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. Title Description Policy Clause

NO. (Please refer to applicable Policy Clause Number in next column) number

1. Name of Insurance ICICI Pru iProtect Smart Plus Policy schedule

Product and Unique UIN: 105N205V02
Identification Number
(UIN)

2. Application Number/ OP01245674 Policy schedule

Policy number

3. Type of Insurance A Non-Participating Non-Linked Life Individual Pure Risk Insurance Product Policy schedule
Policy

4. Basic Policy details Plan Variant: Life Policy schedule

Sum Assured on Death(Insurance Cover Amount) (in ₹) : 30000000
Premium Instalment in first policy year (in ₹) : 7807
Premium Instalment from second policy year onwards (in ₹) : 9114.00
Payment frequency: Monthly
You need to pay premiums for: 10 in years
Policy Term : 61 years
5. Policy Benefits payable on maturity - Not applicable Part C -Clause
Coverage/benefits 1,2,5,6,7
payable Benefits payable on death- Part D clause 3

On death of the Life Assured during the policy term, provided all due premiums
have been paid, the death benefit will be payable. Death benefit amount will be as
per the plan variant chosen by the policyholder.
For more information, refer to Part C, Clause 1 and 2 of policy document.
Benefits Payable on Accidental Death-
Under Life Plus plan variant, in the event of the Life Assured’s death due to an
Accident, where both Accident and death occurs during the Accidental Death
Benefit Term, the Accidental Death Benefit Sum Assured will be payable by Us as
a lump sum.
For more information, refer to Part C, clause 5 of Policy Document.

Benefit payable for Terminal Illness:

In the event, the Life Assured is diagnosed with a Terminal Illness during the
Policy Term, for a premium paying or fully paid In-force policy, an amount equal to
the Death Benefit will be payable to the Claimant. Benefit payable on Terminal
Illness is not applicable for policies sourced though POS personnel.
For more information, refer Part C, clause 6.

Surrender benefits- On policy surrender, Surrender Value equal to Unexpired risk

premium value will be payable according to the premium payment term chosen.

For more information related to surrender, refer to Part D Clause 3 of policy

document.

Lock-in period for Linked Insurance products-

Not applicable

Survival Benefits excluding that payable on maturity-Not Applicable

Options to policyholders for availing benefits, if any, covered under the policy- Life
stage protection: Under Regular pay, You can choose to increase the Sum
Assured at the key milestones of Life Assured such as marriage child birth/
adoption of child, and home loan disbursement provided no claim has been
admitted for any benefits under the policy and the policy is in force.
For more details, refer to Part C, Clause 7 of policy document
Other benefits/options payable, specific to the policy, if any- Not Applicable

6. Options available Not Applicable

(in case of Linked
Insurance Products)

7. Option available Not Applicable

(in case of Annuity
product)

8. Riders opted, if any Name of Rider – Critical Illness benefit Rider schedule
Rider Option - CICM and Policy
schedule
9. Exclusions (events There are certain Exclusions applicable for accidental death cover when offered Part D Clause 5
where insurance as additional benefit under Life Plus variant. Part F, Clause
coverage is not For more information, refer to Part C, Clause 4 of policy document 11
payable), if any
Suicide
If the Life Assured, whether sane or insane, commits suicide within 12 months from
the date of commencement of risk of this Policy, We will refund higher of 80% of
the total premiums paid, if any till the date of death or unexpired risk premium
value as available on the date of death, provided the policy is in force. For more
information, refer to Part F, Clause 11 of policy document

10 Waiting /lien Period, if There is waiting period for policies sourced under POS. Part D ,Clause
any No waiting period for policies sourced other than POS 5.1
For more information, please refer Part C, Clause 5.1 of policy document.

11 Grace period 15 days-For monthly frequency of premium payment Part C-Clause 15

30 days- For other frequencies of premium payment

For more information, refer to Part C, Clause 15 of policy document

12 Free Look Period 30 days Part D -Clause 1

For more information, refer to Part D, Clause 1 of policy document

13 Lapse, paid-up and Lapse: If any premium instalment is not paid within the grace period, then the Part D-Clause
revival of the Policy Policy shall lapse, and the cover will cease. If the Policy is not revived within the 4,Clause 7
revival period, then the surrender value (computed as on date of premium
discontinuance), if any, shall become payable on the earliest of the following
events:
• Event of death or diagnosis of Terminal Illness (if applicable), whichever
happens first, of the Life Assured within revival period
• End of the revival period, and
• Date of maturity. For more details on Lapse, refer to Part D,
Clause 4 of policy document

Revival: A Policy which has lapsed for nonpayment of premium within the grace
period may be revived subject to underwriting and other conditions:
The application for revival should be made within 5 years from the due date of the
first unpaid premium and before the Date of Maturity of the Policy. Revival will be
based on the prevailing Board approved underwriting policy.
For more details on revival, refer to Part D,
Clause 7 of policy document

14. Policy Loan, if Not Applicable

applicable
 15. Claims/Claims Turn around Time – For TAT details for death claim refer to Part F ,Clause
Procedure [Link] 10

For any assistance on Claims, you can call Us on 18002660 (for calls within India)
or +91 8069385555 (for calls outside India). You can also register a health or a
death claim by sending us an email at claimsupport@[Link]

The claim form can be downloaded from the following links:

Digital Claim Form Link:
[Link]

Physical Claim Form Link:

[Link]
[Link]#linked_content

For information on documents required to process claims, please refer to the

policy document (Part F, Clause 10) under the section ‘Specimen Policy
Document’ available on our website at
[Link]

16 Policy Servicing Turn around Time – For TAT details for policy servicing - refer to Part G ,Clause 1
[Link]

For any clarification or assistance, You may contact Our advisor or call Our
customer service representative (between 10.00 a.m. to 7.00 p.m, Monday to
Saturday; excluding national holidays) on 18002660 or visit Our website:
[Link].
Alternatively, You may communicate with Us at any of our branches or the
customer service helpline number 18002660 or email at lifeline@[Link].
For updated contact details, We request You to regularly check Our website.

17. Grievances 1. You may write to GRO by visiting the grievance redressal page of our website: Part G
/Complaints [Link] Alternatively, you
can contact the Grievance redressal officer at our branches or write to us at
gro@[Link]

2. [Link]

3. Kindly refer the Insurance Ombudsman details under part G under the
‘Specimen Policy Document’ available at Download Centre | ICICI Prulife . This is
subject to change from time to time Additionally, the contact details of Ombudsman
can be accessed through [Link]

Note: In case of any conflict, the terms and conditions mentioned in the policy document shall prevail
Declaration by the Policy Holder:
I have read the above and confirm having noted the details.

Place: Pune Shrikant Tambekar

(Signature of the Policyholder)
Date: 27-10-2025 11:36:59