Personal Details: Life To Be Insured: VF HG Age As On Last Birthday: 38 Years Gender: Male

Quote No.:100000000930037 Proposal No.: Policy No.
:
Illustration of benefits for Bharti AXA Life Shining Stars
A Non Linked Non Participating Limited Pay Endowment Life Insurance Plan
UIN : 130N095V01 Illustration generated by: agency

Product Code : NPC12H Illustration Date: 21-06-2019
Rider Code : MEA1B1
Personal Details Benefits and Premium Details

Plan Name Bharti AXA Life Shining Stars Hospital Cash Benefit Rider **
Life To Be Insured : Vf Hg (UIN:130B007V02)
Age as on last birthday : 38 years Policy Term (in Years) 17 years 5 years
Gender : Male Premium Payment Term (in Years) 12 years 5 years
Premium Mode Annual Annual
Maturity Benefit Option Flexi Payout Option -
Age at Maturity (in Years) 55 years 43 years
Sum Assured (Rs.) 1934985 1000
Annualized Premium (Rs.) 100000 1007.04
Modal Premium Payable (Rs.) 100000 1007.04
Tax Applicable for Modal Premium for 1st year 4500 181.27
(Rs.)
Tax Applicable for Modal Premium for 2nd year 2250 181.27
onwards (Rs.)
Modal Premium Payable By You for 1st year (Rs.) 105689
Modal Premium Payable By You for 2nd year onwards (Rs.)103438
Illustration summary over the Policy Term
Guaranteed Benefits
End of Policy Year. Annualized Premium Death Benefit Maturity Benefit Surrender
1 100000 1934985 - -
2 100000 1934985 - -
3 100000 1934985 - 90944
4 100000 1934985 - 203173
5 100000 1934985 - 253483
6 100000 1934985 - 350232
7 100000 1934985 - 476006
8 100000 1934985 - 611455
9 100000 1934985 - 758514
10 100000 1934985 - 919118
11 100000 1934985 - 1093267
12 100000 1934985 - 1282895
13 - 1934985 - 1387384
14 - 1934985 - 1499613
15 - 1934985 - 1621517
16 - 1934985 - 1753096
17 - 1934985 1934985 1934985
Name of the Proposer: __________________________________________________ Signature of the Proposer: ________________________________

Insurance is the subject matter of the solicitation.
Registered address- Unit No. 1904, 19th Floor, Parinee Crescenzo, 'G' Block, Bandra Kurla Complex, BKC Road, Behind MCA Ground, Bandra East, Mumbai -400051, Maharashtra
Service Unit address- Bharti AXA Life Insurance Company Limited, Spectrum tower, 3rd Floor,Malad link road, Malad (west), Mumbai 400064. Maharashtra
IRDA Regn no.-130. Website: www.bharti-axalife.com
Abacus Ver. 3.6 Page: 1 of 5
Name of the Proposer: __________________________________________________ Signature of the Proposer: ________________________________
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Explanation & Information – Shining Stars
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1. This benefit illustration explains the benefits and features of the proposed policy and is not a contract of insurance.
2. Under Flexi Payout Option - M aturity Benefit to be paid as lumpsum at the time of M aturity. The policyholder also has the option to take the
lumpsum at the end of any year during the M aturity Payout period. M aturity Payout period is the period of 4 years from the date of M aturity.
Under Annual Payout Option - M aturity Benefit to be paid as five equal annual payouts at the end of every year during the M aturity Payout period
starting from the date of maturity. The policyholder also has the option to take the present value of any outstanding annual payouts as a lumpsum
amount.
3. The illustration is based on the standard risk class, without taking in to consideration your own circumst ances. They will be determined
according to our underwriting decision.
4. All benefits under this plan are guaranteed.
5. The Death benefit mentioned in the Benefit Illustration is payable in case of Death of Life Insured during the Policy Term
6. The minimum guaranteed surrender value under the policy is 30% of all premiums paid till date if surrendered in 3rd year (for 10 to 15 years
premium payment term) and 2nd policy year(for 7 years, 8 years & 9 years premium payment term). This GSV keeps increasing every year
depending on the policy year of surrender. The GSV is paid only if the policy acquires surrender value. The company may declare surrender value
that is higher than the Guaranteed Surrender Values (i.e. Special Surrender Value). The Special Surrender Values are not guaranteed and subject to
declaration by The Company.
7. For more details on risk factors, terms and conditions please read sales brochure carefully before concluding a sale.
8. Tax benefits are as per the current tax legislations and are subject to change in tax laws. Neither the company nor its agents can offer legal or tax
advice.
9. Bharti AXA Life Insurance Company Ltd., Bharti AXA Life Shining Stars is the name of the Insurance Company, Product and does not in any
way indicate the quality of the contract, its future prospects or returns.
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Explanation & Information – Hospi Cash Rider (if applicable)
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1. This benefit illustration explains the benefit and features of the proposed rider and is not a contract of insurance.
3. Tax benefits are as per Income Tax Act 1961 and are subject to amendments from time to time. GST will be levied as per prevailing rates.
4. Neither the company nor its agents can offer legal or tax advice.
5. The illustration is based on the standard risk class, without taking in to consideration your own circumstances. They will be determined
6. Daily Hospital Cash benefit (DHCB) is the guaranteed benefit payable on a minimum Hospitalization of 48 hours of the Life Ins ured
during the policy Benefit Period subject to the Policy being in effect. The Premium rates will be subject to revision after every
three years (upwards or downwards) subject to experience and will be guaranteed for a period of three years.
7. Bharti AXA Life Insurance Company Ltd., Bharti AXA Life Hospi Cash is the name of the Insurance Company, Rider and does not
in any way indicate the quality of the contract, its future prospects or returns.
8. All benefits payable under the rider are subject to the Waiting Period and other exclusions as applicable. Please read sales
brochure in conjunction with this benefit illustration carefully before concluding a sale.
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Explanation & Information – Accidental Death Benefit Rider (if applicable)
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1. This benefit illustration explains the benefits and features of the proposed policy and is not a contract of insurance.
2. The illustration is based on the standard risk class, without taking in to consideration your own circumstances. They will be determined
3. All benefits under this plan are guaranteed.
5. Tax benefits are as per the current tax legislations and are subject to change in tax laws. Neither the company nor its agent s can offer
Legal or tax advice.
6. Bharti AXA Life Insurance Company Ltd., Bharti AXA Life Accidental Death Benefit Rider is the name of the Insurance Company,
Product and does not in any way indicate the quality of the contract, its future prospects or returns.
Declaration by Proposer
I confirm that before entering in to the contract of insurance I have read and understood the product brochure and the information provided in
this Illustration of benefits and understand that the policy Bond will be issued to me on this basis.
Name of Proposer : ___________________________ Place: ___________________
Signature of proposer : ____________________________ Date: ___________________

Declaration by Advisor / Sales Person
I certify that I have explained the product brochure and this benefit illustration to the proposer and have made no statements that are
inconsistent with the same
__________________________________ _________________________________
Name of the advisor/sales person Signature of the advisor/sales person

KEY FEATURE DOCUMENT – BHARTI AXA Life Shining Stars (UIN : 130N095V01)
Dea r Customer,
Tha nk you for choosing Bharti AXA Li fe Shining Stars. To check your understanding a bout the product, kindly confirm the following
deta ils.
 This is a  Single Premium plan  Limited Premium plan  Regular Premium plan.
Bharti AXA Life Aajeevan S ampatti + key features
 The premium payable is Rs. _______ every _______(month / quarter/ Semi-annual / annual)
 This is a non-linked articipating whole
Premium is payable for ______ years (premium paying term). life limited pay Insurance Product.
 The Policy will mature in ______ years (policy term).

I confirm that I have understood all the questions in the proposal form and answered them accordingly. I also understand that if there are any
misstatements or non-disclosure in my answers, it might result in repudiation of claim.
I understand and agree that to comply with the regulatory requirements and/or guidelines pertaining to AML / KYC. I understan d that insurer’s
customer service executive may contact me to reiterate the policy features under their pre -issuance verification calling (PIVC) process. I
understand that if my application/proposal is identified to undergo the PIVC process, issuance of Policy to me will be subjec t to successful
verification and my concurrence of policy features confirmed thereby.
Si gnature of Propos er i s
We request you to complete the understanding of your policy details and confirm by signing the section. ma nda tory
Si gnature of the Proposer
Below are the basic features of the product chosen by you for your reference:
1. Death Benefit Payable: In case of death of the Life Insured during the poli cy term, provided the policy is in force and all due
premi ums have been paid till the date of death, the Death Benefit will be payable immediately on Death.
Dea th Benefit is the Sum Assured on Death, which is the highest of:
 11 ti mes Annualized Premium*
 105% of a l l premiums paid a s on date of death
 Abs olute a mount a ssured to be paid on death equal to the Sum Assured
 Sum As sured on Maturity, equal to the Sum Assured under the policy
In a ddition to the death benefit mentioned above, the policy s hall continue a fter the death of the Life Insured till the end o f the
Pol i cy Term with no further premiums to be paid and the Ma turity Benefit s hall continue to be payable to the nominee a t the
ti me of Ma turity a s per the Ma turity Pa yout Option chosen by the Policyholder. The nominee will not have a ny ri ghts or
obl igations except to receive the benefits under the Policy.
2. Maturity Benefit : : In case the Life Insured survi ves till Ma turi ty Da te and all due premiums ha ve been paid, the Ma turity
1. Policy Benefit will be payable to the Policyholder on the date of Ma turity.
Benefits Ma turi ty Benefit is the Sum Assured on Ma turi ty, whi ch is equal to the Sum Assured under the poli cy and will be paid as lump
s um.
The Poli cyholder has the flexibili ty to choose any one option from the two Ma turi ty Pa yout Options , as defined below, to rece i ve
this Ma turi ty Benefi t during the Ma turi ty Pa yout Period. Ma turi ty Pa yout peri od is the period of 4 yea rs from the da te of
ma turi ty. The choice of the options ca n be ta ken either a t policy i nception or at l east 90 da ys before the date of maturity.
a) Flexi Pa yout Option – Flexibility to recei ve Ma turity Benefit as a lumpsum amount a t the end of any yea r duri ng the
Ma turi ty Pa yout period. Depending on the yea r of pa yout chosen, the benefi t will be determined as Flexi Payout
Factor * Sum Assured, where the Flexi Pa yout Factors a re as defined below:
Year of Payout Flexi Payout Factors

One Yea r after maturity da te 105%
Two Yea rs after maturity date 110%
Three Years a fter maturity date 116%
Four Yea rs after maturity date 122%

KEY FEATURE DOCUMENT – BHARTI AXA Life Shining Stars (UIN : 130N095V01)
b) Annual Pa yout Option – Ma turi ty Benefi t to be paid as fi ve equal annual pa youts a t the end of every yea r during the
Ma turi ty Pa yout period s ta rting from the da te of maturi ty. Each annual pa yout will be equal to 22% of the Sum
As s ured.
The policyholder ma y choose to ta ke the present value of outs tanding annual pa youts as a lumpsum a mount. The lumpsum shall
be ca l culated as a net present value of outstanding a nnual payouts at a
ra te of 5% p.a .
3. Additional Benefits: Thi s is the optional benefit that ca n be a dded to your basic plan for extra protection.
a)Bharti AXA Life Hospi Cash rider (UIN : 130B007V02): Thi s ri der a llows payment of a fi xed benefit for each day of
hos pitalization and also provi des lump s um benefit i n case of surgery.
b)Bharti AXA Life Accidental Death Benefit Rider (UIN : 130B008V01) : Addi tional Sum As sured is paid out under this
Ri der in case of Death of the Li fe Insured because of a n Acci dent
c)Bharti AXA Life Term Rider (UIN : 130B009V01): - Under this ri der the policyholder can increase the life insurance
covera ge for a nominal premium.
Addi tional premium is required to be paid for these benefits. For more details, please refer the ri der brochure on terms and
condi tions.
The Premium pertaining to health related or critical illness riders shall not exceed 100% of premium under the Base Policy, the
Premiums under all other life insurance Riders put together shall not exceed 30% of premiums under the Base Policy and any
benefit arising under each of the above mentioned Riders shall not exceed the Sum Assured under the Base Policy.
We recommend that you pay your premiums regularly to enjoy all the benefits of the Product. However in case you are not able
to pa y premiums:
2. Non
Before policy has acquired Surrender value, the policy s hall lapse. Lapsation of Policy s hall extinguish all the ri ghts a nd benefits
Payment of
whi ch the policy holder is entitled to under the Policy. No Benefit is Pa yable.
Premiums
After policy has acquired surrender value, the policy wi ll be converted into Paid Up Policy a nd the benefits payable will be
reduced i n accordance to the Paid up Sum Assured.
Bharti AXA Life Insurance Company Limited, Registered Office: Unit No. 1904, 19th Floor, Parinee Crescenzo, 'G' Block, Bandra Kurla Complex,
BKC Road, Behind MCA Ground, Bandra East, Mumbai -400051, Maharashtra
www.bharti-axalife.com, IRDAI Regn, No. 130, CIN – U66010M H2005PLC157108 Comp-Jan-2019-3115
Bharti AXA Life Shining Stars UIN: 130N095V01, Bharti AXA Life Hospi Cash Rider UIN: 130B007V02, Bharti AXA Life Accidental Death Benefit
Rider UIN: 130N0B008V01, Bharti AXA Life T erm Rider UIN: 130B009V01

Personal Details: Life To Be Insured: VF HG Age As On Last Birthday: 38 Years Gender: Male

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Personal Details: Life To Be Insured: VF HG Age As On Last Birthday: 38 Years Gender: Male

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Quote No.:100000000930037 Proposal No.: Policy No.

UIN : 130N095V01 Illustration generated by: agency

Personal Details Benefits and Premium Details

Name of the Proposer: __________________ Signature of the Proposer:

Signature of proposer : __________ Date: _

Insurance is the subject matter of the solicitation.

 The Policy will mature in ______ years (policy term).

Si gnature of the Proposer

Year of Payout Flexi Payout Factors

Insurance is the subject matter of the solicitation.

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