URN No.

BI460180510

Benefit Illustration for Pramerica Life RockSolid Term Insurance

Product Code: T51 Quote Generated by: PLIL

Quotation Date: Sat Mar 30 2024
This benefit illustration is intended to show year-wise premiums payable and benefits under the policy. The illustration is in accordance with the guidelines set by Life Insurance Council & Insurance
Regulatory and Development Authority of India. Some benefits are guaranteed and some benefits are variable with returns based on the future performance of your insurer carrying on life insurance
business. If your policy offers guaranteed benefits then these will be clearly marked “guaranteed” in the illustration table on this page. If your policy offers variable benefits then the illustrations on this
page will show two different rates of assumed future investment returns. These assumed rates of return are not guaranteed and they are not the upper or lower limits of what you might get back, as
the value of your policy is dependent on a number of factors including actual future investment performance.
Customer Details Proposal No.
Name of the Policyholder: Valued Customer Name of the Product Pramerica Life RockSolid Term Insurance
A Non-Linked Non Participating Individual Pure Risk Premium Life
Age: 37 Tag Line:
Insurance Plan
Gender: Male Unique Identification No.: 140N079V01
Existing Policyholder / Staff: No GST & Cess Rate (first year): 18%
GST & Cess Rate (2nd year
18%
onwards):
Name of Life Assured: Valued Customer
Age: 37
Gender: Male
Tobacco User(Yes/No): No
Spouse Cover (Yes/No): No
Name of the Spouse of Life Assured: NA
Age: NA
Gender: NA
Tobacco User(Yes/No): NA
Spouse Cover Sum Assured: NA

Communication Address:
Pramerica Life Insurance Limited 4th Floor, Building No-9B,DLF Cyber City, Phase - III,Gurgaon - 122002, Haryana, Registration No. 140

Company Salesperson's Signature:_______________________________ Proposer's Signature:_______________________________

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 Policy Details Extras if applicable
Distribution Channel: Others Underwriting Extra Details Applicable Rate Duration (years)
Base Sum Assured: Rs. 1,00,00,000
Premium Paying Term: 38 Years
Policy Term: 38 Years
Increasing Cover Option (Yes/No): No
Increasing Cover %: NA
Life Stage Cover (Yes/No): No
Sum Assured On Death:
Rs. 1,00,00,000
(at inception of policy)
Death Benefit Payout Option: Lumpsum
Monthly Income Period: NA Medical Sum Under Consideration (MSUC): Rs. 1,00,00,000. The mentioned amount can be referred to determine the medical
requirements.#
Lump Sum Death Benefit: 100 %
Mode Of Premium Payment: Annual
Medically
Premium Status:
Underwritten
Amount Of Base Installment
Rs. 26,965
Premium:

Communication Address:
Pramerica Life Insurance Limited 4th Floor, Building No-9B,DLF Cyber City, Phase - III,Gurgaon - 122002, Haryana, Registration No. 140

Company Salesperson's Signature:_______________________________ Proposer's Signature:_______________________________

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 Rider Details
Rider Installment
Rider Premium
Description Rider Sum Assured Rider Term Premium (without
Paying Term
GST)
Pramerica Life Accidental Death Benefit Rider (UIN:140B029V01) Rs. 50,00,000 38 38 Rs.4,500
Pramerica Life Accidental Total Permanent Disablity Rider (UIN:140B027V01) Rs. 50,00,000 38 38 Rs.1,700
Pramerica Life Critical Illness Rider (UIN:140B026V01) NA
Pramerica Life Waiver Of Premium Rider (UIN:140B028V01) NA

Premium Summary
Total Instalment
Base Plan Riders
Premium
Instalment Premium without GST & Cess Rs. 26,965 Rs. 6,200 Rs. 33,165
Instalment Premium without GST & Cess after discount, if applicable(First Year only) Rs. 25,617 Rs. 6,200 Rs. 31,817
Instalment Premium with First Year GST & Cess after discount, if applicable Rs. 30,228 Rs. 7,316 Rs. 37,544
Instalment Premium without GST & Cess 2nd Year Onwards after discount, if applicable Rs. 26,965 Rs. 6,200 Rs. 33,165
Instalment Premium with GST & Cess 2nd Year Onwards Rs. 31,819 Rs. 7,316 Rs. 39,135

Communication Address:
Pramerica Life Insurance Limited 4th Floor, Building No-9B,DLF Cyber City, Phase - III,Gurgaon - 122002, Haryana, Registration No. 140

Company Salesperson's Signature:_______________________________ Proposer's Signature:_______________________________

DECIMAL Version No. 2.3.0 Page: 3/6
 (Amount in Rupees)
GUARANTEED NON GUARANTEED

Policy Annualized Survival Maturity Death Policy Cancellation Min Guaranteed Surrender Special Surrender
Age
Year Premium Benefits Benefit Benefit Value Value Value
1 38 25,617 0 0 1,00,00,000 0 0 0
2 39 26,965 0 0 1,00,00,000 0 0 0
3 40 26,965 0 0 1,00,00,000 0 0 0
4 41 26,965 0 0 1,00,00,000 0 0 0
5 42 26,965 0 0 1,00,00,000 0 0 0
6 43 26,965 0 0 1,00,00,000 0 0 0
7 44 26,965 0 0 1,00,00,000 0 0 0
8 45 26,965 0 0 1,00,00,000 0 0 0
9 46 26,965 0 0 1,00,00,000 0 0 0
10 47 26,965 0 0 1,00,00,000 0 0 0
11 48 26,965 0 0 1,00,00,000 0 0 0
12 49 26,965 0 0 1,00,00,000 0 0 0
13 50 26,965 0 0 1,00,00,000 0 0 0
14 51 26,965 0 0 1,00,00,000 0 0 0
15 52 26,965 0 0 1,00,00,000 0 0 0
16 53 26,965 0 0 1,00,00,000 0 0 0
17 54 26,965 0 0 1,00,00,000 0 0 0
18 55 26,965 0 0 1,00,00,000 0 0 0
19 56 26,965 0 0 1,00,00,000 0 0 0
20 57 26,965 0 0 1,00,00,000 0 0 0
21 58 26,965 0 0 1,00,00,000 0 0 0

Communication Address:
Pramerica Life Insurance Limited 4th Floor, Building No-9B,DLF Cyber City, Phase - III,Gurgaon - 122002, Haryana, Registration No. 140

Company Salesperson's Signature:_______________________________ Proposer's Signature:_______________________________

DECIMAL Version No. 2.3.0 Page: 4/6
 (Amount in Rupees)
GUARANTEED NON GUARANTEED

Policy Annualized Survival Maturity Death Policy Cancellation Min Guaranteed Surrender Special Surrender
Age
Year Premium Benefits Benefit Benefit Value Value Value
22 59 26,965 0 0 1,00,00,000 0 0 0
23 60 26,965 0 0 1,00,00,000 6,18,847 0 0
24 61 26,965 0 0 1,00,00,000 6,45,812 0 0
25 62 26,965 0 0 1,00,00,000 6,72,777 0 0
26 63 26,965 0 0 1,00,00,000 6,99,742 0 0
27 64 26,965 0 0 1,00,00,000 7,26,707 0 0
28 65 26,965 0 0 1,00,00,000 7,53,672 0 0
29 66 26,965 0 0 1,00,00,000 0 0 0
30 67 26,965 0 0 1,00,00,000 0 0 0
31 68 26,965 0 0 1,00,00,000 0 0 0
32 69 26,965 0 0 1,00,00,000 0 0 0
33 70 26,965 0 0 1,00,00,000 0 0 0
34 71 26,965 0 0 1,00,00,000 0 0 0
35 72 26,965 0 0 1,00,00,000 0 0 0
36 73 26,965 0 0 1,00,00,000 0 0 0
37 74 26,965 0 0 1,00,00,000 0 0 0
38 75 26,965 0 0 1,00,00,000 0 0 0

# In addition to mentioned MSUC amount, decision to conduct medicals may also take into account detailed underwriting and any previously existing policy (if any) of the customer with
Pramerica Life Insurance Ltd.

Communication Address:
Pramerica Life Insurance Limited 4th Floor, Building No-9B,DLF Cyber City, Phase - III,Gurgaon - 122002, Haryana, Registration No. 140

Company Salesperson's Signature:_______________________________ Proposer's Signature:_______________________________

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Conditions applicable specific to this product:

1. The policy acquires the Policy Cancellation Value immediately upon payment of premiums for at least two full years under limited premium payment policies only. Policy cancellation value shall be
payable upon the policyholder applying for the same before the stipulated date of maturity or at the end of revival period if the policy is not revived, in case of Limited Premium Payment Policies.
Policy cancellation value is calculated as = Policy Cancellation Value (PCV) Factor x (multiplied by) Total Premiums paid^ x (multiplied by) (Unexpired policy term (in months) / (Original Policy Term (in
months) Where, the PCV Factor(other than Single Pay) is as follows:

Policy Year PCV Factor

During the premium payment term or if all due premiums have not been paid 30%
After completion of the premium payment term if all due premiums have been paid 50%
For Single Pay: 70%
^‘Total Premiums Paid’ is the total of all premiums received, excluding rider premiums and taxes

2. No policy cancellation value shall be payable in respect of regular premium policies.

General Conditions:

1. Pramerica Life RockSolid Term Insurance is only the name of the Policy and does not in any way indicate the quality of the policy, its future prospects or returns.
2. The illustrated benefits are assumed as at end of the Policy Year.
3. The illustrative benefits above assume that all Premium are paid on due date at the beginning of the policy year.
4. Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any and Goods & Service Tax and applicable cess and is inclusive
of Discount(if any).
5. The Instalment premium mentioned above (with First Year and 2nd Year GST & Cess) is the Premium payable on the due date and includes tax which is levied as per the applicable tax rates.
6. Installment Premium without GST & Cess is the Premium payable on the due date excluding tax .
7. In case the Death benefit payout option chosen is 'Monthly Income' or 'Lumpsum + Monthly Income', the monthly income factor shall be the prevalent as at the time of claim intimation date.
8. Tax Benefits may be available as per the prevailing Income Tax laws.
9. For more details on risk factors, description of benefits or for any other benefit available under the policy, please refer to the Sales Brochure and Policy Document.
10. For any further clarifications, please feel free to get in touch with your company salesperson.
11. Please contact the Company for further details on various premium paying mediums available under the plan.

I, …………………………………,have explained the premiums, and benefits under I ________________________________________, having received the information with
the product fully to the prospect / policyholder. respect to the above, have understood the above illustration and statements
Date: before entering into the contract.
Place: Date:
Signature of Prospect / Policyholder
Signature of the Agent/Intermediary/ Official

Communication Address:
Pramerica Life Insurance Limited 4th Floor, Building No-9B,DLF Cyber City, Phase - III,Gurgaon - 122002, Haryana, Registration No. 140

Company Salesperson's Signature:_______________________________ Proposer's Signature:_______________________________

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