Personalised proposal for securing your life goals

with

Hi ,
Congratulations on taking the first step towards
fulfilling your life goals with a regular income for
whole of life and a lump sum on maturity along
with the security of a life insurance cover.

Please go through your personalised ICICI Pru Gold

proposal and reach out to your financial planner in
case you need any further details.
ICICI Pru Gold belongs to 'Participating' category of products. In this category of products, your
benefits are partially guaranteed and partially dependent on bonuses. Below is a detailed
explanation of how your plan will work. For your clarity, we have shown the split of your
benefits into guaranteed and bonus linked benefits.

Snapshot of your plan

You pay

Yearly premium of
29 years / Male
` 50,000/- for 12 years

Jun 2025 Jun 2095

Year

Income starts from

Jun 2031

You get
Lump sum
Income every year till you turn 99 years of age on maturity

Income Lump sum Total Benefits

Guaranteed Income: ` 10,875/- Guaranteed lump sum Total Guaranteed benefits:

+ (Sum Assured on Maturity): ` 13,06,875/-
Bonus based income (Cash Bonus): ` 6,00,000/-
+
+
+ =
At 8% ARR: ` 20,125/- Total bonus based benefits:
At 4% ARR: ` 5,875/- Bonus based lump sum At 8% ARR: ` 1,82,33,473/-
(Terminal Bonus): At 4% ARR: ` 28,13,238/-
Total Income: At 8% ARR: ` 1,69,25,348/-
Total benefits:
At 8% ARR: ` 31,000/- At 4% ARR: ` 24,31,363/-
At 8% ARR: ` 1,95,40,348/-
At 4% ARR: ` 16,750/-
Total Lump sum (Maturity Benefit): At 4% ARR: ` 41,20,113/-
(every year At 8% ARR: ` 1,75,25,348/-
from Jun 2031 to Jun 2095 ) At 4% ARR: ` 30,31,363/-

#
Also, get a life insurance cover of ` 6,30,000/- throughout the policy term
 Premium details Payment term Premium Amount

Premium to be paid every year 12 years ` 50,000/-

Detailed break-up of premium and taxes

Yearly Applicable Total Yearly

Premium taxes Premium

Yearly Premium
` 50,000/- ` 2,251/- ` 52,251/-
during 1st year

Yearly Premium
` 50,000/- ` 1,126/- ` 51,126/-
from 2nd year onwards

Additional Flexibility through Savings wallet

You can choose to accumulate your guaranteed income and let it grow, with an
option to withdraw the accumulated amount anytime, partially or completely,
as per your preference during the policy term. With this feature, your policy
acts like a wallet giving you complete freedom to accumulate or withdraw
income as per your requirement.
 Why choose us:

9.17 Cr ` 3.24 Lakh Cr

Lives covered as on Benefits paid till
March 31, 2025 March 31, 2025

` 3.09 Lakh Cr 24 hrs claim settlement

Assets under management as on Quick claim settlement
March 31, 2025 process available

Tax Saving
Get tax benefits on premium
paid & benefits

*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.
#Life insurance cover shown is the Sum Assured on Death (at policy inception). Death Benefit is equal to: Sum Assured on Death, plus Balance in Savings Wallet (if any),
plus Interim Survival Benefit (if any), plus Terminal Bonus (if declared) Where, the Sum Assured on Death is the highest of: 7 times the Annualized Premium or 105% of the
Total Premiums Paid as on the Date of Death or Death Benefit multiple times Annualized Premium.
^The values and the income start date mentioned here are indicative based on the date on which you applied for this policy. The exact values and income start date will be as
per the date of issuance of your policy and are specified in the Policy Certificate attached in your welcome kit.

ICICI Prudential Life Insurance Company. IRDAI Regn No. 105. CIN:L66010MH2000PLC127837.

ICICI Prudential Life Insurance Company Limited. Registered Address:1089 Appasaheb Marathe Marg, Prabhadevi, Mumbai - 400025. For more details on the risk factors,
term & conditions please read the policy document. ICICI Pru Gold UIN: 105N190V04. COMP/DOC/Nov/2022/2311/1563.
 Benefit Illustration - ICICI Pru GOLD

Name of Prospect/Policyholder : Mr. Name of the Product : ICICI Pru GOLD

Age of the Policyholder at inception : 23-Jun-1996 (29 years) Tag Line : A Participating Non-Linked
Life Individual
Savings Product
Gender of the Policyholder : MALE
Name of the Life Assured : Mr. Unique Identification Number : 105N190V04
Age of the Life Assured at inception : 23-Jun-1996 (29 years) GST Rate for Year 1 : 4.5%
Gender of the Life Assured : MALE GST Rate For Year 2 Onwards : 2.25%
Policy Term : 70 years Sales Channel : IndusInd Bank Limited
Premium Payment Term : 12 years
Amount of Instalment Premium (Without : Rs. 50,000/-
GST)
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 Deferred Income Sum Assured on Maturity Rs. 600,000
Deferment Period 5 years Sum Assured on Death (at inception of the policy) Rs. 630,000
Bonus Type Simple Bonus Save The Date feature Not Applicable

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 Rs. 50,000/- - - - Rs. 50,000/-
Instalment Premium with first year GST Rs. 52,251/- - - - Rs. 52,251/-
Instalment Premium with GST 2nd year onwards Rs. 51,126/- - - - Rs. 51,126/-

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. 10,875 Guaranteed Booster as per frequency chosen by you: Not Applicable
Frequency of Guaranteed Income: Annual (arrears) Frequency of Guaranteed Booster: Not Applicable
Guaranteed Income payable in a year: Rs. 10,875 Guaranteed Booster payable in a year, when due: Not Applicable
Total Guaranteed Income payable (A) Rs. 706,875
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. 5,875 Rs. 20,125
Frequency of Cash Bonus: Annual (arrears) Annual (arrears)
Estimated Cash Bonus payable in a year Rs. 5,875 Rs. 20,125
Estimated Total Cash Bonus payable over the Income Term (B) Rs. 381,875 Rs. 1,308,125
Estimated Terminal Bonus at Maturity Rs. 2,431,363 Rs. 16,925,348
Estimated Total Maturity Benefit (C) Rs. 3,031,363 Rs. 17,525,348
Total Benefits payable till Maturity (A + B + C) Rs. 4,120,113 Rs. 19,540,348
 Guaranteed Benefits Non-Guaranteed Benefits @ 4% p.a. Non-Guaranteed Benefits @ 8% p.a. Total Benefits including Guaranteed and Non-Guaranteed Benefit
Survival Benefit Maturity Benefit Death Benefit
Policy Annualiz Guarant Guarant Guarantee Death Maturity Reversion Cash Guarantee Special Surrender Reversion Cash Guarantee Special Surrender Total Total Total Total Total Total
Year ed eed eed d Benefits Benefits ary Bonus Bonus d Surrender Benefit ary Bonus Bonus d Surrender Benefit Survival Survival Maturity Maturity Death Death
Premiu Income Booster Surrender Surrender Value Higher of Surrender Value Higher of Benefit @ Benefit @ Benefit @ Benefit @ Benefit @ Benefit @
m Value Value (5 + 10, 11) Value (5 + 15, 16) 4% p.a.(3 + 8% p.a.(3 + 4% p.a. (7 8% p.a. (7 4% p.a.(6 + 8% p.a.(6 +
4 + 9) 4 + 14) +Terminal + Terminal Interim/Ter Interim/Ter
Bonus, if Bonus, if minal minal
declared) 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 20 21 22 23
1 50,000 0 0 7,500 630,000 0 0 0 0 10,489 10,489 0 0 0 10,489 10,489 0 0 0 0 630,000 630,000
2 50,000 0 0 30,000 630,000 0 0 0 0 22,510 30,000 0 0 0 22,510 30,000 0 0 0 0 630,000 630,000
3 50,000 0 0 52,500 630,000 0 0 0 0 36,238 52,500 0 0 0 36,238 52,500 0 0 0 0 630,000 630,000
4 50,000 0 0 100,000 630,000 0 0 0 0 51,864 100,000 0 0 0 51,864 100,000 0 0 0 0 630,000 630,000
5 50,000 0 0 125,000 630,000 0 0 0 0 69,600 125,000 0 0 0 69,600 125,000 0 0 0 0 630,000 630,000
6 50,000 10,875 0 119,000 630,000 0 0 5,875 14,250 73,155 133,250 0 20,125 0 58,905 119,000 16,750 31,000 0 0 630,000 630,000
7 50,000 10,875 0 113,000 630,000 0 0 5,875 28,500 72,346 141,500 0 20,125 0 43,846 113,000 16,750 31,000 0 0 630,000 630,000
8 50,000 10,875 0 109,600 630,000 0 0 5,875 42,750 71,877 152,350 0 20,125 0 29,127 109,600 16,750 31,000 0 0 630,000 630,000
9 50,000 10,875 0 106,805 630,000 0 0 5,875 57,000 71,775 163,805 0 20,125 0 136,614 136,614 16,750 31,000 0 0 630,000 630,000
10 50,000 10,875 0 104,700 630,000 0 0 5,875 71,250 197,547 197,547 0 20,125 0 188,244 188,244 16,750 31,000 0 0 630,000 630,000
11 50,000 10,875 0 103,190 630,000 0 0 5,875 85,500 239,585 239,585 0 20,125 0 232,290 232,290 16,750 31,000 0 0 630,000 630,000
12 50,000 10,875 0 102,380 630,000 0 0 5,875 99,750 420,764 420,764 0 20,125 0 423,514 423,514 16,750 31,000 0 0 630,000 630,000
13 0 10,875 0 75,220 630,000 0 0 5,875 114,000 421,409 421,409 0 20,125 0 432,262 432,262 16,750 31,000 0 0 630,000 630,000
14 0 10,875 0 48,120 630,000 0 0 5,875 128,250 422,249 422,249 0 20,125 0 441,715 441,715 16,750 31,000 0 0 630,000 630,000
15 0 10,875 0 20,960 630,000 0 0 5,875 142,500 423,292 423,292 0 20,125 0 451,933 451,933 16,750 31,000 0 0 630,000 630,000
16 0 10,875 0 0 630,000 0 0 5,875 150,610 424,548 424,548 0 20,125 0 462,982 462,982 16,750 31,000 0 0 630,000 630,000
17 0 10,875 0 0 630,000 0 0 5,875 137,700 426,027 426,027 0 20,125 0 474,935 474,935 16,750 31,000 0 0 630,000 630,000
18 0 10,875 0 0 630,000 0 0 5,875 124,850 430,109 430,109 0 20,125 0 487,871 487,871 16,750 31,000 0 0 630,000 630,000
19 0 10,875 0 0 630,000 0 0 5,875 111,940 435,156 435,156 0 20,125 0 501,880 501,880 16,750 31,000 0 0 630,000 630,000
20 0 10,875 0 0 630,000 0 0 5,875 99,090 440,423 440,423 0 20,125 0 517,059 517,059 16,750 31,000 0 0 630,000 630,000
21 0 10,875 0 0 630,000 0 0 5,875 86,180 445,924 445,924 0 20,125 0 533,520 533,520 16,750 31,000 0 0 630,000 630,000
22 0 10,875 0 0 630,000 0 0 5,875 73,330 451,674 451,674 0 20,125 0 551,385 551,385 16,750 31,000 0 0 630,000 630,000
23 0 10,875 0 0 630,000 0 0 5,875 60,420 457,688 457,688 0 20,125 0 570,791 570,791 16,750 31,000 0 0 630,000 630,000
24 0 10,875 0 0 630,000 0 0 5,875 47,570 463,985 463,985 0 20,125 0 591,889 591,889 16,750 31,000 0 0 630,000 630,000
25 0 10,875 0 0 630,000 0 0 5,875 34,660 470,583 470,583 0 20,125 0 614,850 614,850 16,750 31,000 0 0 630,000 630,000
26 0 10,875 0 0 630,000 0 0 5,875 21,810 477,506 477,506 0 20,125 0 639,859 639,859 16,750 31,000 0 0 630,000 639,859
27 0 10,875 0 0 630,000 0 0 5,875 8,900 484,776 484,776 0 20,125 0 667,024 667,024 16,750 31,000 0 0 630,000 667,024
28 0 10,875 0 0 630,000 0 0 5,875 0 492,417 492,417 0 20,125 0 696,494 696,494 16,750 31,000 0 0 630,000 696,494
29 0 10,875 0 0 630,000 0 0 5,875 0 500,458 500,458 0 20,125 0 728,461 728,461 16,750 31,000 0 0 630,000 728,461
30 0 10,875 0 0 630,000 0 0 5,875 0 508,926 508,926 0 20,125 0 763,138 763,138 16,750 31,000 0 0 630,000 763,138
31 0 10,875 0 0 630,000 0 0 5,875 0 517,854 517,854 0 20,125 0 800,751 800,751 16,750 31,000 0 0 630,000 800,751
32 0 10,875 0 0 630,000 0 0 5,875 0 527,277 527,277 0 20,125 0 841,550 841,550 16,750 31,000 0 0 630,000 841,550
33 0 10,875 0 0 630,000 0 0 5,875 0 537,234 537,234 0 20,125 0 885,808 885,808 16,750 31,000 0 0 630,000 885,808
34 0 10,875 0 0 630,000 0 0 5,875 0 547,770 547,770 0 20,125 0 933,824 933,824 16,750 31,000 0 0 630,000 933,824
35 0 10,875 0 0 630,000 0 0 5,875 0 558,934 558,934 0 20,125 0 985,928 985,928 16,750 31,000 0 0 630,000 985,928
36 0 10,875 0 0 630,000 0 0 5,875 0 570,787 570,787 0 20,125 0 1,042,479 1,042,479 16,750 31,000 0 0 630,000 1,042,479
37 0 10,875 0 0 630,000 0 0 5,875 0 583,395 583,395 0 20,125 0 1,103,875 1,103,875 16,750 31,000 0 0 630,000 1,103,875
38 0 10,875 0 0 630,000 0 0 5,875 0 596,839 596,839 0 20,125 0 1,170,554 1,170,554 16,750 31,000 0 0 630,000 1,170,554
39 0 10,875 0 0 630,000 0 0 5,875 0 611,211 611,211 0 20,125 0 1,242,998 1,242,998 16,750 31,000 0 0 630,000 1,242,998
40 0 10,875 0 0 630,000 0 0 5,875 0 626,621 626,621 0 20,125 0 1,321,736 1,321,736 16,750 31,000 0 0 630,000 1,321,736
41 0 10,875 0 0 630,000 0 0 5,875 0 643,154 643,154 0 20,125 0 1,407,353 1,407,353 16,750 31,000 0 0 643,154 1,407,353
42 0 10,875 0 0 630,000 0 0 5,875 0 660,725 660,725 0 20,125 0 1,500,496 1,500,496 16,750 31,000 0 0 660,725 1,500,496
43 0 10,875 0 0 630,000 0 0 5,875 0 679,413 679,413 0 20,125 0 1,601,876 1,601,876 16,750 31,000 0 0 679,413 1,601,876
 44 0 10,875 0 0 630,000 0 0 5,875 0 699,317 699,317 0 20,125 0 1,712,282 1,712,282 16,750 31,000 0 0 699,317 1,712,282
45 0 10,875 0 0 630,000 0 0 5,875 0 720,544 720,544 0 20,125 0 1,832,589 1,832,589 16,750 31,000 0 0 720,544 1,832,589
46 0 10,875 0 0 630,000 0 0 5,875 0 743,215 743,215 0 20,125 0 1,963,766 1,963,766 16,750 31,000 0 0 743,215 1,963,766
47 0 10,875 0 0 630,000 0 0 5,875 0 767,462 767,462 0 20,125 0 2,106,892 2,106,892 16,750 31,000 0 0 767,462 2,106,892
48 0 10,875 0 0 630,000 0 0 5,875 0 793,434 793,434 0 20,125 0 2,263,168 2,263,168 16,750 31,000 0 0 793,434 2,263,168
49 0 10,875 0 0 630,000 0 0 5,875 0 821,297 821,297 0 20,125 0 2,433,937 2,433,937 16,750 31,000 0 0 821,297 2,433,937
50 0 10,875 0 0 630,000 0 0 5,875 0 851,236 851,236 0 20,125 0 2,620,702 2,620,702 16,750 31,000 0 0 851,236 2,620,702
51 0 10,875 0 0 630,000 0 0 5,875 0 883,461 883,461 0 20,125 0 2,825,152 2,825,152 16,750 31,000 0 0 883,461 2,825,152
52 0 10,875 0 0 630,000 0 0 5,875 0 918,207 918,207 0 20,125 0 3,049,186 3,049,186 16,750 31,000 0 0 918,207 3,049,186
53 0 10,875 0 0 630,000 0 0 5,875 0 955,737 955,737 0 20,125 0 3,294,952 3,294,952 16,750 31,000 0 0 955,737 3,294,952
54 0 10,875 0 0 630,000 0 0 5,875 0 996,354 996,354 0 20,125 0 3,564,879 3,564,879 16,750 31,000 0 0 996,354 3,564,879
55 0 10,875 0 0 630,000 0 0 5,875 0 1,040,396 1,040,396 0 20,125 0 3,861,733 3,861,733 16,750 31,000 0 0 1,040,396 3,861,733
56 0 10,875 0 0 630,000 0 0 5,875 0 1,088,253 1,088,253 0 20,125 0 4,188,664 4,188,664 16,750 31,000 0 0 1,088,253 4,188,664
57 0 10,875 0 0 630,000 0 0 5,875 0 1,140,365 1,140,365 0 20,125 0 4,549,281 4,549,281 16,750 31,000 0 0 1,140,365 4,549,281
58 0 10,875 0 0 630,000 0 0 5,875 0 1,197,241 1,197,241 0 20,125 0 4,947,728 4,947,728 16,750 31,000 0 0 1,197,241 4,947,728
59 0 10,875 0 0 630,000 0 0 5,875 0 1,259,461 1,259,461 0 20,125 0 5,388,787 5,388,787 16,750 31,000 0 0 1,259,461 5,388,787
60 0 10,875 0 0 630,000 0 0 5,875 0 1,327,694 1,327,694 0 20,125 0 5,877,995 5,877,995 16,750 31,000 0 0 1,327,694 5,877,995
61 0 10,875 0 0 630,000 0 0 5,875 0 1,402,713 1,402,713 0 20,125 0 6,421,794 6,421,794 16,750 31,000 0 0 1,402,713 6,421,794
62 0 10,875 0 0 630,000 0 0 5,875 0 1,485,415 1,485,415 0 20,125 0 7,027,706 7,027,706 16,750 31,000 0 0 1,485,415 7,027,706
63 0 10,875 0 0 630,000 0 0 5,875 0 1,576,840 1,576,840 0 20,125 0 7,704,558 7,704,558 16,750 31,000 0 0 1,576,840 7,704,558
64 0 10,875 0 0 630,000 0 0 5,875 0 1,678,203 1,678,203 0 20,125 0 8,462,755 8,462,755 16,750 31,000 0 0 1,678,203 8,462,755
65 0 10,875 0 0 630,000 0 0 5,875 0 1,790,927 1,790,927 0 20,125 0 9,314,616 9,314,616 16,750 31,000 0 0 1,790,927 9,314,616
66 0 10,875 0 0 630,000 0 0 5,875 0 1,916,683 1,916,683 0 20,125 0 10,274,806 10,274,806 16,750 31,000 0 0 1,916,683 10,274,806
67 0 10,875 0 0 630,000 0 0 5,875 0 2,057,446 2,057,446 0 20,125 0 11,360,861 11,360,861 16,750 31,000 0 0 2,057,446 11,360,861
68 0 10,875 0 0 630,000 0 0 5,875 0 2,215,555 2,215,555 0 20,125 0 12,593,860 12,593,860 16,750 31,000 0 0 2,215,555 12,593,860
69 0 10,875 0 0 630,000 0 0 5,875 0 2,393,796 2,393,796 0 20,125 0 13,999,280 13,999,280 16,750 31,000 0 0 2,393,796 13,999,280
70 0 10,875 0 0 630,000 600,000 0 5,875 0 2,595,503 2,595,503 0 20,125 0 15,608,079 15,608,079 16,750 31,000 3,031,363 17,525,348 2,595,503 15,608,079

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. Example to understand when does Survival Benefits become payable: If the date of risk commencement of your policy is Jan 15, 2023, then Survival Benefits will start from:
• For Annual mode: Jan 14, 2024 • For Monthly mode: Feb 14, 2023, under 'Immediate Income' or 'Immediate Income with Booster' variants
• For Annual mode: Jan 14, 2029 • For Monthly mode: Feb 14, 2028, under 'Deferred Income' variant with deferment of 5 years (for example)
• For Annual mode: 1 June of policy year when it is first due to be paid • For Monthly mode: Not Applicable, under all variants when Special Date chosen is 1 June under 'Save The Date' feature
These pay out dates are indicative and the applicable date will be mentioned in the Policy Schedule of your policy document.
2. 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.
3. 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 [Link] chosen Save the Date may change basis the date
of issuance of your policy. The final date and survival benefit values will be as per the date of issuance of your policy and are specified in the Policy Schedule attached in your welcome kit.
4. 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. The surrender values may be different than those illustrated above if surrender takes place before the end of the policy year or if all the instalment premiums
payable in that policy year have not been paid.
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 __________________________________(Name), have explained I ______________________________(Name), having received
the premiums, and benefits under the product fully to the 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
of the Insurer

ICICI Prudential Life Insurance Company Limited.

1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai - 400025
Email: lifeline@[Link]
[Link]
 CUSTOMER INFORMATION SHEET/KNOW YOUR POLICY
This document provides key information about your policy. You are also advised to
go through your policy document.

Sl Title Description Policy Clause

No Number
(Please refer to applicable Policy Clause
Number in next column)
1 Name of Insurance Policy schedule
ICICI Pru Gold
Product and Unique
Identification Number UIN: 105N190V04
(UIN)
2 Policy number Policy schedule

3 Type of Insurance A Participating Non-Linked Life Individual Policy schedule

Policy Savings Product

4 Basic Policy details Sum Assured on : 6,30,000/- Policy schedule

Death (at inception of the policy) (in ₹)
Premium Instalment (in ₹): 50,000/-
Premium Payment frequency : Yearly
Premium payment term : 12 years
Policy term: 70 years
Date of Maturity : Jun 2095
5 Policy Benefits payable on maturity- Part C-Clause
Coverage/benefits , on survival of the Life Assured till the end of 2b,1,2a of
payable the Policy term, for a fully-paid Policy, the Part D -Clause
following will be payable: . This Maturity Benefit 2
will be sum of
•Sum Assured on Maturity, plus
•
•Terminal Bonus (if declared)

For more information, refer to Part C , Clause 2b

of policy document.

Benefits payable on death-

(i)On death of the Life Assured during the Policy
term, for a Premium Paying or Fully Paid Policy,
Death Benefit shall be payable to the Claimant.
Benefits shall be payable as per the plan
chosen by you at inception.

Death Benefit is equal to:

•Sum Assured on Death, plus
•
•Interim Survival Benefit (if any), plus
 •Terminal Bonus (if declared) For more
information, refer to Part C , Clause 1 of policy
document.

Surrender benefits-
You can surrender the policy any time after
payment of at least one full policy year’s
premium(s). Prior to receipt of one full year’s
premium, no surrender value is payable.
On policy surrender, a Surrender Value equal to
the higher of the following will be payable:
• Guaranteed Surrender Value (GSV)
• Special Surrender Value (SSV)

For more information related to surrender, refer

to Part D, Clause 2 of policy document.

Survival Benefits excluding that payable on

maturity- On survival of the Life Assured, the
Survival Benefit amount will be payable
depending upon the Plan variant chosen.
For more information, refer to Part C , Clause 2a
of policy document.

Options to policyholders for availing benefits, if

any, covered under the policy-
Savings Wallet is available for the customer
For more information, refer to Part C , Clause 2a
viii of policy document.

Other benefits/options payable, specific to the

policy, if any- Not applicable.

6 Options available (in Not applicable

case of Linked Insurance
Products)
7 Option available (in case Not applicable
of Annuity product)
8 Riders opted, if any
NA

9 Exclusions (events Suicide: In case of death due to suicide within Part F, Clause
where insurance 12 months from the date of commencement of 11
coverage is not risk under the Policy or from the date of revival
payable), if any of the Policy, as applicable, the Claimant shall
be entitled to at least 80% of the Total
Premiums Paid till the date of death or the
Surrender Value available as on the date of
death whichever is higher, provided the Policy
is in force.
In case any Survival Benefits have already been
paid out, such amount already paid out shall be
deducted from the amount payable on such
death.
The Policy will terminate on making such a
payment and all rights, benefits and interests
under the Policy will stand extinguished.
For more information, refer to Part F, Clause 11
of policy document

10 Waiting /lien Period, if Not Applicable

any
11 Grace Period 15 days-For monthly frequency of premium Part C-Clause 5
payment of Policy
30 days- For other frequencies of premium Document
payment

For more information, refer to Part C, Clause 5

of policy document
12 Free Look Period 30 days Part D -Clause
1
For more information, refer to Part D, Clause 1
of policy document
13 Lapse, paid-up and Lapse: The Policy shall lapse with all benefits Part C-Clause
revival of the Policy and the cover shall cease, if premium payment 3,6
is discontinued by You before acquiring a Part D -Clause
Surrender value(i.e during the first Policy Year). 5
If the Policy is not revived within the Revival
Period, then the Policy shall foreclose and all
rights and benefits under the Policy shall stand
 extinguished.
For more details, refer to Part C, Clause 6 of
policy document

Paid up: If any premium remains unpaid after

the expiry of the grace period and the policy
has acquired a surrender value, the policy’s
status shall be altered to paid-up status with
reduced benefits payable under specified
contingencies.

For more details, refer to Part C, Clause 3 of

policy document

Revival:
A Policy which has discontinued payment of
Premium may be revived subject to Board
Approved Underwriting Policy and certain
condition.
The application for revival is made within 5
years from the due date of the first unpaid
premium or the policy term, whichever is
earlier. Revival will be based on the prevailing
Board approved underwriting policy.
For more details, refer to Part D, Clause 5 of
policy document

14 Policy Loan, if Loans are available provided a positive Part D -Clause

applicable surrender value is payable under the policy at 4
the time of disbursement of the same. Loan
amount of up to 80% of Surrender Value can
be availed.

For more information, refer to Part D, Clause 4

of policy document
15 Claims/Claims Turn around Time – For TAT details for death Part F-Clause
Procedure claim refer to 10
[Link]
[Link]

For any assistance on Claims, you can call Us

on 18002660 (for calls within India) or +91
8069385555 (for calls outside India). You can
also register a health or a death claim by
sending us an email at
claimsupport@[Link]
 The claim form can be downloaded from the
following links:
Digital Claim Form Link:
[Link]
[Link]?execution=e2s1

Physical Claim Form Link:

[Link]
library/life-insurance-claims-related-
[Link]#linked_content

For information on documents required to

process claims, please refer to the policy
document (Part F, Clause 10) under the
section ‘Specimen Policy Document’ available
on our website at
[Link]
[Link]
16 Policy Servicing Turn around Time – For TAT details for policy Part G of Policy
servicing - refer to Document
[Link]
[Link]

For any clarification or assistance, You may

contact Our advisor or call Our customer
service representative (between 10.00 a.m. to
7.00 p.m, Monday to Saturday; excluding
national holidays) on 18002660 or visit Our
website: [Link].
Alternatively, You may communicate with Us
at any of our branches or the customer service
helpline number 18002660 or email at
lifeline@[Link]. For updated contact
details, We request You to regularly check Our
website.
17 Grievances /Complaints i. You may write to gro by visiting the Part G of Policy
grievance redressal page of our Document
website:[Link]
m/services/grie vance-
[Link]. Alternatively, you
can contact the Grievance redressal
officer at our branches or write to us
at gro@[Link]
ii. [Link]
s/grie [Link]
iii. Kindly refer the Insurance
Ombudsman details under part G
 under the ‘Specimen Policy
Document’ available at Download
Centre | ICICI Prulife . This is subject
to change from time to time
Additionally, the contact details of
Ombudsman can be accessed through
[Link] The
concerns of senior citizens will be resolved
on priority ensuring there is a speedy
disposal of the grievances.

Note: In case of any conflict, the terms and conditions mentioned in the policy
document shall prevail.

Declaration by the Policyholder

I have read the above and confirm having noted the details.

Place: (Signature of the Policyholder)

Date
 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).

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