and shall not be
On death or diagnosis of terminal illness, whichever is earlier, the available if Joint Life Option is selected.
GSV Factors for Return of Premium Option and Dual Protect Option policyholder can choose 10 % to 50% of the applicable death
benefit to be paid immediately as lumpsum and the balance
A. Limited Premium
amount to be paid in arrears as equal monthly instalments over a
period of 10 years. The lumpsum percentage has to be chosen at 2. Grace Period
Year of the inception of the policy. The monthly instalment amount will be For Limited Premium policies, you are provided a Grace Period of 15
Surrender
5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 calculated as dividing balance amount (say, S) by annuity factor ( days under monthly mode and one month but not less than 30 days for
/ Policy i.e. a(n)(12)) i.e. S/a(n)(12) where n is the instalment period of 10 other premium payment modes, in case you miss your due premium
Term
years. The current prevailing interest rate is 2.7% and the annuity on the due dates. In case of the Life Assured’s death or diagnosis of
1 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
2 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% factor is 105.23 and these are subject to review at the end of every terminal illness or occurrence of any covered event as per the benefit
3 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% option chosen, during the Grace Period, we will pay the benefit after
financial year and will be changed in case of change in SBI
4 90% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% deducting the unpaid due premiums till date of death or date of the
savings bank interest rate. covered event. During this period the policy will be considered to be in-
5 90% 90% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50%
6 NA 90% 90% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% force.
7 NA NA 90% 90% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% Once the instalment payment starts, this payment remains level
8 NA NA NA 90% 90% 70% 63% 60% 58% 57% 56% 55% 54% 54% 54% 53% 53% 53% 53% 53% 52% throughout the instalment period. The interest rate used to 3. Premium Payment
9 NA NA NA NA 90% 90% 77% 70% 66% 63% 61% 60% 59% 58% 57% 57% 56% 56% 55% 55% 55% calculate annuity factor is subject to review at the end of every Premiums can be paid to us either by monthly/ quarterly/ half yearly/
10 NA NA NA NA NA 90% 90% 72% 74% 70% 67% 65% 63% 62% 61% 60% 59% 59% 58% 58% 57% yearly payment mode for limited premium policies, or as single
11 NA NA NA NA NA NA 90% 90% 82% 77% 73% 70% 68% 66% 65% 63% 62% 61% 61% 60% 59%
financial year and will be changed in case of change in SBI
premium, as selected by you in the Proposal Form. The Limited
12 NA NA NA NA NA NA NA 90% 90% 83% 79% 75% 72% 70% 68% 67% 65% 64% 63% 63% 62% savings bank interest rate.
Premiums should be paid on or before the due dates to avoid any
13 NA NA NA NA NA NA NA NA 90% 90% 84% 80% 77% 74% 72% 70% 68% 67% 66% 65% 64% lapsation.
14 NA NA NA NA NA NA NA NA NA 90% 90% 85% 81% 78% 75% 73% 72% 70% 69% 68% 66% C. Lumpsum and Increasing Income Option:
15 NA NA NA NA NA NA NA NA NA NA 90% 90% 86% 82% 79% 77% 75% 73% 71% 70% 69% On death or diagnosis of terminal illness, whichever is earlier, the PART D
16 NA NA NA NA NA NA NA NA NA NA NA 90% 90% 86% 83% 80% 78% 76% 74% 73% 71%
17 NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 86% 83% 81% 79% 77% 75% 74% policyholder can choose 10 % to 50% of the applicable death
18 NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 87% 84% 81% 79% 78% 76% benefit to be paid immediately as lumpsum and the balance 4. Paid-Up benefits
19 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 87% 84% 82% 80% 78% amount to be paid in arrears as monthly instalments over a period Policy will acquire paid-up value only for plan options – Return of
20 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 87% 85% 83% 81% Premium Option and Dual Protect Option, after expiry of grace period
of 10 years increasing at 5% p.a. simple interest. The lumpsum
21 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 87% 85% 83% from the date of first unpaid premium if all premiums have been paid
22 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 88% 85%
percentage has to be chosen at the inception of the policy. for at least (2) two consecutive years, and subsequent due premiums
23 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 88% not being paid.
24 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 1.5 Waiver of Premium Benefit
25 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 90% This option is available only with Life Option, all variants of Under Return of Premium Option:
Incidence Coverage Option and Long Term Care Option. Waiver
of all future premiums if the Life Assured is diagnosed with any of The paid-up death benefit would be Sum Assured on death as on the
Year of date of policy being made paid-up * (Total numbers of premiums
Surrender / 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 the listed 40 Critial Illnesses, or total permanent disability due to
paid)/ (Total Number of premiums payable over the policy term).
Policy Term accident. If Joint Life Option is chosen along with this option then
1 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% Waiver of Premium Benefit is applicable only on the primary life
2 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30% 30%
The paid-up maturity benefit will be return of 50% or 100% of total
assured. Waiver of Premium Benefit is not available if Better-Half premium paid as on the date of policy being made paid-up, as chosen
3 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35% 35%
4 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% Benefit is chosen. by the policyholder at the inception (as mentioned in the policy
5 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% schedule).
6 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 1.6 Joint Life Option
7 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% This option is available only with Life Option and all variants of Under Dual Protect Option:
8 52% 52% 52% 52% 52% 52% 52% 52% 52% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% 51% Incidence Coverage Option. Insuance coverage commences on
9 54% 54% 54% 54% 54% 53% 53% 53% 53% 53% 53% 53% 53% 53% 53% 52% 52% 52% 52% 52%
both the Life Assureds’ at inception of the policy. The paid-up death benefit would be Sum Assured on death as on the
10 57% 56% 56% 56% 55% 55% 55% 55% 55% 54% 54% 54% 54% 54% 54% 54% 54% 53% 53% 53% date of policy being made paid-up * (Total numbers of premiums
11 59% 58% 58% 58% 57% 57% 57% 56% 56% 56% 56% 56% 55% 55% 55% 55% 55% 55% 54% 54% paid)/ (Total Number of premiums payable over the policy term).
12 61% 61% 60% 60% 59% 59% 58% 58% 58% 57% 57% 57% 57% 56% 56% 56% 56% 56% 56% 55% On occurrence of death of the secondary life assured (spouse)
13 63% 63% 62% 61% 61% 60% 60% 60% 59% 59% 59% 58% 58% 58% 58% 57% 57% 57% 57% 56% during the term of the policy, applicable benefit shall be payable Paid-up Survival benefit:
14 66% 65% 64% 63% 63% 62% 62% 61% 61% 60% 60% 60% 59% 59% 59% 58% 58% 58% 58% 58% as mentioned in the Policy Schedule. In case payout happens for
15 68% 67% 66% 65% 65% 64% 63% 63% 62% 62% 61% 61% 61% 60% 60% 60% 59% 59% 59% 59% a life assured, policy will continue for the other life assured till
16 70% 69% 68% 67% 66% 66% 65% 64% 64% 63% 63% 62% 62% 62% 61% 61% 61% 60% 60% 60%
A. Lumpsum Benefit: 5% of Paid-up Sum Assured on next policy
benefit for both the life assureds’ is exhausted or end of policy anniversary after attaining chosen survival benefit age plus
17 72% 71% 70% 69% 68% 67% 67% 66% 65% 65% 64% 64% 63% 63% 63% 62% 62% 61% 61% 61% term, whichever is earlier. This option is chosen at the inception
18 74% 73% 72% 71% 70% 69% 68% 68% 67% 66% 66% 65% 65% 64% 64% 63% 63% 63% 62% 62% of policy and shall not be available if Better-Half Benefit is
19 77% 75% 74% 73% 72% 71% 70% 69% 68% 68% 67% 67% 66% 65% 65% 65% 64% 64% 63% 63% B. Income Benefit: 0.1% Paid-up Sum Assured as monthly income
selected. from the next monthly policy anniversary after lumpsum payout has
20 79% 77% 76% 75% 74% 73% 72% 71% 70% 69% 69% 68% 67% 67% 66% 66% 65% 65% 64% 64%
21 81% 79% 78% 77% 75% 74% 73% 72% 72% 71% 70% 69% 69% 68% 67% 67% 66% 66% 66% 65% been paid, till death or diagnosis of terminal illness or end of policy
22 83% 82% 80% 79% 77% 76% 75% 74% 73% 72% 71% 71% 70% 69% 69% 68% 68% 67% 67% 66% 1.7 Better-Half Benefit term whichever is earlier.
23 86% 84% 82% 80% 79% 78% 77% 76% 75% 74% 73% 72% 71% 71% 70% 69% 69% 68% 68% 67% This option is available only with Life Option and all variants of
24 88% 86% 84% 82% 81% 80% 78% 77% 76% 75% 74% 73% 73% 72% 71% 71% 70% 69% 69% 68% Incidence Coverage Option. The insurance coverage for where Paid-up Sum Assured =Sum Assured * (Total numbers of
25 90% 88% 86% 84% 83% 81% 80% 79% 78% 77% 76% 75% 74% 73% 72% 72% 71% 71% 70% 69% secondary life assured will start after the death or diagnosis of premiums paid)/ (Total Number of premiums payable over the policy
26 90% 90% 88% 86% 85% 83% 82% 80% 79% 78% 77% 76% 75% 75% 74% 73% 72% 72% 71% 71% Terminal Illness of primary life assured and all the future term)
27 NA 90% 90% 88% 86% 85% 83% 82% 81% 80% 79% 78% 77% 76% 75% 74% 74% 73% 72% 72% premiums after the death or diagnosis of terminal illness of
28 NA NA 90% 90% 88% 87% 85% 84% 82% 81% 80% 79% 78% 77% 76% 75% 75% 74% 73% 73% primary life assured will be waived. 5. Termination Benefit
29 NA NA NA 90% 90% 88% 87% 85% 84% 83% 81% 80% 79% 78% 77% 77% 76% 75% 74% 74%
30 NA NA NA NA 90% 90% 88% 87% 85% 84% 83% 82% 81% 80% 79% 78% 77% 76% 76% 75% On occurrence of death of the secondary life assured (spouse) For plan options other than Return of Premium option & Dual
31 NA NA NA NA NA 90% 90% 88% 87% 86% 84% 83% 82% 81% 80% 79% 78% 77% 77% 76% during the term of the policy, applicable benefit shall be payable Protect Option:
32 NA NA NA NA NA NA 90% 90% 88% 87% 86% 84% 83% 82% 81% 80% 79% 79% 78% 77% as mentioned in the Policy Schedule. This benefit will not be paid
33 NA NA NA NA NA NA NA 90% 90% 89% 87% 86% 85% 84% 82% 82% 81% 80% 79% 78%
if the secondary life assured (spouse) dies before death of the Termination value under single premium is allowed after the completion
34 NA NA NA NA NA NA NA NA 90% 90% 89% 87% 86% 85% 84% 83% 82% 81% 80% 79% of three policy year. The Termination value for single premium mode
primary life assured or in case of simultaneous death of the
35 NA NA NA NA NA NA NA NA NA 90% 90% 89% 87% 86% 85% 84% 83% 82% 81% 80% will be calculated as below:
36 NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 87% 86% 85% 84% 83% 82% 81% primary life assured and spouse or death of the spouse arising
37 NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 87% 86% 85% 84% 83% 82% directly or indirectly due to the same event which caused the death
38 NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 88% 86% 85% 84% 84% of the primary life insured.
39 NA NA NA NA NA NA NA NA NA NA NA NA NA 90% 90% 89% 88% 87% 86% 85%

28 of 45 21 of 45
14601/338228 14601/338228
PART G  any partial or total repudiation of claims by the life insurer,
general insurer or health insurer;
22. Grievance Redressal  disputes over premium paid or payable in terms of insurance
Policy will lapse after the expiry of the grace period from the date of
 Un expiredTerm*  first unpaid premium and no benefit is payable.
You may contact us in case of any grievance or complaint at any of policy;
40%  Pr emiumsPaid   our branches or at Customer Care, IndiaFirst Life Insurance Company  misrepresentation of policy terms and conditions at any time in
 TotalTerm  If the covered events occur before the expiry of grace period then Ltd, 12th & 13th floor, North [C] Wing, Tower 4, Nesco IT Park, Nesco the policy document or policy contract;
benefit will be paid after deducting the due instalment premium, before Center, Western Express Highway, Goregaon (East), Mumbai – 400  legal construction of insurance policies in so far as the dispute
Termination value under limited premium is allowed after the the date of occurrence of covered event. 063, Toll FreeContact No.: 1800 209 8700, Email id: relates to claim;
completion of premium paying term and after paying all due premiums. [email protected]. IRDAI Regn No. 143. CIN:
The Termination value for limited premium mode will be calculated as  policy servicing related grievances against insurers and their
You may revive the policy by paying all the arrears premium with (under U66010MH2008PLC183679. agents and intermediaries;
below. Return of Premium Option and Dual Protect Option) or without (under
plan options other than Return of Premium Option and Dual Protect  issuance of life insurance policy, general insurance policy
𝑈𝑛 𝑒𝑥𝑝 𝑖 𝑟𝑒𝑑𝑇𝑒𝑟𝑚 ∗ Options) any interest within five years from the due date of first unpaid including health insurance policy which is not in conformity with
15% × 𝑇𝑜𝑡𝑎𝑙 𝑃𝑟𝑒𝑚𝑖𝑢𝑚𝑠𝑃𝑎𝑖𝑑 × a. A written communication giving reasons of either redressing or the proposal form submitted by the proposer;
premium and subject to production of satisfactory evidence of health, if
𝑇𝑜𝑡𝑎𝑙𝑇𝑒𝑟𝑚 required as per the board approved underwriting policy. We will always rejecting the grievance will be sent to you within 15 (Fifteen) days  non issuance of insurance policy after receipt of premium in life
have right to refuse such request for revival as per the Board approved from the date of receipt of the grievance. In case We don’t receive insurance and general insurance including health insurance; and
underwriting policy. The current interest charged for delay in premium a revert from You within 8 weeks from the date of Your receipt of
*Unexpired Term will be calculated as on the date of Termination. Our response, We will treat the complaint as closed.
payment is 9.50% p.a. Any change in basis of calculation of revival
interest rate is subject to prior approval from IRDAI. b. However, if you are not satisfied with our resolution provided or any other matter resulting from the violation of provisions of the
have not received any response within 15 (Fifteen) days, then, you Insurance Act, 1938 as amended from time to time or the regulations,
6. Surrender Benefit circulars, guidelines or instructions issued by IRDAI from time to time
The cost of medicals, if any, will be borne by the policyholder. may approach our Grievance Officer at any of our branches or you
You may surrender this Policy during the Policy Term, by submitting a or the terms and conditions of the policy contract, in so far as they relate
written request to us any time after the Policy has acquired the may write to our Grievance Redressal Officer at
[email protected]. to issues mentioned in clauses above.
Surrender Value. Please remember, you cannot revive your Policy
once it is surrendered. An acknowledgment to all such grievances received will be sent
within 3 (Three) working days of receipt of the grievance. The complaint should be made in writing and the same should be duly
c. If you are not satisfied with the response or do not receive a signed by the complainant or by his legal heir(s), nominee(s) or
8. Free Look Period response from us within 15 days, you may approach the Grievance assignee with full details of the complaint and the contact information
For Return of Premium Option and Dual Protect Option:
You have a free look period of 15 days from the date of receipt of the Cell of the Insurance Regulatory and Development Authority of of the complainant.
Surrender value under single premium is payable immediately and policy document and a period of 30 days in case of electronic policies India (IRDAI) on the following contact details:
under limited premium after payment of first two full years premiums. and policies obtained through Distance Marketing, to review the terms
and conditions of the policy and in case you disagree to any of those As per provision 14 of the Insurance Ombudsman Rules, 2017, the
IRDAI Grievance Call Centre (IGCC) TOLL FREE NO: 155255 complaint to the Ombudsman can be made by you or the complainant,
The surrender value will be higher of Guaranteed Surrender Value terms or conditions, you shall have the option to return the policy to us Email ID: [email protected]
(GSV) and Special Surrender Value (SSV). for cancellation, stating the reasons for your objection, then you shall within a period of 1 (One) year from the date of rejection of the
grievance by Us or after receipt of decision which is not to your
be entitled to a refund of the premium paid subject only to a deduction You can also register your complaint online at
The GSV factors are dependent upon policy year of surrender and of a proportionate risk premium for the period of cover and the satisfaction or after expiry of one month from the date of sending
policy term. The GSV factors will be applicable on total premium paid http://www.igms.irda.gov.in/ representation to Us if We fail to furnish reply to You provided the same
expenses incurred by us on medical examination of the life to be
till date of surrender. dispute is not already decided by or pending before or disposed of by
assured and stamp duty charges. Such a request received by us for Address for communication for complaints by fax/paper:
free look cancellation of the policy shall be processed and premium any court or consumer forum or arbitrator.
GSV = GSV factor * total premiums paid less survival benefit/paid-up Consumer Affairs Department,
survival benefit already paid as applicable under Dual Protect Option. refunded within 15 days of receipt of the request. Insurance Regulatory and Development Authority of India, Disclaimers
Sy. No. 115/1, Financial District, Nanakramguda
The SSV will be calculated as: Distance Marketing includes every activity of solicitation (including lead Gachibowli, Hyderabad- 500032, Telangana
generation) and sale of insurance products through the following Applicable taxes levied as per extant tax laws shall be deducted from
Under Return of Premium Option: IRDAI TOLL FREE NO: 18004254732
modes: (i) Voice mode, which includes telephone-calling; (ii) Short the premium or from the allotted units as applicable.
Paid-up maturity benefit multiplied by the SSV factor prevailing at the Messaging service (SMS); (iii) Electronic mode which includes e-mail,
time of surrender internet and interactive television (DTH); (iv) Physical mode which Insurance Ombudsman IndiaFirst Life Insurance Company Limited, IRDAI Regn No.143, CIN:
Under Dual Protect Option: includes direct postal mail and newspaper & magazine inserts; and, (v) In case you are dissatisfied with the decision/resolution of the U66010MH2008PLC183679, Address: 12th & 13th floor, North [C]
Solicitation through any means of communication other than in person Company, you may approach the Insurance Ombudsman located Wing, Tower 4, Nesco IT Park, Nesco Center, Western Express
Surrender under reduced paid-up status: nearest to you (please refer to Annexure of List of Ombudsmen or visit
Discounted value of outstanding paid-up survival benefit multiplied by 9. Loan Highway, Goregaon (East), Mumbai – 400 063. www.indiafirstlife.com,
our website www.indiafirstlife.com) if your grievance pertains to : SMS <LIFE> to 5667735 SMS Charges apply. Toll free No – 1800 209
the SSV factor prevailing at the time of surrender. No loan is available under this policy.
8700. Trade logo displayed above belongs to IndiaFirst Life Insurance
Surrender under fully paid-up status: PART E  Delay in settlement of claims, beyond the time specified in the Co. Ltd. under license. IRDAI Regn No. 143. CIN:
Discounted value of outstanding survival benefit multiplied by the SSV 10. Charges regulations, framed under the Insurance Regulatory and
factor prevailing at the time of surrender. This is a non-linked non-participating term insurance plan. There are U66010MH2008PLC183679.
Development Authority Act, 1999;
no charges applicable under this policy.
The SSV factor will be determined by the Company from time to time
having regard to the investment scenario subject to Regulatory
approval.

7. Reviving your Lapsed Policy

For Return of Premium Option and Dual Protect Option:

Policy will lapse after the expiry of the grace period from the date of
first unpaid premium and before payment of 2 policy years premium in
full.

If the policy lapses, all the benefits will cease after expiry of the grace
period from the date of first unpaid premium.

On death or diagnosis of terminal illness before the expiry of the grace


period then full applicable benefit will be paid after deducting the due
instalment premium before date of death or diagnosis of terminal
illness.

For Plan options other than Return of Premium Option and Dual
Protect Option:

22 of 45 27 of 45
14601/338228 14601/338228
x. Any other document or information that we may need for
(9) Any rights and remedies of an assignee or transferee of a policy of the expectancy of the life of the insured was incorrectly made in validating and processing the claim
life insurance under an assignment or transfer effected prior to the the proposal or other document on the basis of which the policy PART F
commencement of the Insurance Laws (Amendment) Act, 2015 shall was issued or revived or rider issued: Provided that the insurer 11. Making a Claim
not be affected by the provisions of this section. shall have to communicate in writing to the insured or the legal In order to process a claim under this Policy, we will need a written For Accidental Total Permanent Disability –
representatives or nominees or assignees of the insured the intimation about the claim, upon the death of the Life Assured i. Proof of Age of the Life Assured, if the Age of the life assured
(10) Notwithstanding any law or custom having the force of law to the grounds and materials on which such decision to repudiate the occurrence of the any other covered event (as opted at inception of the has not been admitted by us.
contrary, an assignment in favour of a person made upon the condition policy of life insurance is based: Provided further that in case of ii. Claimant’s statement and claim intimation report for
policy) during the Policy Term. This is the first step towards processing
that— repudiation of the policy on the ground of misstatement or Disability.
(a) the proceeds under the policy shall become payable to the suppression of a material fact, and not on the ground of fraud, the your claim. The written intimation should also be accompanied with all iii. Attending Doctor's Certificate duly filled and signed in
policyholder or the nominee or nominees in the event of either the premiums collected on the policy till the date of repudiation shall the required documents as mentioned below: original.
assignee or transferee predeceasing the insured; or be paid to the insured or the legal representatives or nominees or iv. Disability Certificate issued by Attending Neuro
(b) the insured surviving the term of the policy, shall be valid: assignees of the insured within a period of ninety days from the You may submit the claims documents at any of our branches or at physician/Surgeon/Civil Surgeon etc, providing the detail of
Provided that a conditional assignee shall not be entitled to obtain a date of such repudiation. Claims Department, IndiaFirst Life Insurance Company Ltd, 12th & the Physical Severance and its Nature
loan on the policy or surrender a policy. 5) Nothing in this section shall prevent the insurer from calling for 13th floor, North [C] Wing, Tower 4, Nesco IT Park, Nesco Center, (Permanent/Temporary)
proof of age at any time if he is entitled to do so, and no policy v. First Information Report, Panchnama and Inquest report,
Western Express Highway, Goregaon (East), Mumbai – 400 063,
(11) In the case of the partial assignment or transfer of a policy of shall be deemed to be called in question merely because the duly attested by the police or medico-legal certificate.
insurance under sub-section (1), the liability of the insurer shall be terms of the policy are adjusted on subsequent proof that the age Contact No.: 1800 209 8700, Email id: vi. Copy of Driving License of the Life Assured, in case the Life
limited to the amount secured by partial assignment or transfer and of the Life Insured was incorrectly stated in the proposal. [email protected]. IRDAI Regn No. 143. CIN: Assured was driving
such policyholder shall not be entitled to further assign or transfer the U66010MH2008PLC183679. vii. All Hospitalization documents including discharge summary,
residual amount payable under the same policy. 18. Right to Revise/ Delete/ Alter the Terms and Conditions of Admission Notes and all investigation reports.
this Policy Death Claim: viii. Self attested Copy of bank pass book of Policy Holder along
15. Policy Ceases/ Ends/ Terminates We may revise, delete and/ or alter any of the terms and conditions of Incase of natural death with cancelled cheque.
This Policy will cease immediately and automatically on the happening this Policy, by sending a prior written notice of 30 (Thirty) days, with i. Proof of Age of the Life Assured, if the Age of the life assured Any other document or information that we may need for
of the earliest of any of the following: prior approval of the IRDAI. validating and processing the claim.
i. on the date of payment of the claim benefit; or has not been admitted by us.
ii. on the date of intimation of rejection of claim by us; or 19. Governing Law and Jurisdiction ii. Claimant’s statement and claim intimation report duly filled and
For Critical Illness/ Degenerative Diseases:
iii. on the payment of Maturity benefit; or All claims, disputes or differences under this Policy will be governed by signed by claimant/nominee.
i. Proof of Age of the Life Assured, if the Age of the life assured
iv. on the date of payment of Surrender Value; or Indian laws and shall be subject to the jurisdiction of Indian Courts. iii. Death certificate issued under section 12/17 of registration of
has not been admitted by us.
v. on the date of payment of free look cancellation amount; or Births and Deaths Act 1969 (only in case of death of the Life ii. Claimant’s statement and claim intimation report for Critical
vi. on the expiry of the revival period provided we have not received 20. Turn Around Time for various servicing request and claims Assured). Illness or Degenerative Disease
the due unpaid regular Premiums along with interest from you till processing are as mentioned below:
iv. Original Policy document. iii. Attending Doctor's Certificate duly filled and signed in
the expiry of such period and policy has not acquired any paid- Policy Servicing TAT's
v. A self attested copy of Pan Card of Nominee/Claimant. In case original.
up value Full Surrender 15 Days
Nominee/Claimant does not have a pan card issued on his/her iv. First Information Report, Panchnama and Inquest report,
Freelook Cancellation 15 Days duly attested by the police in case Life Assured suffers from
16. Change of Address Request for refund of proposal deposit 15 days name then please submit duly filled and signed Form 60.
Permanent Paralysis of Limbs / Loss of Limbs / Blindness
You are required to inform us in writing, about any change in your/ Refund of outstanding proposal deposit 15 days vi. Self-attested copy of photo-identity proof and address of the
due to accidental injuries or medico-legal certificate.
Nominee(s)’s address with address proof. This will ensure that our Maturity/Survival/Death Claims Nominee(s)/Claimant (e.g. driving license, PAN card, passport, v. All Hospitalization documents including discharge summary,
correspondence reaches you/ the Nominee(s) without any delay. We Processing of Maturity claim / penal interest not paid Due Date Voter ID card etc.) Admission Notes and all investigation reports
will not be liable on account of your failure to up-date your current Raising claim requirements after lodging the Death vii. Self-attested copy of first page of bank pass book of vi. Investigation/Diagnostic reports leading to the Diagnosis of
address in our records or registering an address with us which is
claim 15 Days Nominee(s)/Claimant along with cancelled cheque. the ailment suffered
incorrect.
Death claim decision without investigation viii. Any other document or information that we may need for vii. Self attested Copy of bank pass book of Policy Holder along
requirement 30 Days with cancelled cheque.
17. Disclosures validating and processing the claim
Death claim decision with investigation requirement 120 Days Any other document or information that we may need for
Misrepresentation/Fraudulent Disclosures: shall be governed as
validating and processing the claim.
per Section 45 of Insurance Act, 1938 as amended from time to
time. Incase of un natural death
21. Issue of duplicate Policy Document IndiaFirst reserves the right to subject the Life Insured for Medical
i. Proof of Age of the Life Assured, if the Age of the life assured
1) No policy of life insurance shall be called in question on any has not been admitted by us. examination at IndiaFirst empaneled medical Centres in case of
ground whatsoever after the expiry of three years from the date of If the Policy Document is lost or destroyed, then, the Policyholder can
submit to us the filled in ‘Indemnity Bond for Loss of Policy Document’ ii. Claimant’s statement and claim intimation report duly filled and Accidental Total and Permanent Disability or Critical Illness claims, the
the policy, i.e., from the date of issuance of the policy or the date
form, which is available on our website. signed by claimant/nominee. cost of which would be borne by us.
of commencement of risk or the date of revival of the policy or the
date of the rider to the policy, whichever is later. iii. Death certificate issued under section 12/17 of registration of Maturity Claim:
2) A policy of life insurance may be called in question at any time We will issue a duplicate Policy Document duly endorsed to show that Births and Deaths Act 1969 (only in case of death of the Life
it is being issued following the loss or destruction of the original Policy i. Maturity Claim Intimation form duly filled and signed by / Policy
within three years from the date of issuance of the policy or the Assured). Holder.
date of commencement of risk or the date of revival of the policy Document.
iv. Copies of First Information Report, Panchnama, Inquest report ii. Original Policy Document(s)
or the date of the rider to the policy, whichever is later, on the and post mortem report (Only if Death), duly attested by the iii. Self-Attested Copy of PAN Card of the Policy Holder/ Form
ground of fraud: Provided that the insurer shall have to The Company will not charge any additional fee for the issuance of
duplicate Policy Document. Currently, only Stamp Duty fee (as police (only in case of Accident leading to unnatural death or no.60 if PAN is not available
communicate in writing to the insured or the legal representatives iv. Cancelled Cheque or Self Attested Copy of first page of Pass
or nominees or assignees of the insured the grounds and applicable for the applicable State/Union-Territory) is being charged. Permanent Disability of the Life Assured).
v. All Hospitalization documents including discharge summary, book of the Policy Holder.
materials on which such decision is based. v. Self-Attested Copy of Address Proof (if change in Address).
3) Notwithstanding anything contained in sub-section (2), no insurer Upon the issue duplicate Policy Document, the original Policy Admission Notes and all investigation reports (only in case the
Document will cease to have any legal effect. vi. Duly filled and signed NRI Declaration form applicable only for
shall repudiate a life insurance policy on the ground of fraud if the Life Assured was treated for any illness related to the cause of NRIs.
insured can prove that the mis-statement of or suppression of a death). vii. Any other document or information that we may need for
material fact was true to the best of his knowledge and belief or vi. Original Policy document. validating and processing the claim.
that there was no deliberate intention to suppress the fact or that
vii. A self attested copy of Pan Card of Nominee/Claimant. In case
such mis-statement of or suppression of a material fact are within 12. Exclusions
the knowledge of the insurer: Provided that in case of fraud, the Nominee/Claimant does not have a pan card issued on his/her
onus of disproving lies upon the beneficiaries, in case the name then please submit duly filled and signed Form 60.
Exclusions for Accidental Death Benefit:
policyholder is not alive. viii. Self-attested copy of photo-identity proof and address of the
Accidental Death benefit shall not be paid on death of the insured
4) A policy of life insurance may be called in question at any time Nominee(s)/Claimant (e.g. driving license, PAN card, passport, person occurring directly or indirectly due to or caused, occasioned,
within three years from the date of issuance of the policy or the Voter ID card etc.) accelerated or aggravated by any of the following:
date of commencement of risk or the date of revival of the policy ix. Self-attested copy of first page of bank pass book of
or the date of the rider to the policy, whichever is later, on the 1. Suicide or self-inflicted injury, whether the life assured is medically
Nominee(s)/Claimant along with cancelled cheque.
ground that any statement of or suppression of a fact material to

26 of 45 23 of 45
14601/338228 14601/338228
sane or insane. . Pre-Existing disease means any condition, ailment, injury or disease: Provided that the assignment of a policy to the insurer who bears the 1) A transfer or assignment of a policy of insurance, wholly or in part,
2. War, terrorism, invasion, act of foreign enemy, hostilities, civil war, a. That is/are diagnosed by a physician within 48 months prior to the risk on the policy at the time of the assignment, in consideration of a whether with or without consideration, may be made only by an
martial law, rebellion, revolution, insurrection, military or usurper effective date of the policy issued by the insurer or loan granted by that insurer on the security of the policy within its endorsement upon the policy itself or by a separate instrument, signed
power, civil commotion. War means any war whether declared or not. b. For which medical advice or treatment was recommended by, or surrender value, or its reassignment on repayment of the loan shall not in either case by the transferor or by the assignor or his duly authorised
3. Taking part in any naval, military or air force operation during peace received from, a physician within 48 months prior to the effective date cancel a nomination, but shall affect the rights of the nominee only to agent and attested by at least one witness, specifically setting forth the
time. of the policy or its reinstatement the extent of the insurer's interest in the policy: fact of transfer or assignment and the reasons thereof, the antecedents
4. Committing an assault, a criminal offence, an illegal activity or any After completion of 48 months from date of issuance or reinstatement, Provided further that the transfer or assignment of a policy, whether of the assignee and the terms on which the assignment is made.
breach of law with criminal intent. as the case may be, pre-existing exclusion clause will not be applicable wholly or in part, in consideration of a loan advanced by the transferee
5. Poison, gas or fumes (voluntary or involuntarily, accidentally or 2. Intentional self-inflicted injury, attempted suicide while sane or or assignee to the policyholder, shall not cancel the nomination but (2) An insurer may, accept the transfer or assignment, or decline to act
otherwise taken, administered, absorbed or inhaled). insane. shall affect the rights of the nominee only to the extent of the interest upon any endorsement made under sub-section (1), where it has
6. Service in the armed forces, of any country at war or service in any 3. Alcohol or Solvent abuse or taking of Drugs, narcotics or of the transferee or assignee, as the case may be, in the policy: sufficient reason to believe that such transfer or assignment is not bona
force of an international body. psychotropic substances unless taken in accordance with the lawful Provided also that the nomination, which has been automatically fide or is not in the interest of the policyholder or in public interest or is
7. Participation by the insured person in any flying activity, except as a directions and prescription of a registered medical practitioner. cancelled consequent upon the transfer or assignment, the same for the purpose of trading of insurance policy.
bona fide, fare-paying passenger, pilot, air crew of a recognized airline 4. War, invasion, act of foreign enemy, hostilities (whether war be nomination shall stand automatically revived when the policy is
on regular routes and on a scheduled timetable. declared or not), armed or unarmed truce, civil war, mutiny, rebellion, reassigned by the assignee or retransferred by the transferee in favour (3) The insurer shall, before refusing to act upon the endorsement,
8. Taking part in professional sport(s) or any adventurous pursuits or revolution, insurrection, military or usurped power, civil commotion, of the policyholder on repayment of loan other than on a security of record in writing the reasons for such refusal and communicate the
hobbies. “Adventurous Pursuits or Hobbies” includes any kind of racing strikes. policy to the insurer. same to the policyholder not later than thirty days from the date of the
(other than on foot or swimming), potholing, rock climbing (except on 5. Taking part in any naval, military or air force operation during peace policyholder giving notice of such transfer or assignment.
man-made walls), hunting, mountaineering or climbing requiring the time. (5) Where the policy matures for payment during the lifetime of the
use of ropes or guides, any underwater activities involving the use of 6. Participation by the insured person in any flying activity, except as a person whose life is insured or where the nominee or, if there are more (4) Any person aggrieved by the decision of an insurer to decline to act
underwater breathing apparatus including deep sea diving, sky diving, bona fide, fare-paying passenger, pilot, air crew of a recognized airline nominees than one, all the nominees die before the policy matures for upon such transfer or assignment may within a period of thirty days
cliff diving, bungee jumping, paragliding, hand gliding and parachuting. on regular routes and on a scheduled timetable payment, the amount secured by the policy shall be payable to the from the date of receipt of the communication from the insurer
9. Nuclear Contamination; the radioactive, explosive or hazardous 7. Participation by the insured person in a criminal or unlawful act with policyholder or his heirs or legal representatives or the containing reasons for such refusal, prefer a claim to the Authority.
nature of nuclear fuel materials or property contaminated by nuclear a criminal intent. holder of a succession certificate, as the case may be.
fuel materials or accident arising from such nature. 8. Engaging in or taking part in professional sport(s) or any hazardous (5) Subject to the provisions in sub-section (2), the transfer or
pursuits, including but not limited to, diving or riding or any kind of race; (6) Where the nominee or if there are more nominees than one, a assignment shall be complete and effectual upon the execution of such
Exclusions for Accidental Total Permanent Disability: underwater activities involving the use of breathing apparatus or not; nominee or nominees survive the person whose life is insured, the endorsement or instrument duly attested but except, where the transfer
Total and Permanent Disability (due to accident) shall not be paid if martial arts; hunting; mountaineering; parachuting; bungee-jumping. amount secured by the policy shall be payable to such survivor or or assignment is in favour of the insurer, shall not be operative as
disability occurring directly or indirectly due to or caused, occasioned, 9. Any external congenital anomaly will not be covered, and policy will survivors. against an insurer, and shall not confer upon the transferee or
accelerated or aggravated by any of the following: not be issued for such individuals having external congenital anomaly. assignee, or his legal representative, any right to sue for the amount of
Where External Congenital Anomaly means a condition, which is (7) Subject to the other provisions of this section, where the holder of a such policy or the moneys secured thereby until a notice in writing of
1. Suicide or self-inflicted injury, whether the life assured is medically visible and accessible parts of the body and present since birth, and policy of insurance on his own life nominates his parents, or his spouse, the transfer or assignment and either the said endorsement or
sane or insane. which is abnormal with reference to form, structure or position. or his children, or his spouse and children, or any of them, the nominee instrument itself or a copy thereof certified to be correct by both
2. War, terrorism, invasion, act of foreign enemy, hostilities, civil war, 10. Nuclear Contamination; the radioactive, explosive or hazardous or nominees shall be beneficially entitled to the amount payable by the transferor and transferee or their duly authorised agents have been
martial law, rebellion, revolution, insurrection, military or usurper nature of nuclear fuel materials or property contaminated by nuclear insurer to him or them under sub-section (6) delivered to the insurer:
power, civil commotion. War means any war whether declared or not. fuel materials or accident arising from such nature. unless it is proved that the holder of the policy, having regard to the Provided that where the insurer maintains one or more places of
3. Service in the armed forces, of any country at war or service in any nature of his title to the policy, could not have conferred any such business in India, such notice shall be delivered only at the place where
force of an international body Suicide Exclusion beneficial title on the nominee. the policy is being serviced.
4. Taking part in any naval, military or air force operation during peace In case of death or terminal illness due to suicide within 12 months from
time. the date of commencement of risk under the policy or from the date of (8) Subject as aforesaid, where the nominee, or if there are more (6) The date on which the notice referred to in sub-section (5) is
5. Committing an assault, a criminal offence, an illegal activity or any revival of the policy, as applicable, the nominee or beneficiary of the nominees than one, a nominee or nominees, to whom sub-section (7) delivered to the insurer shall regulate the priority of all claims under a
breach of law with criminal intent. policyholder shall be entitled to at least 80% of the total premiums paid applies, die after the person whose life is insured but before the amount transfer or assignment as between persons interested in the policy; and
6. Alcohol or Solvent abuse or taking of Drugs, narcotics or till the date of death or the surrender value available as on the date of secured by the policy is paid, the amount secured by the policy, or so where there is more than one instrument of transfer or assignment the
psychotropic substances unless taken in accordance with the lawful death whichever is higher, provided the policy is in force. much of the amount secured by the policy as represents priority of the claims under such instruments shall be
directions and prescription of a registered medical practitioner the share of the nominee or nominees so dying (as the case may be), governed by the order in which the notices referred to in sub-section
7. Poison, gas or fumes (voluntary or involuntarily, accidentally or 13. Nomination shall be governed as per section 39 of the shall be payable to the heirs or legal representatives of the nominee or (5) are delivered:
otherwise taken, administered, absorbed or inhaled). Insurance Act, 1938 as amended from time to time. nominees or the holder of a succession certificate, as the case may be, Provided that if any dispute as to priority of payment arises as between
8. Participation by the insured person in any flying activity, except as a and they shall be beneficially entitled to such amount. assignees, the dispute shall be referred to the Authority.
bona fide, fare-paying passenger, pilot, air crew of a recognized airline (1) The holder of a policy of life insurance on his own life may, when
on regular routes and on a scheduled timetable. effecting the policy or at any time before the policy matures for (9) Nothing in sub-sections (7) and (8) shall operate to destroy or (7) Upon the receipt of the notice referred to in sub-section (5), the
9. Taking part in professional sport(s) or any adventurous pursuits or payment, nominate the person or persons to whom the money secured impede the right of any creditor to be paid out of the proceeds of any insurer shall record the fact of such transfer or assignment together
hobbies. “Adventurous Pursuits or Hobbies” includes any kind of racing by the policy shall be paid in the event of his death: policy of life insurance. with the date thereof and the name of the transferee or the assignee
(other than on foot or swimming), potholing, rock climbing (except on Provided that, where any nominee is a minor, it shall be lawful for the and shall, on the request of the person by whom the notice was given,
man-made walls), hunting, mountaineering or climbing requiring the policyholder to appoint any person in the manner laid down by the (10) The provisions of sub-sections (7) and (8) shall apply to all policies or of the transferee or assignee, on payment of such fee as may
use of ropes or guides, any underwater activities involving the use of insurer, to receive the money secured by the policy in the event of his of life insurance maturing for payment after the commencement of the be specified by the regulations, grant a written acknowledgement of the
underwater breathing apparatus including deep sea diving, sky diving, death during the minority of the nominee. Insurance Laws (Amendment) Act, 2015. receipt of such notice; and any such acknowledgement shall be
cliff diving, bungee jumping, paragliding, hand gliding and parachuting. conclusive evidence against the insurer that he has duly received the
10. Any disability due to any kind of sickness, disease before and/or (2) Any such nomination in order to be effectual shall, unless it is (11) Where a policyholder dies after the maturity of the policy but the notice to which such acknowledgement relates.
after the effective date of the cover; any existing external congenital incorporated in the text of the policy itself, be made by an endorsement proceeds and benefit of his policy has not been made to him because
anomaly will not be covered, and policy will not be issued for such on the policy communicated to the insurer and registered by him in the of his death, in such a case, his nominee shall be entitled to the (8) Subject to the terms and conditions of the transfer or assignment,
members having external congenital anomaly. Other than external records relating to the policy and any such nomination may at any time proceeds and benefit of his policy. the insurer shall, from the date of the receipt of the notice referred to in
congenital anomaly all other congenital anomaly will be covered. before the policy matures for payment be cancelled or changed by an sub-section (5), recognize the transferee or assignee named in the
endorsement or a further endorsement or a will, as the case may be, (12) The provisions of this section shall not apply to any policy of life notice as the absolute transferee or assignee entitled to benefit under
Where External Congenital Anomaly means a condition, which is but unless notice in writing of any such cancellation or change has been insurance to which section 6 of the Married Women's Property Act, the policy, and such person shall be subject to all liabilities and equities
visible and accessible parts of the body and present since birth, and delivered to the insurer, the insurer shall not be liable for any payment 1874, applies or has at any time applied: to which the transferor or assignor was subject at the date of the
which is abnormal with reference to form, structure or position. under the policy made bona fide by him to a nominee mentioned in the Provided that where a nomination made whether before or after the transfer or assignment and may institute any proceedings in relation to
11. Nuclear Contamination; the radioactive, explosive or hazardous text of the policy or registered in records of the insurer. commencement of the Insurance Laws (Amendment) Act, 2015, in the policy, obtain a loan under the policy or surrender the policy without
nature of nuclear fuel materials or property contaminated by nuclear favour of the wife of the person who has insured his life or of his wife obtaining the consent of the transferor or assignor or making him a
fuel materials or accident arising from such nature (3) The insurer shall furnish to the policyholder a written and children or any of them is expressed, whether or not on the face of party to such proceedings.
acknowledgement of having registered a nomination or a cancellation the policy, as being made under this section, the said section 6 shall Explanation- Except where the endorsement referred to in sub-section
Exclusions for Critical Illness and Degenerative Diseases: or change thereof, and may charge such fee as may be specified by be deemed not to apply or not to have applied to the policy. (1) expressly indicates that the assignment or transfer is conditional in
In addition to the condition specific exclusion mentioned in the regulations for registering such cancellation or change. terms of subsection (10) hereunder, every assignment or transfer shall
definitions, we will not pay any 14. Assignment shall be governed as per section 38 of the be deemed to be an absolute assignment or transfer and the assignee
claim arising directly or indirectly due to any of the following causes: (4) A transfer or assignment of a policy made in accordance with Insurance Act, 1938 as amended from time to time. or transferee, as the case may be, shall be
1. Pre-Existing disease: section 38 shall automatically cancel a nomination: deemed to be the absolute assignee or transferee respectively.

24 of 45 25 of 45
14601/338228 14601/338228

You might also like