Birla Sun Life Insurance

Version 2.31

BSLI Vision LifeSecure Plan

UID : 0506R1806C3116

Your Sales Illustration

06/06/2016 05:18 PM

This shall form a part of the policy contract

Proposer
Life Insured

Mr. Vijay Kumar R

Mr. Ramachandra C C

Policy Detail
Sum Assured
Policy Term
Premium Paying Term

UIN:109N087V01
Rs. 525,000
15 years
Regular Pay

Premium Payable (in Rs.)

Modal Premium
Premium Rebate
Service Tax & Cess
Installment Premium Payable

Policy

Attn

Year

Age

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22

57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78

Prepared for: Vijay Kumar R

Age : 30
Age : 57

ECS Option : No
Pay Frequency : Annual

Rider Name
AD&D
Critical illness
Surgical Care
Hospital Care
WOP

59,902.50
1,797.08
2,178.95
60,284.38

Premium Paid

Gender : Male
Gender : Male

Guaranteed Benefit

Estimated Bonuses

Sum Assured
Rs.0
Rs.0
Rs.0
Rs.0
Rs.0

Total Death Benefit

Premium
0.00
0.00
0.00
0.00
0.00

Term
------

Total Maturity Benefit

During Year

Cumulative

Death

Maturity

at 4% p.a.

at 8% p.a.

at 4% p.a.

at 8% p.a.

at 4% p.a.

at 8% p.a.

60,284
59,195
59,195
59,195
59,195
59,195
59,195
59,195
59,195
59,195
59,195
59,195
59,195
59,195
59,195
0
0
0
0
0
0
0

60,284
119,479
178,674
237,869
297,064
356,259
415,454
474,649
533,844
593,039
652,233
711,428
770,623
829,818
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013

581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054

0
0
0
0
0
0
0
0
0
0
0
0
0
0
525,000
0
0
0
0
0
0
0

1,575
3,150
4,725
6,300
7,875
9,450
11,025
12,600
14,175
15,750
17,325
18,900
20,475
22,050
23,625
0
0
0
0
0
0
0

21,525
43,050
64,575
86,100
107,625
133,088
158,550
184,013
209,475
234,938
260,400
285,863
311,325
336,788
362,250
0
0
0
0
0
0
0

582,629
584,204
585,779
587,354
588,929
590,504
592,079
593,654
595,229
610,107
671,118
732,128
793,139
854,150
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161

602,579
624,104
645,629
667,154
688,679
714,142
739,604
765,067
790,529
815,992
841,454
866,917
892,379
917,842
943,304
915,161
915,161
915,161
915,161
915,161
915,161
915,161

0
0
0
0
0
0
0
0
0
0
0
0
0
0
548,625
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
887,250
0
0
0
0
0
0
0

BSLI BSLI Vision LifeSecure Plan

Page 1

Birla Sun Life Insurance

Version 2.31

BSLI Vision LifeSecure Plan

UID : 0506R1806C3116

Your Sales Illustration

23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43

79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013

Total

581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
NA

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
525,000

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

06/06/2016 05:18 PM

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
NA

915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
NA

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
915,161
1,463,786

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
915,161
1,802,411

The Sum Assured multiple for this policy is 9.04 times the base premium
In addition, on survival to age 100 you will receive an amount equal to your Guaranteed Death Benefit i.e. Rs 525,000
Death benefit is higher of
Guaranteed Death Benefit plus accrued regular bonuses plus terminal bonus (if any); or
105% of the premiums paid to date excluding any premiums paid towards rider benefit/s, underwriting extras and service tax & cess
In "Your Sales Illustration" benefits are as of year end and assume:
Premiums are paid when due, there is no underwriting extra and current service tax rates remain unchanged.
Premium is inclusive of Service Tax and Cess and any other applicable taxes. All applicable taxes will be additionally included to your premium and levied as per extant tax laws.
Some benefits are guaranteed and some benefits are variable with returns based on the future performance of the company (BSLI). 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 then the illustrations on this page will show two different rates of assumed future investment returns. These assumed rates of return are not guaranteed and they are not the 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. In the illustration above, Guaranteed Death Benefit and Guaranteed Maturity Benefit are fully guaranteed. The Estimated Bonuses; Total Death Benefit & Total Maturity Benefit
in the illustration above are not guaranteed and determined using assumed future investment returns of 4% and 8% as set by the Life Insurance Council.

Prepared for: Vijay Kumar R

BSLI BSLI Vision LifeSecure Plan

Page 2

Birla Sun Life Insurance

BSLI Vision LifeSecure Plan
Your Sales Illustration

Version 2.31
UID : 0506R1806C3116
06/06/2016 05:18 PM

DECLARATION OF THE PROPOSER

DECLARATION OF THE ADVISOR

I have read the product brochure and understand the guaranteed values
indicated in the illustration.

I certify that this illustration has been fully explained to the Proposer and
have made no statements that are inconsistent with this illustration or the
product brochure.

Date : ---------------------

Code of the Agent/ Specified Person/

Unit Manager/ Corporate Agent/ Broker -------------------------

Signature or Thumb Impression of the PROPOSER

Name of Agent / Specified Person / Unit Manager

Name & Signature of Witness (in case of Thumb Impression)

Signature of Agent / Specified Person / Unit Manager

Prepared for:Ramachandra C C
Insurance is the subject matter of the solicitation. For further details please refer to the product brochure.

Birla Sun Life Insurance Company Limited Reg. No. 109

Prepared for: Vijay Kumar R

BSLI BSLI Vision LifeSecure Plan

Page 3

Birla Sun Life Insurance

Version 2.31

BSLI Vision LifeSecure Plan

UID : 0506R1806C3116

Your Sales Illustration - Current Rate

Proposer
Life Insured

Mr. Vijay Kumar R

Mr. Ramachandra C C

Policy Detail
Sum Assured
Policy Term
Premium Paying Term

UIN:109N087V01
Rs. 525,000
15 years
Regular Pay

Premium Payable (in Rs.)

Modal Premium
Premium Rebate
Service Tax & Cess
Installment Premium Payable

Attn

Premium Paid

Year

Age

During Cumulative
Year

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
39
40
41
42

57
58
59
60
61
62
63
64
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

60,284
59,195
59,195
59,195
59,195
59,195
59,195
59,195
59,195
59,195
59,195
59,195
59,195
59,195
59,195
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

Prepared for: Vijay Kumar R

Age : 30
Age : 57

60,284
119,479
178,674
237,869
297,064
356,259
415,454
474,649
533,844
593,039
652,233
711,428
770,623
829,818
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013
889,013

Gender : Male
Gender : Male
ECS Option : No
Pay Frequency : Annual

Rider Name
AD&D
Critical illness
Surgical Care
Hospital Care
WOP

59,902.50
1,797.08
2,178.95
60,284.38

Policy

06/06/2016 05:18 PM

Guaranteed Benefit

Variable Bonus

Death

Maturity

for the year

Cumulative

581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054
581,054

0
0
0
0
0
0
0
0
0
0
0
0
0
0
525,000
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

23,100
23,100
23,100
23,100
23,100
23,100
23,100
23,100
23,100
23,100
23,100
23,100
23,100
23,100
23,100
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

23,100
46,200
69,300
92,400
115,500
138,600
161,700
184,800
207,900
231,000
254,100
277,200
300,300
323,400
346,500
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

BSLI BSLI Vision LifeSecure Plan

Sum Assured
Rs.0
Rs.0
Rs.0
Rs.0
Rs.0

Terminal
Bonus
0
0
0
0
0
3,938
7,875
11,813
15,750
19,688
23,625
27,563
31,500
35,438
91,875
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

Premium
0.00
0.00
0.00
0.00
0.00

Total Benefit at current

rate
Death

Maturity

604,154
627,254
650,354
673,454
696,554
723,592
750,629
777,667
804,704
831,742
858,779
885,817
912,854
939,892
1,019,429
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161
915,161

0
0
0
0
0
0
0
0
0
0
0
0
0
0
963,375
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

Term
-----Surrender
Benefit
0
0
79,927
121,191
154,951
200,818
253,320
313,447
382,175
461,052
551,422
655,311
774,950
913,061
201,652
226,957
234,465
242,078
249,795
257,565
265,440
273,368
281,348
289,380
297,465
305,550
313,635
321,720
329,858
337,943
346,028
354,165
362,303
370,492
378,788
387,292
396,165
405,563
415,905
428,138
442,785
461,423
Page 4

Birla Sun Life Insurance

Version 2.31

BSLI Vision LifeSecure Plan

UID : 0506R1806C3116

Your Sales Illustration - Current Rate

43

99

Total

889,013

581,054
NA

0
525,000

0
0

06/06/2016 05:18 PM

915,161
NA

915,161
1,878,536

The Sum Assured multiple for this policy is 9.04 times the base premium
In addition, on survival to age 100 you will receive an amount equal to your Guaranteed Death Benefit i.e. Rs 525,000
Death benefit is higher of
Guaranteed Death Benefit plus accrued regular bonuses plus terminal bonus (if any); or
105% of the premiums paid to date excluding any premiums paid towards rider benefit/s, underwriting extras and service tax & cess
Surrender Benefit is higher of
Guaranteed Surrender Value
Special Surrender Value
In "Your Sales Illustration" benefits are as of year end and assume:
Premiums are paid when due, there is no underwriting extra and current service tax rates remain unchanged.
Premium is inclusive of Service Tax and Cess and any other applicable taxes. All applicable taxes will be additionally included to your premium and levied as per extant tax laws.
Some benefits are guaranteed and some benefits are variable with returns based on the future performance of the company (BSLI). If your policy offers guaranteed returns then these
will be clearly marked guaranteed in the illustration table on this page. In the illustration above, Guaranteed Death Benefit and Guaranteed Maturity Benefit are fully guaranteed.
The Estimated Bonuses; Total Death Benefit & Total Maturity Benefit in the illustration above are not guaranteed and determined using assumed future bonus rate of Rs. 44 per
1000 sum assured.

Prepared for: Vijay Kumar R

BSLI BSLI Vision LifeSecure Plan

Page 5