Form No Description Pages - Max Life Insurance

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PERIODIC DISCLOSURESFORM L-25- (I) : GEOGRAPHICAL DISTRIBUTION CHANNEL - INDIVIDUALNAME OF THE INSURER: MAX NEW YORK LIFE INSURANCE COMPANY LIMITEDREGISTRATION NO 104: DATE OF REGISTRATION WITH IRDA : NOVEMBER 15, 2000Upto the quarter ending 31st March 11Rural Urban Total BusinessSI.No.State / Union TerritoryNo. of Policies No. of Lives Premium (`Crs)Sum Assured(`Crs)No. of Policies No. of Lives Premium (`Crs)Sum Assured(`Crs)No. of Policies No. of Lives Premium (`Crs)Sum Assured(`Crs)1 Andhra Pradesh 19,336 19,036 25 486 45,414 44,330 107 1,667 64,750 63,366 132 2,1532 Arunachal Pradesh 9 9 0 0 94 91 0 4 103 100 1 43 Assam 3,611 3,560 5 56 5,745 5,601 20 165 9,356 9,161 25 2204 Bihar 9,024 8,909 10 121 8,281 8,074 18 204 17,305 16,983 29 3255 Chattisgarh 2,170 2,138 4 52 6,129 5,971 15 159 8,299 8,109 19 2116 Goa 460 453 1 13 6,168 6,017 18 179 6,628 6,470 19 1927 Gujarat 16,587 16,324 26 437 50,379 49,207 146 1,620 66,966 65,531 172 2,0568 Haryana 10,386 10,217 18 281 24,799 24,225 62 831 35,185 34,442 80 1,1129 Himachal Pradesh 2,055 2,024 3 37 3,202 3,133 5 76 5,257 5,156 8 11410 Jammu & Kashmir 622 612 1 16 4,043 3,946 9 121 4,665 4,558 10 13811 Jharkhand 2,692 2,653 5 64 6,289 6,134 15 160 8,981 8,787 19 22412 Karnataka 5,525 5,440 7 101 25,866 25,249 88 892 31,391 30,689 96 99313 Kerala 7,156 7,050 15 116 16,539 16,160 42 394 23,695 23,210 57 50914 Madhya Pradesh 4,101 4,037 6 113 14,064 13,720 32 445 18,165 17,757 38 55915 Maharashtra 18,400 18,115 30 516 94,008 91,771 283 3,801 112,408 109,887 313 4,31616 Manipur 1,046 1,036 2 31 2,848 2,791 6 83 3,894 3,827 8 11417 Meghalaya 76 75 0 2 342 334 1 14 418 409 2 1618 Mirzoram - - - - 76 74 0 4 76 74 0 419 Nagaland 56 55 0 3 385 375 4 32 441 430 5 3420 Orissa 13,718 13,505 19 222 10,535 10,298 27 256 24,253 23,803 46 47821 Punjab 12,962 12,737 30 349 21,841 21,325 58 707 34,803 34,062 88 1,05622 Rajasthan 10,043 9,885 15 274 25,731 25,084 57 832 35,774 34,969 72 1,10523 Sikkim 54 53 0 2 304 296 1 11 358 350 1 1224 Tamil Nadu 11,480 11,304 17 251 48,240 47,046 135 1,453 59,720 58,350 153 1,70425 Tripura 1,078 1,064 2 17 1,353 1,323 3 31 2,431 2,386 5 4826 Uttar Pradesh 16,241 16,002 22 347 53,441 52,108 113 1,377 69,682 68,110 135 1,72327 UttraKhand 3,015 2,968 7 87 10,696 10,434 25 297 13,711 13,401 32 38428 West Bengal 51,034 50,239 60 590 38,197 37,337 109 896 89,231 87,576 170 1,48729 Andaman & Nicobar Islands 76 75 0 1 423 415 1 13 499 490 1 1430 Chandigarh 1,255 1,234 2 30 6,010 5,858 15 171 7,265 7,092 17 20131 Dadra & Nagrahaveli 2 2 0 0 25 24 0 1 27 26 0 132 Daman & Diu 13 13 0 0 43 42 0 1 56 55 0 133 Delhi 4,905 4,820 7 105 54,585 53,266 175 2,114 59,490 58,086 182 2,22034 Lakshadweep - - - - - - - - - - - -35 Puducherry 114 112 0 5 863 841 2 37 977 953 2 42Company Total 229,302 225,755 340 4,724 586,957 572,899 1,596 19,047 816,259 798,654 1,936 23,772*Premium amount is New Business premium only.6
PERIODIC DISCLOSURESFORM L-25- (II) : GEOGRAPHICAL DISTRIBUTION CHANNEL - GROUPNAME OF THE INSURER: MAX NEW YORK LIFE INSURANCE COMPANY LIMITEDREGISTRATION NO 104: DATE OF REGISTRATION WITH IRDA : NOVEMBER 15, 2000For the quarter ending 31st March 2012Rural (Group) Urban (Group) Total Business (Group)S.No.State / Union TerritoryNo. of Policies No. of Lives Premium (`Crs)Sum Assured(`Crs)No. of Policies No. of Lives Premium (`Crs)Sum Assured(`Crs)No. of Policies No. of Lives Premium (`Crs)Sum Assured(`Crs)1 Andhra Pradesh - - - - 26 444,567 5 (1,160) 26 444,567 5 (1,160)2 Arunachal Pradesh - - - - - - - - - - - -3 Assam - - - - - - - - - - - -4 Bihar - - - - - - - - - - - -5 Chattisgarh - - - - - - - - - - - -6 Goa - - - - - - - - - - - -7 Gujarat - - - - 5 2,368 0 68 5 2,368 0 688 Haryana - - - - 32 (1,354) 8 (796) 32 (1,354) 8 (796)9 Himachal Pradesh - - - - - - - - - - - -10 Jammu & Kashmir - - - - - - - - - - - -11 Jharkhand - - - - 1 1,003 0 80 1 1,003 0 8012 Karnataka - - - - 20 4,699 0 434 20 4,699 0 43413 Kerala - - - - 1 156 0 24 1 156 0 2414 Madhya Pradesh - - - - 2 192 0 13 2 192 0 1315 Maharashtra - - - - 63 73,596 47 3,742 63 73,596 47 3,74216 Manipur - - - - - - - - - - - -17 Meghalaya - - - - - - - - - - - -18 Mirzoram - - - - - - - - - - - -19 Nagaland - - - - - - - - - - - -20 Orissa - - - - - - - - - - - -21 Punjab - - - - 1 1,850 0 15 1 1,850 0 1522 Rajasthan - - - - - 1 0 0 - 1 0 023 Sikkim - - - - - - - - - - - -24 Tamil Nadu - - - - 9 3,538 0 77 9 3,538 0 7725 Tripura - - - - - - - - - - - -26 Uttar Pradesh - - - - 2 69 0 35 2 69 0 3527 Uttarakhand - - - - 2 83 0 4 2 83 0 428 West Bengal - - - - 2 (1,441) 0 (19) 2 (1,441) 0 (19)29 Andaman & Nicobar Islands - - - - - - - - - - - -30 Chandigarh - - - - - 10 0 3 - 10 0 331 Dadra & Nagrahaveli - - - - - - - - - - - -32 Daman & Diu - - - - - - - - - - - -33 Delhi - - - - 28 10,320 23 (12) 28 10,320 23 (12)34 Lakshadweep - - - - - - - - - - - -35 Puducherry - - - - - - - - - - - -Company Total - - - - 194 539,657 84 2,509 194 539,657 84 2,509*Premium amount is New Business premium only.7
Page 1 and 2: NAME OF THE INSURER: MAX NEW YORK L
Page 3 and 4: PERIODIC DISCLOSURESFORM L-25- (I)
Page 5: PERIODIC DISCLOSURESFORM L-25- (I)
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 and 38: PERIODIC DISCLOSURESFORM L-40-QUART
Page 39 and 40: PERIODIC DISCLOSURESForm L - 41 GRI
Page 41 and 42: PERIODIC DISCLOSURESL-42- VALUATION

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