Form No Description Pages - Max Life Insurance

PERIODIC DISCLOSURESFORM L-40-QUARTERLY CLAIMS DATA FOR LIFENAME OF THE INSURER: MAX NEW YORK LIFE INSURANCE COMPANY LIMITEDREGISTRATION NO: 104; DATE OF REGISTRATION WITH IRDA : NOVEMBER 15, 2000STATEMENT FOR THE QUARTER ENDING 31st March 2012INDIVIDUAL CLAIMS: No. of Claims onlyS. No. Claims Experience For Death For Maturity Survival BenefitFor Annuities/PensionFor Surrender Other Benefits1 Claims O/S at the beginning of the period 332 - 1 - - 72 Claims reported during the period* 2,365 1,514 12,890 - 113,749 663 Claims Settled during the period 2,423 1,514 12,872 - 113,749 674 Claims Repudiated during the period 131 - 18 - - 2a Less than 2years from the date of acceptance of risk 130 - 3 - - 1b Grater than 2 year from the date of acceptance of risk 1 - 15 - - 15 Claims Written Back - - - - - -6 Claims O/S at End of the period 143 - 1 - - 4Less than 3months 132 - 1 - - 33 months to 6 months 7 - - - - 16months to 1 year - - - - - -1year and above 4 - - - - -GROUP CLAIMS: No. of Claims onlyS. No. Claims Experience For Death For Maturity Survival BenefitFor Annuities/PensionFor Surrender Other Benefits1 Claims O/S at the beginning of the period 72 - 1 - - -2 Claims reported during the period* 5,565 - 1 - 2 -3 Claims Settled during the period 5,548 - 2 - 2 -4 Claims Repudiated during the period 37 - - - - -a Less than 2years from the date of acceptance of risk 37 - - - - -b Grater than 2 year from the date of acceptance of risk - - - - - -5 Claims Written Back - - - - - -6 Claims O/S at End of the period 52 - - - - -Less than 3months 44 - - - - -3 months to 6 months 8 - - - - -6months to 1 year - - - - - -1year and above - - - - - -TOTAL CLAIMS:No. of Claims onlyS. No. Claims Experience For Death For Maturity Survival BenefitFor Annuities/PensionFor Surrender Other Benefits1 Claims O/S at the beginning of the period 404 - 2 - - 72 Claims reported during the period* 7,930 1,514 12,891 - 113,751 663 Claims Settled during the period 7,971 1,514 12,874 - 113,751 674 Claims Repudiated during the period 168 - 18 - - 2a Less than 2years from the date of acceptance of risk 167 - 3 - - 1b Grater than 2 year from the date of acceptance of risk 1 - 15 - - 15 Claims Written Back - - - - - -6 Claims O/S at End of the period 195 - 1 - - 4Less than 3months 176 - 1 - - 33 months to 6 months 15 - - - - 16months to 1 year - - - - - -1year and above 4 - - - - -*in case of death- the claims for which all the documentations have been completed needs to be shown here.37