Personal details


Additional details

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Proposer Details (Person who will pay premium for this policy)

Please enter Proposer's First Name
Please enter Proposer's Last Name
Please enter Proposer's Birth date
Please enter Proposer's Mobile No


Please select Plan Type

Plan Details

Please enter You Invest Amount
This is your Annual Premium(without Taxes)
Please select Premium Paying Option
Please select Premium Mode
Please select Income Payout Frequency
Pleease enter Sum Assured
Please enter Modal Premium
This is the amount (without Taxes) you will be paying annually/ half-yearly/ monthly as per your Premium Mode chosen. For monthly mode, first 2 months premiums will be combined first time.


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If you are an Existing Bharti AXA Life Customer Please help us.

For more details on risk factors, terms and conditions please read the sales brochure carefully before concluding a sale.

*Provided all due premiums have been paid and policy is in force.