Form No Description Pages - Max Life Insurance

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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 2011INDIVIDUAL 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 703 - 18 - - 42 Claims reported during the period* 2,176 223 10,420 - 117,390 603 Claims Settled during the period 1,961 223 10,388 - 117,390 524 Claims Repudiated during the period 281 - 43 - - 5a Less than 2years from the date of acceptance of risk 236 - 30 - - 3b Grater than 2 year from the date of acceptance of risk 45 - 13 - - 25 Claims Written Back - - - - - -6 Claims O/S at End of the period 637 - 7 - - 7Less than 3months 627 - 7 - - 73 months to 6 months 4 - - - - -6months to 1 year - - - - - -1year and above 6 - - - - -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 217 - - - - -2 Claims reported during the period* 11,918 - - - - 43 Claims Settled during the period 11,855 - - - - 44 Claims Repudiated during the period 175 - - - - -a Less than 2years from the date of acceptance of risk 175 - - - - -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 105 - - - - -Less than 3months 104 - - - - -3 months to 6 months - - - - - -6months to 1 year 1 - - - - -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 920 - 18 - - 42 Claims reported during the period* 14,094 223 10,420 - 117,390 643 Claims Settled during the period 13,816 223 10,388 - 117,390 564 Claims Repudiated during the period 456 - 43 - - 5a Less than 2years from the date of acceptance of risk 411 - 30 - - 3b Grater than 2 year from the date of acceptance of risk 45 - 13 - - 25 Claims Written Back - - - - - -6 Claims O/S at End of the period 742 - 7 - - 7Less than 3months 731 - 7 - - 73 months to 6 months 4 - - - - -6months to 1 year 1 - - - - -1year and above 6 - - - - -*in case of death- the claims for which all the documentations have been completed needs to be shown here.38
PERIODIC DISCLOSURESForm L - 41 GRIEVANCENAME OF THE INSURER: MAX NEW YORK LIFE INSURANCE COMPANY LIMITEDREGISTRATION NO: 104; DATE OF REGISTRATION WITH IRDA : NOVEMBER 15, 2000STATEMENT AS ON: 31st MARCH 2012GRIEVANCE DISPOSALS. No. Particulars Opening Balance * AdditionsComplaints Resolved/ settledFully Accepted Partial Accepted RejectedComplaints Pending1 Complaints made by customersa) Sales Related 30 3,065 2,095 121 878 1b) New Busines Related 259 4,931 4,692 466 32 -c) Policy Servcing related 1,233 4,828 5,430 490 139 2d) Claim Servicing related 1 333 317 141 4 505 -e) Others 13 66 61 6 12 -Total Number 1,868 13,207 12,419 1,087 1,566 32 Duration wise Pending StatusComplaints made bycustomersComplaints made byintermediariesa) Less than 15 days 3 - 3b) Greater than 15 days - - -Total Number 3 - 3* Opening balance should tally with the closing balance of the previous financial year.Total1. The rejected complaints represent all the cases where company is pursuing litigation filed by the claimant and are not in the nature of complaints.39
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
Page 23 and 24: PERIODIC DISCLOSURESFORM L - 33 - N
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 and 32: PERIODIC DISCLOSURESFORM L-36 :PREM
Page 33 and 34: PERIODIC DISCLOSURESFORM L-37-BUSIN
Page 35 and 36: PERIODIC DISCLOSURESFORM L-39-DATA
Page 37: PERIODIC DISCLOSURESFORM L-40-QUART
Page 41 and 42: PERIODIC DISCLOSURESL-42- VALUATION

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