Personalised proposal for securing your life goals

with

Hi ,
Congratulations on taking the first step of securing
future of your loved ones with guaranteed lump
sum amount and a life insurance cover.

Please go through the details of your quote and

contact your advisor who will assist you to
purchase this plan.
 Snapshot of your plan

You pay
Yearly premium ` 50,000/-
for 10 years.
29 years / Male

Age 29 44

Years

You get:

Life Insurance Cover of Total maturity benefit of:

` 5,00,000/- * for entire ` 8,67,278/-
policy term of 15 years

*This is the minimum life insurance cover available under the product

Benefit Benefit term Benefit amount

Total benefit At the end of 15 years ` 8,67,278/-

Life Insurance Cover 15 years ` 5,00,000/- *

Total premium paid ` 5,00,000/- *

The dates and ages mentioned in the illustration throughout the document are only indicative.
 Detailed break-up of premium amount

Instalment Applicable Total Tax benefit

Premium taxes amount under

Instalment Premium
` 50,000/- ` 2,251/- ` 52,251/- Section 80C
for 1st year

Instalment Premium
` 50,000/- ` 1,126/- ` 51,126/- Section 80C
from 2nd year onwards

Why choose us:

9.84 Cr ` 2.87 Lakh Cr

Lives covered as on Benefits paid till
June 30, 2024 June 30, 2024

` 3.08 Lakh Cr 24 hrs claim settlement

Assets under management as on Quick claim settlement
June 30, 2024 process available

Tax Saving
Tax benefits may be applicable on
premiums paid & benefits received

Please note: Total benefits mentioned here are an indicative amount based on the date on which you applied for this policy. The exact benefits will be as
per the date of issuance of your policy and is specified in the Policy Schedule attached in your welcome kit.

Tax benefits as per prevailing tax laws.

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.
ICICI Pru Assured Savings Insurance Plan 105N144V11 .For more details on the risk factors, term & conditions please read the policy document.
 Benefit Illustration of ICICI Pru Assured Savings
Insurance Plan - A Non-Participating Non-Linked Life
Individual Savings Product
Name of the Prospect/Policyholder: : Mr. Name of the Product : ICICI Pru Assured
Savings Insurance Plan
Tag Line : A Non-Participating
Non-Linked Life Individual
Savings Product
Age of the Policyholder : 05-Feb-1996 (29 Years) Gender of the Policyholder : MALE
Name of the Life Assured : Mr. Unique Identification No. : 105N144V11
Age of the Life Assured : 05-Feb-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 : 15 years Sales Channel : Agency
Premium Payment Term : 10 years
Annualized Premium (without GST): : Rs.50,000/-
Mode of payment of premium : Yearly

This benefit illustration is intended to show year-wise premiums payable and benefits under the policy.

Premium Summary
Base Plan Riders Total Instalment Premium
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/-

Policy Details
Sum Assured on Death (at inception of the Policy) Rs. 500,000
Maturity Benefit:
Accrued Guaranteed Additions (A) Rs. 525,000
Guaranteed Maturity Benefit (B) Rs. 342,278
Total maturity amount (A+B) Rs. 867,278

Guaranteed Non-Guaranteed
Policy Year Annualized Guaranteed Guaranteed Maturity Benefit Death Benefit Guaranteed Special Surrender Surrender Value
premium Additions (For the Additions Surrender Value Value (SSV) Payable
year) (Cumulative) (GSV)
1 50,000 5,000 5,000 0 500,000 7,500 15,089 15,089
2 50,000 10,000 15,000 0 505,000 31,500 39,366 39,366
3 50,000 15,000 30,000 0 515,000 57,000 73,408 73,408
4 50,000 20,000 50,000 0 530,000 109,000 117,677 117,677
5 50,000 25,000 75,000 0 550,000 140,000 172,493 172,493
6 50,000 30,000 105,000 0 575,000 172,500 237,976 237,976
7 50,000 35,000 140,000 0 605,000 206,500 314,002 314,002
8 50,000 40,000 180,000 0 640,000 264,840 400,136 400,136
9 50,000 45,000 225,000 0 680,000 330,435 495,557 495,557
10 50,000 50,000 275,000 0 725,000 403,200 598,976 598,976
11 0 50,000 325,000 0 775,000 446,800 644,120 644,120
12 0 50,000 375,000 0 825,000 490,350 692,714 692,714
13 0 50,000 425,000 0 875,000 533,950 745,029 745,029
14 0 50,000 475,000 0 925,000 577,500 801,358 801,358
15 0 50,000 525,000 867,278 975,000 592,500 862,017 862,017

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

Disclaimers
===========

1. The above amounts assume that all premiums are paid when due. The surrender values are illustrated assuming that
the surrender occurs before the GAs are added for that policy year. The death benefit values are illustrated assuming
that death occurs before the Guaranteed Additions are added for that policy year.
2. Maturity Benefit shown in Benefit Summary is payable at the end of the year. Guaranteed Additions accrue at the end
of every year and are payable at the end of the policy term.
3. Please refer to your sales brochure and policy document for more details.
 4. The surrender values may be different than those illustrated above on account of multiple factors such as surrender
taking place before the end of the policy year, non-payment of all the instalment premiums payable in that policy year,
etc. The policyholder is advised to check the surrender value payable with the company before surrendering.

I __________________________________(Name), have explained I ______________________________(Name), having received the

the premiums, and benefits under the product fully to the information with respect to the above, have understood the
prospect / policyholder. above statement before entering into the contract.
Place: Date:
Date: Signature of Agent / Intermediary / Official Signature of Prospect / Policyholder
of the Insurer

ICICI Prudential Life Insurance Company Limited.

1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai - 400025
Email: [email protected]
www.iciciprulife.com
 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 Assured Savings Insurance Plan
Product and Unique
Identification Number UIN: 105N144V11
(UIN)
2 Policy number / Policy schedule
Application number
3 Type of Insurance A Non-Participating Non-Linked Life Individual Policy schedule
Policy Savings Product

4 Basic Policy details Pr

Premium Instalment (in ₹) : 50,000/- Policy schedule
Premium Payment frequency: Yearly
Sum Assured on Death (in ₹):
5,00,000/-
Sum Assured on Maturity/ Guaranteed
Maturity Benefit(₹): 8,67,278/-
Premium payment term : 10 years
Policy term: 15 years
5 Policy Benefits payable on maturity- Part C-Clause
Coverage/benefits On survival of the life assured till the Date of 1,2
payable Maturity for a fully paid policy, the following Part D -Clause
will be payable: 2

1. Guaranteed Maturity Benefit (GMB), plus

2. Accrued Guaranteed Additions

For more information, refer to Part C , Clause 2

of policy document.

Benefits payable on death-

On death of the life assured during the policy
term, for a premium paying or fully paid
policy, we will pay to the Claimant (A or B or
C), whichever is highest.

Where,
A= Sum Assured plus accrued
Guaranteed Additions
B= Guaranteed Maturity Benefit
(GMB) plus accrued Guaranteed
 Additions
C= Minimum Death Benefit
D= Surrender Value payable as on
date of death
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 year’s Premiums.
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 -Not applicable

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.
6 Options available (in Not applicable
case of Linked
Insurance Products)
7 Option available (in Not applicable
case of Annuity
product)
8 Riders opted, if any Rider schedule
and Policy
NA schedule

9 Exclusions (events Suicide: Part F, Clause

where insurance In case of death due to suicide within 12 months 11
coverage is not from the date of commencement of risk under
payable), if any the policy or from the date of Revival of the
policy, as applicable, the Claimant shall be
 entitled to 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.

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
30 days- For other frequencies of premium
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: If you do not pay the Instalment Part C-Clause 3,
revival of the Policy Premium either on the due date or within the Part D -Clause
Grace Period before the policy acquires a 4,5
Surrender Value (i.e during the first Policy Year),
the policy shall lapse and the cover will cease.
No benefits shall become payable under a
lapsed policy. If the policy is not revived within
the Revival Period then the policy shall be
foreclosed and all rights and benefits under the
policy shall be terminated.

For more details, refer to Part D, Clause 5of

policy document

Paid up: If premium payment is discontinued,

before the end of the Premium Payment Term
but after the policy has acquired a surrender
value, the policy can continue as a paid-up
policy with reduced benefits

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

policy document
 Revival:
A policy, which has lapsed for non-payment
of premium or discontinued payment of
premium may be revived subject to the
following conditions:

The application for revival is made within 5

years from the date of the first unpaid
premium and before the termination of the
policy. Revival will be based on the prevailing
Board approved underwriting policy.

For more details, refer to Part D, Clause 4 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 3
the time of disbursement of the same.
Loans amount up to 80% of the Surrender
Value can be availed.

For more information, refer to Part D, Clause 3

of policy document
15 Claims/Claims Turn around Time – For TAT details for death Part F-Clause
Procedure claim refer to 10
https://www.iciciprulife.com/contact-us/our-
services-turn-around-times.html

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
[email protected]

The claim form can be downloaded from the

following links:
Digital Claim Form Link:
https://buy.iciciprulife.com/buy/Claim-
Intimation.htm?execution=e2s1

Physical Claim Form Link:

https://www.iciciprulife.com/insurance-
library/life-insurance-claims-related-
 faqs.html#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
https://www.iciciprulife.com/services/downloa
d-centre.html
16 Policy Servicing Turn around Time – For TAT details for policy Part G
servicing - refer to
https://www.iciciprulife.com/contact-us/our-
services-turn-around-times.html

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: www.iciciprulife.com.
Alternatively, You may communicate with Us
at any of our branches or the customer service
helpline number 18002660 or email at
[email protected]. For updated contact
details, We request You to regularly check Our
website.
17 Grievances /Complaints i. Grievance Redressal Officer: Part G

If You do not receive any resolution

from Us or if You are not satisfied
with Our resolution, You may get in
touch with Our designated grievance
redressal officer (GRO) at
[email protected] or 18002660.

Address: ICICI Prudential Life

Insurance Company Limited,
Ground Floor & Upper
Basement,
Unit No. 1A & 2A, Raheja
Tipco Plaza,
Rani Sati Marg, Malad (East),
Mumbai-400097

For more details please refer to the

“Grievance Redressal” section on
www.iciciprulife.com.
  IRDAI/(IGMS/Call Centre):
If you are not satisfied with the response
or do not receive a response from us within
15 days, you may approach the Grievance
Cell of the Insurance Regulatory and
Development Authority of India (IRDAI) on
the following contact details:
IRDAI Grievance Call Centre (IGCC) TOLL
FREE NO: 155255 (or) 1800 4254 732
Email ID: [email protected]

You can also register your complaint

online at igms.irda.gov.in
Address for communication for
complaints by fax/paper:
Consumer Affairs Department
Insurance Regulatory and Development
Authority of India
Survey No. 115/1, Financial District,
Nanakramguda, Gachibowli,
Hyderabad, Telangana State – 500032

Ombudsman list: Please refer to the policy

document (Part G) under the section under the
‘Specimen Policy Document’ available at
https://www.iciciprulife.com/services/downloa
d-centre.html

This is subject to change from time to time.

Refer
https://www.iciciprulife.com/services/grievanc
e-redressal.html for more details

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