Policy Document – Reliance Group Jan Samriddhi Suraksha Plan POLICY SCHEDULE Name of Proposer: Name of the Plan : Reliance Group Jan Samriddhi Suraksha Plan Name of Principal Officer: Xxxxxxxxxxx Xxxxxxxxxx Xxxxxxxxxxx Xxxxxxxxxx Xxxxxxxxxxx Xxxxxxxxxx being the principal officer of the Reliance Group Jan Samriddhi Suraksha Plan at the time this Policy commenced Name of the Master Policy Holder: XYZ Limited Date of Commencement: the ____ day of ______________ 20_. Sum Assured Based on member’s choice, Sum Assured will be given to the member Premiums Based on Sum Assured chosen by the member, premium will be reflected in member Certificate of insurance Applicable deductions As stated in the Policy Document Policy Period: Period commencing ___ day of ___ 20__ or such other period as may be agreed upon by the Master Policy Holder and Reliance Life Insurance Company Limited Benefits: As stated in the Policy Document. Frequency of Total premiums: Master Policyholder can select the premium paying frequency on behalf of individual members for the following modes: Yearly, Half-Yearly, Quarterly, Monthly Please read Your Policy Details carefully to verify that it correctly reflects the policy you applied for, if you notice any discrepancies please return this policy document to us for correction. Page 1 of 31 UIN: 121N094V01 Policy Document_Reliance Group Jan Samriddhi Suraksha Plan_V_A12.0 Policy Document – Reliance Group Jan Samriddhi Suraksha Plan Reliance Group Jan Samriddhi Suraksha Policy Contract Number_____________ Policy Terms & Conditions and Privileges within referred to This Policy is the evidence of a contract between Reliance Life Insurance Company Limited ('the Company’) and the Master Policyholder referred below. Reliance Life Insurance Company Limited (hereinafter called “RLIC”) agrees to pay the benefits, as stipulated in the Policy Schedule to the Policyholder on the basis of the statements, proposal, declarations and Premium along with taxes as applicable from the Policyholder on the assurance that the Policyholder has agreed to all the policy terms and conditions referred to in the Reliance Group Jan Samriddhi Suraksha Plan (UIN: 121N094V01) policy document kit. The Proposal, Declaration and other information called for from you form the basis of this contract. If any of the details furnished to the Company are incorrect or incomplete, then the Policy will be void. The benefits shall be paid only when the same are payable as per the stipulations in the policy document kit. The Claimant/ Nominee needs to submit satisfactory proof of title and other applicable documents pertaining to the Policy at the RLIC offices for claiming the benefit. It is hereby further declared that this Policy of Assurance shall be subject to the terms, conditions and privileges in this Policy Document kit and that the Policy Schedule and every endorsement placed on the Policy by RLIC shall be deemed to be a part of the Policy. ………………………………… Authorised Signatory Date Reliance Life Insurance Company Limited Registered Office: st H Block, 1 Floor, Dhirubhai Ambani Knowledge City, Navi Mumbai, Maharashtra – 400 710, India Page 2 of 31 UIN: 121N094V01 Policy Document_Reliance Group Jan Samriddhi Suraksha Plan_V_A12.0 Policy Document – Reliance Group Jan Samriddhi Suraksha Plan Table of Contents 1. Free look ......................................................................................................................................... 7 2. Definitions ....................................................................................................................................... 7 3. Key Benefits .................................................................................................................................. 10 3.1. Death benefit - subject to the member-contract being in force ..................................................... 10 3.2. Death due to Accident - subject to the member-contract being in force ....................................... 10 3.3. Death benefit – subject to the member-contract being in paid-up status....................................... 10 3.4. Death due to Accident - subject to the member-contract being in paid-up status.......................... 10 3.5. Maturity benefit ......................................................................................................................... 10 4. Other benefits and features ............................................................................................................. 10 4.1. Rider Benefits ............................................................................................................................ 10 4.2. Surrender by an individual member of the Group Scheme .......................................................... 10 4.3. Discontinuance of due premiums by an individual member within the lock-in period of 5 member- contract years ........................................................................................................................................ 10 4.4. Discontinuance of due premiums by an individual member after the lock-in period of 5 member- contract years ........................................................................................................................................ 11 4.5. Revival of the Policy Account by an individual member............................................................. 12 4.6. Full Surrender of the Scheme by the Master Policyholder:.......................................................... 12 4.7. Non-foreclosure guarantee for in-force member-contract ............................................................ 13 5. Premium payment: ......................................................................................................................... 13 5.1. Payment of premiums ................................................................................................................ 13 5.2. Deposit of premiums .................................................................................................................. 13 5.3. Application of premiums ............................................................................................................ 13 5.4. The Amount and frequency of premiums.................................................................................... 13 5.5. Grace Period .............................................................................................................................. 13 6. Group Administration .................................................................................................................... 13 6.1. Policy Account value ................................................................................................................. 13 6.2. Shadow Account ........................................................................................................................ 15 6.3. New Members ........................................................................................................................... 15 6.4. Option to continue in case of surrender of Group Policy ............................................................. 15 7. Applicable deductions .................................................................................................................... 15 7.1. Premium Allocation Charges...................................................................................................... 15 7.2. Fund Management Charges ........................................................................................................ 16 7.3. Policy Administration Charges ................................................................................................... 16 7.4. Mortality Charges ...................................................................................................................... 16 7.5. Accidental Death benefit Charges .............................................................................................. 17 7.6. Discontinuance Charges ............................................................................................................. 17 7.7. Service Tax ................................................................................................................................ 17 7.8. Charges levied by Government in future .................................................................................... 17 7.9. Guarantees on Charges ............................................................................................................... 18 7.10. Recovery of additional expenses incurred on account of acts of policy holders ........................... 18 8. General conditions ......................................................................................................................... 18 8.1. Proof of age ............................................................................................................................... 18 8.2. Suicide Exclusion ...................................................................................................................... 18 8.3. Member record .......................................................................................................................... 18 8.4. Insurance eligibility ................................................................................................................... 19 8.5. Start and end of Insurance Cover ...............................................................................................