Tata AIA Life Insurance • IRDA of India Regn no.

110
Customer Information Sheet/Know Your Policy
This document provides key information about your policy and will be included as part of your policy kit. You are also advised to go through your policy
document.

Sr Title Description in Simple Words Policy

No (Please refer to applicable Policy Clause Number in next column) Clause
number
1 Name of the Insurance Tata AIA Sampoorna Raksha Promise (UIN:110N176V06) Policy
Product/Rider and Schedule
Unique Identification
Number
2 Policy Number C292697470 Policy
Schedule
3 Type of Insurance Policy Pure risk Policy
Schedule
4 Basic Policy details Instalment Premium: 25844 Policy
Mode of Premium Payment: A Schedule/
Sum Assured on Death: 10000000 Benefit
Sum Assured on Maturity: As per Clause 3.1of Part C Illustration/
Premium Payment Term: 12 As per Part
Policy Term: 40 C
5 Policy Coverage/benefits Benefits payable on maturity: Clause 3(1)
payable Lump Sum Payout on survival of the life assured/s till the maturity date of the policy. (IV) of part C

An amount equal to the 100% of the Total Premiums Paid (excluding loading for modal premiums and Clause 3(1)
discount) towards base benefit option and “Life Stage” or “Top-up SA”, if opted and applicable, shall be (I) of part C
payable at the end of the Policy Term, provided the life assured survives till maturity and the policy is not
terminated earlier. Clause 3(1)
(II) of part C
Benefits payable on death -
Clause 3(1)
In case of death of the Life Insured for an in-force policy (all due premiums have been paid), the death benefit (III) of part C
payable to the Claimant is as outlined below:
Highest of: Clause 6.7
(II) of Part F
1.25 x Single Premium (excluding discount) or DB multiple(1) x Annualised Premium(2) (excluding
discount); Clause 3 (II)
105% of Total Premiums Paid (excluding loading for modal premiums and discount) up to date of death; (1) of Part C
or
An absolute amount assured to be paid on death(3) Clause 3 (II)
(2) of Part C
(1) DB multiple is 7 in case of Life Promise Option and 10 in case of Life Promise Plus option
(2) Clause 3 (II)
in aggregate for Base SA and all tranches of Additional Sum Assured
(3) The absolute amount assured to be paid on death is the Effective Sum Assured applicable as on the date
(3) of Part C
of death. Clause 3 (II)
(4) of Part C
Upon payment of entire sum of the death benefit, the policy terminates and no further benefits are payable
Clause 3 (II)
Terminal Illness (5) of Part C
Terminal Illness payout is payable in lumpsum on the confirmed diagnosis of the Terminal Illness as per the Clause 3 (II)
Option chosen by the you and as detailed below: (6) of Part C
In case of confirmed diagnosis of terminal illness of the life assured for an in-force policy (all due Clause 3 (II)
premiums have been paid): (7) of Part C
The amount payable under the “Payor Accelerator Benefit” shall be 50% of Base SA and all the future
premiums (base benefit option and cover enhancement options, if opted) shall be waived off and the Clause 3(1)(
policy will continue to remain inforce for the remaining applicable benefit(s). V) of part C

Clause 3 (II)
(8) of Part C
Surrender Benefit:

The surrender benefit available under the product varies by the Option chosen. The policy will terminate upon
payment of this benefit.

Under Life Promise Plus and Joint Life Promise Plus Option, a Surrender Value shall be payable on
completion of one policy year, provided one full years’ premium is paid for non-single pay policies. For Single
Pay policies, Surrender Value shall be payable immediately after it is issued.

The surrender value shall be equal to the higher of the Guaranteed Surrender Value (GSV) and the Special
Surrender Value (SSV).

Refer the policy document for more details

Options to policyholders for availing benefits, if any, covered under the policy

Flexible Payout Option

You will have the option to opt for lump sum, staggered benefit or a combination of a lump sum amount and
staggered benefit, as at the time of purchase (referred as the “Payout Plan” henceforth).

If the payout plan chosen includes a staggered benefit, at the time of purchase of the policy, the Policyholder
would stipulate the benefit amount stream payable to the nominee after death of the Life Insured. The
staggered benefit payment frequency can be Annual / Half Yearly / Quarterly / Monthly. Any accrued
staggered benefit, due before intimation of death, will be paid along with first payout under this option. You
can choose between:

a)Level income payout – fixed income payout throughout the chosen benefit period
b)Increasing Income payout – income increases year-on-year based on chosen simple interest rate (up
to 15%) throughout the chosen benefit period

Cover Enhancement Options

Life Stage:

Under Life Stage option, you can increase the coverage amount on happening of any one of the following Life
Stage events, and the option to increase the Sum Assured is exercised within 180 days of the
happening/incidence of the following event(s):
Event Additional Sum Assured as % of Base Sum Assured
Marriage (One Marriage Only) 50%
Birth/Adoption of 1st Child 25%
Birth/Adoption of 2nd Child 25%
Home Loan disbursal* 100%
(subject to underwriting)

Once chosen, the option cannot be changed over the Policy Term, but you will always have a right to stop
exercising the option in the future.

Refer the policy document for more details.

Top-Up SA

Under Top-Up SA option, you can opt to increase the life cover by a fixed percentage at each Policy
Anniversary by paying an additional premium for every increase, subject to satisfactory underwriting as per
Underwriting Policy. You can opt to exercise the Top-SA option at the time of purchase of the Policy, provided
the premium payment term is at least 5 years.

Other benefits/ options payable, specific to the policy, if any

Renewability option at Maturity:

At the Date of Maturity, You can choose to extend the Policy Term. This option can be exercised a maximum
of 5 (five) times subject to Underwriting Policy. Additional premium shall be payable for the extended term.

Cover Continuation Option:

In case of first death of either of the life assureds during the policy term under Joint Life Promise and Joint
Life Promise Plus, the surviving life may choose to continue his / her life cover by taking a Single Premium
policy. The premium for the Single Premium policy shall be determined based on attained age, chosen sum
assured and policy term. The Single Premium policy shall be chosen from Life Promise, Life Promise Plus
options. The Single Premium amount shall be deducted from the death benefit payable with respect to first
death. This option has to be chosen at inception of the policy, however the surviving life assured has a choice
to not exercise this option at later date.

FlexiPay Benefit:

You may opt to defer the due Premium for a period of up to 12 (twelve) months from the due date (“Premium
Deferment Period”), while maintaining the full risk cover under the Policy and the attached riders, if any, at no
additional cost/Premium. In case of occurrence of any insured event during the said period of 12 (twelve)
months, the Sum Assured shall be paid after deducting the unpaid Premiums, if any, as on date of the
occurrence of the insured event covered under this Policy and the attached riders (if any).

At the end of Premium Deferment Period, You are required to pay the due Premiums, including the Premium
applicable for the Premium Deferment Period, i.e. the base cover premium and additional premium (if any).
During the Premium Deferment Period, the Policy shall remain in-force with the benefits applicable under
Grace Period of the Policy.

The Policy document lays down, in detail, the conditions specific to Flexi Pay Benefit:

Instant Payout on Claim Intimation:

In case of death of the Life Insured, post completion of waiting period of 3 Policy Year, from the policy
inception or Revival of the Policy and provided the Policy is in force, an accelerated instant death benefit of
INR 3 Lacs from the Sum Assured will be paid within 1 working day from the claim registration date. This
feature could only be availed with the minimum Sum Assured of INR 1 Cr.

The remaining SA shall be payable post the completion of the claim investigation. Further, in case of any
discrepancy in the claim investigation resulting in the final decision of non-payment of the claim, the company
reserves the right to recover the already paid amount.

Family Plan Option:

The Life insured at the inception (on payment of additional premium) shall have an option to transfer Legacy
Sum Assured to his/her child provided the policy is inforce and the primary Life insured survives till the end of
their policy term. The optional benefit will work as follows:

Primary Life (Benefits defined for Life Promise /Life Promise Plus option as mentioned above)

The Primary Life Insured (i.e. Parent) coverage shall be applicable during the Policy Term wherein the
available coverage terms for Primary Life are till Age 60 or 65 years as per the base plan.
 Upon death or terminal illness of the Primary life during the policy term, death or payor accelerated
benefit, as applicable, shall be payable and the policy will terminate thereafter.
Upon survival of the primary life till the end of the Policy Term, the primary life shall receive Return of
Premiums in case of Life Promise Plus options and no benefit shall be applicable under Life Promise
option. The Sum Assured (including any Top-up or Life stage option) of the primary life shall be
transferred to the secondary life thereafter.

Secondary Life

Upon survival of the primary life till the end of the Policy Term; provided the secondary life (i.e. one
Child, as opted at the inception) is alive, the coverage will commence for the Secondary Life Insured
and shall be covered till the Extended Policy Term.
The Extended Policy Term shall start post the coverage period of primary life and will continue till the
secondary life reaches Age 60.
Upon death of the Secondary Life Insured, the Sum Assured shall be payable and the policy will
terminate thereafter.
Upon survival of the secondary life during the extended period, no benefit shall be payable, and the
policy will terminate thereafter.

Addition clauses applicable

This option is available only for Life Promise and Life Promise Plus options.
Minimum Age gap between primary and secondary life insured should be 18 years.
In case of death of secondary life insured before the policy term, no further addition / change will be
allowed.
The life insured can opt for the benefit only at policy inception by paying an incremental premium to avail
the benefit.

Value-added Service Feature:

Health Management Services:

Eligible Life Insureds of TATA AIA Maha Raksha Supreme Select Plan may avail, Health Management
Services from service provider(s) associated with the Tata AIA Life Insurance Co. Ltd. The Insurer may also
facilitate additional discounts and redeemable vouchers through such service provider, wherever
available.“Health Management Services are complimentary services in the areas of prevention, diagnosis,
treatment or recovery which may include services such as medical consultation, coaching, second opinion,
personal medical case management with the objective of health management and improvement.” These
services are subject to a number of conditions which have been detailed in the Policy document.

LOYALTY PROGRAM REWARD

If You are a member of the Loyalty Program administered by a service provider empaneled by the Company,
You shall be entitled to the Loyalty Program Reward upon the purchase of the Policy and upon meeting the
eligibility criteria. The loyalty programs offer redemption benefits through the service provider’s eco-systems
 based on applicable terms and conditions. Such reward shall accrue as percentage of the Annualized
Premium or Single Premium (as applicable) and shall be made available by the service provider to You in the
form of benefits (points, coins, etc.) in the first policy year by loyalty program service provider. The quantum of
reward shall be determined by the Company’s extant Policy and shall be disclosed in the Company’s website
from time to time.The loyalty program rewards benefit shall be subject to conditions which have been detailed
in the Policy document.

Lock-in period for Linked Insurance products: NA

6 Options available (in NA
case of Linked
Insurance Products)
7 Option available(in case NA
of Annuity product)
8 Riders opted, if any NA
9 Exclusions (events SUICIDE EXCLUSION Clause 4.3.1
where insurance Suicide provisions will be applicable as per the Option selected by Policyholder and detailed as mentioned of part D
coverage is not below:
payable), if any. Clause 4.3.2
Life Promise Plus of Part D

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 at least 80% of the Total
Premiums Paid (including additional premium paid for Family Plan Option benefit, if applicable) 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; or

From the date of exercising the Life Stage Option (if applicable), the nominee or beneficiary of the
policyholder shall be entitled to 80% of the premiums paid (excluding any extra premium, any rider premium
and taxes) for the increased tranche(s). The original death benefit (based on the sum assured chosen at the
time of purchase) and any increased death benefit purchased by exercising the Life Stage Option
subsequently but prior to 12 months from the date of death (due to suicide) will remain payable in full.

TERMINAL ILLNESS BENEFIT

No claim will be payable if the Terminal Illness arises directly or indirectly as a result of attempt to suicide in
the first year from inception or Revival of policy.

In case a Terminal Illness claim is not payable due to the above exclusion, the policy will continue with the
applicable death cover.
10 Waiting /lien Period, if Not Available Clause 4.3.3
any of Part D
11 Grace period A Grace Period of fifteen (15) days for monthly mode and thirty (30) days for all other modes, from the due Clause 6.3
date will be allowed for payment of each subsequent premium. The Policy will remain in force during this of Part F
period. If any premium remains unpaid at the end of its Grace Period, the Policy shall lapse and have no
further value except as may be provided under the Non-Forfeiture Provisions.

In case of death of the Life Insured during the Grace Period but before the payment of the premium then due,
the policy will still be valid and the benefits shall be paid after deductions of the said unpaid premium and also
the balance premium(s), if any, falling due from the date of death and before the next policy anniversary.
12 Free Look Period If you are not satisfied with the terms & conditions of the policy, you have the right to cancel the policy by Clause 4.14
providing a written notice to the Company stating objections/reasons and receive the refund of all premiums of Part D
paid without interest after deducting stamp duty and medical examination cost along with applicable taxes,
cesses and levies which have been incurred for issuing the policy. Such notice must be signed by you and
received directly by the Company within 30 days from the date of receipt of the policy document whether the
Policy is sourced electronically or otherwise.
13 Lapse, paid-up and Non-Forfeiture Benefit on Premium Discontinuance: Clause 6. 5
revival of the Policy and 6.7 of
If any due premium for a non-single pay policy remains unpaid at the end of the grace period, the following is Part F
the treatment under various scenarios:

Premium Paying options Life Coverage Benefits Payable

After one full After one full year’s (if applicable)
year’s premium premium paid
paid
Life Promise Regular or Cover cease to Cover continues with Death Benefit as defined below
Plus Option Limited Pay exist Reduced Paid-Up is payable on death of the Life
Sum Assured Insured
Payor Accelerator Benefit is
payable on confirmed
diagnosis of Terminal Illness of
the Life Insured.
Surrender Value/Unexpired Risk
Premium as defined below is
payable.
Maturity / Survival Value as
defined

REVIVAL
 If a premium is in default beyond the Grace Period and subject to the Policy not having been surrendered, it
may be reinstated/revived, within five years after the due date of first unpaid premium and before the date of
maturity, subject to: (i) Policyholder’s written application for reinstatement/revival; (ii) production of Insured’s
current health certificate and other evidence of insurability, satisfactory to the Company; and (iii) payment of
all overdue premiums with interest.

Refer the policy document for more details

14 Policy Loan, if applicable Not Available Clause 6.6
of Part F
15 Claims/Claims Turn Around Time (TAT) for claims settlement and brief procedure :
Procedure 30 days from receiving all the documents,
90 days from the day of the claim intimation, if further investigation required.
Brief procedure :
i.Intimate claim to us via email/call/or at any one of the branch offices.
ii. Submit all relevant documents along with claim. Please refer to www.tataaia.com for more
details.
iii.Documents shall be verified and processed.
iv.We shall contact you in case of any queries or further information required.
v.Claim amount shall be disbursed if claim is acceptable.
vi.For the detailed procedure, please refer to our website www.tataaia.com.
Helpline/Call Centre number : 1-860-266-9966 (local charges apply)
Contact details of the insurer :
Email - [email protected] Call our helpline number 1-860-266-9966 (local charges apply)
Write directly to us on following address:
Tata AIA Life Insurance Company Limited B - Wing, 9th Floor, I-Think Techno Campus, Behind TCS,
Pokhran Road No.2, Close to Eastern Express Highway, Thane (West) – 400 607, Maharashtra.
Link for downloading claim form and list of documents required including bank account details
www.tataaia.com

16 Policy Servicing Turn Around Time (TAT) : Part G

For Policy Servicing TATs, please visit www.tataaia.com
Helpline/Call Centre number : 1-860-266-9966 (Call charges apply)
Contact details of the insurer :
Email - [email protected] Call our helpline number 1-860-266-9966 (local charges apply)
Write directly to us on following address:
Tata AIA Life Insurance Company Limited B - Wing, 9th Floor, I-Think Techno Campus, Behind TCS,
Pokhran Road No.2, Close to Eastern Express Highway, Thane (West) – 400 607, Maharashtra.
Link for downloading claim form and list of documents required including bank account details
www.tataaia.com

17 Grievance/Complaints Contact details of Grievance Redressal Officer of the Insurer Part G

Customers can email to [email protected] or write to – Grievance Redressal Officer (GRO)
 Tata AIA Life Insurance Company Limited B - Wing, 9th Floor, I-Think Techno Campus, Behind TCS
(Lodha), Thane (West) – 400 607, Mumbai.
Link for registering the grievance with the insurer’s portal The Insurer’s portal may be accessed on
www.tataaia.com
Contact details of Ombudsman

Where the redressal is not satisfactory despite the escalations, you may represent to the Ombudsman. For
further information or latest updated list of Ombudsman Office addresses, kindly visit the IRDA of India
website https://www.cioins.co.in/Ombudsman - Ombudsman / List of Insurance Ombudsmen OR our website
www.tataaia.com
Tata AIA Life Insurance • IRDA of India Regn no. 110

"We", "Us", "Our", "Insurer" or "Company" refers to Tata AIA Life Insurance Company Limited.

Declaration by the Policy Holder:

I have read the above and confirm having noted the details. I further confirm the below that:

a. In case of any change to the Sum Insured/ Rider after submission of the proposal, the details in the revised Benefit Illustration and Customer Information Sheet would be applicable.
b. I have received a copy of the CIS through the download utility/ through my Salesperson.
c. I am aware that on request I can avail of the CIS in local language.

Place:

Date:

(Signature of Policyholder)

OTP XXXX received vide mobile no. XXXXXXXXXX has been used to authenticate your proposal form no. C292697470 , benefit illustration no. Q17474034317365, suitability analysis and
Customer Information Sheet on Fri May 16 2025 19:25:13 GMT+0530 (India Standard Time)