Client Name:*

D.O.B:*

Type of Policy: *

Policy Term: *

Premium Term: *

Waiver of premium Rider *

Hospital Cash Rider *

Hospital Cash Rider (Spouse)

D.O.B (Spouse):

Hospital Cash Rider (Child, below 18yrs)

Number of Children:

Hospital Cash Benefit:

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Sum Assured:

Premium:

Investment Portion: *

Investment Portion: %

Inflation Protector: *

Spouse Benefit: *

Critical Illness Rider: *

D.O.B (Spouse):*

Payment Frequency: *

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Plan Benefits

Error message: Minimum Quarterly premium is 300,000.00 UGX. Your Quarterly premium is 10,360.80 UGX

Currency: UGX

Sum Assured:

Total Premium:

Net Premium:

Risk Premium:

Investment Premium:

Critical Illness Cover:

Permanent Total Disability Cover:

Total Bonus:

Basic Premium:

Waiver of Premium:

Hospital Cash, Principal:

Hospital Cash, Spouse:

Hopsital Cash, Children:

Base Premium:

Spouse Premium:

Critical Illness Premium:

Total Premium Payable:

Total Benefits:

Natural Death Benefit:

Accidental Death Benefit:

Permanent Total Disability Benefit:

Family Annual Income Benefit:

Extended Life Cover:

Critical Illness Benefit:

Spouse Benefit (Natural Death):

Spouse Benefit (Accidental Death):

NB: Net Premium is your monthly Premium Amount.

Esitmated Fund Values

Esitmated Bonus Breakdown

No Bonus

Inflation Protector Breakdown

Policy Year Breakdown

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