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This document contains the highlights of the product Bajaj Allianz Life Assured Wealth Goal UIN: 116N170V02 and is subject to the terms and conditions as contained in the policy document. The
terms and conditions as contained in the policy document shall govern the contractual relationship and shall be binding. For details on any of the matters highlighted herein below, please refer to
policy document upon receipt of the same by you. The standard terms and conditions of the product is also available on the Company website (at [Link])

Key Feature Document

Bajaj Allianz Life Assured Wealth Goal will

give you assurance of income in achieving
your Life Goals with guarantee.

A Non linked, Non Participating, Individual, Life Insurance Savings Plan

You have chosen Second Income option

Income Benefit: Maturity Benefit:
`
` You will receive Guaranteed Income during the income You will receive Sum of all premiums paid (if opted),
period of 25 / 30 years as opted by you plus last regular guaranteed payout.

Death Benefit: Surrender Benefit:

In case of Death of the insured person during the policy You will receive a surrender value which will be the
term, the death benefit shall be payable to the nominee higher of the guaranteed surrender value (GSV) or
in form of equated monthly Income over five years. the special surrender value (SSV)
The Death benefit will be higher of Sum Assured on Note- Please refer Policy Document for more details and the table of
Death or 105% of total premiums paid as on date of applicable GSV & SSV factors.
death or prevailing surrender value.

Revival: Non Payment of Premium:

You may revive your lapsed/ Paid-up Policy during the • If you have not paid first 2 years’ premium, then, no
Revival Period of five (5) years from the due date of first
` benefit will be payable.
unpaid premium, subject to the revival conditions under
the Policy. • If you have paid at least first 2 years’ premium, then
your policy will continue with reduced paid-up
benefits.
Grace Period:
You will have a Grace Period of thirty (30) days for
frequencies other than monthly and fifteen (15) days for Policy Loan:
monthly frequency to pay your due premiums. During You will have an option to avail policy loan upto 80%
the Grace Period, the Policy is considered to be in-force. of the surrender value.

Life Cover
Life cover of an individual will be throughout the policy term provided all due premiums have been paid.

Premium Payment
You will have an option to pay your premiums regularly or for a limited policy term.

Exclusions: Suicide Claim provision

In case of death of Life Assured due to suicide within 12 months from the date of commencement of risk or the date of latest revival of the
Policy, whichever is later, then the nominee or beneficiary of the Policyholder shall be entitled to receive, the higher of 80% of the total
Premiums paid or the Surrender Benefit as on the date of death, provided the Policy is in force and the policy will be terminated.

Free look Cancellation

Within 15 days of the receipt of this policy and thirty (30) days in case of electronic policy and policy obtained through distance mode, the
policyholder will have an option to review the terms and conditions of the policy and if the policyholder disagrees to any of the terms & condi-
tions, he/she will have an option to return the policy stating the reasons for objections. The policyholder shall be entitled to a refund compris-
ing of all premiums (excluding applicable taxes) paid, less the proportionate amount of risk premium including proportionate amount of rider
risk premium for the period the life assured was provided cover and the expenses incurred by the company on account of medical examina-
tion and stamp duty charges.
Tax Benefits
As per applicable tax laws as amended from time to time. You are requested to consult your tax consultant and obtain independent advice
for eligibility and before claiming any benefit under the policy.

Contact Us: Regd. Office Address: Bajaj Allianz life Insurance Co. ltd, Bajaj Allianz House, Airport Road, Yerwada, Pune - 411006., IRDAI Reg No.: 116, Visit us: [Link]-
[Link], BALIC CIN : U66010PN2001PLC015959, Mail us : customercare@[Link], Call on : Toll free no. 1800 209 7272, Fax No: 020-66026789,
Quotation No : 60016167044

Bajaj Allianz Life Assured Wealth Goal

A Non-linked Non-Participating Life Insurance Savings Plan

Name of the Prospect/ Policyholder: Sibabrata Chatterjee Name of the Product: Bajaj Allianz Life Assured
Age: 37 Gender: Male Wealth Goal
Name of the Life Assured: Sibabrata Chatterjee Tag Line: A Non-linked Non-par Life Insurance Plan
Age: 37 Gender: Male Unique Identification Number: 116N170V02
Policy Term: 36 years GST Rate(First Year): 4.50%
Premium Payment Term: 10 years GST Rate(2nd Year onwards): 2.25%
Deferment Period: 1 years
Amount of Installment Premium: 2,09,000
Mode of Payment of Premium: Annual

This benefit illustration is intended to show year-wise premiums payable and benefits under the policy.
Policy Details
Variant Second Income Instalment Income 1,84,541
Income Period 25 Total Income during the year 1,84,541

Income Payout Frequency Yearly Sum Assured on Death (at 23,60,000

inception of the Policy) (Rs.)
Choice of Income Payout date Yes Income Start date 19-02-2033

Premium Summary
Base Plan Riders Total Installment Premium
Installment Premium without GST 2,00,000 0 2,00,000
Installment Premium with First Year GST 2,09,000 0 2,09,000
Installment Premium with GST 2nd year Onwards 2,04,500 0 2,04,500

(Amount in Rupees)
Benefit Summary
Guaranteed Non Guaranteed

Policy Annualised Survival Maturity Death Benefit Guaranteed Surrender Value Special Surrender Value
Year Premium Benefits Benefit (GSV) (SSV)
1 2,00,000 0 0 23,60,000 0 0
2 2,00,000 0 0 23,60,000 1,20,000 1,60,828
3 2,00,000 0 0 23,60,000 2,10,000 2,64,628
4 2,00,000 0 0 23,60,000 4,00,000 3,87,122
5 2,00,000 0 0 23,60,000 5,00,000 5,31,037
6 2,00,000 0 0 23,60,000 6,00,000 6,99,470
7 2,00,000 0 0 23,60,000 7,00,000 8,95,945
8 2,00,000 0 0 23,60,000 8,16,000 11,24,478
9 2,00,000 0 0 23,60,000 9,36,000 13,89,650
10 2,00,000 0 0 23,60,000 10,80,000 16,96,706
11 0 0 0 23,60,000 11,00,000 18,65,149
12 0 1,84,541 0 23,60,000 9,55,459 18,66,667
13 0 1,84,541 0 23,60,000 7,90,918 18,68,286
14 0 1,84,541 0 23,60,000 6,46,377 18,70,023
15 0 1,84,541 0 23,60,000 4,81,836 18,71,887
16 0 1,84,541 0 23,60,000 3,17,295 18,73,894
17 0 1,84,541 0 23,60,000 1,72,754 18,76,060
18 0 1,84,541 0 23,60,000 8,213 18,78,404

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Quotation No : 60016167044

Benefit Summary
Guaranteed Non Guaranteed

Policy Annualised Survival Maturity Death Benefit Guaranteed Surrender Value Special Surrender Value
Year Premium Benefits Benefit (GSV) (SSV)
19 0 1,84,541 0 23,60,000 0 18,80,944
20 0 1,84,541 0 23,60,000 0 18,83,711
21 0 1,84,541 0 23,60,000 0 18,86,727
22 0 1,84,541 0 23,60,000 0 18,90,028
23 0 1,84,541 0 23,60,000 0 18,93,643
24 0 1,84,541 0 23,60,000 0 18,97,612
25 0 1,84,541 0 23,60,000 0 19,01,978
26 0 1,84,541 0 23,60,000 0 19,06,789
27 0 1,84,541 0 23,60,000 0 19,12,106
28 0 1,84,541 0 23,60,000 0 19,17,991
29 0 1,84,541 0 23,60,000 0 19,24,529
30 0 1,84,541 0 23,60,000 0 19,31,815
31 0 1,84,541 0 23,60,000 0 19,39,966
32 0 1,84,541 0 23,60,000 0 19,49,124
33 0 1,84,541 0 23,60,000 0 19,59,462
34 0 1,84,541 0 23,60,000 0 19,71,197
35 0 1,84,541 0 23,60,000 0 19,84,598
36 0 1,84,541 20,00,000 23,60,000 0 0

Notes:
1. The main objec ve of this benefit illustra on is that the policyholder is able to understand the features of the product and the nature
of benefits under different circumstances like survival, death & surrender.
2. The above information must be read in conjunction with Sales Literature & Policy document.
3. Annualized premium excludes underwri ng extra premium, the premiums paid towards the riders, if any and Goods and Service Tax/
and any other applicable taxes.
4. The policy will acquire a surrender value which will be payable as higher of the Guaranteed Surrender Value or Special Surrender
Value. The displayed Special Surrender Values are not guaranteed and only indica ve. These may change from me to me. The
surrender values are illustrated assuming that all due premiums in a policy year are paid.
5. The Death benefit, Maturity Benefit, Surrender benefit as shown in Benefit Summary are payable assuming Maturity/ Death /
Surrender occur at the end of the year. The Income payouts will be paid in arrears as per chosen payout frequency.
6. In case of any conflict between this benefit illustration and your policy document, the latter shall prevail.
7. The Guaranteed Income men oned in the benefit summary is an indica ve amount based on the date on which you applied for this
policy. The exact income will be as per the date of issuance of your policy and is specified in the Policy document.
8. Tax benefits under the policy will be as per the prevailing Income Tax laws. We recommend that you seek professional advice for
applicability of tax benefit on premiums paid and benefits received.
9. For any further clarification, contact our sales representative or e-mail us on customercare@[Link]

I, ___________________________ (name), have explained the I, ___________________________ (name), having received the
premiums and benefits under the policy fully to the prospect / informa on with respect to the above, have understood the above
policyholder. statement before entering into the contract.

Place:
Date: Signature of Agent/ Intermediary/ Official Date: Signature of Prospect / Policyholder
Bajaj Allianz Life Insurance Co. Ltd.
Bajaj Allianz House, Airport Road, Yerawada, Pune - 411006. Reg No.: 116.
Tel:(020) 66026777. Fax:(020) 66026789.
Email: customercare@[Link] Website: [Link]

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