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securing your family

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SIMPLIFIED

LOYALTY
OPPORTUNITIES
SMART
EASY SMART
PROCESS INCOME PROTECTION
EASE
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CAREFREE
COVER ASSURANCE
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ASSURANCE
DOCUMENTATION CONTINUITY LOYALTY
DOCUMENTATION

Congratulations Manikandan ,
You have taken the first step
to secure your loved ones financially with
ICICI Pru iProtect Super

To know more about your policy, please read on…

Key benefits:

Life insurance cover

Defer paying premiums by 12 months with Premium Break

Tax benefits
 Details of the Life Assured (person covered under the policy):
Name Age Gender
Manikandan 24 Male

How does your plan work:

Benefit You pay You get

Life Cover:
₹ 8332/-
₹ 50,00,000/-
every Year
Life cover for 40 Years for 40 years

Detailed break-up of premium amount

Yearly premium amount

Life cover (A) ₹ 8,332/-

Applicable taxes (B) ₹ 1,501/-

Total premium (A+B) ₹ 9,833/-

 Why choose us:

9.84 Cr 3.08 Lakh Cr 2.87 Lakh Cr

lives covered as on assets under management benefits paid till
June 30, 2024 as on June 30, 2024 June 30, 2024

Tax Saving Quick claim

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

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, terms & conditions, please read the policy document.
ICICI Pru iProtect Super. UIN: 105N197V01 . COMP/DOC/Dec/2024/1112/7864
 Benefit Illustration of ICICI Pru iProtect Super
(UIN:105N197V01) - A Non-Participating Non-Linked
Life Individual pure risk insurance product
Name of the Prospect/Policyholder : Mr. Manikandan Name of the Product : ICICI Pru iProtect Super
Age of the Policyholder at policy : 11-Feb-2001 (24 years) Tag Line : A Non-Participating
inception Non-Linked Life Individual
pure risk insurance Product
Gender of the Policyholder : MALE
Is Proposer an existing policyholder? : No Unique Identification No. : 105N197V01
Name of the Life Assured : Mr. Manikandan GST Rate : 18%
Age of the Life Assured at policy : 11-Feb-2001 (24 years)
inception
Gender of the Life Assured : MALE Sales Channel : Agency
Is Life Assured Smoker / Non-Smoker? : Non-Smoker
Policy Term : 40 years
Premium Payment Term : 40 years
Frequency of premium payment : Yearly
Amount of Instalment Premium*(without : Rs. 8,332/-
GST)
*Please refer the section Premium Summary for a detailed break-up of premium payable

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

Policy Details
Sum Assured on Death or Terminal illness Rs. 5,000,000

Premium Summary
Base Plan(1) ICICI Pru Non-Linked ICICI Pru Non-Linked Total Instalment
Accidental Death and Accidental Death and Premium(1+2+3)
Disability Rider (Accidental Disability Rider (Accidental
Death Benefit option)(2) Total & Permanent
Disability Benefit option)(3)
Instalment Premium without GST Rs. 8,332/- 0 0 Rs. 8,332/-
Instalment Premium with GST Rs. 9,833/- 0 0 Rs. 9,833/-

Important points to note:

i. The above illustration is applicable to a standard life from medical, life-style and occupation point of view.
ii. 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.
iii. Tax benefits may be available as per the prevailing Tax laws.

Please refer to your sales brochure and policy document for more details.

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:
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: [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 iProtect Super
Product and Unique
Identification Number UIN: 105N197V01
(UIN)
2 Application number / Policy Schedule
Policy number
3 Type of Insurance A Non-Participating Non-Linked Life Policy Schedule
Policy Individual Pure Risk insurance Product
4 Basic Policy details Premium Instalment in the 1st Year(in ₹) Policy Schedule

8,332/-
Premium Instalment 2nd Year onwards(in ₹)
8,332/-
Sum Assured on Death (in Rs):
50,00,000/-
Premium Payment frequency : Yearly

Premium payment term : 40 years

Policy term : 40 years

5 Policy Benefits payable on maturity Part C -Clause

Coverage/benefits 1,2 & Part D-
payable No Benefits are payable. Clause 3

Benefits payable on death

Death Benefit payable to the Claimant on

diagnosis of Terminal Illness or death of the Life
Assured will be the highest of:
 7 times Annualized Premium;
 105% of the Total Premiums Paid up to
the date of death and
 Sum Assured as stated in Your Policy
Schedule

Upon payment of Death Benefit by the

Company to the Claimant, the policy shall
terminate with all rights and benefits
 thereunder.

Surrender benefits

On Surrender of Policy after payment of one full

year’s premium, Surrender value will be
payable. The Surrender value equal to
Unexpired risk premium value will be payable
according to the premium payment option
chosen by You

For more information, please refer to the policy

document (Part D, Clause 2)

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
NA

Rider Schedule
, Policy
Schedule

9 Exclusions (events Suicide Part F Clause

where insurance 11
coverage is not If the Life Assured, whether sane or insane,
payable), if any commits suicide within 12 months from the
date of commencement of risk of this Policy,
We will refund higher of 80% of the total
premiums paid, if any till the date of death or
surrender value as available on date of death
provided the policy is in force.

In the case of a revived Policy, if the Life

Assured, whether sane or insane, commits
suicide within 12 months of the date of revival
of the Policy, higher of 80% of the total
premiums paid, if any till date of death or
 surrender value as available on date of death
will be payable by Us.

10 Waiting /lien Period, if Not Applicable

any
11 Grace Period Monthly – 15 days Part C, Clause 4
Any other premium payment frequency – 30
days
12 Free Look Period 30 days Part D, Clause1

For more information, refer to Part D, Clause 1

of policy document
13 Lapse, paid-up and Lapsation Part D, Clause
revival of the Policy If any Premium Instalment is not paid within 4,5,
the Grace Period, then the policy shall lapse,
and the cover will cease. For more information,
refer to Part D, Clause 5 of policy document

Paid Up

Not Applicable

Revival
A Policy which has lapsed for nonpayment of
premium may be revived subject to
underwriting and conditions mentioned in Part
D Clause 6

14 Policy Loan, if Not Applicable

applicable
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 1800-2660 (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 -Clause
servicing - refer to 1
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 1800-2660 or visit Our
website: www.iciciprulife.com.
Alternatively, You may communicate with Us
at any of our branches or the customer service
helpline number 1800-2660or 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 -Clause
1
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 1800-2660.

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: