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Aviva Life Insurance Company India Limited

Premium Quotation

Version Number: 42.0

Prepared on: 8/12/2012

Proposed Date of

Commencement:8/12/2012

Proposal Number:

Age of the Life

Insured:31Years

Age of the Child:1Years

Product Features

1. Name of the Product: Aviva Young Scholar Secure2. UIN:122N092V013. Plan Option: Gold4. Premium Paying Frequency: Monthly5. Premium as per Plan Option:4,4006. Cover Description and Premium:

CoverageSum

Assured

Coverage

Term

Premium

Payment

Term

Modal

Premium

Service

Tax

(Year

1)

Service

Tax

(Year 2

onwards)

Total

Amount

(Year 1)

Total

Amount

(Year 2

onwards)

Base

Cover

1243000 20 12 4400 136 68 4536 4468

Accidental

Death

Benefit

Rider

50000 12 12 3 0 0 3 3

Aviva

Term Plus

Rider

50000 12 12 10 1 1 11 11

Aviva

Dread

Disease

Rider

200000 12 12 46 6 6 52 52

Total Amount 4,602 4,534

7.

Illustration Benefits

Policy Annualised Guaranteed Guaranteed Guaranteed Guaranteed Non

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Duration Premium

+

Service Tax

Survival

Benefit

Death

Benefit

(Base Plan

During

the year)

Maturity

Benefit

(At year end)

Surrender

Value (GSV)

Guaranteed

Special

Surrender

Value(At

year end)

1 55,224 1,823,800

2 54,408 1,771,000

3 54,408 1,718,200 31,680 106,836

4 54,408 1,665,400 47,520 151,563

5 54,408 1,612,600 63,360 201,521

6 54,408 1,559,800 79,200 257,301

7 54,408 1,507,000 95,040 319,327

8 54,408 1,454,200 110,880 388,313

9 54,408 1,401,400 126,720 464,820

10 54,408 1,348,600 142,560 549,613

11 54,408 1,295,800 158,400 643,315

12 54,408 20,000 1,243,000 174,240 734,901

13 20,000 1,243,000 174,240 769,439

14 20,000 1,243,000 174,240 805,505

15 20,000 1,243,000 174,240 843,059

16 20,000 1,243,000 174,240 882,282

17 100,000 1,243,000 174,240 857,450

18 1,243,000 174,240 913,459

19 1,243,000 174,240 973,432

20 1,243,000 1,043,000 174,240 1,043,000

Notes:

1. All the benefits shown in the above table are guaranteed provided all the due premiums are paidexcept the special surrender values. Special Surrender Values may change as decided by the

company from time to time.

2. The Modal premium is exclusive of Service Tax and other taxes which will be levied on the ModalPremium as per the prevailing laws.

3. In case of Accidental Death Benefit (ADB) Rider, rider cover ceases from the policy anniversarywhen life insured attains age 60 years last birthday or at the end of Premium Paying Term (PPT),

whichever is earlier.

4. In case of Aviva Dread Disease (DD) Rider, rider cover ceases from the policy anniversary whenlife insured attains age 65 years last birthday or at the end of Premium Paying Term (PPT),

whichever is earlier.

5. In case of Aviva Term Plus Rider, rider cover ceases from the policy anniversary when life insuredattains age 70 years last birthday or at the end of Premium Paying Term (PPT), whichever is

earlier.

6. This illustration does not include any additional premium payable due to underwriting.7. The policy will acquire a minimum guaranteed surrender va lue after payment of one years

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premium and after completion of two policy years which will be equal to 30% premiums paid till

date of surrender excluding first year premium, rider premium, extra premium and taxes, if any.

8. Riders are not mandatory and are available for a nominal extra cost.9. For more details on Benefits and terms & conditions please read sales brochure carefully before

concluding a sale.

10. Insurance is the subject matter of the solicitation.

I ______________________, having received the information with respect to the above, have understood

the above statement before entering into the contract.

FPAs / FPCs Signature

Company SealPolicyholders Signature:

Place:

Date:

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Aviva Young Scholar SecureImportant points you must know about this policy

What is Aviva Young

Scholar Secure?

Aviva Young Scholar Secure is a life insurance plan that helps you secure your

childs education by giving you guaranteed lump sum payouts for your childs

high school, college admission & post-graduation expenses.

What is the guarantee

under this plan?

The death benefit and payouts for educational milestones for the child are guaranteed if

all due premiums have been paid.

What is the Term of this

policy?

The policy term would be equal to 21 minus the entry age of child.

Your policy term is 20 years.

What are the Premium

Payment Term options

under this plan?

The Premium Paying Term would depend on the age of the child:

For entry age 0 to 8 of child: 13 minus age of child

For entry age 9 to 12 of child: Fixed 5 years

The premium payment frequency allowed is Yearly, Half-Yearly and Monthly (For monthly

mode only ECS or Direct Debit is allowed).

Since your childs age is 1 years, you will have to pay premiums regularly for 12

years at Monthly frequency as opted by you.

What are the benefits

under this plan?

Death Benefit: Sum Assured will be paid immediately and the policy will continue

without any liability to pay future premiums till maturity for the benefit of your child. All

survival benefits will continue to be paid as per schedule.

Survival & Maturity Benefit:

TFS: Tuition Fee Support Paid every year starting end of premium paying term till age

17 of child

CAF: College Admission Fund At age 18 of child

HER: Higher Education Reserve Maturity at age 21 of child

The payments are made on the policy anniversary after the child attains the specified

payout age.

Please refer to the Key Feature brochure for details

Rider Benefits: Are applicable as per the riders opted by you

What happens if I stop

paying my premiums?

If you discontinue paying premiums within the first year of the policy; the policy will be

terminated without any benefit or value.

If you discontinue paying premiums after the first year of the policy, your policy becomes

a paid-up policy and:

Death benefits will be reduced

Survival Benefits will not be payable

Maturity Benefit will be equal to paid up Sum Assured

Please refer to the Key Feature brochure for details.

Can I cash in (surrender)

the policy during the term

of the policy?

You do have an option to cash-in (surrender) this policy after completion of 2 policy years

if premiums were paid for at least 1 year after deduction of surrender penalty. The

surrender amount will be less than the amount of premiums paid in most cases.

Please refer the Key Feature brochure for details.

What is not covered under

this policy (Exclusions)?

Only surrender value will be paid in case of death because of actual or attempted suicide

within one year from the date of issuance of policy or date of revival.

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Please refer rider key features for rider exclusions.

Do I have a right to

review my purchase?

You have Freelook Period of 15 days from the date you receive your policy document.

In case you do not agree with terms and conditions, you may cancel the policy where the

premium you have paid will be refunded after deducting proportionate risk charges,

stamp duty and cost of medical examination, if any.

We request you to personally fill the proposal form and provide accurate information to ensure that your

claim is not reduced or declined because of non-disclosure or misrepresentation of information.

Please note: Aviva is not liable for any claim until receipt of premium in full, completion ofunderwriting and

acceptance of risk.

This document does not contain the full terms and conditions of the Policy.Details of the terms and conditions, and

exclusions of the insurance contract are contained in the Key Feature brochure. It is important that you read the entire

Key Feature brochure.

I confirm that I have read the Key Feature brochure and the Official Illustration of the insurance product along with this

document and understand the features such as policy benefits, premium payable including the number of years for

which premium is required to be paid, lock-in period, whether any guarantee is available and if yes then subject to what

conditions.

Signature of the Proposer

Signature of Life Assured

(In case different from

Proposer)

Proposer

name

Name of Life

Assured

Proposal

numberProposal Date