ONE COMPREHENSIVE PLAN

THAT SECURES ALL YOUR LIFE GOALS

Mera Term Plan Plus

Individual, Non-Linked, Non-Par, Pure Risk Premium, Life Insurance Product
UIN: 117N126V04

Return of
Premium Joint Life
Option

Child
Education Cover upto
Benefit 99 Years^

^Maximum maturity age 99 years for all options except Life Plus Health & ROP option. Maximum maturity age for Life Plus
Health & ROP option is 75 years.
1
 PNB MetLife Mera Term Plan Plus
Individual, Non-linked, Non-par, Pure Risk Premium, Life Insurance Product
We work hard to provide the best possible lifestyle to our families and to ensure that we
have enough money to fulfill our key responsibilities like Children’s Education, Marriage,
and Retirement etc. All these goals are easily achievable if we continue through the
working life without being affected by life’s vagaries like Death, Disease or Disability.
However, what if you are no more or are affected with a serious illness or disability? Your
family loses a key earning member and in the case of illness or disability the family also
has to plan their finances so as to take care of your health.
Term plans offer that security and ensure that your loved ones are secure, financially
independent and continue to enjoy the same lifestyle even in your absence. However,
when it comes to your family, it’s best to be double sure.
Presenting PNB MetLife Mera Term Plan Plus, a specially designed protection plan that
provides life cover till age of 99 years even as you choose to pay premiums for a limited
period. You can opt to protect your spouse in the same plan, choose return of premiums
on survival till the end of policy term or customize your plan with one of the coverage
enhancement options, making this a truly comprehensive protection solution.

Key benefits

Benefit Benefit Summary

option

Life Death Benefit

Death Benefit
Life Terminal Illness Benefit
Plus Waiver of premiums on Accidental Total Permanent Disability or diagnosis of
Critical Illness1

Death Benefit
Life Terminal Illness Benefit
Plus Waiver of premiums on Accidental Total Permanent Disability or diagnosis of
Health Critical Illness1
Accelerated Critical Illness Benefit

Premium will vary based on the option chosen by the policyholder

Additional Options
Spouse Coverage Return of Premiums

Cover Enhancement options5

1 Step-Up Benefit 2 Life Stage Benefit 3 Child Education Support Benefit

2
 With PNB MetLife Mera Term Plan Plus

1) Choose to pay for a limited period, one time or throughout policy term as per
your requirement
• Pay for a limited term of 5,10,15,20 years or pay till age 60 OR
• Pay just once and stay protected for the entire term OR
• Pay regularly throughout policy term
2) Choose to stay protected for either whole of life (coverage upto age 99 years)
OR choose coverage term as per your liking2
3) Option to choose protection against Death, Disability, and Disease
• Life: Cover against Death
• Life Plus: Cover against Death and Terminal Illness3 plus all future premiums
waived off on accidental permanent disability or diagnosis of listed critical
illnesses
• Life plus Health: Cover against Death and Terminal Illness3 plus all future
premiums waived off on accidental permanent disability or diagnosis of
critical illness plus accelerated lump sum on diagnosis of listed critical
illnesses3
4) Customise your plan with a choice of additional options4:
• ‘With Return of Premium’6 option to get your premiums back on survival till
maturity
• ‘Spouse Coverage’ to protect your spouse within the same plan
5) Enhance your protection with one out of the ‘Cover Enhancement Options’5 to
ensure your life cover is adequate even as you progress in life
6) Tailor your Benefit Payout option to suit your needs
• Lumpsum : Benefit payable as lump sum
• Monthly Income: Benefit payable as level monthly income for 10 years
• Lump sum plus Monthly Income: Benefit payable as part lump sum and part
level monthly income for 10 years
7) Enhance your cover through riders
8) Tax benefits as per prevailing tax laws~
1
All future premiums are waived off if the Life Assured suffers an Accidental Total permanent disability (ATPD) OR
is diagnosed with any one of the 50 listed Critical Illnesses (CI) – whichever occurs first, subject to the maximum
maturity age of Waiver of Premium benefit.
2
Policholder can choose any policyterm between 10 years and 99-age at entry, if ‘Return of Premiums’ is not chosen
3
Terminal illness benefit and Accelerated Critical Illness benefit is not an additional benefit and it only facilitates
early payment of death benefit upon occurrence of Terminal Illness or covered Critical Illness respectively as
described in this document.
4
The additional options “Spouse Coverage”, “Return of Premiums”, and “Cover enhancement options” which
include “Step-up Sum Assured Benefit”, “Life-stage sum assured benefit” and “Child Education Support Benefit”
will be available on payment of extra premiums
6
Maximum policy term allowed for ‘Return of Premiums’ option will be 40 years and this option needs to be
selected at the inception of the policy. ‘Return of Premiums’ options is not available if Child education support
benefit is chosen.
5
The policyholder may choose only one out of the Cover Enhancement Options
~
You may be eligible to avail the Tax benefits as per the Income Tax Act, 1961, subject to amendments made
thereto from time to time. Please consult your tax consultant for more details
3
How Does the Plan Work?

Varun, 30 years old, wants to Premium Payment Term: 30 years

purchase a term plan for adequate Policy term: 30 years
life cover. He chooses: Basic sum assured: Rs 1 Crore

Benefit option: Life Annualized premium

Additional option: None Rs. 10,400
Death benefit payout option: Lump Sum

Life cover till age 60

In case of death Nominee gets a
Lumpsum of
Rs. 1 Crore on Death

Premium payable=Rs 10,400 for 30 years Varun dies

Policy Terminates

Age 30 31 32 45
Policy Year 0 1 2 15
Premium Payment Term = Policy term = 30 years

In case of survival No benefits will be paid in case of survival

In case, “Return of Premiums” is chosen as additional option, Annualised premium of Rs 23,200
will be charged. Return of Premium on survival = Rs. 6,96,000.

The above examples are for illustrative purposes only. Premium are exclusive of taxes and assuming life assured is
in good health. If ‘With Returns of Premiums’ is chosen, premiums paid on survival till maturity will be excluding
extra premiums and taxes.

Premium Payment Term: 10 years

Arjun, 30 years old, wants life cover for Policy term: 69 years (99- Age at entry)
whole of life. He chooses:
Basic sum assured: Rs 1 Crore

Benefit option: Life Annualized premium

Additional option: None Rs. 1,04,000
Death benefit payout option: Lump Sum

Life cover till age 99

Nominee gets a
In case of death Lumpsum of
Rs. 1 Cr on Death

Premium payable=Rs 1,04,000 for 10 years Arjun dies

Policy Terminates

Age 30 31 32 39 40 80
Policy Year 0 1 2 8 9 49
PPT (10 years) Policy term

In case of survival No benefits will be paid in case of survival

The above examples are for illustrative purposes only. Premiums are exclusive of taxes and assuming life assured is in good health.

4
 Karan, 30 years old, wants to protect Premium Payment Term: 10 years
the lifestyle of his family in his Policy term: 30 years
absence. Therefore, he chooses: Basic Sum Assured: Rs 1 Crore

Benefit option: Life plus

Lump Sum proportion chosen: 50%
Additional option: Return of premiums
Annualized premium
Death benefit payout option: Lump Sum
Rs 33,900
+ Monthly income

Life cover till age 60

In case of death Lump sum payoutof
50 Lakhs
Premium Payable= Accidental Total
Rs 33,900 for 10 years Permanent Disability Level monthly income of
WoP for remaining term Rs 55,110 for 10 years

Karan dies Policy Terminates

Age 30 31 32 35 39 40 48
Policy Year 0 1 2 5 8 9 18
Premium Payment Term (10 years) Policy term
In case of Karan’s unfortunate demise in the 18th policy year, a lumpsum amount of Rs. 50 lakhs i.e. 50% of Basic
Sum Assured will be paid immediately and the balance will be paid as level monthly income of Rs.55,110 for the next
10 years. Monthly Income payable = 50% * 1,00,00,000 * 1.1022% = Rs. 55,110 for 10 years

In case of survival Return of premiums Rs 3,39,000

The above examples are for illustrative purposes only. Premium are exclusive of taxes and assuming life assured is
in good health. The policy terminates after payment of last installment of monthly income. If ‘With Return of
Premiums’ is chosen premiums paid on survival till maturity will be excluding extra premium and taxes.

Manish, 30 years old, wants a single Premium Payment Term: Regular Pay
plan that covers both him and his wife Policy term : 40 years
Priya (30), who is a housewife. He also Basic sum assured:
wants to insure himself against disease For Self Rs. 1 Crore
and disability. Therefore he chooses: For Spouse Rs. 50 Lakhs
Benefit option: Life Plus Health
Additional option: Spouse coverage Annualized premium
Death benefit payout option: Lump sum Rs. 30,058

Life cover till age 70

In case of death 25% of BSA= Lump sum payout 75% of BSA=

Rs 25 lakhs Rs 50 lakhs Rs 75 lakhs

Premium payable= Manish is diagnosed

Rs 30,058 for 40 years with critical illness
Priya Dies Manish Dies
Waiver of all future premiums
Policy Terminates

Age 30 31 32 40 50 57
Policy Year 0 1 2 9 19 26
Premium Payment Term = Policy term = 40 years

In case of survival No benefits will be paid in case of survival

The above examples are for illustrative purposes only. Premium are exclusive of taxes and assuming life assured is in good health. 5
 Premium payment term: Regular pay
Vishal, 30 years old, wants a life cover
which is adequate for him as he Policy term: 30 years
progresses in life. Therefore he chooses: Basic sum assured: Rs 1 Crore

Benefit option: Life Annualized premium

Additional option: Step-Up Benefit Rs. 10,400
Death benefit payout option: Lump sum
Life cover till age 60
In case of death
Additional premium charged for every
addition of step-up sum assured
cumulative step-up SA
Lumpsum payout of Death
Rs. 1.5 Crore Policy Year Premium
0 1 Cr 10,400
1 1.1 Cr 11,220
Death
Benefit: 2 1.2 Cr 12,080
14,970
3 1.3 Cr 12,990
13,960
12,080 12,990 4 1.4 Cr 13,960
10,400
11,220 Vishal dies 14,970
Premiums: 5 1.5 Cr
Policy Terminates Vishal dies, Policy terminates

Age 30 35
Policy Year 0 5
Premium payment term= Policy term = 30 years

No benefits will be paid in case of survival

The above examples are for illustrative purposes only. Premium are exclusive of taxes and assuming life assured is in good health.

Plan at a glance
Parameter Minimum Maximum
Age at entry7 (years) 18 60 (55 if ‘Pay till 60’ is chosen as PPT)
Life, Life Plus : 99
Age at Without RoP 28
Life plus Health : 75
maturity7 (years)
With RoP 28 75
Sum Assured (Rs.) 25,00,000 No limit, subject to Underwriting
Based on the Basic Sum Assured, Entry Age, Policy Term, Premium
Premium (Rs.)
of Premium Option chosen

• Single pay,
Premium Paying Term (years) • Limited pay (5, 10, 15, 20, Pay till Age 60),
• Regular Pay
(Minimum allowed Policy Term for Limited pay option: Premium Payment Term plus 5 years)

Without RoP :
Life, Life Plus : 99-Age at entry
Policy Term (years) 10
Life plus Health : 75 – Age at entry
With RoP : 40
Premium Payment modes Yearly / Half Yearly / Quarterly / Monthly8
PNB MetLife Accidental Death Benefit Plus Rider Plus (117B020V04)
PNB MetLife Serious Illness Rider (117B021V04)
Riders
PNB MetLife Accidental Disability Benefit Rider (UIN: 117B022V03)
PNB MetLife Critical Illness Rider (UIN: 117B023V03)
7
All references to Age are as on age last birthday
8
Monthly mode is available for standing instruction/direct debit options (including Automated Clearing House - ACH)
6
 Sample Premium Rates

Without Return of premiums

Age/
Life plus
Life Life Plus10 Health
option
30 10,400 11,000 17,300
35 14,800 15,900 25,400
40 21,900 24,100 38,300
45 33,400 39,100 59,400
50 51,700 65,900 NA
55 80,800 1,10,300 NA

With Return of premiums

Age/ Life plus

Life Life Plus10 Health
option
30 23,200 26,600 42,400
35 31,700 38,100 60,300
40 42,200 52,800 83,900
45 60,900 80,900 1,24,900

For “Life Plus” option, the premium and benefits under the policy will be reduce to “Life” option from the policy
10

anniversary when the life assured has attained age 75 years.

Above premiums are applicable for a healthy male life with annual mode of payment and premiums paid regularly
for the policy term of 30 years and basic sum assured 1 cr with lump sum payout option. Goods and Services tax
and/or applicable cesses will be charged extra.

Benefits in Detail

Policy Benefits
The Policy has three benefit options – Life, Life Plus and Life plus Health with varying
Policy Benefits under each of the options. The benefit option must be exercised by the
Policy Holder at inception and cannot be altered at any time during the tenure of the
policy. The available policy benefits under each of the option are described hereunder

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The available Benefits under each of the Benefit option are summarized hereunder:

Death Terminal Waiver of Accelerated Critical

Life    
Life Plus    
Life plus Health    

All the three basic Benefit options are available with and without the Maturity Benefit.

DEATH BENEFIT (APPLICABLE FOR LIFE, LIFE PLUS AND LIFE PLUS HEALTH
BENEFIT OPTIONS)
‘Sum Assured on Death’ is payable upon death of the Life Assured, provided the Policy
is in In-force Status as on the date of death of the Life Assured, as per one of the Benefit
Payout options chosen by the Policyholder at inception of the Policy. These Benefit
Payout options are described hereunder. The Death Benefit shall not be payable if the
Terminal Illness Benefit has previously been paid.

Terminal Illness Benefit (applicable for Life Plus and Life plus Health Benefit Option)
‘Sum Assured on Death’ is payable upon Diagnosis of Terminal Illness of the Life
Assured, provided the Policy is in In-force Status as on the date of the Diagnosis, as per
one of the Benefit Payout options chosen by the Policyholder at inception of the Policy.
These Benefit Payout options are described hereunder.

BENEFIT PAYOUT OPTIONS

Death Benefit and Terminal Illness Benefit shall be paid as per the payout option chosen
by the Policyholder at inception and this option cannot be changed at a later date during
the tenure of the Policy These payout options are described as follows:
• Lump sum: Under this option, Sum Assured on Death shall be payable as lump
sum.
• Monthly Income: Under this option, the Sum Assured on Death is payable for
10 years in equal monthly installments at the rate of 1.1022% of the Sum Assured
on Death.
• Lump sum plus monthly income: Under this option, a percentage of the Sum
Assured on Death (as chosen by the Policyholder at inception of the policy) will
be immediately payable as lump sum and the balance shall be paid in equal
monthly installments over 10 years at the rate of 1.1022% of the balance Sum
Assured on Death.
The first instalment of monthly income will be payable after one month from the date of
death (or earlier of death / diagnosis of terminal illness, for Life Plus and Life plus Health
Options) of the life assured.
The payouts for claims with respect to Second Life and the Cover Enhancement
Options (Step Up Benefit, Life Stage Benefit and Child Education Support Benefit) shall
always be payable as lump sum.
8
Waiver of Premium Benefit (applicable for Life Plus and Life plus Health Benefit Option)
All future premiums payable under the Policy shall be waived-off (including additional
premiums paid for “Spouse Coverage”, “Return of Premiums”, “Step-up Benefit”,
“Life-stage Benefit” and “Child Education Support Benefit”, if any), if the Life Assured
suffers either an ATPD (Accidental Total & Permanent Disability) or is diagnosed with
any one of the 50 listed Critical Illnesses. The Policy must be in In-force Status as on the
date of occurrence of the ATPD or the date of Diagnosis of the listed Critical Illnesses.
The Waiver of Premium benefit shall trigger only once either on the occurrence of
ATPD or Diagnosis the Critical Illnesses whichever occurs first. The Waiver of Premium
once triggered shall apply throughout the premium payment term.
For the “Life Plus” option, the premium and benefits under the policy will be reduce to “Life”
option from the policy anniversary when the life assured has attained age 75 years.
Definitions, terms, conditions and specific exclusions for ATPD and covered Critical
Illnesses are set out in later sections of the sales literature.
Waiver of Premiums Benefit will not be applicable for Single Premium policies.
With respect to the 50 listed critical illnesses, there will be a waiting period of 90 days
from Policy inception or from any subsequent revival, whichever is later. If a claim
occurs due to the diagnosis of any of the 50 listed critical illnesses under the Life Plus
option during the waiting period, future premiums and benefits under the policy shall be
reduced to Life option under terms and conditions as applicable otherwise (i.e. same
age at entry, Sum Assured, policy term, premium payment mode, including any
discounts, if applicable).

Accelerated Critical Illness Benefit (applicable for Life plus Health Benefit Option)
If the Life assured is diagnosed with any of the covered Critical Illnesses provided the
Policy is in In-force Status on date of the Diagnosis, 25% of Basic Sum Assured (subject
to maximum of Rs. 50 Lakhs) shall be accelerated and paid immediately as lump sum.
Following the payment of this benefit, the Policy will continue with balance Sum
Assured on Death, which shall be paid upon subsequent death / diagnosis of TI of the
life assured before the end of the policy term.
Definitions, terms, conditions and specific exclusion for ATPD and covered Critical
Illnesses are set out in later sections of the sales literature.
With respect to the 50 listed critical illnesses (‘Waiver of Premium’ on diagnosis of listed
critical illnesses, and acceleration of Basic Sum Assured through ‘Accelerated Critical
Illness Benefit’), there will be a waiting period of 90 days from Policy inception or from
any subsequent revival, whichever is later. If a claim occurs due to the diagnosis of any
of the 50 listed critical illnesses under Life Plus option during waiting period, future
premiums and benefits for the plan shall be reduced to Life option for a similar contract
(i.e. same age at entry, Sum Assured, policy term, premium payment mode, including
any discounts, if applicable).

9
Maturity Benefit
This Benefit is applicable only when ‘Return of Premiums’ option is chosen under the
Policy. This Benefit is available on payment of additional premiums.
The Maturity Benefit payable under the Policy will be equal to the Sum Assured on
Maturity, provided that the Life Assured survives till the Maturity Date of the Policy. The
Policy terminates upon payment of this Maturity Benefit.

Additional Options

The Policy also offers additional options, namely, “Return of Premiums”, and “Spouse
Coverage”.
These benefits are as detailed below, and available to the Life Assured if chosen.

(A) Return of premiums

The Policyholder may opt for this Benefit at Inception of the Policy. For Policies where
‘Return of Premiums’ option is chosen, the Maturity Benefit equal to the Sum Assured
on Maturity is payable, provided that the Life Assured survives till the Maturity Date of
the Policy. This option is available with a maximum policy term of 40 years or maturity
age of 75 years last birthday, whichever is earlier.

(B) Spouse Coverage

Policyholder at inception of this Policy may choose to cover his/her spouse under the
same policy by paying additional premium, as applicable. The spouse is being referred
to as the “Second Life” and the Policyholder is being referred to as the “First Life” for
the purpose of this Benefit.
Only Death Benefit is offered to Second Life and Sum Assured on Death of Second Life
shall be payable in lump-sum only.
To avail this Benefit, Basic Sum Assured with respect to the First Life should be equal to
or greater than Rs.50 lakhs. The coverage to the Second life shall be up to 100% of Basic
Sum Assured of the First Life, subject to Our Board approved underwriting guidelines.
The second life issuance will be subject to underwriting as per underwriting guidelines.
If the Second Life is a housewife or non-earning female, the coverage for Second Life
will be restricted to up to 50% of the Basic Sum Assured chosen by the First Life,
subject to maximum of Rs.50 Lakhs.
The cover offered by ‘Waiver of Premium Benefit’, ‘Terminal Illness Benefit’ and
‘Accelerated Critical Illness Benefit’ (Life Plus and Life plus Health option) shall apply
only to the First Life and shall not be triggered on/by the Second Life.

All future premiums with respect to the second life will be waived-off on earlier
occurrence of:
• Death of the first life
• Diagnosis of terminal illness of the first life

10
 • Waiver of premium on diagnosis of ATPD of the first life
• Waiver of premium on diagnosis with any of the 50 listed Critical Illness of the
first life
Spouse Coverage will not be available if the premium paying term “Pay Till Age 60” is
chosen.
Once this option is chosen the policyholder cannot discontinue the coverage of a
particular life, unless it is due to the insured event as mentioned in this section.
The operating principles for Death Benefit and Terminal Illness Benefit when the
Spouse Cover is chosen shall be as described hereunder.

• Sum Assured on Death in respect of the First Life is

stated in the Schedule. The cover for First Life shall

cease upon payment of the Sum Assured on Death for
the First Life.
On occurrence of death of
• The cover for Second Life shall continue, with all future
the First Life (or on Diagnosis
Installment Premiums that would otherwise have
of Terminal Illness of the First
been payable under the Policy being waived for the
remainder of the Premium Payment Term*.
Plus and Life plus Health)
• On subsequent occurrence of death# of the Second
Life, the Sum Assured on Death in respect of Second
Life is payable as a lump sum and the Policy will
terminate.

• Sum Assured on Death in respect of the Second Life is

payable as a lump sum amount.
• The Policy shall continue with reduced Installment

Policy Term with respect to the First Life$

On occurrence of death of the
• On subsequent occurrence of death or Diagnosis of
Second Life preceding the
Terminal Illness of the First Life (as per applicable
First Life

option stated in the Schedule and the Policy will

terminate.

• Sum Assured on Death in respect of the First Life is

On occurrence of death of the Schedule on occurrence of death or Diagnosis of

both the lives simultaneously Terminal illness
OR occurrence of Terminal • Sum Assured on Death in respect of the Second Life
Illness of First Life and Death will be paid as lump sum on occurrence of death# of
of Second Life the Second Life
• The policy shall terminate

*Waiver of Premiums benefit will not be applicable for Single Premium policies.
$
Reduction of Premiums with respect to the First Life will not be applicable for Single Premium policies.
#
Terminal Illness Benefit is not applicable for Second Life.

11
For policies where ‘Return of premiums’ option is chosen, Maturity benefit will be
treated as described below:
• Sum Assured at Maturity i.e., Total Premiums Paid
On survival of both lives till the
in respect of both the First Life and the Second Life
Maturity Date
will be payable.
In case of death or Diagnosis of
• Sum Assured at Maturity in respect of the Second
Terminal Illness of the First Life,
Life, i.e., total additional premiums paid in respect of
and survival of the Second Life
the Second Life will be payable.
till the Maturity Date
In case of death of the Second • Sum Assured at Maturity in respect of the First Life,
Life, and survival of First Life till i.e., total premiums paid in respect of the First Life
the Maturity Date will be payable.

Cover enhancement options

The Policyholder can choose any one from following 3 Cover Enhancement Options at
inception of the policy. The total sum assured for Cover Enhancement Benefits cannot
exceed 100% of the Basic Sum Assured at any time during the term of the policy. The
issue limits for Cover Enhancement Options will be subject to Our Board approved
underwriting guidelines.

(A) Step up benefit

This Benefit must be chosen at the time of application prior to the Date of Inception of
the Policy and cannot be exercised at a later date. Once this Benefit is chosen, the
Step-up sum assured is added at every Policy Anniversary starting from first Policy
Anniversary for the next 10 years.
Step-up Sum Assured is equal to Step-up Rate multiplied by Basic Sum Assured.
Step-up Rate is fixed at 10%.
An additional premium will be charged for every addition of Step-up sum assured,
based on the Age attained by the Policyholder, and the outstanding Policy Term, at the
time.
The Step-up sum assured as well as the additional premium, both, will apply
prospectively for the remaining Premium Paying Term.
When this option has been chosen, the Death Benefit / Terminal Illness Benefit
(depending on Benefit option chosen) will be Sum Assured on Death payable in
accordance with the Death Benefit Payout option stated in the policy schedule, plus
Step-up sum assured as a lump sum.
When this option has been chosen, the Maturity Benefit (if applicable) will be Sum
Assured on Maturity i.e., Total Premiums Paid including the premiums paid in respect of
step-up benefit.
This Benefit is not eligible for payment under the ‘Accelerated Critical Illness Benefit’.
There will be no further increase in Step-up sum assured from the policy anniversary
following any claim for ‘Waiver of Premium Benefit’, or ‘Accelerated Critical Illness

12
Benefit’ with respect to the Life Assured (First Life in case Spouse Cover is chosen).
The Policyholder has the option to discontinue this Benefit at any time during the
remaining Policy Term by giving written communication before the end of the Grace
Period. Once opted out, the Policyholder cannot opt in again for this Benefit, there will
be no further addition of Step-up sum assured and the Policy will continue with the
Step-up sum assured cumulated till the applicable policy anniversary.
This Benefit will be available subject to the following additional conditions:
• Availability of this Benefit is subject to Our underwriting policy
• The Life Assured is underwritten as a standard life on the Date of Inception of
the Policy.
• Basic Sum Assured should be equal to or greater than Rs.50 Lakh.
• This Benefit will be available only with ‘Regular pay’, with minimum Policy Term
of 20 years.
• This Benefit will not be applicable on the Second Life in case ‘Spouse Coverage’
has been chosen.
• Premium payment mode cannot be changed once chosen, as long as Step up
Benefit is in In-force Status
• In case the Life Assured is underwritten as a non-standard life at Revival, future
increase in the sum assured shall cease.
• The additional Benefit ‘Step up Benefit’ cannot be opted alongside ‘Life Stage
Benefit’ and ‘Child Education Support Benefit’.

(B) Life stage benefit

Under this Benefit, the Policyholder may opt to increase the sum assured at various Life
stages mentioned hereunder. Life stage sum assured can be added without further
underwriting on any of the below specified events in the life of the Life Assured:
• 1st Marriage: 50% of Basic Sum Assured subject to a maximum of Rs. 50 Lakhs
• Birth of 1st child: 25% of Basic Sum Assured subject to a maximum of Rs. 25 Lakhs
• Birth of 2nd child: 25% of Basic Sum Assured subject to a maximum of Rs. 25 Lakhs
• Home loan taken by the Life Assured after the Date of Commencement of Risk
(only once during policy term): 50% of Basic Sum Assured subject to a maximum
of Rs. 50 Lakh
The maximum additional sum assured put together under all these events will be
Rs. 50 Lakhs.
The Policyholder must indicate on or before the Date of Inception of the Policy, if he/she
wishes to avail the Life stage Benefit and once chosen, this Benefit can be exercised within
six months from the date of occurrence of the above specified life stages.
Premium for the Life stage Benefit will be charged separately, in addition to the base
premium, for every addition of Life stage sum assured. Premium for Life stage Benefit
shall be based on the attained Age of the Life Assured, Life stage sum assured,
outstanding Policy Term at the time of addition of the Life stage sum assured and the
Benefit option chosen at Date of Inception of the Policy.

13
The Life stage sum assured as well as the premium for Life stage Benefit, will apply
prospectively for the remaining Premium Payment Term.
When this Benefit has been chosen, Death Benefit / Terminal Illness Benefit (depending
on Benefit option chosen) will be Sum Assured on Death payable in accordance with the
Death Benefit payout option stated in the Schedule, plus the applicable Life stage sum
assured, as a lump sum.
When this option has been chosen, the Maturity Benefit (if applicable) will be Sum
Assured on Maturity i.e., Total Premiums Paid including the premiums paid in respect of
life stage benefit.
This Benefit is not eligible for payment under the ‘Accelerated Critical Illness Benefit’
There will be no further increase in the Life stage sum assured post any claims in
respect of ‘Waiver of Premium Benefit’, or ‘Accelerated Critical Illness Benefit’.
In addition, this Benefit will be available subject to the following conditions:
• Availability of this Benefit is subject to Our underwriting policy.
• The Life Assured is underwritten as a standard life on the Date of Inception of
the Policy.
• Basic Sum Assured should be equal to or greater than Rs.50 Lakh.
• This Benefit will be available only with ‘Regular pay’ and the minimum
outstanding Policy Term at the time of exercising any Life stage Benefit should
be 10 years.
• The Age of the Life Assured is less than or equal to 45 years at the time of the
above mentioned life stages.
• This Benefit will not be applicable on the Second Life in case ‘Spouse Coverage’
has been chosen.
• The additional Benefit ‘Life Stage Benefit’ cannot be opted alongside ‘Step up
Benefit’ and ‘Child Education Support Benefit’.

(C) Child Education Support benefit

Under this Benefit, the Policyholder may opt to increase the sum assured with a specific
focus to provide for the cost of education of one child of the Life Assured. This Benefit
can only be opted on or before the Date of Inception of the Policy.
Additional premiums will be charged from the Date of Inception of this benefit.
Child Education Support benefit sum assured at inception is equal to estimated
outstanding total cost of education, and reduces at every Policy Anniversary as per the
schedule I and Benefit Illustration, provided no claim for death or Diagnosis of Terminal
Illness (if Benefit option chosen is Life Plus and Life plus Health) of the Life Assured is
admitted, during the term of Child Education Support Benefit.
This option can be chosen only if the nominated child has 5 to 19 years of education left
for completion of graduate degree. This additional sum assured is subject to a minimum
of Rs 10 lakh and a maximum of Rs 1 cr.
Outstanding total cost of education is calculated using current annual cost of education
and number of years left out of total years of education. Total years of education is
assumed to be 19 (3 years of primary school, 12 years of formal school and 4 years of 14
graduation, assuming annual progression from one grade to the next). Current annual
cost of education (chosen by policy holder at inception) is assumed to be increasing at
a rate of 10% per year for the term of this benefit.

Term of Child Education Support Benefit (subject to term of basic benefit option)

Current school grade For Regular pay For Limited pay

Nursery 19 19
Junior KG 18 18
Senior KG 17 17
I 16 16
II 15 15
III 14 14
IV 13 13
V 12 12
VI 11 11
VII 10 10
VIII 9 0
IX 8 0
X 7 0
XI 6 0
XII 5 0
Graduation 1 0 0
Graduation 2 0 0
Graduation 3 0 0
Graduation 4 0 0

Premium paying term of Child Education Support Benefit

For Regular pay For Limited pay

Fixed at 5 years

After completion of premium paying term of Child Education Support Benefit, the
subsequent premiums will be reduced to the basic benefit option chosen.
When this Benefit has been chosen, the Death Benefit / Terminal Illness Benefit
(depending on Benefit option chosen) payable during term of Child Education Support
Benefit will be Sum Assured on Death payable in accordance with the Death Benefit
Payout option stated in the Schedule, plus the Child Education Support sum assured, as
specified in the Schedule I/Benefit Illustration, as a lump sum.
This Benefit terminates upon payout of the Child Education Support sum assured on
Death/Diagnosis of Terminal Illness (if applicable, as per chosen benefit option) or upon
expiry of the term of Child Education Support Benefit. 15
Child education support benefit is an additional cover on the life of the parent. In the
event of death of the child during the term of the Child education support benefit the
cover shall continue as per original schedule.
This Benefit is not eligible for payment under the ‘Accelerated Critical Illness Benefit’
In addition, this Benefit will be available subject to the following conditions:
• Availability of this Benefit is subject to Our underwriting policy.
• Basic Sum Assured should be equal to or greater than Rs.50 Lakhs.
• Child Education Support Benefit will not be available for Policies where ‘Return
of Premiums’ option is chosen.
• This benefit will not be available with ‘Single Pay’
• This Benefit will not be applicable on the Second Life in case ‘Spouse Coverage’
has been chosen.
• The additional Benefit ‘Child Education Support Benefit’ cannot be opted
alongside ‘Step up Benefit’ and ‘Life stage Benefit’.
• For Regular Pay option, the term available for this benefit will range from 5 to 19
years, subject to the term of the basic benefit option.
• For Limited Pay option, the term available for this benefit will range from 10 to 19
years, subject to the term of the basic benefit option.

Sum assured on death

The Sum Assured on Death shall be higher of:
• 10 times the Annualized Premium for Limited Pay/Regular Pay and 125% of
Premium for Single Pay
• Basic Sum Assured, which is the absolute amount assured to be paid on death or
Diagnosis of Terminal Illness (if applicable)
• 105% of all premiums paid till the date of death or Diagnosis of Terminal Illness
(if applicable)

Sum assured on maturity

Sum assured at maturity is the Benefit which is guaranteed to be paid on the Maturity
Date if You have opted for Return of Premiums Option under the Policy, and is equal to
Total Premiums paid.
Total Premiums Paid means the total of all the Premiums received under the base
product, excluding any extra premium and taxes, if collected explicitly.

Non-forfeiture Benefits

Lapse
Without Return of Premiums Policies
If the premium is not paid either on the premium due date or within the grace period, all
benefits under the policy will cease.
Single Pay Policies shall not lapse.
No benefits will be paid when the policy is in lapsed status. A lapsed policy can be
revived as defined in the section for Revival.
16
Being a pure protection option, there is no surrender value under any of the premium
paying term options, i.e. Single Pay, Limited Pay and Regular Pay. However, for Limited
and Single Pay we will pay Unexpired Risk Premium Value as mentioned below:

Unexpired Risk Premium :

For Limited Pay : We will pay the unexpired premium value upon:
• Policyholder voluntarily closing the policy during the policy term for Inforce and
fully paid up policies
• For lapsed policies: Earlier of-
o Death during revival period after date of lapse
o End of the revival period
o Policyholder voluntarily closing the policy during revival period

For Single Pay: If the policyholder voluntarily opts to close the policy during the policy
term, we will pay the unexpired premium value, where:
Unexpired Premium Value =

Total Number of Months Remaining to Maturity

70% x x Total Premium Paid
Total Number of Months in the Policy Term

If Spouse Coverage is opted: The total premiums paid with respect to each life
considered in calculation of unexpired risk premium value are premiums (including
premiums which are waived and paid by insurance company, if any) with respect to
each life excluding extra premiums and taxes, if any.

If Spouse Coverage is not opted: The total premiums paid considered in calculation of
unexpired risk premium value are premiums excluding extra premium and taxes, if any.

With Return of Premiums Policies

For Limited and Regular Pay : If the first full Policy year premium is not paid the Policy
shall lapse at the end of the Grace Period and the risk cover and rider benefits, if any,
will cease immediately.
Single Pay policies shall not lapse.
No Benefits will be paid when the Policy is in Lapsed status. A Policy in Lapsed status
can be revived as specified in the section for Revival.
If a Lapsed policy is not revived at the end of the Revival Period, the Policy will be
terminated.

17
Surrender Benefit

With Return of Premiums Policies:

For Regular Pay and Limited Pay :
If all due premiums have been paid for first full policy year, the policy shall acquire
Special Surrender Value after completion of first policy year.
If all due premiums have been paid for at least two full policy years, the policy shall
acquire a guaranteed surrender value.
The policy will be terminated after payment of surrender value.
The surrender value payable shall be higher of guaranteed surrender value and special
surrender value

For Single Pay: The policy shall acquire guaranteed surrender value and special
surrender value, as applicable, immediately on date of commencement of risk.

Guaranteed Surrender Value (GSV) = Total Premiums Paid * GSV factor( For further
details on factors, please refer to www.pnbmetlife.com )
If Spouse Coverage is opted: The total premiums paid with respect to each life
considered in calculation of GSV are premiums (including premiums which are waived
and paid by insurance company, if any) with respect to each life excluding extra
premiums and taxes, if any.
If Spouse Coverage is not opted: Total premiums paid means total of all the premiums
paid under the base product, excluding any extra premium and taxes, if collected
explicitly.
Special Surrender Value (SSV) is the surrender value specified by Us on receipt of a
request for surrender. SSV is not guaranteed and the Company can change these SSV
factors during the term of the Policy in accordance with the applicable Regulations
issued by IRDAI from time to time.

18
Reduced Paid-up Value
If a policy has acquired Surrender Value and no future instalment premiums are paid, the
policy will continue as a paid up policy with reduced benefits (Basic Sum Assured will
be reduced to Paid-up Basic Sum Assured), however the policyholder shall have the
option to surrender the policy. A paid-up policy can be revived as defined in the section
for Revival.
If the policyholder continues the policy as a reduced paid-up policy the reduced
benefits given below shall become payable
Reduced Death Benefit (applicable for Life, Life Plus and Life plus Health Option)
‘Paid-up Sum Assured on Death’ is payable upon death of the Life Assured, as per one
of the Benefit Payout options chosen by the Policyholder at inception of the Policy. The
policy terminates upon payment of this benefit.
The Reduced Death Benefit shall not be payable if the Reduced Terminal Illness Benefit
has previously been paid.
Reduced Terminal Illness Benefit (applicable for Life Plus and Life plus Health Option)
‘Paid-up Sum Assured on Death’ is payable upon Diagnosis of terminal Illness of life
assured, as per one of the Benefit Payout options chosen by the Policyholder at
inception of the Policy. The policy terminates upon payment of this benefit.
Waiver of Premium Benefit (applicable for Life Plus and Life plus Health Option)
No Waiver of Premium Benefit shall be applicable if the Life Assured suffers an ATPD
OR is diagnosed with Critical Illnesses.
Accelerated Critical Illness Benefit (applicable for Life plus Health Option)
{25% of the of the Basic Sum Assured (subject to maximum amount of Rs. 50 lakh)} * t/n
will be accelerated and paid immediately as lump sum if the life assured is diagnosed
with any one of the 50 listed Critical Illnesses. Balance Paid-Up Sum Assured on Death
shall be paid upon subsequent occurrence of death / diagnosis of TI of the life assured
before the end of the policy term.
Where, “t” refers the Number of Installment Premiums paid and “n” refers the Number
of Installment Premiums payable during the Premium Payment Term.

19
If Step Up Benefit is taken:
On occurrence of death or diagnosis of terminal illness (as per applicable benefit
option) of the life assured, the paid-up benefit will be :
Paid-up sum assured on death plus paid-up sum assureds with respect to each step-up
benefit depending on the term applicable to the step-up benefit and the number of
premiums paid for that step-up benefit.
Paid-up sum assured for each step-up benefit is defined as:
Step-up Sum Assured * (Number of Installment Premiums paid for that step-up benefit/
Number of Installment Premiums payable during the Premium Payment Term for that
step-up benefit).

If Life Stage Benefit is taken:

On occurrence of death or diagnosis of terminal illness (as per applicable benefit
option) of the life assured, the paid-up benefit will be
Paid-up sum assured on death plus paid-up sum assureds with respect to each life stage
benefit depending on the term applicable to the life stage benefit and the number of
premiums paid for that life stage benefit.
Paid-up sum assured for each life stage benefit is defined as:
Life Stage Benefit Sum Assured * (Number of Installment Premiums paid for that life
stage benefit/ Number of Installment Premiums payable during the Premium Payment
Term for that life stage benefit).

If ‘Spouse coverage’ is in effect in the policy, reduced benefits would be as

described below:

• Paid –up Sum Assured on Death in respect of the

On occurrence of death of the chosen.

First Life (or on Diagnosis of • On subsequent occurrence of death# of the Second
Terminal Illness of the First Life – Life before the end of the Policy Term, the Paid-up
for Life Plus and Life plus Health Sum Assured on Death in respect of the Second Life
is payable as a lump sum amount and the Policy will
terminate.

• Paid-up Sum Assured on Death in respect of the

Second Life is payable as a lump sum amount
On occurrence of death of the • On subsequent occurrence of death or Diagnosis of
Second Life preceding the First Terminal Illness of the First Life (as per applicable
Life

Payout option chosen and the Policy will terminate.

On occurrence of death of both
the lives simultaneously • Paid-up Sum Assured on Death in respect of both
OR occurrence of Terminal First Life and Second Life is payable and the policy
Illness of First Life and Death of will be terminated.
Second Life simultaneously

20
 1. The ‘Paid-up Sum Assured on Death’ is higher of :
• 10 times the Annualized Premium*(t/n)
• Paid-Up Basic sum assured, which is the absolute amount assured to be paid on death
or diagnosis of terminal illness (if applicable)
• 105% of total premiums paid up to the date of death or diagnosis of terminal illness (if aplicable)
IF SPOUSE COVERAGE IS IN EFFECT WITHIN THE POLICY, THAN 2 AND 3 WOULD ALSO
BE APPLICABLE
2. The ‘Paid-Up Sum Assured on Death’ in repect of second life is higher of :
• 10 times the Annualized Premium in respect of Second Life* (t/n)
• Paid-Up Basic sum assured, which is the absolute amount assured to paid on death in
repect of Second LIfe
• 105% of total premiums paid in repect of Second Life up to the date of death

3. The ‘Paid-Up Sum Assured on Death’ in respect of both the First Life and the Second
Life is higher of :
• 10 times the Annualized Premium in respect of both the First Life and the Second Life* (t/n)
• Paid-Up Basic sum assured, which is the absolute amount assured to paid on death or
diagnosis of terminal illness (if applicable) in repect of Second Life#
• 105% of total premiums paid in repect of both the First Life and Second Life# up to the
date of death or diagnosis of terminal illness (if applicable)
Where ‘Paid-Up Basic Sum Assured on Death is defined as:
Baisc sum assured* (t/n)
Where, “t” refers the Number of Installment Premiums paid and “n” refers the Number of
Installment Prremiums payble during the Premium Payment Term.

#
Terminal Illness Benefit is not applicable for Second Life
Reduced Maturity Benefit
With Return of Premium: Paid-Up Sum Assured on Maturity is payable, where paid-up
sum assured on maturity is 100% of total premiums paid.
Without Return of Premium: Paid up Sum Assured on Maturity is zero.
The Policy terminates upon payment of this Benefit.
Where Step up benefit and Life stage benefit are chosen, paid-up Sum Assured on
Maturity is 100% of total premiums paid in respect of basic death benefit and the Step
up benefit and Life stage benefit respectively.
If ‘Spouse coverage’ and ‘Return of premiums’ is in effect in the policy, reduced benefits
would be as described below:

• Paid-up Sum Assured at Maturity in respect of both

On survival of both lives till the lives, i.e., 100% of total premiums paid in respect of
Maturity Date both the First Life and the Second Life till the policy
becomes paid-up.
In case of death or Diagnosis of • Paid-up Sum Assured at Maturity in respect of the
Terminal Illness of the First Life, second life, i.e., 100% of total additional premiums
and survival of the Second Life paid for Second Life cover till the policy becomes
till the Maturity Date paid-up.
In case of death of the Second • Paid-up Sum Assured at Maturity in respect of the
Life, and survival of First Life till First Life, i.e., 100% of total premiums paid for First
the Maturity Date Life cover till the policy becomes paid-up
The Policy terminates immediately upon payment of this Benefit.
21
 Other benefits

Available Online
PNB MetLife Mera Term Plan Plus is available for sale through online mode.

Flexible premium payment modes & modal factors

You may select to pay premiums by Yearly, Half Yearly, Quarterly or Monthly mode
subject to the minimum annualized premium under each mode.
Modal factors on annualized premium will be applicable as per the table below:
Premium Paying Mode Modal Factor
Annual 1
Half Yearly 0.5131
Quarterly 0.2605
Monthly8 0.0886
Alteration between different Premium Payment Modes is allowed at any Policy
Anniversary on Your request, subject to Clause ‘Alteration of Premium Payment Mode’
mentioned below
Monthly mode is available for standing instruction/direct debit options (including
8

Automated Clearing House - ACH).

Alteration of the Premium payment mode

You may change the Premium Payment Mode provided that You give Us a written
request. The change in Premium Payment Mode will be applied only from the Policy
Anniversary following the date of Your request. You must comply with the applicable
minimum premium criteria on account of mode change. Premium payment mode
cannot be changed if the ‘Step up Benefit is in In-force Status.

Benefits for higher sum assured

Special premium rates will be offered upon choosing higher sum assured, depending on
sum assured slabs.

Loans
There is no policy loan available in this plan.

Riders
The following riders will be offered along with this product
S.No Rider Name
1 PNB MetLife Accidental Death Benefit Rider Plus (117B020V04)
2 PNB MetLife Serious Illness Rider (117B021V04)
3 PNB MetLife Critical Illness Rider (117B023V03)
4 PNB MetLife Accidental Disability Benefit Rider (117B022V03)

22
The riders shall be subject to following:
• Rider Sum Assured limits shall be as per the respective rider type and limits
• Premium for all health riders put together shall be subject to a ceiling of 100% of
the premium of the base product.
• Premium for all non-health riders put together shall be subject to a ceiling of 30%
of the premium of the basic product.
• Premium paying term for riders will be less than or equal to the base premium
paying term.
• Rider can be attached with the product as per terms & conditions of the relevant
rider.
• Rider will not be offered if the term of the rider exceeds outstanding term under
the base policy.

Grace period for other than single premium policies

Grace Period for other than single premium policies the time granted by us from the due
date of payment of Instalment premium, without any penalty or late fee, during which
time the policy is considered to be in-force with the risk cover without any interruption,
as per the terms & conditions of the policy. The grace period for payment of the
Instalment premium for all types of life insurance policies shall be 15 days, where the
policyholder pays the premium on a monthly basis and 30 days in all other cases.

Revival
A Policy that has Lapsed or that has been converted to a Paid-up Policy Status may be
revived during the Revival Period by giving Us written notice to revive the Policy,
provided that:
i. All due arrears of Instalment Premiums along with interest at Prevailing Rate of
Interest, if any, are received by Us in full.
ii. We may change this revival interest rate from time to time. Currently, We charge
interest rate 8% p.a. compounded annually.
iii. The rate of interest is calculated as the 10 Year G-Sec rate as on 1st April plus 50
basis points, rounded up to the nearest 50 basis points. We shall review the interest
rate on an annual basis in April based on the prevailing 10 Year G-Sec rate.
However, under special circumstances where the prevailing 10 Year G-Sec rate is
changing in excess of 200 basis points from the G-Sec rate used for calculating the
current interest rate, We shall review the rate based on the prevailing 10 Year
G-Sec rate.
iv. The Revival of the Policy will be subject to Board approved underwriting policy. A
surrendered Policy cannot be revived.
v. We may revive the Lapsed Policy by imposing such extra premium as it deems fit
as per the Board approved underwriting policy.

Termination
The Policy will be terminated on the occurrence of the earliest of the following:
23
 • The date on which surrender benefits are settled under the policy.
• At the expiry of the revival period as defined above, if the Policy has not been
revived and provided the said Policy has not acquired any Paid- Up Value.
• On payment of the Death or Terminal Illness Benefit or Maturity Benefit (as
applicable), whichever applicable
• On Free Look Cancellation

Terms and conditions

Waiting Period and Survival Period

With respect to the 50 listed critical illnesses (‘Waiver of Premium’ on diagnosis of listed
Critical illnesses, and acceleration of Basic Sum Assured through ‘Accelerated Critical
Illness Benefit’), a waiting period of 90 days from the Date of Inception of the Policy or
from the date of Revival of the Policy shall be applicable for a claim to be admissible
under this Policy.

Free Look Period

Please go through the terms and conditions of your Policy carefully. If you have any
objections to the terms and conditions of your Policy, you may cancel the Policy by
giving a written notice to us within 30 days beginning from the date of receipt of Policy
document whether received electronically or otherwise, stating the reasons for your
objection and you will be entitled to a refund of the Premium paid, subject only to a
deduction of a proportionate risk premium for the period of cover and expenses, if any,
incurred on medical examination and stamp duty charges.

Tax benefits
The tax benefits under this plan may be available as per the prevailing tax laws in India
and amendments thereto from time to time. In respect of any payment made or to be
made under or in relation to this Policy, We will deduct or charge or recover taxes
including GST (service tax and other levies as applicable) at such rates as notified by the
government or such other body authorized by the government from time to time. Tax
laws are subject to change.

Suicide exclusion
In case of death due to suicide within 12 months from the date of commencement of risk
under the policy or from the date of revival of the policy, as applicable, the nominee or
beneficiary of the policyholder 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.
Under Spouse Coverage Option, in case of suicide death of First Life, the cover for First
Life shall terminate on payment of the above Benefits, where the premium paid is the
premium paid with respect to First Life and the cover for Second Life shall continue with
the reduced premium to the extent of premium payable for Second Life. In such case,

24
the Waiver of Premium Benefit shall not be applicable.
Under Spouse Coverage Option, in case of suicide death of Second Life, the cover for
Second Life shall terminate on payment of the above benefits, where the premium paid
is the premium paid with respect to Second Life and the cover for First Life shall
continue with the reduced premium to the extent of premium payable for First Life.

Common Exclusions for Accidental Total Permanent Disability and Diagnosis of 50

listed Critical Illnesses
No benefits shall be applicable if Accidental Total Permanent Disability or Critical
Illness is caused or aggravated directly or indirectly, wholly or partly by any one of the
following. These exclusions are in addition to the exclusions listed in the Base Policy, if any.
• Intentional self-inflicted injury, attempted suicide.
• Any pre-existing condition.
• War, terrorism, invasion, act of foreign enemy, hostilities (whether war be
declared or not), armed or unarmed truce, civil war, martial law, mutiny,
rebellion, revolution, insurrection, military or usurped power, riot or civil
commotion, strikes
• Taking part in any naval, military or air force operation during peace time.
• Participation by the insured person in an assault, a criminal offence, an illegal
activity or any breach of law with criminal intent.
• Engaging in or taking part in professional sport(s) or any hazardous pursuits,
including but not limited to, diving or riding or any kind of race; underwater
activities involving the use of breathing apparatus or not; martial arts; hunting;
mountaineering; parachuting; bungee jumping.
• Alcohol or Solvent abuse or taking of Drugs, narcotics or psychotropic
substances unless taken in accordance with the lawful directions and
prescription of a registered medical practitioner.
• Participation by the insured person in any flying activity, except as a bonafide,
fare paying passenger or pilot and cabin crew of a commercially licensed airline.
• Nuclear contamination: The radioactive, explosive or hazardous nature of
nuclear fuel materials or property contaminated by nuclear fuel materials or
accident arising from such nature.
Pre-existing Disease means any condition, ailment, injury or disease:
a) That is/are diagnosed by a physician not more than 36 months prior to the date of
commencement of the policy issued by the insurer or its reinstatement or
b) For which medical advice or treatment was recommended by, or received from,
a physician not more than 36 months prior to the date of commencement of the
policy issued by the insurer or its reinstatement

Additional exclusions specific Diagnosis of 50 listed Critical Illnesses

Apart from the disease specific exclusions given along with definitions of diseases
below and the exclusions stated above, no benefit will be payable if the critical illness is
caused or aggravated directly or indirectly by any of the following:
• Any disease occurring within 90 days of the start of coverage (i.e. during the

25
 waiting period) or date of reinstatement whichever is later.
• Any external congenital condition.

For Waiver of premium due to Accidental Total Permanent Disability, the following
definition shall apply
The Life assured meeting with an accident resulting in a disability within 180 days from
the happening of such accident and independently of all other causes. As a result of
such disability, life assured should be subject to one (or more) of the following
impairments due to injury,:
• Total and irrecoverable loss of sight of both eyes.
• Amputation or loss of use, of both hands at or above the wrists or
• Amputation or loss of use, of both feet at or above the ankles or
• Amputation or loss of use, of one hand at or above the wrist and one foot at or
above the ankle
To qualify for "loss of use" under any of the above, life assured has to be incapacitated
to such an extent that he is unable to perform three (3) or more Activities of Daily Living
as defined either with or without the use of mechanical equipment, special devices or
other aids and adaptations in use for disabled persons.

Activities of Daily Living are-

• Washing: the ability to wash in the bath or shower (including getting into and out
of the bath or shower) or wash satisfactorily by other means
• Dressing: the ability to put on, take off, secure and unfasten all garments and, as
appropriate, any braces, artificial limbs or other surgical appliances
• Transferring: the ability to move from a bed or an upright chair or wheelchair and
vice versa.
• Mobility: The ability to move indoors from room to room on level surfaces
• Toileting: the ability to use the lavatory or otherwise manage bowel and bladder
functions so as to maintain a satisfactory level of personal hygiene
• Feeding: the ability to feed oneself once food has been prepared and made
available
The above disability must have lasted, without interruption, for at least 180 consecutive
days and must be deemed permanent by a panel of medical practitioners appointed by
the Company
Loss of use of limbs means total, permanent and irreversible loss of all functional use of
a limb or organ. Limb means the whole hand at or above the wrist or the whole foot at
or above the ankle
Loss of sight - means total, permanent and irreversible loss of all vision in both eyes as
a result accident (as applicable). The diagnosis must be clinically confirmed by an
appropriate consultant. The blindness must not be correctable by aides or surgical
procedures.

Definitions for Critical Illnesses

26
1. Cancer of Specified Severity
A malignant tumor characterized by the uncontrolled growth and spread of malignant
cells with invasion and destruction of normal tissues. This diagnosis must be supported
by histological evidence of malignancy. The term cancer includes leukemia, lymphoma
and sarcoma.
The following are excluded –
• All tumors which are histologically described as carcinoma in situ, benign,
pre-malignant, borderline malignant, low malignant potential, neoplasm of
unknown behavior, or non-invasive, including but not limited to: Carcinoma in
situ of breasts, Cervical dysplasia CIN-1, CIN -2 and CIN-3.
• Any non-melanoma skin carcinoma unless there is evidence of metastases to
lymph nodes or beyond;
• Malignant melanoma that has not caused invasion beyond the epidermis;
• All tumors of the prostate unless histologically classified as having a Gleason score
greater than 6 or having progressed to at least clinical TNM classification T2N0M0
• All Thyroid cancers histologically classified as T1N0M0 (TNM Classification) or
below;
• Chronic lymphocytic leukaemia less than RAI stage 3
• Non-invasive papillary cancer of the bladder histologically described as
TaN0M0 or of a lesser classification,
• All Gastro-Intestinal Stromal Tumors histologically classified as T1N0M0 (TNM
Classification) or below and with mitotic count of less than or equal to 5/50 HPFs;

2. Myocardial Infarction - First Heart Attack of Specific Severity

The first occurrence of heart attack or myocardial infarction, which means the death of
a portion of the heart muscle as a result of inadequate blood supply to the relevant area.
The diagnosis for Myocardial Infarction should be evidenced by all of the following
criteria:
• A history of typical clinical symptoms consistent with the diagnosis of acute
myocardial infarction (For e.g. typical chest pain)
• New characteristic electrocardiogram changes
• Elevation of infarction specific enzymes, Troponins or other specific biochemical
markers.
The following are excluded:
• Other acute Coronary Syndromes
• Any type of angina pectoris
• A rise in cardiac biomarkers or Troponin T or I in absence of overt ischemic heart
disease OR following an intra-arterial cardiac procedure.

3. Open Chest CABG

The actual undergoing of heart surgery to correct blockage or narrowing in one or more
coronary artery(s), by coronary artery bypass grafting done via a sternotomy (cutting
through the breast bone) or minimally invasive keyhole coronary artery bypass

27
procedures. The diagnosis must be supported by a coronary angiography and the
realization of surgery has to be confirmed by a cardiologist.
The following are excluded:
• Angioplasty and/or any other intra-arterial procedures

4. Open Heart Replacement and Repair of Heart Valves

The actual undergoing of open-heart valve surgery is to replace or repair one or more
heart valves, as a consequence of defects in, abnormalities of, or disease affected
cardiac valve(s). The diagnosis of the valve abnormality must be supported by an
echocardiography and the realization of surgery has to be
confirmed by a specialist medical practitioner. Catheter based techniques including but
not limited to, balloon valvotomy/valvuloplasty are excluded

5. Coma of Specified Severity

A state of unconsciousness with no reaction or response to external stimuli or internal
needs. This diagnosis must be supported by evidence of all of the following:
• No response to external stimuli continuously for at least 96 hours;
• Life support measures are necessary to sustain life; and
• Permanent neurological deficit which must be assessed at least 30 days after the
onset of the coma.
The condition has to be confirmed by a specialist medical practitioner. Coma resulting
directly from alcohol or drug abuse is excluded.

6. Kidney Failure Requiring Regular Dialysis

End stage renal disease presenting as chronic irreversible failure of both kidneys to
function, as a result of which either regular renal dialysis (haemodialysis or peritoneal
dialysis) is instituted or renal transplantation is carried out. Diagnosis has to be
confirmed by a specialist medical practitioner.

7. Stroke Resulting In Permanent Symptoms

Any cerebrovascular incident producing permanent neurological sequelae. This
includes infarction of brain tissue, thrombosis in an intracranial vessel, haemorrhage and
embolisation from an extracranial source. Diagnosis has to be confirmed by a specialist
medical practitioner and evidenced by typical clinical symptoms as well as typical
findings in CT Scan or MRI of the brain. Evidence of permanent neurological deficit
lasting for at least 3 months has to be produced
The following are excluded:
• Transient ischemic attacks (TIA)
• Traumatic injury of the brain
• Vascular disease affecting only the eye or optic nerve or vestibular functions

8. Major Organ/Bone Marrow Transplant

The actual undergoing of a transplant of:

28
 • One of the following human organs: heart, lung, liver, kidney, pancreas, that
resulted from irreversible end-stage failure of the relevant organ, or
• Human bone marrow using haematopoietic stem cells. The undergoing of a
transplant has to be confirmed by a specialist medical practitioner
• The following are excluded:
• Other stem-cell transplants
• Where only islets of langerhans are transplanted

9. Permanent Paralysis of Limbs

Total and irreversible loss of use of two or more limbs as a result of injury or disease of
the brain or spinal cord. A specialist medical practitioner must be of the opinion that the
paralysis will be permanent with no hope of recovery and must be present for more than
3 months.

10. Motor Neuron Disease with Permanent Symptoms

Motor neuron disease diagnosed by a specialist medical practitioner as spinal muscular
atrophy, progressive bulbar palsy, amyotrophic lateral sclerosis or primary lateral
sclerosis. There must be progressive degeneration of corticospinal tracts and anterior
horn cells or bulbar efferent neurons. There must be current significant and permanent
functional neurological impairment with objective evidence of motor dysfunction that
has persisted for a continuous period of at least 3 months.

11. Multiple Sclerosis with Persisting Symptoms

The unequivocal diagnosis of Definite Multiple Sclerosis confirmed and evidenced by
all of the following:
• Investigations including typical MRI findings which unequivocally confirm the
diagnosis to be multiple sclerosis and
• There must be current clinical impairment of motor or sensory function, which
must have persisted for a continuous period of at least 6 months.
• Neurological damage due to SLE is excluded.

12. Benign Brain Tumor

Benign brain tumor is defined as a life threatening, non-cancerous tumor in the brain,
cranial nerves or meninges within the skull. The presence of the underlying tumor must
be confirmed by imaging studies such as CT scan or MRI.
This brain tumor must result in at least one of the following and must be confirmed by
the relevant medical specialist.
• Permanent Neurological deficit with persisting clinical symptoms for a
continuous period of at least 90 consecutive days or
• Undergone surgical resection or radiation therapy to treat the brain tumor.
• The following conditions are excluded:
Cysts, Granulomas, malformations in the arteries or veins of the brain,

29
 hematomas, abscesses, pituitary tumors, tumors of skull bones and tumors of the
spinal cord.

13. Blindness
Total, permanent and irreversible loss of all vision in both eyes as a result of illness or
accident.
The Blindness is evidenced by:
• Corrected visual acuity being 3/60 or less in both eyes or ;
• The field of vision being less than 10 degrees in both eyes.
The diagnosis of blindness must be confirmed and must not be correctable by
aids or surgical procedure

14. Deafness
Total and irreversible loss of hearing in both ears as a result of illness or accident. This
diagnosis must be supported by pure tone audiogram test and certified by an Ear, Nose
and Throat (ENT) specialist. Total means “the loss of hearing to the extent that the loss
is greater than 90decibels across all frequencies of hearing” in both ears.

15. End Stage Lung Failure

End stage lung disease, causing chronic respiratory failure, as confirmed and evidenced
by all of the following:
• FEV1 test results consistently less than 1 litre measured on 3 occasions 3 months
apart; and
• Requiring continuous permanent supplementary oxygen therapy for hypoxemia;
and
• Arterial blood gas analysis with partial oxygen pressure of 55mmHg or less
(PaO2 < 55mmHg); and
• Dyspnea at rest.

16. End Stage Liver Failure

Permanent and irreversible failure of liver function that has resulted in all three of the
following:
• Permanent jaundice; and
• Ascites; and
• Hepatic encephalopathy.
Liver failure secondary to drug or alcohol abuse is excluded.

17. Loss of Speech

Total and irrecoverable loss of the ability to speak as a result of injury or disease to the
vocal cords. The inability to speak must be established for a continuous period of 12
months. This diagnosis must be supported by medical evidence furnished by an Ear,
Nose, Throat (ENT) specialist.

18. Loss of Limbs

30
The physical separation of two or more limbs, at or above the wrist or ankle level limbs
as a result of injury or disease. This will include medically necessary amputation
necessitated by injury or disease. The separation has to be permanent without any
chance of surgical correction. Loss of Limbs resulting directly or indirectly from
self-inflicted injury, alcohol or drug abuse is excluded.

19. Major Head Trauma

Accidental head injury resulting in permanent Neurological deficit to be assessed no
sooner than 3 months from the date of the accident. This diagnosis must be supported
by unequivocal findings on Magnetic Resonance Imaging, Computerized Tomography,
or other reliable imaging techniques. The accident must be caused solely and directly
by accidental, violent, external and visible means and independently of all other causes.
The Accidental Head injury must result in an inability to perform at least three (3) of the
following Activities of Daily Living either with or without the use of mechanical
equipment, special devices or other aids and adaptations in use for disabled persons.
For the purpose of this benefit, the word “permanent” shall mean beyond the scope of
recovery with current medical knowledge and technology.
• The Activities of Daily Living are:
• Washing: the ability to wash in the bath or shower (including getting into and out
of the bath or shower) or wash satisfactorily by other means;
• Dressing: the ability to put on, take off, secure and unfasten all garments and, as
appropriate, any braces, artificial limbs or other surgical appliances;
• Transferring: the ability to move from a bed to an upright chair or wheelchair and
vice versa;
• Mobility: the ability to move indoors from room to room on level surfaces;
• Toileting: the ability to use the lavatory or otherwise manage bowel and bladder
functions so as to maintain a satisfactory level of personal hygiene;
• Feeding: the ability to feed oneself once food has been prepared and made available.
The following are excluded:
• Spinal cord injury

20. Primary (Idiopathic) Pulmonary Hypertension

An unequivocal diagnosis of Primary (Idiopathic) Pulmonary Hypertension by a
Cardiologist or specialist in respiratory medicine with evidence of right ventricular
enlargement and the pulmonary artery pressure above 30 mm of Hg on Cardiac
Cauterization. There must be permanent irreversible physical impairment to the degree
of at least Class IV of the New York Heart Association Classification of cardiac
impairment
The NYHA Classification of Cardiac Impairment are as follows:
• Class III: Marked limitation of physical activity. Comfortable at rest, but less than
ordinary activity causes symptoms.
• Class IV: Unable to engage in any physical activity without discomfort.
Symptoms may be present even at rest.

31
Pulmonary hypertension associated with lung disease, chronic hypoventilation,
pulmonary thromboembolic disease, drugs and toxins, diseases of the left side of the
heart, congenital heart disease and any secondary cause are specifically excluded

21. Third Degree Burns

There must be third-degree burns with scarring that cover at least 20% of the body’s
surface area. The diagnosis must confirm the total area involved using standardized,
clinically accepted, body surface area charts covering 20% of the body surface area

22. Alzheimer's Disease

Progressive and permanent deterioration of memory and intellectual capacity as
evidenced by accepted standardised questionnaires and cerebral imaging. The
diagnosis of Alzheimer’s disease must be confirmed by an appropriate consultant and
supported by the Company’s appointed doctor. There must be significant reduction in
mental and social functioning requiring the continuous supervision of the life assured.
There must also be an inability of the Life Assured to perform (whether aided or
unaided) at least 3 of the following 6 “Activities of Daily Living” for a continuous period
of at least 3 months: Activities of Daily Living are defined as:
• Washing – the ability to wash in the bath or shower (including getting into and
out of the bath or shower) or wash satisfactorily by other means;
• Dressing – the ability to put on, take off, secure and unfasten all garments and,
as appropriate, any braces, artificial limbs or other surgical appliances;
• Transferring – the ability to move from a bed to an upright chair or wheelchair
and vice versa;
• Toileting – the ability to use the lavatory or otherwise manage bowel and
bladder functions so as to maintain a satisfactory level of personal hygiene;
• Feeding – the ability to feed oneself once food has been prepared and made
available.
• Mobility - the ability to move from room to room without requiring any physical
assistance.
• The following are excluded:
• Any other type of irreversible organic disorder/dementia
• Alcohol-related brain damage.

23. Aplastic Anaemia

Chronic Irreversible persistent bone marrow failure which results in Anaemia,
Neutropenia and Thrombocytopenia requiring treatment with at least TWO of the
following:
• Regular blood product transfusion;
• Marrow stimulating agents;
• Immunosuppressive agents; or
• Bone marrow transplantation.
The diagnosis and suggested line of treatment must be confirmed by a Haematologist

32
acceptable to the Company using relevant laboratory investigations, including
bone-marrow biopsy. Two out of the following three values should be present:
• Absolute neutrophil count of 500 per cubic millimetre or less;
• Absolute Reticulocyte count of 20 000 per cubic millimetre or less; and
• Platelet count of 20 000 per cubic millimetre or less.
Temporary or reversible aplastic anaemia is excluded.

24. Cardiomyopathy
An impaired function of the heart muscle, unequivocally diagnosed as Cardiomyopathy
by a Registered Medical Practitioner who is a cardiologist, and which results in
permanent physical impairment to the degree of New York Heart Association
classification Class IV or its equivalent, for at least six (6) months based on the following
classification criteria:
Class IV - Inability to carry out any activity without discomfort. Symptoms of congestive
cardiac failure are present even at rest. With any increase in physical activity,
discomfort will be experienced. The Diagnosis of Cardiomyopathy has to be supported
by echographic findings of compromised ventricular performance.
Irrespective of the above, Cardiomyopathy directly related to alcohol or drug abuse is
excluded.

25. Medullary Cystic Disease

Medullary Cystic Disease where the following criteria are met:
• the presence in the kidney of multiple cysts in the renal medulla accompanied by
the presence of tubular atrophy and interstitial fibrosis;
• clinical manifestations of anaemia, polyuria, and progressive deterioration in
kidney function; and
• the Diagnosis of Medullary Cystic Disease is confirmed by renal biopsy.
• Isolated or benign kidney cysts are specifically excluded from this benefit.

26. Muscular Dystrophy

A group of hereditary degenerative diseases of muscle characterised by weakness and
atrophy of muscle based on three (3) out of four (4) of the following conditions:
• Family history of other affected individuals;
• Clinical presentation including absence of sensory disturbance, normal
cerebro-spinal fluid and mild tendon reflex reduction;
• Characteristic electromyogram; or
• Clinical suspicion confirmed by muscle biopsy.
The diagnosis of muscular dystrophy must be unequivocal and made by a consultant
neurologist.
The condition must result in the inability of the Life Insured to perform (whether aided
or unaided) at least 3 of the following 5 6 “Activities of Daily Living” for a continuous
period of at least 6 months.
Activities of Daily Living are defined as:

33
 • Washing: the ability to wash in the bath or shower (including getting into and out
of the bath or shower) or wash satisfactorily by other means;
• Dressing: the ability to put on, take off, secure and unfasten all garments and, as
appropriate, any braces, artificial limbs or other surgical appliances;
• Transferring: the ability to move from a bed to an upright chair or wheelchair and
vice versa;
• Mobility: the ability to move indoors from room to room on level surfaces;
• Toileting: the ability to use the lavatory or otherwise manage bowel and bladder
functions so as to maintain a satisfactory level of personal hygiene;
• Feeding: the ability to feed oneself once food has been prepared and made
available

27. Parkinson’s Disease

The unequivocal diagnosis of progressive degenrative primary idiopathic Parkinson’s
disease (all other forms of Parkinsonism are excluded) made by a consultant
neurologist. This diagnosis must be supported by all of the following conditions:
• The disease cannot be controlled with medication; and
• Objective signs of progressive impairment; and
• There is an inability of the Life assured to perform (whether aided or unaided) at
least 3 of the following five (6) “Activities of Daily Living” for a continuous period
of at least 6months.
The Activities of Daily Living are:
• Washing: the ability to wash in the bath or shower (including getting into and out
of the bath or shower) or wash satisfactorily by other means;
• Dressing: the ability to put on, take off, secure and unfasten all garments and, as
appropriate, any braces, artificial limbs or other surgical appliances;
• Transferring: the ability to move from a bed to an upright chair or wheelchair and
vice versa;
• Mobility: the ability to move indoors from room to room on level surfaces;
• Toileting: the ability to use the lavatory or otherwise manage bowel and bladder
functions so as to maintain a satisfactory level of personal hygiene;
• Feeding: the ability to feed oneself once food has been prepared and made
available
Drug-induced or toxic causes of Parkinsonism are excluded.

28. Poliomyelitis
The occurrence of Poliomyelitis where the following conditions are met:
• Poliovirus is identified as the cause,
• Paralysis of the limb muscles or respiratory muscles must be present and persist
for at least 3 months.
The diagnosis of Poliomyelitis must be confirmed by a Registered Medical Practitioner
who is a neurologist.

29. Systemic Lupus Erythematosus (SLE) with Lupus Nephritis

A mutli-system, mutlifactorial, autoimmune disease characterized by the development
34
of auto-antibodies directed against various self-antigens. In respect of this Contract,
Systemic Lupus Erythematosus (SLE) will be restricted to those forms of systemic lupus
erythematosus which involve the kidneys (Class III to Class V Lupus Nephritis,
established by renal biopsy, and in accordance with the WHO Classification). The final
diagnosis must be confirmed by a certified doctor specializing in Rheumatology and
Immunology. There must be positive antinuclear antibody test.
Other forms, discoid lupus, and those forms with only hematological and joint
involvement will be specifically excluded.
WHO Classification of Lupus Nephritis:
Class I: Minimal change Lupus Glomerulonephritis – Negative, normal urine.
Class II: Messangial Lupus Glomerulonephritis – Moderate Proteinuria, active sediment
Class III: Focal Segmental Proliferative Lupus Glomerulonephritis – Proteinuria, active
sediment
Class IV: Diffuse Proliferative Lupus Glomerulonephritis – Acute nephritis with active
sediment and / or nephritic syndrome.
Class V: Membranous Lupus Glomerulonephritis – Nephrotic Syndrome or severe
proteinuria.

30. Apallic Syndrome

Universal necrosis of the brain cortex, with the brain stem remaining intact. Diagnosis
must be definitely confirmed by a Registered Medical practitioner who is also a
neurologist holding such an appointment at an approved hospital. This condition must
be documented for at least one (1) month.

31. Brain Surgery

The actual undergoing of surgery to the brain under general anesthesiaanaesthesia
during which a craniotomy with removal of bone flap to access is the brain is performed.
The following are excluded:
• Burr hole procedures, transphenoidal procedures and other minimally invasive
procedures such as irradiation by gamma knife or endovascular embolizations,
thrombolysis and stereotactic biopsy
• Brain surgery as a result of an accident

32. Surgery of Aorta

The actual undergoing of surgery for a disease or injury of the aorta needing excision
and surgical replacement of the diseased part of the aorta with a graft.
The term “aorta” means the thoracic and abdominal aorta but not its branches.
Surgery performed using only minimally invasive or intra-arterial techniques are
excluded.

33. Rheumatoid arthiritis

The Severe Rheumatoid Arthritis with all of the following factors.

35
 • Is in accordance with the criteria on Rheumatoid Arthritis of the American
College of Rheumatology and has been diagnosed by the Rheumatologist.
• At least 3 joints are damaged or deformed such as finger joint, wrist, elbow, knee
joint, hip joint, ankles, cervical spine or feet toe joint as confirmed by clinical and
radiological evidence and cannot perform at least 3 types of daily routines
permanently for at least 180 days.

34. Severe Crohn's Disease

Crohn’s Disease is a chronic inflammatory disease of the bowel with all of the below
features to be present in spite of optimal therapy:
• Stricture formation causing Intestinal obstruction or Fistula formation between
loops of bowel requiring admission to hospital, and
• Surgical treatment with at least one bowel segment resection is done
The diagnosis must be made by a Specialist Gastroenterologist based on
histolopathological findings and/or the results of endoscopic findings.

35. Ulcerative colitis

Severe Ulcerative Colitis is a definite diagnosis of Ulcerative Colitis made by a Specialist
Gastroenterologist based on histolopathological findings and/or the results of
endoscopic findings with the below features:
• The entire colon is affected, with severe bloody diarrhoea; and
• Surgical treatment with total colectomy is done.

36. Pneumonectomy
The undergoing of surgery on the advice of a consultant medical specialist to remove an
entire lung for any physical injury or disease

37. Pulmonary Artery Graft Surgery

The undergoing of surgery requiring median sternotomy for disease to the pulmonary
artery with excision and surgical replacement of a portion of the diseased pulmonary
artery with a graft.
For the above definition, the following are not covered:
• Any other surgical procedure for example the insertion of stents or endovascular repairs.

38. Progressive Scleroderma

A systemic collagen-vascular disease causing progressive diffuse fibrosis in the skin,
blood vessels and visceral organs. This diagnosis must be unequivocally supported by
biopsy and serological evidence and the disorder must have reached systemic
proportions to involve the heart, lungs or kidneys.
The following conditions are excluded:
• Localised scleroderma (linear scleroderma or morphea);
• Eosinophilicfascitis; and
• CREST syndrome.

39. Bacterial Meningitis

36
Bacterial infection resulting in severe inflammation of the membranes of the brain or
spinal cord resulting in significant, irreversible and permanent neurological deficit. The
neurological deficit must persist for at least 6 weeks. This diagnosis must be confirmed
by:The presence of bacterial infection in cerebrospinal fluid by lumbar puncture; and A
consultant neurologist.

40. Good Pasture's syndrome

Good pasture’s syndrome is an autoimmune disease in which antibodies attack the
lungs and kidneys, leading to permanent lung and kidney damage.
The permanent damage should be for a continuous period of at least 30 days. The
Diagnosis must be proven by Kidney biopsy and confirmed by a Specialist Medical
Practitioner (Rheumatologist).

41. Multiple system Atrophy

A definite diagnosis of multiple system atrophy by a Consultant Neurologist. There must
be evidence of permanent clinical impairment of:
• Bladder control with postural hypotension
• AND any 2 of the following:
a. Rigidity
b. Cerebellar ataxia
• peripheral neuropathy

42. Encephalitis
It is a severe inflammation of brain tissue, resulting in permanent neurological deficit
lasting for a minimum period of 60 days. This must be certified by a Specialist Medical
Practitioner (Neurologist). The permanent deficit must result in an inability to perform at
least three of the Activities of Daily Living either with or without the use of mechanical
equipment, special devices or other aids and adaptations in use for disabled persons.

43. Creutzfeldt-Jakob disease

A definite diagnosis of Creutzfeldt-Jakob disease by a Consultant Neurologist. There
must be permanent clinical impairment of motor function and loss of the ability to do all
of the following:
• Remember;
• Reason; and
• Perceive, understand, express and give effect to ideas.
The above, should be for a minimum period of 30 days to the extent that permanent
supervision or assistance by a third party is required.
For the above definition, the following are not covered:
• Other types of dementia.

44. Fulminant Viral Hepatitis

37
A submissive to massive necrosis of the liver by the Hepatitis virus, leading
precipitously to liver failure. The diagnosis must be supported by all of the following:
• Rapid decreasing of liver size as confirmed by abdominal ultrasound;
• Necrosis involving entire lobules, leaving only a collapsed reticular framework
(histological evidence is required);
• Rapid deterioration of liver function tests;
• Deepening jaundice; and
• Hepatic encephalopathy.
Hepatitis B infection or carrier status alone does not meet the diagnostic criteria.
This excludes Fulminant Viral Hepatitis caused by alcohol, toxic substance or drug.

45. Dissolution of the nerve roots of Brachial Plexus

Multiple Root Avulsions of Brachial Plexus - This means a total and permanent loss of
function and sensitiveness of arms as a result of the damage of at least 2 nerve roots
from accident or illness. The diagnosis must be confirmed by electrodiagnostic study
performed by neurologist.

46. Chronic Recurrent Pancreatitis

The unequivocal diagnosis of recurrent inflammation of the pancreas, involving more
than three attacks of pancreatitis within two years and progressing to a stage of
pancreatic insufficiency, calcification and cysts. The pancreatic insufficiency must be
documented by the presence of weight loss, symptoms of malabsorption, diarrhea,
steatorrhea as well as the need of replacement pancreatic digestive enzymes. The
diagnosis must be made by an gastroenterologist and confirmed by Endoscopic
Retrograde Cholangio Pancreatography (ERCP).
Chronic recurrent pancreatitis resulting directly from alcohol abuse is excluded.

47. Spinal stroke

Death of spinal cord tissue due to inadequate blood supply or haemorrhage within the
spinal column resulting in permanent neurological deficit with persisting clinical
symptoms
Evidence of permanent neurological deficit lasting for atleast 3 months has to be
produced.

48. Syringomelia or Syringobulbia

A definite diagnosis of Syringomelia or Syringobulbia by a Consultant Neurologist,
which has been surgically treated. This includes surgical insertion of a permanent
drainage shunt.
Syringomyelia or syringobulbia is a disorder in which a cyst, or cavity, forms within the
spinal cord. Over time, this cyst can expand and elongate destroying the spinal cord.
The damage may result in pain, paralysis, weakness and stiffness in the back, shoulders
and extremities.

49. Benign spinal cord tumour

38
A non-malignant tumour in the spinal canal or spinal cord , resulting in either of the
following:
• permanent neurological deficit with persisting clinical symptoms for a period of
6 consecutive months OR
• Has undergone invasive surgery to remove the tumour, or treatment by
stereotatic radiosurgery.
This diagnosis must be confirmed by a medical specialist i.e neurologist or
neurosurgeon and must be supported by appropriate evidences
For the above definition, the following are not covered:
• Cysts
• Granulomas
• Malformations in the arteries or veins of the spinal cord
• Haematomas
• Abscess
• Disc protrusion, and
• Osteophytes.

50. Devic's Disease

A definite diagnosis of Devic's disease by a Consultant Neurologist. There must be
current clinical impairment of motor or sensory function, which must have persisted for
a continuous period of at least 6 months

Nomination
Nomination shall be in accordance with provisions of Section 39 of the Insurance Act
1938 as amended from time to time. Nomination of this Policy is not applicable if the
Policy has been effected under Section 6 of the Married Women’s Property Act 1874

Assignment
Assignment shall be in accordance with provisions of Section 38 of the Insurance Act
1938 as amended from time to time. Assignment of this Policy is not applicable if the
Policy has been effected under Section 6 of the Married Women’s Property Act 1874.

Terminal Illness
Terminal Illness is defined as an advanced or rapidly progressing incurable disease
where, in the opinion of two independent medical practitioners’ specializing in
treatment of such illness, life expectancy is no greater than twelve months from the
date of notification of claim. The terminal illness must be diagnosed and confirmed by
independent medical practitioners’ specializing in treatment of such illness registered

39
with the
with the Indian
Indian Medical
Medical Association
Association and
and the
the diagnosis
diagnosis of of Terminal
Terminal Illness
Illness should
should be
be
approved by
approved bythe Company.
the Company.The Company reserves
The Company the rightthe
reserves for independent assessment.
right for independent
The policy terminates
assessment. with
The policy the payment
terminates withof terminal
the paymentillness benefit. illness benefit.
of terminal
A Medical Practitioner is defined as a person who holds a valid registration from the
A Medical Practitioner is defined as a person who holds a valid registration from the
A Medical
medical Practitioner
council of any state of India or Medical Council of India or Council for Indian
medical council of any state of India or Medical Council of India or Council for Indian
Medicine or for Homeopathy
Medicine or for Homeopathy set setup
upby
bythe
theGovernment
GovernmentofofIndia India
oror a State
a State Government
Government
and is thereby
and is therebyentitled
entitledtoto practice
practice medicine
medicine within
within its jurisdiction;
its jurisdiction; and isand is acting
acting withinwithin
the
the scope
scope and and jurisdiction
jurisdiction of hisoflicense.
his license.
The Medical
Medical Practitioner
Practitionershall
shallnot
notinclude:
include:
a) a) A close
A close relative
relative of the
of the policyholder;
policyholder; or b)or
A b)
A person who resides with the policyholder; or c) A person covered under this
person who resides with the policyholder; or c) A person covered under this Policy Policy

About PNB MetLife

PNB MetLife India Insurance Company Limited (PNB MetLife) is one of the leading life
PNB MetLife India Insurance Company Limited (PNB MetLife) is one of the leading life
insurance companies in India. PNB MetLife has as its shareholders MetLife International
insurance companies in India. PNB MetLife has as its shareholders MetLife International
Holdings LLC (MIHL), Punjab National Bank Limited (PNB), Jammu & Kashmir Bank
Holdings LLC (MIHL), Punjab National Bank Limited (PNB), Jammu & Kashmir Bank
Limited (JKB), M. Pallonji and Company Private Limited and other private investors, MIHL
Limited (JKB), M. Pallonji and Company Private Limited and other private investors, MIHL
and PNB being the majority shareholders. PNB MetLife has been present in India since
and PNB being the majority shareholders. PNB MetLife has been present in India since
2001.
2001.
PNB MetLife brings together the financial strength of a leading global life insurance
PNB MetLife brings together the financial strength of a leading global life insurance
provider, MetLife, Inc., and the credibility and reliability of PNB, one of India's oldest and
provider, MetLife, Inc., and the credibility and reliability of PNB, one of India's oldest and
leading nationalised banks. The vast distribution reach of PNB together with the global
leading nationalised banks. The vast distribution reach of PNB together with the global
insurance expertise and product range of MetLife makes PNB MetLife a strong and trusted
insurance expertise and product range of MetLife makes PNB MetLife a strong and
insurance provider.
trusted insurance provider. For more information, visit www.pnbmetlife.com
For more information, visit www.pnbmetlife.com

Extract of Section 41 of the Insurance Act, 1938, as amended from

time to time states

1. No person shall allow or offer to allow, either directly or indirectly, as an

inducement to any person to take out or renew or continue an insurance in respect
of any kind of risk relating to lives or property in India, any rebate of the whole or
part of the commission payable or any rebate of the premium shown on the policy,
nor shall any person taking out or renewing or continuing a policy accept any
rebate, except such rebate as may be allowed in accordance with the published
prospectuses or tables of the insurer
2. Any Person making default in complying with the provisions of this section shall be
punishable with fine which may extend to ten lakh rupees.

40
 GrievanceRedressal
Grievance Redressal

In case you have any query or complaint or grievance, you may approach any of our
following touch points:
• Call 1800-425-69-69 (Toll free)
• Email at [email protected]
• Write to
Customer Service Department, 1st Floor, Techniplex -1, Techniplex Complex, Off Veer
Savarkar Flyover, Goregaon (West), Mumbai – 400062.
• Online through our website www.pnbmetlife.com
• Our nearest PNB MetLife branch across the country
For any escalation with the resolution provided by any of the above touch points, you may,
write to our Grievance Redressal Officer at [email protected]
If you do not get appropriate resolution, you may approach Insurance Ombudsman on
https://www.cioins.co.in/Ombudsman.

Fraud and Misstatement

Treatment will be as per Section 45 of the Insurance Act, 1938 as amended from time to
time.
 Please read this Sales brochure carefully before concluding any sale.
 This product brochure is only indicative of terms, conditions, warranties and
exceptions contained in the insurance policy. The detailed Terms and Conditions
are contained in the Policy Document.
Policy shall not be called in question on ground of misstatement after three years.
(1) No policy of life insurance shall be called in question on any ground whatsoever
after the expiry of three years from the date of the policy, i.e., from the date of
issuance of the policy or the date of commencement of risk or the date of revival of
the policy or the date of the rider to the policy, whichever is later.

(2) A policy of life insurance may be called in question at any time within three years
from the date of issuance of the policy or the date of commencement of risk or the
date of revival of the policy or the date of the rider to the policy, whichever is later,
on the ground of fraud:
Provided that the insurer shall have to communicate in writing to the insured or the
legal representatives or nominees or assignees of the insured the grounds and
materials on which such decision is based.
Explanation I. — For the purposes of this sub-section, the expression "fraud" means
any of the following acts committed by the insured or by his agent, with intent to
deceive the insurer or to induce the insurer to issue a life insurance policy:—
(a) the suggestion, as a fact of that which is not true and which the insured does not

41
 believe to be true;
(b) the active concealment of a fact by the insured having knowledge or belief of the
fact;
(c) any other act fitted to deceive; and
(d) any such act or omission as the law specially declares to be fraudulent.
Explanation II. — Mere silence as to facts likely to affect the assessment of the risk
by the insurer is not fraud, unless the circumstances of the case are such that
regard being had to them, it is the duty of the insured or his agent keeping silence,
to speak, or unless his silence is, in itself, equivalent to speak.

(3) Notwithstanding anything contained in sub-section (2), no insurer shall repudiate a

life insurance policy on the ground of fraud if the insured can prove that the
misstatement of or suppression of a material fact was true to the best of his
knowledge and belief or that there was no deliberate intention to suppress the fact
or that such misstatement of or suppression of a material fact are within the
knowledge of the insurer:
Provided that in case of fraud, the onus of disproving lies upon the beneficiaries, in
case the policyholder is not alive.
Explanation. —A person who solicits and negotiates a contract of insurance shall
be deemed for the purpose of the formation of the contract, to be the agent of the
insurer.

(4) A policy of life insurance may be called in question at any time within three years
from the date of issuance of the policy or the date of commencement of risk or the
date of revival of the policy or the date of the rider to the policy, whichever is later,
on the ground that any statement of or suppression of a fact material to the
expectancy of the life of the insured was incorrectly made in the proposal or other
document on the basis of which the policy was issued or revived or rider issued:
Provided that the insurer shall have to communicate in writing to the insured or the
legal representatives or nominees or assignees of the insured the grounds and
materials on which such decision to repudiate the policy of life insurance is based:
Provided further that in case of repudiation of the policy on the ground of
misstatement or suppression of a material fact, and not on the ground of fraud, the
premiums collected on the policy till the date of repudiation shall be paid to the
insured or the legal representatives or nominees or assignees of the insured within
a period of ninety days from the date of such repudiation.
Explanation. — For the purposes of this sub-section, the misstatement of or
suppression of fact shall not be considered material unless it has a direct bearing on
the risk undertaken by the insurer, the onus is on the insurer to show that had the
insurer been aware of the said fact no life insurance policy would have been issued
to the insured.

(5) Nothing in this section shall prevent the insurer from calling for proof of age at any
time if he is entitled to do so, and no policy shall be deemed to be called in question
merely because the terms of the policy are adjusted on subsequent proof that the
age of the life insured was incorrectly stated in the proposal.
42
PNB MetLife India Insurance Company Limited, Registered office address: Unit No. 701, 702 & 703, 7th Floor, West Wing, Raheja Towers, 26/27
M G Road, Bangalore -560001, Karnataka. IRDAI Registration number 117. CI No: U66010KA2001PLC028883. PNB MetLife Mera Term Plan
Plus (UIN:117N126V04) is an Individual, Non-Linked, Non-Participating, Pure Risk Premium, Life Insurance Plan. This product brochure is only
indicative of terms, conditions, warranties and exceptions contained in the insurance policy. This version of the document invalidates all
previous printed versions for this particular plan. The detailed Terms and Conditions are contained in the Policy Document. Tax benefits are as
per the Income Tax Act, 1961, & are subject to amendments made thereto from time to time. Please consult your tax consultant for more details.
Goods and Services Tax (GST) shall be levied as per prevailing tax laws which are subject to change from time to time. Trade Logo displayed
above belongs to Punjab National Bank and Metropolitan Life Insurance Company and used by PNB MetLife India Insurance Company Limited
under License. Email: [email protected] or Write to us: 1st Floor, Techniplex -1, Techniplex Complex, Off Veer Savarkar Flyover,
Goregaon (West), Mumbai – 400062, Maharashtra. AD-F/2024-25/863.

BEWARE OF SPURIOUS PHONE CALLS AND FICTIOUS/ FRADULENT OFFERS

IRDAI or its officials do not involve in activities like selling insurance policies, announcing bonus or investment of premiums. Public receiving 43
such phone calls are requested to lodge a police complaint.