Bajaj Allianz InvestGain_Ver 2

7/29/2019 Bajaj Allianz InvestGain_Ver 2

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FOR INTERNAL CIRCULATION ONLY

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PRODUCT CIRCULAR

BAJAJ ALLIANZ INVESTGAIN

VERSION: 2

Product Development Department




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TABLE OF CONTENTS

1. PRODUCT TYPE..................................................................................................... 3

2. PRODUCT PACKAGING......................................................................................... 3

3. ELIGIBILITY AND LIMITS ...................................................................................... 4

4. LIMITED PREMIUM PAYMENT TERMS ................................................................... 4

5. ISSUE AGE: ........................................................................................................... 4

6. JOINT LIFE AVAILABILITY..................................................................................... 4

7. BONUS ................................................................................................................. 5

8. MATURITY BENEFIT.............................................................................................. 5

9. DEATH BENEFIT.................................................................................................... 5

10. ADDITIONAL BENEFITS..................................................................................... 5

11. IN-BUILT BENEFITS ........................................................................................... 8

12. INCREASE IN DEATH COVERAGE....................................................................... 9

13. FLEXIBILITY IN COVERAGE................................................................................ 9

14. EXCLUSIONS ..................................................................................................... 9

15. NON DISCLOSURE............................................................................................11

16. PREMIUMS.......................................................................................................11

17. PAID-UP VALUES..............................................................................................13

18. POLICY LOAN ..................................................................................................13

19. TAXATION .......................................................................................................13

APPENDIX A ...............................................................................................................14




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1. PRODUCT TYPE This is a participating endowment plan (with Limited Premium Payment term Options) withminimum guaranteed benefits at maturity or death, whichever is earlier. The guaranteed minimumdeath or maturity benefit will be the “sum assured”. Besides, the policyholder can opt for riders like –Family Income Benefit, Comprehensive Accident Protection (comprising Accidental Death Benefit,Accidental Permanent Partial & Total Disability Benefit, Waiver of Premium Benefit), Critical Illness

Benefit, Hospital Cash Benefit and Mahila Gain

2. PRODUCT PACKAGING There are 4 product packages available:

Package In-Built Benefits Additional Benefits

InvestGain Economy Base Package

InvestGain Gold Base Package + Inbuilt TermCover (Additional DeathBenefit)

InvestGain Diamond Base Package + Inbuilt DoubleTerm Cover (Additional DeathBenefit)

InvestGain Platinum Base Package + Inbuilt TripleTerm Cover (Additional DeathBenefit)

Family Income Benefit,Comprehensive AccidentProtection, Critical IllnessBenefit, Hospital Cash Benefitand Mahila Gain availablewith all packages.

BAJAJ ALLIANZ INVESTGAIN – ECONOMY Base package. The customer may select any 1,2 3 or 4 or any combination or all of the followingadditional benefits:

a) Family Income Benefitb) Comprehensive Accident Protectionc) Critical Illness Benefitd) Hospital Cash Benefit

e) Mahila GainOf the above 5 Additional benefits, only Family Income benefit will be available for the limited premium payment terms. The other 4 additional benefits will not be available for the limited premium payment terms.

BAJAJ ALLIANZ INVESTGAIN – GOLD Base Package + Term Cover In-Built. The customer may select any 1,2 3 or 4 or any combination or allthe following additional benefits:

a) Family Income Benefitb) Comprehensive Accident Protectionc) Critical Illness Benefitd) Hospital Cash Benefite) Mahila Gain

Of the above 5 Additional benefits, only Family Income benefit will be available for the limited premium

payment terms. The other 4 additional benefits will not be available for the limited premium payment terms.

BAJAJ ALLIANZ INVESTGAIN – DIAMOND Base Package + Double Term Cover In-Built. The customer may select any 1,2 3 or 4 or anycombination or all of the following additional benefits:

a) Family Income Benefitb) Comprehensive Accident Protectionc) Critical Illness Benefitd) Hospital Cash Benefite) Mahila Gain




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Of the above 5 Additional benefits, only Family Income benefit will be available for the limited premium payment terms. The other 4 additional benefits will not be available for the limited premium payment terms.

BAJAJ ALLIANZ INVESTGAIN – PLATINUM Base Package + Triple Term Cover In-Built. The customer may select any 1,2 3 or 4 or any combinationor all of the following additional benefits:

a) Family Income Benefit

b) Comprehensive Accident Protectionc) Critical Illness Benefitd) Hospital Cash Benefite) Mahila Gain

Of the above 5 Additional benefits, only Family Income benefit will be available for the limited premium payment terms. The other 4 additional benefits will not be available for the limited premium payment terms.

3. ELIGIBILITY AND LIMITS

Conditions InvestGain Economy InvestGain Gold /Diamond/ Platinum

Minimum Age at Entry 0 (Risk Commences at age 7) 18

Maximum Age at Entry 65 50

Maximum Age at Maturity 70 70Minimum Term 5

Maximum Term 40

Minimum Sum Assured 50000

Maximum Sum Assured No Limit

Minimum Premium Limits Rs. 5000 for Annual Mode, Rs. 3000 for H Yearly, Rs. 3000 for Quarterly,Rs. 700 for Monthly.

Premium Payment Term Equal to the policy term or limited as per the table given.

Issue ages 18 up to 50 for all the additional benefits viz. Family Income Benefit (FIB),Comprehensive Accident Protection, Critical Illness and Hospital Cash.

Comprehensive Accident Protection, Critical Illness and Hospital Cash coverage expires at attainedage 65.

4. LIMITED PREMIUM PAYMENT TERMS There will be an option to select limited premium payment terms as given below.

Policy Term Premium Payment Terms Available

5-9 2 3

10-14 2 3 5

15-19 2 3 5 7 10

20-24 2 3 5 7 10 12

25 and above 2 3 5 7 10 12 15

5. ISSUE AGE:The issue age of the policyholder is calculated as age attained (i.e. age last birthday) as on the date ofcommencement of the related benefit.

6. JOINT LIFE AVAILABILITY Single life only.




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7. BONUS

Reversionary Bonus: After every valuation under sec. 13 of the Insurance Act 1938, at the end of eachfinancial year the Company may declare a rate of reversionary bonus expressed as a percentage. Thispercentage shall be applied to the sum assured plus existing declared reversionary bonuses todetermine the amount of reversionary bonus to be added to the policy at the year-end. The bonus willaccrue during the policy term. No bonus will accrue on lapsed policies.

Interim Bonus: In the event of a death claim part way through a financial year or before the valuationresult is declared, an interim bonus may be payable as per the actuary’s recommendation.

Terminal Bonus: On Life Assured surviving to the end of the Premium Term or on death of lifeassured after 15 (fifteen) policy years but before the end of Premium payment term along with thepayment of the vested bonuses the Company may pay terminal bonus for in force policies as per thenorms applicable at that time.

8. MATURITY BENEFIT In case of survival to maturity, the policyholder will receive the sum assured plus declared compound

reversionary bonuses plus a possible terminal bonus as a lump sum.

9. DEATH BENEFIT The payouts in case of death will be the sum assured plus declared compound reversionary bonusesplus interim bonus (the bonus amounts being the amount accrued from the sum assured plus bonusesthereon). However, if the insured person’s age is below 7 at the time of death, then the death benefit equals the sum of all premiums paid . In case of death after 15 full policy years, the company may payterminal bonus for in-force policies. The policy terminates on death of the life assured.

InvestGainEconomy

InvestGain Gold InvestGainDiamond

InvestGainPlatinum

Benefit Payable incase of death

Sum assured +Accrued Bonuses

Double sumassured + AccruedBonuses

Triple sum assured+ Accrued Bonuses

Quadruple sumassured + AccruedBonuses

10. ADDITIONAL BENEFITS The plan provides the option to choose from 5 additional rider benefits at each Policy Anniversary

a) Comprehensive Accident Protection Benefitb) Hospital Cash Benefitc) Critical Illnessd) Family Income Benefite) Mahila Gain

“Comprehensive Accident Protection benefit” can be included and excluded at each policyanniversary, but once excluded cannot be included again. Hospital Cash Benefit (HCB) and CriticalIllness (CI) can be taken at inception only. HCB & CI can be reduced or excluded subsequently at anypolicy anniversary. Once reduced or excluded, they cannot be increased or included subsequently.

(i)Comprehensive Accidental Protection

Comprehensive Accidental Protection constitutes of a combination of 3 riders

a) Accidental Death Benefit

b) Accidental Permanent Total / Partial Disability Benefit




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c) Waiver of Premium

a) Accidental Death Benefit

. The accidental death coverage can only be chosen if the issue age of the policyholder is not less than18 and not more than 50 years. The coverage is provided until the age being 65. the additionalamount payable in the event of accidental death will be the lower of:

The basic sum assured, or Rs.50,00,000 under all the policies of the policyholder taken together.

The accidental death benefit shall be payable if the policy is in force for the full sum assuredDeath must occur within 180 days from the date of accident as a direct result of the accident.

InvestGainEconomy

InvestGain Gold InvestGainDiamond

InvestGainPlatinum

Benefit Payable incase of death dueto Accident

Double sumassured + AccruedBonuses

Triple sum assured+ Accrued Bonuses

Four times sumassured + AccruedBonuses

Five times sumassured + AccruedBonuses

b) Accidental Permanent Total / Partial Disability Benefit Rider

i. Minimum Sum Assured: Rs.50,000ii. Maximum Sum Assured: Rs.5,000,000 (for all policies taken together)

iii. Minimum Entry Age: 18 Years last birthday

iv. Maximum Entry Age: 50 Years last birthday

v. Maximum Maturity Age: 65 Years last birthday

The amount payable in the event of accidental permanent partial disability as a result of an accidentwithin 180 days from the date of the accident will be the lower one of:

a) 50 % of the Sum Assured of the base plan

b) Rs 25,00,000 under all the policies of the Policyholder taken together

i) If the Policyholder did not receive a benefit for accidental permanent partial disability before, the

amount payable in the event of accidental permanent total disability will be the lower one of:

a) The Sum Assured of the base plan

b) Rs 50,00,000 under all the policies of the Policyholder taken together

ii) If the Policyholder did receive a benefit for accidental permanent partial disability before and the

time passed from the occurrence of the partial disability is less than one Year, the amount payable in

the event of accidental permanent total disability will be the lower one of:

a) 50 % of the Sum Assured of the base plan

b) Rs 25,00,000 under all the polices of the Policyholder taken together

iii) If the Policyholder did receive a benefit for accidental permanent partial disability before and the

time passed from the occurrence of the partial disability is at least one Year, the amount payable in the

event of accidental permanent total disability will be the lower one of:

a) The Sum Assured of the base plan

b) Rs 50,00,000 under all the polices of the Policyholder taken together




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The Policyholder has the option to receive the benefit either as a lump sum or as a 10-Year guaranteed

annuity, the annual annuity being 11 % of the total amount payable. The payment mode of the

annuity is annually in advance. In case the insured person dies within the annuity payment period,

the discounted value of the unpaid instalments will be paid as a lump sum to the nominee and the

Policy terminates.

In the event of accidental permanent total/partial disability all other insurance coverage remains,

except hospital cash benefit, if included

c) Waiver of premium benefitThe waiver of premium benefit can only be chosen if the issue age of the policyholder is not less than18 and not more than 50 years. If selected, coverage is provided until the age being 65. In the event ofaccidental permanent total disability (as described above) the premium for all benefits are waived,and hospital cash benefit, if included, ceases the full insurance coverage for all benefits remains.The waiver of premium benefit shall be avaialableif the policy is in force for the full sum assured andthe claim for accidental permanent total disability is admitted by the company.

(ii) HOSPITAL CASH BENEFIT

The daily hospital cash amount shall be at Rs. 4 per Rs. 1000 sum assured subject to a minimum sumassured of Rs. 50000 and maximum sum assured of Rs. 2,50,000 or the basic sum assured, whichever islower. The hospital cash benefit will only be offered if the issue age of the life assured is not less than18 (eighteen) and not more than 50 (fifty) years. Coverage shall be provided until the age being thematurity age or 65(sixty five) whichever is earlier.

If the insured person has to stay for more than 72 (seventy two) hours in hospital as a result of injury,sickness or disease, the company reimburses for each full day an amount which is the lower one of:

(a) 75 % (seventy five percent) of the room charge in hospital;(b) the daily hospital cash amount.

For every period of hospitalisation during a policy year, the first three days would not be paid for. The

total number of days for which hospital cash would be payable in a policy year would be restricted to60 (sixty) days in a policy year, irrespective of the number of days of hospitalisation. The benefitperiod starts after a waiting period of 60 (sixty) days from the commencement of risk or reinstatementof risk.

(iii) CRITICAL ILLNESS RIDERa. Minimum Sum Assured: Rs.50,000b. Maximum Sum Assured: Should be equal to Basic Sum Assured

c. Minimum Entry Age: 18 Years last birthday

d. Maximum Entry Age: 50 Years last birthday

e. Maximum Maturity Age: 65 Years last birthday

In case the policyholder is diagnosed to have a critical illness and the policy is in force for the full sumassured, the company pays critical illness benefit equal to the Sum Assured. The policy will continue

with all other benefits excluding Critical illness benefit and Hospital cash benefit and the premiumswill be payable accordingly. However, where the life assured dies within 60 days from such diagnosisfor which critical illness benefit has become payable, the death benefit will be payable after deductionof the critical illness benefit.

There is a waiting period of 6 months, i.e. the critical illness benefit can only be claimed if the illness isdiagnosed at least 6 months after the date of commencement of risk or reinstatement of risk. Nobenefit is payable until the insured person has provided satisfactory proof to the company of theoccurrence of the relevant critical illness. This includes a diagnosis confirmed by a registered Medical




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Practitioner appointed by the company and must be supported by acceptable clinical, radiological,histological and laboratory evidence. For the definition of critical illness see Annexure I.

(IV) FAMILY INCOME BENEFIT If this benefit is selected, in case of death or accidental total permanent disability of the Life Assuredduring the term of the policy, ALL FUTURE PREMIUMS ARE WAIVED and a monthly familyincome benefit of 1% of the sum assured is payable for a period till the end of the policy term, or

for 10 years, whichever is higher, subject to the Family Income benefit not running beyond thecalculated age of 70 of the life assured. However, this benefit will not be available in the event ofaccidental permanent total disability happening after age 65 of the Life Assured.The Family Income Benefit can only be chosen if the issue age of the Life Assured is not less than 18and not more than 50 years.

The Family Income Benefit is available for the premium payment terms (where PPT = Policy term aswell as Limited Premium Payment Term)

Family Income Benefit is payable only if the policy is in force for the full Sum Assured.

(V) MAHILA GAINMahilaGain Rider is available in two combinations. It should be taken at inception only.

Combination 1: Critical Illness Benefit, Reconstructive Surgery Benefit for Breast(s) due to BreastCancer, Congenital Disability Benefit, and Complications of Pregnancy Benefit.Combination 2: Critical Illness Benefit & Reconstructive Surgery Benefit for Breast(s) due to BreastCancer.

Benefit Minimum Ageat Entry

Maximum Age atEntry

Maximum Age atexpiry of the benefit

Critical Illness Benefit, ReconstructiveSurgery Benefit for Breast(s) due toBreast Cancer, Congenital DisabilityBenefit, Complications of PregnancyBenefit

18 40 45

Critical Illness Benefit & ReconstructiveSurgery Benefit for Breast(s) due to

Breast Cancer:

18 45 55

11. IN-BUILT BENEFITS

TERM COVER The term cover is in-built into 3 packages in the following manner.

InvestGain Gold InvestGain Diamond InvestGain Platinum

Term Cover Single Term Cover Double Term Cover Triple Term Cover

Amount Payable onDeath

Double Sum Assured+ Bonuses

Triple Sum Assured +Bonuses

Quadruple SumAssured + Bonuses

The term cover can only be chosen if the issue age of the life assured is not less than 18 and not morethan 50 years.




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12. INCREASE IN DEATH COVERAGE The policyholder has the option to include additional death coverage of 50% of the basic sumassured at each of the following three occasions: marriage, birth of the first child and

birth of the second child.The additional death coverage is not subject to underwriting. The premium for the additional

death coverage will be based on rates available at that time. The additional death coverage doesnot increase the basic sum assured or the Double/Triple/Quadruple Cover INBUILT INTOInvestGain GOLD/DIAMOND & PLATINUM.

13. FLEXIBILITY IN COVERAGE At each policy anniversary the policyholder has the option to adjust his coverage level of theadditional benefits. The possible adjustments are: inclusion of coverage not selected before orexclusion of coverage, subject to conditions relating to such inclusions and exclusion.

Comprehensive Accident Protection i.e. Accidental death benefit, Accidental permanent total &partial disability benefit and Waiver of premium benefit have to be taken together. Thiscombination can be included and excluded at any policy anniversary.

Family Income Benefit, Critical illness benefit, Hospital cash benefit and MahilaGain will have tobe selected at issue only. These additional benefits cannot be included at any policy anniversarysubsequently if not selected at inception. However, if selected at issue, these additional benefitscan be removed or reduced at a later policy anniversary. Once the policyholder opts out orreduces any of these benefits, he cannot select it again in future or increase it again in future.

However, in case of the life assured being a minor at the time of commencement of the policy, weshall provide the option of adding both these benefits on attaining age 18, subject to medicalunderwriting.

In case of reduction or exclusion, no surrender value is paid. Coverage is included at thepublished premium rates available at the time of inclusion.

14. EXCLUSIONS

i) The death cover is subject to the following exclusions:Suicide within one year from commencement of risk, whether sane or not.In case of the above, all paid premiums are refunded.

ii) In the following cases the death benefit will be paid but the accidental death benefit will not bepaid:

(a) Death occurs as a result of the insured person committing any breach of law(b) Death as a consequence of the insured person being under the influence of alcohol or

drugs other than in accordance with the directions of a registered medical practitioner(c) Death as a result of self-inflicted injuries whilst sane or insane

(d) Death occurs as s result of the insured person taking part in any naval, military or airforce operation during peace time

(e) Death occurs as a result of the insured person participating in or training for anydangerous or hazardous sport or competition or riding or driving in any form of race orcompetition

(f) Death occurs as a result of suicide after the first policy year(g) Death occurs as a result of aviation, gliding or any form of aerial flight other than as a fare

paying passenger of a recognised airline on regular routes and on a scheduled timetable(h) Failure to seek or follow medical advice(i) Death occurs as results of war, invasion, civil war, rebellion, and riot.




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iii) In the following cases the disability benefit and waiver of premium benefit will not be paid:

(a) Disability occurs as a result of the insured person committing any breach of law(b) Disability as a result of war, invasion, civil war or rebellion(c) Disability as a consequence of the insured person being under the influence of alcohol or

drugs other than in accordance with the directions of a registered medical practitioner(d) Disability occurs as s result of the insured person taking part in any naval, military or air

force operation(e) Disability occurs as a result of the insured person participating in or training for any

dangerous or hazardous sport or competition or riding or driving in any form of race orcompetition

(f) Disability occurs as a result of aviation, gliding or any form of aerial flight other than as afare paying passenger of a recognised airline on regular routes and on a scheduledtimetable

(g) Disability occurs as a result of attempted self injury whilst sane or insane(h) Failure to seek or follow medical advice

iv) In the following cases the critical illness benefit will not be paid:(a) Critical illness occurs as a result of the insured person committing any breach of law

(b) Critical illness or the related symptoms existed at the date of commencement orreinstatement of risk

(c) Critical illness is diagnosed within 6 months of the date of commencement orreinstatement

(d) Critical illness as a result of AIDS, any AIDS related illness or HIV infection(e) Critical illness as a result of self-inflicted injuries whilst sane or insane(f) Critical illness as a result of war, invasion, civil war or rebellion(g) Critical illness as a consequence of the insured person being under the influence of alcohol

or drugs other than in accordance with the directions of a registered medical practitioner(h) Critical illness occurs as s result of the insured person taking part in any naval, military or

air force operation(i) Critical illness occurs as a result of the insured person participating in or training for any

dangerous or hazardous sport or competition or riding or driving in any form of race or

competition(j) Critical illness occurs as a result of aviation, gliding or any form of aerial flight other than

as a fare paying passenger of a recognised airline on regular routes and on a scheduledtimetable

(k) Failure to seek or follow medical advice

v) The hospital cash benefit will not be paid if the hospital confinement is due to:(a) Routine eye tests, dental treatment or other examination and/or tests not incidental to the

treatment or diagnosis of an injury, sickness or disease(b) War, invasion, civil war, rebellion(c) Pregnancy, miscarriage (except as a result of an accident), impotency, sex change,

abortion or birth control

(d) Sleep disorder, psychiatric or mental disorders.(e) Self-inflicted injuries or attempted suicide while sane or insane(f) AIDS, any AIDS related illness or HIV infection(g) Prostheses, cosmetic surgery or reconstructive surgery unless as a result of an accidental

injury(h) Any pre-existing conditions(i) Any injury, sickness or disease received as a result of the insured person committing any

breach of law




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(j) Any injury, sickness or disease received as a result of the insured person being under theinfluence of alcohol or drugs other than in accordance with the directions of a registeredmedical practitioner

(k) Any injury, sickness or disease received as a result of the insured person taking part inany naval, military or air force operation

(l) Any injury, sickness or disease received as a result of the insured person participating inor training for any dangerous or hazardous sport or competition or riding or driving in

any form of race or competition(m) Any injury, sickness or disease received as a result of aviation, gliding or any form of

aerial flight other than as a fare paying passenger of a recognised airline on regular routesand on a scheduled timetable

15. NON DISCLOSURE

In case of non-disclosure or fraud or misrepresentation in any document leading to the acceptance ofthe risk, the company may at its discretion repudiate the claim, subject to Section 45 of the InsuranceAct.

16. PREMIUMS

PREMIUM PAYMENT TERM Under this plan, we offer premium payment terms that are equal to the policy term and limitedpremium payment terms as well.

FREQUENCY The following payment modes are available: Annual, half yearly and quarterly. Monthly is permittedonly by salary deduction. If monthly premiums are set up by deduction from salary and thepolicyholder ceases at any time to have a salary available for making deductions then the policyholderwill have the option to pay his monthly premium directly for a temporary period in the event ofindustrial strife, loss of wage due to prolonged illness etc. The premium frequency may be changed onthe request of the policyholder to annual, half yearly, or quarterly.

PREMIUM FREQUENCY FACTOR The basic premium will be derived for annual premium payment mode. The premium for frequenciesother than annual is then given by the annual premium multiplied with the frequency factor. Thefactors are:

Premium frequency Monthly Quarterly Half yearly

Frequency factor 0.09 0.26 0.51

DAYS OF GRACE 1 month and not less than 30 days. After that the policy will lapse provided that where a policy hasacquired a surrender value it shall be kept alive to the extent of paid –up sum insured. (As per section113 of the Insurance Act)

REINSTATEMENT Permitted, subject to underwriting, within 5 years from the due date of the first unpaid premiumsubject to the payment of outstanding premiums plus 10 % interest from the original premium duedates. The policy can be reinstated without underwriting requirements upto six months from the duedate of first unpaid premium. The underwriting requirement will be declaration of good health forreinstatement in the 7th month. After the 7th month, the underwriting requirements will be as perprevailing underwriting norms.




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PREMIUM LIMITS Minimum premium per premium payment depends on the premium frequency as follows:

Premium frequency Yearly Half yearly Quarterly Monthly

Minimum premium Rs. 5000 Rs. 3000 Rs. 3000 Rs. 700

In case of monthly premium payment, the same are acceptable only if three monthly instalments arereceived with the proposal, that is the minimum premium deposit should be Rs. 2100/-.

PREMIUM DISCOUNT

For Premium Payment Term = Policy Term Premium discount will be offered for all policies where the sum assured exceeds the minimal sumassured by at least Rs. 10,000. The discount is Rs. 84 for each full Rs. 10,000 by which the sumassured exceeds the minimum sum assured of Rs. 50,000.

For Limited Premium Payment TermPremium discount will be offered for all policies where the sum assured exceeds the minimal sumassured of Rs. 50,000 by at least Rs. 10,000. The discount for each full Rs. 10,000 by which the sumassured exceeds the minimum sum assured is given in the table below.

Premium Payment Term Rebate (Rs.)

2 yrs 200

3 yrs 150

5 yrs 100

7 yrs 100

10yrs and Above 84

PREMIUM FOR MALE / FEMALE The premium rates shall be published for Male Lives. The basic premium for a female life will beequivalent to the premium for a two-year younger male policyholder for the base policy only.All Additional Benefit premium will be same for both male and female lives.

REVIEW OF PREMIUM The premium rates for the critical illness benefit are guaranteed for five years only from the date ofcommencement of the policy. The company reserves the right to carry out a general review of theexperience from time to time and change the premium as a result of such review. The company willgive notice in writing about the change and the insured person will have the option not to pay anincreased premium. In such case the critical illness coverage will be excluded.

In case of the hospital cash benefit the premiums are yearly reviewable. The company will give noticein writing about the change and the insured person will have the option not to pay an increasedpremium. In such case the hospital cash coverage will be excluded.

PERMISSIBLE ALTERATIONS The premium frequency may be changed.




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17. PAID-UP VALUES Available if premium payment ceases after policy has acquired a surrender value. All originallyspecified benefits will cease. The sum assured will be reduced by a factor equal to the proportion ofthe number of premiums paid to the total number of premiums payable. The vested bonuses as on thepaid-up date remain attached to the policy. A paid-up policy will not accrue any further bonus.

In case of death before maturity, the sum assured reduced as above and bonuses vested upto the paidup date is paid and the policy will terminate.

In case of survival to the date of the maturity, the reduced amount of sum assured as above andvested bonuses as on the paid-up date will be paid and the policy will terminate.

18. POLICY LOAN Provided the policy has acquired a surrender value, loans are granted within the limit of 90% of thesurrender value of the policy. The company decides the interest rate for the loan at the date when theloan is granted. The interest on the loan shall be paid compounding half yearly. In case the policymatures or a claim occurs, the company is entitled to deduct the outstanding amount together with allinterest. In case of non-payment of premium or interest, if outstanding policy loan and interestexceeds the surrender value, the company has the right to terminate the policy and appropriate the

amount towards the dues. In such event all benefit under the policy shall cease.

19. TAXATION Contribution - Eligible for tax relief under sec.80C of IT Act, as of now.

Hospital Cash & Critical Illness Benefit premium eligible for Sec 80(D) benefitas of now

Policyholder - Death Benefit tax free under Sec 10(10) D, as of nowMaturity benefit (including ECO) tax free under Sec 10(10) D, as of now




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APPENDIX A

CRITICAL ILLNESSES TO BE COVERED

First Heart Attack

The death of a portion of heart muscle as a result of inadequate blood supplies to the relevant

area. The diagnosis should be based on all of the following:- history of typical chest pain, if any.- new and recent electrocardiographic changes indicating myocardial infarction- elevation of cardiac enzymesDiagnosis based on the elevation of Troponin T Test, alone shall not be considered diagnostic of aheart attack.Angina or chest pain are especially excluded.

Coronary Artery Disease Requiring Surgery

The undergoing of heart surgery to correct narrowing of blockage of left main coronary artery orthree or more coronary arteries with bypass grafts in persons with limiting anginal symptoms butexcluding non-surgical techniques such as balloon angioplasty, laser relief of an obstruction orother forms of Coronary artery clearing through catheters or similar devices. Narrowing of theaffected artery should be more than 75 %.

Stroke

Any cerebrovascular incident producing neurological sequel lasting more than twenty-four hoursand including infarction of brain tissue, haemorrhage and embolisation from an extra-cranicalsource. There must be evidence of permanent neurological deficit for more than six months. Thediagnosis must be based on changes seen in a CT scan or MRI & certified by a recognisedconsultant neurologist holding an appointment in this capacity with a major hospital.Cerebral symptoms due to transient ischaemic attacks, any reversible ischaemic neurologicaldeficit, migraine, cerebral injury resulting from trauma or hypoxia and vascular disease affectingthe eye or optic nerve as well as ischaemic disorders of the vestibular system are excluded.

Cancer

The presence of one or more malignant tumours including leaukaemia (other than chroniclymphocytic leukaemia), lymphomas and Hodgkins disease characterised by the uncontrollablegrowth and spread of malignant cells and the invasion and destruction of normal tissuediagnosed by a medical practitioner who is a consultant oncologist. The following cancers are notcovered by the policy: -

I. Tumours showing the malignant changes of carcinoma in situ (including cervicaldysplacia CIN-1, CIN-2, and CIN- 3) or, which are histologically described as premalignant and Ductal carcinoma in situ of the breast.

II. Melanomas of less than 1.5-mm maximum thickness as determined by histologicalexamination or less than Clark Level 3 Depth of invasion;

III. All hyperkeratoses or basal cells carcinomas of the skin;

IV. All squamous cell carcinomas of the skin unless there has been a spread to other organs;V. Kaposi’s sarcoma and other tumours associated with HIV infections or AIDS;

VI. Papillary carcinoma of the bladder and Prostatic cancers which are histologicallydescribed as TNM Classification T1(includingT1(a) T2 (b) or are of another equivalent orlesser classification ) and

VII. Hodgkins disease stage 1.




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Kidney Failure

End stage renal disease of chronic irreversible failure of kidneys of the insured person undergoingregular peritoneal dialysis or haemodialysis or having had a renal transplantation.

Major Organ Transplantation

The undergoing as a recipient of a transplant of a heart, heart and lung, liver, kidney, pancreas

(excluding the transplantation of the islets of Langerhans only) or bone marrow.

Multiple Sclerosis

Unequivocal diagnosis by a recognised consultant neurologist holding an appointment in thiscapacity in a major hospital. The following combination, which has persisted for at least acontinuous period of six (6) months: -I. Symptoms referable to tracts (white matter) involving the optic nerves, brain stem and

spinal cord, producing well-defined neurological deficits;II. A multiplicity of discrete lesions; andIII. A well-documented history of exacerbation and remissions of said

symptoms/neurological deficits.IV. Confirmed by modern investigational techniques.

Aorta Graft Surgery

The undergoing of surgery to correct any narrowing, dissection or aneurysm of the thoracic orabdominal aorta. Narrowing of Aorta of congenital is excluded.

Primary Pulmonary Arterial Hypertension

Means primary pulmonary hypertension with substantial right ventricular enlargementestablished by investigations including cardiac catheterization, resulting in permanent irreversiblephysical impairment to the degree of at least class 3 of the NEW YORK Heart AssociationClassification of cardiac impairment and resulting in the Life Insured being unable to performhis/her usual occupation.

Alzheimer’s Disease

Deterioration or loss of intellectual capacity or abnormal behaviour as evidence by the clinicalstate and accepted standardised questionnaires or tests arising from Alzheimer’s diseaseexcluding neurosis, psychiatric illness, and any drug or alcohol related organic disorder, resultingin significant reduction in mental and social functioning requiring the continuous supervision ofthe life insured. The diagnosis must be clinically confirmed by recognised consultant neurologistholding an appointment in this capacity in a major hospital.

Paralysis

The complete and permanent loss of use of both arms or both legs or one arm and one leg,through paralysis of grade 0-2/6 motor power caused by illness, persisting for at least six monthsfrom the date of illness.Unequivocal diagnosis by recognised consultant neurologist holding an appointment in thiscapacity in a major hospital must certify it.

APPENDIX B

Accidental permanent total disability

Disability as a result of an accident and must be total and permanent, and the accident must resultin one of:

• Loss of both eyes




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• Loss of both arms or both hands

• Loss of one arm and one leg

• Loss of one arm and one foot

• Loss of one hand and one foot

• Loss of one hand and one leg

• Loss of both legs

• Loss of both feet

• Removal of the lower jawDisability must occur within 180 days from the date of accident. A written intimation of theaccident must be given within 60 days of the accident.

Accidental permanent partial disability

Disability as a result of an accident and must be permanent and the accident must result in one of:

• Loss of one eye

• Loss of one leg

• Loss of one arm

• Loss of one hand

• Loss of one foot

Disability must occur within 180 days from the date of accident. A written intimation of theaccident must be given within 60 days of the accident.

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