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Life Partner Plus

UIN- 104N029V01
Participating
Policy/Proposal No:[ _________________ ]
Date of Illustration - Oct 13, 2011 7:26:15 PM
Insured

RUDRA

Age at inception of Policy

Sex

Male

Class

Standard

Face Amount

Rs 2,13,604

Bonus Option

Paid Up Additions

Payment Mode

Annual Billed

Payor Name
Payor Age

Payor Sex

Male

Premium Payment Term

10 Pay

PREMIUM SUMMARY
Basic Premium

Rs

25,000.21

Annual - Billed

TOTAL

Rs

25,000.21

Annual - Billed

Signature of Agent/Specified Person/Principal officer:___________________________________________

Policy Holders Signature:___________________________________________

MAX NEW YORK LIFE INSURANCE CO. LTD, 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurgaon 122 002

Page 1 of 5

YEARLY DETAIL
The following ledger provides year by year illustrative figures for premiums required, for the policy that you have chosen.
General Details
Year

Guaranteed

Age

Non Guaranteed Lower Rate 6%:

Annual
Premium

Death
Benefit

Surrender
Value

Money
Back
Payments

Net
Outlay

( Rs )

( Rs )
(BOY)

( Rs )
(EOY)

( Rs )
(EOY)

( Rs )

25,000

25,000

25,000

25,000

Non Guaranteed Higher Rate 10%:

Death
Benefit

Annual
Bonus

Surrender
value of PUA

Total
Surrender
Value

Net
Outlay

( Rs )
(EOY)

( Rs )
(EOY)

( Rs )
(EOY)

( Rs )

(BOY)

25,000

25,000

50,750

25,000

77,273

22,954

25,000

50,750

77,273

3,749

25,000

1,04,592

30,759

25,000

1,32,730

38,641

25,000

1,55,518

25,000

2,17,356

25,000

1,61,712

46,604

25,000

25,000

1,91,563

10

25,000

2,13,604

54,644

62,768

11

25,000

2,13,604

70,970

10

12

11

13

25,000

2,13,604

2,13,604

12
13

14

15

14

16

15
16

Death
Benefit

Annual
Bonus

Surrender
value of PUA

Total
Surrender
Value

(BOY)

( Rs )
(EOY)

( Rs )
(EOY)

( Rs )
(EOY)

25,000

25,000

25,000

22,954

25,000

2,580

3,899

34,658

3,277

6,741

45,381

2,87,484

3,995

10,421

25,000

3,65,547

4,738

25,000

4,42,533

5,502

25,000

5,03,827

71,679

25,000

72,397

2,13,604

73,121

2,13,604

73,851

2,13,604

74,591

17

2,13,604

18

2,13,604

17

19

18

20

19

21

20
21

50,750

77,273

7,055

22,954

25,000

2,00,439

5,065

7,339

38,098

25,000

2,94,730

6,534

12,903

51,544

57,026

25,000

4,05,744

8,094

20,220

66,825

15,003

69,647

25,000

5,33,283

9,753

29,466

84,111

20,549

83,316

25,000

6,68,433

11,523

40,825

1,03,593

6,291

27,104

98,074

25,000

7,96,813

13,406

54,466

1,25,436

5,71,188

7,106

34,729

1,06,408

25,000

9,40,357

15,408

70,582

1,42,261

6,44,355

7,330

43,463

1,15,860

10,99,009

16,376

89,337

1,61,734

7,17,003

7,562

52,761

1,25,882

12,61,304

17,427

1,09,809

1,82,930

7,89,153

7,803

62,643

1,36,494

14,27,576

18,539

1,32,129

2,05,980

8,60,847

8,056

73,138

1,47,729

15,97,912

19,739

1,56,427

2,31,017

75,336

9,32,140

8,313

84,299

1,59,635

17,72,597

21,033

1,82,901

2,58,237

76,090

10,02,996

8,587

96,140

1,72,230

19,51,879

22,413

2,11,705

2,87,795

2,13,604

76,850

10,73,501

8,867

1,08,717

1,85,567

21,35,907

23,902

2,43,037

3,19,887

2,13,604

77,619

11,43,638

9,159

1,22,067

1,99,686

23,24,957

25,489

2,77,115

3,54,735

2,13,604

78,395

12,13,420

9,461

1,36,245

2,14,640

25,19,156

27,221

3,14,178

3,92,572

22

2,13,604

79,179

12,82,849

9,783

1,51,287

2,30,466

27,18,913

29,070

3,54,476

4,33,655

23

2,13,604

79,971

13,51,989

10,103

1,67,251

2,47,223

29,24,367

31,062

3,98,265

4,78,237

22

24

2,13,604

80,770

14,20,752

10,446

1,84,199

2,64,969

31,35,789

33,182

4,45,896

5,26,666

23

25

2,13,604

81,578

14,89,207

10,800

2,02,196

2,83,773

33,53,248

35,497

4,97,665

5,79,242

24

26

2,13,604

82,393

15,57,344

11,178

2,21,287

3,03,681

35,77,188

37,993

5,53,915

6,36,309

25

27

2,13,604

83,218

16,25,223

11,570

2,41,570

3,24,788

38,07,894

40,683

6,15,091

6,98,309

26

28

2,13,604

84,049

16,92,831

11,974

2,63,110

3,47,159

40,45,625

43,583

6,81,601

7,65,650

Signature of Agent/Specified Person/Principal officer:___________________________________________

Policy Holders Signature:___________________________________________

MAX NEW YORK LIFE INSURANCE CO. LTD, 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurgaon 122 002

Page 2 of 5

General Details
Year

Guaranteed

Age

Non Guaranteed Lower Rate 6%:

Annual
Premium

Death
Benefit

Surrender
Value

Money
Back
Payments

Net
Outlay

( Rs )

( Rs )
(BOY)

( Rs )
(EOY)

( Rs )
(EOY)

( Rs )

Non Guaranteed Higher Rate 10%:

Death
Benefit

Annual
Bonus

Surrender
value of PUA

Total
Surrender
Value

Net
Outlay

( Rs )
(EOY)

( Rs )
(EOY)

( Rs )
(EOY)

( Rs )

(BOY)

Death
Benefit

Annual
Bonus

Surrender
value of PUA

Total
Surrender
Value

(BOY)

( Rs )
(EOY)

( Rs )
(EOY)

( Rs )
(EOY)

27

29

2,13,604

84,891

17,60,153

12,392

2,85,988

3,70,878

42,90,653

46,706

7,53,928

28

30

2,13,604

85,739

18,27,167

12,837

3,10,288

3,96,027

45,43,230

50,067

8,32,587

9,18,326

29

31

2,13,604

86,597

18,93,923

13,297

3,36,097

4,22,695

48,03,591

53,730

9,18,089

10,04,686

30

32

2,13,604

87,462

19,60,400

13,770

3,63,456

4,50,918

50,72,214

57,670

10,10,931

10,98,393

31

33

2,13,604

88,336

20,26,581

14,276

3,92,419

4,80,755

53,49,379

61,907

11,11,638

11,99,974

32

34

2,13,604

89,220

20,92,538

14,798

4,23,098

5,12,319

56,35,390

66,515

12,20,878

13,10,098

33

35

2,13,604

90,113

21,58,255

15,355

4,55,534

5,45,648

59,30,778

71,466

13,39,248

14,29,361

34

36

2,13,604

91,015

22,23,804

15,927

4,89,825

5,80,840

62,35,862

76,783

14,67,444

15,58,458

35

37

2,13,604

91,924

22,89,165

16,517

5,26,051

6,17,975

65,50,974

82,553

16,06,206

16,98,131

36

38

2,13,604

92,843

23,54,334

17,148

5,64,275

6,57,118

68,76,692

88,745

17,56,323

18,49,166

37

39

2,13,604

93,772

24,19,390

17,795

6,04,584

6,98,356

72,13,370

95,387

19,18,566

20,12,338

38

40

2,13,604

94,710

24,84,315

18,463

6,47,062

7,41,772

75,61,385

1,02,579

20,93,824

21,88,534

39

41

2,13,604

95,656

25,49,105

19,172

6,91,775

7,87,432

79,21,360

1,10,284

22,83,037

23,78,694

40

42

2,13,604

96,613

26,13,830

19,902

7,38,934

8,35,547

82,93,690

1,18,620

24,87,535

25,84,148

41

43

2,13,604

97,579

26,78,478

20,677

7,88,612

8,86,190

86,78,994

1,27,628

27,08,417

28,05,995

42

44

2,13,604

98,555

27,43,106

21,475

8,40,933

9,39,488

90,77,905

1,37,271

29,46,937

30,45,492

43

45

2,13,604

99,539

28,07,703

22,324

8,95,924

9,95,463

94,90,813

1,47,682

32,04,070

33,03,609

44

46

2,13,604

1,00,535

28,72,342

23,196

9,53,716

10,54,251

99,18,419

1,58,819

34,81,214

35,81,749

45

47

2,13,604

1,01,541

29,37,007

24,092

10,14,359

11,15,900

1,03,61,168

1,70,824

37,79,562

38,81,103

46

48

2,13,604

1,02,556

30,01,692

25,043

10,77,931

11,80,486

1,08,19,805

1,83,654

41,00,570

42,03,125

47

49

2,13,604

1,03,583

30,66,468

26,023

11,44,540

12,48,123

1,12,94,829

1,97,581

44,45,677

45,49,260

48

50

2,13,604

1,04,617

31,31,331

27,057

12,14,300

13,18,917

1,17,87,315

2,12,344

48,16,747

49,21,364

49

51

2,13,604

1,11,954

31,96,345

28,124

12,87,351

13,99,305

1,22,97,537

2,28,343

52,15,426

53,27,380

50

52

2,13,604

1,20,368

32,61,508

29,254

13,63,815

14,84,183

1,28,26,599

2,45,424

56,43,811

57,64,179

51

53

2,13,604

1,29,459

33,26,885

30,417

14,43,877

15,73,336

1,33,75,081

2,63,781

61,04,030

62,33,489

52

54

2,13,604

1,39,291

33,92,470

31,646

15,27,699

16,66,990

1,39,43,843

2,83,363

65,98,478

67,37,770

53

55

2,13,604

1,49,941

34,58,320

32,915

16,15,479

17,65,420

1,45,33,470

3,04,525

71,29,575

72,79,517

54

56

2,13,604

1,61,495

35,24,430

34,253

17,07,459

18,68,955

1,51,45,114

3,27,241

77,00,479

78,61,974

55

57

2,13,604

1,74,049

35,90,848

35,635

18,03,887

19,77,936

1,57,79,647

3,51,453

83,14,291

84,88,339

Signature of Agent/Specified Person/Principal officer:___________________________________________

8,38,818

Policy Holders Signature:___________________________________________

MAX NEW YORK LIFE INSURANCE CO. LTD, 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurgaon 122 002

Page 3 of 5

General Details
Year

Guaranteed

Age

Non Guaranteed Lower Rate 6%:

Annual
Premium

Death
Benefit

Surrender
Value

Money
Back
Payments

Net
Outlay

( Rs )

( Rs )
(BOY)

( Rs )
(EOY)

( Rs )
(EOY)

( Rs )

56

58

2,13,604

1,87,715

57

59

2,13,604

58

60

2,13,604

59

61

60

62

61

63

62
63

Non Guaranteed Higher Rate 10%:

Death
Benefit

Annual
Bonus

Surrender
value of PUA

Total
Surrender
Value

Net
Outlay

( Rs )
(EOY)

( Rs )
(EOY)

( Rs )
(EOY)

( Rs )

(BOY)

Death
Benefit

Annual
Bonus

Surrender
value of PUA

Total
Surrender
Value

(BOY)

( Rs )
(EOY)

( Rs )
(EOY)

( Rs )
(EOY)

36,57,564

37,093

19,05,336

20,93,051

1,64,37,638

3,77,732

2,02,614

37,24,611

38,632

20,11,947

22,14,561

1,71,20,401

4,05,900

96,88,271

98,90,885

2,02,864

16,020

37,92,027

40,223

21,23,830

23,26,694

1,78,28,728

4,36,255

1,04,54,752

1,06,57,616

2,13,604

2,03,146

16,020

-16,020

38,59,799

41,059

22,41,207

24,44,353

-16,020

1,85,63,770

4,67,182

1,12,79,297

1,14,82,443

2,13,604

2,03,462

16,020

-16,020

39,26,597

41,948

23,63,506

25,66,968

-16,020

1,93,23,823

5,00,667

1,21,64,610

1,23,68,072

2,13,604

2,03,817

16,020

-16,020

39,92,497

42,898

24,91,008

26,94,825

-16,020

2,01,10,355

5,36,505

1,31,15,740

1,33,19,556

64

2,13,604

2,04,218

16,020

-16,020

40,57,574

43,906

26,24,125

28,28,343

-16,020

2,09,24,241

5,75,041

1,41,38,324

1,43,42,542

65

2,13,604

2,04,673

16,020

-16,020

41,21,890

44,934

27,63,354

29,68,027

-16,020

2,17,66,594

6,16,667

1,52,39,042

1,54,43,715

64

66

2,13,604

2,05,182

16,020

-16,020

41,85,441

46,057

29,10,562

31,15,744

-16,020

2,26,38,763

6,61,816

1,64,33,156

1,66,38,338

65

67

2,13,604

2,05,765

16,020

-16,020

42,48,292

47,283

30,64,790

32,70,554

-16,020

2,35,41,895

7,10,516

1,77,20,403

1,79,26,168

66

68

2,13,604

2,06,435

16,020

-16,020

43,10,539

48,532

32,27,074

34,33,509

-16,020

2,44,77,265

7,63,495

1,91,12,000

1,93,18,436

67

69

2,13,604

2,07,211

16,020

-16,020

43,72,154

49,887

33,98,408

36,05,619

-16,020

2,54,46,561

8,20,570

2,06,20,625

2,08,27,835

68

70

2,13,604

2,08,112

16,020

-16,020

44,33,199

51,346

35,80,242

37,88,354

-16,020

2,64,50,672

8,83,045

2,22,61,628

2,24,69,740

69

71

2,13,604

2,09,163

16,020

-16,020

44,93,714

52,911

37,74,458

39,83,621

-16,020

2,74,91,410

9,51,073

2,40,55,206

2,42,64,369

70

72

2,13,604

2,10,400

16,020

-16,020

45,53,714

54,623

39,83,440

41,93,840

-16,020

2,85,69,896

10,26,176

2,60,25,972

2,62,36,371

71

73

2,13,604

2,11,863

16,020

-16,020

46,13,227

56,485

42,10,176

44,22,039

-16,020

2,96,87,954

11,08,930

2,82,05,184

2,84,17,047

72

74

2,13,604

2,29,624

16,020

-16,020

46,72,254

58,536

44,58,650

46,88,275

-16,020

3,08,46,783

12,01,441

3,06,33,179

3,08,62,803

Rs 2,29,624

Maturity Value:

Rs 47,46,811

89,75,784

91,63,500

Rs 3,20,64,243

NOTES:
(BOY)

Beginning of Year Value

(EOY)

End of Year Value

Signature of Agent/Specified Person/Principal officer:___________________________________________

Policy Holders Signature:___________________________________________

MAX NEW YORK LIFE INSURANCE CO. LTD, 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurgaon 122 002

Page 4 of 5

Important Notes:
-- This illustration is applicable for sale in Jammu & Kashmir only (exclusive of service tax).
-- This is only an illustrative document. It does not purport to be a contract of insurance and does not in any way create any rights and/or obligations. Bonuses (if applicable and shown in the illustration) are not guaranteed, and bonus rates will be based on
the actual company experience from time to time. Some of the benefits are guaranteed and some benefits are variable with returns based on the future performance of your insurer carrying on life insurance business. If your policy offers guaranteed returns
then these will be clearly marked "guaranteed" in the illustration table on this page. If your policy offers variable returns then the illustrations on this page will show the different rates of assumed future investment returns. These assumed rates of return
are not guaranteed and they are not the upper or lower limits of what you might get back, as the value of your policy is dependent on a number of factors including future investment performance.
-- Policy benefits are payable provided all premiums are paid, when they are due. The illustrative benefits above assume that all premiums that are due will be paid on the due dates.
-- Please refer to the product brochures, for understanding the product features and explanation of the terms used in this illustration.
-- Service Tax and Education Cess would be levied as per applicable laws and would be to the account of the policyholder.
-- This plan may entitle you to certain tax benefits on your premiums as well as on your maturity value:
-- U/s 80C of the Income Tax Act 1961 on your premiums.
-- U/s 10(10D) of the Income Tax Act 1961 on your maturity proceeds of the policy.
-- U/s 80D of the Income Tax Act 1961, on your premiums towards Health insurance.
(Please note that if the premium paid in a financial year exceeds 20% of the Sum Assured, under section 10 (10D) benefit will not be available and 80C benefit will not be available for the premium exceeding 20% of the Sum Assured under the current tax
laws.)
-- The company reserves the right to revise the premium rates at portfolio level in plans for health insurance based upon the actuarial review of the claims experience subject to prior approval of IRDA and shall be communicated to you at least 30 days
prior to such change.

I ________________________________________________________ (Name), having received the information with respect to the above, have understood the above statement before entering into the contract.

Signature of Agent/Specified Person/Principal Officer:

Policy Holders Signature:

Name and ID:

Policy Holders Name:

Place:

Date:

Date:
Company Seal:

MAX NEW YORK LIFE INSURANCE CO. LTD, 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurgaon 122 002
2010.1.2.8.6.56.40APS41880931213604110000 100000001000000 10000018001000000 0 1

Page 5 of 5