Hi VALUABLE CUSTOMER,

Your Benefit Illustration

IndiaFirst Life Super Protection Plan secures your future by protecting your loved ones and
ensuring financial stability. Heres an example showcasing how its features and benefits can
add value to someones life:

Mr. VALUABLE CUSTOMER, age 21

is now protected with a life cover of 1,00,00,000 for 10 Years, till age 85

Your Policy Details

Policy Term 64 Years
Number of years your life is covered

Premium Policy Term 10 Years

Number of yea rs you pa y premium

Plan Options Life with Return of Premium Option

The Pla n option chos en by you a t inception

Maturity Benefit Rs. 3,82,000

Amount pa ya ble on Surviva l of Life As s ured till end of the Policy Term

Instalment Premium (excl. taxes) Rs. 38,200

Ins ta lment Premium Pa ya ble

Premium Frequency Annual

Frequency or mode for pa ying premium

Sum Assured on Death Rs. 1,00,00,000

Amount pa ya ble on dea th of Life As s ured during the Policy Term
Benefit Illustration

Name of the Prospect / Mr. VALUABLE CUSTOMER Proposal No:

Policyholder: IndiaFirst Life Super
Age of the Prospect / Name of the Product: Protection Plan
21
Policyholder: Non-Linked, Non-
Name of Life Assured: Mr. VALUABLE CUSTOMER Participating, Life
Tag Line: Individual Pure Risk/
Age of Life Assured: 21
Name of Secondary Life: NA Savings Product
Age of Secondary Life: NA Unique Identification 143N075V01
Number:
Policy term (in years): 64
1st Year - 4.50% p.a
Premium Payment Term (in GST Rate :
years): 10 2nd Year onwards - 2.25%
p.a
Amount of Instalment 38,200
premium (In Rs.):
Mode of Premium Payment: Yearly
Gender of life assured: Male
Individual or Joint Life: Individual
Wop Option Opted No
This benefit illustration is intended to show year-wise premiums payable and benefits under the policy.
Policy Details
Policy Option Life with Return of Premium Sum Assured on Maturity Rs. 382,000
Option
Smoker/Non Smoker Non-Smoker Sum Assured on Death (at inception 10,000,000
of the policy) Rs.

Rider Details
Policy Premium Premium Payment Instalment Premium Instalment
Name of Rider UIN Sum Assured Term Payment Term Mode without GST Premium
with GST
IndiaFirst Life Accidental 143B019V01 0 0 0 - 0 0
Death Benefit Rider
Indiafirst Life Total & 143B021V01 0 0 0 - 0 0
Permanent Disability Rider

Premium Summary
Base Plan Rider Total Instalment Premium
Instalment Premium without GST (Rs.) 36,863 0 36,863
Instalment Premium with First year 38,522 0 38,522
GST (Rs.)
Instalment Premium with GST 2nd 37,693 0 37,693
year onwards (Rs.)

(Amounts in Rupees)
Guaranteed Non Guaranteed
Policy Single/
Annualized Survival Other Maturity Death Guaranteed Special Surrender
Year Surrender
Premium* Benefits/Loyalty Benefits, if Benefit Benefit Surrender Value Value (SSV)** Value Payable
Additions any (GSV)
1 36,863 0 0 0 10,000,000 0 7,088 7,088
2 36,863 0 0 0 10,000,000 22,920 14,472 22,920
3 36,863 0 0 0 10,000,000 40,110 22,221 40,110
4 36,863 0 0 0 10,000,000 76,400 30,424 76,400
5 36,863 0 0 0 10,000,000 95,500 39,159 95,500
6 36,863 0 0 0 10,000,000 114,600 48,515 114,600
7 36,863 0 0 0 10,000,000 133,700 58,589 133,700
8 36,863 0 0 0 10,000,000 154,970 69,462 154,970
 (Amounts in Rupees)
Guaranteed Non Guaranteed
Policy Single/
Annualized Survival Other Maturity Death Guaranteed Special Surrender
Year Surrender
Premium* Benefits/Loyalty Benefits, if Benefit Benefit Surrender Value Value (SSV)** Value Payable
Additions any (GSV)
9 36,863 0 0 0 10,000,000 176,816 81,209 176,816
10 36,863 0 0 0 10,000,000 199,175 93,930 199,175
11 0 0 0 0 10,000,000 201,925 97,918 201,925
12 0 0 0 0 10,000,000 204,637 102,216 204,637
13 0 0 0 0 10,000,000 207,388 106,798 207,388
14 0 0 0 0 10,000,000 210,100 111,685 210,100
15 0 0 0 0 10,000,000 212,812 116,881 212,812
16 0 0 0 0 10,000,000 215,563 122,365 215,563
17 0 0 0 0 10,000,000 218,275 128,164 218,275
18 0 0 0 0 10,000,000 221,025 134,289 221,025
19 0 0 0 0 10,000,000 223,737 140,727 223,737
20 0 0 0 0 10,000,000 226,488 147,490 226,488
21 0 0 0 0 10,000,000 229,200 154,571 229,200
22 0 0 0 0 10,000,000 231,912 161,988 231,912
23 0 0 0 0 10,000,000 234,663 169,739 234,663
24 0 0 0 0 10,000,000 237,375 177,789 237,375
25 0 0 0 0 10,000,000 240,125 186,138 240,125
26 0 0 0 0 10,000,000 242,837 194,755 242,837
27 0 0 0 0 10,000,000 245,588 203,596 245,588
28 0 0 0 0 10,000,000 248,300 212,614 248,300
29 0 0 0 0 10,000,000 251,012 221,770 251,012
30 0 0 0 0 10,000,000 253,763 231,009 253,763
31 0 0 0 0 10,000,000 256,475 240,295 256,475
32 0 0 0 0 10,000,000 259,225 249,598 259,225
33 0 0 0 0 10,000,000 261,937 258,903 261,937
34 0 0 0 0 10,000,000 264,688 268,202 268,202
35 0 0 0 0 10,000,000 267,400 277,514 277,514
36 0 0 0 0 10,000,000 270,112 286,864 286,864
37 0 0 0 0 10,000,000 272,863 296,281 296,281
38 0 0 0 0 10,000,000 275,575 305,817 305,817
39 0 0 0 0 10,000,000 278,325 315,508 315,508
40 0 0 0 0 10,000,000 281,037 325,377 325,377
41 0 0 0 0 10,000,000 283,788 335,437 335,437
42 0 0 0 0 10,000,000 286,500 345,691 345,691
43 0 0 0 0 10,000,000 289,212 356,114 356,114
44 0 0 0 0 10,000,000 291,963 366,682 366,682
45 0 0 0 0 10,000,000 294,675 377,333 377,333
46 0 0 0 0 10,000,000 297,425 382,000 382,000
47 0 0 0 0 10,000,000 300,137 382,000 382,000
48 0 0 0 0 10,000,000 302,888 382,000 382,000
49 0 0 0 0 10,000,000 305,600 382,000 382,000
50 0 0 0 0 10,000,000 308,312 382,000 382,000
51 0 0 0 0 10,000,000 311,063 382,000 382,000
52 0 0 0 0 10,000,000 313,775 382,000 382,000
53 0 0 0 0 10,000,000 316,525 382,000 382,000
54 0 0 0 0 10,000,000 319,237 382,000 382,000
55 0 0 0 0 10,000,000 321,988 382,000 382,000
56 0 0 0 0 10,000,000 324,700 382,000 382,000
57 0 0 0 0 10,000,000 327,412 382,000 382,000
58 0 0 0 0 10,000,000 330,163 382,000 382,000
59 0 0 0 0 10,000,000 332,875 382,000 382,000
60 0 0 0 0 10,000,000 335,625 382,000 382,000
61 0 0 0 0 10,000,000 338,337 382,000 382,000
62 0 0 0 0 10,000,000 341,088 382,000 382,000
63 0 0 0 0 10,000,000 343,800 382,000 382,000
64 0 0 0 382,000 10,000,000 343,800 382,000 382,000
Notes:
1. Please consult our 'Insurance Consultant' for any clarifications on this illustration.
*2. Annualized Premium excludes underwri ng extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any, and
Goods and Services Tax.
3. Refer Sales Literature for explan on of terms used in illustra on and more details on risk factors, exclusions and other terms and condi ons
about the product.
3. Premiums payable maybe eligible for tax benefits as per Income Tax Act (as applicable from time to time).
4. All benefits payable under the Policy maybe subject to the tax laws and other financial enactments, as applicable from time to time.
5. The Company declares that it may charge extra premium subject to underwriting of proposal before the acceptance of risk.
6. Surrender benefit, if any as per the above table, shall be higher of Guranteed Surrender Value and Special Surrender Value.
**Special Surrender Value in the above table is based on current prevailing market environment condi ons and underlying experience. It shall be
reviewed annually and may be revised in the future.
Please check with the Company on the Special Surrender Value to be payable at the time of surrender.
Special Surrender Value shown in the first year for Limited Pay op on shall become payable a er comple on of first policy year provided one full
year premium has been received.

I, ____________(name) , have explained the premiums, and benefits I, VALUABLE CUSTOMER , having received the information with
under the product fully to the prospect / policyholder. respect to the above, have understood the above statement before
entering into the contract.

Place: Signature of Agent / Intermediary / Official of the

Date: 10 Jul 2025 Insurer Date: 10 Jul 2025 Signature of Prospect / Policyholder

Request you to submit the following mandatory requirements along with the application form:
1) Standard Age Proof
2) Photo
3) Photo Identity Proof
4) Address Proof

Disclaimer - IndiaFirst reserves the right to call for any addi onal documents/requirements basis the informa on provided by you in the applica on
form. The requirements stated herein are applicable only in case of the current applica on. Any simultaneous applica on or previous applica ons
may necessitate addi onal requirements by the Company. Please get in touch with your BDM for scheduling of medicals if any. Self-a ested AML /
KYC documents for the proposer / premium payor only are to be submitted.

IndiaFirst Life Insurance Company Ltd , 12th & 13th floor, North ( C ) Wing, Tower 4, Nesco IT Park, Nesco Centre, Western Express Highway,
Goregaon (East), Mumbai – 400 063. Website: [Link] , Toll Free No. : 1800 209 8700. IRDAI Regn No. 143. CIN:
U66010MH2008PLC183679
 CUSTOMER INFORMATION SHEET/ KNOW YOUR POLICY
This document provides key information about your policy. You are also advised to go through your policy document.

Sl Description Policy
No Title (Please refer to applicable Policy Clause Number in next column) Clause
Number

Name of
Insurance
1 Product and IndiaFirst Life Super Protection Plan (UIN: 143N075V01)
Unique
Identification
Number

2 Policy Number

Type of
3 Insurance Pure Risk, Savings
Policy

Plan Option: Life with Return of Premium Option

Chosen Sum Assured on Death: INR 1,00,00,000

Sum Assured on Death at Inception: INR 1,00,00,000

Maturity Benefit: INR 3,82,000

Mode of Premium Payment: Yearly

Installment Premium: INR 36,863

Premium Payment Term (in years): 10 Years

Policy Term (in years): 64 years

Basic Policy Waiver of Premium Benefit: No Part A

4 Details Policy
Joint Life Option: No Schedule

Riders opted

IndiaFirst Life Accidental Death Benefit Rider (UIN: 143B019V01) Not Applicable
Rider Instalment Premium: INR 0.00
Rider Sum Assured: INR 0
Rider Premium Payment Term: 0 years
Rider Policy Term: 0 years

IndiaFirst Life Total and Permanent disability Rider (UIN: 143B021V01) Not Applicable
Rider Instalment Premium: INR 0.00
Rider Sum Assured: INR 0
Rider Premium Payment Term: 0 years
Rider Policy Term: 0 years
 Part C,
Benefits payable on death: Clause
On Death during the policy term when the policy is in force, the death benefit is paid, and the policy 1. 1.1
terminates.
Death Benefit will be Higher of
Sum Assured on Death or
105% of Total premiums paid (TPP)
Part C,
Please refer to Part C, Clause 1.1 of your policy document for more details. Clause
Policy 1.1.3
Coverage/ Benefits payable on maturity:
5 benefits For Life with Return of Premium Option, on survival up to the end of policy term provided the policy is in
payable force, 100% of Total Premiums Paid will be payable as Maturity Benefit.

Survival Benefits excluding that payable on maturity: Part C,

There is no survival benefit payable under this Policy. Clause
1.1.2
Surrender Benefits:
Surrender Benefit is applicable only under Life with Return of Premium Option. Please refer to Part C, Clause
4 of your policy document for more details. Part C,
Clause 4

Options
available (in
6 case of Linked Not Applicable.
Insurance
products)

7 Riders opted, Pls refer details under Point 4 above.

if any

Exclusions Suicide Exclusions:

(events where In case of death or terminal illness due to suicide within 12 months from the date of commencement of risk Part F,
8 insurance under the policy or from the date of revival of the policy, as applicable, the nominee or beneficiary of the Clause
coverage is policyholder shall be entitled to 80% of the total premiums paid till the date of death or the surrender value 14
not payable), available as on the date of death whichever is higher, provided the policy is in force.
if any

Waiting /lien Part C,

9 Period, if any For Life Option, in case of critical illness, a waiting period of 180 days will be applicable. Clause
1. 1.7

You are provided a Grace Period of 15 days under monthly mode and one month but not less than 30 days for Part C,
other premium payment modes in case you miss your due premium on the due dates. In case of the Life Clause 6
10 Grace Period Assured’s death or occurrence of any covered event as per the benefit option chosen during the Grace
Period, we will pay the benefit after deducting the unpaid due premiums till date of death or date of the
covered event. During this period the policy will be considered in-force.

You have a free look period of 30 days from the date of receipt of the policy document whether electronically
or otherwise, to review the terms and conditions of the policy and in case you disagree to any of those terms Part D,
or conditions, you shall have the option to return the policy to us for cancellation, stating the reasons for Clause
Free Look cancellation, provided that no claim has been made under the policy. In such an event, irrespective of your 10
11
Period reasons, you shall be entitled to a refund of the premium paid subject only to a deduction of a proportionate
risk premium for the period of cover and the expenses incurred by us on medical examination of the life to be
assured and stamp duty charges. Such a request received by us for free look cancellation of the policy shall
be processed and premium refunded within 7 days of receipt of the request.

There is no Paid-Up benefit payable for Life Option. For Life with Return of Premium Option, please refer Part Part C,
Lapse, paid- C, Clause 3 of your policy document. Clause 3
12 up and revival
of the Policy For revival & lapse conditions, please refer to Part D, Clause 8 of your policy document for more details. Part D,
Clause 8
 Policy Loan will be available for “Option 2: Life with Return of Premium Option” subject to the following term
and conditions.
The loan amount will be subject to 80% of the surrender value.
The minimum loan amount should be Rs. 1,000.
For in-force and fully paid-up policies, if the outstanding loan along with interest exceeds 90% of the
surrender value, company will send a notice to the policy holder to repay the loan partially or
completely. If loan is not repaid subsequent to receipt of the notice, then we will adjust the
outstanding loan along with interest before any payment of benefits. After recovering the outstanding
loan along with interest, remaining benefit, if any, will be payable
For other than in-force and fully paid-up policies, as and when the outstanding loan along with interest Part D,
13 Policy Loan, if exceeds 90% of the surrender value for paid-up cases, company will send a notice to the policyholder Clause
applicable to repay the loan partially or completely. If loan is not repaid within a stipulated period, the policy will 11
be compulsorily surrendered and the outstanding loan along with interest will be recovered from the
surrender proceeds or paid-up value.
The basis used for the calculation of interest rate on loan is 10-year G-Sec rate as at the end of last
financial year plus the absolute margin of 250 basis points rounded up to the nearest 50 basis points.
The derived interest rate will be applicable in the succeeding financial year. Currently, the interest rate
on loan for FY 2024-25 is 10.00% p.a. (simple). It is arrived at by adding a margin of 250 basis points
on the effective annual 10-year G-Sec and rounding up to the nearest 50 basis points (10.00% ˜ 7.18%
+ 2.50%).
Any change in the methodology of calculating the loan interest rate shall be subject to prior approval from
the authority.
 Death Claim:
In case of natural death
i. Proof of Age of the Life Assured if the Age of the life assured has not been admitted by us.
ii. Claimant's statement and claim intimation report. Completely filled and signed by claimant/nominee.
iii. Valid QR code Scannable Death certificate issued under section 12/17 of registration of Births and
Deaths Act 1969 (only in case of death of the Life Assured) Part F,
iv. Original Policy Document Clause
v. A self-attested copy of Pan Card of Nominee/Claimant. In case Nominee/Claimant does not have a pan 13
card issued on his/her name then please submit duly filled and signed Form 60.
vi. Self-attested copy of photo-identity proof and address of the Nominee(s)/Claimant (e.g. driving
license, PAN card, passport, Voter ID card etc.)
vii. Self-attested copy of bank passbook of Nominee(s)/Claimant along with cancelled cheque with Printed
Nominee name, Ac no and IFSC code available on the same.
Any other document or information that we may need for validating and processing the claim.

In case of unnatural death

In case of unnatural death, apart from above mentioned documents, we will need the following document.
i. Clear Readable copies of Medico Legal Certificate, First Information Report, Panchnama, Inquest report
Final Viscera Report, Final Police investigation closure report and postmortem report (Only if Death),
duly attested by the police (only in case of Accident leading to unnatural death or Permanent Disability
of the Life Assured).
ii. All Hospitalization documents including discharge summary Admission Notes and all investigation
reports (only mandatory in case the Life Assured was treated for any illness related to the cause of
death).
Any other document or information that we may need for validating and processing the claim.

Claims can be intimated through.

Courier – Intimation with supporting documents can be sent to the claims department at head office by
Claims/Claims courier to the below address.
14 Claims Department, IndiaFirst Life Insurance Company Ltd, 12th Floor, North (C) wing, Tower 4, NESCO IT
Procedure
Park, Nesco Center, Western Express Highway, Goregaon (East), Mumbai – 400063
Email – Intimation with supporting documents can be sent to [Link]@[Link]
Website - Visit IndiaFirst website for online claim intimation at
[Link] and follow few simple steps to complete the
claim intimation.
WhatsApp – Say Hi on +91 22 6274 9898 and follow few simple steps to complete the claim intimation

Turn Around Time for various servicing request and claims processing are as mentioned below:

Maturity/Survival/Death Claims

Processing of Maturity claim / Due

penal interest not paid date

Raising claim requirements 15 Days Part F,

after lodging the Death claim Clause
22
Death claim decision without 15 Days
investigation requirement

Death claim decision with 45 Days

Investigation requirement

The claim form can be downloaded from the following link:

[Link]

You may submit the claims documents at any of our branches or at Claims Department, IndiaFirst Life
Insurance Company Ltd, 12th & 13th floor, North (C) Wing, Tower 4, NESCO IT Park, Nesco Center, Western
Express Highway, Goregaon (East), Mumbai - 400 063, Contact No.: 1800 209 8700, Email id:
[Link]@[Link]
 Turn Around Time for various servicing request and claims processing are as mentioned below:

Policy Servicing TAT's

Full Surrender 7 Days

Freelook Cancellation 7 Days

Part F,
Request for Refund of Clause
Proposal Deposit 15 days 22
Policy
15 Servicing Refund of outstanding
proposal deposit 30 days

The policy servicing form can be downloaded from the following link:
[Link]

You may contact us in case of any grievance at any of our branches or at Customer Care, IndiaFirst Life
Insurance Company Ltd, 12th & 13th Floor, North (C) Wing, Tower 4, NESCO IT Park, Nesco Center, Western
Express Highway, Goregaon (East), Mumbai – 400 063.
Contact No.: 1800 209 8700, Email id: [Link]@[Link]. IRDAI Regn No. 143.
CIN: U66010MH2008PLC183679.

You may contact us in case of any grievance at any of our branches or at Customer Care, IndiaFirst Life
Insurance Company Ltd, 12th & 13th Floor, North (C) Wing, Tower 4, NESCO IT Park, Nesco Center, Western Part G,
Express Highway, Goregaon (East), Mumbai – 400 063. Contact No.: 1800 209 8700, Email id: Clause
[Link]@[Link]. IRDAI Regn No. 143. CIN: U66010MH2008PLC183679. 24

a. An acknowledgment to all such grievances received will be sent immediately from the date of receipt
of the grievance.
b. A written communication giving reasons of either redressing or rejecting the grievance will be sent to
you within 14 days from the date of receipt of the grievance. In case We dont receive a revert from You
within 8 weeks from the date of Your receipt of Our response, We will treat the complaint as closed.
However, if you are not satisfied with our resolution provided or have not received any response within
14 days, then, you may approach our Grievance Officer at any of our branches or you may write to our
Grievance Redressal Officer at [Link]@[Link].
c. If you are not satisfied with the resolution or have not received any response within 14 days then you
can contact the insurance ombudsman. For the list of ombudsman office please refer Annexure B in
Grievance/ your policy document.
16 d. Further, you may approach the Grievance Cell of the Insurance Regulatory and Development Authority
Complaints
of India (IRDAI) on the following contact details.

IRDAI Grievance Call Centre (IGCC) TOLL FREE NO: 155255

Email ID: complaints@[Link]

You can also register your complaint online at

[Link]

Address for communication for complaints by fax/paper:

Policyholder Protection & Grievance Redressal Department (PPGR),
Insurance Regulatory and Development Authority of India,
Sy. No. 115/1, Financial District, Nanakramguda
Gachibowli, Hyderabad- 500032, Telangana
IRDAI TOLL FREE NO: 18004254732

For more details on Annexure B - Insurance Ombudsman, refer to your policy document Part G, Clause 23.

Note: Customer Information Sheet contains brief information about the key features of the Product. The same shall not be construed as terms and
conditions of the Policy or part thereof. For detailed terms and conditions governing the Policy, please read all parts of the Policy document. In case
of any conflict between the information given in the Customer Information Sheet and the terms and conditions of the policy, the terms and
conditions of the Policy shall prevail.
Declaration by the Policy Holder

I, VALUABLE CUSTOMER , have read the above and confirm having noted the details.

Place:
Date: 10 Jul 2025

(Signature of the Policy Holder)

Note: The product related documents can be downloaded from below link:
[Link]