Duplicate

23-Mar-2015

MR. VENKATA SATYANARAYANA RAJUSIVANGI

FLAT 406 GOKUL APTS
B S MAQTA STREET
BEGUMPET,.
HYDERABAD 500016
TELANGANA
G.O. Name : X1379
Policy No. : 256886300
Telephone : 9542622222,9676398685
Email ID : VENKAT.SHIVA83@GMAIL.COM

Subject - Welcome to Max Life Insurance Family

Dear MR. VENKATA SATYANARAYANA RAJUSIVANGI,
Thank you for choosing Max Life Insurance as your preferred life insurance partner.
I welcome you to the rapidly expanding and satisfied family of Max Life Insurance policyholders. Max Life Insurance
is driven by the vision to be India's most admired life insurance company by securing the financial future of its
customers. We are committed to offering you long-term savings, protection and retirement solutions backed by the
highest standards of customer service.
Over the last thirteen years of our journey, we have created a strong, profitable and successful organization. Today,
the Company has presence in over 750 cities across India, with a strong base of over 32 lakh policies in-force.
In the financial year 2013-14, the Company progressed well on key business parameters:
■ The Revenue of the Company grew 17% to Rs. 8,191 crore. The Company declared a Bonus of Rs. 391 crore
for its participating policyholders.
■ The Company had Assets Under Management of Rs. 24,716 crore, Sum Assured in-force of Rs. 1,99,660 crore
& a Solvency Ratio of 485%, more than 3 times the mandatory requirement of 150%.

Our belief in customer centricity & service excellence is the driving force behind this strong performance. Max Life
Insurance offers a Claims Guarantee to all its policyholders under which the Company commits to pay claims within
10 working days of the receipt of all the death claim documents/clarifications from the nominee, else the Company will
pay interest at the rate of 6% per annum.
The enclosed policy documents explain all the features, benefits and terms of your Max Life Insurance policy in a simple
and easy to understand manner. In the unlikely event of your not being completely satisfied with the policy, you have
the option to cancel it by returning the original copy with a written request to us within 15 days from the date of the
receipt of this document.
We will be delighted to offer you any further assistance or clarification you may require about your policy. We look
forward to being your partner for life.
Yours Sincerely,

Rajesh Sud
CEO & Managing Director
AGENT NAME: AXIS BANK LTD ROAD NO.2 BANJARA HILLS
(526813), PH.NO.: 9000528528, ADDRESS:Unit No.1, Ground Floor,
MCH No.8-2-273, 276 277, Pavani Avenue , Road No.2, Banjara Hills,,
Hyderabad 500034 (N/A), SERVICING BRANCH ADDRESS: Unit No.1,
Ground Floor MCH No.8-2-273, 276 277 Pavani Avenue , Road No.2, Banjara
Hills, Hyderabad Hyderabad 500034 , PH.NO.:

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 Key Feature Document
Max Life
Life Gain Premier
Traditional Participating Endowment Insurance Plan
(UIN NO: 104N079V01)
This document is the summary of important points in your Policy contract and must be read to
understand your Policy contract better

Policy Holder Name: MR. VENKATA Premium Payment Mode: Annual

SATYANARAYANA RAJUSIVANGI
Life Insured Name: MR. VENKATA Total Premium Amount (including Rider `1,94,004.64
SATYANARAYANA RAJUSIVANGI premium & applicable taxes):
Policy No: 256886300 Premium Payment due date: 26th of Feb Every Year
Date of Commencement: 26-Feb-2015 Premium Payment Term (In Years): 08
(Date from which Life
Insurance cover starts)
Maturity Date: 26-Feb-2030 Last Premium Due Date: 26-Feb-2022
Guaranteed Maturity Sum ` 20,00,254.00 Policy Term (in years): 15
Assured:
Guaranteed Death Benefit as on Date of Commencement: `21,34,051.04
(Minimum Amount payable on death of Life Insured)

Aim of the Policy

• To provide financial protection to your loved ones in case of untimely death of Life Insured.
• To help you save in a systematic manner for your life stage needs like children's education, marriage or your retirement.

Benefits under the Policy

• Benefits if Life insured lives

If the Life Insured has survived on the Maturity Date and we have received all the due Premiums, you will get the sum total of the following on Maturity Date:
• Guaranteed Maturity Sum Assured (i.e. The minimum amount payable on policy maturity);
• Accrued Paid Up Additions (Applicable if the Bonus declared is used to purchase additional Sum Assured), if any; and
• Terminal Bonus (if any).
Terminal Bonus is an additional Bonus paid only once on earlier of: death, surrender or maturity. The Terminal Bonus accrues in a Policy only if the
Policy has been in force for atleast 10 complete Policy Years from Date of Commencement. In case of Surrender, the cash value of Terminal Bonus
will be payable.
• Benefits if Life Insured dies
In case of death of the Life Insured during the Policy Term and provided we have received all the due Premiums, you will get sum total of the following:
• Guaranteed Death Benefit (i.e. The minimum amount payable on death of Life Insured);
• Accrued Paid Up Additions (Applicable if the Bonus declared is used to purchase additional Sum Assured), if any; and
• Terminal Bonus, if any.
Guaranteed Death Benefit will be highest of the following:
• 11 times the Annualised Premium;
• 105% of all the Premiums received by us till the date of death of the Life Insured; or
• Guaranteed Maturity Sum Assured.
• Benefits if Life insured is Diagnosed with a terminal illness:
We will pay up to 50% of the Guaranteed Maturity Sum Assured or the Reduced Paid Up Maturity Sum Assured. This is subject to maximum
total amount of Rs. 10 Lakhs for all our policies providing for Terminal Illness benefit on the life of the Life Insured. Upon payment of the Terminal
Illness benefit, the benefits under all policies then in force, which provide for the Terminal Illness benefit will be proportionately reduced. The
Terminal Illness benefit paid will be deducted from the Policy benefits at the time of termination of the Policy due to death, surrender or maturity.

Terminal Illness means the Life Insured being Diagnosed with a disease, which in the opinion of a Medical Practitioner, and on approval of
such an opinion by our Medical Practitioner, is likely to result in death of the Life Insured within six months from the date of such certification
by the Medical Practitioner.

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 For policies with Premium Payment Term of 6 or 8 years, 50% of the Reduced Paid Up Maturity Sum Assured will be payable if you discontinue Premium payment after
paying Premium for first two Policy Years.

For policies with Premium Payment Term of 10 years or more, 50% of the Reduced Paid Up Maturity Sum Assured will be payable if you discontinue Premium payment
after paying Premium for first three Policy Years.

Your Commitment

• Please continue to pay Premiums on time for the entire Premium Payment Term. We provide various easy and convenient payment options for you to
choose from. To know more about our Premium payment options log on to www.maxlifeinsurance.com
• We encourage you to read the details of the Policy document including the Proposal Form to ensure the accuracy of information. Any fraudulent,
non-disclosure or misrepresentation of material facts by you might result in cancellation of the Policy and claim not being paid.

Risks under the Policy

Following are the key risks of this Policy and require your attention:
• The actual returns of the Policy may be different from what is shown in the benefit illustration. In the benefit illustration, scenarios are depicted at 4%
and 8% gross investment returns.
• Bonuses are not guaranteed and are declared at our discretion. However, once declared, bonuses are guaranteed. The bonuses under the Policy
depend on our investments, claims, costs and customer retention experience.

Things you would like to know

• Do I have an option to cancel my Policy?
Yes, you may cancel your Policy within 15 days free look period, from the day you receive the Policy document. We will refund the entire
Premium received by us after deducting the proportionate risk Premium for the period of cover, charges of stamp duty paid and the expenses
incurred on medical examination of the Life Insured, if any.
• Are there any tax benefits under this Policy?
You may be entitled to certain tax benefits on the Premiums paid and the benefits under the Policy as per the prevailing tax laws. Please consult
your tax advisor for further details.
• Are there any exclusions under the Policy?
In case of death of Life Insured due to suicide within 12 months from the Date of Commencement or the date of revival of Policy, all risks and
benefits under this Policy shall cease and no benefits are payable under this Policy. In such an event, we will pay:
• Higher of Special Surrender Value (Refer benefit illustration) or total Premiums received, in case the Policy has acquired a Surrender Value
(Refer benefit illustration); or
• Total Premiums received, in case the Policy has not acquired a Surrender Value.
• What are the bonus options available under my Policy?
Cash Bonus will be declared every year from the end of second Policy Year. These bonus options can be changed before the start of next
Policy Year. You may choose any one of the following bonus options:
• Paid in Cash: The bonus declared will be paid to you through NEFT;
• Premium Offset: The bonus declared will be used to offset the future Premiums payable by you. In case the declared bonus is more than
the Premium, we will refund it to you through NEFT; or
• PaidUp Additions: The bonus will be used to purchase additional sum assured called Paid Up Additions, which will further participate in
future bonuses. The cash value of the Paid Up Addition can be withdrawn as and when required by you.
• How can I take money out of my Policy?
You have the following options to avail money under your Policy:
• You may surrender partially or in full, the accrued Paid Up Additions (if any), subject to a minimum withdrawal amount of Rs. 5,000;
• You may surrender your Policy at any time once the Surrender Value for your Policy is available. You would be eligible for the Surrender
Value if you have paid atleast:
• First two years Premium where the Premium Payment Term is six or eight years; or
• First three years Premium where the Premium Payment Term is ten or twelve years.
The Surrender Value will be higher of Guaranteed Surrender Value or Special Surrender Value. However, you are likely to get a higher value
under the Policy, if the Policy is kept in force till maturity; or
• You may request to avail a loan on the Policy, subject to a maximum of 50% of the Surrender Value and as per the terms and conditions
of loans provisions of the Policy.
• What happens if I delay my Premium Payment?
You have a grace period of 30 days (15 days in case of monthly Premium payment mode) from the Premium due date, during which you can
pay the Premium without any interest. During the grace period, the insurance cover continues. If the Life Insured dies during this period, we
will pay the death benefit after deducting due Premium.

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 If you do not pay the Premium within the grace period, and your Policy has acquired a Surrender Value, then the insurance cover will be reduced
proportionately in the ratio of the Premiums received by us to the total Premiums payable.
However, if your Policy has not acquired a Surrender Value, the Policy shall lapse and no benefit will be available, on the expiry of grace period.
We may restore the benefits of the lapsed Policy if you pay all due Premiums within two years from the due date of the first unpaid Premium
with late fee and/or interest. You will be required to produce evidence of insurability of the Life Insured at your own cost.
However, if a reduced paid up Policy is not revived within the period as mentioned above, then, the same cannot be revived and will continue
to be under Reduced Paid Up Mode.
• How can I customise my Policy?
• You can enhance your Policy cover as per your needs by availing the applicable rider, with a nominal increase in the Premium.
• You can either choose to take the bonus in cash, offset your Premium or purchase Paid-Up Additions which will also be eligible for future
bonus.
• How can I manage my Policy?
You can register on our customer portal at www.maxlifeinsurance.com to get convenient access to the following self-management options:
• Conveniently access Policy statements, receipts and Premium due information;
• Update your contact details;
• Change the Premium payment mode to annual, semi-annual, quarterly or monthly mode; or
• Pay renewal Premiums online.

For any assistance you can reach us at 1800 200 5577 or e-mail at service.helpdesk@maxlifeinsurance.com

Disclaimer: The information contained in this document and any attachments does not form any contract between the parties. The aim of this document is to summarize
the key features of your Policy and does not replace the Policy, in any way, which contains additional details & which is the formal contract which covers the relationship
between us. In case of any discrepancy between the Policy contract and this document, the terms, conditions and interpretation of the Policy contract shall prevail.

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 Max Life Insurance Company Limited
Regd. Office: Max House, 1, Dr. Jha Marg, Okhla, New Delhi -110020

Max Life Life Gain Premier

A Traditional Participating Endowment Insurance Plan
UIN - 104N079V01

Max Life Insurance Company Limited has entered into this contract of insurance on the basis of
the Proposal Form together with the Premium deposit, statements, report or other documents and
declarations received from the Proposer for effecting a life insurance contract on the life of the person
named in the Schedule hereto.

The Company agrees to pay the benefits under this Policy on the happening of the insured event, while
this Policy is in force subject to the terms and conditions stated herein.

On examination of this Policy, if You notice any mistake or error, this Policy should be returned to
Us for rectifying the same.

Signed by and on behalf of

Max Life Insurance Company Limited

AnaljitSingh
Chairman

Max Life Insurance Company Limited

Plot No. 90A, Sector 18, Gurgaon, 122015, Haryana, India
Phone 4219090 Fax 4159397 (From Delhi and Other cities: 0124) Customer Helpline: 1800-200-4006
Regd Office: Max House, 3rd Floor, 1 Dr. Jha Marg, Okhla, New Delhi 110 020, India
Visit us at: www.maxlifeinsurance.com E-mail: axis.helpdesk@maxlifeinsurance.com
Corporate Identity Number: U74899DL2000PLC106723 IRDA Registration No: 104

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 SCHEDULE
BASE POLICY - Max Life Life Gain Premier TYPE OF POLICY - Traditional Participating Endowment
Insurance Plan
UIN - 104N079V01 OFFICE - AXIS BANK LTD Road No.2, Banjara Hills
Policy No./ Proposal No.: 256886300 Client ID: 5004433254
Date of Proposal: 26-Feb-2015
Policyholder/Proposer : Age Admitted: Yes
MR. VENKATA SATYANARAYANA RAJUSIVANGI Gender: Male
PAN: CACPS5370M Tel No./Mobile No.: / 9542622222,9676398685
Identification Source & I.D No.: Email:VENKAT.SHIVA83@GMAIL.COM
Relationship with Life Insured: Same Person
Date of Birth: 13-Nov-1983
Address:
FLAT 406 GOKUL APTS
B S MAQTA STREET BEGUMPET,.
HYDERABAD 500016
TELANGANA
Life Insured: Age Admitted: Yes
MR. VENKATA SATYANARAYANA RAJUSIVANGI Gender: Male
Identification Source & ID No. :
Date of Birth: 13-Nov-1983
Age: 31
Nominee(s): Appointee (if nominee is minor):
MRS.RAJYA LAKSHMI SIVANGI
Date of Birth:
24-Aug-1987
Effective date: 26-Feb-2015 Premium Payment Mode: Annual
Premium Payment Method: Two-stage autopay Bill Draw Date: 08TH
Bonus Option: Paid-up Additions Bank Account Number: 915010010427088

Bank Account Details for Pay outs

Bank A/C no. : 915010010427088 Bank Name : AXIS BANK LTD
Agent's name/Broker's name: AXIS BANK LTD ROAD NO.2 Agent's code/Broker's code: 526813
BANJARA HILLS
Agent's/Broker's License No.: 1891411
Email:
Address: Mobile/Landline Telephone Number: 9000528528,
Unit No.1, Ground Floor, MCH No.8-2-273, 276 277, Pavani
Avenue , Road No.2, Banjara Hills,
Hyderabad 500034 (N/A)
List of Maturity Insured Guaranteed Guaranteed Policy Premium Annual Extra *Premium Service Due Date
Coverage Date Event Maturity Death Benefit Payment Premium (INR) tax When
Term Premium
Sum on the Term (INR) (INR) Premium
Assured Effective (INR) is Payable/
(INR) Date Date
(INR) When the
Last
Premium
is Payable
BASE POLICY
Max Life 26-FEB-30 Maturity or 20,00,254.00 21,34,051.04 15 08 1,94,004.64 NA 1,94,004.64 2,997.37 26th of Feb
Life Gain death of the Every Year;
Premier Life Insured 26-Feb-2022

Annualised Premium: 1,94,004.64

Total Premium including rider premium : 1,94,004.64
Total Service Tax: 2997.37
Total Premium payable on the due dates along with service tax : 1,97,002.01
*Please note that the Premium is (Annual Premium plus Extra Premium) multiplied by the applicable Modal Factor.
NOTE: On examination of this Policy, if You notice any mistake or error, this Policy should be returned to Us for rectifying the same.

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1. DEFINITIONS AND INTERPRETATION xiii. "Guaranteed Surrender Value" means the minimum
1.1. Definitions surrender value computed in accordance with Section
8.4, which is guaranteed by Us;
The words and phrases listed below shall have the meanings
attributed to them wherever they appear in this Policy unless xiv. "Insurance Act" means the Insurance Act, 1938;
the context otherwise requires: xv. "Life Insured" means the person named in the
Schedule, on whose life this Policy is effected;
i. "Actuarial Valuation Surplus" means the surplus
arising in the Participating life policyholders' fund, xvi. "Maturity Date" means the date specified in the
established by Us for Participating life insurance Schedule, on which the Policy Term expires and the
policies and calculated by the Appointed Actuary in maturity benefit as specified in Section 3.1 or Section
accordance with the standards or guidance issued by 3.4.2(i), as the case may be, becomes payable;
the Institute of Actuaries of India and in accordance xvii. "Medical Practitioner" means a person who holds
with the Insurance Regulatory and Development a valid registration from the medical council of any
Authority (Distribution of Surplus) Regulations, 2002; State of India or Medical Council of India or any
ii. "Age" means the Life Insured's age on last birthday other such body or Council for Indian Medicine
as on the Effective Date or on the previous Policy or for homeopathy set up by the Government of
Anniversary, as the case may be; India or by a State Government and is thereby
entitled to practice medicine within its jurisdiction
iii. "Annual Premium" means an amount specified in
and is acting within the scope and jurisdiction of his
the Schedule, which is payable under the annual
license, provided such Medical Practitioner is not
Premium payment mode under this Policy, excluding
the Life Insured covered under this Policy or the
Extra Premium, if any and excluding service tax or any
Policyholder or is not a spouse, lineal relative of the
other taxes, cesses or levies, if any;
Life Insured and/or the Policyholder or a Medical
iv. "Annualised Premium" means the sum total of Practitioner employed by the Policyholder/Life
Annual Premium and Extra Premium, if any, as Insured;
specified in the Schedule;
xviii. "Modal Factor" means the applicable factor used by
v. "Authority" means the Insurance Regulatory Us for determining the Premium payable by You under
and Development Authority established under the this Policy, if You have opted to pay the Premium in
Insurance Regulatory and Development Authority Act, any mode other than annual Premium payment mode.
1999 or any other regulatory authority regulating The Modal Factor for semi-annual Premium payment
insurance companies in India; mode is 0.52, for quarterly Premium payment mode
vi. "Cash Bonus" means a share in the Actuarial is 0.265 and for monthly Premium payment mode is
Valuation Surplus determined by Our Appointed 0.09;
Actuary, to be communicated to You, based on the xix. "Nominee" means the person named by You and
declaration made by Us, which can be utilized in the registered with Us in accordance with Section 10.6,
manner specified under Section 3.5.1; who is authorized to receive the death benefit under
vii. "Company", "We", "Us", "Our", "Insurer" means this Policy, on the death of the Life Insured;
Max Life Insurance Company Limited; xx. "Paid Up Additions" means the additional sum
viii. "Diagnosis" or "Diagnosed" means the definitive assured purchased from the Cash Bonus(es) declared
diagnosis made by a Medical Practitioner, based upon under this Policy at rates approved by the Authority,
radiological, clinical, and histological or laboratory which are not guaranteed;
evidence acceptable to Us provided the same is xxi. "Participating" means participating in the Actuarial
acceptable and concurred by Our appointed Medical Valuation Surplus of the participating life policyholders'
Practitioner. In the event of any doubt regarding the fund;
appropriateness or correctness of the Diagnosis, We
xxii. "Policy" means this Max Life Life Gain Premier plan,
will have the right to call for an examination of the Life
the operation, regulation and management of which is
Insured and/or the evidence used in arriving at such
governed by the documents comprising these terms
Diagnosis, by an independent expert selected by Us.
and conditions, the Proposal Form, the Schedule and
The opinion of such an expert as to such Diagnosis
any additional information/document(s) provided to Us
shall be binding on both You and Us;
in respect of the Proposal Form along with any written
ix. "Effective Date" means the date as specified in the instructions from You subject to Our acceptance of the
Schedule, on which the insurance coverage under this same;
Policy commences;
xxiii. "Policy Anniversary" means the annual anniversary
x. "Extra Premium" means an additional amount of the Effective Date;
charged by Us, as per Our board approved
xxiv. "Policyholder", "Proposer", "You", "Your" means
underwriting policy, which is determined on the basis
the person named in the Schedule who has taken this
of disclosures made by You in the Proposal Form
Policy from Us;
or on the basis of any other information received by
Us including through medical examinations of the Life xxv. "Policy Term" means the term of this Policy as
Insured in relation to this Policy; specified in the Schedule;
xi. "Guaranteed Death Benefit" means an amount xxvi. "Policy Year" means a period of 12 (Twelve) months
which will be highest of the following: commencing from the Effective Date and every Policy
Anniversary thereafter;
a. 11 (Eleven) times the Annualised Premium; or
xxvii. "Premium" means an amount as specified in the
b. 105% (One Hundred Five percent) of all the
Schedule, payable by You, by the due dates and in
Premiums received from You till the date of death
the manner specified in the Schedule, to secure the
of the Life Insured; or
benefits under this Policy, excluding service tax or any
c. Guaranteed Maturity Sum Assured. other taxes, cesses or levies, if any;
xii. "Guaranteed Maturity Sum Assured" means a xxviii. "Premium Payment Term" means the term as
guaranteed amount as specified in the Schedule, specified in the Schedule, during which the Premiums
payable on the Maturity Date, if the Life Insured has are payable by You to Us under this Policy;
survived on such date and all due Premiums have xxix. ''Proposal Form" means the form filled in and
been received by Us; completed by You, giving full particulars, for the

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 purpose of obtaining insurance coverage under this 3. BENEFITS
Policy; 3.1. Maturity Benefit
xxx. "Reduced Paid Up Death Benefit" means an amount
Subject to Sections 3.4, 4, 5, 10.3, 10.4 and 10.10
equal to the Guaranteed Death Benefit multiplied by
below, if the Life Insured has survived on the Maturity
the resultant of the total Premiums less Extra Premium
Date and We have received all the due Premiums,
(if any) received by Us till the date of the death of the
then, We shall pay the sum total of the following, on
Life Insured divided by the total Premiums less Extra
the Maturity Date, to a person specified under Section
Premium (if any) payable by You;
4.1:
xxxi. "Reduced Paid Up Maturity Sum Assured" means
an amount equal to the Guaranteed Maturity Sum i. Guaranteed Maturity Sum Assured;
Assured multiplied by the resultant of the total ii. accrued Paid Up Additions, if any; and
Premiums less Extra Premium (if any) received by Us iii. Terminal Bonus, if any.
divided by total Premiums less Extra Premium (if any)
3.2. Death Benefit
payable by You;
3.2.1. Subject to Sections 3.4, 4, 5, 10.3, 10.4 and 10.10
xxxii. ''Reduced Paid Up Mode" means the Policy with
below and provided the insurance coverage under
reduced paid up benefits as specified under Section
this Policy is in force, then, upon the death of the
3.4;
Life Insured during the Policy Term, We shall pay the
xxxiii. "Schedule" means the schedule and any sum total of the following, to a person specified under
endorsements attached to and forming part of this Section 4.1:
Policy and if an updated Schedule is issued, then, the
Schedule which is latest in time; i. Guaranteed Death Benefit;
xxxiv. "Special Surrender Value" means the special ii. accrued Paid Up Additions, if any; and
surrender value computed in accordance with Section iii. Terminal Bonus, if any.
8.5; 3.3. Terminal Illness Benefit
xxxv. ''Special Surrender Value Factors" are factors 3.3.1. Subject to Sections 3.4, 4, 5, 10.3, 10.4 and 10.10
determined by Us in consultation with and approved below, if the Life Insured is Diagnosed with Terminal
by the Authority to compute the Special Surrender Illness at any time during the Policy Term, We shall
Value. These factors can be revised by Us on the basis on receipt of Your written request, pay the following
of Our experience from time to time in consultation benefits to the Life Insured:
with and approval of the Authority;
i. Up to 50% (Fifty percent) of the Guaranteed
xxxvi. "Surrender Value" means an amount payable as per
Maturity Sum Assured or the Reduced Paid Up
Section 8 on surrender of this Policy, which will be
Maturity Sum Assured, as the case may be, on
the higher of the Guaranteed Surrender Value or the
the date of intimation, subject to a maximum
Special Surrender Value;
cumulative amount of INR 10,00,000 (Rupees Ten
xxxvii. ''Terminal Bonus" means the bonus payable by Us in Lakhs) under all Our policies issued with respect
accordance with Section 3.5.2; and to the Life Insured which provide for Terminal
xxxviii. ''Terminal Illness" means the Life Insured being Illness benefit, on the approval of Terminal Illness
Diagnosed with a disease which, in the opinion of claim filed by You. Upon payment of the Terminal
a Medical Practitioner and on approval of such an Illness benefit, the benefits under all policies then
opinion by Our appointed Medical Practitioner, is likely in force, which provide for the Terminal Illness
to result in the death of the Life Insured within 6 (Six) benefit, will be proportionately reduced and will
months from the date of such certification by a Medical be payable in accordance with the terms of the
Practitioner. respective policies.
1.2. Interpretation ii. The maturity benefit or the death benefit or the
i. References to the masculine or the singular will Surrender Value, as the case may be, will be
include references to the feminine and the plural, and reduced by the amount of Terminal Illness benefit
vice versa. already paid and the remaining maturity benefit
or remaining death benefit or the remaining
ii. References to any statute or statutory enactment shall
Surrender Value, as the case may be, will be
include re-enactment or amendment to the same.
payable, subject to the terms of this Policy.
iii. Section headings are for sake of reference only and
3.3.2. If the Life Insured is alive during the Policy Term and
have no interpretive value.
the Policy is not under Reduced Paid Up Mode, You
iv. Reference to days, unless context otherwise requires, shall continue to pay all the due Premiums.
means calendar days only.
3.3.3. The bonus(es), if any, will be declared by Us on
2. ELIGIBILITY the basis of the original Guaranteed Maturity Sum
2.1. This Policy has been written on a single life basis. Assured.
2.2. The minimum Age of the Life Insured on the Effective Date 3.3.4. Terminal Illness benefit can be availed under this
should be 18 (Eighteen) years. Policy only once during the Policy Term.
2.3. The maximum Age of the Life Insured on the Effective Date 3.4. Reduced Paid Up Benefit
should be: 3.4.1. If this Policy has acquired a Surrender Value as per
i. 55 (Fifty Five) years for a Policy where the Policy Term Section 8 below, then, in the event of non-payment of
is of 15 (Fifteen) years and 20 (Twenty) years; and the due Premiums by You to Us, this Policy will not
ii. 50 (Fifty) years for a Policy where the Policy Term is lapse and will continue with reduced paid up benefits
of 25 (Twenty Five) years. in accordance with this Section 3.4. A Policy under the
Reduced Paid Up Mode will thereafter be free from all
2.4. The maximum Age of the Life Insured on the Maturity Date liabilities of payment of the future Premiums to Us.
cannot exceed:
3.4.2. If this Policy is under Reduced Paid Up Mode, then,
i. 70 (Seventy) years for a Policy where the Policy Term the benefits payable shall be as follows:
is of 15 (Fifteen) years; and
i. Maturity Benefit
ii. 75 (Seventy Five) years for the Policy where the Policy
Term is of 20 (Twenty) years and 25 (Twenty Five) Subject to Sections 4, 5, 10.3 and 10.4 below, if
years. the Life Insured has survived on the Maturity Date,
then, We shall pay the sum total of the following,
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 to a person specified under Section 4.1 on the as premium for purchasing Paid Up
Maturity Date: Additions. Such Paid Up Additions shall
a. Reduced Paid Up Maturity Sum Assured; and participate in the future Cash Bonus(es)
as and when declared by Us and
b. accrued Paid Up Additions, if any.
shall mature along with this Policy. The
ii. Death Benefit Cash Bonus(es) will be declared on the
Subject to Sections 4, 5, 10.3 and 10.4 below, Guaranteed Maturity Sum Assured and
upon the death of the Life Insured during the on the accrued Paid Up Additions, if
Policy Term, We shall pay the sum total of the any which were purchased and have not
following, to a person specified under Section 4.1: been withdrawn by You in the past.
a. Reduced Paid Up Death Benefit; and 2) In the event of death of the Life Insured
b. accrued Paid Up Additions, if any. prior to the Maturity Date or if the Life
Insured survives on the Maturity Date,
iii. If this Policy is under the Reduced Paid Up Mode: We shall pay Paid Up Additions accrued
a. the Terminal Illness benefit payable, if any, till such date, if any, to a person specified
will be computed on the basis of the Reduced in Section 4.1. In case of surrender of this
Paid Up Maturity Sum Assured; Policy, We shall only pay the cash value
b. all rider benefits will cease under this Policy; of the Paid Up Additions to You.
c. You shall not be entitled to withdraw the cash 3) We reserve the right to change/ amend
value of the Paid Up Additions; the rates to buy Paid Up Additions, as
such rates are not guaranteed and may
3.5. Bonus(es) be revised on the basis of Our actual
Under this Policy during the Policy Term, You shall experience, subject to the prior approval
be eligible to receive the following bonus(es), if any, of the Authority.
declared by Us: 4) You have an option to withdraw the
i. Cash Bonus; and cash value of accrued Paid Up Additions,
ii. Terminal Bonus. partially or in full subject to a minimum
withdrawal amount of INR 5,000 (Rupees
3.5.1. Cash Bonus Five Thousand). The cash value of the
i. Under this Policy, We may declare a Cash Bonus Paid Up Additions will be determined
on the Guaranteed Maturity Sum Assured and on using the Paid Up Addition purchase
the accrued Paid Up Additions, if any, based on rates which are not guaranteed and
the Actuarial Valuation Surplus. can be revised by Us, subject to prior
ii. The Cash Bonus(es) on the Guaranteed Maturity approval of the Authority. However, such
Sum Assured shall be payable from the end of withdrawal will not be permitted, if this
nd th Policy is under the Reduced Paid Up
2 (Second) Policy Year (i.e. from the end of 24
Mode or if the loan under the Policy
Policy month) onwards and thereafter at the end
is outstanding. The remaining Paid Up
of every subsequent Policy Year as and when
Additions will continue to participate in
declared by Us, till the date of death of the Life
bonus(es), as and when declared by Us.
Insured or the date of termination of the Policy in
accordance with Section 11, whichever is earlier. iv. Subject to Sections 10.7.6 and 10.8.1, You may
The Cash Bonus(es) on the accrued Paid Up send a written request to Us for changing the
Additions, if any, shall be payable from the end of bonus option. However, such a change shall
rd
3 (Third) Policy Year (i.e. from the end of 36
th become effective on the Policy Anniversary date,
Policy month) onwards and thereafter at the end which follows the receipt of such written request.
of every subsequent Policy Year as and when 3.5.2. Terminal Bonus
declared by Us, till the date of death of the Life i. Under this Policy, We may at Our discretion pay
Insured or the date of termination of the Policy in an additional 1 (One) time Terminal Bonus on the
accordance with Section 11, whichever is earlier. earlier of the death of the Life Insured or on the
We may or may not declare the Cash Bonus(es) survival of the Life Insured till the Maturity Date or
as the same are not guaranteed. on surrender of this Policy, provided this Policy is
iii. You can utilize the Cash Bonus as per one of the in force for at least 10 (Ten) complete Policy Years
following options chosen by You in the Proposal from the Effective Date.
Form or subsequently in accordance with Section ii. Upon surrender of this Policy after completion of
3.5.1(iv): 10 (Ten) Policy Years from the Effective Date,
a. Paid in Cash only the cash value of the Terminal Bonus will be
You have an option to take the Cash Bonus payable by Us. The cash value of the Terminal
as and when declared by Us, by cheque or by Bonus, if any, will be determined using the
any other means as determined by Us. Paid Up Addition purchase rates which are not
b. Premium Offset guaranteed and can be revised by Us, subject to
the prior approval of the Authority.
You have an option to offset the Premium
payable under this Policy by the Cash Bonus 4. PAYMENT OF BENEFITS
payable to You by Us, if any. In the event the 4.1. Subject to Sections 3, 5 and 10.4, the benefits are payable
Cash Bonus exceeds the Premium payable under this Policy only on submission of satisfactory proof of
by You to Us under this Policy, We shall pay the Life Insured's death to Us or of the Life Insured surviving
such balance to You. However, if the Cash on the Maturity Date. The benefits under this Policy shall be
Bonus payable to You is not sufficient to offset payable to:
the Premium payable by You to Us under i the Policyholder, if the Policyholder and the Life Insured
this Policy, then, You shall pay the balance are different; or
Premium to Us.
ii. You, if the Life Insured and the Policyholder are same
c. Purchase Paid Up Additions (only in the case of maturity benefit); or
1) You have an option to utilize the
Cash Bonus(es) declared by Us, if any,
9 of 26
 iii. Nominee(s), in case of the death of the Life Insured, INR 4,000 to be paid
if the Policyholder and the Life Insured are same, quarterly
provided a valid nomination has been recorded with Us
INR 1,500 to be paid
in accordance with Section 10.6; or Monthly
monthly
iv. assignee(s), where an assignment and/or endorsement
has been recorded with Us in accordance with Section 6.3. Any change in the Premium payment mode will result in a
10.7; or change in the Premium amount basis the applicable Modal
Factors. A change in Premium payment mode shall be
v. proving executors, administrators or other legal
effective only on the Policy Anniversary following the receipt
representatives who have obtained representation to
of such request.
Your estate from a competent court, if You or the
Nominee are not living at that time; or 6.4. The Premiums are to be paid by You by the due dates and in
the manner specified in the Schedule.
vi. such person or persons as directed by a court of
competent jurisdiction in India, limited at all times to the 6.5. You can pay the Premiums at any of Our offices or through our
monies payable under this Policy. website www.maxlifeinsurance.com or by any other means,
as informed by Us from time to time. Any Premium paid by
4.2. Any benefit/ claim payment under this Policy shall be You through a cheque or any other instrument/ medium will be
made by Us in Indian Rupees or in any other currency deemed to have been received only after the same has been
in accordance with the applicable guidelines issued by the fully realized and credited to Our bank account.
Reserve Bank of India from time to time. 6.6 The Premium payment receipt shall be issued in Your name,
4.3. Once the benefits under this Policy are paid to a person which shall be subject to realization of cheque or any other
specified in Section 4.1, the same shall constitute a valid instrument/medium.
discharge of Our liability under this Policy. 7. TAXES
5. CLAIM PROCEDURE 7.1. All Premiums are subject to applicable taxes, cesses, levies
5.1. For processing a claim request under this Policy, We will including service tax, education cess, etc. which shall be
require all of the following documents: entirely borne by You and will be paid by You along with the
i. claimant's statement in the prescribed form; Premium. If any imposition (tax or otherwise) is levied on Us
by any statutory or administrative body under this Policy, We
ii. original Policy document;
reserve the right to claim the same from You. Alternatively, We
iii. death certificate issued by the local/municipal authority have the right to deduct the amount from the benefits payable
(only in the case of the death of the Life Insured); by Us under this Policy.
iv. identity proof of the beneficiary including Nominee(s) 7.2. Tax benefits and liabilities under this Policy are subject to
bearing their photographs and signatures (only in the prevailing tax laws. Tax laws and the benefits arising from
case of the death of the Life Insured); and the same are subject to change. You are advised to seek the
v. any other documents or information required by Us for opinion of Your tax advisor in relation to applicable tax benefits
assessing and approving the claim request. and liabilities.
5.2. We reserve the right to scrutinize the documents submitted 8. SURRENDER
by the claimant and/or investigate the cause of death of the 8.1. This Policy shall acquire a Surrender Value provided:
Life Insured/ the Policyholder and deny the claim partially or
i. all the due Premiums for the first 2 (Two) Policy Years
completely on the basis of Our scrutiny of the documents
have been received and applied by Us on or after the due
or investigation, as the case may be. We shall only pay
dates for the Policy where the Premium Payment Term is
the appropriate benefits under this Policy subject to Our
of 6 (Six) years or 8 (Eight) years; or
satisfaction:
ii. all the due Premiums for the first 3 (Three) Policy Years
i. that the benefits have become payable as per the terms have been received and applied by Us on or after the due
and conditions of this Policy; and dates for the Policy where the Premium Payment Term is
ii. of the bonafides and credentials of the said person of 10 (Ten) years or 12 (Twelve) years.
claiming the benefits under this Policy.
8.2. You may request in writing to surrender this Policy at any
5.3. Any person claiming the benefits under this Policy can time only if the Policy has acquired the Surrender Value.
download the claim request documents from Our website On receipt of such a request, this Policy shall terminate
www.maxlifeinsurance.com or can obtain the same from any and the Surrender Value (if any) prevailing on the date of
of Our branches and offices. request for the surrender of this Policy, shall be payable by
6. PREMIUMS Us. If the Policy has not acquired the Surrender Value in
accordance with Section 8.1 above, then, no Surrender Value
6.1. The Premiums under this Policy can be paid by You annually, shall become payable by Us.
semi-annually, quarterly or monthly as per the Premium
8.3. The Surrender Value payable will be subject to the condition
payment mode that You have chosen.
that there are no statutory or other restrictions to the contrary.
6.2. You have an option to change the Premium payment mode by Upon surrender of this Policy, no benefits under this Policy
submitting a written request to Us. We will allow the change in shall be payable thereafter and this Policy will terminate.
the Premium payment mode provided the minimum premium
8.4. Guaranteed Surrender Value
excluding Extra Premium, if any, as mentioned in the table
below, are adhered to and the Guaranteed Maturity Sum 8.4.1.The Guaranteed Surrender Value will be determined in
Assured remains unchanged: the Policy Year in which the surrender is effected, as a
percentage of the total Premiums less Extra Premium
Minimum premium (if any) received and applied by Us on or after the
(excluding Extra Premium, due dates, in accordance with the table below, plus
Premium payment mode service tax, any other guaranteed cash value of accrued Paid Up Additions,
taxes, cesses or levies, if if any, which have not been withdrawn by You. The
any) guaranteed cash value of accrued Paid Up Additions
INR 8,500 to be paid is based on guaranteed cash value rates which are
Annual
annually determined by Us in consultation and approval from
INR 6,000 to be paid the Authority and which are different from the Paid
Semi - Annual Up Addition purchase rates as mentioned in Section
semi-annually
3.5.1.iii.c.4).
Quarterly

10 of 26
 Percentage (%) of total Premiums less Extra Premium (if any) Received (subject to the condition that Premiums for the first 2
(Two) Policy Years or first 3 (Three) Policy Years, as the case may be, have been received and applied by Us, in accordance
with the Section 8.1)
Policy Year of surrender Policy with Premium Policy with Premium Policy with Premium Policy with Premium
Payment Term of 6 years Payment Term of 6 years Payment Term of 10 Payment Term of 12
or 8 years and with the or 8 years and with the years and with the years and with the
Policy Term of 15 years Policy Term of 20 years Policy Term of 20 years Policy Term of 25 years
1 0% 0% 0% 0%
2 30% 30% 0% 0%
3 30% 30% 30% 30%
4-7 50% 50% 50% 50%
8 56% 53% 53% 52%
9 61% 57% 57% 55%
10 67% 60% 60% 57%
11 73% 63% 63% 59%
12 79% 67% 67% 62%
13 84% 70% 70% 64%
14 90% 73% 73% 66%
15 90% 77% 77% 69%
16 - 80% 80% 71%
17 - 83% 83% 74%
18 - 87% 87% 76%
19 - 90% 90% 78%
20 - 90% 90% 81%
21 - - - 83%
22 - - - 85%
23 - - - 88%
24 - - - 90%
25 - - - 90%
8.5. Special Surrender Value then, this Policy shall not terminate and will continue with
8.5.1. Special Surrender Value will be determined by Us benefits payable under this Policy.
from time to time, in consultation with and approval 9.5. If You have availed loan under this Policy, accordingly, the
by the Authority. This Special Surrender Value will paid-in Cash Bonus option and Premium offset Cash Bonus
always be greater than or equal to the Guaranteed option as specified in Sections 3.5.1.iii.a) and 3.5.1.iii.b)
Surrender Value. The Special Surrender Value is not respectively will not be available to You and We will change
guaranteed. the Cash Bonus option to purchase Paid Up Additions
8.5.2. Special Surrender Value is the sum of: option.
i. (Reduced Paid Up Maturity Sum Assured 9.6. Upon grant of a loan under this Policy, this Policy shall
divided by 1000) multiplied by the Special automatically be assigned in Our favour, till the time the
Surrender Value Factor; entire loan amount including interest or dues towards such
loan has been repaid to Us. On repayment of the loan
cash value of accrued Paid Up Additions, if any;
ii. and accumulated interest to Us, if any, this Policy will be
and
reassigned to You. On such repayment and on receipt of
iii. cash value of Terminal Bonus, if any. Your request to change the Cash Bonus option, We will
9. LOANS change the Cash Bonus option.
9.1. Once this Policy has acquired the Surrender Value, then, 9.7. We reserve the right to recover the outstanding loan along
You will be eligible for grant of loans from Us. with the accrued interest from the benefits payable in the
case of surrender or maturity or death of the Life Insured,
9.2. The minimum amount of loan which can be granted by Us
by deducting the appropriate amounts from the benefits
under this Policy is INR 10,000 (Rupees Ten Thousand).
payable on happening of such events.
The maximum amount of loan which can be granted under
this Policy during the Policy Term shall not exceed 50% 10. GENERAL PROVISIONS
(Fifty percent) of the Special Surrender Value payable under 10.1. Free Look
this Policy, subject to such terms and conditions as may be
10.1.1. You have a period of 15 (Fifteen) days from the
determined by Us from time to time.
date of receipt of this Policy to review the terms
9.3. If You have obtained a loan under this Policy, then, You and conditions of this Policy. If You disagree to
are required to pay interest on such loan as may be any of the terms or conditions of this Policy, You
determined by Us from time to time. The interest on the have the option to return the original Policy to
loan will be compounded and applied annually on the Policy Us, by stating the objections/ reasons for such
Anniversary at 11% (Eleven percent) per annum, which rate disagreement. Upon return of this Policy by You,
may be revised by Us from time to time. this Policy shall terminate forthwith and all rights,
9.4. If the loan amount granted to You and the accumulated benefits including the death and maturity benefit and
interest on such loan exceeds the Surrender Value, this interests under this Policy shall cease immediately.
Policy will terminate. However, if You have availed a loan We will only refund the Premiums received by Us,
under this Policy and We have received all due Premiums, after deducting the proportionate risk Premium for
the period of cover, charges of stamp duty paid and
11 of 26
 the expenses incurred on medical examination of of this Policy makes or advances any claim knowing
the Life Insured, if any. it to be false or fraudulent in any way, then, We
10.2. Suicide Exclusion will cancel this Policy immediately by paying the
Surrender Value, if any, subject to such fraud being
10.2.1. Notwithstanding anything stated herein, if the Life established by Us in accordance with Section 45 of
Insured commits suicide, whether sane or insane, the Insurance Act.
within 12 (Twelve) months from the Effective Date or
the date of revival of this Policy, all risks and benefits 10.6. Nomination
under this Policy shall cease and no benefits are 10.6.1. In the Proposal Form, You can nominate a person
payable under this Policy. In such an event, We will as Your Nominee in accordance with Section 39
only pay the following to a person specified under of the Insurance Act. The person named by You
Section 4.1: in the Proposal Form or the person who has been
i. higher of the Special Surrender Value or total nominated and registered with Us at a later date as
Premiums received (excluding rider premiums, Your Nominee(s), shall be the person to whom the
if any), if the Policy has acquired a Surrender death benefit under this Policy will be paid in the
Value; or event of death of the Life Insured.
ii. the total Premiums received (excluding rider 10.6.2. A change in nomination may be made by You at
premiums, if any) by Us, if the Policy has not any time during the Policy Term by informing Us in
acquired a Surrender Value. writing and registering the same with Us.
10.6.3. Where the Nominee is a minor, You are required to
10.3. Declaration of the Correct Age
appoint an appointee to receive the benefits in the
10.3.1. Declaration of the correct Age of the Life event of the Life Insured's death during such time
Insured is important for Our underwriting process, the Nominee remains a minor. In case of a minor
before issuance of this Policy. The Premiums are Nominee, You must inform Us of the name and
calculated on the basis of the Age of the Life relationship of the appointee to receive the benefits
Insured. If the Age declared in the Proposal Form is on behalf of the minor Nominee.
found to be incorrect at any time during the Policy 10.6.4. While processing the claim request for the death
Term or at the time of claim, We may: benefit under this Policy, the Nominee will be
i. revise the Premium and/or applicable benefits required to produce all the necessary documents
payable under the Policy in accordance with to give valid discharge for the payment of the death
the premium and benefits that would have been benefit secured under this Policy.
payable, if the correct Age of the Life Insured 10.6.5. We do not express any opinion on the validity or
would have made him eligible to be covered legality of the nomination made by You.
under this Policy on the Effective Date; or
10.7. Assignment
ii. cancel the Policy by paying the Surrender
Value, if any, subject to Section 45 of the 10.7.1. You may assign this Policy either by an
Insurance Act, if the correct Age of the Life endorsement on the Policy document or by way
Insured would have made him ineligible to be of a separate legal instrument in accordance with
covered under this Policy on the Effective Date. Section 38 of the Insurance Act, in favour of
a person named by You whereby the beneficial
10.4. Full Disclosure and Incontestability interest, right and title under this Policy are
10.4.1. Insurance is a contract of utmost good faith and We transferred to such person. In either case, it must
rely and trust upon Your representations. This Policy be signed by the assignor stating the fact of
has been underwritten and issued by Us based on assignment.
the information provided by You in/ with the Proposal 10.7.2. You may assign this Policy by informing Us in
Form. In case of any concealment, non-disclosure writing, which We shall duly record upon receipt of
or fraud or misrepresentation, We shall cancel the Your information in this behalf. You should submit
Policy immediately by paying the Surrender Value, the notice of assignment (including any change
if any, subject to such concealment, non-disclosure, thereof) for registration with Us.
fraud or misrepresentation being established by Us 10.7.3. An absolute assignment shall automatically cancel
in accordance with Section 45 of the Insurance Act. a nomination except any assignment in Our favour,
10.4.2. We also draw Your attention to Section 45 of the in accordance with Section 39 of the Insurance Act.
Insurance Act which states as follows: 10.7.4. In registering an assignment, We do not accept
"No policy of life insurance effected after the expiry of two years any responsibility or express any opinion as to its
from the date on which it was effected be called in question validity or legality.
by an insurer on the ground that a statement made in the 10.7.5. Assignment is not permitted if this Policy is taken
proposal form for insurance or in any report of a medical officer, under the Married Women's Property Act, 1874.
or referee, or friend of the insured, or in any other document 10.7.6. If this Policy is assigned to any person other than
leading to the issue of the policy, was inaccurate or false, an individual by You, then, the Cash Bonus option
unless the insurer shows that such statement was on a material shall automatically be changed by Us to purchase
matter or suppressed facts which it was material to disclose and Paid Up Addition option as specified in Section
that it was fraudulently made by the policyholder and that the 3.5.1.iii.c) irrespective of any other option that may
policyholder knew at the time of making it that the statement have been chosen by You.
was false or that it suppressed facts which it was material to
disclose. 10.8. Upon Death of Policyholder and Change in
Policyholder
Provided that nothing in this section shall prevent the insurer
10.8.1. If You and the Life Insured are different then,
from calling for proof of age at any time if he is entitled to do so,
upon Your death, no benefits shall become payable
and no policy shall be deemed to be called in question merely
under this Policy and the Cash Bonus option shall
because the terms of the policy are adjusted on subsequent
automatically be changed by Us to purchase Paid
proof that the age of the life insured was incorrectly stated in
Up Addition option as specified in Section 3.5.1.iii.c)
the proposal."
irrespective of any option that may have been
10.5. Fraud chosen by You. Your legal heirs may continue to
10.5.1. If You or anyone acting at Your direction or within avail the benefits under this Policy, by paying the
Your knowledge, or any person under or in respect due Premiums to Us and by submitting the requisite
12 of 26
 documents as specified by Us and subject to other 10.11.3. You have an option to revive a Policy under
conditions prescribed by Us from time to time. Reduced Paid Up Mode, within 2 (Two) years from
10.8.2. You may request Us to make the Life Insured, the the due date of the first unpaid Premium, by:
Policyholder under the Policy by giving Us prior i. requesting Us in writing;
written notice provided that the Life Insured shall ii. paying all the overdue Premiums (along with
not become the Policyholder unless the Life Insured the service tax or any other taxes, cesses or
meets all our eligibilty criteria in accordance with levies, if any), together with interest and/ or late
Our guidelines and policies and We have issued fee as determined by Us from time to time; and
a written endorsement under the Policy confirming
the change in Policyholder. iii. submitting an evidence of insurability at Your
own cost which is acceptable to Us.
10.8.3. From the date of Our written endorsement
confirming the Life Insured as the Policyholder, 10.11.4. The revival of the Policy under the Reduced Paid
You shall automatically cease to have any rights, Up Mode shall take effect only after We have
benefits or obligations under the Policy and all approved the same in accordance with Our board
rights, benefits and obligations shall vest entirely approved underwriting policy and communicated
with the Life Insured. Our decision to You in writing. All accrued
bonus(es) and original benefits including death,
10.9. Grace Period survival and maturity benefits which were originally
10.9.1. We will allow a grace period of 15 (Fifteen) days payable will be restored on such revival. However,
if You have chosen monthly mode for payment no interest shall be payable by Us on such
of the Premium and 30 (Thirty) days, if You have restoration.
chosen any other mode, from the due date of the 10.11.5. If a Policy under Reduced Paid Up Mode is not
unpaid Premium, for paying the overdue Premium revived within the prescribed period as specified in
to Us. During the grace period, We will accept Section 10.11.3, then, the Policy under Reduced
the overdue Premium without any interest and the Paid Up Mode cannot be revived and will continue
insurance coverage under this Policy will continue. to be under Reduced Paid Up Mode for the
10.9.2. During the grace period, if the overdue Premium remaining part of the Policy Term.
is not paid and the Life Insured dies, then, We 10.12.Electronic Transactions
will pay the death benefit under this Policy, after
deducting the said overdue Premium from the 10.12.1. You will comply with all such terms and conditions
amount payable under this Policy. as prescribed by Us from time to time, and
all transactions effected by or through facilities
10.10.Lapsation of Policy for conducting remote transactions including
10.10.1. Subject to Section 3.4, if the Premium (along with the internet, world wide web, electronic data
the service tax or any other taxes, cesses or levies, interchange, call centres, tele-service operations
if any) is not received by Us by the end of the grace (whether voice, video, data or any combination
period as specified in Section 10.9 above, this thereof) or by means of electronic, computer,
Policy shall lapse and no benefits under Section 3 automated machines network or through other
shall be payable under this Policy and no rights can means of telecommunication, established by Us or
be exercised by You till the revival of the Policy. on Our behalf, for and in respect of this Policy, or in
10.10.2. If You revive this Policy in accordance with Section relation to any of Our products and services, shall
10.11 below, then, the benefits and the rights under constitute legally binding and valid transactions
this Policy shall be revived. when executed in adherence to and in compliance
10.10.3. However, if this Policy has acquired a Surrender with the terms and conditions for such facilities, as
Value and upon non-payment of the overdue may be prescribed by Us from time to time.
Premiums by You till the expiry of the grace period 10.13.Amendment
as specified in Section 10.9 above, then, this Policy 10.13.1. No amendments to this Policy will be effective,
shall not lapse and shall by default become a Policy unless such amendments are expressly approved
under Reduced Paid Up Mode. in writing by Us.
10.11. Revival of Policy 10.14.Administrative and Judicial Intervention
10.11.1. A lapsed Policy can be revived at Our discretion, 10.14.1. If any administrative or judicial body imposes any
within 2 (Two) years from the due date of the first condition on this Policy for any reason, We are
unpaid Premium: bound to follow the same which may include
i. on receipt of Your written request to revive this suspension of all benefits and obligations under
Policy by Us; this Policy.
ii. if You produce an evidence of insurability at 10.15.Force Majeure
Your own cost which is acceptable to Us; and 10.15.1. If Our performance or any of Our obligations are in
iii. on payment of all overdue Premiums (along any way prevented or hindered as a consequence
with the service tax or any other taxes, cesses of any act of God or State, strike, lock out,
or levies, if any) to Us with late fee and/ or legislation or restriction by any government or any
interest at such a rate as may be determined other authority or any other circumstances beyond
by Us from time to time. Our anticipation or control, the performance of this
10.11.2. The revival of the lapsed Policy shall take Policy shall be wholly or partially suspended during
effect only after We have approved the same in the continuance of such force majeure. Under an
accordance with Our board approved underwriting intimation/approval of the Authority, We will resume
policy and communicated to You in writing. All the Our obligations under the Policy, to the extent
accrued Cash Bonus(es) and the benefits under possible, after the force majeure conditions ceased
the lapsed Policy shall be revived upon such revival to exist even for the period during which the force
without interest. If a lapsed Policy is not revived majeure conditions existed.
within the prescribed period allowed for revival, 10.16.Other Restrictions
this Policy shall terminate on the expiry of such
10.16.1. This Policy contains no restrictions as to travel or
prescribed period for revival.
occupation.

13 of 26
11. TERMINATION OF POLICY or as communicated by You and registered by Us. We
will send You the notices by post, courier, hand delivery,
11.1. This Policy shall terminate upon the happening of any of the
fax or e-mail/electronic mode or by any other means as
following events:
determined by Us. If You change Your address, or if
i. on the date on which We receive free look cancellation the address of the Nominee changes, You must notify
request as per Section 10.1 from You; or Us immediately and should ensure that the updated
ii. upon payment of the death benefit to a person as information has reached Us.
specified in Section 4.1 or the date of intimation of 14. GOVERNING LAW AND JURISDICTION
repudiation of the claim by Us in accordance with the
provisions of this Policy; or 14.1. Indian law shall govern this Policy and the relationship
between You and Us.
iii. if this Policy has not acquired a Surrender Value and the
due Premiums have not been received by Us, on the 14.2. This Policy and all rights, obligations and liabilities arising
expiry of the prescribed period for revival of the lapsed hereunder, shall be enforced in accordance with the laws
Policy, in accordance with Section 10.11.2; or of India.
iv. on the date of surrender of this Policy; or 14.3. The competent courts in India shall have exclusive
jurisdiction in all matters and causes arising out of this
v. on the Maturity Date; or
Policy.
vi. if the loan and accumulated interest exceeds the
Surrender Value payable in accordance with Section
9.4.
12. DISPUTE REDRESSAL PROCESS UNDER THE POLICY
12.1. All consumer grievances and/or queries may be first
addressed to Our customer helpdesk as mentioned below
or to the office address as mentioned in the Schedule:
Max Life Insurance Company Limited
Plot No. 90A, Sector 18, Gurgaon, 122015, Haryana, India
Tel No : 0124-4219090
Email : axis.helpdesk@maxlifeinsurance.com
12.2. In case You are not satisfied with the decision of the above
office, or have not received any response within 10 (Ten)
days, You may contact by way of a written complaint signed
by You/ complainant or by Your/complainant's legal heirs
with full details of the complaint and Your/complainant's
contact information, to the following official for resolution:
Head Operations and Customer Services
Max Life Insurance Company Limited
Plot No. 90A, Sector 18,
Gurgaon, 122015, Haryana, India.
Toll free No. - 1800-200-4006
Email : manager.services@maxlifeinsurance.com
12.3. In case You are not satisfied with Our decision, or have
not received any reply from Us within a period of 1 (One)
month, You may approach the Insurance Ombudsman at
the address mentioned in Annexure A or at the Authority's
website www.irda.gov.in, if Your grievance pertains to:
i. any partial or total repudiation of claims by Us; or
ii. any dispute on the legal construction of the Policy in so
far as such disputes relate to claims; or
iii. delay in settlement of claim; or
iv. any dispute with regard to Premium paid or payable in
terms of this Policy; or
v. non issuance of any insurance document to customers
after receipt of Premium.
12.4. As per provision 13(3) of the Redressal of Public
Grievances Rules 1998, a complaint to the Insurance
Ombudsman can be made within a period of 1 (One) year
after the insurer has rejected the representation or sent
its final reply on the representation of the complainant,
provided the complaint is not on the same matter, for which
any proceedings before any court, or consumer forum or
arbitrator is pending.
13. COMMUNICATION & NOTICES
13.1. Our contact details are mentioned in Section 12.1
of this Policy. For any updates, please visit Our
website www.maxlifeinsurance.com. You should mention
the correct Policy number for all communications made by
You to Us and for all Premium remittances made by You.
13.2. All notices meant for Us must be in writing and delivered to
Our address as mentioned in Section 12.1 above, or such
other address as We may notify from time to time.
13.3. All notices meant for You will be in writing and will be
sent by Us to Your address as shown in the Schedule
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ENDORSEMENT

Total stamp value : `426.81

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 APPENDIX A: List of Ombudsman
Office of the Contact Details Areas of Jurisdiction
Ombudsman
Ahmedabad Shri P Ramamoorthy,Office of the Insurance Ombudsman, 2nd floor, Ambica House, Near C.U. Gujarat and Union Territories
Shah College, 5, Navyug Colony, Ashram Road, Ahmedabad - 380 014. of Dadra & Nagar Haveli and
Tel.:- 079-27546150/139 Daman and Diu.

Fax:- 079-27546142
Email:-ins.omb@rediffmail.com
Bhopal Shri Raj Kumar Srivastava, Office of the Insurance Ombudsman, Janak Vihar Complex, 2nd Madhya Pradesh and
Floor, 6, Malviya Nagar, Opp. Airtel, Bhopal - 462 011. Chattisgarh.
Tel.:- 0755-2769200/201/202
Fax:- 0755-2769203
Email:-bimalokpalbhopal@gmail.com
Bhubaneshwar Shri B N Mishra, Office of the Insurance Ombudsman, 62, Forest park, Bhubneshwar - 751 009. Orissa.
Tel.:- 0674-2596461/2596455
Fax:- 0674-2596429
Email:-ioobbsr@dataone.in
Chandigarh Sh. Manik B. Sonawane, Office of the Insurance Ombudsman, S.C.O. No. 101, 102 & 103, 2nd Punjab, Haryana, Himachal
Floor, Batra Building, Sector 17 - D, Chandigarh - 160 017. Pradesh, Jammu & Kashmir
Tel.:- 0172-2706196/5861/6468 and Union territory of
Chandigarh.
Fax:- 0172-2708274
Email:-ombchd@yahoo.co.in
Chennai Sh. Virander Kumar, Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor, 453 Tamil Nadu and Union
(old 312), Anna Salai, Teynampet, CHENNAI - 600 018. Territories - Pondicherry
Tel.:- 044-24333678/664/668 Town and Karaikal (which
are part of Union Territory of
Fax:- 044-24333664 Pondicherry).
Email:-chennaiinsuranceombudsman@gmail.com
New Delhi Ms. Sandhya Baliga, Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Delhi and Rajasthan.
Asaf Ali Road, New Delhi - 110 002.
Tel.:- 011-23239611/7539/7532
Fax:- 011-23230858
Email:-iobdelraj@rediffmail.com
Guwahati Shri D.Choudhury, Office of the Insurance Ombudsman, ''Jeevan Nivesh'', 5th Floor, Near Assam, Meghalaya, Manipur,
Panbazar over bridge, S.S. Road, Guwahati - 781001 (ASSAM). Mizoram, Arunachal Pradesh,
Tel.:- 0361-2132204/2131307/2132205 Nagaland and Tripura.

Fax:- 0361-2732937
Email:- ombudsmanghy@rediffmail.com
Hyderabad Sh. G. Rajeswara Rao, Office of the Insurance Ombudsman, 6-2-46, 1st floor, "Moin Court" Lane Andhra Pradesh, Karnataka
Opp. Saleem Function Palace, A. C. Guards, Lakdi-Ka-Pool, Hyderabad - 500 004. and Union Territory of Yanam -
Tel.:- 040-23325325/23312122 a part of the Union Territory of
Pondicherry.
Fax:- 040-23376599
Email:-insombudhyd@gmail.com
Kochi P K Vijaya Kumar, Office of the Insurance Ombudsman, 2nd Floor, CC 27 / 2603, Pulinat Kerala and Union Territory of
Building, Opp. Cochin Shipyard, M. G. Road, Ernakulam - 682 015. (a) Lakshadweep (b) Mahe-a
Tel.:- 0484-2358734/759/9338 part of Union Territory of
Pondicherry.
Fax:- 0484-2359336
Email:- iokochi@asianetindia.com
Kolkata Shri. K B Saha, Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 4, C.R. Avenue, West Bengal, Bihar, Sikkim,
4th Floor, KOLKATA - 700 072. Jharkhand and Union
Tel : 033-22124346/22124339 Territories of Andaman and
Nicobar Islands.
Fax : 033-22124341
Email:-insombudsmankolkata@gmail.com
Lucknow Shri N P Bhagat, Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Uttar Pradesh and
Nawal Kishore Road, Hazratganj, Lucknow-226 001. Uttaranchal.
Tel.:- 0522-2201188/31330/1
Fax:- 0522-2231310
Email:-insombudsman@rediffmail.com
Mumbai Sh. A.K. Dasgupta, Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe S.V. Maharashtra and Goa.
Road, Santacruz (W) Mumbai - 400 054.
Tel.:- 022-26106928/360/6552/6960
Fax:- 022-26106052
Email:- ombudsmanmumbai@gmail.com

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 INSURANCE PREMIUM RECEIPT
Policy Number: 256886300 Date: 23-Mar-2015
Name: Mr. Venkata Satyanarayana Rajusivangi Base Life Insured: MR. VENKATA
SATYANARAYANA RAJUSIVANGI
Address: FLAT 406 GOKUL APTS Receipt Number: 256886300 /2014-15/01
B S MAQTA STREET BEGUMPET,. Your Agent Advisor: Axis Bank Ltd Road No.2 Banjara Hills
Hyderabad - 500016
Telangana General Office AXIS BANK LTD Road No.2, Banjara Hills

Telephone: 9542622222,9676398685,

Dear Mr. Venkata Satyanarayana Rajusivangi,

Thank you for choosing Max Life Insurance. This is to acknowledge receipt of your premium as per details below.
Should you need any further assistance, please call our Customer Help Line - 1800-200-4006 (Toll free from any network). You can
also email at axis.helpdesk@maxlifeinsurance.com

Yours Sincerely,
for Max Life Insurance Co. Ltd. Affix
Re1
revenue
stamp
Authorized Signatory

SUMMARY OF POLICY INFORMATION

Plan Premium paid For Due Date Frequency Effective Date
inclusive of of Coverage
Service Tax # ***
Max Life Life Gain Premier 1,99,999.38 26-Feb-2015 Annual 26-Feb-2015
Total 1,99,999.38
Minimum Guaranteed Death Benefit of base plan and term rider (if any) : RS 21,34,051.04

Next Premium Due on - 26-FEB-2016

Note: || # Subject to realisation of monies. Commencement of risk shall be effective from the date of acceptance of risk. || *** Premium paid towards covering
life of specified person would be eligible for deduction under provisions of Section 80C / 80CCC / 80D of Income Tax 1961, as per applicability and subject to
levies under prevailing Tax Laws. || Service tax and Education cess would be applicable on the premium as per prevailing service tax rate. || We request you
to please consult with your tax consultant for more information.

Max Life Insurance Company Limited

Plot No. 90A, Sector 18, Gurgaon, 122015, Haryana, India
Customer Help Line -1800-200-4006 (Toll free from any network)
Regd Office: Max House, 3rd Floor, 1 Dr. Jha Marg, Okhla, New Delhi 110 020, India
Visit us at: www.maxlifeinsurance.com E-mail: axis.helpdesk@maxlifeinsurance.com
Service Tax Regn. No. AACCM3201EST001
PRM20 V1.5 24052005
E.&O.E

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