TALIC

*U11403*
L&C/Advt/2010/Mar/1110
SALES BENEFIT ILLUSTRATION
Name of the Proposed Insured:
JYOTI JAIN
Age/Sex of the Proposed Insured:
26
Name of the Policyholder:
JYOTI JAIN
Age/Sex of the Policyholder:
26
Insurance Plan
UIN
Female
Female
Benefit Period
(years)
Premium Paying
Period (years)
Proposal Number:
77798
Date:
20-Sep-11
Currency
Rupees
Payment Mode:
Monthly
Sum Assured
First Modal Premium
Tata AIG Life MAHALIFE GOLD
MAHALIFE
110N029V01
GOLD
74
15
385,000
3,009
**Tata AIG Life Accidental Death Benefit
**Accidental Death Benefit
15
15
385,000
34
**Tata AIG Life 15 Year Term Rider
**15
110C008V01
Year Term Rider
15
15
385,000
103
**Tata AIG Life Waiver Of Premium
**Waiver Of Premium
15
15
385,000
20
Agent Number:
4471705
Total
3,166
Total
3,166
Service Tax*
Total Premium Inclusive of Service Tax
49
3,215
Agent Name: Tata AIG Life Insurance Company Ltd
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 10
Tata AIG Life Insurance Company Ltd.

Version 1.0
77798
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
26
27
28
29
30
31
32
33
34
35
36
37
38
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
Basic
Total
Rider
Total
Life
Premium Premium
Premiums
Coverage
37,992
37,992
37,992
37,992
37,992
37,992
37,992
37,992
37,992
37,992
37,992
37,992
37,992
37,992
37,992
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1,884
1,884
1,884
1,884
1,884
1,884
1,884
1,884
1,884
1,884
1,884
1,884
1,884
1,884
1,884
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
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
Non- Guaranteed
Accident Coverage
Total
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
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
11,935
11,935
11,935
11,935
23,870
23,870
23,870
23,870
23,870
23,870
23,870
23,870
23,870
23,870
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
Guaranteed
Total Cash Dividend
(3)
Coupon
(1)
Payable Upto
0
0
0
0
0
0
11,935
23,870
35,805
47,740
71,610
95,480
119,350
143,220
167,090
190,960
214,830
238,700
262,570
286,440
322,245
358,050
393,855
429,660
465,465
501,270
537,075
572,880
608,685
644,490
680,295
716,100
751,905
787,710
823,515
859,320
895,125
930,930
966,735
Non-Guaranteed
Total Coupons(4) Cash Surrender (5) /Maturity

Values (7)
Paid Upto
0
0
0
0
0
0
0
0
0
0
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
0
0
0
0
0
0
0
0
0
0
19,250
38,500
57,750
77,000
96,250
115,500
134,750
154,000
173,250
192,500
211,750
231,000
250,250
269,500
288,750
308,000
327,250
346,500
365,750
385,000
404,250
423,500
442,750
462,000
481,250
500,500
519,750
539,000
558,250
0
0
0
31,285
54,963
80,219
109,459
143,031
172,676
204,277
237,961
253,345
269,743
287,218
305,848
325,718
326,257
326,823
327,416
328,032
328,678
329,352
330,049
330,769
331,516
332,286
333,083
333,903
334,746
335,616
336,513
337,437
338,388
339,378
340,405
341,460
342,542
343,651
344,779
Page 2 of 10

Version 1.0
77798

Scenario:

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
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
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
Guaranteed
Life Coverage
(6)
Total
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
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
Annual Cash
(2)
Dividend
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
35,805
Guaranteed
Total Cash Dividend
(3)
Coupon
(1)
Payable Upto
1,002,540
1,038,345
1,074,150
1,109,955
1,145,760
1,181,565
1,217,370
1,253,175
1,288,980
1,324,785
1,360,590
1,396,395
1,432,200
1,468,005
1,503,810
1,539,615
1,575,420
1,611,225
1,647,030
1,682,835
1,718,640
1,754,445
1,790,250
1,826,055
1,861,860
1,897,665
1,933,470
1,969,275
2,005,080
2,040,885
2,076,690
2,112,495
2,148,300
2,184,105
2,219,910
2,255,715
Non-Guaranteed
(4)
Total Coupons Cash Surrender (5) /Maturity

Values
Paid Upto
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
577,500
596,750
616,000
635,250
654,500
673,750
693,000
712,250
731,500
750,750
770,000
789,250
808,500
827,750
847,000
866,250
885,500
904,750
924,000
943,250
962,500
981,750
1,001,000
1,020,250
1,039,500
1,058,750
1,078,000
1,097,250
1,116,500
1,135,750
1,155,000
1,174,250
1,193,500
1,212,750
1,232,000
1,251,250
(7)
345,923
347,089
348,313
349,545
350,777
352,009
353,238
354,454
355,659
356,853
358,023
359,174
360,298
361,396
362,454
363,482
364,464
365,396
366,277
367,094
367,868
368,618
369,350
370,070
370,786
371,502
372,237
373,019
373,889
374,917
376,222
378,012
380,661
384,854
391,880
404,250
Page 3 of 10

Version 1.0
77798

Scenario:

Guaranteed
Policy
Insured
Anniversary
Age
Basic
Total
Rider
Total
Life
Premium Premium
Premiums
Coverage
Guaranteed
Life Coverage
(6)
Non- Guaranteed
Accident Coverage
Total
Total
Annual Cash
(2)
Total Cash Dividend
Dividend
Guaranteed
(3)
Coupon
Payable Upto
(1)
Non-Guaranteed
(4)

Values (7)
Paid Upto
(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.
404,250
is payable.
Page 4 of 10

Version 1.0
77798

Scenario:
Low Cash Dividend Rate

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
26
27
28
29
30
31
32
33
34
35
36
37
38
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
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
36,108
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
648
648
648
648
648
648
648
648
648
648
648
648
648
648
648
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
Guaranteed
Total
Premiums
Life
Coverage
Life Coverage (6)

Total
36,756
36,756
36,756
36,756
36,756
36,756
36,756
36,756
36,756
36,756
36,756
36,756
36,756
36,756
36,756
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
770,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
Non- Guaranteed
Guaranteed
Accident Coverage
Total
Annual Cash (2)

Dividend
Total Cash Dividend (3)

Payable Upto
Coupon (1)
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
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
2,695
2,695
2,695
2,695
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
0
0
0
0
0
0
2,695
5,390
8,085
10,780
16,170
21,560
26,950
32,340
37,730
43,120
48,510
53,900
59,290
64,680
72,765
80,850
88,935
97,020
105,105
113,190
121,275
129,360
137,445
145,530
153,615
161,700
169,785
177,870
185,955
194,040
202,125
210,210
218,295
0
0
0
0
0
0
0
0
0
0
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
Non-Guaranteed
Total Coupons(4)Cash Surrender (5) /Maturity

Values (7)
Paid Upto
0
0
0
0
0
0
0
0
0
0
19,250
38,500
57,750
77,000
96,250
115,500
134,750
154,000
173,250
192,500
211,750
231,000
250,250
269,500
288,750
308,000
327,250
346,500
365,750
385,000
404,250
423,500
442,750
462,000
481,250
500,500
519,750
539,000
558,250
0
0
0
31,285
54,963
80,219
109,459
143,031
172,676
204,277
237,961
253,345
269,743
287,218
305,848
325,718
326,257
326,823
327,416
328,032
328,678
329,352
330,049
330,769
331,516
332,286
333,083
333,903
334,746
335,616
336,513
337,437
338,388
339,378
340,405
341,460
342,542
343,651
344,779
Page 5 of 10

Version 1.0
77798

Scenario:

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
Insured
Basic Rider
Age Premium Premium
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
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
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
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
Total
Guaranteed
Life Coverage
Total
(6)
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
385,000
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
Annual Cash
Dividend
(2)
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
8,085
Guaranteed
Total Cash Dividend

Payable Upto
(3)
226,380
234,465
242,550
250,635
258,720
266,805
274,890
282,975
291,060
299,145
307,230
315,315
323,400
331,485
339,570
347,655
355,740
363,825
371,910
379,995
388,080
396,165
404,250
412,335
420,420
428,505
436,590
444,675
452,760
460,845
468,930
477,015
485,100
493,185
501,270
509,355
Coupon
(1)
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
19,250
Non-Guaranteed
(4)

Values (7)
Paid Upto
577,500
596,750
616,000
635,250
654,500
673,750
693,000
712,250
731,500
750,750
770,000
789,250
808,500
827,750
847,000
866,250
885,500
904,750
924,000
943,250
962,500
981,750
1,001,000
1,020,250
1,039,500
1,058,750
1,078,000
1,097,250
1,116,500
1,135,750
1,155,000
1,174,250
1,193,500
1,212,750
1,232,000
1,251,250
345,923
347,089
348,313
349,545
350,777
352,009
353,238
354,454
355,659
356,853
358,023
359,174
360,298
361,396
362,454
363,482
364,464
365,396
366,277
367,094
367,868
368,618
369,350
370,070
370,786
371,502
372,237
373,019
373,889
374,917
376,222
378,012
380,661
384,854
391,880
404,250
Page 6 of 10

Version 1.0
77798

Scenario:

Guaranteed
Policy
Anniversary
Insured
Basic Rider
Age Premium Premium
Total
Premiums
Life
Coverage
Total
Life Coverage
Total
(6)
Accident Coverage
Total
(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
Guaranteed
14
Non- Guaranteed
Annual Cash
Dividend
(2)
Total Cash Dividend

Payable Upto
Guaranteed
(3)
Coupon
(1)
Non-Guaranteed
(4)

Values (7)
Paid Upto
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.
404,250
is payable.
Page 7 of 10

Version 1.0
77798
Exclusion For Disability Riders:
Tata AIG Life Waiver of Premium
UIN
110B016V01
The Supplementary Disability Contracts shall not cover any Disability caused directly or indirectly, wholly or partly, by any of the following occurrences:
(a)
(b)
(c)
(d)
(e)
(f)
assault or murder;
riot and civil commotion, industrial action or terrorist activity;
war, declared or undeclared, or revolution;
service in the armed forces in time of declared or undeclared war or while under orders for warlike operations or restoration of public order;
Self destruction or attempted self-destruction or self-inflicted injuries while sane or insane;
entering, exiting, operating, servicing, or being transported by any aerial device or conveyance except when the Insured is on a commercial passenger airline on a regular
scheduled passenger trip over its established passenger route;
(g) any congenital defect which has manifested or was diagnosed before the Insured attains 17 years of age.
(h) in our opinion the insured was suffering from Acquired Immuno-Deficiency Syndrome (AIDS) or infection by any Human Immuno-Deficiency Virus (HIV).
For the purpose of this Policy:1)
The definition of AIDS shall be that used by the World Health Organization in 1987, or any subsequent revision by the World Health Organization of that definition.
2)
Infection shall be deemed to have occurred where blood or other relevant test(s) indicate in the opinion of the Company either the presence of any Human Immunodeficiency
Virus or Antibodies to such a Virus.
(i)
deliberate act(s) of the Policyholder, Nominee or Insured;
(j)
violation or attempted violation of the law or resistance to arrest;
(k) Exclusions under the General Provisions of the Basic Policy.
No benefit will be provided for a Disability resulting from a physical or mental condition which existed before the Issue Date or Commencement Date of the relevant Supplementary
Disability Contract which was not disclosed in the Application or health statement.

Page 8 of 10

Version 1.0
77798
Exclusion For Accident Riders:
UIN
110C003V01
110C004V01
110C005V01
Tata AIG Life Accidental Death Benefit (ADB) Rider

Tata AIG Life Accidental Death and Dismemberment (Long scale) (ADDL) Rider
Tata AIG Life Accidental Death and Dismemberment (Short scale) (ADDS) Rider
No benefit shall be payable under the Supplementary Accident Contracts for any losses caused directly or indirectly, wholly or partly, by any one of the following occurrences:
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
Assault or murder;
Service in the armed forces in time of declared or undeclared war or while under orders for warlike operations or restoration of public order;
Self-destruction or any attempted self-destruction or self-inflicted injury while sane or insane;
Participation in any fight or affray;
Racing of any kind other than on foot;
Participation in scuba diving;
Accident occurring while or because the Insured is under the influence of alcohol or any non-prescribed drug;
Food poisoning or bacterial infection (except pyogenic infection which shall occur with and through an accidental cut or wound);
Entering, exiting, operating, servicing, or being transported by any aerial device or conveyance except when the Insured is on a commercial passenger airline
on a regular scheduled passenger trip over its established passenger route;
Physical handicap or mental infirmity existing at the time of insurance application or reinstatement of the Supplementary Contract;
(k)
(l)
(m)
(n)
(o)
(p)
Any kind of sickness, disease or congenital anomalies;

Complications of surgical procedures or accidents occurring during surgical or therapeutic procedures;
Hunting, mountaineering or climbing requiring the use of ropes or guides;
Ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear waste;
Radioactive, toxic, explosive or other dangerous properties of any nuclear equipment or any part of the equipment;
Any underwater or subterranean operation or activity;

Page 9 of 10

Version 1.0
77798
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.

Page 10 of 10

Version 1.0
77798

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*U11403*

Name of the Proposed Insured:

Age/Sex of the Proposed Insured:

Name of the Policyholder:

Age/Sex of the Policyholder:

First Modal Premium

Tata AIG Life MAHALIFE GOLD

**Tata AIG Life Accidental Death Benefit

**Accidental Death Benefit

**Tata AIG Life 15 Year Term Rider

**Tata AIG Life Waiver Of Premium

Agent Name: Tata AIG Life Insurance Company Ltd

Contact Phone Number:

* Service Tax rate currently applicable is 1.55%

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

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

Tata AIG Life Insurance Company Ltd.

Projection Of Values (For Illustration Only)

High Cash Dividend Rate

Death Benefits on Policy Anniversary

What you will get back

Annual Cash (2)

Total Cash Dividend

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

Tata AIG Life Insurance Company Ltd.

Projection Of Values (For Illustration Only)

High Cash Dividend Rate

Death Benefits on Policy Anniversary

What you will get back

Total Cash Dividend

Total Coupons Cash Surrender (5) /Maturity

Tata AIG Life Insurance Company Ltd.

Projection Of Values (For Illustration Only)

High Cash Dividend Rate

Death Benefits on Policy Anniversary

What you will get back

Total Cash Dividend

Total Coupons Cash Surrender (5) /Maturity

Tata AIG Life Insurance Company Ltd.

Projection Of Values (For Illustration Only)

Low Cash Dividend Rate

Death Benefits on Policy Anniversary

What you will get back

Life Coverage (6)

Annual Cash (2)

Total Cash Dividend (3)

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

Tata AIG Life Insurance Company Ltd.

Projection Of Values (For Illustration Only)

Low Cash Dividend Rate

Death Benefits on Policy Anniversary

What you will get back

Total Cash Dividend

Total Coupons Cash Surrender (5) /Maturity

Tata AIG Life Insurance Company Ltd.

Projection Of Values (For Illustration Only)

Low Cash Dividend Rate

Death Benefits on Policy Anniversary

What you will get back

Total Cash Dividend

Total Coupons Cash Surrender (5) /Maturity

Tata AIG Life Insurance Company Ltd.

Exclusion For Disability Riders:

U11403