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IDBI Fortis Wealthsurance Foundation Plan


Policy Holder's Name                                                                     ***Enter Policy Holder name***


Life Insured's Information
Life Insured's Name                                                                      ***Enter Life Insured's name***
Date of Birth of Life Insured                                                            ***Enter Date of Birth***
Attained age ( age last birthday )                                        0
Gender                                                                                   ***Select Gender***
Mode of Premium Payment                                                                  ***Select Mode***
Term (in years)                                                                          ***Enter Policy Term***
Premium Payment Term (in years)                                                          ***Enter Premium Paying Term***
Amount of Installment premium ( in Rs.)                                                  ***Enter Premium Amount***
Annualised Premium (in Rs.)                                               0
Sum Insured (in Rs.)                                                                     ***Enter Sum Insured***




                                                                                                       0
Riders are not allowed for entry age less than 18 years
                                                                    Sum Assured                       Term
Available Riders
                                                                       (in Rs.)                    (in years)
Accidental Death Benefit
Accidental Death and Disablement Benefit
Major Diseases Benefit
Hospital Cash Benefit




Policy Owner's Information (in case of WOP Riders)
Name
Date of Birth of Policy Owner                                                      ***Enter Date of Birth***
Attained age                                                       0
WOP benefit on Death can not be taken if the Life Insured and Policy Owner are the same person.
Available Riders                                                      Applicable                  Sum Assured                        Term
                                                                    ( Yes / No )                    (in Rs.)                      (in years)
Waiver of Premium Benefit on TPD#                                                                      0                              0
Waiver of Premium Benefit on Death                                                                     0                              0

                                                           **Total allocation percentage should be 100%.
Funds Available                                               Allocation percentage(%)              Charges
Monthly interest account                                                                             1.00%
Guaranteed return fund                                                                               1.50%
                                                                                                                       Capital guaranteed fund should be allowed only for sing
Capital guaranteed fund                                                                              2.25%
                                                                                                                       regular premium for PPT less than or equal to 5
Market linked funds
Equity growth fund                                                                                   2.00%
Nifty index fund                                                                                     1.75%
Bond fund                                                                                            1.50%
Income fund                                                                                          1.25%
Liquid fund                                                                                          1.00%
Asset allocator funds
Aggressive asset allocator fund*                                                                    2.75%
Moderate asset allocator fund*                                                                      2.25%
Cautious asset allocator fund*                                                                      1.875%
                                                                                                    0.000%
                                                                         0%
Average Fund Management Charge

                                                           **Total allocation percentage should be 100%.
Note : Min. investment % in any Fund = 15%
      Max. investment % in any Fund = 100%, except Liquid Fund where Max. = 40%
                            CHK
                            TRUE
IDBI Fortis Wealthsurance Foundation Plan (Regular Premium) - Benefit Illustration                                                                                                                                                                                                                       Proposal No. -

( Product Unique Identification No. - 135L001V01 )                                                                                                                                                                                                                                                       Policy No. -
IN THIS POLICY, THE INVESTMENT RISK IN INVESTMENT PORTFOLIO IS BORNE BY THE POLICYHOLDER.
Note: Some benefits are guaranteed and some benefits are variable with returns based on the future performance of IDBI Fortis Life Insurance Company Limited. If your policy offers guaranteed returns then these will be clearly marked quot;guaranteedquot; in the illustration table on this page. If your policy offers variable returns then the
illustration 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.

              Personal and policy details                                                                                                                 Sum          Annual Rider                                             Term of                                                  Effective Annual Yield
                                                                                                                                                                                                             Total rider
                                                                                                        Riders Details                                                                   Service tax and
 Insured Person :                                      -                                                                                                 Insured         Premium                                                  Rider
                                                                                                                                                                                                              premium                                            With mortality & terminal illness and    Without mortality & terminal illness
                                                                                                                                                                                         Education cess
                                                                                                                                                                                                             charge**                                                      rider charges                         and rider charges
 Current Age :                                         0                                                                                                                  charge                                                  Benefit
 Gender :                                              0                   Major Diseases Benefit                           (UIN : 135C005V01)            -                 -                  -                   -                  -
 Sum Insured :                                        0                    Accidental Death Benefit                         (UIN : 135C001V01)            -                 -                  -                   -                  -                           6% rate :              #N/A              6% rate :               #N/A
 Policy Term :                                        0                    Accidental Death and Disablement Benefit         (UIN : 135C002V01)            -                 -                  -                   -                  -                           10% rate :             #N/A              10% rate :              #N/A
 Premium Payment Term :                               0                    Hospital Cash Benefit                            (UIN : 135C004V01)            -                 -                  -                   -                  -
 Mode of Premium Payment :                             0                   Waiver of Premium Benefit on TPD#                (UIN : 135C006V01)            -                 -                  -                   -                  -
 Amount of Installment Premium :                      0                    Waiver of Premium Benefit on Death               (UIN : 135C003V01)            -                 -                  -                   -                  -
 Annualised Premium :                                 0                    **Service Tax and Education Cess at rate of 10.30% of mortality & terminal illness and rider charges is allowed for in this illustration. This rate may vary.
 Maturity Date :                             16 Apr 2009

This illustration shows how charges and variations in investment earnings will affect the benefits payable under this policy. The illustration does not say to simulate the performance of any particular option in the range from the IDBI Fortis Investment Basket.
IDBI Fortis currently offers two guaranteed fund options. The Guaranteed Return Fund provides a fixed minimum growth in the unit price over the fund term. The Capital Guarantee Fund, while giving exposure to equities, guarantees the return of at least the face value of each unit on the specified maturity date. If you have selected either
of these options the applicable guaranteed minimum unit prices and fund maturity dates are shown below :
         Fund                          Fund Maturity Date                  Guaranteed unit price at fund maturity                 *Error* : Please check Date of Birth in the Input sheet.
Guaranteed Return Fund                   31 August 2013                                 Rs 15.03                                  *Error* : Please check Sum Insured in the Input sheet.
 Capital Guaranteed Fund                 28 February 2014                               Rs 10.00                                  *Error* : Please check Total Fund Proportion in the Input sheet.
                                                                                                                                         Assuming gross interest rate of 6%                                                                                             Assuming gross interest rate of 10%
                                                                                                                                                                                   Variable                 Guaranteed                                                                                                  Variable                 Guaranteed
                                                                                                                   Amount of                                                                                                                    Amount of
                                                             Amount
                                            Amount of                         Amount of                            Mortality &                           Gross                                                                                  Mortality &                             Gross
             Age at         Annualised                     available for                           Fund                                                                                                                         Fund
                                            Premium                             Policy                              Terminal                          Investment                                                                                 Terminal                            Investment
                                                                                                                                                                                          Surrender                                                                                                                           Surrender
Policy Year start of         Regular                       investment                           Management                         Total charges                                                                             Management                          Total charges
                                                                                                                                                                       Fund Value at                                                                                                                     Fund Value at
                                            Allocation                      Administration                         Illness and                        earnings on                                                                               Illness and                          earnings on
                                                                                                                                                                                         Value at year     Death Benefit                                                                                                     Value at year       Death Benefit
           policy year       Premium                          (out of                             charge                                                                                                                       charge
                                                                                                                                                                         Year end                                                                                                                          Year end
                                             charges                           charges                                 Rider                             Fund                                                                                       Rider                               Fund
                                                                                                                                                                                             end                                                                                                                                 end
                                                            premium)
                                                                                                                   charges**                                                                                                                    charges**

     -             0             -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A               -                #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                 -                #N/A
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     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
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     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A
     -            -              -             #N/A             #N/A               -                #N/A             #DIV/0!            #N/A              #N/A              #N/A              #N/A              #N/A              #N/A             #DIV/0!              #N/A             #N/A                  #N/A                #N/A              #N/A

THE ABOVE INTEREST RATES ARE ONLY FOR ILLUSTRATION PURPOSE.                                                                                                                                                                                                                                        All the monetary values are in Rupees (Cont. to page 2)
Important notes :
     Please read this illustration in conjunction with the policy pack.
1    The benefit on survival to maturity date is the fund value at the end of the policy term.                                                                                Mortality & Terminal Illness charges per Rs 1000 of Sum at Risk :
2    The benefit on death during the policy term is the greater of the sum insured and the fund value on the date of valid notification of death to us.                       Age last birthday        Rate       Age last birthday      Rate        Age last birthday
                                                                                                                                                                                                                                                                             Rate
     Note that the terminal illness benefit is equal to the death benefit, subject under certain conditions to a maximum of Rs 25,00,000. Refer to the
     policy pack for full details.                                                                                                                                                       0            0.00              26               1.82               51               5.91
3    The policy acquires a surrender value after completion of 3 policy years and partial withdrawals may be made after completion of 3 policy years.                                    1            0.00              27               1.85               52               6.53
4    This illustration does not show the effect of any top ups or partial withdrawals that you may choose to make.                                                                       2            0.00              28               1.87               53               7.21
5    This illustration has been prepared for premiums paid yearly and assuming that charges are deducted at the beginning of each policy year. For                                       3            0.00              29               1.89               54               7.96
     premiums paid more frequently than yearly, the illustration will vary slightly.                                                                                                     4            0.00              30               1.91               55               8.77
6    The mortality & terminal illness charges are based on the excess of sum insured over the fund value and is deducted at the start of each policy                                     5            0.00              31               1.92               56               9.64
     month by cancellation of units (although for simplicity this illustration assumes that the charge is calculated and deducted annually at the start of                               6            0.00              32               1.92               57              10.58
     each policy year).                                                                                                                                                                  7            0.93              33               1.92               58              11.58
7    The policy administration charge of Rs 60 per month is deducted at the start of each policy month by cancellation of units (although for                                            8            0.93              34               1.93               59              12.65
     simplicity this illustration assumes that the charge is deducted annually at the start of each policy year).                                                                        9            0.93              35               1.96               60              13.77
8    We offer a range of unit linked funds and you can change the direction of your premiums or switch between funds at any time. The funds have                                        10            0.93              36               2.02               61              14.71
     different fund management charges depending upon the funds chosen. Fund management charges are adjusted daily against the unit price.                                              11            0.93              37               2.10               62              15.92
9    Tax benefits under Section 80C, 80D and 10(10D) of the Income Tax Act 1961 may be available and are subject to changes in the tax laws.                                            12            0.93              38               2.21               63              17.37
     Please consult your tax advisor for details.                                                                                                                                       13            0.90              39               2.33               64              19.08
10   **Service Tax and Education Cess at 10.30% of mortality & terminal illness and rider charges is allowed for in this illustration.                                                  14            0.99              40               2.47               65              21.05
      This rate may vary. We will charge you or deduct from your investment amount any taxes, duties or surcharges of whatever description                                              15            1.09              41               2.64               66              23.26
     levied or that may be levied by any statutory authority.                                                                                                                           16            1.25              42               2.83               67              25.73
11   Government of India, vide notification No. 18/2008 dated 10th May 2008, has levied service tax on services in relation to management of                                            17            1.33              43               3.07               68              28.46
     investment under Unit Linked Insurance Plans (ULIPs) with effect from the date of 16th May 2008. Therefore in accordance with the guidelines                                       18            1.41              44               3.32               69              29.90
     we will deduct additional service tax for Premium Allocation Charges, Policy Administration Charges and Fund Management Charges.                                                   19            1.47              45               3.54               70              33.65
     Your amount invested and returns will be lower than illustrated to the extent of deduction of service tax.                                                                         20            1.54              46               3.78               71              37.81
     Important things you must understand about your Unit Linked Policy :                                                                                                               21            1.60              47               4.08               72              42.42
12   The past performance of any fund of the company is not necessarily indicative of the future performance of that fund.                                                              22            1.65              48               4.44               73              47.51
13   Unit Linked Life Insurance products are different from the traditional insurance products and are subject to the risk factors.                                                     23            1.70              49               4.87               74              53.13
14   The premium paid in Unit Linked Life Insurance policies are subject to investment risks associated with capital markets and the NAVs of the                                        24            1.75              50               5.36               75              59.32
     units may go up or down based on the performance of fund and factors influencing the capital market and the insured is responsible for                                             25            1.79
      his/her decisions.
15   IDBI Fortis Life Insurance Company Limited is only the name of the Insurance Company and IDBI Fortis Wealthsurance Foundation Plan is only                     22        Rider premium charge: If any rider benefits are attached to this policy the annual premiums in respect of these riders are shown in the policy schedule.
     the name of the unit linked life insurance contract and does not in any way indicate the quality of the contract, its future prospects or returns.                       The rider premiums are charged to you by cancelling units to the value of one twelfth of the annual rider premium at the beginning of each policy
16   Please know the associated risks and the applicable charges from your Insurance agent or the Intermediary or the policy document of the insurer.                         month (although for simplicity this illustration assumes that the charge is calculated and deducted annually at the start of each policy year).
17   The various funds offered under this contract are the names of the funds and do not in any way indicate the quality of these plans, their future                         **We will also deduct service tax, surcharges, cess and any other levies applicable to the rider premium charges.
     prospects and returns.
     Charges and Glossary for various terms of charges used :                                                                                                                 Rider Charges per Rs 1000 of Sum Insured :
18   Premium Allocation Charge : Your annualised regular premiums are allocated to units in the unit linked funds you have chosen after deducting                                                                                                           -
                                                                                                                                                                              Major Diseases Benefit                         (UIN : 135C005V01)
              #N/A                                                                                                                                                                                                                                          -
                                                                                                                                                                              Accidental Death Benefit                       (UIN : 135C001V01)
19   Fund Management Charge : 0.000%                                                                                                                                                                                                                        -
                                                                                                                                                                              Accidental Death and Disablement Benefit       (UIN : 135C002V01)
                                                                                                                                                                                                                                                            -
                                                                                                                                                                              Hospital Cash Benefit                          (UIN : 135C004V01)
     Funds Selected               Allocation %        Charges                          Funds Selected                        Allocation %         Charges                                                                                                   -
                                                                                                                                                                              Waiver of Premium Benefit on TPD#              (UIN : 135C006V01)
     Monthly interest account          0%              1.00%                           Income fund                                0%               1.25%                                                                                                    -
                                                                                                                                                                              Waiver of Premium Benefit on Death             (UIN : 135C003V01)
     Guaranteed return fund            0%              1.50%                           Liquid fund                                0%               1.00%                      #Waiver of Premium Benefit on Total and Permanent Disablement
     Capital guaranteed fund           0%              2.25%                           Aggressive asset allocator fund*           0%               2.75%
     Equity growth fund                0%              2.00%                           Moderate asset allocator fund*             0%               2.25%                      I, , having received the information with respect to the above, have understood the above statement
     Nifty index fund                  0%              1.75%                           Cautious asset allocator fund*             0%              1.875%                      before entering into the contract.
     Bond fund                         0%              1.50%                           *estimated
                                                                                                                                                                              Marketing official's                                                                                      Policyholder's Signature
20   The policy administration charge is Rs 60 per month which we deduct by cancelling units at the beginning of each policy month.                                           Signature :
21   Mortality & terminal illness charge : At the beginning of each policy month we will calculate the mortality & terminal illness charge for your                           Company Seal :
     policy :
     • The life cover is the amount by which the sum insured exceeds the fund value.
     • The mortality & terminal illness charge is the premium rate for the age of the insured person multiplied by the life cover.
     • If your fund value is greater than the sum insured then the life cover is nil and we will not deduct any mortality & terminal illness charge.                          Place :                                                                                                   ()
     • We will deduct the mortality & terminal illness charge from the fund value by cancelling units.                                                                        Date :
     • There is no sum insured and no mortality & terminal illness charge for a child aged less than seven.
     • We will also deduct service tax, surcharges, cess and any other levies applicable to the mortality & terminal illness charge.
     • The premium rates are one twelfth of the rates set out in the following table :



                                                                                                                                             IDBI Fortis Life Insurance Company Limited
                                                                                                       Registered Office : 1st Floor,Tradeview, Oasis Complex, Kamala City, P.B. Marg, Lower Parel (W), Mumbai - 400 013, India.
                                                                                                                                         Registration Number : 135, Website : www.idbifortis.com
                                                                                                                        Toll-Free : 18001025005 (For non-MTNL subscribers) /1800221120 (for MTNL subscribers)
                                                                                                                                          Insurance is the subject matter of the solicitation.
IDBI Fortis Wealthsurance Foundation Plan (Regular Premium) - Sales Illustration
( Product Unique Identification No. - 135L001V01 )
IN THIS POLICY, THE INVESTMENT RISK IN INVESTMENT PORTFOLIO IS BORNE BY THE POLICYHOLDER.
Note: Some benefits are guaranteed and some benefits are variable with returns based on the future performance of IDBI Fortis Life Insurance Company Limited. If your policy offers guaranteed returns then these will be clearly marked quot;guaranteedquot; in the illustration table on this page. If your policy offers variable returns then the
illustration 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.

              Personal and policy details                                                                                                                 Sum         Annual Rider                                                Term of                                                Effective Annual Yield
                                                                                                                                                                                                                Total rider
                                                                                                                                                                                        Service tax and
 Insured person :                                  -                                                    Riders Details                                   Insured         Premium                                                    Rider
                                                                                                                                                                                                                 premium                                         With mortality & terminal illness and   Without mortality & terminal illness
                                                                                                                                                                                        Education cess
                                                                                                                                                                                                                charge**                                                   rider charges                        and rider charges
 Current age :                                        0                                                                                                                    charge                                                  Benefit
 Gender :                                             0                     Major Diseases Benefit                           (UIN : 135C005V01)            -                 -                  -                   -                  -
 Sum insured :                                       0                      Accidental Death Benefit                         (UIN : 135C001V01)            -                 -                  -                   -                  -                          6% rate :              #N/A             6% rate :             #N/A
 Policy term :                                       0                      Accidental Death and Disablement Benefit         (UIN : 135C002V01)            -                 -                  -                   -                  -                          10% rate :             #N/A             10% rate :            #N/A
 Premium payment term :                              0                      Hospital Cash Benefit                            (UIN : 135C004V01)            -                 -                  -                   -                  -
 Mode of Premium Payment :                            0                     Waiver of Premium Benefit on TPD#                (UIN : 135C006V01)            -                 -                  -                   -                  -
 Amount of Installment Premium :                     0                      Waiver of Premium Benefit on Death               (UIN : 135C003V01)            -                 -                  -                   -                  -
 Annualised Premium :                                0                      **Service Tax and Education Cess at rate of 10.30% of mortality & terminal illness and rider charges is allowed for in this illustration. This rate may vary.
 Maturity Date :                          16 Apr 2009

This illustration shows how charges and variations in investment earnings will affect the benefits payable under this policy. The illustration does not say to simulate the performance of any particular option in the range from the IDBI Fortis Investment Basket.
IDBI Fortis currently offers two guaranteed fund options. The Guaranteed Return Fund provides a fixed minimum growth in the unit price over the fund term. The Capital Guarantee Fund, while giving exposure to equities, guarantees the return of at least the face value of each unit on the specified maturity date. If you have selected either
of these options the applicable guaranteed minimum unit prices and fund maturity dates are shown below :
         Fund                          Fund Maturity Date                   Guaranteed unit price at fund maturity
Guaranteed Return Fund                   31 August 2013                                  Rs 15.03
 Capital Guaranteed Fund                 28 February 2014                                Rs 10.00
                                                                                                                                          Assuming gross interest rate of 6%                                                                                            Assuming gross interest rate of 10%
                                                                                                                                                                                    Variable                 Guaranteed                                                                                              Variable                   Guaranteed
                                                                                                                                     Amount of                                                                                                                    Amount of
                                             Amount of        Amount
                             Annualised                                       Amount of                                              Mortality &                                                                                                                  Mortality &
             Age at                         Premium +       available for                          Partial           Fund                                                                                                        Partial            Fund
                              Regular                                           Policy                                                Terminal                                                                                                                     Terminal
                                                                                                                                                                                           Surrender                                                                                                                         Surrender
Policy Year start of                          Top-Up        investment                           Withdrawal       Management                          Total charges                                                            Withdrawal        Management                         Total charges
                                                                                                                                                                        Fund Value at                                                                                                                    Fund Value at
                             Premium +                                      Administration                                           Illness and                                                                                                                  Illness and
                                                                                                                                                                                          Value at year     Death Benefit                                                                                                   Value at year       Death Benefit
           policy year                      Allocation         (out of                            Amount            charge                                                                                                      Amount             charge
                                                                                                                                                                          Year end                                                                                                                         Year end
                              Top-Ups                                          charges                                                   Rider                                                                                                                        Rider
                                                                                                                                                                                              end                                                                                                                               end
                                             charges         premium)
                                                                                                                                     charges**                                                                                                                    charges**

         -               0             -             #N/A            #N/A                  -                 -               #N/A           #DIV/0!              #N/A              #N/A               -                #N/A                  -            #N/A            #DIV/0!               #N/A                #N/A                -                #N/A
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THE ABOVE INTEREST RATES ARE ONLY FOR ILLUSTRATION PURPOSE.                                                                                                                                                                                                                                        All the monetary values are in Rupees (Cont. to page 2)
Important notes :
     Please read this illustration in conjunction with the policy pack.
1    The benefit on survival to maturity date is the fund value at the end of the policy term.                                                                                Mortality & Terminal Illness charges per Rs 1000 of Sum at Risk :
2    The benefit on death during the policy term is the greater of the sum insured and the fund value on the date of valid notification of death to us.                       Age last birthday        Rate       Age last birthday      Rate        Age last birthday
                                                                                                                                                                                                                                                                             Rate
     Note that the terminal illness benefit is equal to the death benefit, subject under certain conditions to a maximum of Rs 25,00,000. Refer to the
     policy pack for full details.                                                                                                                                                    0               0.00              26               1.82               51               5.91
3    The policy acquires a surrender value after completion of 3 policy years and partial withdrawals may be made after completion of 3 policy years.                                 1               0.00              27               1.85               52               6.53
4    This illustration also shows the effect of any top ups or partial withdrawals that you may choose to make.                                                                       2               0.00              28               1.87               53               7.21
5    This illustration has been prepared for premiums paid yearly and assuming that charges are deducted at the beginning of each policy year. For                                    3               0.00              29               1.89               54               7.96
     premiums paid more frequently than yearly, the illustration will vary slightly.                                                                                                  4               0.00              30               1.91               55               8.77
6    The mortality & terminal illness charges are based on the excess of sum insured over the fund value and is deducted at the start of each policy                                  5               0.00              31               1.92               56               9.64
     month by cancellation of units (although for simplicity this illustration assumes that the charge is calculated and deducted annually at the start of                            6               0.00              32               1.92               57              10.58
     each policy year).                                                                                                                                                               7               0.93              33               1.92               58              11.58
7    The policy administration charge of Rs 60 per month is deducted at the start of each policy month by cancellation of units (although for                                         8               0.93              34               1.93               59              12.65
     simplicity this illustration assumes that the charge is deducted annually at the start of each policy year).                                                                     9               0.93              35               1.96               60              13.77
8    We offer a range of unit linked funds and you can change the direction of your premiums or switch between funds at any time. The funds have                                     10               0.93              36               2.02               61              14.71
     different fund management charges depending upon the funds chosen. Fund management charges are adjusted daily against the unit price.                                           11               0.93              37               2.10               62              15.92
9    Tax benefits under Section 80C, 80D and 10(10D) of the Income Tax Act 1961 may be available and are subject to changes in the tax laws.                                         12               0.93              38               2.21               63              17.37
     Please consult your tax advisor for details.                                                                                                                                    13               0.90              39               2.33               64              19.08
10   **Service Tax and Education Cess at 10.30% of mortality & terminal illness and rider charges is allowed for in this illustration.                                               14               0.99              40               2.47               65              21.05
      This rate may vary. We will charge you or deduct from your investment amount any taxes, duties or surcharges of whatever description                                           15               1.09              41               2.64               66              23.26
     levied or that may be levied by any statutory authority.                                                                                                                        16               1.25              42               2.83               67              25.73
11   Government of India, vide notification No. 18/2008 dated 10th May 2008, has levied service tax on services in relation to management of                                         17               1.33              43               3.07               68              28.46
     investment under Unit Linked Insurance Plans (ULIPs) with effect from the date of 16th May 2008. Therefore in accordance with the guidelines                                    18               1.41              44               3.32               69              29.90
     we will deduct additional service tax for Premium Allocation Charges, Policy Administration Charges and Fund Management Charges.                                                19               1.47              45               3.54               70              33.65
     Your amount invested and returns will be lower than illustrated to the extent of deduction of service tax.                                                                      20               1.54              46               3.78               71              37.81
     Important things you must understand about your Unit Linked Policy :                                                                                                            21               1.60              47               4.08               72              42.42
12   The past performance of any fund of the company is not necessarily indicative of the future performance of that fund.                                                           22               1.65              48               4.44               73              47.51
13   Unit Linked Life Insurance products are different from the traditional insurance products and are subject to the risk factors.                                                  23               1.70              49               4.87               74              53.13
14   The premium paid in Unit Linked Life Insurance policies are subject to investment risks associated with capital markets and the NAVs of the                                     24               1.75              50               5.36               75              59.32
     units may go up or down based on the performance of fund and factors influencing the capital market and the insured is responsible for                                          25               1.79
      his/her decisions.
15   IDBI Fortis Life Insurance Company Limited is only the name of the Insurance Company and IDBI Fortis Wealthsurance Foundation Plan is only                     22        Rider premium charge: If any rider benefits are attached to this policy the annual premiums in respect of these riders are shown in the policy schedule.
     the name of the unit linked life insurance contract and does not in any way indicate the quality of the contract, its future prospects or returns.                       The rider premiums are charged to you by cancelling units to the value of one twelfth of the annual rider premium at the beginning of each policy
16   Please know the associated risks and the applicable charges from your Insurance agent or the Intermediary or the policy document of the insurer.                         month (although for simplicity this illustration assumes that the charge is calculated and deducted annually at the start of each policy year).
17   The various funds offered under this contract are the names of the funds and do not in any way indicate the quality of these plans, their future                         **We will also deduct service tax, surcharges, cess and any other levies applicable to the rider premium charges.
     prospects and returns.
     Charges and Glossary for various terms of charges used :                                                                                                                 Rider Charges per Rs 1000 of Sum Insured :
18   Premium Allocation Charge : Your annualised regular premiums are allocated to units in the unit linked funds you have chosen after deducting                                                                                                           -
                                                                                                                                                                              Major Diseases Benefit                         (UIN : 135C005V01)
              #N/A                                                                                                                                                                                                                                          -
                                                                                                                                                                              Accidental Death Benefit                       (UIN : 135C001V01)
19   Fund Management Charge : 0.000%                                                                                                                                          Accidental Death and Disablement Benefit       (UIN : 135C002V01)             -
                                                                                                                                                                              Hospital Cash Benefit                          (UIN : 135C004V01)             -
     Funds Selected               Allocation %        Charges                          Funds Selected                        Allocation %         Charges                                                                                                   -
                                                                                                                                                                              Waiver of Premium Benefit on TPD#              (UIN : 135C006V01)
     Monthly interest account          0%              1.00%                           Income fund                                0%               1.25%                                                                                                    -
                                                                                                                                                                              Waiver of Premium Benefit on Death             (UIN : 135C003V01)
     Guaranteed return fund            0%              1.50%                           Liquid fund                                0%               1.00%                      #Waiver of Premium Benefit on Total and Permanent Disablement
     Capital guaranteed fund           0%              2.25%                           Aggressive asset allocator fund*           0%               2.75%
     Equity growth fund                0%              2.00%                           Moderate asset allocator fund*             0%               2.25%
     Nifty index fund                  0%              1.75%                           Cautious asset allocator fund*             0%              1.875%
     Bond fund                         0%              1.50%                           *estimated

20   The policy administration charge is Rs 60 per month which we deduct by cancelling units at the beginning of each policy month.
21   Mortality & terminal illness charge : At the beginning of each policy month we will calculate the mortality & terminal illness charge for your
     policy :
     • The life cover is the amount by which the sum insured exceeds the fund value.
     • The mortality & terminal illness charge is the premium rate for the age of the insured person multiplied by the life cover.
     • If your fund value is greater than the sum insured then the life cover is nil and we will not deduct any mortality & terminal illness charge.
     • We will deduct the mortality & terminal illness charge from the fund value by cancelling units.
     • There is no sum insured and no mortality & terminal illness charge for a child aged less than seven.
     • We will also deduct service tax, surcharges, cess and any other levies applicable to the mortality & terminal illness charge.
     • The premium rates are one twelfth of the rates set out in the following table :



                                                                                                                                            IDBI Fortis Life Insurance Company Limited
                                                                                                                      Tradeview, Oasis Complex, Kamala City, P.B. Marg, Lower Parel (W), Mumbai - 400 013, India.
                                                                                                                          Registration Number : 135, Tel : +91 22 2490 8109/10, Website : www.idbifortis.com
                                                                                                                                         Insurance is the subject matter of the solicitation.
Supplementary Illustration for Guaranteed Return Funds
About this illustration
This supplementary illustration is intended to describe how the Guaranteed Return Fund works, the effect of the investment returns after deducting the
1.50% pa fund management charge and to show the extent of the guarantee. For simplicity it ignores administration, mortlity and rider premium
charges. You must read this supplementary illustration in conjuction with the personalised benefit illustration above to see the effect of these charges.

This illustration shows an investment of Rs 1,00,000. For other amounts the illustration applies proportionately.

                                  Guaranteed Return Fund - Maturity Date 31 December 2012 at a minimum unit price of 13.5089
                                                                                                                               Higher rate (7.75% annual return)
                                                                                           Lower rate (6% annual return)
                                                                           Investment
                                                                                                     Allocated                             Allocated
                                                                             amount
                                                                Date                    Unit price               Fund value   Unit price               Fund value
                                                                                                       units                                 units
Guaranteed Fund commencent date                      0      1 Jan 2008                  10.0000                               10.0000
Date of investement in Guaranteed Fund           27 days   27 Jan 2008     100,000      10.0326      9,967.51    100,000      10.0449      9,955.30     100,000
                                                  1 year   31 Dec 2008                  10.4500                  104,160      10.6250                   105,775
                                                 2 years   31 Dec 2009                  10.9202                  108,847      11.2890                   112,385
                                                 3 years   31 Dec 2010                  11.4116                  113,745      11.9946                   119,410
                                                 4 years   31 Dec 2011                  11.9251                  118,864      12.7442                   126,872
                                                                                                                                                        134,803
Guaranteed Fund maturity date                    5 years   31 Dec 2012                  12.4618                  124,213      13.5408

The prevailing fund unit price as on 31 December 2012 is (a)                            12.4618                               13.5408
The guaranteed unit price on 31 December 2012 is (b)                                    13.5089                               13.5089

                                                                                                                                                        134,803
Therefore, on 31 December 2012, your fund maturity proceeds will be                      13.5089     9,967.51 134,650          13.5408     9,955.30
            The maturity proceeds will be
            based on the greater of the
            prevailing fund unit price on the
            date of maturity (a) and the
            guranteed unit price (b)
Our guarantee
We guarantee that the unit price of the guaranteed return fund will not be less than 13.5089 on the fund maturity date on 31 December 2012.
There is no guarantee on any other date. If you decide to withdraw from the Guaranteed Return Fund before the maturity date by way of switch or
partial withdrawal, and to meet administration, mortality and rider premium charges, we will cancel the required number of units at the prevailing unit
price. For switches and partial withdrawals, we will also apply a surrender charge of 2% of the proceeds.


Operation of the fund
The Guaranteed Return Fund is a close end fund with a maturity date on 31 December 2012. The fund commenced on 1 January 2008 and has a fixed
maximum term of 5 years. We will accept new subscritions for a limited amount of time following the fund commencement date, typically two or three
months, depending on changing investment conditions.

A new policyholder who invests in the fund may be an investor in the fund for less than 5 years. In the illustration above, our policyholder has invested
27 days after the fund commenced, and will therefore be an investor in the fund for four years, eleven months and four days.
The unit price of the fund on the commenecement date was 10.0000 and when our policyholder invests 27 days later, the unit price could be 10.0326 or
10.0449 or some other amount depending on the actual investment return over the 27 days. The number of units allocated to our policyholder will
therefore depend on the day he or she invests, and on the unit price on that day.

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Benefit Illustration -- Wealthsurance Foundation Plan Ms Office Ver11.0

  • 1. IDBI Fortis Wealthsurance Foundation Plan Policy Holder's Name ***Enter Policy Holder name*** Life Insured's Information Life Insured's Name ***Enter Life Insured's name*** Date of Birth of Life Insured ***Enter Date of Birth*** Attained age ( age last birthday ) 0 Gender ***Select Gender*** Mode of Premium Payment ***Select Mode*** Term (in years) ***Enter Policy Term*** Premium Payment Term (in years) ***Enter Premium Paying Term*** Amount of Installment premium ( in Rs.) ***Enter Premium Amount*** Annualised Premium (in Rs.) 0 Sum Insured (in Rs.) ***Enter Sum Insured*** 0 Riders are not allowed for entry age less than 18 years Sum Assured Term Available Riders (in Rs.) (in years) Accidental Death Benefit Accidental Death and Disablement Benefit Major Diseases Benefit Hospital Cash Benefit Policy Owner's Information (in case of WOP Riders) Name Date of Birth of Policy Owner ***Enter Date of Birth*** Attained age 0 WOP benefit on Death can not be taken if the Life Insured and Policy Owner are the same person. Available Riders Applicable Sum Assured Term ( Yes / No ) (in Rs.) (in years) Waiver of Premium Benefit on TPD# 0 0 Waiver of Premium Benefit on Death 0 0 **Total allocation percentage should be 100%. Funds Available Allocation percentage(%) Charges Monthly interest account 1.00% Guaranteed return fund 1.50% Capital guaranteed fund should be allowed only for sing Capital guaranteed fund 2.25% regular premium for PPT less than or equal to 5 Market linked funds Equity growth fund 2.00% Nifty index fund 1.75% Bond fund 1.50% Income fund 1.25% Liquid fund 1.00% Asset allocator funds Aggressive asset allocator fund* 2.75% Moderate asset allocator fund* 2.25% Cautious asset allocator fund* 1.875% 0.000% 0% Average Fund Management Charge **Total allocation percentage should be 100%. Note : Min. investment % in any Fund = 15% Max. investment % in any Fund = 100%, except Liquid Fund where Max. = 40% CHK TRUE
  • 2. IDBI Fortis Wealthsurance Foundation Plan (Regular Premium) - Benefit Illustration Proposal No. - ( Product Unique Identification No. - 135L001V01 ) Policy No. - IN THIS POLICY, THE INVESTMENT RISK IN INVESTMENT PORTFOLIO IS BORNE BY THE POLICYHOLDER. Note: Some benefits are guaranteed and some benefits are variable with returns based on the future performance of IDBI Fortis Life Insurance Company Limited. If your policy offers guaranteed returns then these will be clearly marked quot;guaranteedquot; in the illustration table on this page. If your policy offers variable returns then the illustration 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. Personal and policy details Sum Annual Rider Term of Effective Annual Yield Total rider Riders Details Service tax and Insured Person : - Insured Premium Rider premium With mortality & terminal illness and Without mortality & terminal illness Education cess charge** rider charges and rider charges Current Age : 0 charge Benefit Gender : 0 Major Diseases Benefit (UIN : 135C005V01) - - - - - Sum Insured : 0 Accidental Death Benefit (UIN : 135C001V01) - - - - - 6% rate : #N/A 6% rate : #N/A Policy Term : 0 Accidental Death and Disablement Benefit (UIN : 135C002V01) - - - - - 10% rate : #N/A 10% rate : #N/A Premium Payment Term : 0 Hospital Cash Benefit (UIN : 135C004V01) - - - - - Mode of Premium Payment : 0 Waiver of Premium Benefit on TPD# (UIN : 135C006V01) - - - - - Amount of Installment Premium : 0 Waiver of Premium Benefit on Death (UIN : 135C003V01) - - - - - Annualised Premium : 0 **Service Tax and Education Cess at rate of 10.30% of mortality & terminal illness and rider charges is allowed for in this illustration. This rate may vary. Maturity Date : 16 Apr 2009 This illustration shows how charges and variations in investment earnings will affect the benefits payable under this policy. The illustration does not say to simulate the performance of any particular option in the range from the IDBI Fortis Investment Basket. IDBI Fortis currently offers two guaranteed fund options. The Guaranteed Return Fund provides a fixed minimum growth in the unit price over the fund term. The Capital Guarantee Fund, while giving exposure to equities, guarantees the return of at least the face value of each unit on the specified maturity date. If you have selected either of these options the applicable guaranteed minimum unit prices and fund maturity dates are shown below : Fund Fund Maturity Date Guaranteed unit price at fund maturity *Error* : Please check Date of Birth in the Input sheet. Guaranteed Return Fund 31 August 2013 Rs 15.03 *Error* : Please check Sum Insured in the Input sheet. Capital Guaranteed Fund 28 February 2014 Rs 10.00 *Error* : Please check Total Fund Proportion in the Input sheet. Assuming gross interest rate of 6% Assuming gross interest rate of 10% Variable Guaranteed Variable Guaranteed Amount of Amount of Amount Amount of Amount of Mortality & Gross Mortality & Gross Age at Annualised available for Fund Fund Premium Policy Terminal Investment Terminal Investment Surrender Surrender Policy Year start of Regular investment Management Total charges Management Total charges Fund Value at Fund Value at Allocation Administration Illness and earnings on Illness and earnings on Value at year Death Benefit Value at year Death Benefit policy year Premium (out of charge charge Year end Year end charges charges Rider Fund Rider Fund end end premium) charges** charges** - 0 - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A - #N/A #N/A #DIV/0! #N/A #N/A #N/A - #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A - #N/A #N/A #DIV/0! #N/A #N/A #N/A - #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A - - - #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A #N/A #DIV/0! #N/A #N/A #N/A #N/A #N/A THE ABOVE INTEREST RATES ARE ONLY FOR ILLUSTRATION PURPOSE. All the monetary values are in Rupees (Cont. to page 2)
  • 3. Important notes : Please read this illustration in conjunction with the policy pack. 1 The benefit on survival to maturity date is the fund value at the end of the policy term. Mortality & Terminal Illness charges per Rs 1000 of Sum at Risk : 2 The benefit on death during the policy term is the greater of the sum insured and the fund value on the date of valid notification of death to us. Age last birthday Rate Age last birthday Rate Age last birthday Rate Note that the terminal illness benefit is equal to the death benefit, subject under certain conditions to a maximum of Rs 25,00,000. Refer to the policy pack for full details. 0 0.00 26 1.82 51 5.91 3 The policy acquires a surrender value after completion of 3 policy years and partial withdrawals may be made after completion of 3 policy years. 1 0.00 27 1.85 52 6.53 4 This illustration does not show the effect of any top ups or partial withdrawals that you may choose to make. 2 0.00 28 1.87 53 7.21 5 This illustration has been prepared for premiums paid yearly and assuming that charges are deducted at the beginning of each policy year. For 3 0.00 29 1.89 54 7.96 premiums paid more frequently than yearly, the illustration will vary slightly. 4 0.00 30 1.91 55 8.77 6 The mortality & terminal illness charges are based on the excess of sum insured over the fund value and is deducted at the start of each policy 5 0.00 31 1.92 56 9.64 month by cancellation of units (although for simplicity this illustration assumes that the charge is calculated and deducted annually at the start of 6 0.00 32 1.92 57 10.58 each policy year). 7 0.93 33 1.92 58 11.58 7 The policy administration charge of Rs 60 per month is deducted at the start of each policy month by cancellation of units (although for 8 0.93 34 1.93 59 12.65 simplicity this illustration assumes that the charge is deducted annually at the start of each policy year). 9 0.93 35 1.96 60 13.77 8 We offer a range of unit linked funds and you can change the direction of your premiums or switch between funds at any time. The funds have 10 0.93 36 2.02 61 14.71 different fund management charges depending upon the funds chosen. Fund management charges are adjusted daily against the unit price. 11 0.93 37 2.10 62 15.92 9 Tax benefits under Section 80C, 80D and 10(10D) of the Income Tax Act 1961 may be available and are subject to changes in the tax laws. 12 0.93 38 2.21 63 17.37 Please consult your tax advisor for details. 13 0.90 39 2.33 64 19.08 10 **Service Tax and Education Cess at 10.30% of mortality & terminal illness and rider charges is allowed for in this illustration. 14 0.99 40 2.47 65 21.05 This rate may vary. We will charge you or deduct from your investment amount any taxes, duties or surcharges of whatever description 15 1.09 41 2.64 66 23.26 levied or that may be levied by any statutory authority. 16 1.25 42 2.83 67 25.73 11 Government of India, vide notification No. 18/2008 dated 10th May 2008, has levied service tax on services in relation to management of 17 1.33 43 3.07 68 28.46 investment under Unit Linked Insurance Plans (ULIPs) with effect from the date of 16th May 2008. Therefore in accordance with the guidelines 18 1.41 44 3.32 69 29.90 we will deduct additional service tax for Premium Allocation Charges, Policy Administration Charges and Fund Management Charges. 19 1.47 45 3.54 70 33.65 Your amount invested and returns will be lower than illustrated to the extent of deduction of service tax. 20 1.54 46 3.78 71 37.81 Important things you must understand about your Unit Linked Policy : 21 1.60 47 4.08 72 42.42 12 The past performance of any fund of the company is not necessarily indicative of the future performance of that fund. 22 1.65 48 4.44 73 47.51 13 Unit Linked Life Insurance products are different from the traditional insurance products and are subject to the risk factors. 23 1.70 49 4.87 74 53.13 14 The premium paid in Unit Linked Life Insurance policies are subject to investment risks associated with capital markets and the NAVs of the 24 1.75 50 5.36 75 59.32 units may go up or down based on the performance of fund and factors influencing the capital market and the insured is responsible for 25 1.79 his/her decisions. 15 IDBI Fortis Life Insurance Company Limited is only the name of the Insurance Company and IDBI Fortis Wealthsurance Foundation Plan is only 22 Rider premium charge: If any rider benefits are attached to this policy the annual premiums in respect of these riders are shown in the policy schedule. the name of the unit linked life insurance contract and does not in any way indicate the quality of the contract, its future prospects or returns. The rider premiums are charged to you by cancelling units to the value of one twelfth of the annual rider premium at the beginning of each policy 16 Please know the associated risks and the applicable charges from your Insurance agent or the Intermediary or the policy document of the insurer. month (although for simplicity this illustration assumes that the charge is calculated and deducted annually at the start of each policy year). 17 The various funds offered under this contract are the names of the funds and do not in any way indicate the quality of these plans, their future **We will also deduct service tax, surcharges, cess and any other levies applicable to the rider premium charges. prospects and returns. Charges and Glossary for various terms of charges used : Rider Charges per Rs 1000 of Sum Insured : 18 Premium Allocation Charge : Your annualised regular premiums are allocated to units in the unit linked funds you have chosen after deducting - Major Diseases Benefit (UIN : 135C005V01) #N/A - Accidental Death Benefit (UIN : 135C001V01) 19 Fund Management Charge : 0.000% - Accidental Death and Disablement Benefit (UIN : 135C002V01) - Hospital Cash Benefit (UIN : 135C004V01) Funds Selected Allocation % Charges Funds Selected Allocation % Charges - Waiver of Premium Benefit on TPD# (UIN : 135C006V01) Monthly interest account 0% 1.00% Income fund 0% 1.25% - Waiver of Premium Benefit on Death (UIN : 135C003V01) Guaranteed return fund 0% 1.50% Liquid fund 0% 1.00% #Waiver of Premium Benefit on Total and Permanent Disablement Capital guaranteed fund 0% 2.25% Aggressive asset allocator fund* 0% 2.75% Equity growth fund 0% 2.00% Moderate asset allocator fund* 0% 2.25% I, , having received the information with respect to the above, have understood the above statement Nifty index fund 0% 1.75% Cautious asset allocator fund* 0% 1.875% before entering into the contract. Bond fund 0% 1.50% *estimated Marketing official's Policyholder's Signature 20 The policy administration charge is Rs 60 per month which we deduct by cancelling units at the beginning of each policy month. Signature : 21 Mortality & terminal illness charge : At the beginning of each policy month we will calculate the mortality & terminal illness charge for your Company Seal : policy : • The life cover is the amount by which the sum insured exceeds the fund value. • The mortality & terminal illness charge is the premium rate for the age of the insured person multiplied by the life cover. • If your fund value is greater than the sum insured then the life cover is nil and we will not deduct any mortality & terminal illness charge. Place : () • We will deduct the mortality & terminal illness charge from the fund value by cancelling units. Date : • There is no sum insured and no mortality & terminal illness charge for a child aged less than seven. • We will also deduct service tax, surcharges, cess and any other levies applicable to the mortality & terminal illness charge. • The premium rates are one twelfth of the rates set out in the following table : IDBI Fortis Life Insurance Company Limited Registered Office : 1st Floor,Tradeview, Oasis Complex, Kamala City, P.B. Marg, Lower Parel (W), Mumbai - 400 013, India. Registration Number : 135, Website : www.idbifortis.com Toll-Free : 18001025005 (For non-MTNL subscribers) /1800221120 (for MTNL subscribers) Insurance is the subject matter of the solicitation.
  • 4. IDBI Fortis Wealthsurance Foundation Plan (Regular Premium) - Sales Illustration ( Product Unique Identification No. - 135L001V01 ) IN THIS POLICY, THE INVESTMENT RISK IN INVESTMENT PORTFOLIO IS BORNE BY THE POLICYHOLDER. Note: Some benefits are guaranteed and some benefits are variable with returns based on the future performance of IDBI Fortis Life Insurance Company Limited. If your policy offers guaranteed returns then these will be clearly marked quot;guaranteedquot; in the illustration table on this page. If your policy offers variable returns then the illustration 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. Personal and policy details Sum Annual Rider Term of Effective Annual Yield Total rider Service tax and Insured person : - Riders Details Insured Premium Rider premium With mortality & terminal illness and Without mortality & terminal illness Education cess charge** rider charges and rider charges Current age : 0 charge Benefit Gender : 0 Major Diseases Benefit (UIN : 135C005V01) - - - - - Sum insured : 0 Accidental Death Benefit (UIN : 135C001V01) - - - - - 6% rate : #N/A 6% rate : #N/A Policy term : 0 Accidental Death and Disablement Benefit (UIN : 135C002V01) - - - - - 10% rate : #N/A 10% rate : #N/A Premium payment term : 0 Hospital Cash Benefit (UIN : 135C004V01) - - - - - Mode of Premium Payment : 0 Waiver of Premium Benefit on TPD# (UIN : 135C006V01) - - - - - Amount of Installment Premium : 0 Waiver of Premium Benefit on Death (UIN : 135C003V01) - - - - - Annualised Premium : 0 **Service Tax and Education Cess at rate of 10.30% of mortality & terminal illness and rider charges is allowed for in this illustration. This rate may vary. Maturity Date : 16 Apr 2009 This illustration shows how charges and variations in investment earnings will affect the benefits payable under this policy. The illustration does not say to simulate the performance of any particular option in the range from the IDBI Fortis Investment Basket. IDBI Fortis currently offers two guaranteed fund options. The Guaranteed Return Fund provides a fixed minimum growth in the unit price over the fund term. The Capital Guarantee Fund, while giving exposure to equities, guarantees the return of at least the face value of each unit on the specified maturity date. If you have selected either of these options the applicable guaranteed minimum unit prices and fund maturity dates are shown below : Fund Fund Maturity Date Guaranteed unit price at fund maturity Guaranteed Return Fund 31 August 2013 Rs 15.03 Capital Guaranteed Fund 28 February 2014 Rs 10.00 Assuming gross interest rate of 6% Assuming gross interest rate of 10% Variable Guaranteed Variable Guaranteed Amount of Amount of Amount of Amount Annualised Amount of Mortality & Mortality & Age at Premium + available for Partial Fund Partial Fund Regular Policy Terminal Terminal Surrender Surrender Policy Year start of Top-Up investment Withdrawal Management Total charges Withdrawal Management Total charges Fund Value at Fund Value at Premium + Administration Illness and Illness and Value at year Death Benefit Value at year Death Benefit policy year Allocation (out of Amount charge Amount charge Year end Year end Top-Ups charges Rider Rider end end charges premium) charges** charges** - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A - #N/A - #N/A #DIV/0! #N/A #N/A - #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A - #N/A - #N/A #DIV/0! #N/A #N/A - #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A - 0 - #N/A #N/A - - #N/A #DIV/0! #N/A #N/A #N/A #N/A - #N/A #DIV/0! #N/A #N/A #N/A #N/A THE ABOVE INTEREST RATES ARE ONLY FOR ILLUSTRATION PURPOSE. All the monetary values are in Rupees (Cont. to page 2)
  • 5. Important notes : Please read this illustration in conjunction with the policy pack. 1 The benefit on survival to maturity date is the fund value at the end of the policy term. Mortality & Terminal Illness charges per Rs 1000 of Sum at Risk : 2 The benefit on death during the policy term is the greater of the sum insured and the fund value on the date of valid notification of death to us. Age last birthday Rate Age last birthday Rate Age last birthday Rate Note that the terminal illness benefit is equal to the death benefit, subject under certain conditions to a maximum of Rs 25,00,000. Refer to the policy pack for full details. 0 0.00 26 1.82 51 5.91 3 The policy acquires a surrender value after completion of 3 policy years and partial withdrawals may be made after completion of 3 policy years. 1 0.00 27 1.85 52 6.53 4 This illustration also shows the effect of any top ups or partial withdrawals that you may choose to make. 2 0.00 28 1.87 53 7.21 5 This illustration has been prepared for premiums paid yearly and assuming that charges are deducted at the beginning of each policy year. For 3 0.00 29 1.89 54 7.96 premiums paid more frequently than yearly, the illustration will vary slightly. 4 0.00 30 1.91 55 8.77 6 The mortality & terminal illness charges are based on the excess of sum insured over the fund value and is deducted at the start of each policy 5 0.00 31 1.92 56 9.64 month by cancellation of units (although for simplicity this illustration assumes that the charge is calculated and deducted annually at the start of 6 0.00 32 1.92 57 10.58 each policy year). 7 0.93 33 1.92 58 11.58 7 The policy administration charge of Rs 60 per month is deducted at the start of each policy month by cancellation of units (although for 8 0.93 34 1.93 59 12.65 simplicity this illustration assumes that the charge is deducted annually at the start of each policy year). 9 0.93 35 1.96 60 13.77 8 We offer a range of unit linked funds and you can change the direction of your premiums or switch between funds at any time. The funds have 10 0.93 36 2.02 61 14.71 different fund management charges depending upon the funds chosen. Fund management charges are adjusted daily against the unit price. 11 0.93 37 2.10 62 15.92 9 Tax benefits under Section 80C, 80D and 10(10D) of the Income Tax Act 1961 may be available and are subject to changes in the tax laws. 12 0.93 38 2.21 63 17.37 Please consult your tax advisor for details. 13 0.90 39 2.33 64 19.08 10 **Service Tax and Education Cess at 10.30% of mortality & terminal illness and rider charges is allowed for in this illustration. 14 0.99 40 2.47 65 21.05 This rate may vary. We will charge you or deduct from your investment amount any taxes, duties or surcharges of whatever description 15 1.09 41 2.64 66 23.26 levied or that may be levied by any statutory authority. 16 1.25 42 2.83 67 25.73 11 Government of India, vide notification No. 18/2008 dated 10th May 2008, has levied service tax on services in relation to management of 17 1.33 43 3.07 68 28.46 investment under Unit Linked Insurance Plans (ULIPs) with effect from the date of 16th May 2008. Therefore in accordance with the guidelines 18 1.41 44 3.32 69 29.90 we will deduct additional service tax for Premium Allocation Charges, Policy Administration Charges and Fund Management Charges. 19 1.47 45 3.54 70 33.65 Your amount invested and returns will be lower than illustrated to the extent of deduction of service tax. 20 1.54 46 3.78 71 37.81 Important things you must understand about your Unit Linked Policy : 21 1.60 47 4.08 72 42.42 12 The past performance of any fund of the company is not necessarily indicative of the future performance of that fund. 22 1.65 48 4.44 73 47.51 13 Unit Linked Life Insurance products are different from the traditional insurance products and are subject to the risk factors. 23 1.70 49 4.87 74 53.13 14 The premium paid in Unit Linked Life Insurance policies are subject to investment risks associated with capital markets and the NAVs of the 24 1.75 50 5.36 75 59.32 units may go up or down based on the performance of fund and factors influencing the capital market and the insured is responsible for 25 1.79 his/her decisions. 15 IDBI Fortis Life Insurance Company Limited is only the name of the Insurance Company and IDBI Fortis Wealthsurance Foundation Plan is only 22 Rider premium charge: If any rider benefits are attached to this policy the annual premiums in respect of these riders are shown in the policy schedule. the name of the unit linked life insurance contract and does not in any way indicate the quality of the contract, its future prospects or returns. The rider premiums are charged to you by cancelling units to the value of one twelfth of the annual rider premium at the beginning of each policy 16 Please know the associated risks and the applicable charges from your Insurance agent or the Intermediary or the policy document of the insurer. month (although for simplicity this illustration assumes that the charge is calculated and deducted annually at the start of each policy year). 17 The various funds offered under this contract are the names of the funds and do not in any way indicate the quality of these plans, their future **We will also deduct service tax, surcharges, cess and any other levies applicable to the rider premium charges. prospects and returns. Charges and Glossary for various terms of charges used : Rider Charges per Rs 1000 of Sum Insured : 18 Premium Allocation Charge : Your annualised regular premiums are allocated to units in the unit linked funds you have chosen after deducting - Major Diseases Benefit (UIN : 135C005V01) #N/A - Accidental Death Benefit (UIN : 135C001V01) 19 Fund Management Charge : 0.000% Accidental Death and Disablement Benefit (UIN : 135C002V01) - Hospital Cash Benefit (UIN : 135C004V01) - Funds Selected Allocation % Charges Funds Selected Allocation % Charges - Waiver of Premium Benefit on TPD# (UIN : 135C006V01) Monthly interest account 0% 1.00% Income fund 0% 1.25% - Waiver of Premium Benefit on Death (UIN : 135C003V01) Guaranteed return fund 0% 1.50% Liquid fund 0% 1.00% #Waiver of Premium Benefit on Total and Permanent Disablement Capital guaranteed fund 0% 2.25% Aggressive asset allocator fund* 0% 2.75% Equity growth fund 0% 2.00% Moderate asset allocator fund* 0% 2.25% Nifty index fund 0% 1.75% Cautious asset allocator fund* 0% 1.875% Bond fund 0% 1.50% *estimated 20 The policy administration charge is Rs 60 per month which we deduct by cancelling units at the beginning of each policy month. 21 Mortality & terminal illness charge : At the beginning of each policy month we will calculate the mortality & terminal illness charge for your policy : • The life cover is the amount by which the sum insured exceeds the fund value. • The mortality & terminal illness charge is the premium rate for the age of the insured person multiplied by the life cover. • If your fund value is greater than the sum insured then the life cover is nil and we will not deduct any mortality & terminal illness charge. • We will deduct the mortality & terminal illness charge from the fund value by cancelling units. • There is no sum insured and no mortality & terminal illness charge for a child aged less than seven. • We will also deduct service tax, surcharges, cess and any other levies applicable to the mortality & terminal illness charge. • The premium rates are one twelfth of the rates set out in the following table : IDBI Fortis Life Insurance Company Limited Tradeview, Oasis Complex, Kamala City, P.B. Marg, Lower Parel (W), Mumbai - 400 013, India. Registration Number : 135, Tel : +91 22 2490 8109/10, Website : www.idbifortis.com Insurance is the subject matter of the solicitation.
  • 6. Supplementary Illustration for Guaranteed Return Funds About this illustration This supplementary illustration is intended to describe how the Guaranteed Return Fund works, the effect of the investment returns after deducting the 1.50% pa fund management charge and to show the extent of the guarantee. For simplicity it ignores administration, mortlity and rider premium charges. You must read this supplementary illustration in conjuction with the personalised benefit illustration above to see the effect of these charges. This illustration shows an investment of Rs 1,00,000. For other amounts the illustration applies proportionately. Guaranteed Return Fund - Maturity Date 31 December 2012 at a minimum unit price of 13.5089 Higher rate (7.75% annual return) Lower rate (6% annual return) Investment Allocated Allocated amount Date Unit price Fund value Unit price Fund value units units Guaranteed Fund commencent date 0 1 Jan 2008 10.0000 10.0000 Date of investement in Guaranteed Fund 27 days 27 Jan 2008 100,000 10.0326 9,967.51 100,000 10.0449 9,955.30 100,000 1 year 31 Dec 2008 10.4500 104,160 10.6250 105,775 2 years 31 Dec 2009 10.9202 108,847 11.2890 112,385 3 years 31 Dec 2010 11.4116 113,745 11.9946 119,410 4 years 31 Dec 2011 11.9251 118,864 12.7442 126,872 134,803 Guaranteed Fund maturity date 5 years 31 Dec 2012 12.4618 124,213 13.5408 The prevailing fund unit price as on 31 December 2012 is (a) 12.4618 13.5408 The guaranteed unit price on 31 December 2012 is (b) 13.5089 13.5089 134,803 Therefore, on 31 December 2012, your fund maturity proceeds will be 13.5089 9,967.51 134,650 13.5408 9,955.30 The maturity proceeds will be based on the greater of the prevailing fund unit price on the date of maturity (a) and the guranteed unit price (b) Our guarantee We guarantee that the unit price of the guaranteed return fund will not be less than 13.5089 on the fund maturity date on 31 December 2012. There is no guarantee on any other date. If you decide to withdraw from the Guaranteed Return Fund before the maturity date by way of switch or partial withdrawal, and to meet administration, mortality and rider premium charges, we will cancel the required number of units at the prevailing unit price. For switches and partial withdrawals, we will also apply a surrender charge of 2% of the proceeds. Operation of the fund The Guaranteed Return Fund is a close end fund with a maturity date on 31 December 2012. The fund commenced on 1 January 2008 and has a fixed maximum term of 5 years. We will accept new subscritions for a limited amount of time following the fund commencement date, typically two or three months, depending on changing investment conditions. A new policyholder who invests in the fund may be an investor in the fund for less than 5 years. In the illustration above, our policyholder has invested 27 days after the fund commenced, and will therefore be an investor in the fund for four years, eleven months and four days. The unit price of the fund on the commenecement date was 10.0000 and when our policyholder invests 27 days later, the unit price could be 10.0326 or 10.0449 or some other amount depending on the actual investment return over the 27 days. The number of units allocated to our policyholder will therefore depend on the day he or she invests, and on the unit price on that day.