Aviva Life Insurance Company India Limited

Premium Quotation

Version Number: 65
Prepared On : 27/4/2019

Proposed Date of Commencement:

27/4/2019
Proposal Number: Age of the Life Insured (On DOC):34
Years
Gender : Male
Product Features

1. Name of the Product : Aviva New Family Income Builder

2. Unique Identification No. : 122N103V03
3. Policy Term : 12 Years
4. Premium Paying Term : 12 Years
5. Payout Period : 12 (Year 13 to 24)
6. Premium Paying Frequency : Annual
7. Sum Assured :960,000
8. Premium : 40,000

Premium Modal Goods & Services Tax* Total Premium Amount

Policy Term
Payment Term Premium Year 1 Year 2 onwards Year 1 Year 2 onwards
12 12 40,000 1800 900 41,800 40,900
Total Amount 41,800 40,900

9. Death Benefit :
In case of death of the life insured during the policy term provided all due premiums till date of death have been paid, the Death Sum Assured
payable shall be highest of the following amounts:
a) 10 times of the annualized premium(excluding taxes and extra premiums, if any),
or
b) 105% of all the premiums paid (excluding taxes and extra premiums, if any) as on date of death,
or
c) Maturity Sum Assured
d) Sum Assured of the Policy;
The Death Sum Assured will be paid in the following manner:
• 12 regular annual instalments of “1.5 times the annual premium” (excluding taxes and extra premium, if any) shall be paid. The first
instalment along with Guaranteed Terminal Benefit would be paid at the time of death (subject to admission of claim) and the remaining 11
annual instalments shall be paid on each of the death anniversary of the life insured commencing from first death anniversary date
•A lump sum amount of “6 times the annual premium” (excluding taxes and extra premium, if any) shall be paid along with the 12th annual
instalment on 11th death anniversary of the life insured.

10. Maturity Benefit:

In case the life insured survives till the end of the Policy Term provided all due premiums have been paid; the Maturity Sum Assured will be paid
in the following manner:
•12 regular instalments each amounting to Rs. 60,000 shall be paid at the end of each year during the Payout Period i.e. from year 13 to
24.
•An additional lumpsum amount of Rs. 240,000 shall be paid at the end of Payout Period, i.e. at the end of 24th year.
•In addition to maturity sum assured a Guaranteed Terminal Benefit as given below will also be payable at maturity i.e at the end of the
Policy Term.

11. Guaranteed Terminal Benefit

A Guaranteed Terminal benefit as per the entry age falling in the age bands in the table below will be payable on death (subject to admission of
claim) or at the end of Policy Term

Age at entry
Guaranteed Terminal Benefit
Band(years)
12% of Annual Premium (excluding taxes and extra premium, if
6-15
any)
10% of Annual Premium (excluding taxes and extra premium, if
16-25
any)
8% of Annual Premium (excluding taxes and extra premium, if
26-35
any)
6% of Annual Premium (excluding taxes and extra premium, if
36-40
any)
4% of Annual Premium (excluding taxes and extra premium, if
41-45
any)
2% of Annual Premium (excluding taxes and extra premium, if
46-50
any)
12. Surrender Value:
Policy Year of Annual Premium Guaranteed Non
surrender (excluding extra Surrender Guaranteed
premium and Goods & Services Value Special
Tax*) (GSV) Surrender
Value (SSV)
1 40,000
2 40,000
3 40,000 36,000 52,976
4 40,000 80,000 93,109
5 40,000 100,000 144,480
6 40,000 120,000 195,048
7 40,000 140,000 250,031
8 40,000 160,000 311,435
9 40,000 216,000 375,648
10 40,000 280,000 449,493
11 40,000 396,000 529,760
12 40,000 432,000 597,184

Note

All the benefits shown in the above table are guaranteed provided all the due premiums are paid, except the special surrender values.
Special Surrender Values may change as decided by the company from time to time with prior approval of IRDA.
*Taxes including but not limited to Goods & Services Tax, Cesses as applicable shall also be levied as notified by the Government from
time to time. Tax laws are subject to change.
A policy can be surrendered anytime provided at least three years’ premiums have been paid. Surrender Value payable is greater of the
Guaranteed Surrender Value and the Special Surrender Value. For more details, please read sales brochure of this plan.
If premium payment is discontinued before 3 years’ premiums have been paid, the policy shall lapse. If a lapsed policy is not revived within
the revival period (2 years from date of first unpaid premium), the policy will be terminated by paying the following amounts at the end of the
revival period:
­ If only first year’s premium has been paid then, 30% of the premiums paid (excluding taxes and extra premiums, if any) will be payable. 
­ If two years’ premiums have been paid then, 60% of premiums paid (excluding taxes and extra premium, if any) will be payable. 
In case of death during the revival period, 100% of the premiums paid (excluding taxes and extra premiums, if any) till the time of death will
be returned and the policy shall be terminated without any other benefit.
For more details on terms and conditions please read sales brochure of this plan carefully before concluding a sale.

Signature of the Intermediary :

Proposer’s Signature:
Company Seal
Place:
Date:
Aviva New Family Income Builder
Important points you must know about this policy
What is Aviva New Family Aviva New Family Income Builder is a life insurance plan in which you pay for 12 years and get double of
Income Builder?
What is the guarantee under this plan?
What is the Term of this policy?
What are the Premium Payment Term
options under this plan?
What are the benefits under this plan?
What happens if I stop paying my
premiums?
what you have paid over the next 12 years.
The plan offers guaranteed payout equal to double the premiums you have paid, over 12 years after the policy term,
if all due premiums have been paid.
The policy has a fixed term of 12 years.
The Premium Paying Term is equal to the Policy Term which is fixed for 12 years. The premium payment frequency
allowed is Annual only.
You have to pay premiums regularly for 12 Years at Annual frequency.
Death Benefit:
In case of death of the life insured during the policy term provided all due premiums have been paid till the date of
death, the sum assured will be paid in the following manner:
    • 12 regular annual installments of "1.5 times the annual premium" (excluding taxes and extra premium, if any)
shall be paid. The first installment would be paid at the time of claim settlement and the remaining 11 annual
installments shall be paid on each of the death anniversary of the life insured commencing from first death
anniversary date
    • A lump sum amount of “6 times the annual premium” (excluding taxes and extra premium, if any) shall be paid
along with the 12th payout.
In addition, your nominee also receives the Guaranteed Terminal Benefit along with the first payout
Maturity Benefit:
In case the you survives till the end of the Policy Term and provided all due premiums have been paid; the Maturity
Sum Assured will be paid in the following manner:
    • 12 annual installments of "1.5 times the annual premium" (excluding taxes and extra premium, if any) shall be
paid at the end of each year during the payout period.
    • A lump sum amount of "6 times the annual premium" (excluding taxes and extra premium, if any) shall be paid at
the end of the payout period
• In addition, you also get Guaranteed Terminal Benefit basis your age at entry at the end of premium payment term
of 12 years
Annualised Premium
(Exclusive of extra Guaranteed Maturity Benefit
Policy Duration
premium, Goods & Services Tax* (At the year end)
(At the beginning of the year)
1 40,000
2 40,000
3 40,000
4 40,000
5 40,000
6 40,000
7 40,000
8 40,000
9 40,000
10 40,000
11 40,000
12 40,000 3,200
13 60,000
14 60,000
15 60,000
16 60,000
17 60,000
18 60,000
19 60,000
20 60,000
21 60,000
22 60,000
23 60,000
24 300,000
If the premiums are not paid within the first three years before expiry of grace period, the policy will lapse. A
lapsed policy can be reinstated within 2 years from the date of first unpaid premium. If not reinstated, the policy will
terminate after paying the following amount at the end of reinstatement period:
    • If only first year’s premium has been paid then, 30% of the premium paid. 
    • If two years’ premiums have been paid then, 60% of premiums paid. 
    • In case death occurs during the reinstatement period 100% of all the premiums paid till the date of death will be
returned and the policy shall be terminated.
If the premiums are not paid after first three years before expiry of grace period, your policy becomes a paid-
up policy. A paid up policy can be reinstated within 2 years from the date of first unpaid premium. If the paid up
policy is not revived :
    • Survival and Death benefits will be reduced depending on the ratio of premiums paid to premiums payable.

Can I cash in (surrender) the policy
during the term of the policy?
Annual Premium refers to premium paid each year excluding taxes and extra premium, if any.
Please refer to the Key Feature brochure for details.
You do have an option to cash-in (surrender) this policy if premiums were paid for at least 3 years, after deduction of
surrender penalty. The surrender amount will be less than the amount of premiums paid in most cases.
Please refer to the Key Feature brochure for details.
In case of death of life insured due to suicide within 12 months:

1. From the date of inception of the policy, your nominee or beneficiary shall be entitled to 80% of the premiums
paid excluding any payment for taxes and extra premiums, provided the policy is in force or,
What is not covered under this policy
(Exclusions)?
2. From the date of revival of the policy, your nominee or beneficiary shall be entitled to an amount which is
higher of 80% of the premiums paid excluding any payment for taxes and extra premiums or the Surrender
Value as available on the date of death

You have Freelook Period of 15 days from the date you receive your policy document. In case you cancel the policy
Do I have a right to review my
purchase? during the freelook period, the company will refund the premium on the date of cancellation, after deducting
expenses incurred on medical examinations, if any, and stamp duty.
We request you to personally fill the proposal form and provide accurate information to ensure that your claim is not reduced or
declined because of non-disclosure or misrepresentation of information.
Please note:
• Aviva is not liable for any claim until receipt of premium in full, completion of underwriting and acceptance of risk.
• This document does not contain the full terms and conditions of the Policy. Details of the terms and conditions, and exclusions of the insurance
contract are contained in the Key Feature brochure. It is important that you read the entire Key Feature brochure.
I confirm that I have read the Key Feature brochure and the Official Illustration of the insurance product along with this document and understand
the features such as policy benefits, premium payable including the number of years for which premium is required to be paid, lock-in period,
whether any guarantee is available and if yes then subject to what conditions.
I also confirm that I have applied for a backdated policy and I agree to pay a onetime backdating interest of Rs. 0 + GST @ 18%
along with the first premium .
I agree and confirm to the use of electronic medium, including email, as a mode of communication from and to the Company.
Signature of Life Assured
Signature of the Proposer
(In case different from Proposer)
Proposer name Name of Life Assured
Proposal number Proposal Date