A Unit-linked Non-Participating Individual Life

Savings Insurance Plan

Key Features of the plan

Bajaj Allianz Life Magnum Fortune Plus offers risk coverage during the policy term along with key features of loyalty additions, maturity
Aim of the policy booster, return of mortality charges and flexibility to choose from wide range of funds and investment strategies to meet your
financial goals.

Maturity Benefit:
You will receive the regular premium Fund Value plus top up premium Fund Value as on the maturity date, provided all due premiums
have been paid.

Death Benefit: Provided the policy is in-force, the death benefit payable to the Nominee as lump-sum is:
 The higher of the prevailing sum assured or regular premium Fund Value plus
 The higher of top-up premium sum assured or top-up premium Fund Value, if any; All the above as on date of receipt of intimation
of Death
The Death Benefit is subject to the Guaranteed Death Benefit, which is at least 105% of the Total Premiums paid
Note - Please refer Sales Literature for more details

Loyalty Advantage:

Loyalty addition:
We will contribute to your wealth creation in the form of allocating additional units to your policy from the end of the 10th policy year,
every year till the end of the policy term.
Benefits under The %age of loyalty addition will depend upon the amount of premium you pay.
the plan The applicable percentage of loyalty addition is mentioned below:

Premium % of LA
<1,00,000 0.50%
>=1,00,000L 0.70%

The loyalty addition will be added into the Regular Premium Fund Value as a %-age of last 3 years average fund value.

Maturity Booster:
At the end of the policy term, we will add maturity booster* to your fund value to reward you for your contribution towards your goal.
The amount of maturity booster will depend upon the policy term opted by you.

The maturity booster will be offered basis below particulars.

The applicable percentage of maturity booster is mentioned below:

Category/ Policy term 10th year 15th year 20th year 25th year 30th year
Auto pay 0.25% 0.5% 0.5% 1% 1%
Existing customer 0.25% 0.5% 0.5% 1% 1%
* the MB will be added as a percentage of last 3 years average fund value and only if all the premiums are paid up to date of maturity.

Return of mortality charges:

At the end of the policy term, on the maturity date, the total amount of mortality charges deducted in respect of life cover provided
throughout the policy term, will be added back as ROMC, to the limited Premium Fund Value and Top-up Premium Fund Value, as
applicable. ROMC is not applicable in case of a Surrendered, Discontinued or Paid-up policy and will be payable provided all due limited
Premiums under the policy have been paid up to date.

Bajaj Allianz Life Insurance Co. Ltd.,

Bajaj Allianz House, Airport Road, Yerawada, Pune - 411006. Reg No.: 116. Ver 1 : English
Bonus No bonus is payable in this policy

Premium payment Premiums are payable as per the option chosen as indicated in the benefit illustration

If you do not pay regular premiums during the first five policy If you do not pay regular premium after the first five policy
Year, then at the end of grace period the policy will be converted years, then, your policy will be converted to a paid-up policy
to discontinued policy. immediately with reduced paid-up benefits. You will have to
• You can revive your policy by paying all due regular premiums choose any of the following two options on receiving the notice
within a period of three (3) years from us to intimate you about your policy status -
• If we do not receive any intimation from you about the policy Option A - Pay all due regular premiums or communicate
revival, or we receive an intimation, but the policy is not revived, agreeing to pay all due regular premiums, within a period of
then, we will be constrained to take discontinuance action three (3) years or
• At any time, you have the option to completely withdraw from Option B - Surrender the Policy
Non- payment
the Policy without any risk cover, Guaranteed Benefit, Periodical
of premium Money Backs/Loyalty Benefits, ROMC and receive the If you do not pay all due regular premiums or we do not receive
Discontinued value (as Surrender Value) at the end of the lock-in any intimation from you, then, policy will continue as paid-up till
period of five Policy years or the date of surrender, whichever is the expiry of the revival period, at the end of which, the Surrender
later Value will be paid
Alternatively, you can choose to surrender the Policy without any
risk cover and in that case your life cover shall cease immediately.
The Surrender Value will be available after the end of lock in
period of 5 years or date of surrender, whichever is later
You will not be able to revive your policy once surrendered.

You may revive your discontinued policy during the revival period of three (3) years from the date of discontinuance of the policy
Revival provided the policy is not terminated already

Although it is not advisable to surrender your policy unless there is an extreme urgency, you will have the option to surrender your
policy anytime
i. On surrender during the lock-in period of first five years, the regular premium Fund Value, less the discontinuance/ surrender
charge plus the top up premium Fund Value, if any, as on the date of surrender, will be transferred to the discontinued life policy
Surrender of
Fund (maintained by the company), and life cover shall cease immediately. The Discontinuance Value as at the end of the lock-in
the Policy period will be available to you as Surrender Value.
ii. On surrender after the lock-in period of first five years, the Surrender Value available will be regular premium Fund Value plus top
up premium Fund Value, if any, as on the date of surrender.
The policy shall thereafter terminate upon payment of the full Surrender/ Discontinuance Value by the company

Charge Details

Premium Band Name Annualized Premium/Policy Year 1 2 3-5 6 to PPT

Prime Premium < 1Lakh 4% 4% 4% 0.0%

Premium allocation Prestige 1Lakh <= Premium < 2.4Lakh 3% 3% 3% 0.0%

charge
Priority Premium>= 2.4Lakh 2% 2% 2% 0.0%

All Top ups have a premium allocation charge of 2%.

Charges under Policy administration Year 1 till Policy term:

the Plan charges (PAC) 2.1% of the prevailing annualized premium or Rs 500/ month, whichever is lower

Fund Fund Management Charge per annum

Equity Growth Fund II 1.35%
Accelerator Mid Cap Fund II 1.35%
Pure Stock Fund 1.35%
Pure Stock Fund II 1.30%
Asset Allocation Fund II 1.25%
Blue chip Equity Fund 1.25%
Fund Management Flexi cap fund 1.35%
charges (FMC) Sustainable equity fund 1.35%
Small Cap Fund 1.35%
Dynamic Asset Allocation Fund 1.35%
Individual Short Term Debt Fund 0.95%
Liquid Fund 0.95%
Bond Fund 0.95%
Discontinued Life Policy Fund 0.50%
This charge would be adjusted in unit price.
Miscellaneous Miscellaneous charge of Rs. 100/- per transaction shall be charged.
charge Note- Please refer Sales Literature for more details

Bajaj Allianz Life Insurance Co. Ltd.,

Bajaj Allianz House, Airport Road, Yerawada, Pune - 411006. Reg No.: 116. Ver 1 : English
 Charge Details

Where the Policy is Discontinuance charge for the Discontinuance charge for the
Discontinued during policies having annualized policies having Annualized
the Policy year Premium up to ` 50000/- Premium above ` 50000/-
Lower of 20% * (AP or FV) subject Lower of 6% * (AP or FV) subject
1
to maximum of `3,000 to maximum of `6,000

Lower of 15% * (AP or FV) subject Lower of 4% * (AP or FV) subject

Discontinuance/ 2
to maximum of `2,000 to maximum of `5,000
Surrender Charge
Charges under 3
Lower of 10% * (AP or FV) subject Lower of 3% * (AP or FV) subject
the Plan to maximum of `1,500 to maximum of `4,000

Lower of 5% * (AP or FV) subject Lower of 2% * (AP or FV) subject

4
to maximum of `1,000 to maximum of `2,000

5 & above Nil Nil

Mortality Charge will be deducted at each monthly anniversary by cancellation of units. Female Life
Mortality charges Assured will be eligible for an age-set-back of 3 years. For sub-standard lives, extra Mortality charge
will be applicable which will be deducted as charges by cancellation of units.

Goods and Service Tax/any other applicable tax levied, subject to changes in tax laws are charged
Goods and Service Tax based on type of policy, communication address of Policy Holder. This may change subject to change
(GST) in rate/state in address of the Policy Holder as on date of adjustment.

• The Policy will terminate on payment of the last instalment.

• If you have opted for the Settlement Option
• This Policy shall automatically and immediately terminate on the earlier occurrence of any of the following events:
• On foreclosure of the Policy
• On the date of receipt of intimation of death of the Life Assured (unless the Settlement option has been opted for)
Termination • On payment of Discontinued value or Surrender Value
• The Maturity Date, unless Settlement Option has been opted
• The expiry of the Settlement period, if opted
• On cancellation of Policy during Free look period
• On refund of eligible Premiums/Surrender value under Suicide clause on suicide of Life Assured

You will have the option to review the terms and conditions of the policy and if you disagree to any of the terms & conditions, you will
Free Look have an option to return the policy within 15 days and thirty (30) days in case of electronic Policy or Policy obtained through Distance
Cancelation Mode, stating the reasons for your objections.

Regd. Office Address: Bajaj Allianz Life insurance Company Ltd, Bajaj Allianz House, Airport Road, Pune - 411006 | Reg.No.: 116. | Visit
Contact us us: www.bajajallianzlife.com | BALIC CIN:U66010PN2001PLC015959 | Mail us : customercare@bajajallianz.co.in | Call on : Toll free no.
1800 209 7272

Do's
 Do fill the proposal form very carefully and personally in CAPITAL letters in blue ink only
 Do provide true and complete information
 Do provide correct contact number, address and email ID, and update in case of any change, so that you can receive necessary
communication
 Do sign on all the documents provided by you (Self Attestation)
 Do provide your recent passport photograph
 Do draw cheque/ DD, in favour of “Bajaj Allianz Life Insurance Co. Ltd.”
 Do read the policy bond carefully upon receipt of the same.
Do's and  Do contact us if you do not receive the policy bond or any other communication from the Company within 30 days.
Don'ts  Do read the enclosed Benefit Illustration carefully before signing
 Do register for Auto Debit Instructions/ ECS to ensure timely payments of your premium on due dates.

Don'ts
 Do not sign any blank proposal form
 Do not leave any column blank in the proposal form
 Do not conceal any facts as this could lead to dispute at the time of a claim
 Do not miss or delay your premium payment
 Do not rely on any commitments of any additional benefits made by anyone apart from what has been highlighted herein above

Disclaimer : This document contains the highlights of the product Bajaj Allianz life Magnum Fortune Plus UIN: 116L176V01 and is subject to the terms and conditions as contained in the
policy document. The terms and conditions as contained in the policy document shall govern the contractual relationship and shall be binding. For details on any of the matters highlighted
herein above, please refer to policy document upon receipt of the same by you. The standard terms and conditions of the product is also avail- able on the Company website at
www.bajajallianz.com . | BALIC CIN : U66010PN2001PLC015959 | Mail us : customercare@bajajallianz.co.in | Call on : Toll free no. 1800 209 7272 | Fax No: 02066026789

Bajaj Allianz Life Insurance Co. Ltd.,

Bajaj Allianz House, Airport Road, Yerawada, Pune - 411006. Reg No.: 116. Ver 1 : English
Quotation No : 60033696410

Bajaj Allianz Life Magnum Fortune Plus

A Unit-linked Non-Participating Individual Life Savings Insurance Plan

Customer Details
Name of the Prospect/ Policyholder: PRASANTH SOMANADHAN NAIR
Age (in years): 40
Gender: Male
Name of the Life Assured: PRASANTH SOMANADHAN NAIR
Age (in years): 40
Gender Male

Product / RIders Details

Base Name of Product / Sum Policy Premium Premium Instalment Instalment
Plan / Rider Option Chosen UIN Assured Term Payment Payment Premium GST Rate Premium
Rider (Years) Term (Years) Mode Without GST with GST
Base Bajaj Allianz Life Not Applicable 116L176V01 10,01,000 10 5 Annual 1,00,100 18% on 1,00,100
Plan Magnum Fortune Plus Charges
Total 1,00,100 1,00,100

Investment Strategy Opted for Investor Selectable Portfolio Strategy

Fund opted for along with risk levels
Sr.No Fund Name SFIN Risk Level Fund Management Investment%
Charge
1 Liquid Fund ULIF02510/07/06LIQUIDFUND116 Low 0.95% 0%
2 Bond Fund ULIF02610/07/06BONDFUNDLI116 Moderate 0.95% 0%
3 Individual Short Term Debt Fund ULIF08817/01/23INDSTRMDBT116 Moderate 0.95% 0%
4 Asset Allocation Fund II ULIF07205/12/13ASSETALL02116 High 1.25% 0%
5 Bluechip Equity Fund ULIF06026/10/10BLUECHIPEQ116 High 1.25% 0%
6 Dynamic Asset Allocation Fund ULIF08617/01/23DYNASALLOC116 High 1.35% 0%
7 Equity Growth Fund II ULIF05106/01/10EQTYGROW02116 Very High 1.35% 0%
8 Accelerator Mid-Cap Fund II ULIF05206/01/10ACCMIDCA02116 Very High 1.35% 0%
9 Pure Stock Fund II ULIF07709/01/17PURSTKFUN2116 Very High 1.30% 0%
10 Pure Stock Fund ULIF02721/07/06PURESTKFUN116 Very High 1.35% 0%
11 Flexi Cap Fund ULIF07917/11/21FLXCAPFUND116 Very High 1.35% 0%
12 Sustainable Equity Fund ULIF08017/11/21SUSEQUFUND116 Very High 1.35% 0%
13 Small Cap Fund ULIF08717/01/23SMALLCAPFU116 Very High 1.35% 100%

Some 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 benefits then these will be clearly marked 'guaranteed' in the illustration table
on this page.If your policy offers variable benefits then the illustrations on this page will show two different rates of assumed future
investment returns, of 8 % p.a.and 4 % p.a.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.
How to read and understand this benefit illustration?
This benefit illustration is intended to show what charges are deducted from your premiums and how the unit fund, net of charges and
taxes, may grow over the years of the policy term if the fund earns a gross returns of 8% p.a. and 4% p.a. These rates, i.e. 8% p.a. and
4% p.a. are assumed only for the purpose of illustrating the flow of benefits if the returns are at this level. It should not be interpreted
that the returns under the plan are going to be either 8%p.a. or 4% p.a.
Net Yield mentioned corresponds to the gross investment return of 8% p.a., net of all charges but does not consider mortality, morbidity
charges, underwriting extra, if any, guarantee charges and cost of riders, if deducted by cancellation of units. It demonstrates the
impact of charges exclusive of taxes on the net yield. Please note that the mortality charges per thousand sum assured in general,
increases with age.
The actual returns can vary depending on the performance of the chosen fund, charges towards mortality, morbidity, underwriting
extra, cost of riders, etc. The investment risk in this policy is borne by the policyholder, hence, for more details on terms and conditions
please read sales literature carefully.

C.X.A
Quotation No : 60033696410

Part A of this statement presents a summary view of year-by-year charges deducted under the policy, fund value, surrender value and
the death benefit, at two assumed rates of return. Part B of this statement presents a detailed breakup of the charges, and other
values.

C.X.A
Quotation No : 60033696410

Part A (Amount in Rupees)

At 4% p.a. Gross Investment Return At 8% p.a. Gross Investment Return

Commission payable to
Fund at intermediary (Rs.)
Policy Annualised Mortality Other GST Fund at End Surrender Death Mortality Other GST End of Surrender Death
Year Premium Charges Charges# of Year Value Benefit Charges Charges# Year Value Benefit

1 1,00,100 1,249 6,398 1,376 94,826 0 10,01,000 1,247 6,425 1,381 98,547 0 10,01,000 15,015
2 1,00,100 1,206 7,696 1,602 1,91,937 0 10,01,000 1,195 7,802 1,620 2,03,357 0 10,01,000 1,001
3 1,00,100 1,145 9,026 1,831 2,91,408 0 10,01,000 1,118 9,268 1,869 3,14,856 0 10,01,000 1,001
4 1,00,100 1,075 10,389 2,063 3,93,306 0 10,01,000 1,020 10,827 2,132 4,33,490 0 10,01,000 1,001
5 1,00,100 974 11,784 2,297 4,97,724 0 10,01,000 878 12,486 2,406 5,59,761 0 10,01,000 1,001
6 0 1,054 8,888 1,790 5,05,675 5,05,675 10,01,000 901 9,898 1,944 5,91,318 5,91,318 10,01,000 0
7 0 1,150 8,996 1,826 5,13,698 5,13,698 10,01,000 923 10,339 2,027 6,24,834 6,24,834 10,01,000 0
8 0 1,257 9,105 1,865 5,21,783 5,21,783 10,01,000 936 10,807 2,114 6,60,442 6,60,442 10,01,000 0
9 0 1,379 9,215 1,907 5,29,913 5,29,913 10,01,000 938 11,304 2,204 6,98,288 6,98,288 10,01,000 0
10 0 1,519 9,325 1,952 5,55,075 5,55,075 10,01,000 925 11,833 2,296 7,55,088 7,55,088 10,01,000 0

# includes all charges other than mortality charge, See Part B for details

IN THIS POLICY, THE INVESTMENT RISK IS BORNE BY THE POLICYHOLDER AND THE ABOVE INTEREST RATES ARE ONLY FOR ILLUSTRATIVE PURPOSE.

I, ____KANNAN S S _____, have explained the premiums, I, ____PRASANTH SOMANADHAN NAIR _____, having received
charges and benefits under the policy fully to the prospect / the information with respect to the above, have understood the
policyholder. above statement before entering into the contract.

Place:
Date: Signature of Agent/ Intermediary / Official Date: Signature of Prospect / Policyholder

Part B

(Amount in Rupees)

Gross
Yield 8% Net Yield 5.78 %

Premium Annualised
Annualised Allocation Premium - GST Policy Return of Loyalty Fund FMC Fund Death
Policy Mortality (Excl Guarantee Other Mortality Additions + Surrender
Year Premium Charge Premium Charge on Admin. Charge Charges* Charges Maturity before Incl at End Value Benefit
(AP) Allocation FMC) Charge (ROMC) Booster FMC GST of Year (Lumpsum)
(PAC) Charge
1 1,00,100 3,003 97,097 1,247 1,143 2,102 0 0 0 0 1,00,104 1,557 98,547 0 10,01,000
2 1,00,100 3,003 97,097 1,195 1,134 2,102 0 0 0 0 2,06,540 3,183 2,03,357 0 10,01,000
3 1,00,100 3,003 97,097 1,118 1,120 2,102 0 0 0 0 3,19,768 4,912 3,14,856 0 10,01,000
4 1,00,100 3,003 97,097 1,020 1,103 2,102 0 0 0 0 4,40,241 6,751 4,33,490 0 10,01,000
5 1,00,100 3,003 97,097 878 1,077 2,102 0 0 0 0 5,68,470 8,709 5,59,761 0 10,01,000
6 0 0 0 901 541 2,102 0 0 0 0 6,00,517 9,199 5,91,318 5,91,318 10,01,000
7 0 0 0 923 545 2,102 0 0 0 0 6,34,553 9,719 6,24,834 6,24,834 10,01,000
8 0 0 0 936 547 2,102 0 0 0 0 6,70,713 10,271 6,60,442 6,60,442 10,01,000
9 0 0 0 938 547 2,102 0 0 0 0 7,09,147 10,859 6,98,288 6,98,288 10,01,000
10 0 0 0 925 545 2,102 0 0 10,081 6,474 7,50,015 11,483 7,55,088 7,55,088 10,01,000

(Amount in Rupees)

Gross 4%
Yield

Premium Annualised
GST Policy Return of Loyalty
Policy Annualised
Premium
Allocation Premium -
Premium Mortality (Excl Admin. Guarantee Other Mortality Fund FMC Fund Surrender
Additions + before Incl at End
Death
Benefit
Year Charge Charge on Charge Charge Charges* Charges Maturity Value
(AP) Allocation FMC) (ROMC) Booster FMC GST of Year (Lumpsum)
(PAC) Charge
1 1,00,100 3,003 97,097 1,249 1,144 2,102 0 0 0 0 96,351 1,525 94,826 0 10,01,000
2 1,00,100 3,003 97,097 1,206 1,136 2,102 0 0 0 0 1,94,994 3,058 1,91,937 0 10,01,000
3 1,00,100 3,003 97,097 1,145 1,125 2,102 0 0 0 0 2,96,035 4,627 2,91,408 0 10,01,000
4 1,00,100 3,003 97,097 1,075 1,112 2,102 0 0 0 0 3,99,540 6,234 3,93,306 0 10,01,000
5 1,00,100 3,003 97,097 974 1,094 2,102 0 0 0 0 5,05,605 7,882 4,97,724 0 10,01,000
6 0 0 0 1,054 568 2,102 0 0 0 0 5,13,683 8,008 5,05,675 5,05,675 10,01,000
7 0 0 0 1,150 585 2,102 0 0 0 0 5,21,833 8,135 5,13,698 5,13,698 10,01,000
8 0 0 0 1,257 605 2,102 0 0 0 0 5,30,046 8,264 5,21,783 5,21,783 10,01,000
9 0 0 0 1,379 627 2,102 0 0 0 0 5,38,306 8,393 5,29,913 5,29,913 10,01,000

C.X.A
Quotation No : 60033696410

(Amount in Rupees)

Gross 4%
Yield

Premium Annualised GST Return of Loyalty

Policy Annualised Allocation Premium - Policy Guarantee Other
Mortality (Excl Admin. Mortality Fund FMC Fund Surrender
Additions + before Death
Year Premium Charge Premium Charge on Charge Charges* Charges Maturity Incl at End Value Benefit
(AP) Allocation FMC) Charge (ROMC) Booster FMC GST of Year (Lumpsum)
(PAC) Charge
10 0 0 0 1,519 652 2,102 0 0 12,009 4,999 5,46,589 8,523 5,55,075 5,55,075 10,01,000

C.X.A
Quotation No : 60033696410

In the above illustration, it is assumed that the Premiums are paid at the beginning of the year and benefits are payable at the end of the year.
Notes:
1. Refer the sales literature for explanation of terms used in this illustration.
2. Fund management charge is based on the specific fund option(s) chosen.
3. In case rider charges are collected explicitly through collec on of rider premium, and not by way of cancella on of units, then such charges are not
considered in this illustration. In other cases, rider charges are included in other charges.

I, ___ KANNAN SS _____(name), have explained the premiums, I, ___ PRASANTH SOMANADHAN NAIR _____ (name), having
charges and benefits under the policy fully to the prospect / received the informa on with respect to the above, have
policyholder. understood the above statement before entering into the contract.

Place:
Date: Signature of Agent/ Intermediary / Official Date: Signature of Prospect / Policyholder

Notes: Bajaj Allianz Life Magnum Fortune Plus

1. Please consult our 'Insurance Consultant' for any clarifications on this illustration.
2. Unit Linked Life Insurance Products are different from the traditional insurance products and are subject to the risk factors.
3. All benefits payable under the Policy are subject to the tax laws and other financial enactments, as they exist from time to time.
4. The Regular Premium and Top Up Premium, if any, paid is subject to investment risks associated with capital markets and Unit Prices may go up and
down based on the performance of the underlying assets in the Funds and the factors influencing the Capital market and the Life Assured/ Policyholder
is responsible for his/ her decisions.
5. Bajaj Allianz Life Insurance is the name of the company & Bajaj Allianz Life Magnum Fortune Plus is only the name of the Insurance Plan and does in no
way indicate the quality of the policy, its future prospects or returns.
6. On death of the life assured, Higher of (Prevailing Sum Assured or Regular Premium Fund Value) plus Higher of (Top up Sum Assured or Top up
Premium Fund Value) is payable, provided all due premiums are paid up to date
The total death benefit shall be at least the Guaranteed Benefit of 105% of Total premiums paid.
7. The plan provides Loyalty Advantage, as detailed below. Loyalty Advantage will be added into the fund provided all due premiums under the policy are
paid up to the date of each Loyalty Advantage. The Loyalty Advantage available in the product are:
Return of Mortality Charge (ROMC): Provided all premiums due under the policy are paid up to date, the mortality charges deducted will be added to
the Fund value including to the Top-up Fund Value (in amount and timing).
Loyalty Addi ons (LA): At the end of every year star ng from the 10th policy year, loyalty addi ons are added to regular premium fund value. For
more details, please refer the sales literature.
Maturity Booster: At the end of policy term, maturity booster will be added to regular premium fund value.For more details, please refer the sales
literature.

I, ___ KANNAN SS _____(name), have explained the premiums, I, ___ PRASANTH SOMANADHAN NAIR _____ (name), having
charges and benefits under the policy fully to the prospect / received the informa on with respect to the above, have
policyholder. understood the above statement before entering into the contract.

Place:
Date: Signature of Agent/ Intermediary / Official Date: Signature of Prospect / Policyholder

C.X.A