Customer Details
Product Details
Fund Details
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Select Need
-- Select Need --
Education Funding
Income Replacement
Wealth Accumulation
Wealth Enhancement
Retirement
Living with Impaired Health
*
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Life Assured Details
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Customer Name
*
Gender
Male
Female
Date Of Birth
*
Age of Customer
Tobacco Consumer
No
Yes
NSAP
LA Occupation
--Select Occupation--
Select if Proposer is same as Life Assured
LA Education
--Select Education--
Evidence Income (of Proposer)
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Proposer Details
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Proposer Name
Proposer Gender
-- Select --
Male
Female
Date Of Birth of Proposer
Age of Proposer
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To be entered for Annuity Plan
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Name of Secondary Annuitant
Gender ( Secondary Annuitant )
-- Select --
Male
Female
Date of Birth of Secondary Annuitant
Age of Secondary Annuitant
Product Name
-- Select Product --
*
Policy Category
--Select Policy Category--
Loan Type
-- Select Loan Type --
*
Annuity Plan
--Select Annuity Plan--
*
Vesting/ Maturity Age
*
Claim Option
-- Select --
Policy Term
*
Premium Payment Term
-- Select --
*
Sum Assured
*
Premium Pay Frequency
-- Select --
Half-yearly
Monthly
Quarterly
Yearly
Annual Premium
Maturity Age
-- Select --
85
90
95
100
Type of Life
-- Select --
Preferred Loan
Maturity Option
-- Select --
Graduation Plan
Post-graduation Plan
Doctor Plan
Dual Degree Plan
Marriage Funding Plan
Cover Option
-- Select --
Life Cover
Life Cover with ATPD
Moratorium Term
-- Select --
Sum assured with other companies(LA)
Sum assured with other companies(Proposer)
Sum Assured for Riders
ADB Rider
ATPD Rider
Critical Illness Rider
Hospitality Cash Benefit Rider
Term Rider
Waiver of Premium Rider
PWB Rider
Income Benefit Rider
No
Yes
No
Option 1 (On Death)
Option 2 (CI or ATPD)
Option 3 (CI or ATPD or Death)
Select Product for Fund details
Agent Code
Channel Type
Note:- If you have the Agent Code and Channel, please enter the same, else click on Generate Illustration for your premium calculation.
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Copyright © 2011 Edelweiss Tokio Life Insurance Company Limited. All Rights Reserved. Registered with Insurance Regulatory & Development Authority (IRDA) as Life Insurance Company. Registration No. 147. Insurance is the subject matter of the solicitation.
This is a Private website owned by the Company. Unauthorized scanning of vulnerabilities and exploitation of the same is strictly prohibited. If you have been found to do so, Company may bring Civil and/or Criminal action and/or legal proceedings against you which shall be entirely at your costs and consequences.