For Office Use Only (w.e.f. Sep 24/ Ver 1.

11)

Illustration No: KASP-5915f-4938-Y54

Quotation Number:BB270325185604495

Proposal No:

Policy No.:

Name of the Ms Sakthidevi Devanathan Name of the Product Kotak Assured Savings Plan
Prospect/Policyholder
Tag Line A Non-Participating Non-Linked
Age of the 59 Life Insurance Individual Savings
Prospect/Policyholder (in yrs) Product

DOB of the 02 April 1965 Unique Identification No UIN : 107N081V07

Prospect/Policyholder
Base Goods and Services Tax and Cess Rate 4.50%
Name of Life Assured Ms Sakthidevi Devanathan (GST) (1st Year)

DOB of Life Assured 02 April 1965 Base Goods and Services Tax and Cess Rate 2.25%
(GST) (2nd Year)
Age of Life Assured (in yrs) 59
Rider Goods and Services Tax and Cess Rate 18%
Gender of Life Assured female
(GST)
Policy Term (in yrs) 15
Channel Name Individual Agents
Premium Payment Term (in 10
Agent's Branch Location
yrs)
Prospect/Policyholder's Current Location
Amount of Installment 50,000
Premium (in Rs.)

Mode of Payment of Premium Yearly

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

POLICY DETAILS

Policy Option : Not Applicable Sum Assured (Rs.) : 3,59,928

Sum Assured on Death (at

: 4,31,914
inception of the policy) Rs.

Rider Details

Rider Premium Paying

Rider Name Rider Sum Assured Rider Policy Term Rider Premium (Rs.)
Term

Kotak Term Benefit Rider (UIN: 107B003V03) Not Selected

Kotak Accidental Death Benefit Rider

Not Selected
(UIN:107B001V04)

Kotak Permanent Disability Benefit Rider

Not Selected
(UIN:107B002V03)

Kotak Life Guardian Rider (UIN: 107B012V02) Not Selected

Kotak Accidental Disability Guardian Rider (UIN

Not Selected
107B011V02)

Kotak Critical Illness Plus Benefit Rider (UIN

2,00,000 6 5 3908
107B020V02)

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Quotation Number:BB270325185604495

PREMIUM SUMMARY

Base Plan Riders (Please refer Rider Details table) Total Installment Premium

Installment Premium (without GST) 50,000 3,908 53,908

Installment Premium (with First Year GST) 52,250 4,611 56,861

Installment Premium (with GST, Second Year onwards) 51,125 4,611 55,736

BENEFIT ILLUSTRATION TABLE

Non-Guaranteed
Guaranteed Benefits
Benefits
End of Policy Age of Life Annualised Surrender Value
Annual Premium Accrued Guaranteed Guaranteed Special
Year Insured Premium Basic Sum Guaranteed Payable
Guaranteed Loyalty Maturity Benefit Death Benefit Surrender Value Surrender Value
Assured Yearly Addition
Yearly Additions Additions (GSV) (SSV)

1 60 50,000 50,000 3,59,928 5,000 5,000 0 0 4,36,914 0 17,967 17,967

2 61 50,000 50,000 3,59,928 10,000 15,000 0 0 4,46,914 34,173 39,483 39,483

3 62 50,000 50,000 3,59,928 15,000 30,000 0 0 4,61,914 61,689 65,138 65,138

4 63 50,000 50,000 3,59,928 20,000 50,000 0 0 4,81,914 1,16,865 95,645 1,16,865

5 64 50,000 50,000 3,59,928 25,000 75,000 0 0 5,06,914 1,52,885 1,31,813 1,52,885

6 65 50,000 50,000 3,59,928 30,000 1,05,000 0 0 5,36,914 1,93,040 1,75,307 1,93,040

7 66 50,000 50,000 3,59,928 35,000 1,40,000 0 0 5,71,914 2,38,294 2,27,919 2,38,294

8 67 50,000 50,000 3,59,928 40,000 1,80,000 0 0 6,11,914 2,93,802 2,89,937 2,93,802

9 68 50,000 50,000 3,59,928 45,000 2,25,000 0 0 6,56,914 3,62,385 3,62,791 3,62,791

10 69 50,000 50,000 3,59,928 50,000 2,75,000 0 0 7,06,914 4,47,173 4,98,798 4,98,798

11 70 0 0 3,59,928 0 2,75,000 0 0 7,06,914 4,79,608 5,33,225 5,33,225

12 71 0 0 3,59,928 0 2,75,000 0 0 7,06,914 5,28,913 5,70,691 5,70,691

13 72 0 0 3,59,928 0 2,75,000 0 0 7,06,914 6,00,253 6,11,763 6,11,763

14 73 0 0 3,59,928 0 2,75,000 0 0 7,06,914 6,98,875 6,57,005 6,98,875

15 74 0 0 3,59,928 0 2,75,000 71,986 7,06,914 7,06,914 0 0 0

Notes:
Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any and Goods and Services Tax.
Annual Premium is the Premium payable in a policy year, including modal loadings & excluding loading for extra mortality, Goods & Services tax, Cess and Rider premium.

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Quotation Number:BB270325185604495

Terms & Conditions:

1. This is A Non-Participating Non-Linked Life Insurance Individual Savings Product. The illustration stated is for a healthy individual and
would be subject to underwriting.

2. The policy will acquire a surrender value after completion of first policy year provided one full year's premium has been paid. During
the Policy Term, Surrender Value payable will be higher of Guaranteed Surrender Value and Special Surrender Value.

3. The above illustrated benefits are derived on the basis of details of life insured provided at the time of filling the proposal form. If the
details are found inaccurate or there are any changes before or at the time of the policy issuance for eg: change in age, the illustrated
benefits will be subject to revision.

4. Goods and Services Tax & Cess, as applicable are levied at the applicable Tax rates in accordance with the prevailing Tax Laws.
Prevailing tax laws are applicable on this policy which may vary from time to time.

5. The values shown are for illustrative purposes only. For more details on risk factors, terms and conditions please read sales brochure
carefully before concluding a sale.

I, _____________________________(Name), have explained the premiums and I, Ms Sakthidevi Devanathan (Name), having received the information with

benefits under the product fully to the prospect / policyholder. respect to the above, have understood the above statement before entering into

the contract.

Place :_____________ __________________________________

Date : 27-Mar-2025 Signature of Agent/ Intermediary/ Official Place :_____________ __________________________________

of the Insurer Date : 27-Mar-2025 Signature of Prospect / Policyholder

[ ] Digitally Accepted for Prospect / Policyholder

Kotak Mahindra Life Insurance Company Limited.

CIN: U66030MH2000PLC128503
Regd. Office: 8th Floor, Plot# C-12, G-Block, BKC, Bandra (E), Mumbai - 400 051

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