XC

1. Date of illustration
PERSONAL DETAILS
Name of the Prospect/Policyholder
Age
Name of the Life Assured
Age
Policy Term
Premium Payment Term
Amount of Instalment Premium
Mode of payment of Premium
Annualized Premium
Category
Gender
SMART INVESTOR
-
SMART INVESTOR
30
15
15
1,00,000
Yearly
1,00,000
No
Male
12-03-2020 Proposal No.
This benefit illustration is intended to show year-wise premiums payable and benefits under the policy.
POLICY DETAILS
Policy Option Annual Payout Option
Maturity Sum Assured
Sum Assured on Death ( at inception of the policy)(`)
(`) 21,86,689
26,50,000
PREMIUM SUMMARY
Base Plan Riders Total Instalment Premium
Instalment Premium without GST 1,00,000 _ 1,00,000
Instalment Premium with First Year GST 1,04,500 _ 1,04,500
Instalment Premium with GST 2nd Year Onwards 1,02,250 _ 1,02,250
YOUR PLAN DETAILS
Name of the Product Future Generali Assured Income Plan
Tag Line
Individual, Non-Linked, Non-Participating,
Savings, Life Insurance Plan
Unique Identification No
GST Rate(FY)
GST Rate(2nd Year Onwards)
133N054V04
4.5%
2.25%
Future Generali India Life Insurance Co. Ltd.
Page 1 of 3Date 12-03-2020 BI NO:1129292633853

2. Policy
Year
Annualized Premium Survival Benefits/ Loyalty
Additions
Other Benefits if any
Guaranteed (end of year)
Maturity benefit Death Benefit
Min Guaranteed
Surrender Value
Non Guaranteed (end of year)
Special Surrender Value
1 1,00,000 - - - 26,50,000 - -
2 1,00,000 - - - 26,50,000 60,000 68,000
3 1,00,000 - - - 26,50,000 1,05,000 1,15,600
4 1,00,000 - - - 26,50,000 2,00,000 1,63,200
5 1,00,000 - - - 26,50,000 2,50,000 2,26,667
6 1,00,000 - - - 26,50,000 3,00,000 2,99,200
7 1,00,000 - - - 26,50,000 3,50,000 3,80,800
8 1,00,000 - - - 26,50,000 4,40,000 4,71,467
9 1,00,000 - - - 26,50,000 5,40,000 5,71,200
10 1,00,000 - - - 26,50,000 6,50,000 7,02,667
11 1,00,000 - - - 26,50,000 7,70,000 8,22,800
12 1,00,000 - - - 26,50,000 9,00,000 9,79,200
13 1,00,000 - - - 26,50,000 10,40,000 11,78,667
14 1,00,000 - - - 26,50,000 12,60,000 13,64,533
15 1,00,000 - - - 26,50,000 13,50,000 15,98,000
16 - - - 2,00,000 - - -
17 - - - 2,00,000 - - -
18 - - - 2,00,000 - - -
19 - - - 2,00,000 - - -
20 - - - 2,00,000 - - -
21 - - - 2,00,000 - - -
22 - - - 2,00,000 - - -
23 - - - 2,00,000 - - -
24 - - - 2,00,000 - - -
25 - - - 2,00,000 - - -
26 - - - 2,00,000 - - -
27 - - - 2,00,000 - - -
28 - - - 2,00,000 - - -
29 - - - 2,00,000 - - -
30 - - - 6,00,000 - - -
• Maturity Sum Assured is the lumpsum value at the end of policy term of the instalments payable during the payout period discounted at a rate of 5.5% p.a. compounded annually.
• Death Benefit illustrated is the sum of 15 annual installments and an additional one time amount paid with the last installment.
the remaining 14 instalments shall be paid on the date corresponding with the death anniversary of the Life Assured in each subsequent year. Additional amount of `4,00,000 shall be paid along
with the last instalment.At the time of intimation of death claim, the nominee has an option to take the death benefit in lump sum equal to the outstanding instalments(including additional amount)
discounted at a compound interest rate of 5.5% per annum.
• In case of death of life assured during the policy term, an amount of `1,50,000 shall be paid in 15 annual instalments with first one being paid on the acceptance of the claim and
(Amount in Rupees.)
Page 2 of 3Date 12-03-2020 BI NO:1129292633853

3. I,______________(name), have explained the premiums, and benefits under the product fully to
the prospect / policyholder.
Place:
DECLARATION BY THE MARKETING OFFICIAL: DECLARATION BY THE PROPOSER:
I, SMART INVESTOR, having received the information with respect to the above, have
understood the above statement before entering into the contract.
Signature of Prospect / PolicyholderDate:Signature of Agent/ Intermediary/ OfficialDate:
Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any, and Goods and Service Tax.
NOTES:
FUTURE GENERALI INDIA LIFE INSURANCE COMPANY LIMITED Corporate Office: Indiabulls Finance centre, Tower 3, 6th Floor, • Senapti Bapat Marg, Elphinstone (W), Mumbai - 400 013. Tel.: 91-22-4097 6666 Fax:
91-22-4097 6600 • Operations Hub: Lodha i-think Techno Campus, 1st Floor, AWing, Pokhran Road No.2, Behind TCS, Thane (W) - 400 601. Call us at: 1800 102 2355 • email: care@futuregenerali.in • Website:
life.futuregenerali.in • IRDARegn. No. 133 • CIN : U66010MH2006PLC165288 3Page 3 of
BI NO:1129292633853