Form No Description Pages - Max Life Insurance

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PERIODIC DISCLOSURESFORM L-36 :PREMIUM AND NUMBER OF LIVES COVERED BY POLICY TYPENAME OF THE INSURER: MAX NEW YORK LIFE INSURANCE COMPANY LIMITEDREGISTRATION NO 104: DATE OF REGISTRATION WITH IRDA : NOVEMBER 15, 2000For the Quarter 31st March 2012S. No.ParticularsPremium( `Crs)No. ofPoliciesNo. of LivesSumInsured,Whereverapplicable(` Crs)Premium( `Crs)For the Quarter 31st March 2011 Upto the Quarter 31st March 2012No. ofPoliciesNo. of LivesSumInsured,Whereverapplicable(` Crs)Premium( `Crs)No. ofPoliciesNo. of LivesSumInsured,Whereverapplicable(` Crs)Premium( `Crs)Upto the Quarter 31st March 2011No. ofPoliciesNo. of Lives- - - - - - - - - - - -vii Group Non Single Premium (GNSP) - - - - - - - - - - - -From 0-10000 - - - - - - - - - - - -From 10,000-25,000 - - - - - - - - - - - -From 25001-50,000 - - - - - - - - - - - -From 50,001- 75,000 - - - - - - - - - - - -From 75,000-100,000 - - - - - - - - - - - -From 1,00,001 -1,25,000 - - - - - - - - - - - -Above Rs. 1,25,000 - - - - - - - - - - - -- - - - - - - - - - - -viii Group Non Single Premium- Annuity- GNSPA - - - - - - - - - - - -From 0-10000 - - - - - - - - - - - -From 10,000-25,000 - - - - - - - - - - - -From 25001-50,000 - - - - - - - - - - - -From 50,001- 75,000 - - - - - - - - - - - -From 75,000-100,000 - - - - - - - - - - - -From 1,00,001 -1,25,000 - - - - - - - - - - - -Above Rs. 1,25,000 - - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - - - - - -- - - - - - - - - - - -2.00 Renewal year Premium - - - - - - - - - - - -i Individual - - - - - - - - - - - -In ` CrsSumInsured,Whereverapplicable(` Crs)From 0-10000 181 - 305,980 6,945 168 - 277,309 6,746 633 - 869,095 20,214 638 - 1,021,879 24,558From 10,000-25,000 563 - 453,144 15,934 511 - 426,728 15,482 1,948 - 1,019,636 36,075 1,685 - 1,456,625 53,285From 25001-50,000 264 - 94,466 6,075 210 - 78,320 5,306 862 - 205,414 13,468 707 - 269,817 18,386From 50,001- 75,000 51 - 15,876 1,612 39 - 14,756 1,506 169 - 28,354 2,964 143 - 54,773 5,597From 75,000-100,000 78 - 10,593 1,233 48 - 7,384 950 245 - 24,858 2,971 167 - 25,683 3,346From 1,00,001 -1,25,000 11 - 1,895 386 9 - 1,697 356 41 - 3,612 777 34 - 6,298 1,325Above Rs. 1,25,000 81 - 3,912 1,778 57 - 2,830 1,507 260 - 8,602 4,060 201 - 10,236 5,595- - - - - - - - - - - - - - - -ii Individual- Annuity - - - - - - - - - - - - - - - -From 0-10000 13 - 18,424 79 17 - 23,213 89 44 - 41,247 129 54 - 80,528 188From 10,000-25,000 27 - 38,498 157 19 - 23,604 62 114 - 70,984 304 55 - 76,254 152From 25001-50,000 13 - 6,108 43 9 - 3,457 22 60 - 14,003 104 22 - 8,642 47From 50,001- 75,000 3 - 1,327 13 2 - 732 6 11 - 1,944 20 4 - 1,976 15From 75,000-100,000 5 - 732 10 4 - 519 7 23 - 2,170 29 10 - 1,290 16From 1,00,001 -1,25,000 1 - 212 3 1 - 134 2 3 - 297 4 2 - 396 6Above Rs. 1,25,000 7 - 338 14 7 - 285 12 32 - 948 40 19 - 705 30- - - - - - - - - - - -iii Group - - - - - - - - - - - -From 0-10000 - - - - - - - - - - - -From 10,000-25,000 - - - - - - - - - - - -From 25001-50,000 - - - - - - - - - - - -From 50,001- 75,000 - - - - - - - - - - - -From 75,000-100,000 - - - - - - - - - - - -From 1,00,001 -1,25,000 - - - - - - - - - - - -Above Rs. 1,25,000 - - - - - - - - - - - -iv Group- Annuity - - - - - - - - - - - -From 0-10000 - - - - - - - - - - - -From 10,000-25,000 - - - - - - - - - - - -From 25001-50,000 - - - - - - - - - - - -From 50,001- 75,000 - - - - - - - - - - - -From 75,000-100,000 - - - - - - - - - - - -From 1,00,001 -1,25,000 - - - - - - - - - - - -Above Rs. 1,25,000 - - - - - - - - - - - -32
PERIODIC DISCLOSURESFORM L-37-BUSINESS ACQUISITION THROUGH DFFERENT CHANNELS (GROUP)NAME OF THE INSURER: MAX NEW YORK LIFE INSURANCE COMPANY LIMITEDREGISTRATION NO: 104; DATE OF REGISTRATION WITH IRDA : NOVEMBER 15, 2000S.No.ChannelsIn ` CrsFor The Qtr Ending 31st March 12 For The Qtr Ending 31st March 11 Upto The Qtr Ending 31st March 12Upto The Qtr Ending 31st March 11No. of Policies/No. of SchemesNo. of LivesCoveredPremium( `Crs)No. of Policies/No. of SchemesNo. of LivesCoveredPremium( `Crs)No. of Policies/No. of SchemesNo. of LivesCoveredPremium( `Crs)No. of Policies/No. of SchemesNo. of LivesCoveredPremium( `Crs)1 Individual agents 19 33,590 0 - - - 64 56,425 2 - - -2 Corporate Agents-Banks - - - - - - - - - - - -3 Corporate Agents -Others - - - - - - - - - - - -4 Brokers 55 (335,593) 2 63 22,765 3 391 199,749 8 369 181,075 75 Micro Agents - - - - - - - - - - - -6 Direct Business 120 841,660 82 59 (774,357) 34 431 2,514,367 184 343 8,407,751 118Total(A) 194 539,657 84 122 (751,592) 37 886 2,770,541 194 712 8,588,826 1261 Referral (B) - - - - - - - - - - - -Grand Total (A+B) 194 539,657 84 122 (751,592) 37 886 2,770,541 194 712 8,588,826 126Note:1. Premium means amount of premium received from business acquired by the source.2. No of Policies stand for no. of policies sold.33
Page 1 and 2: NAME OF THE INSURER: MAX NEW YORK L
Page 3 and 4: PERIODIC DISCLOSURESFORM L-25- (I)
Page 5 and 6: PERIODIC DISCLOSURESFORM L-25- (I)
Page 7 and 8: PERIODIC DISCLOSURESFORM L-25- (II)
Page 9 and 10: PERIODIC DISCLOSURESFORM L-25- (II)
Page 11 and 12: PERIODIC DISCLOSURESL-26-INVESTMENT
Page 13 and 14: PERIODIC DISCLOSURESFORM L-27- UNIT
Page 15 and 16: PERIODIC DISCLOSURESFORM L-27- UNIT
Page 17 and 18: PERIODIC DISCLOSURESFORM L - 29 - D
Page 19 and 20: PERIODIC DISCLOSURESFORM L-31 BOARD
Page 21 and 22: PERIODIC DISCLOSURESFORM L - 33 - N
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Page 25 and 26: PERIODIC DISCLOSURESFORM L - 34 YEI
Page 27 and 28: PERIODIC DISCLOSURESFORM L - 34 YEI
Page 29 and 30: PERIODIC DISCLOSURESFORM L - 35 DOW
Page 31: PERIODIC DISCLOSURESFORM L-36 :PREM
Page 35 and 36: PERIODIC DISCLOSURESFORM L-39-DATA
Page 37 and 38: PERIODIC DISCLOSURESFORM L-40-QUART
Page 39 and 40: PERIODIC DISCLOSURESForm L - 41 GRI
Page 41 and 42: PERIODIC DISCLOSURESL-42- VALUATION

Form No Description Pages - Max Life Insurance

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