BENEFIT ILLUSTRATION

[Date and Time of Illustration – 11 February 2025, 04:11 PM]

Name of the Prospect/Policyholder: Mr. Gxbxb Proposal No:

Age & Gender: 58 Years, Male Name of the Product: Max Life Smart Wealth Income Plan
Name of the Life Assured: Mr. Gxbxb Tag Line: A Non-Linked Participating Individual Life Insurance Savings Plan
Age & Gender: 58 Years, Male Unique Identification No: 104N120V03
Policy Term: 42 Years GST Rate (Base Policy, First 4.50%
Premium Payment Term: 12 Years GST Rate (Rider, First Year): 18.00%
Amount of Installment Premium: `1,04,500 Max Life State: Delhi
Mode of payment of premium: Annual Policyholder Residential State: Delhi

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 returns benefits then
these will be clearly marked “guaranteed” in the illustration table on the next this page. If your policy offers variable returns benefits then the illustration on the next 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 illustrative, 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
Policy Option Early Income Sum Assured (in Rs.) 10,68,376
Policy Continuance Benefit Option No Sum Assured on Death (at inception of the policy) (in Rs.) 11,00,000
Payment Frequency for Guaranteed Income/Cash Bonus Annual

Rider Details
Accidental Death & Dismemberment (ADD) Rider Premium
NA Accidental Death & Dismemberment (ADD) Rider Sum Assured (in Rs.) NA
Payment Term and Rider Term
Term Plus Rider Term NA Term Plus Rider Sum Assured (in Rs.) NA
Waiver of Premium (WOP) Plus Rider Term NA
Critical Illness and Disability Rider - Rider Premium Payment Term
NA Critical Illness and Disability Rider - Coverage Variant NA
and Rider Term
Critical Illness and Disability Rider - Rider Sum Assured NA

Premium Summary

Accidental Death & Waiver of Premium Critical Illness and Total Installment
Base Plan Term Plus Rider
Dismemberment Rider Plus Rider Disability Rider Premium

Installment Premium without GST (in Rs.) 1,00,000 0 0 0 0 1,00,000

Installment Premium with first year GST (in Rs.) 1,04,500 0 0 0 0 1,04,500
Installment Premium with GST 2nd year onwards (in Rs.) 1,02,250 0 0 0 0 1,02,250

UIN: 104N120V03 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 1 of 5
 (Amount in Rupees)

Non-Guaranteed Benefits Non-Guaranteed Benefits Total Benefits including Guaranteed and Non- Guaranteed Benefits
Guaranteed Benefits
@ 4% p.a. @ 8% p.a.
Survival Benefit Surrender Value Death Benefit Maturity Benefit
Single/
Annualiz Survival Total Total
Policy Total
Total Total Total Total Total
ed Benefit Surrender Surrender Survival Survival Surrender
Year Survival Maturity Surrender Death Death Maturity Maturity
Premium (Guaranteed Surrender Benefit (SSV Death Maturity Survival Surrender Benefit (SSV Death Benefit, Benefit, Benefit,
Benefit Benefit Benefit, Benefit, Benefit, Benefit, Benefit,
Income/Gua Death Maturity Benefit Including TB Benefit Benefit Benefit Benefit Including TB Benefit incl. of incl. of [Link] TB, if
(Cash (TB at incl. of TB, if
any @ 8%
incl. of TB, incl. of TB, incl. TB, if incl. TB, if
ranteed Benefit Benefit (GSV) on (TB on (TB at (Cash (GSV) on (TB on Cash Cash any @ 4%
Bonus) Maturity) Bonus, if (Higher of if any @ if any @ any @ 4% any @ 8%
Money Surrender) Death) Maturity) Bonus) Surrender) Death) Bonus, if (Higher of 7
any @ 8% 12 or 13) 4% (4+9) 8% (4+14) (5+10) (5+15)
Back) any @ 4% or 8)
(3+6) (3+11)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
1,00,0 11,00, 11,00,00 11,00,00
1 - - - - 20,828 - - - - 20,828 - - - - 20,828 20,828 - -
00 000 0 0
1,00,0 11,00, 40,49 11,00,00 11,00,00
2 1,282 - 9,936 48,782 58,782 - - 18,226 43,578 - - 11,218 41,774 58,782 43,578 - -
00 000 1 0 0
1,00,0 11,00, 40,49 11,00,00 11,00,00
3 1,282 - 9,936 82,564 1,12,564 - - 21,453 68,376 - - 11,218 41,774 1,12,564 68,376 - -
00 000 1 0 0
1,00,0 11,00, 1,66,34 40,49 11,00,00 11,00,00
4 1,282 - 9,936 1,86,346 - - 74,679 95,353 - - 11,218 41,774 1,86,346 95,353 - -
00 000 6 1 0 0
1,00,0 11,00, 2,05,12 40,49 11,00,00 11,00,00
5 1,282 - 9,936 2,47,628 - - 82,906 1,25,406 - - 11,218 41,774 2,47,628 1,25,406 - -
00 000 8 1 0 0
1,00,0 11,00, 2,43,91 40,49 11,00,00 11,00,00
6 1,282 - 9,936 3,15,910 - - 91,132 1,67,997 - - 11,218 41,774 3,15,910 1,67,997 - -
00 000 0 1 0 0
1,00,0 11,00, 2,82,69 40,49 11,00,00 11,00,00
7 1,282 - 9,936 3,91,192 - - 99,359 2,31,705 - - 11,218 41,774 3,91,192 2,31,705 - -
00 000 2 1 0 0
1,00,0 11,00, 3,67,15 40,49 1,53,26 11,00,00 11,00,00
8 1,282 - 9,936 4,73,474 - - 3,08,162 - - 11,218 41,774 4,73,474 3,08,162 - -
00 000 4 1 5 0 0
1,00,0 11,00, 4,63,12 40,49 2,18,68 11,00,00 11,00,00
9 1,282 - 9,936 5,62,756 - - 3,97,388 - - 11,218 41,774 5,62,756 3,97,388 - -
00 000 6 1 2 0 0
1,00,0 11,00, 5,70,43 40,49 2,95,43 11,00,00 11,00,00
10 1,282 - 9,936 6,74,593 - - 5,00,817 - - 11,218 41,774 6,74,593 5,00,817 - -
00 000 8 1 8 0 0
1,00,0 11,55, 6,89,28 40,49 3,83,72 11,55,00 11,55,00
11 1,282 - 9,936 8,16,791 - - 6,20,436 - - 11,218 41,774 8,16,791 6,20,436 - -
00 000 1 1 5 0 0
1,00,0 12,60, 8,19,44 40,49 4,83,33 12,60,00 12,60,00
12 1,282 - 9,936 9,74,249 - - 7,57,132 - - 11,218 41,774 9,74,249 7,57,132 - -
00 000 3 1 1 0 0
12,60, 8,76,86 40,49 5,10,19 10,59,80 12,60,00 12,60,00
13 - 1,282 - 9,936 10,59,804 - - 8,21,163 - - 11,218 41,774 8,21,163 - -
000 5 1 8 4 0 0
12,60, 9,34,16 40,49 5,36,94 10,87,89 12,60,00 12,60,00
14 - 1,282 - 9,936 10,87,895 - - 8,39,261 - - 11,218 41,774 8,39,261 - -
000 7 1 4 5 0 0
12,60, 9,22,94 40,49 4,95,17 11,15,37 12,60,00 12,60,00
15 - 1,282 - 9,936 11,15,371 - - 8,56,656 - - 11,218 41,774 8,56,656 - -
000 9 1 1 1 0 0
12,60, 9,11,73 40,49 4,53,39 11,44,56 12,60,00 12,60,00
16 - 1,282 - 9,936 11,44,560 - - 8,75,722 - - 11,218 41,774 8,75,722 - -
000 1 1 7 0 0 0

UIN: 104N120V03 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 2 of 5
 Non-Guaranteed Benefits Non-Guaranteed Benefits Total Benefits including Guaranteed and Non- Guaranteed Benefits
Guaranteed Benefits
@ 4% p.a. @ 8% p.a.
Survival Benefit Surrender Value Death Benefit Maturity Benefit
Single/
Annualiz Survival Total Total
Policy Total
Total Total Total Total Total
ed Benefit Surrender Surrender Survival Survival Surrender
Year Survival Maturity Surrender Death Death Maturity Maturity
Premium (Guaranteed Surrender Benefit (SSV Death Maturity Survival Surrender Benefit (SSV Death Benefit, Benefit, Benefit,
Benefit Benefit Benefit, Benefit, Benefit, Benefit, Benefit,
Income/Gua Death Maturity Benefit Including TB Benefit Benefit Benefit Benefit Including TB Benefit incl. of incl. of [Link] TB, if
(Cash (TB at incl. of TB, if
any @ 8%
incl. of TB, incl. of TB, incl. TB, if incl. TB, if
ranteed Benefit Benefit (GSV) on (TB on (TB at (Cash (GSV) on (TB on Cash Cash any @ 4%
Bonus) Maturity) Bonus, if (Higher of if any @ if any @ any @ 4% any @ 8%
Money Surrender) Death) Maturity) Bonus) Surrender) Death) Bonus, if (Higher of 7
any @ 8% 12 or 13) 4% (4+9) 8% (4+14) (5+10) (5+15)
Back) any @ 4% or 8)
(3+6) (3+11)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
12,60, 9,00,51 40,49 4,11,62 11,75,67 12,60,00 12,60,00
17 - 1,282 - 9,936 11,75,671 - - 8,96,625 - - 11,218 41,774 8,96,625 - -
000 3 1 4 1 0 0
12,60, 8,89,29 40,49 3,69,85 12,08,98 12,60,00 12,60,00
18 - 1,282 - 9,936 12,08,985 - - 9,19,615 - - 11,218 41,774 9,19,615 - -
000 5 1 0 5 0 0
12,60, 8,78,07 40,49 3,28,07 12,44,74 12,60,00 12,60,00
19 - 1,282 - 9,936 12,44,745 - - 9,45,070 - - 11,218 41,774 9,45,070 - -
000 7 1 7 5 0 0
12,60, 8,66,85 40,49 2,86,30 12,82,53 12,60,00 12,60,00
20 - 1,282 - 9,936 12,82,533 - - 9,73,322 - - 11,218 41,774 9,73,322 - -
000 9 1 3 3 0 0
12,60, 8,55,64 40,49 2,44,53 13,22,31 10,04,95 12,60,00 12,60,00
21 - 1,282 - 9,936 13,22,313 - - 10,04,956 - - 11,218 41,774 - -
000 1 1 0 3 6 0 0
12,60, 8,44,42 40,49 2,02,75 13,64,26 10,40,51 12,60,00 12,60,00
22 - 1,282 - 9,936 13,64,260 - - 10,40,515 - - 11,218 41,774 - -
000 3 1 6 0 5 0 0
12,60, 8,33,20 40,49 1,60,98 14,08,47 10,80,83 12,60,00 12,60,00
23 - 1,282 - 9,936 14,08,479 - - 10,80,835 - - 11,218 41,774 - -
000 5 1 3 9 5 0 0
12,60, 8,21,98 40,49 1,19,20 14,55,25 11,26,95 12,60,00 12,60,00
24 - 1,282 - 9,936 14,55,250 - - 11,26,959 - - 11,218 41,774 - -
000 7 1 9 0 9 0 0
12,60, 8,10,76 40,49 30,14 15,04,78 11,79,68 12,85,23 12,90,14
25 - 1,282 - 9,936 15,04,782 25,237 - 77,436 11,79,680 - 11,218 41,774 - -
000 9 1 8 2 0 7 8
12,60, 7,99,55 40,49 92,65 15,57,28 12,37,99 13,37,56 13,52,65
26 - 1,282 - 9,936 15,57,285 77,563 - 35,662 12,37,996 - 11,218 41,774 - -
000 1 1 7 5 6 3 7
12,60, 10,25 7,89,29 1,34,67 41,77 1,60,8 16,13,93 13,08,18 13,94,67 14,20,88
27 - - - 16,13,931 - - 13,08,187 - 10,256 41,774 - -
000 6 5 8 4 87 1 7 8 7
12,60, 10,25 7,79,03 1,97,24 41,77 2,35,6 16,74,28 14,20,59 14,57,24 14,95,63
28 - - - 16,74,282 - - 14,20,595 - 10,256 41,774 - -
000 6 8 6 4 31 2 5 6 1
12,60, 10,25 7,68,78 2,65,96 41,77 3,17,7 17,38,65 15,16,05 15,25,96 15,77,72
29 - - - 17,38,652 - - 15,16,050 - 10,256 41,774 - -
000 6 2 5 4 25 2 0 5 5
12,60, 10,25 7,58,52 3,41,50 41,77 4,07,9 18,07,49 16,06,45 16,01,50 16,67,96
30 - - - 18,07,497 - - 16,06,453 - 10,256 41,774 - -
000 6 6 1 4 60 7 3 1 0
12,60, 10,25 7,48,26 4,24,69 41,77 5,07,3 18,81,30 17,06,08 16,84,69 17,67,34
31 - - - 18,81,305 - - 17,06,083 - 10,256 41,774 - -
000 6 9 2 4 40 5 3 2 0
12,60, 10,25 7,38,01 5,16,58 41,77 6,17,1 19,60,70 18,16,07 17,76,58 18,77,11
32 - - - 19,60,706 - - 18,16,070 - 10,256 41,774 - -
000 6 3 6 4 18 6 0 6 8
12,60, 10,25 7,27,75 6,18,23 41,77 7,38,5 20,46,36 19,37,79 18,78,23 19,98,54
33 - - - 20,46,363 - - 19,37,790 - 10,256 41,774 - -
000 6 6 2 4 46 3 0 2 6

UIN: 104N120V03 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 3 of 5
 Non-Guaranteed Benefits Non-Guaranteed Benefits Total Benefits including Guaranteed and Non- Guaranteed Benefits
Guaranteed Benefits
@ 4% p.a. @ 8% p.a.
Survival Benefit Surrender Value Death Benefit Maturity Benefit
Single/
Annualiz Survival Total Total
Policy Total
Total Total Total Total Total
ed Benefit Surrender Surrender Survival Survival Surrender
Year Survival Maturity Surrender Death Death Maturity Maturity
Premium (Guaranteed Surrender Benefit (SSV Death Maturity Survival Surrender Benefit (SSV Death Benefit, Benefit, Benefit,
Benefit Benefit Benefit, Benefit, Benefit, Benefit, Benefit,
Income/Gua Death Maturity Benefit Including TB Benefit Benefit Benefit Benefit Including TB Benefit incl. of incl. of [Link] TB, if
(Cash (TB at incl. of TB, if
any @ 8%
incl. of TB, incl. of TB, incl. TB, if incl. TB, if
ranteed Benefit Benefit (GSV) on (TB on (TB at (Cash (GSV) on (TB on Cash Cash any @ 4%
Bonus) Maturity) Bonus, if (Higher of if any @ if any @ any @ 4% any @ 8%
Money Surrender) Death) Maturity) Bonus) Surrender) Death) Bonus, if (Higher of 7
any @ 8% 12 or 13) 4% (4+9) 8% (4+14) (5+10) (5+15)
Back) any @ 4% or 8)
(3+6) (3+11)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
12,60, 10,25 7,17,50 7,30,99 41,77 8,73,2 21,38,97 20,72,83 19,90,99 21,33,25
34 - - - 21,38,977 - - 20,72,830 - 10,256 41,774 - -
000 6 0 4 4 52 7 0 4 2
12,60, 10,25 7,07,24 8,56,37 41,77 10,23, 22,39,52 22,23,07 21,16,37 22,83,03
35 - - - 22,39,525 - - 22,23,070 - 10,256 41,774 - -
000 6 4 4 4 032 5 0 4 2
12,60, 10,25 6,96,98 9,96,26 41,77 11,90, 23,49,05 23,90,63 22,56,26 24,50,14
36 - - - 23,49,056 - - 23,90,638 - 10,256 41,774 - -
000 6 7 1 4 141 6 8 1 1
12,60, 10,25 6,86,73 11,52,7 41,77 13,77, 24,68,75 25,78,16 24,12,71 26,37,04
37 - - - 24,68,759 - - 25,78,166 - 10,256 41,774 - -
000 6 1 15 4 043 9 6 5 3
12,60, 10,25 6,76,47 13,61,7 41,77 16,26, 26,36,66 28,27,86 26,21,74 28,86,74
38 - - - 26,36,663 - - 28,27,869 - 10,256 41,774 - -
000 6 4 40 4 746 3 9 0 6
12,60, 10,25 6,66,21 15,86,9 41,77 18,95, 28,09,49 30,96,78 28,46,94 31,55,78
39 - - - 28,09,496 - - 30,96,781 - 10,256 41,774 - -
000 6 8 49 4 783 6 1 9 3
12,60, 10,25 6,55,96 17,77,5 41,77 21,82, 29,84,98 33,83,56 30,37,58 34,42,90
40 - - - 29,84,986 - - 33,83,564 - 10,256 41,774 - -
000 6 2 89 4 900 6 4 9 0
12,60, 10,25 6,45,70 19,54,5 41,77 24,85, 31,60,05 36,85,71 32,14,59 37,45,71
41 - - - 31,60,056 - - 36,85,713 - 10,256 41,774 - -
000 6 5 96 4 717 6 3 6 7
12,60, 10,68,3 10,25 21,22,6 24,27,03 41,77 27,89, 31,07,2 33,82,65 40,49,37 34,95,40 41,75,64
42 - - - - - - 10,256 41,774 - -
000 76 6 55 0 4 370 65 5 0 6 1

Notes:
1. Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any, and Goods and Service Tax. Refer Sales literature for explanation of terms used in
this illustration.
2. The survival benefits are payable at the end of the policy year.
3. The surrender Value, death benefit and maturity benefit shown above are at the end of the Policy Year.
4. The Surrender Value is higher of the Guaranteed Surrender Value (GSV) and the Special Surrender Value (SSV).
5. For details on the Surrender Value refer Sales Literature and Policy Document.
6. TB - Terminal Bonus

UIN: 104N120V03 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 4 of 5
I, ……………………………………………. (name),have explained the premiums, and benefits I, ……………………………………………. (name), having received the information with respect
under the product fully to the prospect / policyholder. to the above, have understood the above statement before entering into the contract.

Place: Signature of Agent / Thumb Impression /

Date:2/11/25 Signature / Thumb Impression / Electronic Signature of
Date: 2/11/25 Electronic Signature of Agent / Intermediary / Prospect / Policyholder
Official of the insurer
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N120V03 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 5 of 5