Product Proposal for achieving your Life Goals

Bajaj Allianz Life ACE

A Non linked, Participating, Individual
Life Insurance Savings Plan
UIN: 116N186V02

Hi Mr. Best Investor ,

Congratulations on taking the first step towards fulfilling your Life Goals with Bajaj Allianz Life Insurance. You
have opted for Bajaj Allianz Life ACE , a truly modular product where you are the one in charge of your financial
plan along with life cover

Key Features

Decide your Income Wide range of policy Choice of premium Continuity of policy Life Cover to Tax Benefits
amount and Income term from 10 to 45 payment term from 5 to benefit after death secure your
start year years or up to age 85 10 year or 12 years with Goal Protection planned Life
years Benefit Goals
 Here's your illustration of Bajaj Allianz Life ACE - with Goal Protection Benefit

Age 32 39 61

(8 years)

(30 years)

You Pay You Get

Premium 1st Income Last Income
Including discounts (if any) and Guaranteed Income (A) ₹6,140 ₹6,140
excluding GST
(From Age 32 to 61)
First year
Cash Bonus (B) @8% ₹9,209 @8% ₹9,209
₹ 49,000 Yearly
(From Age 32 to 61) @4% ₹1,535 @4% ₹1,535
Second year Income Benefit (A+B) @8% ₹15,349 @8% ₹15,349
onwards (From Age 32 to 61) @4% ₹7,675 @4% ₹7,675
₹ 50,000 Yearly
Maturity Benefit (At age 61) @8% ₹5,23,884 @4% ₹4,24,248

Total Premium Total Benefits

₹ 3,99,000 @8% ₹ 9,84,354 @4% ₹ 6,54,498

Life Cover(At Inception)

5,50,000

Additional Coverages ( signifies Opted | signifies Not-opted )

Accidental death Benefit Accidental Permanent Total/Partial Family Income Benefit

From age 32 to 61 Disability Benefit
Sum Assured: 5,00,000 | Premium: Rs. 625 Yearly From age 32 to 61
Sum Assured: 5,00,000 | Premium: Rs. 400 Yearly

Critical Illness Benefit Waiver of Premium benefit

2
Above Additonal Coverages Premiums are excluding GST
^Premiums are payable at the beginning of year; ^^Benefits to be received at the end of year. Product features mentioned above are dependent on benefit chosen.The assumed rate of returns indicated
at 4% and 8% are illustrative and not guaranteed and do not indicate the upper or lower limits of returns under the policy.The guaranteed benefits are dependent on the Policy terms, Premium payment
terms availed along with other variable factors.The above benefits/returns shown in the document are for illustrative purpose only & must be read in conjunction with the Benefit Illustration. For more
details on risk factors, terms and conditions please read sales brochure & policy document (available on www.bajajallianzlife.com) carefully before concluding a sale.Tax benefits as per prevailing Income
tax laws shall apply. Please check with your tax consultant for eligibility. Product features mentioned above are dependent on benefit chosen
 Why Bajaj Allianz Life

Total Asset Under AAA; Stable Number of Lives

Managment (AUM) Rating by CARE Covered

Claim settlement Get 1 Day Claim Solvency Ratio

Ratio Approval

~Individual Death Claim Settlement Ratio for FY 2023-2024. | ^Solvency ratio 432% as at 31 March 2024 against IRDAI mandated
150% | % 96.70% of non-investigative individual claims approved in one working day for FY 2023-24. 1 day is counted from date of
intimation of claim before 3 PM on a working day (excluding Non-NAV days for ULIP) at Bajaj Allianz Life offices | $For details refer to
press release published by CARE | **All figures as on 31 March, 2024 | #Individual & Group.

For more details please refer to Company Factsheet

https://www.bajajallianzlife.com/content/dam/balic/pdf/financialinformation/Factsheet/none/Q1/Factsheet-FY-2023-2024.pdf

3
Bajaj A llianz L ife Insurance Co.L td., CIN : U66010P N 2001P L C015959 | IRDA I Reg.N o. 116 BEW ARE OF SPURIOUS PHONE CALLS AND FICTITIOUS /
Mail us: customercare@bajajallianz.co.in | Call on: T oll free no. 1800 209 7272 FRADULENT OFFERS -
Registered O ffice A ddress: Bajaj A llianz House, A irport Road, Yerawada, P une - 411006, IRDAI is not involved in activities like selling insurance policies,
Maharashtra announcing bonus or investment of premiums. Public
T he L ogo of Bajaj A llianz L ife Insurance Co. L td. is provided on the basis of license given receiving such phone calls are requested to lodge a police
by Bajaj Finserv L td.to use its "Bajaj" L ogo and A llianz SE to use its "A llianz" logo. complaint.
Quotation No : 60064049489

Bajaj Allianz Life ACE

A Non linked, Participating, Individual Life Insurance Savings Plan

Name of the Prospect/ Policyholder: Best Investor Name of the Product: Bajaj Allianz Life ACE
Age: 32 Gender: Male Tag Line: A Non linked, Participating, Individual Life
Name of the Life Assured: Best Investor Insurance Savings Plan
Age: 32 Gender: Male Unique Identification Number: 116N186V02
Premium Payment Term: 8 GST Rate(First Year): 4.50%
Policy Term: 30 GST Rate(2nd Year onwards): 2.25%
Deferment Period: 0
Amount of Instalment Premium: 52,276
Mode of Payment of Premium: Annual
How to read and understand this benefit illustration?
This benefit illustration is intented 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 then these will be clearly marked "guaranteed" in the illustration table
on this page. If your policy offers variable benefits then the illustrations on this page will show two different rates of assumed future
investment returns, of 8% p.a. and 4% p.a. These assumed rates of return are not guaranteed and they are not the upper or lower limits
of what you might get back, as the value of your policy is dependent on a number of factors including future investment performance.

Policy Details

Early Income Wealth Income Benefit Annually

Frequency

Premium Allocation 95% 5% Goal Protection Yes

Benefit

Benefit Sum Assured* 1,53,492 12,332 Accumulate Income No

Benefits
Income Period 30 NA
Bonus Type Cash Bonus, Simple Revisionary Bonus and
Sum Assured on Death (at 5,50,000 Terminal Bonus
inception of policy)

*Benefit Sum Assured will be used for calculating Guaranteed Income and declaring Bonuses, and will not be payable on Maturity or
Death.

Rider Accidental Death Benefit Accidental Permanent Total/Partial Disability Benefit

(UIN: 116B034V02) (UIN: 116B036V02)
Sum Assured (Rs.) 5,00,000 5,00,000
Rider Policy Term (Years) 30 30
Installment Premium without GST (Rs.) 625 400

Premium Summary
Base Plan Riders Total Installment Premium
Installment Premium without GST (including 49,000 1,025 50,025
2.00% discount in 1st year)
Installment Premium without GST(2nd year) 50,000 1,025 51,025
Instalment Premium with First Year GST 51,205 1,071 52,276

O.X.X.A.X
Quotation No : 60064049489

Premium Summary
Installment Premium with GST 2nd year 51,125 1,048 52,173
Onwards
(Amount in Rupees )
Benefit Summary
Guaranteed Benefits Non Guaranteed Benefit @ 4% p.a. Non Guaranteed Benefit @ 8% p.a. Total Benefits including Guarantee and Non-Guaranteed Benefits
Annualized Accrued Accrued Survival and Survival and Death Death
Policy Premium Survival Death Maturity Simple Cash Guaranteed Special Simple Cash Guaranteed Special Surrender Surrender Maturity Benefit Maturity Benefit Benefit incl Benefit incl
Year (Excl of Benefit Benefit Benefit Reversionary Bonus Surrender Surrender Reversionary Bonus Surrender Surrender Value Value incl TB (if any) incl TB (if any) TB (if any) TB (if any)
Bonus Value (GSV) Value (SSV) Bonus Value (GSV) Value (SSV) @4% @8% @4% @8% @4% @8%
GST)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
1 49,000 6,140 5,50,000 0 111 1,535 0 14,966 277 9,209 0 14,980 14,966 14,980 7,675 15,349 5,50,000 5,50,000
2 50,000 6,140 5,50,000 0 222 1,535 14,663 30,727 555 9,209 1,530 30,757 31,354 31,371 7,675 15,349 5,50,000 5,50,000
3 50,000 6,140 5,50,000 0 333 1,535 29,496 47,372 832 9,209 6,502 47,421 48,593 48,623 7,675 15,349 5,50,000 5,50,000
4 50,000 6,140 5,50,000 0 444 1,535 69,331 64,997 1,110 9,209 38,676 65,068 69,331 68,036 7,675 15,349 5,50,000 5,50,000
5 50,000 6,140 5,50,000 0 555 1,535 86,668 83,705 1,387 9,209 48,355 83,801 87,270 87,331 7,675 15,349 5,50,000 5,50,000
6 50,000 6,140 5,50,000 0 666 1,535 1,04,006 1,03,604 1,665 9,209 58,040 1,31,247 1,07,654 1,31,247 7,675 15,349 5,50,000 5,50,000
7 50,000 6,140 5,50,000 0 777 1,535 1,21,348 1,24,808 1,942 9,209 67,731 1,79,001 1,29,249 1,79,001 7,675 15,349 5,50,000 5,50,000
8 50,000 6,140 5,50,000 0 888 1,535 1,42,692 1,73,370 2,220 9,209 81,428 2,42,550 1,78,299 2,42,550 7,675 15,349 5,50,000 5,50,000
9 0 6,140 5,50,000 0 999 1,535 1,43,039 1,79,247 2,497 9,209 74,134 2,67,532 1,84,201 2,67,532 7,675 15,349 5,50,000 5,50,000
10 0 6,140 5,50,000 0 1,110 1,535 1,43,391 1,85,480 2,775 9,209 66,850 2,73,307 1,90,435 2,73,307 7,675 15,349 5,50,000 5,50,000
11 0 6,140 5,50,000 0 1,221 1,535 1,39,746 1,92,078 3,052 9,209 55,576 2,79,430 1,96,810 2,79,430 7,675 15,349 5,50,000 5,50,000
12 0 6,140 5,50,000 0 1,332 1,535 1,40,107 1,99,057 3,330 9,209 48,315 2,86,057 2,03,739 2,86,057 7,675 15,349 5,50,000 5,50,000
13 0 6,140 5,50,000 0 1,443 1,535 1,40,473 2,06,433 3,607 9,209 41,068 2,93,046 2,11,038 2,93,046 7,675 15,349 5,50,000 5,50,000
14 0 6,140 5,50,000 0 1,554 1,535 1,40,846 2,14,229 3,885 9,209 33,837 3,00,247 2,18,729 3,00,247 7,675 15,349 5,50,000 5,50,000
15 0 6,140 5,50,000 0 1,665 1,535 1,37,226 2,22,474 4,162 9,209 22,625 3,07,915 2,26,638 3,07,915 7,675 15,349 5,50,000 5,50,000
16 0 6,140 5,50,000 0 1,776 1,535 1,37,615 2,31,202 4,439 9,209 15,435 3,16,257 2,35,198 3,16,257 7,675 15,349 5,50,000 5,50,000
17 0 6,140 5,50,000 0 1,887 1,535 1,38,014 2,40,456 4,717 9,209 14,604 3,24,977 2,44,248 3,24,977 7,675 15,349 5,50,000 5,50,000
18 0 6,140 5,50,000 0 1,998 1,535 1,38,424 2,50,281 4,994 9,209 15,215 3,34,248 2,53,829 3,34,248 7,675 15,349 5,50,000 5,50,000
19 0 6,140 5,50,000 0 2,109 1,535 1,34,846 2,60,727 5,272 9,209 15,658 3,43,945 2,63,792 3,43,945 7,675 15,349 5,50,000 5,50,000
20 0 6,140 5,50,000 0 2,220 1,535 1,35,283 2,71,848 5,549 9,209 16,337 3,54,445 2,74,586 3,54,445 7,675 15,349 5,50,000 5,50,000
21 0 6,140 5,50,000 0 2,331 1,535 1,35,737 2,83,698 5,827 9,209 17,058 3,65,637 2,86,061 3,65,637 7,675 15,349 5,50,000 5,50,000
22 0 6,140 5,50,000 0 2,442 1,535 1,36,210 2,96,331 6,104 9,209 17,826 3,77,221 2,98,268 3,77,221 7,675 15,349 5,50,000 5,50,000
23 0 6,140 5,50,000 0 2,553 1,535 1,32,704 3,09,796 6,382 9,209 18,447 3,89,316 3,11,054 3,89,316 7,675 15,349 5,50,000 5,50,000
24 0 6,140 5,50,000 0 2,664 1,535 1,33,222 3,24,142 6,659 9,209 19,329 4,02,386 3,24,865 4,02,386 7,675 15,349 5,50,000 5,50,000
25 0 6,140 5,50,000 0 2,775 1,535 1,33,768 3,39,409 6,937 9,209 20,281 4,16,093 3,39,540 4,16,093 7,675 15,349 5,50,000 5,50,000
26 0 6,140 5,50,000 0 2,886 1,535 1,34,345 3,55,631 7,214 9,209 21,311 4,34,815 3,55,631 4,34,815 7,675 15,349 5,50,000 5,50,000
27 0 6,140 5,50,000 0 2,997 1,535 1,30,959 3,72,833 7,492 9,209 22,230 4,54,698 3,72,833 4,54,698 7,675 15,349 5,50,000 5,50,000
28 0 6,140 5,50,000 0 3,108 1,535 1,31,612 3,91,030 7,769 9,209 23,451 4,75,352 3,91,030 4,75,352 7,675 15,349 5,50,000 5,50,000
29 0 6,140 5,50,000 0 3,219 1,535 1,40,312 4,10,220 8,046 9,209 25,186 4,97,204 4,10,220 4,97,204 7,675 15,349 5,50,000 5,50,000
30 0 6,140 5,50,000 4,20,918 3,330 1,535 0 0 8,324 9,209 0 0 0 0 4,31,923 5,39,233 5,50,000 5,50,000

There are mul ple product op ons in the product. I understand that returns vary under each op on. I have made choice of inves ng in more
than one product option considering my need and understanding the benefit under each option.
Notes: Annualized Premium excludes underwri ng extra premium, frequency loadings on premiums, the premiums paid towards the riders, if
any, and Goods & Service Tax. Refer Sales literature for explanation of terms used in this illustration.
1. The above benefit illustration demonstrates premium paid at the beginning of the year and all the benefits are paid out at the end of year.
2. The Survival Benefits are payable during the policy year when they are due as per the frequency. Upon payment at Maturity (Last Payout),
the policy terminates, and no further benefits become payable. The Maturity benefit will be the sum of Sum Assured on Maturity plus
Accumulated Income benefits, if not paid earlier, plus Terminal Bonus (if declared).
3. 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.
4. Surrender value illustrated above is end of the policy year value. The Special Surrender Value (SSV) displayed above are not guaranteed and
only indica ve. The Company shall comply with prevailing guidelines w.r.t SSV issued by IRDAI from me to me. Upon payment of surrender
benefit, the policy terminates, and no further benefit becomes payable.
5. The death benefits shown above are at the end of the year. Upon payment of death benefit the policy terminates and no further benefit is
payable. Not Applicable for Policies with Goal Protection Benefit.
6. Income Tax benefits would be available as per the prevailing income tax laws.
7. For more details on risk factors, terms and conditions please read sales brochure carefully before concluding a sale.
8. RB - Reversionary Bonus, TB - Terminal Bonus
9. On payment at Maturity (Last Payout), the policy terminates and no further benefits become payable.

O.X.X.A.X
Quotation No : 60064049489

I,……….….…….(name), have explained the premiums, charges and I………Best Investor ………(name), having received the informa on
benefits under the policy fully to the prospect/policyholder. with respect to the above, have understood the above 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.
Email: customercare@bajajallianz.co.in
www.bajajallianzlife.com

O.X.X.A.X
 CUSTOMER INFORMATION SHEET / KNOW Y OUR POLICY.

This document provides key information about your policy. You are also advised to go through your policy
document.
We request you to kindly review the CIS and acknowledge the same through a link shared to you on your
registered mobile number/Email ID/WhatsApp.

Policy
Sr. Description in Simple Words
Title Clause
No. (Please refer to applicable Policy Clause Number in next column)
Number
Name of the
Insurance
Product and Bajaj Allianz Life ACE Policy
1
Unique (UIN - 116N186V02) Schedule
Identification
Number (UIN)
Quotation Policy
2 60064049489
number Schedule
Type of
Policy
3 Insurance Non-Linked other than pure risk and pension
Schedule
Policy
Installment Premium for Year 1 (Rs): 50,025
Installment Premium Year 2 onwards (Rs): 51,025
Mode of Premium Payment: Annual
Basic Policy Policy
4 Sum Assured on Death (Rs): 5,50,000
Details Schedule
Sum Assured on Maturity (Rs): 4,20,918
Premium Payment Term (Years): 8
Policy Term (Years): 30
Benefits payable on maturity-
Part C
On maturity of the Policy, sum assured on maturity, accumulated income
Section 4
benefits (if any) and bonuses, if declared will be paid.
Benefits payable on death-
Part C
On death of Life assured during the policy term, sum assured on death,
105% of accumulated income benefits (if any) and bonuses, if declared will Section 4
be paid.
 Survival Benefits excluding that payable on maturity -

i.) Option 1- Deferred Income: Guaranteed Income plus cash bonuses, if

declared will be paid in arrears after the end of the Premium Payment Term
and Deferment period and is payable till the end of policy term.

ii.) Option 2- Early Income: Guaranteed Income plus cash bonuses, if

declared will be paid in arrears after the end of Deferment period and is
payable for the end of policy term. Part C
Policy iii.) Option 3- Increasing Income: Guaranteed Income plus cash bonuses, if Section 4
5 Coverage/ben declared will be paid in arrears after the end of the Premium Payment Term
efits payable and Deferment period and is payable till the end of policy term. These
incomes will be declared as a percentage of the Benefit Sum Assured.
Benefit Sum Assured is guaranteed to increase at 5% p.a. (on compounding
basis) every year. The increased Benefit Sum Assured will be used for
calculation of respective years Guaranteed Incomes and Cash bonuses.

iv.) Option 4- Wealth: No Survival benefit is paid.

Surrender Benefits

The policyholder will have the option to surrender the policy. The
surrender value payable will be the higher of the guaranteed surrender
value (GSV) or the special surrender value (SSV). Part D
The policy will acquire a GSV provided two (2) full years' premiums
Section 8
have been paid. SSV shall become payable after completion of first
(1st) policy year provided at least one (1) full years' premium has been
received.
A product option alone in a policy cannot be surrendered.
Options to policyholders for availing benefits, if any, covered under
the policy -
Part D
You can avail the policy survival benefits in yearly/ monthly instalments
Section
or accumulate within the policy. The accumulated amount can be
10
withdrawn anytime during the policy term
Option to take Death/ Maturity Benefit in Installments
Other benefits/options payable, specific to the policy, if any:

No other benefit payable other than survival, maturity, surrender and death -
benefit
Lock-in period for Linked Insurance products:
-
Not Applicable
Options
available (in Not
6 case of Linked Not Applicable Applicabl
Insurance e
Products)
 Option
available(in Not
7 case of Not Applicable Applicabl
Annuity e
product)

Sum
Rider Name UIN
Assured
Accidental Death Benefit 116B034V02 5,00,000
Riders Opted if Policy
8 Accidental Permanent Total/Partial
Any 116B036V02 5,00,000 Schedule
Disability Benefit

For details on the rider, please refer the customer information sheet of the
respective rider.
Suicide Exclusions: In case of death of Life Assured due to suicide within
Exclusions
twelve (12) months from the Date of Commencement of Risk or the date of
(events where Part F
latest revival of the Policy, whichever is later, then, the Claimant shall be
insurance
9 entitled to receive the higher of 80% of the total premiums received till the Section
coverage is
date of death of the Life Assured or the Surrender Value, if any, available as 12
not payable), if
on the date of death, provided the Policy is in-force and the Policy will be
any
terminated. There are no other exclusions in the Policy.
Not
Waiting /lien
10 Not Applicable Applicabl
Period, if any
e

Thirty (30) days for premium payment frequencies other than monthly and Part B
11 Grace Period
fifteen (15) days for monthly frequency. Section 1

Free Look Part D

12 30 Days
Period Section 5
1) Non- payment of premium -

If at least one (1) full years premium is not paid, the policy will,
Part D
immediately & automatically, lapse at the expiry of the grace period,
and no benefit other than the Accumulated income benefit, if any, will Section
be payable under the policy. The Accumulated income benefit, if any, 6
Lapse, paid-up
in the policy will be paid out at the end of grace period.
13 and Revival of
If at least one (1) full years premium has been paid and subsequent and
the Policy
premiums are not paid, then, the policy will be, immediately &
automatically, converted to a reduced paid-up policy at the expiry of Part B
the grace period.
Section 1
2) Revival of the policy - Within five (5) years from the due date of the first
unpaid premium, before the Maturity Date.
You will have the option to take Policy loan, subject to a maximum limit of Part D
Policy Loan If 80% of the [Surrender Value less TB on surrender (if any) less any AIB] +
14 Section
Applicable 50% of TB on surrender (if any). Loan interest rate applicable for the loan
will be as decided by the company from time-to-time. 11
 1. Turn Around Time (TAT) for claims settlement and brief
procedure:
Link for Brief Procedure : https://www.bajajallianzlife.com/life-
insurance-claim-assistance.html
Link for Turn Around Time (TAT) for claims settlement:
https://www.bajajallianzlife.com/content/dam/balic/pdf/customer-
services/services-tat.pdf

2. Helpline/Call Centre Numbers:

Toll free no (24*7) : 1800 2201 02

Sr. Citizens Toll free no. : 1800 2269 70
Claims / Part F
Customer Care No: (022) 40881000
15 Claims Board No.: (022) 66867575 Section
Procedure 22
3. Contact details of the insurer:

Bajaj Allianz Life Insurance Company Limited

House, Ground Floor, Bajaj Allianz, Airport Rd, Yerawada, Pune,
Maharashtra 411006

4. Link for downloading claim form and list of documents required

including bank account details:

https://www.bajajallianzlife.com/life-insurance-claim-assistance.html

WhatsApp- 8806727272

Turn Around Time (TAT):

https://www.bajajallianzlife.com/content/dam/balic/pdf/customer-
services/services-tat.pdf

Helpline/Call Centre number: 1800 209 7272

Contact details of the insurer: In case you have any query, you may
communicate with the Company: Part G
Policy
16 1. By post at: Customer Care Desk, Bajaj Allianz Life Insurance Company Section
Servicing
Ltd., Bajaj Allianz House, 5th floor, Airport Road, Yerawada, Pune – 26
411006
2. By Email: customercare@bajajallianz.co.in

Link for downloading applicable forms and list of documents required

including bank account details:

https://bajajallianzlifeonline.co.in/online/portal/logon/serviceRequest.do?
user_name=WEBSITE&p_flag=0
 Contact details of Grievance Redressal Officer of the insurer:
Grievance Redressal Officer of the insurer - In case you do not receive a
response within 15 days or if you are not satisfied with the resolution, you
may approach Grievance Redressal Officer at gro@bajajallianz.co.in

Link for registering the grievance with the insurer’s portal:Insurance Part G
Grievances company grievance portal - Section
17
/Complaints https://webpartner.bajajallianz.com/GrvOnlineApi/indexOnlineGrv.jsp#_ga=2 26 and
.7272630.541013491.1717475077- 27
1601763320.1694668355&_gac=1.52751388.1715749803.EAIaIQobChMIy
_eqivKOhgMVdWsPAh0NFQrEEAAYASAAEgJObPD_BwE

Contact details of Ombudsman: Find your nearest Ombudsman office at

http://www.cioins.co.in/ombudsman

Declaration by the policyholder

I have read the above and confirm having noted the details
Place:
Date: (Signature of the Policy Holder)

Web-link for the product where sample policy document can be downloaded:
https://www.bajajallianzlife.com/tax-saving-investment-plans/bajaj-allianz-life-ace.html
Disclaimer:
In case of conflict in the content mentioned hereinabove, the terms and conditions mentioned in the policy
document shall prevail.
 CUSTOMER INFORMATION SHEET / KNOW Y OUR POLICY.

This document provides key information about your policy. You are also advised to go through your policy
document.
We request you to kindly review the CIS and acknowledge the same through a link shared to you on your
registered mobile number/Email ID/WhatsApp.

Policy
Sr. Description in Simple Words
Title Clause
No. (Please refer to applicable Policy Clause Number in next column)
Number
Name of the
Insurance
Product and Bajaj Allianz Accidental Death Benefit Rider Policy
1
Unique (116B034V02) Schedule
Identification
Number (UIN)
Quotation Policy
2 60064049489
number Schedule
Type of
Pure Risk Policy
3 Insurance
Schedule
Policy
Installment Premium (Rs) - 625
Mode of Premium Payment - Annual
Basic Policy Sum Assured on Death (Rs) - 5,00,000 Policy
4
Details Sum Assured on Maturity (Rs) - Not Applicable Schedule
Premium Payment Term (Years) - 8
Policy Term (Years) - 30
Benefits payable on maturity - Part C -

No maturity benefit is payable under this Rider Section 4

Benefits payable on death -
Part C -
The Rider Sum Assured will be payable on death of Rider Life Assured
Section 4
due to Accident.
Survival Benefits excluding that payable on maturity - Not Applicable -
Surrender benefits - On surrender of the rider anytime before the maturity
Policy date, you will be eligible for rider surrender value, if rider premium payment Part D -
5 Coverage/ben term is less than rider term and if at least two full year’s premium have been
efits payable paid. Section 6

Options to policyholders for availing benefits, if any, covered under

-
the policy - Not Applicable
Other benefits/options payable, specific to the policy, if any - Not
-
Applicable
Lock-in period for Linked Insurance products - Not Applicable -
 Options
available (in Not
6 case of Linked Not Applicable Applicabl
Insurance e
Products)
Option
available(in Not
7 case of Not Applicable Applicabl
Annuity e
product)
Not
Riders Opted if
8 Not Applicable Applicabl
Any
e
The Rider does not cover any other risk, other than those mentioned below
-

i. Death occurs as a result of the insured person committing any breach

of law with criminal intent
ii. Death as a consequence of the insured person being under the
influence of alcohol or drugs other than in accordance with the
Exclusions directions of a registered medical practitioner
(events where iii. Death as a result of self-inflicted injuries
insurance iv. Death occurs as a result of the insured person taking part in any naval, Part D -
9
coverage is military or air force operation during peace time Section 9
not payable), if v. Death occurs as a result of the insured person participating in or
any training for any dangerous or hazardous sport or competition or riding
or driving in any form of race or competition
vi. Death occurs as a result of suicide
vii. Death occurs as a result of aviation, gliding or any form of aerial flight
other than as a fare paying passenger of a recognised airline on
regular routes and on a scheduled timetable
viii. Death occurs as a result of war, invasion, civil war, rebellion, riots.

Not
Waiting / lien
10 Not Applicable Applicabl
Period, if any
e
As per
Thirty (30) days for premium payment frequencies other than monthly and
11 Grace Period base
fifteen (15) days for monthly frequency.
policy

Free Look Part D -

12 30 days
Period Section 5
Part F -
Non- payment of premium - As per base policy subject to termination
Section
conditions.
Lapse, paid-up 12
13 and Revival of
Revival of the policy – A lapsed Rider can be revived subject to the Part D
the Policy
revival conditions applicable to the base Policy. Section 7
 Not
Policy Loan If Applicabl
14 Not Applicable
Applicable e

Turn Around Time (TAT) for claims settlement and brief procedure:

Link for Brief Procedure : https://www.bajajallianzlife.com/life-

insurance-claim-assistance.html
Link for Turn Around Time (TAT) for claims settlement:
https://www.bajajallianzlife.com/content/dam/balic/pdf/customer-
services/services-tat.pdf

Helpline/Call Centre Numbers:

Toll free no (24*7) : 1800 2201 02

Sr. Citizens Toll free no. : 1800 2269 70

Claims / Part F -
Customer Care No: (022) 40881000
15 Claims Section
Procedure Board No.: (022) 66867575 15
Contact details of the insurer:

Bajaj Allianz Life Insurance Company Limited

House, Ground Floor, Bajaj Allianz, Airport Rd, Yerawada, Pune,

Maharashtra 411006

Link for downloading claim form and list of documents required

including bank account details:

https://www.bajajallianzlife.com/life-insurance-claim-assistance.html

WhatsApp- 8806727272
Turn Around Time (TAT):

https://www.bajajallianzlife.com/content/dam/balic/pdf/customer-
services/services-tat.pdf

Helpline/Call Centre number: 1800 209 7272

Contact details of the insurer: In case you have any query, you may
communicate with the Company: Part G -
Policy
16
Servicing 1. By post at: Customer Care Desk, Bajaj Allianz Life Insurance Company As per
Ltd., Bajaj Allianz House, 5th floor, Airport Road, Yerawada, Pune – base
411006 policy
2. By Email: customercare@bajajallianz.co.in

Link for downloading applicable form and list of documents required

including bank account details:

https://bajajallianzlifeonline.co.in/online/portal/logon/serviceRequest.do?
user_name=WEBSITE&p_flag=0
 Contact details of Grievance Redressal Officer of the insurer:
Grievance Redressal Officer of the insurer - In case you do not receive a
response within 15 days or if you are not satisfied with the resolution, you
may approach Grievance Redressal Officer at gro@bajajallianz.co.in

Link for registering the grievance with the insurer’s portal:Insurance Part G -
company grievance portal-
Grievances As per
17
/Complaints https://webpartner.bajajallianz.com/GrvOnlineApi/indexOnlineGrv.jsp#_ga=2 base
.7272630.541013491.1717475077- policy
1601763320.1694668355&_gac=1.52751388.1715749803.EAIaIQobChMIy
_eqivKOhgMVdWsPAh0NFQrEEAAYASAAEgJObPD_BwE

Contact details of Ombudsman: Find your nearest Ombudsman office at

http://www.cioins.co.in/ombudsman

Declaration by the policyholder

I have read the above and confirm having noted the details
Place:
Date: (Signature of the Policy Holder)

Web-link for the product where sample policy document can be downloaded:
Disclaimer:
In case of conflict in the content mentioned hereinabove, the terms and conditions mentioned in the policy
document shall prevail.
 CUSTOMER INFORMATION SHEET / KNOW Y OUR POLICY.

This document provides key information about your policy. You are also advised to go through your policy
document.
We request you to kindly review the CIS and acknowledge the same through a link shared to you on your
registered mobile number/Email ID/WhatsApp.

Policy
Sr. Description in Simple Words
Title Clause
No. (Please refer to applicable Policy Clause Number in next column)
Number
Name of the
Insurance
Product and Bajaj Allianz Accidental Permanent Total/Partial Disability Benefit Rider Policy
1
Unique (116B036V02) Schedule
Identification
Number (UIN)
Quotation 60064049489 Policy
2
number Schedule
Type of As per
Benefit (Where an Insurance Policy pays a fixed amount under the policy on
3 Insurance base
the occurrence of a covered event)
Product/ Policy policy
Sum Assured
(Basis) (Along 5,00,000 Policy
4
with amount) Schedule

In the event of Permanent Disability to the Rider Life Assured due to an

accident, and if the disability is within 180 days from the date of an accident,
the benefit amount payable is given below:

i. If the disability is Permanent & Partial Disability, the benefit amount

payable will be 50% of Rider Sum Assured.
ii. If an Accidental Permanent Partial Disability Benefit has not been
received earlier under the rider and if the disability is Permanent &
Total, the benefit amount payable will be the Rider Sum Assured and
Policy
the rider terminate thereafter
Coverage
iii. If an Accidental Permanent Partial Disability Benefit has already been Part C -
(What the
5 received earlier under the rider, and if the disability is permanent &
policy covers) Section 5
total and is within one year from the previous occurrence, the benefit
(Policy Clause
amount payable will be 50% of Rider Sum Assured and rider will
Number/s)
terminate thereafter
iv. If an Accidental Permanent Partial Disability Benefit has already been
received earlier under the rider, and if the disability is permanent &
total and is at any-time after one year from the previous occurrence,
the benefit amount payable will be the Rider Sum Assured and rider
will terminate thereafter
v. Once the full benefit has been under the Rider, no further benefit shall
be payable for any Accidental Permanent Partial Disability.
 The Rider does not cover any other risks, other than those mentioned
below:

a) Disability as a result of the Rider Life Assured committing any breach of

law with criminal intent;

b) Disability of insured person as a result of war, invasion, civil war,

rebellion or riot;

c) Disability as a consequence of the insured person being under the

Exclusions influence of alcohol or drugs other than drugs prescribed by and taken in
Part D -
(what the accordance with the directions of a registered medical practitioner;
6 Section
policy does not d) Disability as a result of the insured person taking part in any naval,
cover) 10
military or air force operation;

e) Disability as a result of the insured person participating in or training for

any dangerous or hazardous sport or competition or riding or driving in any
form of race or competition;

f) Disability of insured person as a result of aviation, gliding or any form of

aerial flight other than as a fare paying passenger on a civilian airline plying
on regular routes and according to a scheduled timetable;

g) Disability of insured person as a result of attempted self-injury

Waiting Period
Time
period
during
which
specified
diseases/t
reatments Not
7 are not Not Applicable Applicabl
covered e
It is
counted
from the
beginning
of the
policy
coverage
 Financial limits
of coverage

i) Sub-limit (It
is a pre-
defined limit
and the
insurance
company will
not pay any
amount in
excess of this
limit)

ii) Co-payment
(It is a
specified
amount/percen
tage of the
admissible
claim amount
to be paid by i. Sub limit – Not Applicable
policyholder/in ii. Co-payment – Not Applicable Not
8 sured) iii. Deductible – Not Applicable Applicabl
iv. Any other limit (as applicable) – Not Applicable e
iii) Deductible
(It is a
specified
amount:

- Up to which
an insurance
company will
not pay any
claim, and

- Which will be
deducted from
total claim
amount (if
claim amount
is more than
the specified
amount)

iv) Any other

limit (as
applicable)
 Turn Around Time (TAT) for claims settlement and brief procedure:

Link for Brief Procedure : https://www.bajajallianzlife.com/life-

insurance-claim-assistance.html
Link for Turn Around Time (TAT) for claims settlement:
https://www.bajajallianzlife.com/content/dam/balic/pdf/customer-
services/services-tat.pdf

Helpline/Call Centre Numbers:

Toll free no (24*7) : 1800 2201 02

Sr. Citizens Toll free no. : 1800 2269 70 Part F –

Claims/Claims
9 Customer Care No: (022) 40881000 Section
Procedure
Board No.: (022) 66867575 17

Contact details of the insurer:

Bajaj Allianz Life Insurance Company Limited

House, Ground Floor, Bajaj Allianz, Airport Rd, Yerawada, Pune,

Maharashtra 411006

Link for downloading claim form and list of documents required

including bank account details:

https://www.bajajallianzlife.com/life-insurance-claim-assistance.html

Turn Around Time (TAT):

https://www.bajajallianzlife.com/content/dam/balic/pdf/customer-
services/services-tat.pdf

Helpline/Call Centre number: 1800 209 7272

Contact details of the insurer: In case you have any query, you may
communicate with the Company: Part G –
Policy
10
Servicing 1. By post at: Customer Care Desk, Bajaj Allianz Life Insurance Company As per
Ltd., Bajaj Allianz House, 5th floor, Airport Road, Yerawada, Pune – base
411006 policy
2. By Email: customercare@bajajallianz.co.in

Link for downloading applicable form and list of documents required

including bank account details:

https://bajajallianzlifeonline.co.in/online/portal/logon/serviceRequest.do?
user_name=WEBSITE&p_flag=0
 Contact details of Grievance Redressal Officer of the insurer:
Grievance Redressal Officer of the insurer - In case you do not receive a
response within 15 days or if you are not satisfied with the resolution, you
may approach Grievance Redressal Officer at gro@bajajallianz.co.in

Link for registering the grievance with the insurer’s portal:Insurance Part G –
company grievance portal-
Grievances/Co As per
11
mplaints https://webpartner.bajajallianz.com/GrvOnlineApi/indexOnlineGrv.jsp#_ga=2 base
.7272630.541013491.1717475077- policy
1601763320.1694668355&_gac=1.52751388.1715749803.EAIaIQobChMIy
_eqivKOhgMVdWsPAh0NFQrEEAAYASAAEgJObPD_BwE

Contact details of Ombudsman: Find your nearest Ombudsman office at

http://www.cioins.co.in/ombudsman
Free look cancellation – 30 days
Policy Renewal – Not applicable Part D –
Things to
12 Migration and Portability – Not applicable
remember Section 6
Change in sum insured – Not applicable
Moratorium Period – Not applicable
Please disclose all pre-existing disease/s or condition/s before buying a
rider. Non-disclosure may affect the claim settlement.
Your Proposal
13 Disclosure of material information while applying for the rider and changes
obligations form
during the rider period should be communicated to Bajaj Allianz Life
Insurance customer care ID via registered email id of the customer.

Declaration by the policyholder

I have read the above and confirm having noted the details
Place:
Date: (Signature of the Policy Holder)

Web-link for the product where sample policy document can be downloaded:
Disclaimer:
In case of conflict in the content mentioned hereinabove, the terms and conditions mentioned in the policy
document shall prevail.