Reliance Nippon Life Insurance
A Reliance Capital Company
BENEFIT ILLUSTRATION FOR - RELIANCE'S GUARANTEED MONEY BACK PLAN
Reliance's Guaranteed Money Back Plan
Name of the Life Insured :
Advisor/Employee Code :
Name of the Insurance Advisor :
Sex :
Date of Quotation :
Age of the Life Assured :
Yrs.
Age Proof :
Policy Term :
Premium Paying Term :
Mode of Premium Payment:
Sum Assured for Basic Plan
  Age For Rider Term For Rider Premium Term For Rider Sum Assured For Rider
Reliance Term Life Insurance Benefit Rider :
Reliance New Major Surgical Benefit Rider  :
Reliance New Critical Conditions (25) Rider :
Reliance Nippon Life Insurance Family Income Benefit Rider  :