KOTAK GROUP ASSURE (Product UIN: 107N051V03)

Certificate Of Insurance
SCHEDULE
Certificate No: GA000027 10524 00 Loan ID: 65600418
Name of the Member: Nadikatla Vasudev
Address: H NO 1-2-214/2, PRAKASHAM RD, Cover Amount at inception - Rs: 2300000
Premium Amount (Exclusive of Service-tax) Rs: 34079
KORUTLA MANDAL, KARIMNGR KARIMNGR Premium Amount (Inclusive of Service-tax) Rs: 38292
ANDHRA PRADESH 505326 Cover Commencement Date: 19/06/2014
Cover Termination Date: 18/06/2034
Age of the Life Insured as on Date of Commencement: 29
Name of Nominee: As per DOGH
Type of Policy: Single Life
Premium payment Mode: Single Premium
Type of Cover: Reducing Cover
Benefit Option Selected: Easy group Assure
Branch: KARIMNAGAR Region: ANDHRA PRADESH
Our Valued Member,
We take great pride in extending life insurance cover to you under Kotak Group Assure#. Kotak Group Assure (Policy no GA000027) is a group insurance cover designed for
the members of Sundaram BNP Paribas Home Finance Limited (hereinafter referred to as “the Policyholder”)
This Certificate of Insurance (COI) is issued on the basis of the facts, information and declaration provided in the Member Data//Membership Form cum Declaration of Good
Health (DOGH) duly provided/signed and executed by you. This COI is issued for the purpose of information only and mere possession of this COI shall not entitle any person
to the cover unless he/she satisfies all the relevant terms and conditions (including but not limited to the eligibility criteria for Membership and payment of premiums) as
specified in the Policy Contract.
This COI is the summary of the key terms of the Policy Contract. In the event of any difference, discrepancy or conflict between the terms of this COI and the policy arises, the
terms of the Policy Contract shall prevail. In all events, the Policy Contract shall be the final and superseding document governing your cover benefit under the Policy Contract.
In the event of any difference or discrepancy between this COI and the details provided in the “list of proposed lives to be insured” by the Policyholder to the Insurer, the
details provided in the “list of proposed lives to be insured” by the policyholder shall prevail for payment of benefits under this COI, subject to the terms and conditions of the
policy contract.
Please note that this arrangement can be modified, suspended or withdrawn at any time by Kotak Mahindra Old Mutual Life Insurance Ltd and /or the Policyholder without
prior intimation.
# Kotak Group Assure is being offered in customized form to the Members of Sundaram BNP Paribas Home Finance Limited. The Benefits payable will be calculated on the
basis of the benefit option(as mentioned in the table above) as chosen by the Policyholder.
Sincerely,
for Kotak Mahindra Old Mutual Life Insurance Ltd.

Authorised Signatory
(This document is issued for information purposes only. Refer the within mentioned policy document for applicable terms and conditions)
Simplified Version of the Terms and Conditions of the Policy Contract
Terms used
 Kotak Mahindra Old Mutual Life Insurance Ltd. (hereinafter referred to as "the Insurer")
 Sundaram BNP Paribas Home Finance Limited , (hereinafter referred to as “the Policyholder”)
 Kotak Group Assure (hereinafter referred to as “the Policy/ the Policy Contract”)
 Member is a person who is entitled to be a member as defined in the Policy Contract and has been added to the list of „Members‟ in accordance with the terms of the
Policy Contract.
 Cover Schedule – is a schedule decided between the Insurer and the Policyholder, giving the details of the cover amount amortised at the specified rate of interest in the
period between the cover commencement date and cover termination date, including coverage for moratorium (with or without accrued interest for moratorium period, as
applicable), if any.
1. Benefit Terms &Conditions: The Policy Contract provides insurance cover for Group of members of the Policyholder at the discretion of the member. The eligibility
criteria for admission to this Group are specified in the Policy contract. In case of any difference between the cover amount & tenure as mentioned in the Cover Schedule and
any other document arises, the Cover Amount and the Cover Tenure as per the Cover Schedule will prevail.
Option Event on which Benefit becomes payable
Easy Group Assure On Death
Once the Benefits (payable on the occurrence of any of the events as mentioned in the table above) are paid, the life cover stands terminated and no further benefits are paid
under this contract.
The insurance cover is valid from the Cover Commencement Date and shall be valid till the Cover Termination Date (mentioned above). The insurance cover is however,
subject to the terms and conditions of the Policy Contract. Accordingly, where more than one Certificate of Insurance is issued to a member, cover under the policy across all
such certificates would be restricted to above mentioned limits irrespective of the total outstanding principal loan amount availed by member under the Policy Contract. This is
a non-participatory plan with no savings or maturity value attached to it.
2. Beneficiary: The Beneficiary under this Policy Contract shall be the nominee/ legal heir (as per the coverage specified under the caption of Benefits Payable in the Policy
Contract) or to such person as may be directed by a competent court in India. The said benefits shall be payable in India. The Policyholder shall be responsible to identify the
eligible legal heirs of the Member in case of death of the nominee.
3. Documentation/Underwriting Requirement: A Member is required to submit certain documents for life insurance cover (apart from the documents to be submitted for the
loan to the Policyholder) under this Policy Contract, mentioned herein:
a. “Proof of age” for the purposes of verifying the eligibility, and the age band which they fall in at the time of availing the cover. Please note that the Insurer may vary or
decline benefit(s) if it comes to the notice of the Insurer that the actual age of the member differs from the age declared to the Insurer at the time of commencement of
cover. The Insurer will refund the premium after deducting expenses (if any) for that person, if the person (life to be insured) is not within the age range. If at a future date,
the age is found to be different from the age declared, the Insurer will have the right to recover/refund the balance premium for the concerned Member before settling
his/her claim.
b. “Membership Form cum Declaration of Good Health (DOGH)” in the format required by the Insurer at the time of availing of the cover. It may be noted that the cover
shall be declined if the member is not able to provide satisfactory evidence of good health as required under this Policy Contract.
c. As per the underwriting conditions in the policy contract, the member may be required to mandatorily undergo medical tests and submit to the Insurer the Membership
Form cum Declaration of Good Health as provided by the Insurer. The premium can also be rated up or cover can be reduced based on the assessments made by the
underwriters.
4. Tax: This policy contract is subject to the tax laws and other legislation prevailing in India. In the event of the amendments to any of the provisions of the Tax laws and / or
the legislations, impacting cash flows accruing from this Policy Contract, the Insurer reserves the right to revise the benefit(s) under this Policy Contract and / or modify the
terms and conditions entailed in this contract. References to any enactment are to be construed as referring also to any amendment, re-enactment (whether before or after the
date of signing of this Policy) or enactment that has replaced the first mentioned enactment (with or without amendment) and to any regulation and / or order made under it.
Any dispute that may arise in connection with this policy shall be subject to the jurisdiction of the Courts of Mumbai.
5. Loans: This policy acquires no paid-up values or loan values.
6. Discontinuation of Policy: This Policy Contract may be discontinued by the Policyholder or the Insurer for new entrants by giving the other party at least one month's prior
notice in writing. However in case of single premium payment mode the cover for the existing members will continue even after the discontinuance of the policy. In case of
regular premium payment mode the cover for the existing members will continue only for the period for which the premiums have been paid. Thereafter, the cover will
continue subject to the payment of future premiums as per the premium rate table, for the balance remaining term of their loan, subject to all the policy terms and conditions.
7. Surrender Value: The Surrender value would become payable on voluntary surrender of insurance cover by the Insured Member or in case of cancellation of the loan from
inception. In case of surrender of the Policy by the Policyholder or foreclosure of loan by the Member or transfer of loan to another company by the Members, the cover shall
continue till the end of the contracted term, unless expressly surrendered by the Member.
For the purpose of considering the foreclosure of loan, the date of intimation of foreclosure to the Insurer by the Policyholder or Member, whichever is earlier, shall be
considered as the date of Surrender.
Particulars Surrender Value in case of surrender within the free look period would be as Surrender Value in case of surrender after the free look
under: period would be as under:
Single Free look cancellation Amount= Single premium × (Outstanding Cover Surrender Value = 75% × Single Premium × (Outstanding Cover
Premium Term*/Cover Term*) × (Outstanding Cover Amount*/Total Cover Amount*) - Term*/ Cover Term*) × (Outstanding Cover Amount*/Total
Stamp duty and Medical expenses, if any. Amount*)
*As per the Cover Schedule issued by the Insurer.
8. Cessation of Cover: A member cover ceases on the earliest of – the date the person ceases to be a member, the member attaining the age limit as mentioned in the Policy
Contract, the date of scheduled expiry of cover as per cover schedule or surrender of the insurance cover by the member.
9. Suicide Exclusion: In the event of the Member committing suicide within one year of the date of cover commencement of the Member, 80% of the premiums paid will be
payable to the nominee.
10. Fraud/Misrepresentation: In case of fraud or misrepresentation by the Member, the COI shall be cancelled immediately by paying the surrender value, subject to the
fraud or misrepresentation being established by the insurer in accordance with section 45 of the Insurance Act, 1938.
11. Free Look Period: In case the Member is not agreeable to any of the provisions stated in this Certificate of Insurance, then there is an option of returning the Certificate of
Insurance stating the reasons thereof within 30 days from the date of the receipt of the Certificate of Insurance. The cancellation request should be submitted to
Policyholder/Insurer within 30 days of receipt of Certificate of Insurance by the Member. On receipt of the letter along with the original Certificate of Insurance document the
Insurer shall arrange to refund the applicable amount as per the Clause No. 7 (Surrender Value). A Certificate of Insurance once returned shall not be revived, reinstated or
restored at any point of time and a new proposal will have to be made for a new Certificate of Insurance.
12. Claims: All claims shall be paid to the Member himself/herself or his/her nominee/legal heir, as the case may be. All claims must be notified to the Insurer by the
Policyholder/Nominee/Member in writing preferably within 3 months of the date of the death along with the death certificate or preferably within 30 days for claims arising out
of critical illness, accidental disability or terminal illness from the date of the claim event along with proof of claim and the documents as specified in the Policy Document.
The Insurer may condone the delay on merit for delayed claims, where the delay is genuine and proved to be for reasons beyond the control of the life insured/claimant.
The Insurer is not liable for any claim unless the premiums in respect of such concerned member have been paid and realised.
The benefits/claim payment will be facilitated through the Policyholder for onward transfer to the nominee/legal heir/Member or to such other person(s) as directed by a Court
of competent jurisdiction in India.
All amounts due under this policy are payable in Indian Currency at the office of the Insurer situated at Mumbai, but the Insurer at its absolute discretion may fix an alternative
place of payment for the claim at any time before or after the claim arises.
The following documents are prescribed in the Policy Document:
1) Death Claim Intimation Form 2) Proof of age of life insured. 3) Original death certificate and related documents based on death, 4) Last attending doctors certificate and
hospital papers (where cause of death is suspicious) 5) Original Certificate of Insurance. 6) Original Membership Form cum Declaration of Good Health. 7) Proof of identity of
beneficiaries if claim is payable to beneficiaries, 8) Particulars of Beneficiary(ies), if any, in writing in the Insurer‟s format signed by the authorised representative of the
Policyholder, 9) Policyholder declaration certificate 10) If death is due to accident or any other unnatural cause - Certified copy of the FIR filed with the police authorities, A
certified copy of the post mortem/autopsy report, A certified copy of the driving license if death occurred while driving
Additional requirements may be called for by the Insurer depending on the circumstances of the death of the Member on a case-to-case evaluation. The claimant can lodge
claim at following address of the Policyholder
Sundaram BNP Paribas Home Finance Limited, Sundaram Towers I Floor, 46 Whites Road, Chennai – 600 014.
or at the following address of the Company and comply with further documentation requirements as mentioned in the Policy Contract.
The Claims Manager - Group Claims, Kotak Mahindra Old Mutual Life Insurance Ltd., (IRDA Regn. No: 107)7th Floor, Building No.21, Infinity Park, Off Western Express
Highway, General A.K. Vaidya Marg, Malad (E), Mumbai – 400097
For any clarifications on policy terms, conditions & exclusions or claims, the member may contact either the Policyholder at the address mentioned above.
Alternately you may contact the Insurer Alternately you may contact the Insurer at the below mentioned address or call at 022- 64511556 (Monday-Friday (excluding
public holidays) between 10.00 a.m. to 6.00 p.m); or email at kli.groupoperations@kotak.com
Group Operations, Kotak Mahindra Old Mutual Life Insurance Ltd., (IRDA Regn. No: 107) 7th Floor, Building No.21, Infinity Park, Off Western Express Highway, General
A.K. Vaidya Marg, Malad (E), Mumbai – 400097
Note: This group contract is subject to prevailing Indian Laws.
The above is the simplified version of important terms and conditions applicable to the Policy contract, which are compiled for the information and benefit of the member.
Member shall be liable for the compliance of additional terms and conditions in the master policy contract, if any.
For details on all terms and conditions of the said policy contract the Member should contact the Policyholder for reference to the Policy contract.
** Service Tax including Education Cess, surcharges and other levies. As per applicable rate levied under laws of India from time to time.

Registered Office: Kotak Mahindra Old Mutual Life Insurance Ltd, 4th Floor,Vinay Bhavya Complex,159 A, CST Road Kalina Santacruz (E), Mumbai- 400098,
CINU66030MH2000PLC128503 Toll-Free No-18002098800, Fax: 022- 67257452, Email: clientservicedesk@kotak.com, Website: http://insurance.kotak.com

Annexure 1:

Easy Group Assure

Benefits:
On death: Sum Assured is paid.
On maturity: No maturity benefit
Exclusions
A. Self inflicted injuries or attempted suicide within the one year from the commencement of member cover/ date of revival of member cover.