Dilip Namdev Dalvi

NEW SAPTARUSHI CHS

G-55/2/1 SECTOR 4
NERUL
NERUL NODE-III S O
THANE
MAHARASHTRA-400706
Mobile Number : 8169338283
Email ID : DALVIDILIP46@GMAIL.COM

Dear Dilip Namdev Dalvi,

This is your life insurance policy. It is a legal document. Please read it carefully.
We have highlighted some important points regarding your policy that you should keep in mind:

Name of Your Plan : ICICI Pru Gold –

A Non-Linked Participating
You have an option to review the policy within 30 days from
Individual Life Insurance Savings the date you receive it. In this period, if you are not satisfied
Plan with the policy terms and conditions, you can return the
Policy Number : I5647757
policy to us with reasons for cancellation. We will refund the
Mobile Number : 8169338283
premium paid after deduction of Stamp duty, proportionate
Email ID :
dalvidilip46@gmail.com risk premium for the period of cover and the expenses borne
by us on medical tests, if any.
Sum Assured on Death : 5,25,000
(at inception of the policy)(in `)
Premium installment (in `) : 50,000
Premium Payment Frequency : Yearly
This product has been sold to you by the Agent/
Next Premium Due Date : March 31, 2025
Intermediary/ Company as applicable, in accordance with
Premium Payment Term : 12 Years
the suitability information and declarations given by you in
Policy Term : 25 Years
the Customer Suitability Form. The same is attached with
In case of any discrepancies in the above details please inform us
immediately.
your Policy Document. This section shall not be applicable if
you have decided to waive off suitability assessment.

Name : IDFC FIRST BANK LIMITED

You can contact Us on 1860-266-7766 or visit any of Our
Chennai branch offices for any claims to be made under the policy
Code/License No. : 01405376 and we will assist the claimant through the entire process.
Contact No. : 1860 266 7766 You may contact your advisor for any queries you have or
Address : KRM Tower 7th Floor No.1 any clarifications that you require in relation to the policy
terms and conditions or any policy servicing requirements.
Harrington Road Chetpet Chennai Tamil
Nadu 600031

In order to pay your future premiums with ease, we recommend that you register for auto-debit. For doing so please log into
your account on our website and submit the auto-debit mandate.
In case of any queries or clarifications required, please feel free to contact your advisor or reach us at any of our service
centres mentioned below. We will be happy to assist you.
Warm regards,

Authorised Signatory

ICICI Prudential Life Insurance Co Ltd. Registered Address: ICICI Prulife Towers, 1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai-400025, Reg No:105. Unique
Identification Number as specified by IRDAI 105N190V02. COMP/DOC/Dec/2023/1412/4952. CIN: L66010MH2000PLC127837 Fax Number : +91-22-42058222
April 4, 2024
I5647757
Dilip Namdev Dalvi
NEW SAPTARUSHI CHS
G-55/2/1 SECTOR 4
NERUL
NERUL NODE-III S O
THANE
MAHARASHTRA-400706
Mobile Number : 8169338283
Email ID: DALVIDILIP46@GMAIL.COM

Kit Type : Insurance Kit

Your Policy and Premium Detail

Policy Number I5647757
Product Name ICICI Pru Gold
Premium Amount `50,000
Sum Assured `5,25,000
Premium Paying Term 12
Policy Term 25

Subject: DILIP NAMDEV DALVI, Congratulations! Your dreams are insured now.

Dear DILIP NAMDEV DALVI,

It is our privilege to welcome you to the IDFC FIRST Bank Family on account of your ICICI Pru Gold underwritten by ICICI Prudential Life
Insurance.
As an esteemed customer, we are delighted to start this new relationship with you.
We can assure you of our commitment to provide you with the best of our services and are always ready to help you with personal and
professional financial planning solutions in relation to your insurance policy, and solve any questions you may have in connection with the
services.
Your insurance policy comes with a host of features and package based benefits to make your insurance experience - Simple, Secure and
Convenient.
For more details on the features and services available under the insurance product, please go through the complete policy documents
shared by insurance service provider.
Please feel free to get in touch with us via any of the below channels.
• Call your relationship officer/SP
• Email at Banker@idfcfirstbank.com
• Visit your IDFC FIRST Bank branch
• Connect with our Call Center 24x7 on 1860 258 2000
We thank you for your patronage and look forward to serving you for years to come.

Thank you!

Nikhil Verma
Principal Officer
IDFC FIRST Bank

ICICI Prudential Life Insurance Co Ltd. Registered Address: 1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai-400025, Reg No:105.CIN: L66010MH2000PLC127837.
Trade logo displayed above belongs to ICICI Bank Ltd & Prudential IP services Ltd and used by ICICI Prudential Life Insurance Company Ltd under license.
COMP/DOC/Jun/2023/286/3342.
Features of ICICI Pru Gold
ICICI Pru Gold is a protection and savings oriented participating life insurance plan that
provides you with a lifelong regular income to meet your long-term recurring financial
needs. It also provides a life cover to take care of your loved ones in your absence. Read
on to know more about the benefits of this policy.

What are the benefits of this policy?

99 years of age: You will start receiving a regular income immediately from Apr
a) Regular income till 85 Aug2024
2021 `
to Apr
Aug2048
2087. The income will be partly guaranteed and partly dependent on bonuses which will be
declared throughout the policy term.
The below table shows the income you are likely to receive at two different scenarios:

Assumed rate of return# You will receive

8% ` 13,480/-
10,00,000/-
4% ` 7,085/-10,00,000/-
Note: For more details, please refer to the EBI.

b) Maturity Benefit: You will receive a lump sum at the end of the policy term i.e. in Mar
Aug 2049
2087. This lump sum is
referred to as ‘Maturity Benefit’ in the EBI, which comprises of the guaranteed benefit (Sum Assured on Maturity)
and the bonus (Terminal bonus).
The below table shows the lump sum that you are likely to receive at two different scenarios:

Bonus (B)
Guaranteed You will
Benefit (A) Assumed rate receive (A+B)
Bonus Amount
of return#
8% ` 3,20,026/-
10,00,000/- ` 9,20,026/-
10,00,000/-
` 6,00,000/-
10,00,000/-
4% ` 1,07,934/-
10,00,000/- ` 7,07,934/-
10,00,000/-

c) Life Insurance Benefit: If the person whose life is covered under this policy passes away during the policy term, a
lump sum will be paid to the person specified by you (known as the Nominee) in your policy.
The amount which will be paid will be as follows:
• Sum Assured on Death of ` 5,25,000/-
10,00,000 + Balance in Savings Wallet + Interim Survival Benefit (if any) +
Terminal Bonus (if declared);
where Sum Assured on Death is higher of: a) Death benefit multiple times Annualized premium (as mentioned
above), b) 7 times Annualized premium or c) 105% of Total Premiums Paid as on the date of death.
The Nominee can initiate the process of receiving this amount by visiting www.iciciprulife.com/claims.

d) Savings Wallet: This feature gives you the option to accumulate your income and further grow your savings. `
`

This option acts like a wallet, giving you the flexibility to accumulate or withdraw income as per your
requirement.

e) Tax benefits: You can avail tax benefits on the premiums you pay towards this plan and the benefits you receive,
subject to conditions under section 80C, 10(10D), 115BAC & other provisions of the Income Tax Act, 1961. Tax
laws are subject to amendments from time to time.

How much premium do you need to pay?

50,000/-
Pay your premium of ` 10,00,000/- every year
6 months for 12 years. Stay invested till the end of policy
10
`
term, i.e. Mar 2049
till 2040>.
<July
What happens if you don’t pay premiums for the complete premium payment term?
It is in your best interest that you pay premiums till Mar
Aug 2035
2030 and stay invested till Mar 2049 in this policy so
July 2080 `

that you enjoy all the benefits of this policy. `

If you stop paying premiums after paying for at least two full years, your policy will continue with reduced
benefits. For more details, please refer to Part C Clause 3 of your Policy Document. If you stop paying premiums
in the first two years, no benefits will be payable.

ARR stands for Assumed rate of return. If the policy offers guaranteed returns, then these will be clearly marked "guaranteed" in the Benefit Illustration.
#

Since the policy offers variable returns, the given illustration shows two different rates of assumed future investment returns. The returns shown above
are not guaranteed and they are not the upper or lower limits of what you might get back, as the maturity value of policy depends on a number of
factors including future investment performance.

The values mentioned above are indicative based on the date on which you applied for this policy. The exact values will be as per the date of issuance
#

of your policy and are specified in the Policy Certificate attached in your welcome kit.
“The values appearing in this feature document are based on the information provided and the type of cover sought by you in the duly filed proposal
form. It is pertinent to note that any change affected by you in the details provided in the proposal form may lead to a change in the benefits or premium
payable under this policy.”
IRDAI Reg No: 105. CIN: L66010MH2000PLC127837. ICICI Prudential Life Insurance Co. Ltd. Registered Address: 1089, Appasaheb Marathe Marg,
Prabhadevi, Mumbai-400025. UIN 105N190V02.. COMP/DOC/Nov/2022/2311/1551.
 vc

ICICI Pru Gold (UIN :105N190V02)

(This is a Non-Linked Participating Individual Life Insurance Savings Plan)
Policy Preamble
This Policy is the evidence of a contract between ICICI Prudential Life Insurance Company Limited(Us/We/Company) and the
Policyholder(You) referred to below.
We have issued this Policy on the basis of the details provided by You in the Proposal Form submitted along with the required
declarations, personal statement, applicable medical reports, the first premium deposit and any other information and documentation
which constitute evidence of the insurability of the Life Assured for the issuance of the Policy.
We agree to provide the benefits set out in this Policy subject to its terms and conditions.
Policy Schedule
Name of the Life Assured : Dipali Dilip Dalvi
Address : NEW SAPTARUSHI CHS, G-55/2/1 SECTOR 4, Category : NON-MEDICAL
NERUL, NERUL NODE-III S O, THANE, Maharashtra-400706

Date of Birth : February 05, 1964 Age(Years) : 60 Gender : F Age Admitted : YES

Name of the Policyholder : Dilip Namdev Dalvi

Policy No : I5647757 Policy Issue Date : March 31, 2024
Policy Acceptance Date : March 31, 2024 Date of Maturity : March 31, 2049
Premium Payment Term (PPT) in years : 12 Policy Term in years : 25
Premium Payment Option : Limited Pay Periodicity of payment of premium
(premium frequency) : Every year
Due date of last premium payable : March 31, 2035 Total instalment premium(`) : 50,000
Policy sourced by Distance Mode : N
Plan Variant : Immediate Income
Sum
Deferment
Assured
Period
on Death(at
:0 inception of the policy)(`) : 5,25,000
Guaranteed Income(`) : 2,990
Frequency of Survival Benefit : Yearly
Income Start Date : April 5, 2024
Sum
Guaranteed
AssuredBooster(`)
on Maturity(`)
: 2,990
: 6,00,000
Opted for Savings Wallet? : No

Relationship
Appointee Name
Relationship Appointee' of the
Nominee(s) Nominee’s Percentage [in case the Appointe
Gender to the Life s appointee
Name Age Share Nominee is a e’s Age
Assured Gender with the Life
minor]
Assured
NA NA NA NA NA NA NA NA NA

Goods and Services tax would be charged extra, as applicable.

Policy Schedule, terms and conditions of the Policy and the endorsements by Us, if any, shall form an integral part of this contract and shall be
binding on Us and You.

The Policy shall stand cancelled by Us, without any further notice, in the event of dishonour of the first premium deposit.

Signed for and on behalf of the ICICI Prudential Life Insurance Company Limited, at Head Office, Mumbai on March 31, 2024 (Issue Date).

Digitally signed by AMISH MANIKANT BANKER

Date: 2024.04.04 20:59:31 IST
Reason: Digitally Signed
Location: Mumbai
Authorised Signatory
Stamp Duty of Rs.105 /- (ONE HUNDRED FIVE RUPEES) paid LOA/ENF-2/CSD/5/2024(Validity Dt.25/01/2024 to 31/12/2025)/1020 dated 25th
Jan 2024.
This is an output of a digitally signed print file
Please immediately inform Us about any change in address or contact details.
Please examine the policy and approach Us immediately in case of any discrepancies.
 PREMIUM RECEIPT

Name of Policy Holder Dilip Namdev Dalvi

Policy Name ICICI Pru Gold

Policy Number Receipt Number Date of Receipt

I5647757 Q3495454 March 15, 2024

Premium Details (`) Payment Details

Premium Installment(A) 50,000 Frequency of Payment Yearly

Goods and Services tax(B) 2,250 Cheque / Transaction No . 816879

Premium Amount received(A+B) 52,250 Cheque / Transaction Date March 11, 2024

Bank Name IDFC BANK LTD

Balance Premium (`)

The amount indicated as 'balance in deposit' (if any) will be adjusted towards
Balance in deposit 1 the next premium or refunded to you as applicable

Consolidated revenue stamp duty paid: Notification No - Mudrank - CSD/79/2023/3028-26/06/2023

Income Tax Benefits :

Tax benefits on Life Insurance policy would be available u/s 80C, on Pension Policy u/s 80CCC & on Health riders (if any) u/s 80D

Please note :
For premium payments (including top-ups) aggregating Rs.50,000 or more in a year, updating PAN details is mandatory.
Option of submitting Form 60/61 is available in case of no PAN.
The risk of the company under this policy starts with effect from the date of the issuance of this policy March 31,2024 or the
date of encashment of the first premium deposit, whichever is later.
In any case, the Policy shall stand cancelled in case of non-encashment of the First Premium Deposit by the Company.
This is an authenticated Receipt/Intimation/Statement. In case of any discrepancies, kindly notify us within 14 working days
through any of our touch points mentioned on page 1 of the policy document.
NRI customers are requested to retain a copy of the instrument/proof of transaction of the payment of premium. Such copy of
instrument/proof of transaction would be required to be produced at time of any payments request from you. It would help us in
confirming the source/form of receipt of premium , which could aid the process of repatriation at the Authorized dealer's end.
Goods and Services tax and/or cess(if any).

Other details :
UIN - Unique Identification Number specified by ICICI PRU GOLD 105N190V02

We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the
aggregate turnover notified under sub-rule (4) of rule 48, we are not required to prepare an invoice in terms of the provisions of
the said sub-rule.
 Policy Document - Terms and Conditions of your policy
nominated by You to receive the Death Benefit. Nomination can be effected only if
ICICI PruGold
Policyholder is same as Life Assured. 27. Paid-up Date is the date on which the
(A Non-Linked Participating Individual Life Insurance Savings Plan) premium remains unpaid after the expiry of grace period and after payment of at
PART-B least first two full years’ premium. 28. Paid-up Policy is a Policy wherein premium
payment has been discontinued after acquiring a Surrender Value. 29. Policy
Definitions
means the contract of Insurance entered into between You and Us as evidenced by
1. Age means age of the Life Assured in completed years as on Date of this“Policy document”. 30. Policy Acceptance Date means the date as specified in
Commencement of Risk of Policy. 2. Annualized Premium shall be the premium the Policy Schedule from which this Policy was effected. 31. Policy Anniversary
amount payable in a year chosen by the Policyholder, excluding the taxes, rider means the annual anniversary of the date of commencement of risk of the policy.
premiums, underwriting extra premiums and loadings for modal premiums, if any. 32. Policy Document means this document, the Proposal Form, the Policy
3. Appointee means the person appointed by You and named in the Policy Schedule and any additional information/document(s) provided to Us in respect of
Schedule, to receive the benefits payable under the Policy until Your nominee the Proposal Form, and any endorsement issued by Us. 33. Policy Issue Date
attains the age of majority. This is applicable only where the nominee is a minor. 4. means the date as specified in the Policy Schedule. 34. Policy Month means the
Assignee shall mean a person or an entity to whom the rights of this Policy has period between two consecutive Month Anniversaries. 35. Policy Year means a
been transferred by the Policyholder/ You in accordance with Section 38 of the period of 12 months commencing from the date of commencement of risk of policy
Insurance Act 1938 as amended from time to time. 5. Assignment is the process of and every policy anniversary thereafter. 36. Policy Term means the period
transferring the rights and benefits to an “Assignee”. Assignment should be in between the Policy Acceptance Date and the Date of Maturity as specified in the
accordance with the provisions of section 38 of the Insurance Act, 1938 as Policy Schedule. 37. Policy Schedule means the Policy schedule and any
amended from time to time. 6. Bonuses applicable are defined as follows a) Cash endorsements attached to and forming part of this Policy. 38. Premium means the
Bonus: Cash bonus is one of the components of Survival Benefit and is equal to instalment premium specified in the Policy Schedule which is payable/has been
cash bonus rate multiplied by Annualized Premium. Cash bonus, if declared, will be received under the Policy. 39. Premium Payment Term means the period specified
declared annually and paid out as outlined in Part C, Clause 2(a), provided the in the Policy Schedule during which Premium is payable. 40. Proposal Form means
policy is in force. b) Interim Cash Bonus: Interim Cash Bonus is equal to Interim a form to be completed by You for availing an insurance Policy, and to furnish all
Cash bonus rate multiplied by Annualized Premium. Interim Cash Bonus, if Material information required by Us to assess risk and to decline or to undertake
declared, will be paid on Death of the Life Assured during the policy term, provided the risk, and in the event of acceptance of risk, to determine the rates, advantages,
the policy is in force. c) Contingent Terminal Bonus: Contingent Terminal Bonus, if terms and conditions of a cover to be granted. Explanation: “Material” shall mean
declared, may only explicitly accrue to paid-up policies at the time of policy and include all important, essential and relevant information that enables Us to
becoming paid up and will be payable on termination due to death, surrender or take an informed decision while underwriting the risk. 41. Regulator is the
maturity (whichever happens first). d) Terminal Bonus: Terminal Bonus, if declared, authority that has regulatory jurisdiction and powers over Us. Currently the
provided the policy is in force will be paid on the death of the Life Assured, Regulator is the Insurance Regulatory and Development Authority of India (IRDAI).
surrender of the policy or on maturity. 7. Claimant means the person(s) entitled to 42. Revival of the Policy means restoration of Policy benefits which has lapsed or
receive the Policy benefits as per the terms and conditions of the Policy and has acquired paid-up status due to non-payment of due premiums. 43. Revival
applicable laws, and includes the Policyholder, the nominee (s), the assignee, or Period means the period of five consecutive years from the date of first unpaid
their respective legal heir(s), the legal representative(s) or the holder(s) of premium, during which period You are entitled to revive the lapsed or paid-up
succession certificate, as the case may be. 8. Date of Commencement of Risk is Policy. 44. Sum Assured on Death (at inception of the Policy) means the minimum
the Policy Acceptance Date or the Policy Issue Date whichever is later. 9. Date of amount payable on Your death at the inception of the policy in accordance with the
Maturity means the date specified in the Policy Schedule on which the term of the terms and conditions of the Policy and is specified in the Policy Schedule. 45. Sum
Policy ends and maturity benefit, if applicable, is payable. 10. Death Benefit Assured on Maturity means the minimum amount payable to you on the date of
means the benefit, which is payable on death as specified in the Policy document. maturity and is specified in the Policy Schedule. 46. Surrender means complete
11. Deferment Period means the period, in years post which the Survival Benefit withdrawal/termination of the Policy by You. 47. Surrender Value means an
becomes payable at the end of every year/month.This is specified in the Policy amount, if any, that becomes payable in case of surrender in accordance with the
Schedule and is only applicable under Deferred Income Plan variant. 12. Distance terms and conditions of the Policy. 48. Total Premiums paid means total of all the
Mode means every activity of solicitation (including lead generation) and sale of premiums received, excluding any extra premium, any rider premium and taxes.
insurance products through the following modes: (i) voice mode, which includes 49. You or Your means the Policyholder of the Policy at any point of time. 50. We or
telephone-calling (ii) short messaging service (SMS) (iii) electronic mode which Us or Our or Company means ICICI Prudential Life Insurance Company Limited.
includes e-mail, internet and interactive television (DTH) (iv) physical mode which
Part - C
includes direct postal mail and newspaper and magazine inserts and (v)
solicitation through any means of communication other than in person. 13. Free The benefits under this policy shall be payable as per the plan chosen by you at
Look Period is the period of 15 days (30 days if the Policy is an electronic Policy or inception. The plan chosen by you is mentioned in the policy schedule. There are
is purchased through Distance Mode) from the date of receipt of the Policy three plan variants available i.e. Immediate Income, Immediate Income with
Document by the Policyholder to review the terms and conditions of this Policy and Booster and Deferred Income. The benefits applicable under each plan are as
where the Policyholder disagrees to any of those terms and conditions, he/ she has mentioned below.
the option to return this Policy as detailed in Part D of this Policy Document. 14. 1. Death Benefit For All three plan variants: (i) On death of the Life Assured during
Fully paid Policy is a Policy for which all premiums have been paid, as per the the Policy term, for a premium paying or fully paid Policy, Death Benefit shall be
Premium Payment Term selected, and no further premiums are due. 15. Grace payable to the Claimant. Death Benefit is equal to: • Sum Assured on Death, plus •
Period means the time granted by Us from the due date for the payment of Balance in the Savings Wallet (if any), plus • Interim Survival Benefit (if any), plus •
premium, without any penalty / late fee, during which time the Policy continues Terminal Bonus (if declared) Where, the Sum Assured on Death is the highest of: •
with risk cover without interruption, as per the terms of the Policy. 16. Guaranteed 7 times the Annualized Premium, • 105% of the Total Premiums Paid as on the
Income (GI) is the amount as mentioned in Your Policy Schedule and is payable as Date of Death, and • Death Benefit multiple (as given in the table below) times
per Part C, Clause 2(a). 17. Guaranteed Booster (GB) means an amount as Annualized Premium.
mentioned in Your Policy Schedule and is payable as per Part C, Clause 2(a), under
Age Multiple Age Multiple Age Multiple Age Multiple
Immediate Income with Booster variant. 18. Income Term means the period ≤5 15.0 17 13.8 29 12.6 41 11.4
between the start of the policy year in which the survival benefit is first due to be 6 14.9 18 13.7 30 12.5 42 11.3
paid and the date of maturity of the policy. 19. In-force policy means a policy 7 14.8 19 13.6 31 12.4 43 11.2
where either all due premiums have been paid for the premium payment term or 8 14.7 20 13.5 32 12.3 44 11.1
are being regularly paid by You. 20. Insured event is death of the Life Assured 9 14.6 21 13.4 33 12.2 45 11.0
10 14.5 22 13.3 34 12.1 46 10.9
during the term of the Policy. 21. Life Assured means the person named in the
11 14.4 23 13.2 35 12.0 47 10.8
Policy Schedule on whose life the Policy has been issued. 22. Limited Pay means 12 14.3 24 13.1 36 11.9 48 10.7
premiums need to be paid regularly for a limited portion of the Policy term. 23. 13 14.2 25 13.0 37 11.8 49 10.6
Maturity Benefit means the benefit, if any, which is payable on maturity i.e. at the 14 14.1 26 12.9 38 11.7 ≥ 50 10.5
end of the Policy term, as specified in the Policy document. 24. Month anniversary 15 14.0 27 12.8 39 11.6
16 13.9 28 12.7 40 11.5
means the monthly anniversary of the Date of Commencement of Risk of policy.
25. Nomination is the process of nominating a person(s) in accordance with The Interim Survival Benefit will be computed as below: • For “Immediate Income”
provisions of Section 39 of the Insurance Act, 1938 as amended from time to time. and “Deferred Income” variants: Interim Survival Benefit = (Interim Cash Bonus
26. Nominee means the person(s) named in the Policy Schedule who have been Rate *Annualized Premium + Guaranteed Income) * Months elapsed since last
 Survival Benefit payout date / 12 • For “Immediate Income with Booster” variant: Wallet on the due date, the Survival Benefit will be deemed to have been paid and
Interim Survival Benefit = (Interim Cash Bonus Rate * Annualized Premium + any amount within the Savings Wallet will be non-participating in nature. This
Guaranteed Income + Guaranteed Booster) *Months elapsed since last Survival option can be opted for and opted out at any time during the Income Term. B. This
Benefit payout date / 12, where the Guaranteed Booster will be applicable in case option to accumulate Survival Benefit can be availed for both in-force as well as
death happens in the policy year when the same is payable. (ii) On payment of paid-up policies. At any point of time, You will be able to check the balance
Death Benefit to the Claimant, the policy will terminate and all rights, benefits and available in your wallet. C. The money within the wallet will be accumulated daily
interests under the policy will stand extinguished. at an interest rate linked to the Reverse Repo Rate published by Reserve Bank of
2a. Survival Benefit (i) For Immediate Income Plan: On survival of the Life Assured, India (RBI). The interest rate used for accumulation under this feature will be
the Survival Benefit will be payable from the first policy year at the end of every reviewed twice every year on 1st of June and 1st of December, and will be set equal
policy year/month as chosen by You at the inception, provided the policy is in force. to Reverse Repo Rate published on RBI’s website as on the review date. The
This would be paid till termination of the coverage/policy due to lapse, death, current Reverse Repo Rate as at December 1, 2023 is 3.35% p.a. Any change in
surrender or maturity, whichever happens first. The Survival Benefit will comprise bases used for determination of applicable interest rate will be subject to prior
of the sum of the following: • Guaranteed Income (GI) • Cash Bonus (CB), if approval from IRDAI and will be disclosed to You. D. You also have an option to
declared (ii) For Immediate Income with Booster Plan: On survival of the Life withdraw, completely or partially, the balance in the wallet anytime during the
Assured, the Survival Benefit (if due) will be payable from the first policy year at the Income Term. E. You have the option to utilize the balance in the Savings Wallet to
end of every policy year/month as chosen by You at the inception, provided the offset any premiums due to be paid during the premium payment term. The same
policy is in force. This would be paid till termination of the coverage/policy due to has to be provided to Us as a request prior to the premium due date. Upon receipt of
lapse, death, surrender or maturity, whichever happens first. The Survival Benefit such request and confirmation of the same, We shall automatically deduct the
will comprise of the sum of the following: • Guaranteed Income (GI) • Guaranteed authorized amount on the premium due date from the Savings Wallet.If the
Booster (GB)*, and • Cash Bonus (CB), if declared *Guaranteed Booster (GB)will be amount available for offset is not sufficient to adjust the due premium, the balance
payable only every 5th policy year as a part of the Survival Benefit, and will be due premium shall remain payable by You as on the premium due date. We shall
equal to 100% of the Guaranteed Income (GI) as applicable for the year of payment. recognize the settlement of due premium only after receipt of the same in full. F. In
(iii) For Deferred Income Plan: On survival of the Life Assured, provided the policy case the balance in the wallet is not withdrawn completely during the income term,
is in-force,the Survival Benefits will be payable at the end of every policy such balance will be paid to the claimant in the event of death, surrender or
year/month as chosen by You at the inception, from the end of the Deferment maturity, whichever is earlier along with other benefit payments (if any., On
Period as chosen by You, till termination of the coverage/policy due to lapse, death, payment of this benefit, the policy will terminate, and all rights, benefits and
surrender or maturity, whichever happens first. The Survival Benefit will comprise interests under the policy will stand extinguished.
of the sum of the following: • Guaranteed Income (GI) • Cash Bonus (CB), if 2b. Maturity Benefit For All three plan variants: For a fully-paid Policy, on survival of
declared (iv) The Guaranteed Income (GI) will be set as Guaranteed Income rate the Life Assured till the end of the Policy term, a Maturity Benefit will be payable in
multiplied by Annualized Premium at policy inception and will remain guaranteed lump sum on the date of maturity. This Maturity Benefit will be sum of • Sum
to be paid every year/month throughout the income term. The Guaranteed Income Assured on Maturity, plus • Balance in the Savings Wallet (if any), plus • Terminal
rates have been provided in Appendix I. (v) The Cash Bonus (CB) will be computed Bonus (if declared) The Sum Assured on Maturity shall be the sum of Annualized
as Cash Bonus rate multiplied by Annualized Premium where the bonus rate will be Premium payable under the policy. On payment of this benefit, the policy will
as declared by the Company. The Cash Bonus rate may vary by the plan variant terminate and all rights, benefits and interests under the policy will stand
chosen, age at entry of the Life Assured, premium payment term, policy term, and extinguished. Tax Benefits may be applicable as per the prevailing tax laws.
the Deferment Period chosen under the “Deferred Income” variant. The Cash
Bonus rate will be as declared by the Company at the end of each financial year. 3. Paid-up Policy If any premium remains unpaid after the expiry of the grace period
For a new policy sold with Date of Commencement of Risk on or after April 1 in any and the policy has acquired a surrender value, the policy’s status shall be altered to
financial year, there may not be any Cash Bonus rate declared for such policies paid-up status with the following reduced benefits payable under specified
when the Survival Benefit becomes due to be paid. In such circumstances, the contingencies as described below. A paid-up policy will not be entitled to any
Company will pay a fixed cash income benefit in lieu of Cash Bonus. This fixed cash future bonus, in terms of Cash Bonus or Terminal Bonus. a. Death Benefit On death
income benefit will be based on a non-participating Cash Income rate (declared by of the Life Assured during the Policy Term, the following will be payable: Death
the Company annually in advance and same as the cash bonus rate declared) and Benefit shall be equal to: • Paid-up Sum Assured on Death, plus • Balance in the
once declared shall remain guaranteed to be paid as part of Survival Benefit as and Savings Wallet (if any), plus • Interim Paid-up Survival Benefit (if any), plus •
when it is due. Such payments in the form of fixed benefit shall continue till a Cash Contingent Terminal Bonus (if declared). Paid-up Sum Assured on Death = Sum
Bonus rate (as applicable for the policy) is declared and the Cash Bonus benefit, if Assured on Death X {number of months for which premiums are paid / (12 X
declared, becomes payable at the next benefit due date. There will not be any Premium Payment Term)} The Interim Paid-up Survival Benefit will be computed
associated shareholder transfer with such fixed cash income benefit. (vi) You have as below: • For “Immediate Income” and “Deferred Income” variants: Interim Paid-
the option to receive the Survival Benefit annually or monthly. The option needs to up Survival Benefit = Paid-up GI * Months elapsed since last Survival Benefit
be chosen at policy inception which cannot be changed later during the policy term. payout date / 12 • For “Immediate Income with Booster” variant: Interim Paid-up
Following modal factors would apply depending on the option chosen by You. Any Survival Benefit = (Paid-up GI + Paid-up GB) * Months elapsed since last Survival
change in modal factor will be subject to prior approval from IRDAI. Benefit payout date / 12, where the Paid-up GB will be applicable in case death
happens in the policy year when the same is payable. On payment of this paid-up
Frequency Modal factor death benefit to the Claimant, the policy will terminate and all rights, benefits and
Monthly 96% interests under the policy will stand extinguished. b1. Survival Benefit On survival
Annual 100% of the life assured, paid-up survival benefit in the form of paid-up GI will be payable
at the end of every year/month, from the later of Paid-up date or start of the income
(vii) Save the Date: The Survival Benefits will by default be paid on the policy term, till termination of the policy due to death, surrender or maturity, whichever
anniversary if annual frequency of payment has been opted for. Alternately, You happens first. Paid-up GI = GI X {number of months for which premiums are paid /
can choose to receive the Survival Benefit on any one ‘Special Date’, during the (12 X Premium Payment Term)} In case You have selected the “Immediate Income
policy year prior to the policy anniversary, as per your choice and the benefit will be with Booster” variant at inception where You will receive Guaranteed Booster (GB),
paid on this chosen date every year through the income term till policy termination. the same shall be paid in the form of paid-up GB in the policy years’ when it is due.
This will be the ‘Save the Date’ feature. This option to receive Survival Benefit on Paid-up GB = GB X {number of months for which premiums are paid / (12 X
any one ‘Special Date’ can be availed by both in-force as well as paid-up policies. In Premium Payment Term)} “Save the Date” and “Savings Wallet”, as mentioned in
case You opt for a Special Date other than the policy anniversary, the Survival Clause 2a (vii) and 2a (viii) above, are applicable for paid-up policies also. b2.
Benefit payable each year would be adjusted by multiplying the amount with the Maturity Benefit On survival of the life assured till the end of the policy term, for a
Save the Date factors mentioned in Appendix II, varying by the policy month in paid-up policy, the following will be payable: Maturity Benefit is the sum of: • Paid-
which the Special Date falls: In case You have selected the “Immediate Income with up Sum Assured on Maturity, plus • Balance in the Savings Wallet (if any), plus •
Booster” variant at inception where you will receive Guaranteed Booster (GB) Contingent Terminal Bonus (if declared). Paid-up Sum Assured on Maturity = Sum
benefit as part of the Survival Benefit, then the same shall be paid (adjusted as Assured on Maturity X {number of months for which premiums are paid / (12 X
above) on the Special Date in the policy year when it is due. This option needs to be Premium Payment Term)} On payment of this paid-up maturity benefit, the policy
selected at policy inception and cannot be changed during the policy tenure. will terminate and all rights, benefits and interests under the policy will stand
(viii) Savings Wallet: A. You have an option to accumulate the Survival Benefit, extinguished. On revival of a paid-up policy, the paid-up Sum Assured on Death,
instead of taking the same as a periodic payment during the policy term. You need paid-up Sum Assured on Maturity and paid-up Survival Benefit will be restored to
to opt in for this feature through explicit consent vide request submitted to Us, the original Sum Assured on Death, Sum Assured on Maturity and Survival Benefit,
whereby the Survival Benefit when due will be transferred to the Savings Wallet respectively. In addition, the difference between the Paid-up Survival Benefit
(linked to the underlying policy). Upon crediting the Survival Benefit in the Savings already paid out during the revival period and the Survival Benefit for a premium
 paying or fully paid policy (as applicable) will also be payable to You. The above will Value the policy will terminate and all rights, benefits and interests under the policy
include all applicable Cash Bonuses (or Fixed Cash Income, if applicable) declared will stand extinguished. I. Guaranteed Surrender Value GSV will be calculated as
since premium discontinuance up to the date of revival. The Contingent Terminal follows: GSV = GSV Factor X Total Premiums Paid, less Survival Benefits (if any)
Bonus (if any) attached to the policy will be reversed. paid till date, subject to a minimum of zero. The GSV factors are provided in
4. Premium Payment a) You are required to pay premiums for the entire premium Appendix III. The Guaranteed Surrender Value factors are applicable at the
payment term on the due dates and for the amount mentioned in the Policy beginning of the year and shall be linearly interpolated to arrive at the factors
Schedule. b) Premiums under the Policy can be paid in yearly, half-yearly or applicable at the time of surrender any time during the year of surrender. All the
monthly mode. c) For monthly and half-yearly modes of premium payments, factors applicable to Guaranteed Surrender Value calculation are guaranteed
additional loadings will be applied to both the base premium and the extra throughout the policy term. II. Special Surrender Value SSV for policies
mortality premium. The additional loadings, expressed as a percentage of the surrendering after premium payment of two full policy years will be calculated as
annual premium will be as given below: follows: SSV = SSV Factor X Total Premiums Paid, less Survival Benefits (if any)
paid till date, subject to a minimum of zero, plus Terminal Bonus (applicable for
Mode of Premium Payment Loading (% of Annual Premium) premium paying or fully paid policies) or Contingent Terminal Bonus (applicable for
Monthly 4.5% Reduced Paid-up policies), if declared. Contingent Terminal Bonus has been
described under Clause 3(d) and 3(e) below. The Special Surrender Value factors
Half-yearly 2.5%
are applicable at the beginning of the year and shall be linearly interpolated to
Yearly Nil arrive at the factors applicable at the time of surrender any time during the year of
surrender. Any change in SSV factors will be subject to prior approval from IRDAI.
d) Any change in premium payment frequency will be allowed during the Premium
3. Computation of Bonuses a. Bonuses will be applied through the simple bonus
Payment Term only on policy anniversary. e) The grace period for payment of
method. b. Cash Bonuses may be declared annually throughout the policy term for
premium is 15 days for monthly mode of premium payment and 30 days for other
all three variants, and will be expressed as a proportion of the Annualized
frequencies of premium payment. f) If any premium instalment is not paid within
Premium. For each variant, an Interim Cash Bonus may also be payable (if
the grace period before the Policy acquires a surrender value then the Policy shall declared) at the time of death benefit payout during the inter-valuation period. A
lapse, no benefits will be payable and the cover will cease. On revival of a lapsed separate Terminal Bonus may be declared under each variant, and will be payable
policy, all benefits under the policy will be restored. All applicable Survival Benefits on death, surrender and maturity, respectively, for a premium paying or a fully paid
since premium discontinuance up to the date of revival shall become payable to policy. c. All such bonuses are non-guaranteed in nature and declaration of the
You. If any premium instalment is not paid within the grace period any time after same are at the discretion of the Company, and whilst the Company intends to
the Policy acquires a surrender value then the Policy shall become a paid-up Policy declare bonuses every year, it is possible that it may not declare any bonus for a
and reduced benefits will continue as described in Part C, Clause 3 above. g) You given year. However, once declared, the bonus shall become guaranteed to be
are required to pay premiums for the entire premium payment term. h) You may pay paid in accordance with the benefits offered under the product. The bonus rates
premium through any of the following modes: i. Cheque ii. Demand Draft iii. Pay declared (if any) may vary, as per discretion of the company, by: • The contingency
Order iv. Banker’s cheque v. Internet facility as approved by us from time to time vi. such as survival, death, surrender or maturity; and/or • The policy status either in-
Electronic Clearing System/Direct Debit vii. Credit or Debit cards held in your name force with no outstanding due premiums or in-force as reduced paid-up policy. The
viii. any other mode, subject to applicable laws and Company’s internal policies i) latter will be in the form of Contingent Terminal Bonus, if declared. d. Contingent
Amount and modalities will be subject to our rules and relevant legislation or Terminal Bonus may only explicitly accrue to policies that become paid-up, if the
regulation. j) Any payment made towards first or renewal premium is deemed to be premiums have been paid for first two policy years. The Contingent Terminal
received by Us only when it is received at any of Our branch offices or authorized Bonus, if declared, will accrue to the policy at the time of policy becoming paid up
collection points and after an official printed/digital receipt is issued by Us. k) No and will be payable to these policies on termination due to death, surrender or
person or individual or entity is authorized to collect cash or self-cheque or bearer maturity (whichever happens first). e. The Contingent Terminal Bonus would be
cheque on Our behalf. l) Cheque or demand drafts must be drawn only in favour of reversed on revival. Terminal Bonus would be reversed on revival. f. Once a policy
becomes a paid-up policy, no future cash or terminal bonuses shall be payable.
ICICI Prudential Life Insurance Company Limited. m) Please ensure that You
4. Loans (i) Loans are available once the policy has attained a Surrender Value. (ii)
mention the proposal number for the first premium deposit and the Policy number
Loan amount of up to 80% of Surrender Value can be availed. (iii) For other than in-
for the renewal premiums on the cheque or demand draft. n) In the event, first
force and fully paid policies, if the outstanding loan amount including interest
premium deposit or renewal premium is being paid by You via online/ internet
exceeds the surrender value, the policy will be foreclosed after giving intimation
banking then please mention the application number or policy number as
and reasonable opportunity to the policyholder to continue the policy. (iv) In the
applicable in the comment section during the transaction. o) Where Premiums
event of failure to repay by the required date, the policy will be foreclosed, and all
have been remitted otherwise than in cash, the application of the Premiums rights, benefits and interests under the policy will stand extinguished. (v) An in-
received will be conditional on the realization of the proceeds of the instrument of force and fully paid policy will not be foreclosed. (vi) Before any benefits are paid
payment, including electronic mode. p) If You suspend payment of premium for any out, loan outstanding together with the interest thereon if any will be deducted and
reason whatsoever, We will not be held liable. In such an event, benefits, if any, will the balance amount will be payable. (vii) Loans may be granted on the proof of title
be available only in accordance with the Policy terms and conditions. to the Policy. (viii) The policy shall be assigned to and be held by us as security for
5. Grace Period If You are unable to pay an instalment premium by the due date, you repayment of the loan and interest thereon. (ix) Applicable interest rate will be
will be given a grace period of 15 days for payment of due instalment premium if equal to 1.50% plus prevailing yield on 10 year Government Securities. The yield on
You have chosen monthly frequency, and 30 days for payment of due instalment 10 year Government Securities will be sourced from www.bloomberg.com. The
premium if You have chosen any other frequency, commencing from the premium loan interest rate in November 2023 is 8.781% p.a. compounded half-yearly. (x)
due date. The life cover continues during the grace period. In case of death of Life The loan interest rate will be reviewed on the 15th day of every month by the
company based on the 10-year G-Sec yield of one day prior to such review. (xi) The
Assured during the grace period, We will pay the applicable Death Benefit.
basis for computing loan interest will be reviewed from time to time and may be
6. Advance Premium Collection of advance premium shall be allowed within the revised subject to the prior approval of the IRDAI.
same financial year for the premium due in that financial year. However, where the 5. Revival A policy which has discontinued payment of premium may be revived
premium due in one financial year is being collected in advance in earlier financial subject to underwriting and the following conditions: • The application for revival is
year, we may collect the same for a maximum period of three months in advance made within 5 years from the due date of the first unpaid premium or the policy
from the due date of the premium. The premium so collected in advance shall only term, whichever is earlier. Revival will be based on the prevailing Board approved
be adjusted on the due date of the premium. underwriting policy. • You furnish, at your own expense, satisfactory evidence of
health of the Life Assured as required by the prevailing Board approved
PART - D
underwriting policy. • The arrears of Premiums together with interest at such rate
1. Free look Period (15 / 30 days refund Policy) You have an option to review the
as We may charge for late payment of premiums are paid, based on the prevailing
Policy within 15 days from the date you receive it, or 30 days in case of electronic
Company Policy. Revival interest rates will be set monthly and is equal to 1.50%
policies or policies sourced through Distance Mode (as defined in Part B, Clause plus prevailing yield on 10 year Government Securities. The yield on 10 year
12). In this period, if you are not satisfied with the Policy terms and conditions, you Government Securities will be sourced from www.bloomberg.com. The revival
can return the Policy to us with reasons for cancellation. We will refund the interest rate for November 2023 is 8.781% p.a. compounded half-yearly. • The
premium paid after deduction of Stamp duty, proportionate risk premium for the revival interest rate will be reviewed on the 15th day of every month by the
period of cover and the expenses borne by us on medical tests, if any. The Policy company based on the 10-year G-Sec yield of one day prior to such review. The
shall terminate on payment of this amount and all rights, benefits and interests revival of the policy may be on terms different from those applicable to the policy
under this Policy will stand extinguished. before premiums were discontinued; for example, extra mortality premiums or
2. Surrender The Policy will acquire a Surrender Value on payment of at least 2 full charges may be applicable. The revival will take effect only if it is specifically
years’ premiums. On policy surrender, a Surrender Value equal to the higher of the communicated by Us to You. The Company reserves the right to refuse to revive
following will be payable: • Guaranteed Surrender Value (GSV) • Special Surrender the policy. Any change in revival conditions will be subject to prior approval from
Value (SSV) Plus, any balance in the Savings Wallet. On payment of Surrender IRDAI and will be disclosed to policyholders.
6. Foreclosure The Policy shall lapse with all benefits and the cover shall cease, if address proof f)Medical cause of the death issued by the last treating/ last
premium payment is discontinued before acquiring a surrender value. If the Policy attending doctor, if any g)Medical records (Admission notes, Discharge
is not revived within the Revival Period, then the Policy shall foreclose and all rights Summary/Death summary, test reports etc., if any h) Pan card/ Form 60 of the
and benefits under the Policy shall stand extinguished. Claimant i) Any other documents or information as may be required by the
7. To whom benefits are payable Benefits are payable to the Policyholder or to the Company for processing of the claim depending on the cause of the death. For
Assignee(s), nominee where an endorsement has been recorded in accordance unnatural deaths: a) Claimant’s Statement b) Original Policy Document c) Death
with Section 38 and Section 39 of the Insurance Act, 1938 as maybe applicable. If Certificate of the Life Assured issued by the local municipal authority d) Cancelled
the Policyholder and the Life Assured are different, then in the event of death of the Cheque for processing electronic payment e) Claimant’s recent photograph, photo
Policyholder and upon subsequent intimation of the death with the Company: a. If Identity proof & address proof f) Post Mortem report & viscera/ chemical analysis
the Life Assured is a minor: the policy shall vest on the guardian of the minor life report g) FIR report, final police investigation report, police panchnama/ Inquest
assured till he/she attains the age of majority. Upon attaining the age of majority report, driving license h) Pan card/ Form 60 of the Claimant i) Any other documents
the ownership of the policy shall be changed according to Clause 8 below; b. If the or information as may be required by the Company for processing of the claim
Life Assured is major: the policy shall vest on the Life Assured. Thereafter, the Life depending on the cause of the death. For processing a maturity claim, survival
Assured shall become the Policyholder and will be entitled to all benefits and benefit claims under this Policy, We will require the following documents a)
subject to all liabilities as per the terms and conditions of the policy. The Life Cancelled Cheque for processing electronic payment b) KYC of Proposer of the
Assured cum Policyholder can register due nomination as per Section 39 of the policy Claim payments are made only in Indian currency in accordance with the
Insurance Act, 1938 as amended from time to time. prevailing Exchange control regulations and other relevant laws and regulations in
8. Policy on the life of a Minor For policies issued on minor’s life, the date of India. In case the Claimant is unable to provide any or all of the above documents, in
commencement of risk will be the date of commencement of the policy. If the Policy exceptional circumstances such as a natural calamity, the Company may at its
has been taken on the life of a minor, on attaining the age of majority i.e. 18 years, own discretion conduct an investigation and may subsequently settle the claim.
the Policy will vest on him/her. Thereafter, the Life Assured shall become the 11. Suicide In case of death due to suicide within 12 months from the date of
Policyholder who will then be entitled to all the benefits and subject to all liabilities commencement of risk under the Policy or from the date of revival of the Policy, as
as per the terms and conditions of the Policy. The Life Assured cum Policyholder applicable, the Claimant shall be entitled to at least 80% of the total premiums paid
can register due nomination as per Section 39 of the Insurance Act, 1938 as till the date of death or the surrender value available as on the date of death
amended from time to time. whichever is higher, provided the Policy is in force. The Policy will terminate on
making such a payment and all rights, benefits and interests under the Policy will
PART E
stand extinguished.
This section is not applicable to Your Policy.
12. Issue of duplicate Policy We shall issue a duplicate of Policy document, on
PART F receipt of a written request for the same from You along with the necessary
General Conditions documents as may be required by Us and at such charges as may be applicable
1. Age We have calculated the premiums under the Policy on the basis of the Age of from time to time. The current charges for issuance of duplicate Policy is ` 200.Free
the Life Assured as declared by You in the Proposal Form. In case if the age proof of look option is not available on issue of duplicate Policy document.
the Life Assured was not submitted at the time of Proposal, You will be required to 13. Amendment to Policy document Any variations, modifications or amendment of
submit such an Age proof of the Life Assured acceptable to Us, and have the Age any terms of the Policy document shall be communicated to you in writing by an
admitted. If the Age of the Life Assured has been misstated, We will take one of the endorsement on the Policy document.
following actions: a)If the Correct Age of the Life Assured makes him ineligible for
PART - G
this product, We will offer a suitable plan as per Our underwriting norms. If You do
Grievance Redressal Mechanism and List of Ombudsman
not wish to opt for the alternative plan or if it is not possible for Us to grant any other
1. Customer service
plan, We will cancel the Policy and refund the premiums paid (without interest)
For any clarification or assistance You may contact Our advisor or call Our
under the Policy after adjustment against the paid benefits. The Policy will
customer service representative (between 10.00 a.m. to 7.00 p.m, Monday to
terminate on the said payment. b)If the Correct Age of the Life Assured makes him
Saturday; excluding national holidays) on the numbers mentioned on the reverse
eligible for this Policy, Maturity Benefit depending upon the Correct Age will be
of the Policy folder or on Our website: www.iciciprulife.com.
revised. The provisions of Section 45 of the Insurance Act, 1938 as amended from
Alternatively, You may communicate with Us at any of our branches or the
time to time shall be applicable.
customer service desk whose details are mentioned in the Welcome Letter.
2. Nomination Nomination under the Policy will be governed by Section 39 of the
For updated contact details, We request You to regularly check Our website.
Insurance Act, 1938 as amended from time to time. Please refer to Appendix IV for
i. Grievance Redressal Officer: If You do not receive any resolution from Us or if You
details on this section.
are not satisfied with Our resolution, You may get in touch with Our designated
3. Assignment Assignment of the Policy will be governed by Section 38 of the
grievance redressal officer (GRO) at gro@iciciprulife.com or 1860 266 7766.
Insurance Act, 1938 as amended from time to time. Please refer to Appendix V for
Address: ICICI Prudential Life Insurance Company Limited,
details on this section.
Ground Floor & Upper Basement,
4. Incontestability Incontestability will be as per Section 45 of the Insurance Act,
Unit No. 1A & 2A, Raheja Tipco Plaza,
1938 as amended from time to time. Please refer to Appendix VI for details on this
Rani Sati Marg, Malad (East),
section.
Mumbai-400097.
5. Misstatement & Fraud Misstatement and Fraud will be as per Section 45 of the
Insurance Act, 1938 as amended from time to time. Please refer to Appendix VI for For more details please refer to the “Grievance Redressal” section on
details on this section. The Policy is subject to the terms and conditions as www.iciciprulife.com.
mentioned in the Policy document and is governed by the Laws of India. ii. Grievance Redressal Committee: If You do not receive any resolution or if You are
6. Communication address Our communication address is: Address: Customer not satisfied with the resolution provided by the GRO, You may escalate the matter
Service Desk ICICI Prudential Life Insurance Company Limited, Ground Floor & to Our internal grievance redressal committee at the address mentioned below:
Upper Basement, Unit No. 1A & 2A, RahejaTipco Plaza, Rani Sati Marg, Malad ICICI Prudential Life Insurance Co. Ltd.
(East), Mumbai- 400097 Maharashtra. Telephone: 1860 266 7766 Facsimile: 022 Ground Floor & Upper Basement,
4205 8222 E-mail: lifeline@iciciprulife.com We expect You to immediately inform Unit No. 1A & 2A, RahejaTipco Plaza,
Us about any change in Your address or contact details. Rani Sati Marg, Malad (East), Mumbai- 400097.
7. Electronic transactions All transactions carried out by You through Internet, Maharashtra.
electronic, call centres, tele-service operations, computer, automated machines If you are not satisfied with the response or do not receive a response from us
network or through other means of communication will be valid and legally binding within 15 days, you may approach the Grievance Cell of the Insurance Regulatory
on Us as well as You. This will be subject to the relevant guidelines and terms and and Development Authority of India (IRDAI) on the following contact details:
conditions as may be specified by Us. IRDAI Grievance Call Centre (IGCC) TOLL FREE NO: 155255 (or) 1800 4254 732
8. Jurisdiction The Policy is subject to the terms and conditions as mentioned in the Email ID: complaints@irdai.gov.in
Policy document and is governed by the laws of India. Indian courts shall have You can also register your complaint online at igms.irda.gov.in
exclusive jurisdiction over all differences or disputes arising in relation to this Address for communication for complaints by fax/paper:
Policy. Consumer Affairs Department
9. Legislative changes Tax Benefits may be applicable as per the prevailing tax Insurance Regulatory and Development Authority of India
laws. Survey No. 115/1, Financial District, Nanakramguda, Gachibowli,
10. Payment of claim For processing a death claim under this Policy, We will require Hyderabad, Telangana State – 500032.
the following documents (as may be relevant): For natural deaths: a) Claimant’s Insurance Ombudsman: The Central Government has established an office of the
Statement b) Original Policy Document c) Death Certificate of the Life Assured Insurance Ombudsman for redressal of grievances with respect to life insurance
issued by the local municipal authority d) Cancelled Cheque for processing policies. As per Insurance Ombudsman Rules, 2017 and Insurance Ombudsman
electronic payment e) Claimant’s recent photograph,photo Identity proof and (Amendment) Rules, 2021, the Ombudsman shall receive and consider complaints or
 alleging deficiency in performance required of an insurer (including its agents and / 2706468. Email: bimalokpal.chandigarh@cioins.co.in Areas of Jurisdiction: Punjab,
intermediaries) or an insurance broker, on any of the following grounds: a. delay in Haryana (excluding Gurugram, Faridabad, Sonepat and Bahadurgarh), Himachal
settlement of claims, beyond the time specified in the regulations, framed under the Pradesh, Union Territories of Jammu & Kashmir, Ladakh & Chandigarh.
Insurance Regulatory and Development Authority of India Act, 1999; b. any partial or 6. CHENNAI: Office of the Insurance Ombudsman, Fatima Akhtar Court, 4th Floor,
total repudiation of claims by the life insurer, General insurer or the health insurer; c. 453, Anna Salai, Teynampet, CHENNAI – 600 018. Tel.:- 044 - 24333668 /
disputes over premium paid or payable in terms of insurance policy; d. 24335284. Email: bimalokpal.chennai@cioins.co.in Areas of Jurisdiction: Tamil
misrepresentation of policy terms and conditions at any time in the policy document Nadu, PuducherryTown and Karaikal (which are part of Puducherry).
or policy contract; e. legal construction of insurance policies in so far as the dispute 7. DELHI: Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building,
relates to claim; f. policy servicing related grievances against insurers and their Asaf Ali Road, New Delhi – 110 002. Tel.:- 011 - 23232481/23213504. Email:
agents and intermediaries; g. issuance of life insurance policy, general insurance bimalokpal.delhi@cioins.co.in Areas of Jurisdiction: Delhi & following Districts of
policy including health insurance policy which is not in conformity with the proposal Haryana - Gurugram, Faridabad, Sonepat & Bahadurgarh.
form submitted by the proposer; h. non-issuance of insurance policy after receipt of 8. ERNAKULAM: Office of the Insurance Ombudsman, 10th Floor, LIC Building
premium in life insurance and general insurance including health insurance; and i. ‘Jeevan Prakash’, M G Road, Ernakulam, Kochi – 682 011. Tel.: 0484 - 2358759 /
any other matter arising from non-observance of or non-adherence to the provisions 2359338. Email: bimalokpal.ernakulam@cioins.co.in Areas of Jurisdiction: Kerala,
of any regulations made by the Authority with regard to protection of policyholders‘ Lakshadweep, Mahe-a part of Union Territory of Puducherry.
interests or otherwise, or of any circular, guideline or instruction issued by the 9. GUWAHATI: Office of the Insurance Ombudsman, Jeevan Nivesh, 5th Floor, Nr.
Authority, or of the terms and conditions of the policy contract, in so far as such Panbazar over bridge, S.S. Road, Guwahati – 781001(ASSAM). Tel.:- Tel.: 0361 -
matter relates to issues referred to in clauses (a) to (h). 2632204 / 2602205. Email: bimalokpal.guwahati@cioins.co.in Areas of
Manner in which complaint to be made: 1. Any person who has a grievance against Jurisdiction: Assam, Meghalaya, Manipur, Mizoram, Arunachal Pradesh,
an insurer or insurance broker, may himself or through his legal heirs, nominee or Nagaland and Tripura.
assignee, make a complaint in writing to the Insurance Ombudsman within whose 10. HYDERABAD: Office of the Insurance Ombudsman, 6-2-46, 1st floor, "Moin
territorial jurisdiction the branch or office of the insurer or the insurance broker, as the Court", Lane Opp. Saleem Function Palace, A. C. Guards, Lakdi-Ka-Pool,
case may be complained against or the residential address or place of residence of Hyderabad - 500 004. Tel : 040 - 23312122. Email:
the complainant is located. 2. The complaint shall be in writing, duly signed or made bimalokpal.hyderabad@cioins.co.in Areas of Jurisdiction: Andhra Pradesh,
by way of electronic mail or online through the website of the Council for Insurance Telangana, Yanam and part of Union Territory of Puducherry.
Ombudsmen by the complainant or through his legal heirs, nominee or assignee and 11. JAIPUR: Office of the Insurance Ombudsman, Jeevan Nidhi – II Bldg., Gr. Floor,
shall state clearly the name and address of the complainant, the name of the branch Bhawani Singh Marg, Jaipur - 302 005. Tel : 0141 - 2740363. Email:
or office of the insurer against whom the complaint is made, the facts giving rise to the bimalokpal.jaipur@cioins.co.in Areas of Jurisdiction: Rajasthan.
complaint, supported by documents, the nature and extent of the loss caused to the 12. KOLKATA: Office of the Insurance Ombudsman, Hindustan Bldg. Annexe, 7th
complainant and the relief sought from the Insurance Ombudsman. 3. No complaint Floor, 4, C.R. Avenue, Kolkatta - 700 072. Tel : 033 - 22124339 / 22124340. Email:
to the Insurance Ombudsman shall lie unless— a) the complainant has made a bimalokpal.kolkata@cioins.co.in Areas of Jurisdiction: West Bengal, Sikkim,
representation in writing or through electronic mail or online through website of the Andaman & Nicobar Islands.
insurer or insurance broker concerned o the insurer named in the complaint and— i. 13. LUCKNOW: Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan,
either the insurer or insurance broker, as the case may be had rejected the complaint; Phase-II, Nawal Kishore Road, Hazratganj, Lucknow - 226 001. Tel: 0522 -
or ii. the complainant had not received any reply within a period of one month after 2231330 / 2231331. Email: bimalokpal.lucknow@cioins.co.in Areas of
the insurer or insurance broker, as the case may be received his representation; or iii. Jurisdiction: Districts of Uttar Pradesh : Lalitpur, Jhansi, Mahoba, Hamirpur, Banda,
the complainant is not satisfied with the reply given to him by the insurer or insurance Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh,
broker, as the case may be; b) The complaint is made within one year— i. after the Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur,
order of the insurer rejecting the representation is received; or ii. after receipt of Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi,
decision of the insurer or insurance broker, as the case may be which is not to the Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar,
satisfaction of the complainant; iii. after expiry of a period of one month from the date Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia,
of sending the written representation to the insurer or insurance broker, as the case Sidharathnagar.
may be if the insurer or insurance broker, as the case may be named fails to furnish 14. MUMBAI: Office of the Insurance Ombudsman, 3rd Floor, Jeevan Seva Annexe, S.
reply to the complainant. 4. The Ombudsman shall be empowered to condone the V. Road, Santacruz (W), Mumbai - 400 054. Tel :
delay in such cases as he may consider necessary, after calling for objections of the 69038821/23/24/25/26/27/28/28/29/30/31. Email:
insurer or insurance broker, as the case may be against the proposed condonation bimalokpal.mumbai@cioins.co.in Areas of Jurisdiction: Goa, Mumbai Metropolitan
and after recording reasons for condoning the delay and in case the delay is Region (excluding Navi Mumbai & Thane).
condoned, the date of condonation of delay shall be deemed to be the date of filing of 15. NOIDA: Office of the Insurance Ombudsman, Bhagwan Sahai Palace 4th Floor,
the complaint, for further proceedings under these rules. 5. No complaint before the Main Road, Naya Bans, Sector 15, Distt: Gautam Buddh Nagar, U.P-201301. Tel:
Insurance Ombudsman shall be maintainable on the same subject matter on which 0120-2514252 / 2514253. Email: bimalokpal.noida@cioins.co.in Areas of
proceedings are pending before or disposed of by any court or consumer forum or Jurisdiction: State of Uttarakhand and the following Districts of Uttar Pradesh:
arbitrator. 6. The Council for Insurance Ombudsmen shall develop a complaints Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kannauj,
management system, which shall include an online platform developed for the Mainpuri, Mathura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah,
purpose of online submission and tracking of the status of complaints made under Farrukhabad, Firozbad, Gautam Buddh nagar, Ghaziabad, Hardoi, Shahjahanpur,
rule 14. The Ombudsman shall not award compensation exceeding more than Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Hathras, Kanshiramnagar,
Rupees Thirty Lakhs (including relevant expenses, if any). We have given below the Saharanpur.
details of the existing offices of the Insurance Ombudsman. We request You to 16. PATNA: Office of the Insurance Ombudsman, 2nd Floor, Lalit Bhawan, Bailey
regularly check our website at www.iciciprulife.com or the website of the IRDAI at Road, Patna 800 001. Tel : 0612-2547068. Email: bimalokpal.patna@cioins.co.in
www.irdai.gov.in for updated contact details. Areas of Jurisdiction: Bihar, Jharkhand.
17. PUNE: Office of the Insurance Ombudsman, Jeevan Darshan Bldg., 3rd Floor, C.T.S.
1. AHMEDABAD: Office of the Insurance Ombudsman, Jeevan Prakash Building, No.s. 195 to 198, N.C. Kelkar Road, Narayan Peth, Pune – 411 030. Tel: 020-
6th floor, Tilak Marg, Relief Road, AHMEDABAD – 380 001. Tel.:- 079 - 41312555. Email: bimalokpal.pune@cioins.co.in Areas of Jurisdiction: Maharashtra,
25501201/02/05/06. Email: bimalokpal.ahmedabad@cioins.co.in Areas of Areas of Navi Mumbai and Thane (excluding Mumbai Metropolitan Region).
Jurisdiction: Gujarat, Dadra & Nagar Haveli, Daman and Diu. In case of dispute in respect of interpretation of these terms and conditions and
2. BENGALURU: Office of Insurance Ombudsman, Jeevan Soudha Building,PID No. special provisions/conditions the English version shall stand valid.
57-27-N-19, Ground Floor, 19/19, 24th Main Road, JP Nagar, Ist Phase, Bengaluru YOU ARE REQUESTED TO EXAMINE THIS POLICY DOCUMENT, AND IF ANY
– 560 078. Tel No: 080 - 26652048 / 26652049. Email: MISTAKE BE FOUND THEREIN, RETURN IT IMMEDIATELY FOR CORRECTION.
bimalokpal.bengaluru@cioins.co.in Areas of Jurisdiction: Karnataka. Age / 5 6 7 8 9 10 11 12
3. BHOPAL: Office of the Insurance Ombudsman, 1st floor of LIC Zonal Office Building, PPT
Jeevan Shikha, 60-B, Hoshangabad Road, (Opp. Gayatri Manddir), Bhopal – 462 011. 0 - 25 5.00% 7.00% 8.50% 10.00% 12.50% 13.50% 14.50% 15.00%
Tel.:- 0755 - 2769201 / 2769202. Email: bimalokpal.bhopal@cioins.co.in Areas of 26 - 30 4.50% 6.50% 8.00% 9.50% 12.00% 13.00% 13.50% 14.00%
Jurisdiction: Madhya Pradesh, Chhattisgarh. 31 - 35 4.50% 6.50% 8.00% 9.25% 11.25% 12.25% 13.00% 13.00%
4. BHUBANESHWAR: Office of the Insurance Ombudsman, 62, Forest park, 36 - 40 3.75% 5.75% 7.00% 8.25% 10.00% 11.00% 12.00% 12.00%
Bhubaneswar – 751 009. Tel.:- 0674 - 2596461 /2596455. Email: 41 - 45 3.50% 5.50% 6.50% 8.00% 8.75% 10.00% 10.50% 10.50%
bimalokpal.bhubaneswar@cioins.co.in Areas of Jurisdiction: Odisha. 46 - 50 3.25% 5.25% 6.50% 8.00% 8.00% 8.50% 9.50% 10.50%
51 - 55 NA 5.00% 5.00% 7.00% 7.50% 7.50% 8.50% 9.50%
5. CHANDIGARH: Office of the Insurance Ombudsman, S.C.O. No. 101, 102 & 103,
56 - 60 NA NA 4.00% 5.50% 5.50% 5.50% 5.50% 6.50%
2nd Floor, Batra Building, Sector 17 – D, Chandigarh – 160 017. Tel.:- 0172 - 2706196
For Immediate Income with Booster Plan: Deferment Period 6:
Age / PPT 6 7 8 9 10 11 12 Age / PPT 7 8 9 10 11 12
0 - 25 7.00% 8.50% 10.00% 12.50% 13.50% 14.50% 15.00% 0 - 25 14.75% 19.00% 24.00% 24.00% 25.25% 25.50%
26 - 30 6.50% 8.00% 9.50% 12.00% 13.00% 13.50% 14.00%
26 - 30 14.00% 17.00% 21.25% 22.75% 23.25% 23.75%
31 - 35 6.50% 8.00% 9.25% 11.25% 12.25% 13.00% 13.00%
31 - 35 14.00% 16.50% 20.00% 21.50% 22.50% 22.00%
36 - 40 5.75% 7.00% 8.25% 10.00% 11.00% 12.00% 12.00%
41 - 45 5.50% 6.50% 8.00% 8.75% 10.00% 10.50% 10.50% 36 - 40 12.50% 15.25% 18.00% 19.50% 21.00% 20.50%
46 - 50 5.25% 6.50% 8.00% 8.00% 8.50% 9.50% 10.50% 41 - 45 12.50% 15.00% 16.00% 18.00% 18.25% 18.50%
51 - 55 NA 5.00% 7.00% 7.50% 7.50% 8.50% 9.50% 46 - 50 12.50% 14.75% 15.00% 15.50% 17.00% 18.50%
56 - 60 NA NA 5.50% 5.50% 5.50% 5.50% 6.50% 51 - 55 NA 13.50% 14.00% 14.25% 15.75% 17.50%
For Deferred Income Plan: 56- 60 NA NA 10.50% 10.75% 11.00% 12.75%
Deferment Period 1:
Age / PPT 7 8 9 10 11 12 Deferment Period 7:

0 - 25 9.25% 11.00% 13.75% 14.75% 16.00% 16.50% Age / PPT 7 8 9 10 11 12

26 - 30 8.75% 10.50% 13.25% 14.25% 14.75% 15.25% 0 - 25 16.50% 21.50% 26.50% 27.00% 27.75% 28.00%
26 - 30 15.50% 18.50% 23.50% 25.00% 25.50% 25.50%
31 - 35 8.75% 10.25% 12.50% 13.50% 14.25% 14.25%
31 - 35 15.50% 18.00% 22.00% 23.50% 23.75% 24.00%
36 - 40 7.75% 9.00% 11.00% 12.00% 13.25% 13.25%
36 - 40 14.00% 17.00% 20.00% 21.50% 22.00% 22.50%
41 - 45 7.25% 8.75% 9.75% 11.00% 11.50% 11.50%
41 - 45 13.75% 16.75% 17.75% 20.00% 20.25% 20.50%
46 - 50 7.25% 8.75% 8.75% 9.50% 10.50% 11.50%
46 - 50 13.50% 16.50% 16.75% 17.00% 18.75% 20.25%
51 - 55 NA 7.00% 8.25% 8.25% 9.50% 10.50%
51 - 55 NA 15.00% 15.75% 16.00% 17.50% 19.25%
56- 60 NA NA 6.25% 6.25% 6.25% 7.25% 56- 60 NA NA 12.00% 12.25% 12.50% 14.25%

Deferment Period 2:
Deferment Period 8:
Age / PPT 7 8 9 10 11 12
0 - 25 10.25% 12.00% 15.75% 16.50% 17.50% 18.00% Age / PPT 7 8 9 10 11 12
0 - 25 19.50% 24.00% 30.00% 30.00% 30.25% 30.50%
26 - 30 9.75% 11.50% 14.50% 15.75% 16.25% 16.75%
26 - 30 19.50% 20.25% 26.00% 27.50% 28.00% 28.25%
31 - 35 9.75% 11.25% 13.75% 14.75% 15.50% 15.50%
31 - 35 19.50% 19.75% 24.25% 26.00% 26.25% 26.50%
36 - 40 8.50% 10.00% 12.25% 13.25% 14.50% 14.25%
36 - 40 19.50% 19.50% 22.00% 23.75% 24.00% 24.50%
41 - 45 8.00% 9.75% 10.75% 12.25% 12.75% 12.75%
41 - 45 19.00% 19.00% 19.75% 22.00% 22.25% 22.50%
46 - 50 8.00% 9.75% 9.75% 10.25% 11.50% 12.75%
46 - 50 18.00% 18.00% 19.75% 20.00% 20.75% 22.25%
51 - 55 NA 9.50% 9.50% 9.50% 10.50% 11.50% 51 - 55 NA 17.00% 17.00% 17.25% 19.25% 21.25%
56- 60 NA NA 14.00% 14.75% 15.50% 16.25%

Deferment Period 3: Deferment Period 9:

Age / PPT 7 8 9 10 11 12 Age / PPT 7 8 9 10 11 12
0 - 25 11.50% 13.25% 17.25%18.00% 19.00% 19.50% 0 - 25 NA 28.00% 34.50% 34.50% 34.50% 35.00%
26 - 30 10.50% 12.75% 16.00% 17.25% 17.75% 18.25% 26 - 30 NA 23.75% 28.50% 30.25% 30.50% 31.00%
31 - 35 10.50% 12.25% 15.00% 16.25% 17.00% 17.00% 31 - 35 NA 23.25% 26.75% 28.50% 29.50% 30.00%
36 - 40 9.50% 11.25% 13.50% 14.75% 16.00% 15.75% 36 - 40 NA 22.75% 23.75% 26.25% 27.75% 28.00%
41 - 45 9.00% 11.00% 11.75% 13.50% 14.00% 14.00% 41 - 45 NA 21.50% 21.50% 24.25% 24.50% 24.75%
46 - 50 9.00% 11.00% 10.75% 11.50% 12.75% 14.00% 46 - 50 NA 21.25% 21.25% 24.00% 24.25% 24.50%
51 - 55 NA 9.75% 10.25% 10.25% 11.50% 12.75% 51 - 55 NA 21.00% 21.00% 24.00% 24.25% 24.50%
56- 60 NA NA 7.75% 7.75% 8.00% 9.25% 56- 60 NA NA 17.00% 17.00% 18.00% 18.00%

Deferment Period 10:

Deferment Period 4:
Age / PPT 7 8 9 10 11 12
Age / PPT 7 8 9 10 11 12
0 - 25 NA NA 37.50% 38.50% 38.50% 38.50%
0 - 25 12.25% 14.75% 19.25% 19.50% 21.00% 21.50%
26 - 30 NA NA 31.50% 33.00% 33.50% 33.75%
26 - 30 11.75% 14.00% 17.75% 19.00% 19.50% 20.00%
31 - 35 NA NA 29.50% 31.25% 32.25% 33.25%
31 - 35 11.75% 13.50% 16.50% 17.75% 18.75% 18.50%
36 - 40 NA NA 27.00% 28.00% 30.00% 30.00%
36 - 40 10.25% 12.25% 14.75% 16.25% 17.50% 17.25%
41 - 45 NA NA 25.50% 27.00% 28.00% 29.00%
41 - 45 10.00% 12.00% 13.25%14.75% 15.50% 15.25%
46 - 50 NA NA 23.00% 26.75% 26.75% 27.00%
46 - 50 10.00% 12.00% 12.00% 12.75% 14.00% 15.25%
51 - 55 NA NA 22.75% 26.75% 26.75% 26.75%
51 - 55 NA 10.75% 11.50% 11.25% 12.75% 14.25%
56- 60 NA NA 20.50% 20.00% 21.00% 21.25%
56- 60 NA NA 8.50% 8.75% 9.00% 10.25%
Deferment Period 11:
Deferment Period 5: Age / PPT 7 8 9 10 11 12
Age / PPT 7 8 9 10 11 12 0 - 25 NA NA NA 44.00% 44.00% 44.00%
0 - 25 13.50% 17.00% 21.00%21.75% 3.00% 23.50% 26 - 30 NA NA NA 36.25% 36.75% 36.75%
26 - 30 12.75% 15.25% 19.50% 20.75% 21.25% 21.75% 31 - 35 NA NA NA 34.25% 34.75% 35.25%
31 - 35 12.75% 15.00% 18.25% 19.50% 20.50% 20.25% 36 - 40 NA NA NA 31.75% 32.25% 32.75%
36 - 40 11.50% 13.50% 16.50% 17.75% 19.25% 18.75% 41 - 45 NA NA NA 29.75% 30.25% 31.75%
41 - 45 11.00% 13.50% 14.50% 16.50% 17.00% 16.75% 46 - 50 NA NA NA 29.50% 29.50% 29.75%
46 - 50 11.00% 13.50% 13.25% 14.00% 5.50% 16.75% 51 - 55 NA NA NA 29.50% 29.50% 29.50%
51 - 55 NA 12.00% 12.25% 12.50% 14.25% 15.75% 56- 60 NA NA NA 24.00% 25.00% 25.00%
56- 60 NA NA 10.00% 10.50% 11.00% 11.50%
Deferment Period 12: assignment to the insurer or other transferee or assignee for purpose of loan or
Age / PPT 7 8 9 10 11 12 against security or its reassignment after repayment. In such case, the nomination
will not get cancelled to the extent of insurer’s or transferee’s or assignee’s interest
0 - 25 NA NA NA NA 49.00% 49.00%
in the Policy. The nomination will get revived on repayment of the loan. 10. The right
26 - 30 NA NA NA NA 40.25% 40.25%
of any creditor to be paid out of the proceeds of any Policy of life insurance shall not
31 - 35 NA NA NA NA 38.00% 38.75% be affected by the nomination. 11. In case of nomination by Policyholder whose
36 - 40 NA NA NA NA 35.75% 36.75% life is insured, if the nominees die before the Policyholder, the proceeds are payable
41 - 45 NA NA NA NA 33.25% 33.75% to Policyholder or his heirs or legal representatives or holder of succession
46 - 50 NA NA NA NA 32.50% 32.50% certificate. 12. In case nominee(s) survive the person whose life is insured, the
51 - 55 NA NA NA NA 32.50% 32.50% amount secured by the Policy shall be paid to such survivor(s). 13. Where the
56- 60 NA NA NA NA 30.00% 30.00% Policyholder whose life is insured nominates his a. parents or b. spouse or c.
children or d. spouse and children e. or any of them the nominees are beneficially
Deferment Period 13: entitled to the amount payable by the insurer to the Policyholder unless it is proved
Age / PPT 7 8 9 10 11 12 that Policyholder could not have conferred such beneficial title on the nominee
having regard to the nature of his title. 14. If nominee(s) die after the Policyholder
0 - 25 NA NA NA NA NA 52.00%
but before his share of the amount secured under the Policy is paid, the share of the
26 - 30 NA NA NA NA NA 44.00%
expired nominee(s) shall be payable to the heirs or legal representative of the
31 - 35 NA NA NA NA NA 41.00%
nominee or holder of succession certificate of such nominee(s). 15. If Policyholder
36 - 40 NA NA NA NA NA 40.00% dies after maturity but the proceeds and benefit of the Policy has not been paid to
41 - 45 NA NA NA NA NA 35.75% him because of his death, his nominee(s) shall be entitled to the proceeds and
46 - 50 NA NA NA NA NA 35.75% benefit of the Policy. 16. The provisions of Section 39 are not applicable to any life
51 - 55 NA NA NA NA NA 35.50% insurance Policy to which Section 6 of Married Women’s Property Act, 1874 applies
56- 60 NA NA NA NA NA 33.50% or has at any time applied Where nomination is intended to be made to spouse or
children or spouse and children under Section 6 of MWP Act, it should be
Appendix II – Save the Date factors specifically mentioned on the Policy. In such a case only, the provisions of Section
39 will not apply.
Policy Month Factor Policy Month Factor Policy Month Factor
Disclaimer: This is a simplified version of Section 39 of the Insurance Act, 1938 as
1 92% 5 94% 9 97%
amended from time to time. The Policyholders are advised to refer to The Insurance
2 93% 6 95% 10 98% Act, 1938 as amended from time to time for complete and accurate details.
3 93% 7 96% 11 98% Appendix V – Section 38 – Assignment and Transfer of Insurance Policies
4 94% 8 96% 12 99% Assignment or transfer of a Policy should be in accordance with Section 38 of the
Insurance Act, 1938 as amended from time to time. The extant provisions in this
Appendix III – GSV Factors regard are as follows: 1. This Policy may be transferred/assigned, wholly or in part,
Policy year / with or without consideration. 2. An Assignment may be effected in a Policy by an
Premium payment 5 6 7 8 9 10 11 12 endorsement upon the Policy itself or by a separate instrument under notice to the
term Insurer. 3. The instrument of assignment should indicate the fact of transfer or
0 0% 0% 0% 0% 0% 0% 0% 0% assignment and the reasons for the assignment or transfer, antecedents of the
1 0% 0% 0% 0% 0% 0% 0% 0% assignee and terms on which assignment is made. 4. The assignment must be
2 30% 30% 30% 30% 30% 30% 30% 30% signed by the transferor or assignor or duly authorized agent and attested by at
3 35% 35% 35% 35% 35% 35% 35% 35%
4 50% 50% 50% 50% 50% 50% 50% 50% least one witness. 5. The transfer of assignment shall not be operative as against
5 50% 50% 50% 50% 50% 50% 50% 50% an insurer until a notice in writing of the transfer or assignment and either the said
6 60% 60% 50% 50% 50% 50% 50% 50% endorsement or instrument itself or copy there of certified to be correct by both
7 70% 65% 60% 50% 50% 50% 50% 50% transferor and transferee or their duly authorised agents have been delivered to the
8 80% 75% 65% 65% 60% 60% 55% 55% insurer. 6. Fee to be paid for assignment or transfer can be specified by the
9 80% 80% 75% 75% 70% 70% 65% 65%
10 80% 80% 80% 80% 75% 75% 75% 75% Authority through Regulations. 7. On receipt of notice with fee, the insurer should
11 90% 90% 90% 90% 80% 80% 80% 80% Grant a written acknowledgement of receipt of notice. Such notice shall be
12 90% 90% 90% 90% 90% 90% 90% 90% conclusive evidence against the insurer of duly receiving the notice. 8. If the insurer
maintains one or more places of business, such notices shall be delivered only at the
Appendix I – Guaranteed Income Rate place where the Policy is being serviced. 9. The insurer may accept or decline to act
For Immediate Income Plan: upon any transfer or assignment or endorsement, if it has sufficient reasons to
believe that it is a. not bonafide or b. not in the interest of the Policyholder or c. not in
Appendix IV– Section 39 – Nomination by Policyholder public interest or d. is for the purpose of trading of the insurance Policy. 10. Before
Nomination of a life insurance Policy is as below in accordance with Section 39 of refusing to act upon endorsement, the Insurer should record the reasons in writing
the Insurance Act, 1938 as amended from time to time. The extant provisions in this and communicate the same in writing to Policyholder within 30 days from the date
regard are as follows: 1. The Policyholder of a life insurance on his own life may of Policyholder giving a notice of transfer or assignment. 11. In case of refusal to act
nominate a person or persons to whom money secured by the Policy shall be paid in upon the endorsement by the Insurer, any person aggrieved by the refusal may
the event of his death. 2. Where the nominee is a minor, the Policyholder may prefer a claim to IRDAI within 30 days of receipt of the refusal letter from the Insurer.
appoint any person to receive the money secured by the Policy in the event of 12. The priority of claims of persons interested in an insurance Policy would depend
Policyholder’s death during the minority of the nominee. The manner of on the date on which the notices of assignment or transfer is delivered to the
appointment to be laid down by the insurer. 3. Nomination can be made at any time insurer; where there are more than one instruments of transfer or assignment, the
before the maturity of the Policy. 4. Nomination may be incorporated in the text of priority will depend on dates of delivery of such notices. Any dispute in this regard
the Policy itself or may be endorsed on the Policy communicated to the insurer and as to priority should be referred to Authority. 13. Every assignment or transfer shall
can be registered by the insurer in the records relating to the Policy. 5. Nomination be deemed to be absolute assignment or transfer and the assignee or transferee
can be cancelled or changed at any time before Policy matures, by an shall be deemed to be absolute assignee or transferee, except a. where
endorsement or a further endorsement or a will as the case may be. 6. A notice in assignment or transfer is subject to terms and conditions of transfer or assignment
writing of Change or Cancellation of nomination must be delivered to the insurer for OR b. where the transfer or assignment is made upon condition that i. the proceeds
the insurer to be liable to such nominee. Otherwise, insurer will not be liable if a under the Policy shall become payable to Policyholder or nominee(s) in the event of
bonafide payment is made to the person named in the text of the Policy or in the assignee or transferee dying before the insured OR ii. the insured surviving the term
registered records of the insurer. 7. Fee to be paid to the insurer for registering of the Policy Such conditional assignee will not be entitled to obtain a loan on Policy
change or cancellation of a nomination can be specified by the Authority through or surrender the Policy. This provision will prevail notwithstanding any law or
Regulations. 8. On receipt of notice with fee, the insurer should grant a written custom having force of law which is contrary to the above position. 14. In other
acknowledgement to the Policyholder of having registered a nomination or cases, the insurer shall, subject to terms and conditions of assignment, recognize
cancellation or change thereof. 9. A transfer or assignment made in accordance the transferee or assignee named in the notice as the absolute transferee or
with Section 38 shall automatically cancel the nomination except in case of assignee and such person a. shall be subject to all liabilities and equities to which
the transferor or assignor was subject to at the date of transfer or assignment and
b. may institute any proceedings in relation to the Policy c. obtain loan under the
Policy or surrender the Policy without obtaining the consent of the transferor or
assignor or making him a party to the proceedings.
Disclaimer: This is a simplified version of Section 38 of the Insurance Act, 1938 as
amended from time to time. The Policyholders are advised to refer to The Insurance
Act, 1938 as amended from time to time for complete and accurate details.

Appendix VI – Section 45 – Policy shall not be called in question on the ground of

misstatement after three years
Provisions regarding Policy not being called into question in terms of Section 45 of
the Insurance Act, 1938, as amended from time to time. are as follows: 1. No Policy
of Life Insurance shall be called in question on any ground whatsoever after expiry
of 3 yrs from a) the date of issuance of Policy or b) the date of commencement of risk
or c) the date of revival of Policy or d) the date of rider to the Policy whichever is
later. 2. On the ground of fraud, a Policy of Life Insurance may be called in
question within 3 years from a) the date of issuance of Policy or b) the date of
commencement of risk or c) the date of revival of Policy or d) the date of rider to the
Policy whichever is later. For this, the insurer should communicate in writing to the
insured or legal representative or nominee or assignees of insured, as applicable,
mentioning the ground and materials on which such decision is based. 3. Fraud
means any of the following acts committed by insured or by his agent, with the
intent to deceive the insurer or to induce the insurer to issue a life insurance Policy:
a) The suggestion, as a fact of that which is not true and which the insured does not
believe to be true; b) The active concealment of a fact by the insured having
knowledge or belief of the fact; c) Any other act fitted to deceive; and d) Any such
act or omission as the law specifically declares to be fraudulent. 4. Mere silence is
not fraud unless, depending on circumstances of the case, it is the duty of the
insured or his agent keeping silence to speak or silence is in itself equivalent to
speak. 5. No Insurer shall repudiate a life insurance Policy on the ground of Fraud, if
the Insured / beneficiary can prove that the misstatement was true to the best of his
knowledge and there was no deliberate intention to suppress the fact or that such
mis-statement of or suppression of material fact are within the knowledge of the
insurer. Onus of disproving is upon the Policyholder, if alive, or beneficiaries. 6. Life
insurance Policy can be called in question within 3 years on the ground that any
statement of or suppression of a fact material to expectancy of life of the insured
was incorrectly made in the proposal or other document basis which Policy was
issued or revived or rider issued. For this, the insurer should communicate in writing
to the insured or legal representative or nominee or assignees of insured, as
applicable, mentioning the ground and materials on which decision to repudiate
the Policy of life insurance is based. 7. In case repudiation is on ground of mis-
statement and not on fraud, the premium collected on Policy till the date of
repudiation shall be paid to the insured or legal representative or nominee or
assignees of insured, within a period of 90 days from the date of repudiation. 8. Fact
shall not be considered material unless it has a direct bearing on the risk
undertaken by the insurer. The onus is on insurer to show that if the insurer had
been aware of the said fact, no life insurance Policy would have been issued to the
insured. 9. The insurer can call for proof of age at any time if he is entitled to do so
and no Policy shall be deemed to be called in question merely because the terms of
the Policy are adjusted on subsequent proof of age of life insured. So, this Section
will not be applicable for questioning age or adjustment based on proof of age
submitted subsequently.
 Proposal No : OS24031813

Sales details

LOB/Agent Code : 01405376 Agent/AFSM Name : CHENNAI IDFC FIRST BANK LIMITED

Channel Code : CA AFSM Code : 01511306

Bank : IDFC Branch : D627

Source : SPBB LIM/CSR Code : 999999999

CAFOS Code : 250891 SP/POS Code : SP0106536564

Opp ID : 1100649579

IN UNIT-LINKED INSURANCE POLICIES(ULIPs), THE INVESTMENT RISK IN INVESTMENT PORTFOLIO IS BORNE BY THE POLICY HOLDER.
IMPORTANT GUIDELINES:
1) Insurance is contract of utmost good faith between the Insurer and the Insured. The Proposer and the Life to be Assured are required to disclose all facts in response to the question in this
proposal form. 2) Any cancellation/alteration is to be signed by the Proposer/Life to be Assured as applicable. 3) For adding nominee(s) or assignee to the policy please refer to the servicing
forms available on the website.
I/We understand the importance of disclosing all material information and confirm that I/we shall share details which are true and correct, failing which the company reserves the right to
cancel the policy and/or repudiate any claims under the policy and initiate appropriate action.

Proposer Basic Details

Full Name : MR. DILIP NAMDEV DALVI Father's Name: NAMDEV DALVI

Mother's Name: BHAGIRATHI DALVI Spouse Name: DIPALI DALVI

Gender : MALE Date Of Birth : Jun 01,1958

Marital status : MARRIED

Life Assured Basic Details

Full Name : MRS/SMT. DIPALI DILIP DALVI Father's Name : RAMCHANDRA PAWAR

Mother's Name : SUMITRA PAWAR Spouse's Name : DILIP DALVI

Gender : FEMALE Date Of Birth : Feb 05,1964

Marital status : MARRIED

Proposer/Policy Owner Electronic Insurance Account(eiA)

Do you have an Electronic Insurance Account?: NO Insurance Repository : NO PREFERENCE

Do you wish to convert your ICICI Prudential policies into electronic policies : YES

Proposer Personal Details

Relationship With The Life Assured : SPOUSE Education : 10th Pass

Occupation : SELF EMPLOYED Organization Type: OTHERS -PRIVATE LIMITED

Name Of Organization : OTHERS - SANKET GAS EQUIPMENT Annual Income : INR 9,00,000
(Politically Exposed Persons (PEPs) are individuals who have been entrusted with prominent public functions by a foreign country,
Politically Exposed : NO including the heads of States or Governments, senior politicians, senior government or judicial or military officers, senior
executives of state-owned corporations and important political party officials including their family members and close relatives).

Have you ever been or currently being investigated, charge sheeted, prosecuted or convicted

or acquittal or having pending charges in respect of any criminal/civil offences in any court of

law in India or abroad?If Yes, give details : NO

Life Assured Personal Details

Education : 10th Pass Occupation : HOUSEWIFE

Contact Details

Mailing Address : NEW SAPTARUSHI CHS, G-55/2/1 SECTOR 4, NERUL NODE-III S O, NERUL, THANE- 400706, MAHARASHTRA, INDIA
 E-mail ID : DALVIDILIP46@GMAIL.COM Contact Number : 8169338283

Permanent Address : SAME AS MAILING ADDRESS

Nationality : INDIAN Resident Status : RESIDENT INDIAN

Mailing Address Of Life Assured: NEW SAPTARUSHI CHS, G-55/2/1 SECTOR 4, NERUL NODE-III S O, NERUL, THANE- 400706, MAHARASHTRA, INDIA

E-mail ID : SANKETGASEQPT@GMAIL.COM Contact Number : 9763306502

Permanent Address Of Life Assured: SAME AS MAILING ADDRESS

Nationality : INDIAN Resident Status : RESIDENT INDIAN

Previous Policy Details

Details of Life Insurance/Mediclaim/Health/Personal Accident policies of the Life to be Assured held/applied with ICICI Prudential Life Insurance Company Limited/other companies. (Have any

such proposals on your life / application for reinstatement ever been accepted with extra premium, postponement, decline, withdrawal, non completion, been offered on modified terms.) : No

Policy Number / Base Sum Assured (in

Company Name Proposal Date Policy decision
Application Number Rs)

Has any of your insurance application or reinstatement application on life, accident, medical or health, critical illness, or disability ever been declined, postponed or accepted at extra

premium or modified terms? (If Yes, please provide the details)NO.

Has any claim under any such policy or scheme ever been made? If so, please give full particulars detailing cause and amount of claim.NO .

If The Life To Be Assured Is A Student/Housewife, Please Provide Insurance Details Of Parents/Husband/Siblings : . NO

Proposer KYC Details

IT Proof : PANCARD - ADPPD3817J Source Of Funds : BUSINESS INCOME

Address Proof : AADHAAR CARD COPY ID Proof : AADHAAR CARD COPY

Objective Of Taking This Policy : SAVING AND PROTECTION Would You Like To Share Your Portfolio/Fund Details With Your Advisor/Agent : YES

Life Assured KYC Details

Age Proof : AADHAAR CARD COPY

Health Details of Life Assured

Suppressing facts or giving wrong information will adversely impact payment of your claim.

Height : 5 feet 3 inches

Weight : 55(Kgs)

Do You Consume Or Have Ever Consumed Tobacco? : NO

Do You Consume Or Have Ever Consumed Alcohol? : NO

Do You Consume Or Have Ever Consumed Narcotics? : NO

Is your occupation associated with any specific hazard or do you take part in activities or have hobbies that could be dangerous in any way? (e.g. occupation- chemical factory, mines,

explosives, radiation, corrosive chemicals & hobbies aviation other than as a fare paying passenger, shipping, diving, mountaineering, any form of racing etc.) : NO

Are you employed in the armed (navy, airforce, army), para military or police forces? (If yes, please provide Rank, Department/Division, Date of last medical & category after medical

exam) : NO

Family details of the life assured(include parents/sibling) Are any of your family members suffering from /have suffered from/have died of heart disease,Diabetes Mellitus, cancer or any

other hereditary/familial disorder, before 55 years of age.if yes please provide details below? : NO

Have you lost weight of 10 kgs or more in the last six months? : NO

Do you have any congenital defect/abnormality/physical deformity/handicap? : NO

Have you undergone or been advised to undergo any tests/investigations or any surgery or hospitalized for observation or treatment in the past? : NO

Did you have any ailment/injury/accident requiring treatment/medication for more than a week or have you availed leave for more than 5 days on medical grounds in the last two years? : N

O
 Hypertension/High BP/high cholesterol : NO Chest Pain/Heart Attack/any other heart disease or problem : NO

Undergone angioplasty,bypass surgery,heart surgery : NO Diabetes/High Blood Sugar/Sugar in Urine : NO

Asthma,Tuberculosis or any other respiratory disorder : NO Nervous disorders/stroke/paralysis/epilepsy : NO

Any GastroIntestinal disorders like Pancreatitis,Colitis etc. : NO Liver disorders/Jaundice/Hepatitis B or C : NO

Genitourinary disorders related to kidney,prostate,urinary system : NO Cancer, Tumor, Growth or Cyst of any Kind : NO

HIV infection AIDS or positive test for HIV : NO Any blood disorders like Anaemeia, Thalassemia etc : NO

Psychiatric or mental disorders : NO Any other disorder not mentioned above : NO

Have you ever suffered/are suffering from or have undergone investigations or treatment for any gynecological complications such as disorders of cervix,uterus,ovaries,breast, breast

lump,cyst etc? : NO

Are you pregnant at present? : NO

Product Details

Product Name : ICICI PRU GOLD

Policy Term (in yrs) : 25

Premium Payment Term(in Yrs) : 12

Guaranteed Maturity Benefit/Guaranteed Surrender Benefit/Sum Assured on Maturity (in INR) : 6,00,000

Sum Assured/Modal Income (in INR) : 3,020

Modal Premium (in INR) : 50,000

Deferment Period : 0

Mode : YEARLY

Frequency of Guaranteed Income : Yearly Income Accumulation : No

Income Accumulation Start Date : NA Income Accumulation End Date: NA

Income Start Date : 2024-04-05

Plan Option : Immediate Income

Particulars of the first premium deposit

Mode Of Deposit : MPOS Amount : 52,251

Bank : IPRU BRANCH

Note 1. Cheque/DD should be drawn in favour of "ICICI Prudential Life Insurance Co. Ltd." only. Please mention application no. and name of the proposer behind the cheque/DD. 2. In the event of non-realization of first premium deposit, the policy, if issued, shall be
treated as cancelled/void from inception. 3. Incase of non-acceptance/withdrawal of this application for insurance, the company shall return the first premium deposit without any interest and after deducting the expenses incurred on the medical test/examination. 4.
Kindly submit PAN/Form 60 (as defined under Income Tax Rules, 1962), at the time of applying for the policy. The premium payment can be done only through the acceptable premium collection modes. Where any customer/policyholder wishes or proposes to make
any payment in cash, it can be accepted up to the limit of ` 49,999/- only at the authorized collection points. In case you opt to pay cash up to an acceptable limit , you are requested to pay cash only at the authorized collection points and not to advisor or employee.
The company will not be responsible for any loss in this regard. 5. Please submit a cash authority letter along with the cash if you are depositing the cash through a third party. 6. Payments made through credit cards can be accepted only if the card is issued in the
name of the relevant proposer/policy holder.

Payout Mode
Mode selected would be used by the company to makepayout(s) to the proposer. Payout would be in accordance and subject to the terms and conditions of the policy.

Account Type : SAVING Bank Name : HDFC BANK LTD TURBHE(TBE) HDFC0001030

Branch : HDFC BANK LTD TURBHE(TBE) HDFC0001030 Account Number : 50100531994290

MICR Code : 400240108 Do you wish to set the preference month for renewal premium as November: NA

Note 1. Please provide a cancelled copy of your cheque if any of the above payout option is selected. 2. In case of non credit to my bank account with or without assigning any reasons there of or if the transaction is delayed or not effected at all for reasons of
incomplete/incorrect information, I would not hold ICICI Prudential Life Insurance Co. Ltd. responsible. 3. Further, the company reserves the right to use any alternative payout option in spite of opting for Direct Credit option.

Declaration & Authorization

I/We declare that I/we have answered all the questions in the proposal form and have duly signed it after understanding its contents. I/ We have fully understood the nature of the questions

including health related questions and the importance of disclosing all material information while answering such questions. I/We declare that the answers given by me/us to all the questions

in the proposal form and the information given to ICICI Prudential Life Insurance Co. Ltd. as to the state of health and habits of the life/lives to be assured are true and complete in every

respect and that I/we have not withheld any material information or suppressed any material fact. I/ We have made no statement to the Insurance Advisor, Medical Examiner or any other

person associated with the Company which in any way modifies the answer given by me/ us in this proposal form. I/We undertake to notify the Company of any change in the information

given by me/ us in the proposal form with respect to the Life/ Lives to be Assured subsequent to the signing of this proposal form and before the receipt of the policy document. I/We also
understand that the the premium and the benefits payable under the Policy are subject to taxes/ duties/ charges in accordance to applicable laws. I/We confirm that all premiums will be paid

from bonafide sources. I/We hereby authorize ICICI Prudential Life Insurance Co. Ltd. to assess the health status and conduct screening/confirmation/telephonic verification/reconfirmation of

the life/lives to be assured including the health status through medical examinations which may include Laboratory tests, Cardiology, Radiological investigations and other medical tests

including blood tests to detect bacterial/viral/fungal infections if required by the Company. I/We hereby give my/our consent to undergo HIV1/2 test. I/We hereby authorize ICICI Prudential

Life Insurance Co. Ltd. to send all service related communications to the contact details registered with the company related to this proposal/policy. The Company reserves the right to

accept, decline or offer alternate terms on my/our proposal for Life/Health Insurance. In order to enable the Company to assess the risk under this proposal and any time thereafter, I/we

hereby, authorize the past and present employer(s)/business associates/medical practitioner(s)/hospital and medical source/any life and non-life insurance Company to provide the records of

employment/business or other details as may be considered relevant. I/we agree and authorize the Company, for the purpose of processing of this Proposal or servicing of the resulting

policy, to verify/share relevant information provided herein on confidential basis within ICICI group and/or third party agencies. This proposal form shall be a part of the life insurance policy

contract, in case of its acceptance by the Company. I/we agree that the PAN details and other information provided by me/us in the proposal form maybe used by the Company to

download/verify my/our KYC documents from the CERSAI* CKYC portal for processing this application. I/We understand that only the acceptable officially valid documents would be relied

upon for processing this application. (*Central Registry of Securitisation and Asset Reconstruction and security Interest of India.) I hereby consent to receiving information from Central KYC

Registry through sms/ email on the above registered number/email address related to this proposal/policy. I understand that in case of fraud or misstatement by me/us, the policy shall be

treated by the Company in accordance with Section 45 of the Insurance Act, 1938 as amended from time to time.

Date : Mar 9, 2024

This is electronicaly generated proposal/application form, doesnot require signature.

Place : MAHARASHTRA

The Insurance Laws (Amendment) Act, 2015

Section 39 Nomination by policyholder: (1) The holder of a policy of life insurance on his own life may, when effecting the policy or at any time before the policy matures for payment,

nominate the person or persons to whom the money secured by the policy shall be paid in the event of his death: Provided that, where any nominee is a minor, it shall be lawful for the

policyholder to appoint any person in the manner laid down by the insurer, to receive the money secured by the policy in the event of his death during the minority of the nominee. (2) Any

such nomination in order to be effectual shall, unless it is incorporated in the text of the policy itself, be made by an endorsement on the policy communicated to the insurer and registered by

him in the records relating to the policy and any such nomination may at any time before the policy matures for payment be cancelled or changed by an endorsement or a further

endorsement or a will, as the case may be, but unless notice in writing of any such cancellation or change has been delivered to the insurer, the insurer shall not be liable for any payment

under the policy made bona fide by him to a nominee mentioned in the text of the policy or registered in records of the insurer. (3) The insurer shall furnish to the policyholder a written

acknowledgement of having registered a nomination or a cancellation or change thereof, and may charge such fee as may be specified by regulations for registering such cancellation or

change. (4) A transfer or assignment of a policy made in accordance with section 38 shall automatically cancel a nomination: Provided that the assignment of a policy to the insurer who

bears the risk on the policy at the time of the assignment, in consideration of a loan granted by that insurer on the security of the policy within its surrender value, or its reassignment on

repayment of the loan shall not cancel a nomination, but shall affect the rights of the nominee only to the extent of the insurer's interest in the policy: Provided further that the transfer or

assignment of a policy, whether wholly or in part, in consideration of a loan advanced by the transferee or assignee to the policyholder, shall not cancel the nomination but shall affect the

rights of the nominee only to the extent of the interest of the transferee or assignee, as the case may be, in the policy: Provided also that the nomination, which has been automatically

cancelled consequent upon the transfer or assignment, the same nomination shall stand automatically revived when the policy is reassigned by the assignee or retransferred by the

transferee in favour of the policyholder on repayment of loan other than on a security of policy to the insurer. (5) Where the policy matures for payment during the lifetime of the person whose

life is insured or where the nominee or, if there are more nominees than one, all the nominees die before the policy matures for payment, the amount secured by the policy shall be payable

to the policyholder or his heirs or legal representatives or the holder of a succession certificate, as the case may be. (6) Where the nominee or if there are more nominees than one, a

nominee or nominees survive the person whose life is insured, the amount secured by the policy shall be payable to such survivor or survivors. (7) Subject to the other provisions of this

section, where the holder of a policy of insurance on his own life nominates his parents, or his spouse, or his children, or his spouse and children, or any of them, the nominee or nominees

shall be beneficially entitled to the amount payable by the insurer to him or them under sub-section (6) unless it is proved that the holder of the policy, having regard to the nature of his title to

the policy, could not have conferred any such beneficial title on the nominee. (8) Subject as aforesaid, where the nominee, or if there are more nominees than one, a nominee or nominees,

to whom sub-section (7) applies, die after the person whose life is insured but before the amount secured by the policy is paid, the amount secured by the policy, or so much of the amount

secured by the policy as represents the share of the nominee or nominees so dying (as the case may be), shall be payable to the heirs or legal representatives of the nominee or nominees

or the holder of a succession certificate, as the case may be, and they shall be beneficially entitled to such amount. (9) Nothing in sub-sections (7) and (8) shall operate to destroy or impede

the right of any creditor to be paid out of the proceeds of any policy of life insurance. (10) The provisions of sub-sections (7) and (8) shall apply to all policies of life insurance maturing for

payment after the commencement of the Insurance Laws (Amendment) Act, 2015 (5 of 2015). (11) Where a policyholder dies after the maturity of the policy but the proceeds and benefit of

his policy has not been made to him because of his death, in such a case, his nominee shall be entitled to the proceeds and benefit of his policy. (12) The provisions of this section shall not

apply to any policy of life insurance to which section 6 of the Married Women's Property Act, 1874 (3 of 1874), applies or has at any time applied: Provided that where a nomination made

whether before or after the commencement of the Insurance Laws (Amendment) Act, 2015 (5 of 2015), in favour of the wife of the person who has insured his life or of his wife and children

or any of them is expressed, whether or not on the face of the policy, as being made under this section, the said section 6 shall be deemed not to apply or not to have applied to the policy.

Section 41 Prohibition of rebates: (1) No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take or renew or continue an insurance in respect

of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy, nor shall any person

taking out or renewing or continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectuses or tables of the insurer: Provided that

acceptance by an insurance agent of commission in connection with a policy of life insurance taken out by himself on his own life shall not be deemed to be acceptance of a rebate of

premium within the meaning of this sub-section if at the time of such acceptance the insurance agent satisfies the prescribed conditions establishing that he is a bona fide insurance agent

employed by the insurer.

Section 45 Policy not to be called in question on ground of mis statement after three years: (1) No policy of life insurance shall be called in question on any ground whatsoever after the

expiry of three years from the date of the policy, i.e., from the date of issuance of the policy or the date of commencement of risk or the date of revival of the policy or the date of the rider to
the policy, whichever is later. (2) A policy of life insurance may be called in question at anytime within three years from the date of issuance of the policy or the date of commencement of risk

or the date of revival of the policy or the date of the rider to the policy, whichever is later, on the ground of fraud: Provided that the insurer shall have to communicate in writing to the insured

or the legal representatives or nominees or assignees of the insured the grounds and materials on which such decision is based. Explanation I. For the purposes of this sub-section, the

expression 'fraud' means any of the following acts committed by the insured or by his agent, with the intent to deceive the insurer or to induce the insurer to issue a life insurance policy: (a)

the suggestion, as a fact of that which is not true and which the insured does not believe to be true; (b) the active concealment of a fact by the insured having knowledge or belief of the fact;

(c) any other act fitted to deceive; and (d) any such act or omission as the law specially declares to be fraudulent. Explanation II. Mere silence as to facts likely to affect the assessment of the

risk by the insurer is notfraud, unless the circumstances of the case are such that regard being had to them, it is the duty of the insured or his agent, keeping silence to speak, or unless his

silence is, in itself, equivalent to speak. (3) Notwithstanding anything contained in sub-section (2), no insurer shall repudiate a life insurance policy on the ground of fraud if the insured can

prove that the mis-statement of or suppression of a material fact was true to the best of his knowledge and belief or that there was no deliberate intention to suppress the fact or that such mis

-statement of or suppression of a material fact are within the knowledge of the insurer. Provided that in case of fraud, the onus of disproving lies upon the beneficiaries, in case the

policyholder is not alive. Explanation. - A person who solicits and negotiates a contract of insurance shall be deemed for the purpose of the formation of the contract, to be the agent of the

insurer. (4) A policy of life insurance may be called in question at any time within three years from the date of issuance of the policy or the date of commencement of risk or the date of revival

of the policy or the date of the rider to the policy, whichever is later, on the ground that any statement of or suppression of a fact material to the expectancy of the life of the insured was

incorrectly made in the proposal or other document on the basis of which the policy was issued or revived or rider issued: Provided that the insurer shall have to communicate in writing to the

insured or the legal representatives or nominees or assignees of the insured the grounds and materials on which such decision to repudiate the policy of life insurance is based: Provided

further that in case of repudiation of the policy on the ground of mis-statement or suppression of a material fact, and not on the ground of fraud, the premiums collected on the policy till the

date of repudiation shall be paid to the insured or the legal representatives or nominees or assignees of the insured within a period of ninety days from the date of such repudiation.

Explanation - For the purposes of this sub-section, the mis-statement of or suppression of fact shall not be considered material unless it has a direct bearing on the risk undertaken by the

insurer, the onus is on the insurer to show that had the insurer been aware of the said fact no life insurance policy would have been issued to the insured. (5) Nothing in this section shall

prevent the insurer from calling for proof of age at anytime if he is entitled to do so, and no policy shall be deemed to be called in question merely because the terms of the policy are

adjusted on subsequent proof that the age of the life insured was incorrectly stated in the proposal."
 Benefit Illustration - ICICI Pru GOLD

Proposal No : OS24031813
Name of Prospect/Policyholder : Mr. DILIP NAMDEV DALVI Name of the Product : ICICI Pru GOLD
Age of the Policyholder at inception : 01-Jun-1958 (65 years) Tag Line : Non Linked Participating
Individual Life Insurance
Savings Plan
Gender of the Policyholder : MALE
Name of the Life Assured : Mrs. DIPALI DILIP DALVI Unique Identification Number : 105N190V02
Age of the Life Assured at inception : 05-Feb-1964 (60 years) GST Rate for Year 1 : 4.5%
Gender of the Life Assured : FEMALE GST Rate For Year 2 Onwards : 2.25%
Policy Term : 25 years Sales Channel : IDFC First Bank
Premium Payment Term : 12 years
Amount of Instalment Premium (Without : Rs. 50,000/-
GST and cesses if any)
Mode of payment of premium : Yearly

How to read and understand this benefit illustration?

This benefit illustration is intended to show year-wise premiums payable and benefits under the policy, at two assumed rates of interest i.e., 8%
p.a. and 4% p.a. 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, these will be clearly marked "guaranteed" in the illustration table on
this page. If your policy offers variable benefits, then the illustration 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.

Policy Details
Plan Option Immediate Income Sum Assured on Maturity Rs. 600,000
Deferment Period Not Applicable Sum Assured on Death (at inception of the policy) Rs. 525,000
Bonus Type Simple Bonus Save The Date feature Opted in

Premium Summary
Base Plan ICICI Pru Non-Linked ICICI Pru Non-Linked ICICI Pru Non-Linked Total Instalment
Accidental Death and Accidental Death and Waiver of Premium Premium
Disability Rider Disability Rider Rider
(Accidental Death (Accidental Total &
Benefit option) Permanent Disability
Benefit option)
Instalment Premium without GST and Cesses, if any Rs. 50,000/- - - - Rs. 50,000/-
Instalment Premium with first year GST and Cesses, if Rs. 52,251/- - - - Rs. 52,251/-
any
Instalment Premium with GST and Cesses, if any 2nd Rs. 51,126/- - - - Rs. 51,126/-
year onwards

Summary of Benefits payable over the course of the Policy Term

Guaranteed Benefits payable as Survival Benefits during the Income Term
Guaranteed Income as per frequency chosen by you: Rs. 3,020 Guaranteed Booster as per frequency chosen by you: Not Applicable
Frequency of Guaranteed Income: Annual Frequency of Guaranteed Booster: Not Applicable
Guaranteed Income payable in a year: Rs. 3,020 Guaranteed Booster payable in a year, when due: Not Applicable
Total Guaranteed Income payable (A) Rs. 75,500
Benefit payable at the end of policy term (Maturity Benefit)
Benefits at 4% p.a. Benefits at 8% p.a.
Estimated Cash Bonus as per frequency chosen by you Rs. 4,065 Rs. 10,460
Frequency of Cash Bonus: Annual Annual
Estimated Cash Bonus payable in a year Rs. 4,065 Rs. 10,460
Estimated Total Cash Bonus payable over the Income Term (B) Rs. 101,625 Rs. 261,500
Estimated Terminal Bonus at Maturity Rs. 107,934 Rs. 320,026
Estimated Total Maturity Benefit (C) Rs. 707,934 Rs. 920,026
Total Benefits payable till Maturity (A + B + C) Rs. 885,059 Rs. 1,257,026
 Benefit Details
Total Benefits including Guaranteed and Non-Guaranteed Benefit
Guaranteed Benefits Non-Guaranteed Non-Guaranteed Survival Benefit Maturity Benefit Death Benefit Surrender Benefit4
Benefits @ 4% p.a. Benefits @ 8% p.a.
Po Annuali Guaran Guaran Surrende Death Maturity Cash Surrende Cash Surrender Total Total Total Total Total Total Total Total
l. sed teed teed r Benefit Benefit Benefit Bonus r Benefit Bonus Benefit Survival Surviv Maturity Maturity Death Death Surrender Surrender
Ye Premiu Income Booste Benefit al Benefit @ Benefit @ Benefit @ Benefit @ Benefit Benefit
ar m r @ 4% Benefit 4% p.a. (7 8% p.a. (7 4% p.a.(6 8% p.a.(6 @4% p.a. @8% p.a.
p.a.(3 + @ 8% +Terminal + + + (5 + 9) (5 + 11)
4 + 8) p.a.(3 + Bonus, if Terminal Interim/Te Interim/Te
4 + 10) declared) Bonus, if rminal rminal
declared) Bonus, if Bonus, if
declared) declared)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
1 50,000 3,020 0 0 530,033 0 4,065 0 10,460 0 7,085 13,480 0 0 533,421 538,750 0 0
2 50,000 3,020 0 0 530,033 0 4,065 20,410 10,460 7,620 7,085 13,480 0 0 533,421 538,750 20,410 7,620
3 50,000 3,020 0 0 530,033 0 4,065 51,870 10,460 32,685 7,085 13,480 0 0 533,421 538,750 51,870 32,685
4 50,000 3,020 0 0 530,033 0 4,065 71,660 10,460 46,080 7,085 13,480 0 0 533,421 538,750 71,660 46,080
5 50,000 3,020 0 0 530,033 0 4,065 89,575 10,460 57,600 7,085 13,480 0 0 533,421 538,750 89,575 57,600
6 50,000 3,020 0 0 530,033 0 4,065 107,490 10,460 69,120 7,085 13,480 0 0 533,421 538,750 107,490 69,120
7 50,000 3,020 0 0 530,033 0 4,065 141,435 10,460 96,670 7,085 13,480 0 0 533,421 538,750 141,435 96,670
8 50,000 3,020 0 0 530,033 0 4,065 199,960 10,460 148,800 7,085 13,480 0 0 533,421 538,750 199,960 148,800
9 50,000 3,020 0 0 530,033 0 4,065 269,955 10,460 212,400 7,085 13,480 0 0 533,421 538,750 269,955 212,400
10 50,000 3,020 0 0 530,033 0 4,065 327,050 10,460 263,100 7,085 13,480 0 0 533,421 538,750 327,050 263,100
11 50,000 3,020 0 0 582,533 0 4,065 412,445 10,460 342,100 7,085 13,480 0 0 585,921 591,250 412,445 342,100
12 50,000 3,020 0 0 635,033 0 4,065 470,617 10,460 432,966 7,085 13,480 0 0 638,421 643,750 470,617 432,966
13 0 3,020 0 0 635,033 0 4,065 477,457 10,460 444,288 7,085 13,480 0 0 638,421 643,750 477,457 444,288
14 0 3,020 0 0 635,033 0 4,065 484,735 10,460 456,969 7,085 13,480 0 0 638,421 643,750 484,735 456,969
15 0 3,020 0 0 635,033 0 4,065 492,502 10,460 471,207 7,085 13,480 0 0 638,421 643,750 492,502 471,207
16 0 3,020 0 0 635,033 0 4,065 500,859 10,460 487,291 7,085 13,480 0 0 638,421 643,750 500,859 487,291
17 0 3,020 0 488,660 635,033 0 4,065 21,131 10,460 16,772 7,085 13,480 0 0 638,421 643,750 509,791 505,432
18 0 3,020 0 485,640 635,033 0 4,065 33,885 10,460 40,507 7,085 13,480 0 0 638,421 643,750 519,525 526,147
19 0 3,020 0 482,620 635,033 0 4,065 47,513 10,460 67,249 7,085 13,480 0 0 638,421 643,750 530,133 549,869
20 0 3,020 0 479,600 635,033 0 4,065 62,164 10,460 97,602 7,085 13,480 0 0 638,421 643,750 541,764 577,202
21 0 3,020 0 476,580 635,033 0 4,065 78,021 10,460 132,336 7,085 13,480 0 0 638,421 643,750 554,601 608,916
22 0 3,020 0 473,560 635,033 0 4,065 95,374 10,460 172,502 7,085 13,480 0 0 638,421 648,578 568,934 646,062
23 0 3,020 0 470,540 635,033 0 4,065 114,532 10,460 218,027 7,085 13,480 0 0 638,421 691,084 585,072 688,567
24 0 3,020 0 467,520 635,033 0 4,065 135,951 10,460 268,687 7,085 13,480 0 0 638,421 738,723 603,471 736,207
25 0 3,020 0 0 630,000 600,000 4,065 0 10,460 0 7,085 13,480 707,934 920,026 630,000 789,525 0 0

Note: Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any, and
Goods & Service Tax, if any.

Important points to note:

1. The Survival Benefits are payable during the policy year when they are due as per the frequency or date chosen at inception. The payments will
continue to be paid on the due date(s) as applicable till the last policy year, provided the Life Assured is alive. The payments will stop once the policy
matures.
2. If Save the date is opted, the survival benefit values mentioned here are indicative based on the date on which this benefit illustration was generated
for this policy. The exact values will be as per the date of issuance of your policy and are specified in the Policy Schedule attached in your welcome kit.
3. The Surrender Value (benefit amount payable on policy surrender) and Death Benefit (benefit amount payable on death of the Life Assured)
mentioned above are illustrated assuming that the event occurs at the end of the respective year and after the payment of any survival benefit due at
the end of respective year. The Maturity Benefits mentioned are payable at the end of the policy term. Post payment of this benefit (whichever is the
earliest) the policy terminates and no further benefit is payable.
4. The surrender value payable will be higher of Guaranteed Surrender Value or Special Surrender Value (including any Terminal Bonus payable, if
declared) and is illustrated under 'Total Surrender Benefit' columns. The guaranteed benefit illustrated under 'Surrender Benefit' is the minimum
amount payable under both 4% and 8% gross return per annum.
5. Savings Wallet: At any point during the policy term, you will have the option to accumulate Survival Benefit instead of taking as payment and
withdraw the accumulated Survival Benefit partially or completely. If not withdrawn, any balance left will be paid out along with death, surrender or
maturity payment, whichever hapepns first. For more details, please refer to the policy document.
6. Please refer to your sales brochure and policy document for more details. In case of any discrepancy between this document and policy document,
the latter shall prevail.
7. For any further clarifications, policyholder can contact their advisor or the Company.

I, __________________________________, have explained I, ______________________________, having received the

the premiums, and benefits under the policy fully to the information with respect to the above, have understood the
prospect / policyholder. above statement before entering into the contract.

Place: Place:
Date: Signature of Agent / Intermediary / Official Date: Signature of Prospect / Policyholder
 ICICI Prudential Life Insurance Company Limited.
1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai - 400025
Email: lifeline@iciciprulife.com
www.iciciprulife.com
 HOW TO READ YOUR 'BI'
The benefit Illustration provides a year-by-year summary of how your benefits will look like. ICICI Pru Gold belongs to 'Participating'
category of products. In this category of products, your benefits are partially guaranteed and partially dependent on bonuses.
Therefore, all the benefits will be shown at an assumed rate of returns of 4% and 8%. The guaranteed benefits are shown in sub-
section 'Guaranteed Benefits' and the bonus based benefits are shown under sub-section 'Non-Guaranteed Benefits'.

Here are a few pointers which will help you read the table in the Benefit Illustration better:

1 Policy year:
This refers to the number of years you stay invested or the term chosen by you. Policy year is shown in column 1.

2 Annualized premium:
This is the premium you need to pay for the premium payment duration selected by you. The annualized
premium is shown in column 2.

3 Survival benefit (Income):

This refers to the income amount paid to the life assured throughout the income term. Total Income is a combination of
'guaranteed income' and 'bonus-based income (cash bonus). The guaranteed part of income is shown in column 3. The
bonus based income is shown at 8% and 4% ARR respectively in column 10 and 8. Therefore, to refer to the total income
payable every year, please refer to column 13 (@8% ARR) and column 12(@4% ARR). In case you have opted for
'Immediate Income with Booster' plan option, over and above income you will receive a guaranteed booster every 5th
policy year. The guaranteed booster is shown in column 4.

4
Maturity benefit:
This is a lump sum payable on maturity and is a combination of 'guaranteed lump sum (sum assured on maturity)' and
'bonus-based lump sum (Terminal bonus)'. The guaranteed lump sum is shown in column 7. Total maturity benefit is shown
in column 15 (@8% ARR) and column 14 (@4% ARR).

5 Death benefit (Life cover):

This refers to the lump sum that will be paid to the nominee on death of the life assured. It is a combination of guaranteed
life cover and bonus-based cover (Interim/terminal bonus). The guaranteed life cover is shown in column 6 and total life
cover is shown in column 17 (@8% ARR) and column 16 (@4% ARR).

6
Surrender benefit:
This is the amount paid to you if you exit the plan. The final surrender value is calculated as higher of (the guaranteed
surrender value and bonus-based surrender value). The final surrender value is shown in the last two columns i.e. column
19 (@8% ARR) and column 18 (@4% ARR).