*U11403*

L&C/Advt/2010/Mar/1110
SALES BENEFIT ILLUSTRATION

Name of the Proposed Insured:

SM

Age/Sex of the Proposed Insured:

Name of the Policyholder:

NM

Age/Sex of the Policyholder:

35

Insurance Plan

Female

Male

UIN

Tata AIG Life MAHALIFE GOLD

MAHALIFE
110N029V01
GOLD

Agent Number:

4471705

Agent Name:

Benefit Period
(years)

Premium Paying
Period (years)

95

15

Proposal Number:

60713

Date:

21-Jun-11

Currency

Rupees

Payment Mode:

Annual

Sum Assured

First Modal Premium

500,000

43,500

Total

43,500

Total

43,500

Service Tax*
Total Premium Inclusive of Service Tax

674
44,174

Contact Phone Number:

* Service Tax rate currently applicable is 1.55%

** Please refer to the Exclusion Page(s) attached to this Life Insurance Illustration for the exclusion on the rider(s) attached.
Service tax is applicable as per governing laws and the same shall be borne by the policyholder. Tata AIG Life Insurance Company Limited reserves the right to recover from the Policyholder, any levies and duties (including service tax), as imposed by the government from time
to time.

Some benefits are guaranteed and some benefits are variable with return based on the future performance of your life insurance company (Tata AIG Life Insurance Company Ltd).
If your policy offers guaranteed returns then these will be clearly marked "guaranteed" in the illustration table on this page. If your policy offers variable returns the illustration will have two pages that will show two different rates of assumed future investment returns and
corresponding cash dividend rates. The above cash dividends have been determined using assumed future investment returns of 10% & 6% respectively. The rates used have been set by the Life Insurance Council. These assumed rates of return are not guaranteed and
they are not upper or lower limits of what you might get back as the value of your policy is dependent on a number of factors including future investment performance.
Note: This illustration is not an insurance contract. Read this benefit illustration along with a product brochure for detailed terms and conditions before concluding a sale.
Insurance is the subject matter of the solicitation

This product is underwritten by Tata AIG Life Insurance Company Ltd.

Policyholder's Initials/Signatutre___________

Tata AIG Life Insurance Company Ltd. (Regn No. 110)

Corporate & Registered Office: Delphi - B Wing, 2nd floor, Orchard Avenue, Hiranandani Business Park, Powai , Mumbai - 400076
For more information, call the Tata AIG Life Insurance Company Ltd. toll free Helpline at 1-800-119966 (facility available to MTNL and BSNL users)

Page 1 of 8

Tata AIG Life Insurance Company Ltd.

Version 1.0
60713

Projection Of Values (For Illustration Only)

Scenario:

High Cash Dividend Rate

Death Benefits on Policy Anniversary

Guaranteed

Policy

Insured

Anniversary

Age

0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38

5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43

Basic

Total

Rider

Total

Life

Premium Premium

Premiums

Coverage

43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000

43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

What you will get back

Guaranteed

Life Coverage

(6)

Total

500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000

Non- Guaranteed

Accident Coverage
Total

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Annual Cash (2)

Dividend

0
0
0
0
0
0
15,500
15,500
15,500
15,500
31,000
31,000
31,000
31,000
31,000
31,000
31,000
31,000
31,000
31,000
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500

Guaranteed

Total Cash Dividend

(3)

Coupon

(1)

Payable Upto

0
0
0
0
0
0
15,500
31,000
46,500
62,000
93,000
124,000
155,000
186,000
217,000
248,000
279,000
310,000
341,000
372,000
418,500
465,000
511,500
558,000
604,500
651,000
697,500
744,000
790,500
837,000
883,500
930,000
976,500
1,023,000
1,069,500
1,116,000
1,162,500
1,209,000
1,255,500

Non-Guaranteed

Total Coupons(4) Cash Surrender (5) /Maturity

Values (7)

Paid Upto

0
0
0
0
0
0
0
0
0
0
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000

0
0
0
0
0
0
0
0
0
0
25,000
50,000
75,000
100,000
125,000
150,000
175,000
200,000
225,000
250,000
275,000
300,000
325,000
350,000
375,000
400,000
425,000
450,000
475,000
500,000
525,000
550,000
575,000
600,000
625,000
650,000
675,000
700,000
725,000

0
0
0
40,160
70,535
102,910
140,365
183,345
221,265
261,665
304,715
323,945
344,430
366,260
389,520
414,315
414,535
414,765
415,010
415,270
415,545
415,835
416,140
416,470
416,815
417,190
417,585
418,005
418,455
418,925
419,425
419,955
420,510
421,090
421,700
422,340
423,010
423,710
424,445

Policyholder's Initials/Signatutre___________
Tata AIG Life Insurance Company Ltd. (Regn No. 110)
Corporate & Registered Office: Delphi - B Wing, 2nd floor, Orchard Avenue, Hiranandani Business Park, Powai , Mumbai - 400076
For more information, call the Tata AIG Life Insurance Company Ltd. toll free Helpline at 1-800-119966 (facility available to MTNL and BSNL users)

Page 2 of 8

Tata AIG Life Insurance Company Ltd.

Version 1.0
60713

Projection Of Values (For Illustration Only)

Scenario:

High Cash Dividend Rate

Death Benefits on Policy Anniversary

Guaranteed

Policy

Insured

Anniversary

Age

39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77

44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82

Basic

Total

Rider

Total

Life

Premium Premium

Premiums

Coverage

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

What you will get back

Guaranteed

Life Coverage

(6)

Total
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000

Non- Guaranteed

Accident Coverage
Total
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Annual Cash

(2)

Dividend
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500

Guaranteed

Total Cash Dividend

(3)

Coupon

(1)

Payable Upto
1,302,000
1,348,500
1,395,000
1,441,500
1,488,000
1,534,500
1,581,000
1,627,500
1,674,000
1,720,500
1,767,000
1,813,500
1,860,000
1,906,500
1,953,000
1,999,500
2,046,000
2,092,500
2,139,000
2,185,500
2,232,000
2,278,500
2,325,000
2,371,500
2,418,000
2,464,500
2,511,000
2,557,500
2,604,000
2,650,500
2,697,000
2,743,500
2,790,000
2,836,500
2,883,000
2,929,500
2,976,000
3,022,500
3,069,000

Non-Guaranteed
(4)

Total Coupons Cash Surrender (5) /Maturity

Values

Paid Upto
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000

750,000
775,000
800,000
825,000
850,000
875,000
900,000
925,000
950,000
975,000
1,000,000
1,025,000
1,050,000
1,075,000
1,100,000
1,125,000
1,150,000
1,175,000
1,200,000
1,225,000
1,250,000
1,275,000
1,300,000
1,325,000
1,350,000
1,375,000
1,400,000
1,425,000
1,450,000
1,475,000
1,500,000
1,525,000
1,550,000
1,575,000
1,600,000
1,625,000
1,650,000
1,675,000
1,700,000

(7)

425,215
426,015
426,855
427,730
428,635
429,570
430,540
431,540
432,575
433,640
434,735
435,865
437,030
438,230
439,465
440,750
442,085
443,455
444,860
446,300
447,765
449,250
450,765
452,355
453,955
455,555
457,155
458,750
460,330
461,895
463,445
464,965
466,460
467,920
469,345
470,720
472,055
473,330
474,540

Policyholder's Initials/Signatutre___________
Tata AIG Life Insurance Company Ltd. (Regn No. 110)
Corporate & Registered Office: Delphi - B Wing, 2nd floor, Orchard Avenue, Hiranandani Business Park, Powai , Mumbai - 400076
For more information, call the Tata AIG Life Insurance Company Ltd. toll free Helpline at 1-800-119966 (facility available to MTNL and BSNL users)

Page 3 of 8

Tata AIG Life Insurance Company Ltd.

Version 1.0
60713

Projection Of Values (For Illustration Only)

Scenario:

High Cash Dividend Rate

Death Benefits on Policy Anniversary

Guaranteed

Policy

Insured

Anniversary

Age

78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95

83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100

Basic

Total

Rider

Total

Life

Premium Premium

Premiums

Coverage

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

What you will get back

Guaranteed

Life Coverage

(6)

Non- Guaranteed

Accident Coverage

Total

Total

500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Annual Cash

(2)

Guaranteed

Total Cash Dividend

Dividend

(3)

Coupon

(1)

Payable Upto

46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500
46,500

Non-Guaranteed
(4)

Total Coupons Cash Surrender (5) /Maturity

Values (7)

Paid Upto

3,115,500
3,162,000
3,208,500
3,255,000
3,301,500
3,348,000
3,394,500
3,441,000
3,487,500
3,534,000
3,580,500
3,627,000
3,673,500
3,720,000
3,766,500
3,813,000
3,859,500
3,906,000

25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000

1,725,000
1,750,000
1,775,000
1,800,000
1,825,000
1,850,000
1,875,000
1,900,000
1,925,000
1,950,000
1,975,000
2,000,000
2,025,000
2,050,000
2,075,000
2,100,000
2,125,000
2,150,000

475,685
476,745
477,750
478,725
479,675
480,610
481,540
482,470
483,425
484,440
485,570
486,905
488,600
490,925
494,365
499,810
508,935
525,000

(1) Coupon is a guaranteed feature. Coupon is payable depending on the sum assured of the basic policy.
(2) Annual Cash Dividend is declared based on the investment, expenses, and mortality experience of the company and is not guaranteed.
This illustration assumes the Annual Cash Dividend if it is declared at the rates mentioned below:Policy Anniversary
6-9
10 - 19
20 & above
Annual Cash Dividend per 1,000 Basic
Sum Assured

31

62

93

(3) This illustration shows as the column "Total Cash Dividend Payable Upto" the progressive total of Annual Cash Dividends paid out.
(4) This illustration shows as the column "Total Coupons Paid Upto" the progressive total of coupon amounts paid out.
(5) Cash Surrender Value is available upon surrender of the policy. The company will guarantee a minimum basic cash surrender value of 30% of the premiums paid
(excluding the first year's premium and extra premiums, if any) on your basic policy provided three annual premiums have been paid in full.
(6) Life Coverage Total includes term rider coverage provided under the term rider, if attached to this policy.
(7) The last value shows the Maturity of the Policy. On maturity you will receive Life Coverage (Excluding that on attached term rider, if any) & Final Coupon i.e. Rs.

525,000

is payable.

Policyholder's Initials/Signatutre___________
Tata AIG Life Insurance Company Ltd. (Regn No. 110)
Corporate & Registered Office: Delphi - B Wing, 2nd floor, Orchard Avenue, Hiranandani Business Park, Powai , Mumbai - 400076
For more information, call the Tata AIG Life Insurance Company Ltd. toll free Helpline at 1-800-119966 (facility available to MTNL and BSNL users)

Page 4 of 8

Tata AIG Life Insurance Company Ltd.

Version 1.0
60713

Projection Of Values (For Illustration Only)

Scenario:

Low Cash Dividend Rate

Death Benefits on Policy Anniversary

Guaranteed

Policy
Anniversary

0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38

Insured
Basic Rider
Age Premium Premium

5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43

43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Total

What you will get back

Guaranteed

Total
Premiums

Life
Coverage

Life Coverage (6)

Total

43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
43,500
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000

500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000

Non- Guaranteed

Guaranteed

Accident Coverage
Total

Annual Cash (2)

Dividend

Total Cash Dividend (3)

Payable Upto

Coupon (1)

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
3,500
3,500
3,500
3,500
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500

0
0
0
0
0
0
3,500
7,000
10,500
14,000
21,000
28,000
35,000
42,000
49,000
56,000
63,000
70,000
77,000
84,000
94,500
105,000
115,500
126,000
136,500
147,000
157,500
168,000
178,500
189,000
199,500
210,000
220,500
231,000
241,500
252,000
262,500
273,000
283,500

0
0
0
0
0
0
0
0
0
0
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000

Non-Guaranteed

Total Coupons(4)Cash Surrender (5) /Maturity

Values (7)
Paid Upto

0
0
0
0
0
0
0
0
0
0
25,000
50,000
75,000
100,000
125,000
150,000
175,000
200,000
225,000
250,000
275,000
300,000
325,000
350,000
375,000
400,000
425,000
450,000
475,000
500,000
525,000
550,000
575,000
600,000
625,000
650,000
675,000
700,000
725,000

0
0
0
40,160
70,535
102,910
140,365
183,345
221,265
261,665
304,715
323,945
344,430
366,260
389,520
414,315
414,535
414,765
415,010
415,270
415,545
415,835
416,140
416,470
416,815
417,190
417,585
418,005
418,455
418,925
419,425
419,955
420,510
421,090
421,700
422,340
423,010
423,710
424,445

Policyholder's Initials/Signatutre___________
Tata AIG Life Insurance Company Ltd. (Regn No. 110)
Corporate & Registered Office: Delphi - B Wing, 2nd floor, Orchard Avenue, Hiranandani Business Park, Powai , Mumbai - 400076
For more information, call the Tata AIG Life Insurance Company Ltd. toll free Helpline at 1-800-119966 (facility available to MTNL and BSNL users)

Page 5 of 8

Tata AIG Life Insurance Company Ltd.

Version 1.0
60713

Projection Of Values (For Illustration Only)

Scenario:

Low Cash Dividend Rate

Death Benefits on Policy Anniversary

Guaranteed

Policy
Anniversary
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77

Insured
Basic Rider
Age Premium Premium
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Total
Premiums

Life
Coverage

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000

Total

What you will get back

Guaranteed

Life Coverage
Total

(6)

500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000

Non- Guaranteed

Accident Coverage
Total
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Annual Cash
Dividend

(2)

10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500

Guaranteed

Total Cash Dividend

Payable Upto

(3)

294,000
304,500
315,000
325,500
336,000
346,500
357,000
367,500
378,000
388,500
399,000
409,500
420,000
430,500
441,000
451,500
462,000
472,500
483,000
493,500
504,000
514,500
525,000
535,500
546,000
556,500
567,000
577,500
588,000
598,500
609,000
619,500
630,000
640,500
651,000
661,500
672,000
682,500
693,000

Coupon

(1)

25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000

Non-Guaranteed
(4)

Total Coupons Cash Surrender (5) /Maturity

Values (7)
Paid Upto
750,000
775,000
800,000
825,000
850,000
875,000
900,000
925,000
950,000
975,000
1,000,000
1,025,000
1,050,000
1,075,000
1,100,000
1,125,000
1,150,000
1,175,000
1,200,000
1,225,000
1,250,000
1,275,000
1,300,000
1,325,000
1,350,000
1,375,000
1,400,000
1,425,000
1,450,000
1,475,000
1,500,000
1,525,000
1,550,000
1,575,000
1,600,000
1,625,000
1,650,000
1,675,000
1,700,000

425,215
426,015
426,855
427,730
428,635
429,570
430,540
431,540
432,575
433,640
434,735
435,865
437,030
438,230
439,465
440,750
442,085
443,455
444,860
446,300
447,765
449,250
450,765
452,355
453,955
455,555
457,155
458,750
460,330
461,895
463,445
464,965
466,460
467,920
469,345
470,720
472,055
473,330
474,540

Policyholder's Initials/Signatutre___________
Tata AIG Life Insurance Company Ltd. (Regn No. 110)
Corporate & Registered Office: Delphi - B Wing, 2nd floor, Orchard Avenue, Hiranandani Business Park, Powai , Mumbai - 400076
For more information, call the Tata AIG Life Insurance Company Ltd. toll free Helpline at 1-800-119966 (facility available to MTNL and BSNL users)

Page 6 of 8

Tata AIG Life Insurance Company Ltd.

Version 1.0
60713

Projection Of Values (For Illustration Only)

Scenario:

Low Cash Dividend Rate

Death Benefits on Policy Anniversary

Guaranteed

Policy
Anniversary
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95

Insured
Basic Rider
Age Premium Premium
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Total
Premiums

Life
Coverage

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000

Total

What you will get back

Guaranteed

Life Coverage
Total

(6)

Non- Guaranteed

Accident Coverage
Total

500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000
500,000

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

(1) Coupon is a guaranteed feature. Coupon is payable depending on the sum assured of the basic policy.
(2) Annual Cash Dividend is declared based on the investment, expenses, and mortality experience of the company and is not guaranteed.
This illustration assumes the Annual Cash Dividend if it is declared at the rates mentioned below:Policy Anniversary
6-9
10 - 19
Annual Cash Dividend per 1,000 Basic Sum Assured

Annual Cash
Dividend

14

(2)

10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500

Guaranteed

Total Cash Dividend

Payable Upto

(3)

703,500
714,000
724,500
735,000
745,500
756,000
766,500
777,000
787,500
798,000
808,500
819,000
829,500
840,000
850,500
861,000
871,500
882,000

Coupon

(1)

25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000
25,000

Non-Guaranteed
(4)

Total Coupons Cash Surrender (5) /Maturity

Values (7)
Paid Upto
1,725,000
1,750,000
1,775,000
1,800,000
1,825,000
1,850,000
1,875,000
1,900,000
1,925,000
1,950,000
1,975,000
2,000,000
2,025,000
2,050,000
2,075,000
2,100,000
2,125,000
2,150,000

475,685
476,745
477,750
478,725
479,675
480,610
481,540
482,470
483,425
484,440
485,570
486,905
488,600
490,925
494,365
499,810
508,935
525,000

20 & above
21

(3) This illustration shows as the column "Total Cash Dividend Payable Upto" the progressive total of Annual Cash Dividends paid out.
(4) This illustration shows as the column "Total Coupons Paid Upto" the progressive total of coupon amounts paid out.
(5) Cash Surrender Value is available upon surrender of the policy. The company will guarantee a minimum basic cash surrender value of 30% of the premiums paid
(excluding the first year's premium and extra premiums, if any) on your basic policy provided three annual premiums have been paid in full. The last value shows the Maturity of the Policy.
(6) Life Coverage Total includes term rider coverage provided under the term rider, if attached to this policy.
(7) The last value shows the Maturity of the Policy. On maturity you will receive Life Coverage (Excluding that on attached term rider, if any) & Final Coupon i.e. Rs.
525,000

is payable.

Policyholder's Initials/Signatutre___________
Tata AIG Life Insurance Company Ltd. (Regn No. 110)
Corporate & Registered Office: Delphi - B Wing, 2nd floor, Orchard Avenue, Hiranandani Business Park, Powai , Mumbai - 400076
For more information, call the Tata AIG Life Insurance Company Ltd. toll free Helpline at 1-800-119966 (facility available to MTNL and BSNL users)

Page 7 of 8

Tata AIG Life Insurance Company Ltd.

Version 1.0
60713

Declaration:
I have received a copy of this Sales Illustration and understand that any non-guaranteed benefits assumed in the Sales Illustration
are subject to change and are not guaranteed.

Signed:

___________________________

Name :

___________________________

Date:

___________________________

This is an illustrative document and not a contract. Your policy will contain the exact terms of coverage.

Authorised Official / Intermediary of Tata AIG Life Insurance Company Ltd.

Signed:

___________________________

Name :

___________________________

Date:

___________________________

Tax benefits are available as per Income-tax Act, 1961 and are subject to modifications made thereto from time to time.
Tata AIG Life Insurance Company Ltd. does not assume the responsibility on tax implications mentioned any where in this document.
Please consult your own tax consultant to know the tax benefit available to you.

Tata AIG Life Insurance Company Ltd. (Regn No. 110)

Corporate & Registered Office: Delphi - B Wing, 2nd floor, Orchard Avenue, Hiranandani Business Park, Powai , Mumbai - 400076
For more information, call the Tata AIG Life Insurance Company Ltd. toll free Helpline at 1-800-119966 (facility available to MTNL and BSNL users)

Page 8 of 8

Tata AIG Life Insurance Company Ltd.

Version 1.0
60713