Regular Premium Product Name Bajaj Allianz Save Assure

Transcription

1 The Company has received a Proposal Form, declaration and e first Regular Premium from e Policyholder / Life Assured as named in is Schedule. The said Proposal Form and declaration along wi any statement, report or oer document leading to e issue of is Policy and referred to erein having been accepted and agreed to by e Company and e Policyholder as e basis of e contract of insurance, bo parties to e assurance contract do hereby furer accept and affirm at e Policy, in consideration of and subject to due receipt of subsequent Regular Premiums as set out in e Schedule, wi all its parts (Policy Document and Endorsements if any) shall be subject to e terms and conditions as contained in is Policy. Name of e Policyholder Address Address Address Pin code Bajaj Allianz Life Insurance Company Limited Schedule Non Participating Non Linked Endowment Plan Regular Premium Product Name Bajaj Allianz Save Assure Gender Age at Entry Date of Bir Age Name of e Life Assured Policy No. Product Name Bajaj Allianz Save Assure Product Code Unique Identification No: 116N118V01 Policy Commencement Date Date of Commencement of Risk Age Date of Bir Age Gender Policy Term Sum Assured (`) Regular Premium (`) Sum Assured on Dea (`) 115% * Sum Assured Premium Paying Term Maturity Date Premium Payment Frequency Maturity Benefit 115% of Sum Assured Due Date of Last Premium Due Dates of Premium Details of e Nominee Nominee(s) Name Nominee(s)Age Relationship to e Life Assured Appointee Name [in case e Nominee(s) is(are) a minor(s)]: Relationship to e Life Assured

2 Sales Representative Details Name Address Phone Number Code Id TOTAL PREMIUM PAYABLE FOR SELECTED PREMIUM PAYMENT FREQUENCY: ` In Words: Rupees.Only If any of e information given above is incorrect and not consistent wi e Proposal Form, we request you to kindly send back e whole set-of documents to e Company citing e error/mistake for rectification. To whom e Benefits are Payable: The Benefits are payable to e Policyholder or e Life Assured or e Nominee(s) where a valid nomination has been registered by e company (in accordance wi section 39 of e Insurance Act 1938), or e executors, administrators or e legal representatives who should take out representation to e estate or to such persons as directed by e court of competent jurisdiction in India, limited at all times to e monies payable under is Policy. The Policy shall be subject to and governed by e terms of e Policy Document along wi e Schedule contained herein and endorsements if any, made from time to time and all ese shall togeer form a single agreement All taxes, including GST, eier existing or ose at may apply in future (including enhancements of existing taxes) will be charged extra. Payment of such taxes shall be e responsibility of e Policyholder. Bajaj Allianz Life Insurance Company does not provide any warranty or assurance at e Policyholder will be, by virtue of purchasing is Policy, eligible for any income tax or oer tax rebate or relief. Signed on behalf of Bajaj Allianz Life Insurance Company Limited for Policy No. Issued on Auorised Signatory:

3 Policy Document "This Policy is issued on e basis of e information given and declaration made by e Policyholder in e Proposal Form, which is incorporated herein and forms e basis of is Policy." 1. Definitions & Abbreviations The following terms shall have e meaning assigned to em below. The singular includes e plural and references to e male include e female where e context so permits. a. Age means age as at last birday. b. Annual Premium means e total amount of Regular Premium payable by e Policyholder in a Policy Year. c. Business Day is e common working day of e Corporate Office of e Company d. Company refers to BAJAJ ALLIANZ LIFE INSURANCE COMPANY LIMITED. e. Date of Commencement of Risk means e date specified in e Schedule (unless e Policyholder is informed oerwise by e Company) from which e risk cover of e Life Assured commences under e Policy. f. Dea Benefit has e meaning given in Section 8a) below. g. Early Termination Value has e meaning given in Section 4d) below. h. Goods and Service Tax is charged based on type of policy communication address of Policy Holder. This may change subject to change in rate/state in address of e Policy Holder as on date of adjustment. i. Grace Period means a period of fifteen (15) days for a monly Premium Payment Frequency and irty (30) days for oer an monly Premium Payment Frequency, from e due date of e Regular Premium payment. j. GST means Goods and Service Tax. k. IRDAI means e Insurance Regulatory and Development Auority of India. l. Life Assured means e person named as e Life Assured in e Schedule whose life is assured under is Policy. m. Maturity Benefit has e meaning given in Section 8b) below. n. Maturity Date means e date specified in e Schedule on which e Maturity Benefit shall become payable to e Policyholder. o. Nominee means e person specified in e Schedule who has been nominated in writing to e Company by e Policyholder, who is entitled to receive e Dea Benefits under e Policy. p. Paid-up Sum Assured is e reduced value of e Sum Assured arrived at by multiplying e Sum Assured wi e proportion of e number of Regular Premiums paid to e total number of Regular Premiums payable under e Policy. q. Paid-up Sum Assured on Dea is arrived at by multiplying e Sum Assured on Dea wi e proportion of e number of Regular Premiums paid to e total number of Regular Premiums payable under e Policy. r. Policy means e arrangements established by e Policy Document. s. Policy Anniversary means e date corresponding numerically wi e Policy Commencement Date in each subsequent year during e Policy Term. t. Policy Commencement Date means e date of commencement of e Policy as specified in e Schedule. u. Policy Document means is Policy wording and at of e Additional Rider Benefits, if any, e Schedule (which is attached to and forms part of is Policy and includes any Annexure or endorsement to it and, if more an one, en, e latest in time) and e Proposal Form. v. Policyholder means e adult person named in e Schedule who has concluded e Policy wi e Company. w. Policy Term means e period between e Policy Commencement Date and e Maturity Date, as specified in e Schedule. x. Policy Year means e year commencing on e Policy Commencement Date or a Policy Anniversary ereof. y. Premium Payment Frequency is a regular time interval as specified in e Schedule, at which e Regular Premium is payable during e Premium Paying Term. z. Premium Paying Term means e period specified in e Schedule during which e Regular Premium is payable. aa. Proposal Form means e Policyholder s statements in e proposal for is Policy submitted by or on behalf of e Policyholder along wi any oer information or documentation provided to e Company prior to inception of e Policy. bb. Regular Premium means e amount inclusive of premium wi respect of any Additional Rider Benefits chosen but exclusive of applicable taxes, if any, payable by e Policyholder at regular intervals during e Premium Paying Term, in amount and at e Premium Payment Frequency, bo, as specified in e Schedule. cc. Sum Assured is e amount as specified in e Schedule under e Policy. dd. Sum Assured on Dea is e amount as specified in e Schedule under e Policy and is e higher of: (i) For age at entry less an 45 years, higher of 10 times annualised premium* or 105% of total premium* paid till date of dea or 115% of sum assured. ( For age at entry 45 years & above, higher of 7 times annualised premium* or 105% of total premium* paid till date of dea or 115% of sum assured. *Annualized Premium and total premium is exclusive of extra premium and GST. ee. Surrender Benefit has e meaning given in Section 8c) below. 2. Policy Description a) The Policy is a non-linked, non-participating, limited premium paying, endowment plan b) The plan provides Dea Benefit, Maturity Benefit and Surrender Benefit. 3. Regular Premium a) Regular Premium is payable in full on e premium due dates specified in e Schedule or wiin e Grace Period allowed, during e Premium Paying Term. b) The Company does not have any obligation to issue a notice at Regular Premium is due or for e amount at is due. c) The Company will not accept any amount less an e Regular Premium due along wi applicable taxes, if any. d) Where e Regular Premium along wi applicable taxes, if any, in full has not been paid even wiin e Grace Period, e Policy shall be subject to e Non-payment of Regular Premium and Forfeiture condition(s) as per Section 4 below. 4. Non payment of Regular Premium and Forfeiture If a Regular Premium has not been paid in full before e expiry of e Grace Period, e Policy will be subject to e below mentioned conditions. a) If e Regular Premiums due during e first ree (3) Policy Years are not paid, e Policy will immediately and automatically be converted to a lapsed policy at e expiry of e Grace Period Subject to sub section c) below. In addition to e benefits mentioned above which are as per regulation or Insurance Act, 1938, an Early Termination Value will be available. b) If e Regular Premiums due during e first ree (3) Policy Years are paid, but subsequent premiums are not paid, e Policy will immediately and automatically be converted to a paid-up policy on e expiry of e Grace Period. The Sum Assured and e Sum Assured on Dea under e Policy will be reduced to e Paid-up Sum Assured and e Paid-up Sum Assured on Dea respectively. Any Additional Rider Benefit available under e Policy as on e date of such conversion will lapse and no benefits wi respect to any Additional Rider Benefits under e Policy will be payable ereafter. c) The Policyholder may revive e lapsed/paid-up Policy during e revival period of two (2) years from e due date of first unpaid Regular Premium, subject to e conditions per Section 6 below. d) Early Termination Value is available for a Policy where at least one (1) full year's Regular Premium have been paid but ree (3) full years' Regular Premium have not been paid and 12 mons from e Policy Commencement Date have been completed under e Policy. In case of early termination by e Policyholder or nonpayment of due premium during is period, e following Early Termination Value will be paid. Number of Full Years Regular Early Termination Value as a Percentage Premiums paid of e Premiums paid till date 1 11% 2 15% I) Where, in e table above, premiums taken are excluding premiums for all additional rider benefits, extra premiums and GST & applicable taxes, if any This Early Termination Value will be paid on request for early termination of e Policy by Policyholder, on dea or at end of e revival period, whichever happens earlier. 5. Flexibilities The Policyholder may, subject to e approval of e Company, exercise any of e following options by using e application form specified by e Company and meeting e condition set out erein. a) Alteration of Premium Payment Frequency The Premium Payment Frequency may be changed at any time during e Premium Paying Term, provided e existing & requested Premium Payment Frequencies can be aligned and subject to minimum Regular Premium allowed wi respect to each Premium Payment Frequency under e plan. Monly Premium Payment Frequency is allowed only by salary deduction schemes & rough ECS. b) Dea Benefits or Maturity Benefits in installments i) The Nominee / Policyholder will have e option to receive e Dea Benefit or Maturity Benefit in monly instalments over a period of five (5) or ten (10) years from e date of intimation of dea or e Maturity Date. The first instalment shall be due from e date of intimation of dea or e Maturity Date. This option has to be communicated by e Nominee / Policyholder to e Company along wi e claim documents.

4 i Each monly instalment will be based on instalment factors for e period chosen by e Nominee / Policyholder. The instalment factors payable will be: If e period chosen is 5 years: 1.04 * dea or maturity benefit divided by 60. If e period chosen is 10 years: 1.08 * dea or maturity benefit divided by 120. The Company reserves e right to revise e factors of 1.04 & 1.08 (mentioned above) at anytime, subject to IRDAI approval for e same. At anytime after e instalments have commenced, e Nominee / Policyholder will have e option to discontinue e remaining instalments 1) The Nominee / Policyholder will be eligible for e amount of Dea Benefit or Maturity Benefit (as applicable) less e total amount of instalments already paid as on e date of surrender, provided e amount payable is non-zero. No furer monly instalments shall be payable. 2) If e amount of Dea Benefit or Maturity Benefit (as applicable) less e total amount of instalments already paid as on e date of surrender is less an or equal zero, e future instalments will not be surrendered. The future instalments will be paid as and when ey become due. 6. Revival a) If e Policy is lapsed/paid-up due to non payment of due Regular Premium (as mentioned in Section 4 above), e Policy can be revived by e Policyholder, subject to e conditions mentioned below: i) The application for revival is received wiin two (2) years from e due date of e first unpaid Regular Premium; i The arrears of Regular Premiums togeer wi interest, as decided by e Company from time-to-time, are paid; The Policyholder furnishes, at his own expense, satisfactory evidence (as decided by e Company) on heal of e Life Assured The revival of e Policy may be on terms different from ose applicable to e Policy before it was lapsed or became paid-up, based on e prevailing board approved underwriting norms of e Company; v) The revival will take effect only on it being specifically communicated by e Company to e Policyholder; vi) The Company may refuse to revive e Policy based on e board approved underwriting guidelines and refund e amount deposited for e purpose of revival of e Policy. b) On revival, e Sum Assured, Sum Assured on Dea and any Additional Rider Benefit, if opted to be continued, as it/ey prevailed on e date of lapse/paid-up will be reinstated, subject to Sub-Section a) above. 7. Foreclosure If loan has been taken under e Policy, e Policy is paid-up [as mentioned in Section 4b) above] and if at any time e loan outstanding plus interest-on-loan exceeds e Surrender Benefit available en under e Policy, e Policy will be immediately and automatically foreclosed after sufficient notice [as mentioned in Section 9e) below] and no furer benefits will be available under e Policy. 8. Policy Benefits a) Dea Benefit : On dea of e Life Assured before e Maturity Date, e Company subject to Section 10, Section 13 and Section 21 below, provided e Policy has not been terminated per Section 11 below, shall pay e amount mentioned below to e Nominee/Policyholder/Legal heirs as Dea Benefit. 1) If all e due Regular Premiums are paid in full up to e date of dea and Policy is in force for e full Sum Assured: Sum Assured on Dea 2) If e Policy is a paid-up policy [as per Section 4b) above]: Paid-up Sum Assured on Dea 3) If e Policy is lapsed [as per Section 4a) above]: I) Early Termination Value [as per Section 4d) above], if at least one (1) full year s Regular Premium has been paid and 12 mons have elapsed from e Policy Commencement Date. Nil, oerwise b) Maturity Benefit On Maturity Date, provided e Policy has not been terminated per Section 11 below, e Company shall pay e amount mentioned below to e Policyholder as Maturity Benefit. 1) If all e due Regular Premiums have been paid in full and Policy is in force for e full Sum Assured: 115% of e Sum Assured 2) If e Policy is a paid-up policy [as per Section 4b) above]: 115% of e Paid-up Sum Assured 3) If e Policy is lapsed [as per Section 4a) above]: Nil c) Surrender Benefit The Policy acquires Surrender Benefit any time after ree (3) full years Regular Premiums have been paid, subject to e below mentioned conditions: I) The Surrender Benefit payable will be e higher of e Guaranteed Surrender Value (GSV) or e Special Surrender Value (SSV). i The GSV is equal to a proportion (as per e table below base on e Policy Year of surrender) of e premiums paid till e date of surrender, e proportion depending on e Policy Year in which Policy is being surrendered, where premium will be arrived at by excluding premiums wi respect to any Additional Rider Benefit, GST & oer applicable taxes and any extra premiums from e Regular Premium. For a Policy at is not lapsed [as per Section 4b above] and in e Premium Paying Term, e SSV will be arrived at by multiplying e Paid-up Sum Assured, as on e date of paid-up or date of surrender (whichever is earlier), wi e appropriate SSV factor, bo, as on date of surrender. For an in-force Policy in e period after e Premium Paying Term (i.e., a fully-paidup Policy), e SSV will be arrived at by multiplying e Sum Assured wi e appropriate SSV factor as on e date of surrender. v) SSV factors are not guaranteed and e Company shall revise and declare e SSV factors from time-to-time, subject to IRDAI approval. 9. Policy Loan The Policyholder will have e option to take loan under e Policy, provided e Policy has acquired Surrender Benefit. a) The maximum amount of loan allowed will be 90% of e amount of Surrender Benefit available under e Policy as on e date of loan. b) The loan rate of interest applicable on e loan amount will be decided by e Company from time to time. c) The Policyholder can repay part or full amount of loan & loan interest ere-under at any time during e Policy Term. d) Any loan and/or loan-interest outstanding as on e date of dea or on e Maturity Date, if dea of e life assured or maturity of e Policy takes place during e subsistence of loan, will be recovered from e Dea Benefit or Maturity Benefit, as applicable. e) Notwistanding what has been mentioned in Sub-Section c) above, any time during e Policy Term, if e outstanding loan plus loan interest becomes equal to e Surrender Benefit available under e Policy as on at date, e Policyholder will be informed of e same wi a 30-days advance notice. If under a Policy at is paid-up [as per Section 4b) above], e full or part of e loan and/or loan interest is not repaid wiin e above mentioned notice period, e Policy will be foreclosed automatically and immediately by adjusting e amount of Surrender Benefit to e outstanding loan plus loan-interest, wiout any requirement of furer notice to e Policyholder and no benefits under e Policy will be payable. 10. Suicide Exclusions If e Life Assured commits suicide wheer sane or insane, wiin one (1) year from e Date of Commencement of Risk or e date of e latest revival of e Policy, e Company s liability shall be limited to e extent of e amount mentioned below, wheer or not any beneficial interest has been created erein. If e dea is wiin one (1) year From e Date of Commencement of Risk, e amount payable will be 80% of e Regular Premium paid OR From e date of e latest revival, e amount payable will be e 80% of e Regular Premium paid or e amount of Surrender Benefit as on e date of intimation of dea, whichever is higher. Any outstanding loan plus interest will be deducted from is amount payable. The validity of e contract of insurance and applicability of Suicide Exclusion clause will be determined in accordance wi e actual date of dea of e Life Assured and not e date of intimation of dea. 11. Termination Conditions This Policy shall immediately and automatically terminate on e earliest occurrence of any of e following events: i) On payment of Early Termination Value. i Policy Surrender 3 4 to 9 10 to Year Onwards GSV % 30% 50% 55% 60% On full surrender of e Policy; On e expiry of e revival period, if at least ree (3) full years Regular Premiums have not been paid

5 On foreclosure, if e outstanding loan plus loan interest under a paid-up Policy becomes equal to e Surrender Benefit available under e Policy and no payment is made even on e expiry of 30 days from notice as mentioned in Section 9e) above. v) On receipt of intimation of dea of e Life Assured at e Company s office vi) On e Maturity Date General Conditions 12. Age Proof a) The Regular Premium payable under e Policy is calculated on e basis of e Life Assured s Age and gender as declared in e Proposal Form. If e Life Assured s Age has not been admitted by e Company, e Policyholder shall furnish such proof of e Life Assured s Age as is acceptable to e Company and have e Age admitted. b) If e Age so admitted (e correct Age ) is found to be different from e Age declared in e Proposal Form, en, wiout prejudice to e Company s oer rights and remedies including ose under e Insurance Act 1938, e following actions shall be taken: I) If e correct Age is such as would have made e Life Assured uninsurable under is Policy, e plan of assurance shall stand altered to such plan of assurance as is generally granted by e Company for e Life Assured s correct Age, which will be subject to e terms and conditions as are applicable to at plan of assurance. If it is not possible to grant any oer plan of assurance, e Policy shall stand terminated wi immediate effect by e Company and no benefits will payable under e Policy. The Company may at its discretion consider payment of a refund comprising e all Regular Premiums (excluding applicable taxes) paid, less e proportionate amount of risk premium & Additional Rider Benefit premium, if any, for e period e Life Assured was on cover and e expenses incurred by e Company on medical examination and stamp duty charges. i If e Life Assured s correct Age is higher an e Age declared in e Proposal Form, e Regular Premium payable under e Policy shall be altered corresponding to e correct Age of e Life Assured and e accumulated difference between e corrected Regular Premium and e original Regular Premium from e Policy Commencement Date up to e date of such alteration shall be collected from e Policyholder. If e Policyholder disagrees to pay e same, e Policy will be terminated wi immediate effect by e Company and e Surrender Benefit, if any, as on e date of termination shall become payable. If e Life Assured s correct Age is lower an e Age declared in e Proposal Form, e Regular Premium payable under e Policy shall be altered corresponding to e correct Age of e Life Assured from e next due date of Regular Premium. However, e Company shall not make a refund of e excess premium collected earlier. 13. Assignment and Nomination Assignment should be in accordance wi provisions of section 38 of e Insurance Act 1938 as amended from time to time. [A Leaflet containing e simplified version of e provisions of section 38 is enclosed in Annexure AA (as given by IRDAI) for reference] Nomination should be in accordance wi provisions of section 39 of e Insurance Act 1938 as amended from time to time. [A Leaflet containing e simplified version of e provisions of section 39 is enclosed in Annexure BB (as given by IRDAI) for reference] 14. Non-disclosure & Fraud In case of fraud or misrepresentation by e Policyholder, e Policy, subject to fraud or misrepresentation being established in accordance wi section 45 of e Insurance Act, 1938, shall be terminated immediately by returning e Surrender Benefit, if any, as on e date of termination. 15. Notices Any notice, direction or instruction to be given under is Policy shall be in writing and delivered by hand, post, facsimile or to: a. The Policyholder/Life Assured: i) Shall be sent eier by hand, post, courier, facsimile, Short Messaging Service (SMS), Voice call, or rough any oer digital/electronic media to e Policyholder to e address or communication/ correspondence details specified by e Policyholder in e Enrollment/Proposal Form or as per subsequent most recent change of address and/or communication/correspondence details intimation submitted by em to e Company. The Company shall not be responsible for any consequences arising out of nonintimation of change of e Policyholder s/life Assured s address and/or communication/correspondence details. In case e notice comes back to e Company undelivered to e Policyholder/Life Assured due to any reason, ere shall be no obligation upon e Company to make any attempt again towards dispatch of e notice which was returned undelivered. b. The Company, shall be submitted by hand, post, facsimile or Bajaj Allianz Life Insurance Company, GE Plaza, Airport Road, Yerawada, Pune Toll Free No Fax: customercare@bajajallianz.co.in The Policyholder must ensure at he keeps e Company informed if ere is a change of address and contact details. This will enable e Policyholder to receive regular updates, and communication from time to time and facilitate efficient and timely payouts by e Company of e benefits under e Policy. 16. Electronic Transactions Subject to Section 15 above, e Policyholder agrees to adhere to and comply wi all such terms and conditions as e Company may prescribe from time to time wi regard to all transactions and hereby agrees and confirms at all transactions (oer an ose requiring a written notice or communication under is Policy) effected by or rough facilities for conducting remote transactions including e Internet, World Wide Web, electronic data interchange, call centres, tele-service operations (wheer voice, video, data or combination ereof) or by means of electronic, computer, automated machines network or rough oer means of telecommunication, established by or on behalf of e Company, for and in respect of e Policy or its terms, or e Company's oer products and services, shall constitute legally binding and valid transactions when done in adherence to and in compliance wi e Company's terms and conditions for such facilities, as may be prescribed from time to time. 17. Free Look Period Wiin 15 days [irty (30) days in case is Policy is issued under e provisions of IRDAI Guidelines on Distance Marketing of Insurance Products] of e receipt of is Policy, e Policyholder has e option to review e terms and conditions of e Policy and if e Policyholder disagrees to any of e terms & conditions, he has an option to return e Policy stating e reasons for his objections. The Policyholder shall be entitled to a refund comprising e all Regular Premiums (excluding applicable taxes) paid, less e proportionate amount of risk premium & Additional Rider Benefit premium, if any, for e period e Life Assured was on cover and e expenses incurred by e Company on medical examination and stamp duty charges. 18. Currency All amounts payable eier to or by e Company shall be payable in India and in Indian Currency. 19. Waiver Failure or neglect by eier party to enforce at anytime e provisions of is Policy shall not be construed or be deemed to be a waiver of eier party's right herein nor in anyway affect e validity of e whole or any part of is Policy nor prejudice eier party's right to take subsequent action. 20. Modifications This Policy Document constitutes e complete contract of insurance. This Policy Document cannot be changed or varied except by an endorsement to e Policy, in writing and signed by an officer of e Company auorized for e purpose. 21. Payment of claim The Company shall be under no obligation to make any payment under Section 8a) above unless and until e Company has received from e Policyholder (or e Nominee, or legal heirs, and at no expense to e Company) any information and documentation it requests, including but not limited to: i) Written notice as soon as possible and in any event preferably wiin 180 days of e dea of e Life Assured, and e circumstances resulting to e dea of e Life Assured. i The claimant s proof of entitlement to receive payment under e Policy. Original Policy Document. Original dea certificate of e Life Assured issued by a competent auority. v) Medical cause of dea certificate from e doctor who last attended to e Life Assured or from e hospital in which e dea occurred. vi) v vi If e dea is due to unnatural causes; a copy of First Information Report (FIR) and Post Mortem Report (PMR). Post Mortem Report is mandatory for claiming e dea benefit due to an Accident under e Policy. Any oer document as asked for by e Company depending on e facts and circumstances of each case. Wiout Prejudice to e right of e Company to insist for any of e documents as mentioned herein above to examine e admissibility of claim for e benefits under e policy of insurance, e Company may at its sole discretion, consider claims where e claimant is unable to submit required documents. 22. Loss of Policy Document a) If e Policy Document is lost or destroyed, en subject to Sub Section c) below, at e request of e Policyholder, e Company, if satisfied at e Policy Document

6 has been lost or destroyed, will issue a copy of e Policy Document duly endorsed to show at it is issued following e loss or destruction of e original document. The Company will charge a fee for e issuance of a copy of e Policy Document. b) Upon e issue of a copy of e Policy Document, e original Policy Document will cease to have any legal effect. c) The Company reserves e right to make such investigations into and call for such evidence of e loss or destruction of e Policy Document at e expense of e Policyholder, as it considers necessary before issuing a copy of e Policy Document. d) It is hereby understood and agreed at e Policyholder will protect e Company and hold e Company harmless from and against any claims, costs, expenses, awards or judgments arising out of or howsoever connected wi e original Policy Document or arising out of e issuance of a copy of e Policy Document. 23. Grievance Redressal In case you have any query or compliant/grievance, you may contact e Grievance Officer of any nearest Customer Care Center at Branch Office of e Company during e Company s office hours from 9 am to 6 pm. Alternatively, you may communicate wi e Company: By post at: Customer Care Desk, Bajaj Allianz Life Insurance Company Ltd., GE Plaza, Airport Road, Yerawada, Pune By Phone at: Toll Free No By Fax at: By customercare@bajajallianz.co.in In case you are not satisfied wi e resolution provided to you by e above office, or have not received any response wiin 10 days, or you have any suggestion in respect of is Policy or on e functioning of e office, you may contact e following official for resolution: Grievance Redressal Officer, Bajaj Allianz Life Insurance Company Ltd. 3rd Floor, Bajaj Finserv, Survey No: 208/1-B, Behind Weik Field IT Park, Viman Nagar, Pune Tel. No: Fax: (+91 20) ID: customercare@bajajallianz.co.in If Policyholder is not satisfied wi e response or does not receive a response from e Company wiin fifteen (15) days, he may approach e IRDAI Grievance Cell Centre (IGCC) on e following contact details: By Phone: TOLL FREE NO: By complaints@irda.gov.in By post at: Consumer Affairs Department Insurance Regulatory and Development Auority of India 9 floor, United India Towers, Basheerbagh, Hyderabad , Andhra Pradesh By Fax at: The Policyholder can also register his complaint online at 24 Ombudsman a) In case you are not satisfied wi e decision/resolution of e Company, you may approach e Insurance Ombudsman if your grievance pertains to any of e following: i) Insurance claim at has been rejected or dispute of a claim on legal construction of e Policy i Delay in settlement of claim Dispute wi regard to premium Non-receipt of your insurance document b) The current address of e Insurance Ombudsman is provided as Address & Contact Details of Ombudsmen Centres attached herewi. For e latest list of insurance ombudsman, please refer to e IRDAI website at c) The complaint should be made in writing and duly signed by e complainant or by his legal heirs wi full details of e complaint and e contact information of complainant. d) Also please note at as per provision 13(3) of e Redressal of Public Grievances Rules 1998, e complaint to e Ombudsman can be made i) Only if e grievance has been rejected by e grievance redressal mechanism of e Company. i The complaint should be filed wiin a period of one year from e date of rejection by e Company. The complaint should not be simultaneously under any litigation. 25 Governing Law Any and all disputes arising out of and under is Policy shall be governed by and determined in accordance wi Indian law and by e Indian Courts. 26 Taxation Payment of taxes, including GST, as applicable, shall be e responsibility of e Policyholder. The Policyholder agrees to pay or allows e Company to deduct/charge from any of e benefits payable or premium received under is Policy, a sum on account of any tax or oer payment which may be imposed by any legislation, order, regulation or oerwise, upon e Company, Policyholder or any oer beneficiary, which in e opinion of e Company is necessary and appropriate. 27 Status of Insurance Agent The insurance agent is only auorized by e Company to arrange completion and submission of e Proposal Form. The insurance agent is not auorized to act as e Company s legal representative and any representation made by e insurance agent which is against e express terms and conditions as contained in is Policy shall not be binding on e Company. Information or payment given to e insurance agent should not be considered as having been given to e Company. In absence of any specific auorisation to an insurance agent to accept premium on behalf of e Company and issue receipt ereof, payment made to an insurance agent shall be considered from e date of receipt of e premium amount by e Company. In e event of happening of any eventuality between e date of payment of premium amount to e insurance agent and e date of receipt of e premium amount by e Company, same shall be considered in accordance wi e terms and conditions as contained herein above as if e premium was not paid as on e date of happening of e eventuality. 28 Fraud, Misrepresentation and forfeiture Fraud, Misrepresentation and forfeiture would be dealt wi in accordance wi provisions of section 45 of e Insurance Act 1938 as amended from time to time. [A Leaflet containing e simplified version of e provisions of section 45 is enclosed in Annexure CC (as given by IRDAI) for reference] 29 Provided at noing in e section shall prevent e insurer from calling for proof of age at any time if he is entitled to do so and no policy shall be deemed to be called in question merely because e terms of e Policy are adjusted on subsequent proof at e age of e Life Insured was incorrectly stated in e proposal.

7 Address & Contact Details of Ombudsman Centres In case you have any grievance, you may approach e Company Grievance Cell. In case you are not satisfied wi e decision/resolution of e Company or if your complaint is not resolved/ not satisfied/not responded for 30 days, you may approach e Office of Insurance Ombudsman, in line wi e details provided hereinabove in e policy document, at e addresses given below: AHMEDABAD BENGALURU BHOPAL BHUBANESHWAR CHANDIGARH CHENNAI DELHI GUWAHATI HYDERABAD Office of e Insurance Ombudsman,6 Floor, Jeevan Prakash Bldg.,Tilak Marg, Relief Road, Ahmedabad Tel no s: /02/05/06, bimalokpal.ahmedabad@ecoi.co.in. Office of e Insurance Ombudsman, Jeevan Soudha Building, PID No N-19 Ground Floor, 19/19, 24 st Main Road, JP Nagar, 1 Phase, Bengaluru , Tel.: / , bimalokpal.bengaluru@ecoi.co.in. nd Office of e Insurance Ombudsman, Janak Vihar Complex, 2 Floor, 6, Malviya Nagar, Opp. Airtel Office, Near New Market, Bhopal , Tel.: / Fax: , bimalokpal.bhopal@ecoi.co.in. Office of e Insurance Ombudsman,62, Forest park, Bhubaneshwar , Tel.: / Fax: , bimalokpal.bhubaneswar@ecoi.co.in. nd Office of e Insurance Ombudsman, S.C.O.No.101,102 & 103, 2 Floor, Batra Building, Sector 17 D, Chandigarh ,Tel.: / Fax: , bimalokpal.chandigarh@ecoi.co.in. Gujarat, Dadra & Nagar Haveli, Daman and Diu Karnataka Madhya Pradesh, Chhattisgarh Orissa Punjab, Haryana, Himachal Pradesh, Jammu & Kashmir, Chandigarh Office of e Insurance Ombudsman, Fatima Akhtar Court, 4 Floor, 453 (old 312), Anna Salai, Teynampet, Tamil Nadu, Pondicherry Town and Karaikal CHENNAI , Tel.: / Fax: , bimalokpal.chennai@ecoi.co.in. (Which are part of Pondicherry) Office of e Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi Delhi Tel.: / Fax: , bimalokpal.delhi@ecoi.co.in. Office of e Insurance Ombudsman, Jeevan Nivesh, 5 Floor, Nr. Panbazar over bridge, S.S. Road, Guwahati Assam, Meghalaya, Manipur, Mizoram, Arunachal (ASSAM), Tel.: / Fax: , bimalokpal.guwahati@ecoi.co.in. Pradesh, Nagaland and Tripura st Office of e Insurance Ombudsman, , 1 floor, "Moin Court", Lane Opp. Saleem Function Palace, A. C. Guards, Lakdi-Ka-Pool, Hyderabad , Tel.: / Fax: , bimalokpal.hyderabad@ecoi.co.in. JAIPUR Office of e Insurance Ombudsman, Jeevan Nidhi II Bldg., Gr. Floor, Bhawani Singh Marg, Jaipur Tel.: , bimalokpal.jaipur@ecoi.co.in. Andhra Pradesh, Telangana, Yanam and part of Territory of Pondicherry Rajasan ERNAKULAM KOLKATA MUMBAI PUNE PATNA LUCKNOW nd Office of e Insurance Ombudsman, CC 22/ Floor, Pulinat Bldg.,Opp. Cochin Shipyard, M.G.Road, Kerala, Lakshadweep, Mahe -a part of Ernakulam , Tel.: / Fax: , bimalokpal.ernakulam@ecoi.co.in. Pondicherry Office of e Insurance Ombudsman, Hindustan Bldg. Annexe, 4 Floor, 4, C.R. Avenue, KOLKATA , West Bengal, Bihar, Sikkim, Jharkhand Andaman Tel.: / , Fax : , bimalokpal.kolkata@ecoi.co.in. & Nicobar Islands rd Office of e Insurance Ombudsman, 3 Floor, Jeevan Seva Annexe, S. V. Road, Santacruz (W), Mumbai , Tel.: / , Fax: , bimalokpal.mumbai@ecoi.co.in. nd Office of e Insurance Ombudsman, Jeevan Darshan Bldg., 2 Floor, C.T.S. No.s. 195 to 198,N.C. Kelkar Road, Narayan Pe, Pune , Tel.: , bimalokpal.pune@ecoi.co.in. st Office of e Insurance Ombudsman, 1 Floor, Kalpana Arcade Building, Bazar Samiti, Road, Bahadurpur, PATNA , Tel No: , bimalokpal.patna@ecoi.co.in. Office of e Insurance Ombudsman, 6 Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow , Tel.: / Fax: , bimalokpal.lucknow@ecoi.co.in. Goa, Mumbai Metropolitan Region excluding Navi Mumbai & Thane Maharashtra, Area of Navi Mumbai and Thane, excluding Mumbai Metropolitan Region Bihar Districts of Uttar Pradesh: Laitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur, Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amei, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorkhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharanagar NOIDA Office of e Insurance Ombudsman, 4 Floor, Bhagwan Sahai Palace, Main Road, Naya Bans, Sector 15, NOIDA , Tel: /51/53, bimalokpal.noida@ecoi.co.in. State of Uttaranchal and e following Districts of Uttar Pradesh: Agra, Aligarh, Bagpat, Bareilly, Bijnor, Budaun, Bulandshehar, Etah, Kanooj, Mainpuri, Maura, Meerut, Moradabad, Muzaffarnagar, Oraiyya, Pilibhit, Etawah, Farrukhabad, Firozbad, Gautambodhanagar, Ghaziabad, Hardoi, Shahjahanpur, Hapur, Shamli, Rampur, Kashganj, Sambhal, Amroha, Haras, Kanshiramnagar, Saharanpur Annexure Ver. 2.1 (072017)

8 Annexure AA Section 38 of Insurance Act, 1938, as amended from time to time Assignment and Transfer of Insurance Policies Assignment or transfer of a Policy should be in accordance wi section 38 of e Insurance Act, 1938, as amended by The Insurance Laws (Amendment) Act, 2015 dated The extant provisions in is regard are as follows: 1. This Policy may be transferred / assigned, wholly or in part, wi or wiout consideration. 2. An assignment may be effected in a Policy by an endorsement upon e Policy itself or by a separate instrument under notice to e Company. 3. The instrument of assignment should indicate e fact of transfer or assignment and e reasons for e assignment or transfer, antecedents of e assignee and terms on which assignment is made. 4. The assignment must be signed by e transferor or assignor or duly auorized agent and attested by at least one witness. 5. The transfer of assignment shall not be operative as against e Company until a notice in writing of e transfer or assignment and eier e said endorsement or instrument itself or copy ere of certified to be correct by bo transferor and transferee or eir duly auorized agents have been delivered to e Company. 6. Fee to be paid for assignment or transfer can be specified by e IRDAI rough Regulations. 7. On receipt of notice wi fee, e insurer should Grant a written acknowledgement of receipt of notice. Such notice shall be conclusive evidence against e Company of duly receiving e notice. 8. If e Company maintains one or more places of business, such notices shall be delivered only at e place where e Policy is being serviced. 9. The Company may accept or decline to act upon any transfer or assignment or endorsement, if it has sufficient reasons to believe at it is (a) not bona-fide or (b) not in e interest of e Policyholder / Life Assured or (c) not in public interest or (d) is for e purpose of trading of e Policy. 10. Before refusing to act upon endorsement, e Company should record e reasons in writing and communicate e same in writing to Policyholder wiin 30 days from e date of Policyholder giving a notice of transfer or assignment. 11. In case of refusal to act upon e endorsement by e Company, any person aggrieved by e refusal may prefer a claim to IRDAI wiin 30 days of receipt of e refusal letter from e Company. 12. The priority of claims of persons interested in e Policy would depend on e date on which e notices of assignment or transfer is delivered to e Company; where ere are more an one instruments of transfer or assignment, e priority will depend on dates of delivery of such notices. Any dispute in is regard as to priority should be referred to IRDAI. 13. Every assignment or transfer shall be deemed to be absolute assignment or transfer and e assignee or transferee shall be deemed to be absolute assignee or transferee, except a. where assignment or transfer is subject to terms and conditions of transfer or assignment OR b. where e transfer or assignment is made upon condition at i. e proceeds under e Policy shall become payable to Policyholder or Nominee(s) in e event of assignee or transferee dying before e Life Assured OR ii. e Life Assured surviving e Policy Term. Such conditional assignee will not be entitled to obtain a loan on Policy or surrender e Policy. This provision will prevail notwistanding any law or custom having force of law which is contrary to e above position. 14. In oer cases, e Company shall, subject to terms and conditions of assignment, recognize e transferee or assignee named in e notice as e absolute transferee or assignee and such person a. shall be subject to all liabilities and equities to which e transferor or assignor was subject to at e date of transfer or assignment and b. may institute any proceedings in relation to e Policy c. obtain loan under e Policy or surrender e Policy wiout obtaining e consent of e transferor or assignor or making him a party to e proceedings 15. Any rights and remedies of an assignee or transferee of e Policy under an assignment or transfer effected before commencement of The Insurance Laws (Amendment) Act, 2015 shall not be affected by is section. [Disclaimer: Section 38 of e Insurance Act, 1938, as amended from time to time shall be applicable. Policy Holders are advised to refer to Original text of Section 38 as amended from time to time for complete and accurate details. ] Annexure BB Section 39 of e Insurance Act, 1938, as amended from time to time Nomination by Policyholder Nomination of a life insurance Policy is as below in accordance wi Section 39 of e Insurance Act, 1938, as amended by The Insurance Laws (Amendment) Act, 2015 dated The extant provisions in is regard are as follows: 1. The Policyholder of a life insurance Policy on his own life may nominate a person or persons to whom money secured by e Policy shall be paid in e event of his dea. 2. Where e Nominee is a minor, e Policyholder may appoint any person to receive e money secured by e policy in e event of Policyholder s dea during e minority of e Nominee. The manner of appointment to be laid down by e Company. 3. Nomination can be made at any time before e maturity of e Policy. 4. Nomination may be incorporated in e text of e Policy itself or may be endorsed on e Policy communicated to e Company and can be registered by e Company in e records relating to e Policy. 5. Nomination can be cancelled or changed at any time before Policy matures, by an endorsement or a furer endorsement or a will as e case may be. 6. A notice in writing of change or cancellation of nomination must be delivered to e Company for e Company to be liable to such Nominee. Oerwise, Company will not be liable if a bona-fide payment is made to e person named in e text of e Policy or in e registered records of e Company. 7. Fee to be paid to e Company for registering change or cancellation of a nomination can be specified by e IRDAI rough Regulations. 8. On receipt of notice wi fee, e Company should grant a written acknowledgement to e Policyholder of having registered a nomination or cancellation or change ereof. 9. A transfer or assignment made in accordance wi section 38 of Insurance Act, 1938, as amended from time to time, shall automatically cancel e nomination except in case of assignment to e Company or oer transferee or assignee for purpose of loan or against security or its reassignment after repayment. In such case, e nomination will not get cancelled to e extent of Company s or transferee s or assignee s interest in e Policy. The nomination will get revived on repayment of e loan. 10. The right of any creditor to be paid out of e proceeds of any Policy of life insurance shall not be affected by e nomination. 11. In case of nomination by Policyholder whose life is insured, if e Nominees die before e Policyholder, e proceeds are payable to Policyholder or his heirs or legal representatives or holder of succession certificate. 12. In case Nominee(s) survive e person whose life is insured, e amount secured by e Policy shall be paid to such survivor(s). 13. Where e Policyholder whose life is insured nominates his/her (a) parents or (b) spouse or (c) children or (d) spouse and children or (e) any of em, e Nominees are beneficially entitled to e amount payable by e Company to e Policyholder unless it is proved at Policyholder could not have conferred such beneficial title on e Nominee having regard to e nature of his title. 14. If Nominee(s) die after e Policyholder but before his share of e amount secured under e Policy is paid, e share of e expired Nominee(s) shall be payable to e heirs or legal representative of e Nominee(s) or holder of succession certificate of such Nominee(s). 15. The provisions of sub-section 7 and 8 (13 and 14 above) shall apply to all life insurance Policies maturing for payment after e commencement of The Insurance Laws (Amendment) Act, 2015 (i.e ). 16. If Policyholder dies after maturity but e proceeds and benefit of e Policy has not been paid to him because of his dea, his Nominee(s) shall be entitled to e proceeds and benefit of e Policy. 17. The provisions of section 39 of e Insurance Act, 1938, as amended from time to time, are not applicable to any life insurance Policy to which section 6 of Married Women s Property Act, 1874, applies or has at any time applied except where before or after The Insurance Laws (Amendment) Act, 2015, a nomination is made in favour of spouse or children or spouse and children wheer or not on e face of e Policy it is mentioned at it is made under section 39 of e Insurance Act, 1938, as amended from time to time. Where nomination is intended to be made to spouse or children or spouse and children under section 6 of MWP Act, it should be specifically mentioned on e Policy. In such a case only, e provisions of section 39 of Insurance Act, 1938, as amended from time to time, will not apply. [Disclaimer: Section 39 of e Insurance Act, 1938, as amended from time to time shall be applicable. Policy Holders are advised to refer to Original text of Section 39 as amended from time to time for complete and accurate details.] Annexure CC Section 45 of e Insurance Act, 1938, as amended from time to time Policy shall not be called in question on e ground of mis-statement after ree years. Provisions regarding Policy not being called into question in terms of section 45 of e Insurance Act, 1938, as amended by The Insurance Laws (Amendment) Act, 2015 dated are as follows: 1. No Policy of life insurance shall be called in question on any ground whatsoever after expiry of ree (3) years from (a) e Policy Commencement Date or (b) e Date of Commencement of Risk or (c) e date of latest revival of e Policy or (d) e Date of Commencement of Rider; whichever is later. 2. On e ground of fraud, a Policy of life insurance may be called in question wiin ree (3) years from (a) e Policy Commencement Date or (b) e Date of Commencement of Risk or (c) e date of latest revival of e Policy or (d) e Date of Commencement of Rider; whichever is later. For is, e Company should communicate in writing to e Company or legal representative or Nominee or assignees of Policyholder, as applicable, mentioning e ground and materials on which such decision is based. 3. Fraud means any of e following acts committed by Life Assured or Policyholder or by his agent, wi e intent to deceive e Company or to induce e Company to issue e life insurance Policy: a. The suggestion, as a fact of at which is not true and which e Life Assured or Policyholder does not believe to be true; b. The active concealment of a fact by e Life Assured or Policyholder having knowledge or belief of e fact; c. Any oer act fitted to deceive; and d. Any such act or omission as e law specifically declares to be fraudulent. 4. Mere silence is not fraud unless, depending on circumstances of e case, it is e duty of e Life Assured or Policyholder or his agent keeping silence to speak or silence is in itself equivalent to speak. 5. No Insurer shall repudiate a life insurance Policy on e ground of Fraud, if e Life Assured or Policyholder / Beneficiary can prove at e misstatement was true to e best of his knowledge and ere was no deliberate intention to suppress e fact or at such mis-statement of or suppression of material fact are wiin e knowledge of e insurer. Onus of disproving is upon e Policyholder, if alive, or beneficiaries. 6. Life insurance Policy can be called in question wiin ree (3) years on e ground at any statement of or suppression of a fact material to expectancy of life of e Life Assured or Policyholder was incorrectly made in e Proposal Form or oer documents, basis which Policy was issued or revived or Rider issued. For is, e Company should communicate in writing to e Life Assured or Policyholder or legal representative or Nominee or assignees of Policyholder, as applicable, mentioning e ground and materials on which decision to repudiate e Policy of life insurance is based. 7. In case repudiation is on ground of mis-statement and not on fraud, e premium(s) collected on Policy till e date of repudiation shall be paid to e Policyholder or legal representative or Nominee or assignees of Policyholder, wiin a period of 90 days from e date of repudiation. 8. Fact shall not be considered material unless it has a direct bearing on e risk undertaken by e Company. The onus is on Company to show at if e Company had been aware of e said fact, no life insurance Policy would have been issued to e Policyholder. 9. The Company can call for proof of age at any time if he is entitled to do so and no Policy shall be deemed to be called in question merely because e terms of e Policy are adjusted on subsequent proof of age of Life Assured. So, is Section will not be applicable for questioning age or adjustment based on proof of age submitted subsequently. [Disclaimer: Section 45 of e Insurance Act, 1938, as amended from time to time shall be applicable. Policy Holders are advised to refer to Original text of Section 45 as amended from time to time for complete and accurate details.] Annexure Ver. 2.1 (072017)