Policy Pack - Inward Doc. - 00768606

PRAMERICA LIFE RAKSHAK GOLD
(A Non-Linked Non-Participating Endowment Life Insurance Plan)
19/11/2021
Client ID: 55070307

ÌPPÇ* ,5 'd\È6pÎ
PP1001011221000768606 / 084
Mr Sijin V M
S/o Marydasan Yohannan
Vill Mulavana Po Padappakara
Ps Kundara Teh & Dist Kollam
Vijayarmandiram
Kollam - 691503, Kerala
7083473130, 8007638408
Dear Mr Sijin V M,
We would like to take this opportunity to welcome you to Pramerica Life Insurance-PRAHRI, our exclusive channel for defence
personnel, dedicated towards providing 8nancial protection to their families through life insurance.
Our international partner, Prudential International Insurance Holdings, Ltd., is a fully owned subsidiary of Prudential Financial, Inc.; a
145-year-old corporation with operations in the United States, Asia and Latin America. For generations, Prudential has been providing
8nancial security to US Armed Forces, their Veterans and families through various programmes like Serving Group Life Insurance (SGLI),
Veteran Group Life Insurance (VGLI) and Family Group Life Insurance (FGLI) and has USD 1.6 Trillion (as on 31st March 2021), Assets
Under Management (AUM).
The team at Pramerica Life Insurance-PRAHRI, comprises of over one thousand veterans, and is dedicated towards serving the Indian
Armed Forces through customized products, services and support. We take great pride in serving you, our hero, who has selBessly
dedicated his life towards protecting the citizens of India.
Pramerica Life Insurance-PRAHRI is the 8rst initiative of its kind in the life insurance industry and has been with our soldiers for over a
PLIL/Operation/DEFENCE/Welcome Letter/037_01-Sept-2021
decade. With our 138 branches (as on 31st March 2021), we cover our soldiers for all war and war-like situations, casualties
attributable to military service, training or any other circumstances that may arise. Not only this, we also have a dedicated team
that processes claims received from the families of defence personnel, on top priority and within a record turnaround time of 4 days
(upon receipt of complete set of documents). With a 98.61% claim paid ratio (as on 31st March 2021), we have been consistently
delivering on our promise of protecting you and your family.
This life insurance policy is a promise that you will take care of your loved ones and their future even if you are not around. Therefore,
we bring to you an option to express your love and care for your nominee through a personalized card.
We would like to take this opportunity to congratulate you on taking the wise decision of securing your and your family’s future.
We look forward to a long association with you and assure you of our best services at all times!
Warm Regards
Kalpana Sampat
Managing Director and CEO
Page 1 of 22
Registered Office & Communication Address: 4th Floor, Building No. 9, Tower-B, Cyber City, DLF City Phase III, Gurgaon 122002, Haryana.
CIN: U66000HR2007PLC052028 Tel.: 0124 - 4697000, Fax: 0124 - 4697100/ 7200, E-mail: [email protected]
Website: www.pramericalife.in I Customer Service Helpline (Toll Free): 1800 102 7070 I IRDAI Registration Number: 140
POLICY DOCUMENT - PART A
a) Forwarding Letter
19/11/2021
Client ID: 55070307

Mr Sijin V M
Vijayarmandiram
7083473130, 8007638408
Policy number 00768606 Policy premium (in Rs.) & frequency 2,966.51 & Monthly
Premium payment term (years) 10 Next premium due date 18/12/2021
Registered contact number 8007638408
Dear Mr Sijin V M,
Welcome to Pramerica Life Insurance family.
Thank you for choosing us as your preferred life insurance partner. We would like to take this opportunity to congratulate you on
taking the wise decision of securing your and your family’s future. Do not forget to inform your nominee/s about the details of your life
insurance policy. Please 8nd enclosed your welcome kit which includes the following relevant details:
→ Policy Schedule
→ Your 8rst premium’s receipt
→ Terms & Conditions
→ A copy of the proposal form
→ Bene8t Illustration
We request you to verify the welcome kit for the correctness of the particulars mentioned in the documents.
In case of any discrepancy, please feel free to contact our sales representative, call us on 1800 102 7070 (toll free) or email us at
[email protected]
For your convenience, we have summarized some additional details about your policy.
Freelook period: Please review the terms and conditions of your policy with in a span of 15 days from the date of receipt of your policy
document. 15 days is your freelook period which gives you an option to return your policy stating the reasons for your objection. The
Policy will accordingly be cancelled and we shall refund the premium after deducting the charges already incurred by us such as
medical fees, stamp duty & proportionate risk premium for the period covered.
Claim support: In case of any claim related query you or your nominee/s may contact our sales representative whose details are given
PLIL/Operation/NB-UF/Welcome Letter/037_01-Sept-2021
below, call us on 1800 102 7070 (toll free) or email us at [email protected]
We look forward to a long association with you and assure you of our best services at all times!
Warm Regards
Kalpana Sampat
Your Agent Name - Mr Pawandeep Singh, Code – PLIL70065626, Phone No - 7347359193, Email ID -
[email protected]
Your Branch Contact Details - 807,808,809,810 SOHRAB HALL, PLOT.NO 134/1A,138 AND 139, GHORPADI,TA
HAVELI, Pune, 411001, Maharashtra, PUN, Code - PUN, Phone No. - 18001027070, GSTIN Number -
27AACCD6557A1ZV
Page 2 of 22
b) Policy Preamble
Pramerica Life Insurance Limited (the Company) has entered into this Policy with the Policyholder inter alia on the basis of the proposal
form, information, statements, medical reports and documents the Policyholder has provided about himself / herself and the Life
Insured in the Proposal Form and otherwise which shall be deemed to be a part of this Policy.
This Policy is subject to the terms and conditions stated in the Policy Document.
The Company agrees to pay the bene8ts on the happening of the insured event as detailed in the Policy Document, and while this
Policy is in force.
Signed by and on behalf of
Pramerica Life Insurance Limited
Kalpana Sampat
Date: 19/11/2021
PLIL/Operation/NB-UF/Policy Pack/SCH_RG/019_01-Dec-2019_01
Page 3 of 22
c) Policy Schedule
A. POLICY DETAILS
Plan Name Pramerica Life Rakshak Gold
Policy Number 00768606 Plan Code T40
Policyholder Mr Sijin V M Life Insured Mr Sijin V M
(Name and Address of the S/o Marydasan Yohannan, Vill (Name and Address of the S/o Marydasan Yohannan,
Policyholder shall be printed Mulavana Po Padappakara Life Insured shall be Vill Mulavana Po
here) Ps Kundara Teh & Dist Kollam, printed here) Padappakara
Vijayarmandiram Ps Kundara Teh & Dist
Kollam, 691503, Kerala
Life Insured Mr Sijin V M Gender Male
Date of Birth 22/05/1989 Age 32
Policy Installment Premium 2,966.51 Age Admitted (Yes/No) Yes
Policy Commencement Date 18/11/2021 Policy Term 15
Premium Frequency Monthly Premium Payment Period 10
Currency of the Policy INDIAN RUPEES Policy Expiry Date 18/11/2036
B. BENEFIT DETAILS
Base Policy
Coverage Type Life Insurance Basic Death UIN 140N049V04
Basic Sum Assured INR 1,81,011.00 Coverage Term 15
Monthly Payout INR 3,620.00 Risk Commencement Date 18/11/2021
Guaranteed Maturity Bene9t INR 452527.50 Date When last Premium Due 18/10/2031
The Monthly Payout speci8ed above would be payable as per the terms and conditions of the Policy.
C. DETAILS OF NOMINEE AND APPOINTEE
Details of Nominee 1
Name Mrs. Sajitha Kumari
Relationship Wife Date of Birth 22/03/1985
Share (%) 100.00 E<ective Date 18/11/2021
Address W/o Sijin V M, Vill Mulavana Po Padappakara
Ps Kundara Teh & Dist Kollam, Vijayarmandiram
Appointee details, if
Nominee is minor
Page 4 of 22
Notes:
1. Please verify the correctness of the particulars stated above. If any of the details speci8ed herein is incorrect / incomplete,
please contact your Company Salesperson or nearest branch along with the Policy Document for necessary correction /
amendment.
2. Where the 8rst Premium is paid by cheque, the assumption of risk by the Company under this Policy is subject to
encashment of the cheque.
3. Please inform the Company promptly of any change in the address of the Policyholder and Nominee/Appointee.
4. Please read the Policy details carefully to verify that the terms match those applied for.
5. To claim a bene8t or to request a change in your Policy details, please contact your representative or call the Company on
1800 102 7070.
6. The communication address of the policy holder shall be treated as the place of supply for GST purposes and tax will be
charged accordingly.
Signed for and on behalf of
Pramerica Life Insurance Limited, at Gurgaon on 19/11/2021

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504 736 440 760 391 760 c
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488 399 467 376 467 292 c
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287 430 299 479 406 555 c
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260 786 245 707 239 652 c
239 651 l
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B
Q
Digitally signed by RAJESH KRISHNAN

Date: 2021.12.01 12:34:50 +05:30
Location: Gurgaon
Rajesh Krishnan
Senior Vice President & Head - Operations
Stamp Value
Rs. 229.88
The consolidated stamp duty in pursuance of Indian Stamp Act, 1899 on issue of insurance policy has been paid via Certi8cate number
518 Date 25/10/2021 issued by Govt. of Haryana.
Page 5 of 22
ORIGINAL FOR RECIPIENT / DUPLICATE FOR SUPPLIER
19/11/2021
Client ID: 55070307
Mr Sijin M
Vijayarmandiram
India
Premium Receipt
Dear Mr Sijin M.
Thank you for choosing us as your preferred life insurer.
Received from Mr Sijin M a sum of Rs. 3,100.00 towards 8rst premium on the policy as per the details below.
Plan Pramerica Life Rakshak Gold
Policy No. 00768606 Total Amount of Premium Rs. 2,966.51
Date of Commencement 18/11/2021 Taxable amount of Premium Rs. 741.63
Policy Term 15 Amount Payable Rs. 3,100.00
Frequency of Payment Monthly Balance held in deposit Rs. 3,100.00
Amount of IGST @ 18 Rs. 133.49 Amount of CGST @ 0 Rs. 0
Amount of UTGST @ 0 Rs. 0 Amount of SGST @ 0 Rs. 0
You may be entitled for Tax bene8ts under Section 80C/80CCC/80D as applicable as per Income Tax Act, 1961. Tax bene8t under the
policy will be as per the prevailing Income Tax laws and are subject to amendments from time to time. For Tax related queries please
contact your independent tax advisor.
Total Modal Premium Rs. 3,100.00 Next Premium Due on 18/12/2021
For further assistance, please feel free to contact your Pramerica Life Insurance Salesperson. You may also call us on our Customer
Service Helpline (Toll Free) 18001027070 or email us at [email protected].
HSN Code for Goods or Services and Description
997132 - Life Insurance Service excluding reinsurance services
Details of Your Agent/ Broker/ Corporate Agent
Your Agent Name - Mr Pawandeep Singh, Code – PLIL70065626, Phone No - 7347359193, Email ID -
PLIL/Operation/NB-UF/Premium Receipt-Trad/038_01-Dec-2019_10
[email protected]
Your Branch Contact Details - 807,808,809,810 SOHRAB HALL, PLOT.NO 134/1A,138 AND 139, GHORPADI,TA
HAVELI, Pune, 411001, Maharashtra, PUN, Code - PUN, Phone No. - 18001027070, GSTIN Number -
27AACCD6557A1ZV
% DSUnknown
q
1G
1g
0.1 0 0 0.1 9 0 cm
0 J 0 j 4 M []0 d
1i
0g
313 292 m
313 404 325 453 432 529 c
478 561 504 597 504 645 c
504 736 440 760 391 760 c
286 760 271 681 265 626 c
265 625 l
100 625 l
100 828 253 898 381 898 c
451 898 679 878 679 650 c
679 555 628 499 538 435 c
488 399 467 376 467 292 c
313 292 l
h
308 214 170 -164 re
f
0.44 G
1.2 w
1 1 0.4 rg
287 318 m
287 430 299 479 406 555 c
451 587 478 623 478 671 c
478 762 414 786 365 786 c
260 786 245 707 239 652 c
239 651 l
74 651 l
74 854 227 924 355 924 c
425 924 653 904 653 676 c
653 581 602 525 512 461 c
462 425 441 402 441 318 c
287 318 l
h
282 240 170 -164 re
B
Q
Digitally signed by RAJESH KRISHNAN

Date: 2021.12.01 12:36:59 +05:30
Location: Gurgaon
1. Whether tax payable on reverse charge basis - No

2. Deductions shall be applicable as per the relevant provisions of Income Tax Act
3. Where the 8rst premium is paid by cheque, the assumption of risk by the Company under this Policy is subject to
encashment of the cheque
Disclaimer : The customer hereby irrevocably agrees to indemnify the Company for any willful misrepresentation on account of cash paid by the
customer, under the policy leading to losses, directly and indirectly, to the Company in contravention of applicable laws.
Page 6 of 22
PART B
Definitions
Words or phrases appearing in the Policy Document in initial GMM factor for different Policy Terms shall be as under:
capitals will have the meanings given to them below:
i) 150% for Policy Term of 12 years
Where appropriate, any reference to the singular includes ii) 175% for Policy Term of 15 years
references to the plural, references to the male include iii) 175% for Policy Term of 18 years
references to the female and references to any statute
include references to any subsequent changes to that IRDAI means the Insurance Regulatory and Development
statute. Authority of India.
In case of any conflict between the interpretations of any of Lapse means when all benefits under the Policy cease due
the terms of this Policy Document, the Part C (Specific Terms to non-payment of Premium on due date or within the Grace
and Conditions) shall override Part B (Definitions) of this Period.
Policy Document.
Life Insured means the person on whose life this Policy is
General Terms effected and is named in the Schedule.
Annualized Premium means the Premium payable in a Maturity Date means the Policy Expiry Date specified in the
Policy Year chosen by the policyholder, excluding the taxes, Schedule and when the coverage under the Policy ends.
rider premiums, underwriting extra Premium and loadings
for modal Premium, if any. Monthly Payout means the amount specified in the
Schedule and payable monthly in case of death of the Life
Application Form means the application form and any Insured, according to the terms and conditions of this Policy.
other information / document provided by the Policyholder
to the Company before the inception of this Policy. Nominee means the person named in the Policy Schedule
who has been nominated in accordance with Section 39 of
Appointee means the person named by the Policyholder to the Insurance Act, 1938, as amended from time to time, to
receive payment, under this Policy if the Nominee is a minor receive the Death Benefit. Nomination can be effected only
at the time payment becomes due. if Policyholder is same as Life Insured.
Base Sum Assured means the amount specified in the Policy means this contract of insurance as evidence by the
Schedule payable according to the terms and conditions of Policy Document.
this Policy.
Policy Anniversary means the anniversary of the Risk
Claimant shall mean the Life Insured (or) the Policyholder Commencement Date.
(or) the assignee (or) the Nominee where a valid nomination
has been effected or the Legal Heirs of the Policy Commencement Date means the date when this
Policyholder/Nominee as the case may be. Policy is issued and is specified in the Schedule.
Death Sum Assured means the amount payable in case of Policy Document means the Terms & Conditions, the
death of the Life Insured according to the terms and Application Form and the Schedule as amended from time
conditions of this Policy. to time.
PLIL/Operation/NB-UF/Policy Pack/T&C_RG/019_01-Dec-2019_01
Grace Period means a period of 30 days from the date the Policy Term means the period between the Risk
Policy installment Premium become due during which time Commencement Date and Policy Expiry Date.
the Policy is considered to be in force without any
interruption as per the terms of the Policy. This Grace Period Policy Year means the 12 months period starting from the
applies to all premium payment modes (Premium Risk Commencement Date and accordingly thereafter every
Frequency) subsequent Policy Anniversary.
Guaranteed Maturity Multiple (GMM) means a factor Policyholder means the person named in the Schedule who
which shall be applied to the Base Sum Assured or Paid up has concluded this Policy with the Company. Policyholder is
Sum Assured, as the case may be, for the purpose of the owner of the Policy. In case of absolute assignment, the
calculating the benefit payable on Maturity Date. assignee will become the Policyholder. In case of partial or
conditional assignment, the assignee will have the first right
in the Policy extent to the assignment done.
Page 7 of 22
Premium means the amount of premium payable by the

Policyholder. The Schedule details the amount payable Schedule means the document attached to this Policy
(Policy Installment Premium), when it is to be paid which provides a snapshot of the Policy and benefits details
(Premium Frequency) and the term over which it is to be and any annexure attached to it from time to time and any
paid (Premium Paying Period). endorsements the Company has made and, if more than
one, then the latest in time.
Revival means restoration of the Policy by the Company,
which was discontinued due to the non-payment of Surrender Value means the benefit payable on surrender
Premium, with all the benefits mentioned in the Policy of the Policy in accordance with the terms and conditions of
Document, as per the terms and conditions of the Policy. the Policy.
Total Premiums Paid means total of all the premiums
Rider means an optional insurance cover which is received, excluding any extra premium, any rider premium
purchased along with the Base Policy which provides and taxes.
additional benefit on happening of event specified therein.
Risk Commencement Date means the date as specified in

the Schedule from which the risk cover starts under this
Policy.
Page 8 of 22
PART C
Specific Terms and Conditions
Section One: Policy Benefits
(a) Benefit Payable on Death

(Rate per 1,000 of Base Sum Assured)
If the Life Insured dies at any time before the Maturity Date,
while the Policy is in force for full Policy benefits, the Policy Policy Term
Company will pay to the Claimant, the Death Sum Assured Year 12 Years 15 Years 18 Years
plus the accrued Annual Guaranteed Additions. 1 30 30 30
2 30 30 30
The total Death Sum Assured shall be payable in the form of 3 30 30 30
a) Immediate Benefit b) Monthly Payouts and c) Benefit at 4 40 40 40
scheduled Maturity Date. 5 40 40 40
6 40 40 40
The Death Sum Assured shall be highest of the following:
7 50 50 50
8 50 50 50
a) 11 times the Annualized Premium (OR)105% of
9 50 50 50
the Total Premiums paid till date of death
(excluding underwriting extra, if any) (OR) 10 60 60 60
b) Minimum Guaranteed Sum Assured on maturity 11 60 60 60
which is equal to Base Sum Assured multiplied by 12 60 60 60
GMM Factor (OR) 13 - 70 70
c) The absolute amount assured to be payable on 14 - 70 70
death shall be sum of the following three 15 - 70 70
components: 16 - - 80
1. Base Sum Assured payable immediately at 17 - - 80
the time of death (“Immediate Benefit”) 18 - - 80
2. Monthly Payout as specified in the Policy
Schedule, commencing from the end of Section Two: Discontinuation of Premium Payments
month of death, during the Policy Term
subject to a minimum of 36 monthly a) If the Premium for first two consecutive Policy Years has
payments (“Monthly Payouts”) not been received in full within the Grace Period, the
3. Base Sum Assured multiplied by Policy shall automatically lapse at the end of the Grace
Guaranteed Maturity Multiple factor Period.
payable on the scheduled Maturity Date
(“Benefit at scheduled Maturity Date”) b) A lapsed Policy can be revived as per the Terms and
Conditions of this Policy. If the Life Insured dies during
All benefits shall be paid to the Claimant. In the absence of the Grace Period, the Company shall deduct the
a Claimant, the benefits will be paid to the legal heirs of the Premium due from the amount payable.
Claimant.
c) If the Premium for at least first two consecutive Policy
The Policy covers death under all situations (including death Years has been received in full and thereafter if any
during declared or undeclared war civil commotion, Policy Installment Premium is not received within the
invasion, terrorism, hostilities) except death due to suicide Grace Period, the Policy shall automatically become
as specified in the Suicide Clause. paid-up with reduced benefits at the end of grace
period.
(b) Benefit Payable on Maturity
d) Benefit Payable on Death while the Policy is in paid-
On survival of Life Insured to the Maturity Date and provided up status
Policy is In-force for full Policy benefits, the Company will
pay an amount equal to the Base Sum Assured multiplied by If the Life Insured dies at any time before the Maturity
Guaranteed Maturity Multiple factor plus accrued Annual Date, while the Policy is in the paid-up status, the
Guaranteed Additions. Company will pay the Paid-up Death Sum Assured plus
AGA accrued till the date of paid-up.
The Annual Guaranteed Addition will accrue to the Policy at
the end of each completed Policy Year as per the rates Where Paid-up Death Sum Assured is equal to T divided
specified below, provided the Policy is in-force for full by N multiplied by Death Sum Assured.
benefits:
Page 9 of 22
T is Total number of Premium paid under the Policy and every half-year, or month respectively till the end of the
N is Total number of Premium payable under the Policy Premium Paying Period. If the corresponding date does not
over the entire Policy Term exist in a particular month, then the last day of that calendar
month shall be deemed to be the due date for payment.
The total Paid-up Death Sum Assured shall be payable
in the form of a) Immediate Benefit b) Monthly Payouts The Policyholder may request in writing to the Company for
and c) Benefit at Maturity Date. a change in Premium Frequency. Any such change shall be
effective from the Policy Anniversary and shall be subject to
Company receiving from the Policyholder all documents
e) Benefit Payable on Maturity in case of Paid-up Policy required by the Company. Change in Premium Frequency
shall result in a change in the Policy Installment Premium.
On survival of the Life Insured to the Maturity Date,
while the Policy is in the paid-up status, the Company Policy Installment Premium shall be deemed to have been
will pay Paid-up Sum Assured multiplied by paid only when received and realized by the Company.
Guaranteed Maturity Multiple plus accrued Annual
Guaranteed Addition till the date of paid-up. Section Four: Grace Period
Where: Grace Period means a period of 30 days from the date the
Policy installment Premium become due during which time
Paid-up Sum Assured is equal to T divided by N the Policy is considered to be in force without any
multiplied by Base Sum Assured interruption as per the terms of the Policy. This Grace Period
applies to all premium payment modes (Premium
T is Total number of Premium paid under the Policy and Frequency)
N is Total number of Premium payable under the Policy If the Life Insured dies during the Grace Period, the Company
over the entire Policy Term will pay the benefit payable on death after deduction of the
Premium due under the Policy.
f) If a Policy has not acquired Surrender Value due to non-
payment of Premium, during first 2 policy years, and
provided that the first policy year premium is paid in
full, the Company will pay 15% of the Premiums paid
(excluding underwriting extras) on the expiry of the
revival period or death of the Policyholder or on receipt
of written request from the Policyholder, whichever is
earlier and the Policy will terminate thereafter.
Section Three: Payment of Premium
If the Premium Frequency is annual, then Premium must be

paid on each Policy Anniversary. If the Premium Frequency
is semi-annual or monthly, the Premium must be paid on the
date corresponding with the Policy Commencement Date in
Page 10 of 22
PART D
Policy Servicing
Section One: Revival ‘X’ will vary in different Policy Years and the rates are
specified below:
A lapsed or paid-up policy can be revived within five years Policy GSV as a percentage of Premium
from the date of first unpaid Premium and before Maturity Year of paid# (X)
Date. The Company will revive the Policy only if the Surrender Policy Term
Company has received written notice from the Policyholder 12 Years 15 Years 18 Years
along with the requisite documents / information and the 2 30% 30% 30%
outstanding Premium with interest specified by the 3 35% 35% 35%
Company.
4 50% 50% 50%
5 50% 50% 50%
The rate of interest shall be reset on an annual basis at the
6 55% 50% 50%
beginning of every financial year (April) and would be
determined based on the average 10-year G-Sec YTM plus 7 55% 50% 50%
75 bps rounded down to 25 bps. The average of the 8 60% 55% 55%
benchmark would be taken from the previous financial year 9 65% 55% 55%
for the period 1st July xxxx to 31st Dec xxxx. The current 10 75% 55% 55%
applicable rate of interest on policy reinstatement is 7.75% 11 90% 60% 60%
per annum which would be applicable for the FY 2019-20. 12 90% 60% 60%
13 NA 75% 65%
The revival of the Policy shall be effective from the date on 14 NA 90% 65%
which the Company has issued a written endorsement 15 NA 90% 70%
confirming the revival of the Policy. The Policyholder 16 NA NA 75%
understands and agrees that there is no obligation on the
17 NA NA 90%
Company to revive the Policy or to revive it on the same
18 NA NA 90%
terms, and the revival is subject to the underwriting
#Premiums paid is exclusive of any underwriting extras.
requirements of the Company as applicable from time to
time. The medical cost, if any, shall be borne by the
Guaranteed Surrender Value Factor For Annual
Policyholder.
Guaranteed Additions:
If the Policy is revived by the Company, the Policyholder will The Guaranteed Surrender Value factors are based on the
also become entitled for the full Policy benefits from the outstanding Policy Term to Maturity Date and where
date of revival including full Annual Guaranteed Addition for outstanding duration is not in complete years, the factors
the Policy Year(s) during which the Policy was in lapse / paid- would be calculated by linear interpolation.
up status, as per the terms and conditions of the Policy. Outstandi Guaranteed
ng Surrender Value
Section Two: Surrender of Policy Duration Factor For AGAs
(In Years)
The Policy can be surrendered only if the Premium for first 0 100.00%
two consecutive Policy Years has been paid in full. On 1 89.31%
Surrender of the Policy, the Company will pay the Surrender 2 79.80%
Value equal to higher of Guaranteed Surrender Value (GSV) 3 71.33%
4 63.79%
and Special Surrender Value (SSV).

5 57.06%
GSV is equal to ‘X’% of the Premium paid (excluding 6 51.06%
underwriting extra) till the date of surrender plus 7 45.70%
guaranteed Surrender Value of accrued Annual Guaranteed 8 40.92%
Addition which would be calculated as Guaranteed 9 36.64%
Surrender Value Factor (multiplied by) AGA Accrued till the 10 32.82%
date of surrender. 11 29.40%
12 26.35%
13 23.62%
14 21.17%
15 18.99%
16 17.03%
17 15.28%
18 13.72%
Page 11 of 22
The SSV is reviewable and shall be determined by the Any inforce or fully paid up policy will not be foreclosed on
Company from time to time subject to prior approval from the account of outstanding loan amount (including
the IRDAI. Please contact your Company Salesperson for outstanding interest on loan, if any) exceeding the surrender
further details. value.
A reduced paid-up Policy can be surrendered before the Section Four: Free Look Period
Maturity Date. In such an event, the Surrender Value of the
reduced paid-up Policy would be paid. Please contact your The Policyholder shall have a period of 15 days from the
Company Salesperson for further details. receipt of this Policy Document to review the terms and
conditions of this Policy and if the Policyholder disagrees
The Surrender Value of reduced paid-up Policy is reviewable with any of the terms and conditions, Policyholder has the
and shall be determined by the Company from time to time. option to return this Policy stating the reasons for the
objections upon which the Company shall refund to the
After a Policy has been surrendered, the Policy shall Policyholder the Premium paid subject to deduction of a
terminate and all benefits under the Policy shall cease. proportionate risk Premium for the period of risk cover, any
expenses incurred by the Company towards medical
Section Three: Loan examination of the Life Insured and stamp duty charges. In
case Policy is purchased through distance mode, the Free
At any time after the Policy acquires a Surrender Value, the Look Period shall be 30 days.
Policyholder may avail of a loan under the Policy subject to
the following: Part E
a) At any time, the total loan amount that will be Not Applicable
granted by the Company shall be 75% of the
Surrender Value;
b) The Policyholder agrees to pay interest on the
outstanding loan. The rate of interest shall be reset
on an annual basis at the beginning of every
financial year. The loan interest rate is based on
yield on average 10-years GSEC YTM plus 150 bps
rounded down to 25 bps. The average of the
benchmark would be taken from the previous
financial year for the period 1st JulyXXXX to 31st
DecXXXX. E.g., the rate of interest applicable for FY
2019-20 would be based on average of 10 year
GSec rates
for the period - 1st July XXXX to 31st Dec XXXX.
The current applicable rate of interest is 8.5% per
annum which may change from time to time;
c) The outstanding loan amount and unpaid interest
on the loan amount shall be deducted from any
amount payable under the Policy by the Company;
d) The Policyholder agrees that the loan is subject to
the terms and conditions of the Company as
applicable from time to time.
Page 12 of 22
Part F
General Terms and Conditions
Section One: Suicide Clause

Basic documentation if death is due to Un-natural cause
If death occurs due to suicide or attempted suicide, whether i. The Company’s claim form duly completed.
sane or insane, within twelve months of the Risk ii. The Policy Document in original.
Commencement Date or within 12 months from the date of iii. Evidence of the date of birth of the Life Insured if
revival of the Policy, then the Company’s only obligation the Company has not admitted the age of the Life
under this Policy shall be to pay an amount equal to higher Insured.
of 80% of the Total Premiums paid (excluding underwriting iv. The original or a legalised copy of the death
extra, if any) till the date of death or Surrender Value, if any, certificate showing the circumstances, cause and
as on the date of death, provided the policy is in force. the date of death of the Life Insured.
v. Copies of the First Information Report and the
Section Two: Death during Grace Period Final Investigation Report thereof, duly attested by
the concerned police officials
If the Life Insured dies during the Grace Period, the Company vi. Copy of the post-mortem report duly attested by
will pay the benefit payable on death after deduction of the the concerned officials, as applicable
Premium due under the Policy.
Section Three: Termination of the Policy The Company may on a case to case basis and subject
to exceptional circumstances may condone the
This Policy shall immediately and automatically terminate submission of any of the above mentioned documents/
on the occurrence of the first of the following events and the information while processing the claim.
applicable amount, if any have been paid in accordance with
the terms and conditions of this Policy: Section Five: Maturity Claim Processing
a. The Maturity Date The Maturity Benefit will be paid if and only if:
b. The date of the death of the Life Insured a. The Policy has matured and the Life Insured is alive on
c. On completion of revival period of a lapsed policy the Maturity date
d The date of payment of Surrender Value b. No Death claim has been made on the Policy
c. The Policy has not surrendered or cancelled or
Section Four: Death Claim Processing terminated
d. All relevant document in support of Maturity claim
In order for the Company to make any payment under the have been provided to the Company
Policy that it is necessary that the Company:
Basic documentation for Maturity Claim:
a) Is immediately notified of the Life Insured’s death in a. NEFT Mandate
writing, and preferably within 90 days of death. b. Cancelled cheque
Company may condone the delay in filing a claim c. KYC Documents
beyond 90 days where the claimant can establish that
the delay was due to unforeseen circumstances and Section Six: Assignment
beyond the control of the claimant.
The provisions of Assignment are governed by Section 38 of
b) Is provided with the opportunity of establishing to its Insurance Act, 1938 as amended from time to time.
satisfaction that a claim is payable.
A Leaflet containing the simplified version of the provisions
c) Receives all reasonable cooperation and is entitled to of Section 38 of the Insurance Act 1938 is enclosed as
seek any documentation and information, including Annexure A for reference.
but not limited to:
Basic documentation if death is due to natural Cause Section Seven: Nomination
i. The Company’s claim form duly completed.
ii. The Policy Document in original. The provisions of nomination are governed by Section 39 of
iii. Evidence of the date of birth of the Life Insured if the Insurance Act, 1938 as amended from time to time.
the Company has not admitted the age of the Life
Insured. A Leaflet containing the simplified version of the provisions
iv. The original or a legalised copy of the death of Section 39 of the Insurance Act 1938 is enclosed as
certificate showing the circumstances, cause and Annexure B for reference.
the date of death of the Life Insured.
Page 13 of 22
Section Eight: Miscellaneous refund the excess Premium received (without interest )
under the Policy based on the correct age of Life Insured.
a) Loss of the Policy Document
d) Currency & Territorial Limits
i) If the Policy Document is lost or destroyed then the
Company reserves the right to make such All Premium and any amounts payable under the Policy are
investigations into and call for such evidence of the loss payable within India and in the currency of the Policy
of the Policy Document, at the Policyholder’s expense, specified in the Schedule.
as the Company considers necessary before issuing a
duplicate Policy Document. e) Governing Law & Jurisdiction
ii) If the Company agrees to issue a duplicate Policy Any and all disputes or differences arising out of or in respect
Document then: of this Policy shall be governed by and determined in
accordance with Indian law and shall be subject to the
1. The Policyholder agrees to pay an amount not jurisdiction of Indian Courts.
exceeding Rs. 250/- towards the Company’s fee for
the issue of a duplicate, and f) Entire Contract & Agent’s Authority
2. The original Policy Document will cease to be of The Policy Document comprises the entire contract
any legal effect and the Policyholder shall between the Policyholder and the Company, and it cannot
indemnify and keep the Company indemnified be changed or altered unless the Company approves it in
and hold the Company harmless from and against writing by endorsement on the Schedule and, where
any costs, expenses, claims, awards or judgments required, the approval of the IRDAI has been obtained.
arising out of or howsoever connected to the
original Policy Document. The insurance agent is authorised to arrange the completion
and submission of the Policyholder’s Application Form. The
b) Notices insurance agent is not authorised to amend the Policy
Document, or to accept any notice on the Company’s behalf
i) All notices meant for the Company whether under this or to accept payments on the Company’s behalf. If any
Policy or otherwise must be in writing and delivered to money meant for the Company in any form is paid to an
the Company at the address as mentioned below. insurance agent then such payment is made at the
ii) All notices meant for the Policyholder will be in writing Policyholder’s risk and the agent will be acting only as the
and will be sent by the Company to the Policyholder’s Policyholder’s representative.
address shown in the Schedule or any such other
address as may be communicated to the Company by g) Taxes
the Policyholder.
iii) The Company shall not be responsible for any In respect of any payment made or to be made under this
consequences related to or arising out of non Policy, the Company shall deduct or charge taxes and other
intimation of changes to the Policyholder’s address. levies as applicable from time to time, at such rates as
notified by the Government of India or a body authorised by
c) Misstatement of Age the Government of India from time to time.
If the correct age of the Life Insured is different from that h) Fraud and misrepresentation
mentioned in the Application Form, the Company will assess
the eligibility of the Life Insured for the Policy in accordance Fraud, misrepresentation and forfeiture shall be dealt with
with the correct age of the Life Insured. in accordance with Section 45 of the Insurance Act, 1938, as
amended from time to time.
If on the basis of correct age, the Life Insured is not eligible
for the Policy, the Policy shall be cancelled immediately after A Leaflet containing the simplified version of the provisions
refunding the Premium received by the Company under the of Section 45 of the Insurance Act 1938 is enclosed as
Policy as per the provisions of section 45 of Insurance Act as Annexure C for reference.
amended from time to time.
If the age of the Life Insured is higher than the age specified
in the Application Form, the Company will decrease the Base
Sum Assured and other benefits based on the correct age of
Life Insured.
If the age of the Life Insured is lower than the age specified
mentioned in the Application Form, the Company will
Page 14 of 22
PART G
Other Details
Grievance Redressal place of residence of the complainant is located.
I) In case of any clarification or query please contact your The complaint shall be in writing, duly signed by the
Company Salesperson. complainant or through his legal heirs, nominee or assignee
and shall state clearly the name and address of the
II) The Company may be contacted at:
complainant, the name of the branch or office of the insurer
Customer Service Help Line: 1800-102-7070 (Toll Free) against whom the complaint is made, the facts giving rise to
(9.30 am to 6.30 pm from Monday to Saturday) the complaint, supported by documents, the nature and
Email: [email protected] extent of the loss caused to the complainant and the relief
Email for Senior Citizen: sought from the Insurance Ombudsman.
[email protected] You may approach the Insurance Ombudsman if your
Website: www.pramericalife.in grievance pertains to any of the following:
Communication Address: Customer Service, Pramerica a. Delay in settlement of claim beyond the time specified in
Life Insurance Limited (Erstwhile DHFL Pramerica Life the regulations, framed under the Insurance Regulatory
Insurance Company Limited), 4th Floor, Building No. 9 and Development Authority of India Act, 1999
b. Any partial or total repudiation of claims
B, Cyber City, DLF City Phase III, Gurgaon– 122002 Office
c. Disputes over premium paid or payable in terms of
hours: 9.30 am to 6.30 pm from Monday to Friday
insurance policy
III) Grievance Redressal Officer : d. Misrepresentation of policy terms and conditions
If the response received from the Company is not e. Legal construction of insurance policies in so far as the
satisfactory or no response is received within two dispute relates to claim
weeks (Business Days) of contacting the Company, f. Policy servicing related grievances against insurers and
the matter may be escalated to: Email- their agents and intermediaries
[email protected] g. Issuance of Life insurance policy, which is not in
conformity with the proposal form submitted by the
Grievance Redressal Officer
proposer
Pramerica Life Insurance Limited (Erstwhile DHFL
h. Non-issuance of insurance policy after receipt of premium
Pramerica Life Insurance Company Limited), 4th Floor, i. Any other matter resulting from the violation of
Building No. 9 B, Cyber City, DLF City Phase III, provisions of the Insurance Act, 1938 or the regulations,
Gurgaon– 122002 circulars, guidelines or instructions issued by the IRDAI
GRO Contact Number: 0124 – 4697069 from time to time or the terms and conditions of the
Office hours 9.30 am to 6.30 pm from Monday to Friday policy contract, in so far as they relate to issues mentioned
IV) IRDAI- Grievance Redressal Cell: at clauses (a) to (f)
If after contacting the Company, the Policyholders
query or concern is not resolved satisfactorily or within No complaint to the Insurance Ombudsman shall lie unless
timelines the Grievance Redressal Cell of the IRDAI may (a) The complainant makes a written representation to the
be contacted. insurer named in the complaint and—
Call Center Toll Free number – 155255 (i) Either the insurer had rejected the complaint, or
Email Id- [email protected] (ii) The complainant had not received any reply within a
Complaints against Life Insurance Companies: period of one month after the insurer received his
Insurance Regulatory and Development Authority of representation, or
(iii) The complainant is not satisfied with the reply given
India, Consumer Affairs Department

Sy. No. 115/1, Financial District to him by the insurer
Nanakramguda, Gachibowli
Hyderabad – 500032 (b) The complaint is made within one year—
(i) After the order of the insurer rejecting the
V) Insurance Ombudsman: representation is received, or
The office of the Insurance Ombudsman has been (ii) After receipt of decision of the insurer which is not to
established by the Government of India for the the satisfaction of the complainant, or
r e d r e s s a l of any grievance in respect of life (iii) After expiry of a period of one month from the date of
insurance policies. sending the written representation to the insurer if the
insurer named fails to furnish reply to the complainant.
Any person who has a grievance against an insurer, may
himself or through his legal heirs, nominee or assignee, The address of the Insurance Ombudsman are attached
make a complaint in writing to the Insurance Ombudsman herewith and may also be obtained from the following link
within whose territorial jurisdiction the branch or office of on the internet
the insurer complained against or the residential address or Link http://www.cioins.co.in/ombudsman.html
Page 15 of 22
Annexure – ‘A’ instruments of transfer or assignment, the priority will

depend on dates of delivery of such notices. Any
Section 38 - Assignment and Transfer of Insurance dispute in this regard as to priority should be referred
Policies to Authority.
13. Every assignment or transfer shall be deemed to be
Assignment or transfer of a policy should be in accordance absolute assignment or transfer and the assignee or
with Section 38 of the Insurance Act, 1938 as amended by transferee shall be deemed to be absolute assignee
Insurance Laws (Amendment) Act, 2015. The extant or transferee, except
provisions in this regard are as follows: a. where assignment or transfer is subject to terms and
conditions of transfer or assignment OR
1. This policy may be transferred/assigned, wholly or in b. where the transfer or assignment is made upon
part, with or without consideration. condition that
2. An Assignment may be effected in a policy by an i) the proceeds under the policy shall become
endorsement upon the policy itself or by a separate payable to policyholder or nominee(s) in the event
instrument under notice to the Insurer. of assignee or transferee dying before the insured
3. The instrument of assignment should indicate the fact OR
of transfer or assignment and the reasons for the ii) the insured surviving the term of the policy
assignment or transfer, antecedents of the assignee Such conditional assignee will not be entitled to
and terms on which assignment is made. obtain a loan on policy or surrender the policy.
4. The assignment must be signed by the transferor or This provision will prevail notwithstanding any law
assignor or duly authorized agent and attested by at or custom having force of law which is contrary to
least one witness. the above position.
5. The transfer of assignment shall not be operative as 14. In other cases, the insurer shall, subject to terms and
against an insurer until a notice in writing of the conditions of assignment, recognize the transferee or
transfer or assignment and either the said assignee named in the notice as the absolute transferee
endorsement or instrument itself or copy there of or assignee and such person
certified to be correct by both transferor and a. shall be subject to all liabilities and equities to
transferee or their duly authorized agents have been which the transferor or assignor was subject
delivered to the insurer. to at the date of transfer or assignment and
6. Fee to be paid for assignment or transfer can be b. may institute any proceedings in relation to the
specified by the Authority through Regulations. policy
7. On receipt of notice with fee, the insurer should Grant c. obtain loan under the policy or surrender the
a written acknowledgement of receipt of notice. Such policy without obtaining the consent of the
notice shall be conclusive evidence against the insurer transferor or assignor or making him a party to
of duly receiving the notice. the proceedings
8. If the insurer maintains one or more places of 15. Any rights and remedies of an assignee or transferee
business, such notices shall be delivered only of a life insurance policy under an Assignment or
at the place where the policy is being serviced. transfer effected before commencement of the
9. The insurer may accept or decline to act upon any Insurance Laws (Amendment) Act, 2015 shall not be
transfer or assignment or endorsement, if it has affected by this section.
sufficient reasons to believe that it is-
a. not bonafide or [Disclaimer: This is not a comprehensive list of amendments of
b. not in the interest of the policyholder or Insurance Laws (Amendment) Act, 2015 and only a simplified
c. not in public interest or version prepared for general information. Policy Holders are
advised to refer to the insurance Act as amended from time to

d. is for the purpose of trading of the insurance
time for complete and accurate details. ]
policy.
10. Before refusing to act upon endorsement, the Insurer
should record the reasons in writing and
communicate the same in writing to Policyholder
within 30 days from the date of policyholder giving a
notice of transfer or assignment.
11. In case of refusal to act upon the endorsement by
the Insurer, any person aggrieved by the refusal may
prefer a claim to IRDAI within 30 days of receipt of the
refusal letter from the Insurer.
12. The priority of claims of persons interested in an
insurance policy would depend on the date on which
the notices of assignment or transfer is delivered to
the insurer; where there are more than one
Page 16 of 22
Annexure – ‘B’
Section 39 - Nomination by policyholder 13. Where the policyholder whose life is insured nominates
his
Nomination of a life insurance Policy is as below in a. parents or
accordance with Section 39 of the Insurance Act, 1938 as b. spouse or
amended by Insurance Laws (Amendment) Act, 2015. The c. children or
extant provisions in this regard are as follows: d. spouse and children
e. or any of them
1. The policyholder of a life insurance on his own life may
nominate a person or persons to whom money the nominees are beneficially entitled to the amount
secured by the policy shall be paid in the event of his payable by the insurer to the policyholder unless it is
death. proved that policyholder could not have conferred
2. Where the nominee is a minor, the policyholder may such beneficial title on the nominee having regard to
appoint any person to receive the money secured by the nature of his title.
the policy in the event of policyholder’s death during 14. If nominee(s) die after the policyholder but before his
the minority of the nominee. The manner of share of the amount secured under the policy is paid,
appointment to be laid down by the insurer. the share of the expired nominee(s) shall be payable
3. Nomination can be made at any time before the to the heirs or legal representative of the nominee or
maturity of the policy. holder of succession certificate of such nominee(s).
4. Nomination may be incorporated in the text of the 15. The provisions of sub-section 7 and 8 (13 and 14 above)
policy itself or may be endorsed on the policy shall apply to all life insurance policies maturing for
communicated to the insurer and can be registered by payment after the commencement of Insurance
the insurer in the records relating to the policy. Laws (Amendment) Act, 2015.
5. Nomination can be cancelled or changed at any time 16. If policyholder dies after maturity but the proceeds
before policy matures, by an endorsement or a further and benefit of the policy has not been paid to him
endorsement or a will as the case may be. because of his death, his nominee(s) shall be entitled
6. A notice in writing of Change or Cancellation of to the proceeds and benefit of the policy.
nomination must be delivered to the insurer for the
17. The provisions of Section 39 are not applicable to any
insurer to be liable to such nominee. Otherwise,
life insurance policy to which Section 6 of Married
insurer will not be liable if a bonafide payment is made
Women’s Property Act, 1874 applies or has at any
to the person named in the text of the policy or in the
time applied except where before or after Insurance
registered records of the insurer.
Laws (Amendment) Act 2015, a nomination is made
7. Fee to be paid to the insurer for registering change or
in favour of spouse or children or spouse and
cancellation of a nomination can be specified by the
children whether or not on the face of the policy it is
Authority through Regulations.
mentioned that it is made under Section 39. Where
8. On receipt of notice with fee, the insurer should grant
nomination is intended to be made to spouse or
a written acknowledgement to the policyholder of
children or spouse and children under Section 6 of
having registered a nomination or cancellation or
MWP Act, it should be specifically mentioned on the
change thereof.
policy. In such a case only, the provisions of Section
9. A transfer or assignment made in accordance with
39 will not apply.
Section 38 shall automatically cancel the nomination
except in case of assignment to the insurer or other
[Disclaimer: This is not a comprehensive list of amendments of
transferee or assignee for purpose of loan or against
Insurance Laws (Amendment) Act, 2015 and only a simplified
security or its reassignment after repayment. In such
version prepared for general information. Policy Holders are

case, the nomination will not get cancelled to the
advised to refer to the insurance Act as amended from time to
extent of insurer’s or transferee’s or assignee’s
time for complete and accurate details. ]
interest in the policy. The nomination will get revived
on repayment of the loan.
10. The right of any creditor to be paid out of the proceeds
of any policy of life insurance shall not be affected by
the nomination.
11. In case of nomination by policyholder whose life is
insured, if the nominees die before the policyholder,
the proceeds are payable to policyholder or his heirs
or legal representatives or holder of succession
certificate.
12. In case nominee(s) survive the person whose life is
insured, the amount secured by the policy shall be
paid to such survivor(s).
Page 17 of 22
Annexure – ‘C’ 5. No Insurer shall repudiate a life insurance Policy on the

ground of Fraud, if the Insured /beneficiary can prove
Section 45 – Policy shall not be called in question on the that the misstatement was true to the best of his
ground of mis-statement after three years knowledge and there was no deliberate intention to
suppress the fact or that such mis-statement of or
Provisions regarding policy not being called into question in suppression of material fact are within the knowledge
terms of Section 45 of the Insurance Act, 1938, as amended of the insurer. Onus of disproving is upon the
by Insurance Laws (Amendment) Act, 2015 and are as policyholder, if alive, or beneficiaries.
follows:
6. Life insurance Policy can be called in question within
1. No Policy of Life Insurance shall be called in question 3 years on the ground that any statement of or
on any ground whatsoever after expiry of 3 yrs suppression of a fact material to expectancy of life of
from the insured was incorrectly made in the proposal or
a. the date of issuance of policy or other document basis which policy was issued or
b. the date of commencement of risk or revived or rider issued. For this, the insurer should
c. the date of revival of policy or communicate in writing to the insured or legal
d. the date of rider to the policy representative or nominee or assignees of insured, as
whichever is later. applicable, mentioning the ground and materials on
which decision to repudiate the policy of life
2. On the ground of fraud, a policy of Life Insurance may insurance is based.
be called in question within 3 years from
a. the date of issuance of policy or 7. In case repudiation is on ground of mis-statement and
b. the date of commencement of risk or not on fraud, the premium collected on policy till the
c. the date of revival of policy or date of repudiation shall be paid to the insured or
d. the date of rider to the policy legal representative or nominee or assignees of
whichever is later. insured, within a period of 90 days from the date of
repudiation.
For this, the insurer should communicate in writing to
the insured or legal representative or nominee or 8. Fact shall not be considered material unless it has a
assignees of insured, as applicable, mentioning the direct bearing on the risk undertaken by the insurer.
ground and materials on which such decision is The onus is on insurer to show that if the insurer had
based. been aware of the said fact, no life insurance policy
would have been issued to the insured.
3. Fraud means any of the following acts committed by
insured or by his agent, with the intent to deceive 9. The insurer can call for proof of age at any time if he is
the insurer or to induce the insurer to issue a life entitled to do so and no policy shall be deemed to be
insurance policy: called in question merely because the terms of the
a. The suggestion, as a fact of that which is not true and policy are adjusted on subsequent proof of age of life
which the insured does not believe to be true; insured. So, this Section will not be applicable for
b. The active concealment of a fact by the insured questioning age or adjustment based on proof of
having knowledge or belief of the fact; age submitted subsequently.
c. Any other act fitted to deceive; and
d. Any such act or omission as the law specifically [Disclaimer: This is not a comprehensive list of amendments of
declares to be fraudulent. Insurance Laws (Amendment) Act, 2015 and only a simplified
version prepared for general information. Policy Holders are

4. Mere silence is not fraud unless, depending on advised to refer to the insurance Act as amended from time to
circumstances of the case, it is the duty of the time for complete and accurate details. ]
insured or his agent keeping silence to speak or
silence is in itself equivalent to speak
Page 18 of 22
Address & Contact Details of Ombudsmen Centres
Office of The Governing Body of Insurance Council (Monitoring

Body for Offices of Insurance Ombudsman)
3rd Floor, Jeevan Seva Annexe, Santacruz (West), Mumbai – 400054. Tel no: 26106671/6889.
Email id: [email protected] website: www.cioins.co.in
=================================================================================
If you have a grievance, approach the grievance cell of Insurance Company first. If
complaint is not resolved/ not satisfied/not responded for 30 days then
You can approach The Office of the Insurance Ombudsman (Bimalokpal)
Please visit our website for details to lodge complaint with Ombudsman.
Jurisdiction of Office Union

Office Details Jurisdiction of Office Union Territory, District Office Details
Territory, District
Office of the Insurance Ombudsman, Gujarat, Office of the Insurance Ombudsman, Karnataka.
Jeevan Prakash Building, 6th floor, Dadra & Nagar Haveli, Jeevan Soudha Building,PID No. 57-27-N-
Tilak Marg, Relief Road, Daman and Diu. 19
Ahmedabad – 380 001. Ground Floor, 19/19, 24th Main Road,
Tel.: 079 - 25501201/02/05/06 JP Nagar, Ist Phase,
Email: [email protected] Bengaluru – 560 078.
Tel.: 080 - 26652048 / 26652049
Email: [email protected]
Office of the Insurance Ombudsman, Madhya Pradesh Office of the Insurance Ombudsman, Orissa.
Janak Vihar Complex, 2nd Floor, Chattisgarh. 62, Forest park,
6, Malviya Nagar, Opp. Airtel Office, Bhubneshwar – 751 009.
Near New Market, Tel.: 0674 - 2596461 /2596455
Bhopal – 462 003. Fax: 0674 - 2596429
Tel.: 0755 - 2769201 / 2769202 Email:
Fax: 0755 - 2769203 [email protected]
Office of the Insurance Ombudsman, Punjab, Office of the Insurance Ombudsman, Tamil Nadu,
S.C.O. No. 101, 102 & 103, 2nd Floor, Haryana(excluding Gurugram, Faridabad, Fatima Akhtar Court, 4th Floor, 453, Tamil Nadu
Batra Building, Sector 17 – D, Sonepat and Bahadurgarh) Anna Salai, Teynampet, PuducherryTown and
Chandigarh – 160 017. Himachal Pradesh, Union Territories of CHENNAI – 600 018. Karaikal (which are part
Tel.: 0172 - 2706196 / 2706468 Jammu & Kashmir, Tel.: 044 - 24333668 / 24335284 of Puducherry).
Fax: 0172 - 2708274 Ladakh & Chandigarh Fax: 044 - 24333664
Email: [email protected] Email: [email protected]
Office of the Insurance Ombudsman, Delhi & Office of the Insurance Ombudsman, Assam,
2/2 A, Universal Insurance Building, Following Districts of Haryana - Gurugram, Jeevan Nivesh, 5th Floor, Meghalaya,
Asaf Ali Road, Faridabad, Sonepat & Bahadurgarh. Nr. Panbazar over bridge, S.S. Road, Manipur,
New Delhi – 110 002. Guwahati – 781001(ASSAM). Mizoram,
Tel.: 011 - 23232481/23213504 Tel.: 0361 - 2632204 / 2602205 Arunachal Pradesh,
Email: [email protected] Email: [email protected] Nagaland and Tripura.
PLIL/Operation/NB-UF/Policy Pack/Ombudsman List_RG/019_01-Dec-2019_01
Office of the Insurance Ombudsman, Andhra Pradesh, Office of the Insurance Ombudsman, Rajasthan.
6-2-46, 1st floor, "Moin Court", Telangana, Jeevan Nidhi – II Bldg., Gr. Floor,
Lane Opp. Saleem Function Palace, Yanam and Bhawani Singh Marg,
A. C. Guards, Lakdi-Ka-Pool, part of Union Territory of Puducherry. Jaipur - 302 005.
Hyderabad - 500 004. Tel.: 0141 - 2740363
Tel.: 040 - 23312122 Email: [email protected]
Fax: 040 - 23376599
Office of the Insurance Ombudsman, Kerala, Office of the Insurance Ombudsman, West Bengal,
2nd Floor, Pulinat Bldg., Lakshadweep, Hindustan Bldg. Annexe, 4th Floor, Sikkim,
Opp. Cochin Shipyard, M. G. Road, Mahe-a part of Union Territory of 4, C.R. Avenue, Andaman & Nicobar
Ernakulam - 682 015. Puducherry. KOLKATA - 700 072. Islands.
Tel.: 0484 - 2358759 / 2359338 Tel.: 033 - 22124339 / 22124340
Fax: 0484 - 2359336 Fax : 033 - 22124341
Email: [email protected] Email: [email protected]
Page 19 of 22
Office of the Insurance Ombudsman, Districts of Uttar Pradesh : Office of the Insurance Ombudsman, Goa,
6th Floor, Jeevan Bhawan, Phase-II, Lalitpur, Jhansi, Mahoba, Hamirpur, 3rd Floor, Jeevan Seva Annexe, Mumbai Metropolitan
Nawal Kishore Road, Hazratganj, Banda, Chitrakoot, Allahabad, Mirzapur, S. V. Road, Santacruz (W), Region
Lucknow - 226 001. Sonbhabdra, Fatehpur, Pratapgarh, Mumbai - 400 054. excluding Navi Mumbai
Tel.: 0522 - 2231330 / 2231331 Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Tel.: & Thane.
Fax: 0522 - 2231310 Lucknow, Unnao, Sitapur, Lakhimpur, 69038821/23/24/25/26/27/28/28/29/30/31
Email: [email protected] Bahraich, Barabanki, Raebareli, Sravasti, Fax: 022 - 26106052
Gonda, Faizabad, Amethi, Kaushambi, Email: [email protected]
Balrampur, Basti, Ambedkarnagar,
Sultanpur, Maharajgang, Santkabirnagar,
Azamgarh, Kushinagar, Gorkhpur, Deoria,
Mau, Ghazipur, Chandauli, Ballia,
Sidharathnagar.
Office of the Insurance Ombudsman, State of Uttaranchal and the following Office of the Insurance Ombudsman, Bihar,
Bhagwan Sahai Palace Districts of Uttar Pradesh: 1st Floor,Kalpana Arcade Building,, Jharkhand
4th Floor, Main Road, Agra, Aligarh, Bagpat, Bareilly, Bijnor, Bazar Samiti Road,
Naya Bans, Sector 15, Budaun, Bulandshehar, Etah, Kanooj, Bahadurpur,
Distt: Gautam Buddh Nagar, Mainpuri, Mathura, Meerut, Moradabad, Patna 800 006.
U.P-201301. Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Tel.: 0612-2680952
Tel.: 0120-2514252 / 2514253 Farrukhabad, Firozbad, Email: [email protected]
Email: [email protected] Gautambodhanagar, Ghaziabad, Hardoi,
Shahjahanpur, Hapur, Shamli, Rampur,
Kashganj, Sambhal, Amroha, Hathras,
Kanshiramnagar, Saharanpur.
Office of the Insurance Ombudsman, Maharashtra,

Jeevan Darshan Bldg., 3rd Floor, Area of Navi Mumbai and Thane
C.T.S. No.s. 195 to 198, excluding Mumbai Metropolitan Region.
N.C. Kelkar Road, Narayan Peth,
Pune – 411 030.
Tel.: 020-41312555
PLIL/Operation/NB-UF/Policy Pack/Ombudsman List_RG/019_01-Dec-2019_01
Page 20 of 22
Benefits of continuing your Life Insurance Policy
1. Financial protection for your family – Paying premium regularly will ensure financial protection for you and your family in case of
any unforeseen event.
2. Tax Rebate for you – As per prevailing tax laws, premium(s) paid and payouts received by you or your beneficiaries are eligible for
income tax rebate. Ongoing source of funds– In certain plans, the premiums paid by you are invested thereby providing you a
steady return on investment over a period of time.
3. Certain plans allow you the flexibility of partially withdrawing the amount in case of financial emergencies.
Disadvantages of Lapsation/Policy Switching
Lapsing an existing policy and/ or buying a new policy may have the following disadvantages:
• You may pay higher premiums on the new policy on account of change in age or health conditions. In addition you may be re-
quired to undergo a medical examination
• You may have to pay Surrender charges on the existing policy. A new policy will attract fixed charges such as admin fees again.
• Contestability period of two years, restarts again on a new policy
• You may lose all accrued benefits on your existing policy
• You are at risk of having no cover between cancellation & new policy commencement
Page 21 of 22
Customer First. Protecting Your Interests.
Policy Servicing & Claims Servicing Time Frames
Policy Servicing Related TATs
S No. Service Maximum Turn Around Time
1 Processing of proposal and communication of decisions including requirements/issue 15 Days
of policy/Cancellations.
2 Obtaining copy of the proposal 15 Days
3 Post Policy issue service requests 15 Days
Payment Related TATs

1. Free Look Cancellation, Surrender, withdrawal, refund of proposal deposits (if any) 15 Days
2. Maturity, Survival Benefits Claims and Annuities On due date
3 Post Policy issue service requests 15 Days
Grievance Related TATs

1. Acknowledge a Grievance 3 Days
2. Resolve a Grievance 15 Days
Death Claim Related TATs

1. Raising claims requirements after lodging the claim 15 Days
2. Death Claim Settlement without Investigation (Life) from the date of receipt of all rel- 30 Days
evant papers and clarifications
3. Death Claim Settlement with Investigation (Life) 120 days
• Investigation to be completed– 90 Days
• Claim Settlement thereafter - 30 Days
4. Claim Settlement without Investigation (Health) 30 Days
5. Claim Settlement with Investigation (Health) 75 Days
• Investigation to be completed– 30 Days
• Claim Settlement thereafter - 45 Days from the last necessary documents
In case of any delay, the company shall pay interest at a rate, as specified in Insurance Regulatory and Development Authority of India
(Protection of Policyholders’ Interest) Regulations, 2017 and any clarifications/amendments issued by the Authority from time to time.
If the response received from the Company is not satisfactory or no response is received within two weeks (Business Days) of
contacting the Company, the matter may be escalated to:
• Email: [email protected]
• Grievance Redressal Officer, Pramerica Life Insurance Limited., 4th Floor, Building No. 9B, Cyber City, DLF City Phase III,
Gurgaon - 122002
• GRO Contact Number: 0124 - 4697069
• Office hours: 9.30 am to 6.30 pm from Monday to Friday
IRDA’s Integrated Grievance Management System (IGMS)

Pramerica Life Insurance is pleased to integrate with IRDA’s Integrated Grievance Management System (IGMS), in case the
complaint is not addressed or a satisfactory resolution is not provided by the Insurer you may escalate your complaint to the:
• IRDA’s online facility (Integrated Grievance Management System) which helps policyholders register complaints and track
their status. For this purpose, you may login in to www.igms.irda.gov.in
• Call Center Toll Free Number 155255
• Email: [email protected]
• Complaints against Life Insurance Companies:
Insurance Regulatory Development Authority Consumer Affairs Department
Sy. No. 115/1, Financial District Nanakramguda, Gachibowli Hyderabad – 500032
Consumer Education Website:
Insurance Regulatory Development Authority has Launched a Consumer Education Website, which provides useful information
on buying insurance, standard claim procedures/documentations, Dos and Don’ts for a policy holder, general alerts, dealing with
intermediaries and FAQs etc.
Policy holders can visit www.policyholder.gov.in. The link is also available under “Customer Services” section on the home page of
our Company website www.pramericalife.in
Page 22 of 22

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PRAMERICA LIFE RAKSHAK GOLD

(A Non-Linked Non-Participating Endowment Life Insurance Plan)

Client ID: 55070307

Client ID: 55070307

Signed by and on behalf of

Pramerica Life Insurance Limited

Policyholder Mr Sijin V M Life Insured Mr Sijin V M

Signed for and on behalf of

Pramerica Life Insurance Limited, at Gurgaon on 19/11/2021

Digitally signed by RAJESH KRISHNAN

Digitally signed by RAJESH KRISHNAN

1. Whether tax payable on reverse charge basis - No

Premium means the amount of premium payable by the

Risk Commencement Date means the date as specified in

Section One: Policy Benefits

(a) Benefit Payable on Death

If the Premium Frequency is annual, then Premium must be

and Special Surrender Value (SSV).

applicable from time to time.

Section One: Suicide Clause

Grievance Redressal place of residence of the complainant is located.

India, Consumer Affairs Department

Annexure – ‘A’ instruments of transfer or assignment, the priority will

advised to refer to the insurance Act as amended from time to

version prepared for general information. Policy Holders are

Annexure – ‘C’ 5. No Insurer shall repudiate a life insurance Policy on the

version prepared for general information. Policy Holders are

Address & Contact Details of Ombudsmen Centres

Office of The Governing Body of Insurance Council (Monitoring

Jurisdiction of Office Union

Office of the Insurance Ombudsman, Maharashtra,

PLIL/Operation/NB-UF/Policy Pack/Ombudsman List_RG/019_01-Dec-2019_01

Benefits of continuing your Life Insurance Policy

Disadvantages of Lapsation/Policy Switching

Payment Related TATs

Grievance Related TATs

Death Claim Related TATs

IRDA’s Integrated Grievance Management System (IGMS)

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