BENEFIT ILLUSTRATION

[Date and Time of Illustration – 22 November 2024, 02:15 PM]

Name of the Prospect/Policyholder: Mr. Proposal No:

Age & Gender: 35 Years, Male Name of the Product: Max Life Smart Wealth Advantage Guarantee Plan
Name of the Life Assured: Mr. A Non-linked Non Participating Individual Life
Tag Line:
Age & Gender: 35 Years, Male Insurance Savings Plan
Policy Term: 35 Years Unique Identification No: 104N124V10
Premium Payment Term: 10 Years GST Rate (Base Policy, First Year): 4.50%
Amount of Installment Premium: `1,04,500 GST Rate (Base Policy, Subsequent
2.25%
Mode of payment of premium: Annual Year):
Annual Income Amount: `28,830 GST Rate (Rider, First Year): NA
Income Start Year, if applicable: 1st year GST Rate (Rider, Subsequent Year): NA
Income Period, if applicable: NA
Deferment Period, if applicable: NA Max Life State: Tamil Nadu
Policyholder Residential State: Tamil Nadu

This benefit illustration is intended to show year-wise premiums payable and benefits under the policy.
Policy Details
Policy Option Early Wealth Sum Assured on Maturity (in Rs.) 10,08,905
Sum Assured (at inception of the policy) upon Death (in
Death Benefit Multiple NA 11,00,000
Rs.)
Sum Assured (Inbuilt Additional Accidental Death
Policy Continuance Benefit Option No 5,50,000
Benefit) (in Rs.)
Special Date Option No Opted Special Date NA

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

UIN: 104N124V10 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 1 of 7
 Premium Summary
Accidental Death & Waiver of Premium Critical Illness and
Term Plus Rider Total Installment
Base Plan Dismemberment Plus Rider Disability Rider
Premium
Rider

Installment Premium without GST (in Rs.) 1,00,000 0 0 0 0 1,00,000

Installment Premium with first year GST (in Rs.) 1,04,500 0 0 0 0 1,04,500
Installment Premium with GST 2nd year onwards
1,02,250 0 0 0 0 1,02,250
(in Rs.)

(Amount in Rupees)

Guaranteed Non Guaranteed

Single/ Total Other

Policy Accrued
Annualized Annual Auto Debit Money Back Benefits, if Inbuilt Guaranteed
Year Total Guaranteed Total Special Surrender
Premium Premium Booster Base Loyalty (In case of any (Sum Additional Surrender
Survival Additions (if Maturity Death Surrender Value
(BOY) (BOY) Income Income Life Long Assured on Accidental Value (EOY)
(EOY) Benefit any) (EOY) Benefit Benefit Value Payable
(BOY) (EOY) Income) Maturity) Death
(BOY) (EOY) (EOY) (EOY)
(EOY) Benefit

11,00,00
1 1,00,000 1,00,000 - 28,830 - - 28,830 - - - - - 28,127 28,127
0

11,00,00
2 1,00,000 1,00,000 - 28,830 - - 28,830 - - - - 2,340 60,432 60,432
0

11,00,00
3 1,00,000 1,00,000 - 28,830 - - 28,830 - - - - 18,510 97,385 97,385
0

11,00,00 1,39,49 1,39,4

4 1,00,000 1,00,000 - 28,830 - - 28,830 - - - - 84,680
0 9 99

UIN: 104N124V10 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 2 of 7
 Guaranteed Non Guaranteed

Single/ Total Other

Policy Accrued
Annualized Annual Auto Debit Money Back Benefits, if Inbuilt Guaranteed
Year Total Guaranteed Total Special Surrender
Premium Premium Booster Base Loyalty (In case of any (Sum Additional Surrender
Survival Additions (if Maturity Death Surrender Value
(BOY) (BOY) Income Income Life Long Assured on Accidental Value (EOY)
(EOY) Benefit any) (EOY) Benefit Benefit Value Payable
(BOY) (EOY) Income) Maturity) Death
(BOY) (EOY) (EOY) (EOY)
(EOY) Benefit

11,00,00 1,87,34 1,87,3

5 1,00,000 1,00,000 - 28,830 - - 28,830 - - - - 1,05,850
0 7 47

11,00,00 2,41,56 2,41,5

6 1,00,000 1,00,000 - 28,830 - - 28,830 - - - - 1,27,020
0 1 61

11,00,00 3,12,05 3,12,0

7 1,00,000 1,00,000 - 28,830 - - 28,830 80,712 - - - 1,72,404
0 5 55

11,00,00 3,91,78 3,91,7

8 1,00,000 1,00,000 - 28,830 - - 28,830 1,61,425 - - - 2,29,635
0 1 81

11,00,00 4,81,73 4,81,7

9 1,00,000 1,00,000 - 28,830 - - 28,830 2,42,137 - - - 2,89,838
0 0 30

11,00,00 5,66,06 5,66,0

10 1,00,000 1,00,000 9,000 28,830 - - 28,830 3,22,850 - - - 3,52,995
0 3 63

11,00,00 5,77,25 5,77,2

11 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 3,38,985
0 5 55

11,00,00 5,89,24 5,89,2

12 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 3,24,965
0 6 46

11,00,00 6,02,10 6,02,1

13 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 3,10,955
0 0 00

UIN: 104N124V10 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 3 of 7
 Guaranteed Non Guaranteed

Single/ Total Other

Policy Accrued
Annualized Annual Auto Debit Money Back Benefits, if Inbuilt Guaranteed
Year Total Guaranteed Total Special Surrender
Premium Premium Booster Base Loyalty (In case of any (Sum Additional Surrender
Survival Additions (if Maturity Death Surrender Value
(BOY) (BOY) Income Income Life Long Assured on Accidental Value (EOY)
(EOY) Benefit any) (EOY) Benefit Benefit Value Payable
(BOY) (EOY) Income) Maturity) Death
(BOY) (EOY) (EOY) (EOY)
(EOY) Benefit

11,00,00 6,15,88 6,15,8

14 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 2,96,935
0 1 81

11,00,00 6,30,64 6,30,6

15 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 2,82,925
0 6 46

11,00,00 6,46,45 6,46,4

16 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 2,68,905
0 9 59

11,00,00 6,63,41 6,63,4

17 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 2,54,895
0 4 14

11,00,00 6,81,58 6,81,5

18 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 2,40,875
0 2 82

11,00,00 7,01,08 7,01,0

19 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 2,26,865
0 2 82

11,00,00 7,22,01 7,22,0

20 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 2,12,845
0 9 19

11,00,00 7,44,50 7,44,5

21 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 1,98,835
0 0 00

11,00,00 7,68,68 7,68,6

22 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 1,84,815
0 3 83

UIN: 104N124V10 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 4 of 7
 Guaranteed Non Guaranteed

Single/ Total Other

Policy Accrued
Annualized Annual Auto Debit Money Back Benefits, if Inbuilt Guaranteed
Year Total Guaranteed Total Special Surrender
Premium Premium Booster Base Loyalty (In case of any (Sum Additional Surrender
Survival Additions (if Maturity Death Surrender Value
(BOY) (BOY) Income Income Life Long Assured on Accidental Value (EOY)
(EOY) Benefit any) (EOY) Benefit Benefit Value Payable
(BOY) (EOY) Income) Maturity) Death
(BOY) (EOY) (EOY) (EOY)
(EOY) Benefit

11,00,00 7,94,71 7,94,7

23 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 1,70,805
0 3 13

11,00,00 8,22,75 8,22,7

24 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 1,56,785
0 9 59

11,00,00 8,52,99 8,52,9

25 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 1,42,775
0 5 95

11,07,00 8,85,60 8,85,6

26 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 1,28,755
8 6 06

11,51,05 9,20,84 9,20,8

27 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 1,14,745
7 5 45

11,98,62 9,58,89 9,58,8

28 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 1,00,725
0 6 96

12,50,09 10,00,0 10,00,

29 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 96,855
3 74 074

13,05,81 10,44,6 10,44,

30 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 96,855
8 54 654

13,66,19 10,92,9 10,92,

31 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 96,855
2 53 953

UIN: 104N124V10 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 5 of 7
 Guaranteed Non Guaranteed

Single/ Total Other

Policy Accrued
Annualized Annual Auto Debit Money Back Benefits, if Inbuilt Guaranteed
Year Total Guaranteed Total Special Surrender
Premium Premium Booster Base Loyalty (In case of any (Sum Additional Surrender
Survival Additions (if Maturity Death Surrender Value
(BOY) (BOY) Income Income Life Long Assured on Accidental Value (EOY)
(EOY) Benefit any) (EOY) Benefit Benefit Value Payable
(BOY) (EOY) Income) Maturity) Death
(BOY) (EOY) (EOY) (EOY)
(EOY) Benefit

14,31,70 11,45,3 11,45,

32 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 96,855
6 65 365

15,02,87 12,02,3 12,02,

33 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 96,855
5 00 300

15,80,31 12,64,2 12,64,

34 - - - 28,830 - - 28,830 3,22,850 - - 5,50,000 96,855
2 49 249

10,08,90 13,31,75 16,64,69 13,31,7 13,31,

35 - - - 28,830 - - 28,830 3,22,850 5,50,000 96,855
5 5 3 55 755

Notes:
• EOY: End of Year, BOY = Beginning of Year
• Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any, and Goods and Service Tax.
• Total Annual Premium includes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any but excludes Goods and Service Tax.
• The Surrender Value payable shall be higher of ‘Minimum Guaranteed Surrender Value’ and ‘Special Surrender Value’. Any additional Surrender Value over and above the ‘Minimum
Guaranteed Surrender Value’ is not guaranteed.
• The above benefits are assuming income payment mode as Annual and with the assumption that no special date is opted by you. For details on other income payment modes and
special date options, please refer the Policy Document.
• The Net Rate of Return has been calculated based on the total survival (including auto-debit booster) and total maturity benefit, assuming that all premiums have been paid as and
when due (excluding applicable taxes, cesses and levies and rider premiums, if any).
• Refer Sales literature (Prospectus) and Policy Document for explanation of terms used in this illustration.
• Surrender value (both GSV and SSV) shown above is after payment of survival benefit applicable during the year of surrender.
• The above benefit illustration assumes that all premiums (excluding the first premium) are paid via auto debit mode of premium payment. Note that auto debit boosters are
applicable only on the premiums paid via auto debit mode of premium payment. Auto debit booster shall be payable only to the fully paid-up policies where all due premiums have
been paid.

UIN: 104N124V10 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 6 of 7
I, ………………………………….... (name), have explained the premiums, I, ……………………………………………. (name), having received the
and benefits under the product fully to the prospect / policyholder. information with respect to the above, have understood the above statement
before entering into the contract.

Place Date:11/22/24 Signature / Thumb Impression / Electronic

Signature / Thumb Impression / Electronic
Date: 11/22/24 Signature of Prospect/ Policyholder
Signature of Agent/ Intermediary / Official of
the insurer
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N124V10 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 7 of 7