Reference Number: 0000BI

Edelweiss Tokio Life - CritiCare+

UIN : 147N030V01
Personal Particulars
Nilkantha Prasad
Name of the Life Insured Barnwal Gender Male Date of Birth 19-Sep-1951

Age ( Years ) 66 Mode Of Payment Month Claim Option Single Claim

All amount are in rupees

Monthly
Sum Assured Premium Swachh Krishi Kalyan Total
Policy Term Premium Service Tax
(Rs.) Paying Term Bharat Cess Cess Premium
(Rs.)
CritiCare+ - Single Claim Option 5,00,000 12 12 3,550 303 10 10 46476

Installment Premium (with Service Tax) 3,873

Projected Values
Policy Monthly Base Monthly Premium Lump Sum Benefit on Critical Illness
1 3,873 5,00,000
2 3,873 5,00,000
3 3,873 5,00,000
4 3,873 5,00,000
5 3,873 5,00,000
6 3,873 5,00,000
7 3,873 5,00,000
8 3,873 5,00,000
9 3,873 5,00,000
10 3,873 5,00,000
11 3,873 5,00,000
12 3,873 5,00,000

Terms and Conditions

1. This document is for illustration purposes only. This illustration is based on the terms and conditions of the life insurance policy as on date of
the illustration. The above information must be read in conjunction with the sales brochure & policy document.
2. The pemium amount is guaranteed for the first five policy years and may be reviewable afterwards with prior approval of IRDA.
3. Insurance is the subject matter of solicitation.
4. Service Tax (and cess if any) is levied on the premium as per the prevailing Service Tax Laws and the same shall be borne by the
policyholder.

I have received the information with respect to the above product and understood the above statement before entering into the
contract.

Note: The above benefit illustration is subject to payment of stipulated premiums on due dates

_______________________________ _______________________________
Marketing officials' signature: Signature of Proposer *

_______________________________ _______________________________ _______________________________

Marketing officials' Name: Company Seal Name of the Proposer *

* Or Life Assured where Proposer and Life Assured

are same person
_______________________________ _______________________________
Date(ddmmyyyy): Place
Version: 1.0.0.0 | 26-Oct-2016