Flexible Premium Adjustable Life Insurance Policy
MetLife Insurance Company USA
MetLife Brief Description of Your Policy This is a flexible premium life insurance policy where premiums can be paid until Attained Age 121. It does not pay dividends. You may continue the coverage provided by the Policy beyond Attained Age 121. If the Insured dies while the Policy is in force, we will pay the Policy Proceeds to the Beneficiary. We must receive due proof of the Insured’s death. Any payment will be subject to all of the provisions of the Policy.
Right to Examine Your Policy Please read the Policy to be sure it meets your needs. You may return the Policy to our Designated Office or to our representative within [10] days from the date you receive it. If you return it within this period, we will refund any payments made and void the Policy from the start.
Your MetLife Policy Insured [John Middle Doe] Policy Number [Specimen] Issue Age of Insured [35] Sex of Insured [Male]
The Policy is a legal contract between the Owner and MetLife Insurance Company USA.
Policy Start Date [DATE]
PLEASE READ YOUR CONTRACT CAREFULLY.
Policy Issue Date [DATE]
Signed for MetLife Insurance Company USA at its Main Administrative Office [CITY, NC ZIP].
President
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Secretary
Page 1
Table of Contents
Page Policy Specifications…………………………………………………………………………………………. Schedule of Benefits……………………………………………………………………………….. Planned Premium Payments……………………………………………………………………… Schedule of Charges……………………………………………………………………………….. Table of Guaranteed Maximum Monthly Cost of Insurance Rates……………………………. Minimum Death Benefit Factors…………………………………………………………………... Definitions……………………………………………………………………………………………………... Premium Payments for Your Policy………………………………………………………………………… Premiums, Grace Period and Reinstatement……………………………………………………. Your Policy’s Value…………………………………………………………………………………………... Cash Value………………………………………………………………………………………….. Accessing Your Policy Value……………………………………………………………………………….. Cash Surrender Value of Your Policy……………………………………………………………. Loans………………………………………………………………………………………………… Withdrawals…………………………………………………………………………………………. Surrenders…………………………………………………………………………………………… Changing Your Policy………………………………………………………………………………………... Policy Changes……………………………………………………………………………………… Benefits Provided by Your Policy…………………………………………………………………………… Death Benefit………………………………………………………………………………………... Benefits on or after Attained Age 121……………………………………………………………. Payment of the Policy Benefits……………………………………………………………………. Available Payment Options…………………………………………………………………………………. Payment Options…………………………………………………………………………………… Life Income Tables…………………………………………………………………………………. Charges Applied to Your Policy………………………………………………………………………… Charges Included in the Monthly Deduction…………………………………………………….. Other Charges………………………………………………………………………………………. General Provisions of Your Policy………………………………………………………………………….. General Provisions…………………………………………………………………………………. Owner and Beneficiary……………………………………………………………………………...
3 3 3 4 6 7 9 10 10 11 11 12 12 13 13 14 15 15 16 16 17 18 18 18 19 20 20 21 22 22 24
Riders, Endorsements and Amendments, if any, and a copy of the Application are a part of the Policy and follow the Owner and Beneficiary Section.
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Policy Specifications Schedule of Benefits
Policy Plan/Benefit Flexible Premium Adjustable Life Insurance [WAIVER OF SPECIFIED PREMIUM RIDER] [ACCELERATION OF DEATH BENEFIT RIDER]
Your MetLife Policy Face Amount/Benefit Amount Risk [$50,000] [MONTHLY PREMIUM WAIVED: $50.00]
Class [Standard Non Smoker] [CLASS: 1]
Insured [John Middle Doe] Policy Number [Specimen] Initial Face Amount [$50,000] Issue Age of Insured [35]
[OVERLOAN PROTECTION RIDER] [AVIATION LIMITATION RIDER]
Sex of Insured [Male]
[MILITARY AND NAVAL LIMITATION RIDER]
Date of Coverage [DATE]
[SPECIAL HAZARD EXCLUSION PROVISIONS RIDER] [WAIVER EXCLUSION RIDER]
Death Benefit Option [A]
[TRAVEL EXCLUSION RIDER]
Planned Premium Payments* [$0]
Cash Value Guaranteed Interest Rate [2.00%]
Payments for Year 1
[$1,200.00]
Loan Interest Rate Credited [2.00%]
Payments for Years 2 - 20
[$581.84]
Payments for Years 21 & Later
[$550.00]
Planned First Year Lump Sum Planned [Annual] Premium Payments
Withdrawing Money from Your Policy Maximum Number of Withdrawals Yearly [12] Minimum Withdrawal Amount
[$100.00]
Percentage Used to Calculate Maximum Withdrawal Amount
[90.0%]
Other Minimums That Apply to Your Policy Minimum Face Amount
[$50,000]
Minimum Face Amount Decrease
[$5,000.00]
Minimum Face Amount Increase
[$5,000.00]
Minimum Premium Payment Amount
[$50.00]
* It is possible that insurance coverage may not continue to Attained Age 121 even if your Planned Premium Payments are paid in a timely manner. You may change your Planned Premium Payments; however, new Policy Specifications pages will not be sent to you for such a change. We may offer you promotional programs.
[(Sex-Distinct)] Page 3
Policy Specifications Schedule of Charges Maximum Percent of Premium Charge # For Premium Payments up to and including [$581.84]## each policy year Year 1 43.00% 18.00% Years 2 & Later Maximum Monthly Policy Charge $10.00 Years 1 – 20 $10.00 Years 21 & Later Maximum Monthly Coverage Expense Charge # 0.2667 per $1,000 Year 1 0.2667 per $1,000 Years 2 – 20 0.1905 per $1,000 Years 21 & Later Maximum Fixed Loan Interest Rate 5.00% Years 1- 20 4.00% Years 21 & Later
Your MetLife Policy For Premium Payments in excess of [$581.84]## each policy year 13.00% 13.00%
Insured [John Middle Doe] Policy Number [Specimen] Initial Face Amount [$50,000] Issue Age of Insured [35] Sex of Insured [Male] Date of Coverage [DATE] Death Benefit Option [A]
# If the Policy is reinstated, any time that the Policy was not in force will not be counted when we determine the charges. ## This premium (called “Target Premium”) will be recalculated if: any Requested Increase or face decrease is made; any riders are changed, added or removed; there is a change in the Insured’s risk class; a Withdrawal that decreases the Face Amount is made; or there was a misstatement of the Insured’s age or sex. We will send you a new Policy Specifications page reflecting the new premiums upon any of these changes.
The length of time coverage will remain in force depends on: the amount, timing, and frequency of premium payments; current charges; interest credited; Loans taken; Withdrawals made; and the cost of additional benefits. The Planned Premium Payment may need to be increased to keep the Policy in force. The Policy will stay in effect after Attained Age 121 as long as the Cash Surrender Value remains greater than or equal to zero. No charges will be taken on or after Attained Age 121. However, Loan Interest will be charged on any Policy Loan. Any chan ges to the Cost of Insuran ce Rates and charges shown above will not excee d t he maximum s sh own. Credited interest rates may be changed at any time. Factors may only be changed based on changes in our future expectations as to: mortality; investment ea rnings; taxes; e xpenses; and persistency. Changes will only be mad e according t o procedures and standards file d, if require d, with the insuran ce supervisory o fficial of the state whi ch gove rns the Policy. Cha nges will b e made on a future basis only (and will not recoup past losses or distribute past gains) and will not be unfairly discriminatory. All charges are fully described in your Policy in the Charges Applied to Your Policy Section.
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Policy Specifications
Schedule of Charges (continued)
Your MetLife Policy
Surrender Charge Schedule
Insured [John Middle Doe]
Beginning of Year* [1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 & Later
Surrender Charge $10.27 10.24 9.84 9.42 8.99 8.50 7.65 6.79 5.93 5.07 4.21 3.36 2.50 1.64 0.79 0.00]
Policy Number [Specimen] Initial Face Amount [$50,000] Issue Age of Insured [35] Sex of Insured [Male] Policy Start Date [DATE] Date of Coverage [DATE] Death Benefit Option [A]
* Measured from the Date of Coverage. If the Policy is reinstated, any time that the Policy was not in force will not be counted when we determine the charges. When We Deduct a Surrender Charge A Surrender Charge may be deducted during the first 15 years: after the Policy Start Date; and after the Date of Coverage of each Requested Increase. During the surrender charge period, a Surrender Charge will apply: upon surrender; upon lapse; upon a Withdrawal that decreases the Face Amount; upon a change in Death Benefit Option that decreases the Face Amount; and upon a requested decrease in Face Amount. The Surrender Charges for the first coverage month in each coverage year for the portion of the Face Amount issued on the Date of Coverage are shown above. In the first coverage year, the Surrender Charge is level in all months. In coverage years 2 through 15, the Surrender Charge decreases linearly each coverage month, rounded to two decimal places. The Surrender Charges for each Requested Increase will be shown in a new Surrender Charge Schedule page. A proportionate Surrender Charge will be deducted for: Withdrawals that decrease the Face Amount; changes in Death Benefit Option that decrease the Face Amount; and for requested decreases in the Face Amount.
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Policy Specifications
Table of Guaranteed Maximum Monthly Cost of Insurance Rates (per $1,000 of Net Amount at Risk) Attained Age
Rate
[35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64
0.0909 0.0959 0.1001 0.1076 0.1143 0.1218 0.1318 0.1443 0.1585 0.1752 0.1944 0.2128 0.2328 0.2445 0.2579 0.2771 0.2997 0.3307 0.3641 0.4068 0.4595 0.5132 0.5710 0.6205 0.6776 0.7464 0.8305 0.9332 1.0486 1.1700
Attained Age
Rate
65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94
1.2984 1.4287 1.5609 1.7034 1.8513 2.0309 2.2323 2.4974 2.7779 3.0740 3.3987 3.7541 4.1685 4.6549 5.2198 5.8398 6.5510 7.2976 8.1097 9.0174 10.0424 11.1923 12.4651 13.8494 15.3335 16.9089 18.4164 20.0153 21.7337 23.5855
Attained Age
Rate
95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121+
25.5731 27.4319 29.4579 31.6727 34.0996 36.7714 38.9514 41.3354 43.9463 46.8129 49.9254 53.3626 57.1735 61.4191 66.1733 71.5294 77.6168 83.3334 83.3334 83.3334 83.3334 83.3334 83.3334 83.3334 83.3334 83.3334 83.3334]
Your MetLife Policy Insured [John Middle Doe] Policy Number [Specimen] Initial Face Amount [$50,000] Issue Age of Insured [35] Sex of Insured [Male] Date of Coverage [DATE] Mortality Table [2001 CSO Mortality Table for a Male Smoker, Age Nearest Birthday] Monthly Cost of Insurance Factor 1.00165158
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Policy Specifications
Minimum Death Benefit Factors
Your MetLife Policy
Attained Age
Factor
Attained Age
Factor
Attained Age
Factor
[35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64
2.50 2.50 2.50 2.50 2.50 2.50 2.43 2.36 2.29 2.22 2.15 2.09 2.03 1.97 1.91 1.85 1.78 1.71 1.64 1.57 1.50 1.46 1.42 1.38 1.34 1.30 1.28 1.26 1.24 1.22
65 66 67 68 69 70 71 72 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95
1.20 1.19 1.18 1.17 1.16 1.15 1.13 1.11 1.09 1.05 1.05 1.05 1.05 1.05 1.05 1.05 1.05 1.05 1.05 1.05 1.05 1.05 1.05 1.05 1.05 1.04 1.03 1.02 1.01 1.01
96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121+
1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01 1.01]
Insured [John Middle Doe] Policy Number [Specimen] Date of Coverage [DATE] Death Benefit Calculation Test* [Guideline Premium Test]
* This test is used to determine whether this Policy qualifies as life insurance under applicable tax law. You may not change the test, which was chosen on the Application, after the Policy has been issued.
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See next page.
Definitions
Definitions Application Application means the application, including any amendments, for: your Policy; any riders that are made a part of your Policy; and any policy changes. A copy of your Application is attached to and is part of the Policy. Attained Age The Attained Age is equal to the Issue Age plus the number of completed policy years. This includes any period during which the Policy was lapsed. Date of Coverage The Date of Coverage is the effective date of each piece of the Policy’s Face Amount. The Date of Coverage for the Initial Face Amount is the same as the Policy Start Date. The Date of Coverage for each increase in Face Amount will be shown on the Policy Specifications page for that piece of coverage. The contestable and suicide periods for each increase in Face Amount are measured from that coverage’s Date of Coverage. Designated Office The Designated Office is our Main Administrative Office or any other office we designate. Excess Loan An Excess Loan occurs when the Policy Loan Balance exceeds the Cash Value of the Policy less any Surrender Charge. Initial Face Amount The Initial Face Amount is the Face Amount of the Policy on the Policy Start Date. The Initial Face Amount can be decreased as described in the Decreasing Your Policy’s Face Amount provision. In Writing In Writing means in a written or other form satisfactory to us and received at our Designated Office. Insured The Insured is the person whose life is covered by the Policy. Interest Crediting Start Date The Interest Crediting Start Date is the date we start crediting interest to your Policy. The first Net Premium is applied to the Policy on this date. This date will be the later of: 1. The Policy Issue Date; and 2. The date we receive the first premium at our Designated Office.
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Issue Age The Issue Age is the age of the Insured. It is determined by using his or her birthday nearest to the Policy Start Date. Face Amount The Face Amount of the Policy is the dollar amount we use to calculate the Death Benefit. The Face Amount may be increased or decreased as described in the Changing Your Policy’s Face Amount provision. Net Amount at Risk We use the Net Amount at Risk to determine the Monthly Cost of Insurance for your Policy. For Death Benefit Option A, the Net Amount at Risk is equal to: the greatest of the Face Amount divided by the Monthly Cost of Insurance Factor, the Cash Value times the applicable Minimum Death Benefit Factor, and the minimum death benefit required by applicable tax law; less the Cash Value. For Death Benefit Option B, the Net Amount at Risk is equal to: the greatest of the Face Amount divided by the Monthly Cost of Insurance Factor plus the Cash Value, the Cash Value times the applicable Minimum Death Benefit Factor, and the minimum death benefit required by applicable tax law; less the Cash Value. The Cash Value used in the Net Amount at Risk calculation is the Cash Value at the start of the policy month before the deduction of the Total Monthly Cost of Insurance. The Monthly Cost of Insurance Factor is shown on the Policy Specifications page. The applicable Minimum Death Benefit Factor is based on the Insured’s Attained Age. It is shown on the Minimum Death Benefit Factors page. If the Face Amount or Death Benefit of a rider is to be included for the purposes of calculating the Net Amount at Risk under the Death Benefit Options, it will be indicated in the rider. The Net Amount at Risk will be allocated to the pieces of coverage in the following order: 1. Each increase in Face Amount in succession, starting with the most recent increase; and then 2. To the coverage provided by the remaining Initial Face Amount (which includes any increase in Face Amount resulting from a Death Benefit Option change). Net Premium The Net Premium is the portion of the premium that will be applied to your Policy’s Cash Value. It is equal to: the premium paid; less the premium paid times the applicable Percent of Premium Charge for the current policy year.
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Definitions
Premium Payments for Your Policy
(continued)
Premiums, Grace Period and Reinstatement Payee A Payee is a person, corporation, partnership, trust or charity entitled to receive the Policy Proceeds, surrender proceeds or Withdrawal amount in one sum or under a Payment Option. If the Payee is not a natural person, the choice of a Payment Option will be subject to our consent. Planned First Year Lump Sum The Planned First Year Lump Sum is the amount of premium stated in the Application that is intended to be paid as a lump sum by the first policy anniversary. This amount is shown on the Policy Specifications page. Planned Premium Payment The Planned Premium Payment is the amount stated in the Application that is intended to be paid as a premium on the Planned Premium Payment Due Dates. This amount is shown on the Policy Specifications page 4. You may change this amount by making a request In Writing. Planned Premium Payment Due Date The Planned Premium Payment Due Date is based on the Policy Start Date and the mode in which you choose to pay premiums. If premiums are paid on an annual mode, it is the policy anniversary each year. If premiums are paid on other than an annual mode, it is the policy anniversary and each semi-annual, quarterly or monthly anniversary, as applicable. Policy Issue Date The Policy Issue Date is used to measure the contestable and suicide periods for the initial coverage. Policy Loan Balance The Policy Loan Balance at any time is equal to the outstanding Loan plus Loan Interest accrued to date. Policy Proceeds The Policy Proceeds is the amount paid to the Beneficiary upon receipt of due proof of the Insured’s death. Policy Start Date The Policy Start Date is used to measure policy years, months and anniversaries. It may be referred to as Policy Date on the Application.
Paying Premiums for Your Policy The first premium is due as of the Policy Start Date. The Policy will not be in force until the first premium is paid. If you have the Policy and the first premium has not been paid, we will consider that you have the Policy for inspection only. Premiums after the first premium must be paid at our Designated Office. Premiums may be paid in any amount and at any interval subject to the following conditions: 1. There is a minimum amount for premium payments. Except with our consent, any premium payment must be at least the Minimum Payment Amount shown on the Policy Specifications page. 2. Total premiums paid in any policy year may not be equal to or exceed an amount that would cause the Policy to fail to qualify as life insurance under applicable tax law. 3. Premium payments cannot be made after Attained Age 121, unless they are required under a Grace Period. 4. If we receive a premium that causes the Death Benefit to increase by an amount that exceeds that Net Premium, we have the right to refuse that premium payment. We may require additional evidence of insurability before we accept that premium payment. You may request a change to your Planned Premium Payments. However, we will not process an increase to the Planned Premium Payment if payment of the increased planned premium would cause the Policy to fail to qualify as life insurance under applicable tax law. If we receive a payment, we will treat it as a premium payment, unless you request otherwise In Writing. Continuation of Insurance after Premium Payments Stop If you stop making premium payments, the insurance provided under the Policy, including benefits provided by any rider made a part of the Policy, will continue in accordance with the provisions of the Policy for as long as the Cash Surrender Value is large enough to cover the Monthly Deductions. See the Grace Period for Submitting any Amount Due provision.
Requested Increase A Requested Increase is an increase in Face Amount that you applied for after the Policy Issue Date. We, Us and Our We, us and our refer to MetLife Insurance Company USA. You and Your You and your refer to the Owner of the Policy.
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Premium Payments for Your Policy
Your Policy’s Value
(continued)
Cash Value Grace Period for Submitting Any Amount Due If, on a monthly anniversary date, the Cash Surrender Value is less than the next Monthly Deduction, we will give you a 62-day period called the “Grace Period” to allow you to pay premium sufficient to keep your Policy from lapsing. The required premium is called the “Amount Due”. At the start of the Grace Period, we will send a notice of the Amount Due. We will send this notice to your last known address and to that of any assignee on record. If we do not receive the Amount Due by the end of the Grace Period: the Policy will lapse; and it will terminate without Cash Surrender Value If the Insured dies during the Grace Period, any Amount Due will be deducted from the Policy Proceeds. Reinstating Your Policy after Lapse If the Policy has lapsed, you may reinstate your Policy (excluding riders) prior to Attained Age 121 and within three years after the date of lapse. This is called a “Reinstatement”. Riders can be reinstated if stated in the rider or with our consent. To reinstate your Policy, you must submit a request In Writing and the following: 1. Proof that the Insured is insurable by our standards. 2. Payment of the Monthly Deductions that were due and not paid at the time of lapse. 3. Payment of an amount large enough to keep the Policy in force for at least four months. Any Loan in effect at the time of lapse may be paid or reinstated. If the Loan is reinstated, the reinstated Cash Value will be: reduced by any Loan Interest due at the time of lapse; and increased by any Surrender charge deducted at the time of lapse. If the Loan is not reinstated, the reinstated Cash Value will be: reduced by any Policy Loan Balance at the time of lapse; and increased by any Surrender Charge deducted at the time of lapse. If the Insured is alive on the date we approve the request for Reinstatement, the Policy will be in force from the date we approve the Reinstatement application. We will deduct a full Monthly Deduction for the policy month in which we approve the Reinstatement application.
Cash Value of Your Policy Your Policy will accumulate cash value. See the Cash Surrender Value of Your Policy provision for information on the value available to you. The Cash Value on the Interest Crediting Start Date is equal to: 1. The initial Net Premium; less 2. The Monthly Deductions due from the Policy Start Date through the Interest Crediting Start Date. The Cash Value on any day after the Interest Crediting Start Date is equal to: 1. The Cash Value on the previous day, with interest on such value at the current rate(s); less 2. Any Withdrawal made on that day (including any Surrender Charge taken on that day as a result of the Withdrawal); less 3. Any Cash Value paid to you on that day to allow the Policy to continue to qualify as a life insurance contract; less 4. Any Surrender Charge taken on that day due to a requested decrease in Face Amount or Death Benefit Option change; plus 5. Any Net Premium received on that day; less 6. The Monthly Deduction to cover the cost of the policy month which starts on that day, if that day is a monthly anniversary. Cash Value of Your Policy on and after Attained Age 121 If the Policy is continued beyond Attained Age 121, the Cash Value on and after Attained Age 121 will be determined in the same way described above, except: 1. There will be no Monthly Deductions taken; and 2. Premium Payments cannot be made on or after Attained Age 121, except for payments required under a Grace Period.
If the Insured is not alive on the date we approve the request for Reinstatement, such approval is void. The Surrender Charge, Maximum Monthly Coverage Expense Charge and Maximum Percent of Premium Charge at the time of Reinstatement will be those in effect at the time of lapse. See the Charges Applied to Your Policy Section.
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Your Policy’s Value
Accessing Your Policy Value
(continued)
Cash Surrender Value of Your Policy The Interest We Credit to Your Policy’s Cash Value Interest is credited to the Cash Value of your Policy. The rate of interest we credit could be different for the un-loaned Cash Value and the amount of Cash Value securing a Loan. The effective annual interest rate applied to the un-loaned Cash Value will never be less than the Cash Value Guaranteed Interest Rate shown on the Policy Specifications page.
Cash Surrender Value The Cash Surrender Value of the Policy is the amount we use to determine what is available to you for Loans, Withdrawals and Surrenders. It is equal to the Cash Value at the time of surrender, less: 1. Any Policy Loan Balance; less 2. Any Surrender Charge.
The effective annual interest rate applied to the Cash Value securing any Loan will never be less than the Loan Interest Rate Credited shown on the Policy Specifications page. Basis of Computation The minimum cash values and guaranteed cost of insurance rates are based on the mortality table and the Cash Value Guaranteed Interest Rate as shown on the Policy Specifications page. All values are at least equal to those required by the law of the state that governs the Policy. We have filed a detailed statement, if required, showing the method of calculating cash values and reserves with the insurance supervisory official of that state.
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Accessing Your Policy Values (continued)
Loans
Withdrawals
Borrowing Money from Your Policy If your Policy has Loan Value, you can borrow money from your Policy by making a request In Writing. The maximum amount you may borrow is defined below as the Loan Value.
Withdrawing Money from Your Policy After the first policy year, you may make a request In Writing for a Withdrawal from the Cash Surrender Value. A Withdrawal is subject to the conditions below. 1. The maximum amount that can be withdrawn from your Policy is determined on each policy anniversary for that policy year. The maximum withdrawal amount is the greater of: a. The Cash Surrender Value at the start of that policy year times the Percentage Used to Calculate Maximum Withdrawal Amount, as shown on the Policy Specifications page; and b. The previous year’s maximum withdrawal amount. 2. The maximum amount is limited by the following conditions. No Withdrawal will be processed unless: a. The Cash Surrender Value after the Withdrawal is large enough to cover two Monthly Deductions; b. The Face Amount after the Withdrawal, excluding riders, is at least the Minimum Face Amount shown on the Policy Specifications page; and c. The Policy continues to qualify as life insurance under applicable tax law after the Withdrawal. 3. There is a minimum amount you can withdraw from your Policy at any one time. The minimum amount is shown on the Policy Specifications page as the Minimum Withdrawal Amount. 4. There is a limit on how many Withdrawals from your Policy you can make in any policy year. This limit is shown on the Policy Specifications page as the Maximum Number of Withdrawals Yearly. We may charge a fee for a Withdrawal. If we do, it will not be more than [$25.00].
The Loan Value on the date the loan is made is equal to: 1. The Cash Value; plus 2. Interest at the Cash Value Guaranteed Interest Rate credited to the next policy anniversary; less 3. Any Policy Loan Balance; less 4. Loan Interest at the Maximum Fixed Loan Interest Rate to the next policy anniversary; less 5. The most recent Monthly Deduction charged, times the number of policy months to the next policy anniversary; and less 6. Any Surrender Charge. The Policy will be the sole security for such Loan. We have the right to defer your Loan for up to six months from the date we receive your request, unless the loan is being used to pay premiums to us. Repaying Your Loan and Loan Interest Your Policy Loan Balance can be repaid in whole or in part at any time before the death of the Insured while the Policy is in force. Any payment we receive will be applied as a premium payment unless it is clearly marked as a Loan or Loan Interest repayment. The Policy Proceeds and Cash Surrender Value reflect the deduction of any outstanding Policy Loan Balance. If your Policy has an Excess Loan, we will send a notice to your last known address and that of any assignee of record. We will allow you a Grace Period for payment of the excess due. If the excess due remains unpaid at the end of the Grace Period, the Policy will lapse without value. The Grace Period will end 62 days from the date the notice is sent.
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We have the right to change the minimum amounts or the maximum number of Withdrawals.
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Accessing Your Policy Values (continued)
Surrenders The Face Amount of the Policy will be decreased if necessary after the Withdrawal so that the Net Amount at Risk is not greater than it was prior to the Withdrawal. The Face Amount will be decreased in the following order, unless any rider made a part of the Policy states otherwise: 1. Each Requested Increase in succession, starting with the most recent increase; and then 2. The remaining Initial Face Amount; and then 3. Any increase in Face Amount resulting from a change in Death Benefit Option. A decrease in Face Amount may require a decrease in the amounts provided by any riders made a part of the Policy. If the piece of the Face Amount being decreased is still in its surrender charge period, a Surrender Charge will be deducted from the Cash Value. The Death Benefit of the Policy after the Withdrawal will be based on the new Face Amount and the reduced Cash Value. Unless otherwise requested, the amount will be paid to you in one sum, which includes placing the amount in an account that earns interest. If an account is established, you will be the accountholder and will have immediate access to all of the funds in the account. You may choose In Writing to apply all or part of the amount to a Payment Option. See the Payment Options Section. We may defer payment of the Withdrawal for up to six months.
Surrendering Your Policy You may surrender the Policy for its Cash Surrender Value during the lifetime of the Insured. We will determine the Cash Surrender Value as of the date we receive your request In Writing. If you surrender the Policy within 31 days after the policy anniversary date, the Cash Surrender Value you receive will not be less than the Cash Surrender Value on that anniversary date, reduced by: any Loans taken; any Loan Interest accrued to date; and any Withdrawals made during the 31-day period. If the surrender occurs on a monthly anniversary, the Policy will terminate on that date. Further, the Cash Surrender Value will not be reduced by the Monthly Deduction due on that date for a subsequent policy month. If the surrender occurs on any date other than a monthly anniversary, the Policy will terminate on the next monthly anniversary date. If the Insured dies on or after the date of surrender and before the Policy terminates: the surrender will be reversed; the Cash Surrender Value paid to you will be converted to a Loan; and the Policy Proceeds will be paid. This means the Cash Surrender Value paid to you will be deducted from the Policy Proceeds. See the Payment to Your Beneficiary provision. Unless otherwise requested, the proceeds will be paid to you in one sum, which includes placing the amount in an account that earns interest. If an account is established, you will be the accountholder and will have immediate access to all of the funds in the account. You may choose In Writing to apply all or part of the proceeds to a Payment Option. See the Payment Options Section. We may defer payment of the full Cash Surrender Value for up to six months.
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Changing Your Policy
Policy Changes Policy Changes After the first policy anniversary and prior to Attained Age 121, you can request policy changes at any time unless we have stated otherwise in the Policy. We may allow only one change per policy year. No change will be made that would result in the Policy failing to qualify as life insurance under applicable tax law. Following are the types of changes that are allowed. Changing Your Policy’s Face Amount You can ask us to decrease or increase the Face Amount of your Policy. The request must be In Writing. Decreasing Your Policy’s Face Amount Each requested decrease in Face Amount will be subject to the following: 1. The decrease will reduce the Face Amount in the following order, unless any rider made a part of the Policy states otherwise: a. Each Requested Increase in succession, starting with the most recent Requested Increase; and then b. The remaining Initial Face Amount; and then c. Any increase in Face Amount resulting from a change in Death Benefit Option. 2. The Face Amount after the requested decrease may not be less than the Minimum Face Amount shown on the Policy Specifications page. 3. The decrease must be at least equal to the Minimum Face Amount Decrease shown on the Policy Specifications page. 4. If the Face Amount being decreased is still in its surrender charge period, a Surrender Charge will apply to the decrease in Face Amount as explained in the Surrender Charge Schedule. 5. Decreasing the Face Amount could result in a decrease in amounts provided by any riders made a part of the Policy. 6. The decrease may require us to distribute a portion of the Cash Value to you. 7. The Policy must continue to qualify as life insurance under applicable tax law after the decrease.
Increasing Your Face Amount Each Requested Increase will be subject to the following: 1. We must receive proof satisfactory to us that the Insured is insurable by our standards on the date of the Requested Increase. 2. The charges for the increase will be based on the risk class the Insured qualifies for on the Date of Coverage for the Requested Increase. 3. New insurance must be available under our underwriting rules on the same plan at the Attained Age of the Insured on the date of the Requested Increase. 4. The increase must be at least equal to the Minimum Face Amount Increase shown on the Policy Specifications page. 5. The total Face Amount after the increase cannot be greater than our published maximums. The total Face Amount is equal to the Face Amount before the Requested Increase plus the Requested Increase. We will send new Policy Specifications pages to show the Date of Coverage for and charges applicable to the increase in Face Amount. The increase will take effect on the date we approve the Requested Increase.
We will send new Policy Specifications pages to show the decreased Face Amount. The decrease will take effect on the date we receive your request.
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Changing Your Policy
Benefits Provided by Your Policy
(continued)
Death Benefit Changing Your Policy’s Death Benefit Option You can ask us to change your Death Benefit Option. The request must be In Writing. We may require proof that the Insured is insurable by our standards on the date of the change. The effective date of the change will be the date we approve your request. The Death Benefit payable will not change as a result of this change, but the Face Amount may change. Changes are allowed as follows: 1. Change from Death Benefit Option A to Death Benefit Option B. The Face Amount of the Policy will be decreased, if necessary, to equal the Death Benefit less the Cash Value on the effective date of the change. This change will not be allowed if it would result in a Face Amount for the Policy that is less than the Minimum Face Amount shown on the Policy Specifications page. If the Face Amount being decreased is still in the surrender charge period, a Surrender Charge will apply to the decrease in Face Amount as explained in the Surrender Charge Schedule. The decrease will reduce the Face Amount in the following order, unless any rider made a part of the Policy states otherwise: a. Each Requested Increase in succession, starting with the most recent increase; and then b. The remaining Initial Face Amount; and then c. Any increase in Face Amount resulting from a change in Death Benefit Option. A decrease in Face Amount could result in a decrease in amounts provided by any riders made a part of the Policy.
Payment to Your Beneficiary We will pay the Policy Proceeds to the Beneficiary upon receipt of due proof of the Insured’s death. The Policy Proceeds are equal to: 1. The Death Benefit; plus 2. Any insurance on the life of the Insured provided by riders (unless the rider’s Face Amount or Death Benefit is reflected in the Death Benefit of the Policy); plus 3. The Total Monthly Cost of Insurance for the portion of the policy month from the date of the Insured’s death to the end of that policy month; plus 4. Any premium received after the date of the Insured’s death; less 5. Any Amount Due under a Grace Period provision as of the date of the Insured’s death; less 6. Any Policy Loan Balance. In no event will the amount payable upon the death of the Insured be less than the minimum amount required to permit the Policy to qualify as life insurance under the applicable tax law. Death Benefit Options Your Policy allows you to choose between two Death Benefit Options. The amount of the Death Benefit depends upon the Death Benefit Option in effect on the date of the Insured's death. The Death Benefit Option in effect is shown on the most recent Policy Specifications page.
2. Change from Death Benefit Option B to Death Benefit Option A. The Face Amount of the Policy will be increased, if necessary, to equal the Death Benefit on the effective date of the change. Addition of Riders You can ask us to add a rider to the Policy. The request must be In Writing. Proof of insurability may be required. If we approve your request, the addition of the rider will take effect on the Issue Date of the Rider. Change in Risk Class You can apply for a better risk class. The request must be In Writing. Proof of insurability will be required. If we approve your request, the change will take effect on the date we approve your request.
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Benefits Provided by Your Policy (continued) Benefits on or after Attained Age 121 Death Benefit Option A The Death Benefit prior to Attained Age 121 is equal to the greater of: 1. The Face Amount; and 2. The Policy's Cash Value times the applicable Minimum Death Benefit Factor for the Insured’s Attained Age as shown on the Minimum Death Benefit Factors page. Death Benefit Option B The Death Benefit prior to Attained Age 121 is equal to the greater of: 1. The Face Amount plus the Cash Value on the date of death; and 2. The Policy's Cash Value times the applicable Minimum Death Benefit Factor for the Insured’s Attained Age as shown on the Minimum Death Benefit Factors page. In no case will the Death Benefit be less than the minimum amount required to meet the definition of life insurance under applicable tax law. If the Face Amount or Death Benefit of a rider is to be included for the purposes of calculating the Death Benefit under the above Options, it will be indicated in the rider. Any time the Death Benefit less the Cash Value is greater than the then current Face Amount, we have the right to distribute a portion of the Cash Value to you. The amount of the distribution will be the amount required to make the Death Benefit less the Cash Value after the distribution equal to the then current Face Amount.
Benefits Payable on or after Attained Age 121 If the Insured is living and the Policy is in force at Attained Age 121, you may choose to terminate the Policy and receive the Cash Surrender Value, if it is greater than zero, as a Maturity Benefit. Continuation of the Policy beyond Attained Age 121 You may continue the Policy beyond Attained Age 121 until the death of the Insured. If the Policy is in force on or after Attained Age 121, the amount of the Death Benefit depends on the Death Benefit Option in effect on the date of the Insured’s death. The Death Benefit Option is shown on the most recent Policy Specifications page. Death Benefit Option A The Death Benefit on or after Attained Age 121 will be the greater of: 1. The Face Amount on the date of the Insured’s death plus any rider death benefits determined as of the day prior to Attained Age 121 (unless otherwise indicated in the rider); and 2. 101 percent of the Cash Value on the date of the Insured’s death. Death Benefit Option B The Death Benefit on or after Attained Age 121 will be: the Face Amount of the Policy on the date of the Insured’s death; plus the Cash Value on the date of the Insured’s death. If the Face Amount or Death Benefit of a rider made a part of the Policy is to be included for the purposes of calculating the Death Benefit under the above Options, it will be indicated in the rider. The Policy could lapse after Attained Age 121 if there is an Excess Loan. If the Policy is in force on or after Attained Age 121: loans may be taken; and loan repayments, Withdrawals, and surrenders may be made. Please note: The Policy may not qualify as a life insurance contract under applicable tax law on or after Attained Age 121 and may be subject to tax consequences. Please consult a tax advisor prior to continuing the Policy beyond Attained Age 121.
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Benefits Provided by Your Policy (continued)
Available Payment Options
Payment of the Policy Benefits
Payment Options
Payment of the Policy Proceeds Unless otherwise requested, when the Insured dies we will pay the Policy Proceeds to the Payee in one sum, which includes placing the amount in an account that earns interest. If an account is established, the Payee will be the accountholder and will have immediate access to all of the funds in the account.
Choices of Payment Options; Option Date The choice of a Payment Option and the naming of the Payee must be In Writing. You can make, change or revoke the choice before the death of the Insured. The Option Date is the effective date of the Payment Option, as chosen.
The Payee can choose to apply all or part of the Policy Proceeds to any Payment Option. Further, with our consent, any Payee who is entitled to receive proceeds in one sum when a Payment Option ends, or at the death of a prior Payee, or when the proceeds are withdrawn, can choose to apply the proceeds to a Payment Option.
When a Payment Option starts, a contract will be issued by us or by an affiliate that will describe the terms of the Option. If your Policy has a collateral assignment, it will modify a prior choice of a Payment Option. In this case, the amount due any assignee will be payable to the assignee in one sum and the balance will be applied under the Payment Option. Life Income Options Guaranteed Life Income Options are based on the age of the Payee on the Option Date. We will require proof of age. The Life Income payments will be based on the rates shown in the Life Income Tables; or, if they are greater, our Payment Option rates on the Option Date. If the rates at a given age are the same for different periods certain, the longest period certain will be deemed to have been chosen. Single Life Income Option If this Option is chosen, we will make monthly payments during the lifetime of the Payee. Single Life Income – 10 Year Guaranteed Payment Period Option If this Option is chosen, we will make monthly payments during the life of the Payee with a guaranteed payment period of 10 years. Joint and Survivor Life Income Option If this Option is chosen, monthly payments will be made: 1. While either of two Payees is living, called "Joint and Survivor Life Income", or 2. While either of two Payees is living, but for at least 10 years, called “Joint and Survivor Life Income, 10 Years Certain".
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Available Payment Options (continued) Life Income Tables Interest Only Option We will hold the proceeds at interest during the life of the Payee or for any other period agreed to by us. Interest on the proceeds: 1. Will be paid each month to the Payee starting one month after the Option Date; or 2. Will be added to the principal amount each year and will earn interest. At the death of the Payee, or at the end of the period agreed to, the balance of principal and any accrued interest will be paid in one sum. We will set the rate of interest each year; but the rate will not be less than 1/2 percent per year.
Minimum Payments under Payment Options Monthly payments for each $1,000 applied will not be less than the amounts shown in the following Tables. On request, we will provide additional information about amounts of minimum payments. The amounts shown below are based on an interest rate of 1/2 percent a year and the 2000 Annuity Mortality Table. Single Life Income Payee's Age
Life Income Male
Female
Unisex
50
$2.32
$2.15
$2.22
55
2.60
2.39
2.47
Other Payment Options and Frequencies Other Payment Options and payment frequencies may be arranged with us.
60
2.96
2.69
2.79
65
3.41
3.08
3.21
70
4.02
3.60
3.76
Limitations If installments under an Option would be less than [$50.00], proceeds can be applied to a Payment Option only with our consent.
75
4.86
4.31
4.52
80
6.01
5.33
5.58
85
7.62
6.82
7.12
90 & over
9.87
9.04
9.36
After a Payee Dies Amounts to be paid after the death of a Payee under a Payment Option will be paid as due to the successor Payee. If there is no successor Payee, amounts will be paid in one sum to the estate of the last Payee to die. If a Payee under a Life Income Option dies within 30 days after the Option Date, the amount applied to the Option, less any payments made, will be paid in one sum, unless a Payment Option is chosen.
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Payee's Age
10 Year Guaranteed Payment Period Male
Female
Unisex
50
$2.32
$2.15
$2.21
55
2.59
2.38
2.46
60
2.93
2.68
2.78
65
3.36
3.06
3.18
70
3.92
3.55
3.69
75
4.63
4.20
4.36
80
5.47
5.03
5.20
85
6.39
6.04
6.18
90 & over
7.26
7.06
7.14
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Available Payment Options
Charges Applied to Your Policy
(continued)
Charges Included in the Monthly Deduction Joint and Survivor Life Income Joint and Survivor Age of Both
One Male and
Payees
One Female
Unisex
50
$1.95
$1.94
55
2.14
2.14
60
2.39
2.38
65
2.69
2.69
70
3.10
3.09
75
3.64
3.63
80
4.39
4.37
85
5.45
5.42
90 & over
6.96
6.93
Age of Both Payees
Joint and Survivor, 10 Years Certain One Male and One Female
Unisex
50
$1.95
$1.94
55
2.14
2.14
60
2.39
2.38
65
2.69
2.69
70
3.10
3.09
75
3.63
3.62
80
4.35
4.33
85
5.28
5.26
90 & over
6.37
6.35
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Monthly Deduction On each monthly anniversary date, we deduct charges from your Policy’s Cash Value. The sum of these charges is called the “Monthly Deduction”. The Monthly Deduction for the next month is deducted on the monthly anniversary date and is equal to: 1. The Monthly Coverage Expense Charge; plus 2. The Monthly Policy Charge; plus 3. The monthly costs for any riders made a part of the Policy, unless otherwise indicated in a rider; plus 4. The Total Monthly Cost of Insurance (described in the Monthly Cost of Insurance provision). We will not take any Monthly Deductions from your Policy’s Cash Value on or after Attained Age 121. Monthly Coverage Expense Charge A Monthly Coverage Expense Charge will be assessed for each piece of coverage, except coverage amounts resulting from a change in Death Benefit Option. The Charge for each piece of coverage is equal to: the Face Amount of the coverage; times its applicable Monthly Coverage Expense Charge rate for the year; divided by 1,000. The Maximum Monthly Coverage Expense Charge for each piece of coverage is shown on that coverage’s Policy Specifications page. If the Policy is reinstated, any time that the Policy was not in force will not be counted when we determine the applicable Monthly Coverage Expense Charge. Monthly Policy Charge A Monthly Policy Charge will be assessed on your Policy. The applicable Monthly Policy Charge will never exceed the Maximum shown on the Policy Specifications page.
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Charges Applied Your Policy (continued)
Other Charges Total Monthly Cost of Insurance A Monthly Cost of Insurance Charge will be assessed for each piece of coverage. The Charge covers the cost of providing insurance coverage for the next month. It is included in the Total Monthly Cost of Insurance. The Total Monthly Cost of Insurance is equal to: 1. The Net Amount at Risk that is allocated to the remaining Initial Face Amount plus any increase in Face Amount resulting from a change in Death Benefit Option multiplied by the Monthly Cost of Insurance Rate for the Initial Face Amount, divided by 1,000; plus 2. The Net Amount at Risk that is allocated to each Requested Increase multiplied by the Monthly Cost of Insurance Rate for each Requested Increase, divided by 1,000. Monthly Cost of Insurance Rates At the start of each policy year, we will set the “Monthly Cost of Insurance Rate” used to calculate the Monthly Cost of Insurance charge for your Policy. Separate Monthly Cost of Insurance Rates are determined for: the Initial Face Amount plus any increase in Face Amount resulting from a Death Benefit Option change; and for each Requested Increase. The Monthly Cost of Insurance Rate for each piece of coverage is based on the Attained Age, risk class, sex and completed years from the Policy Start Date for the Initial Face Amount and from the Date of Coverage for each Requested Increase. If the Death Benefit is equal to the Policy’s Cash Value times the applicable Minimum Death Benefit Factor, any increase in Cash Value will cause an automatic increase in the Death Benefit. The Monthly Cost of Insurance Rate for such an increase is based on the Attained Age, the risk class used for the most recent Requested Increase, sex and completed years from the Date of Coverage for the most recent Requested Increase. The Monthly Cost of Insurance Rates for each piece of coverage will never exceed the rates shown on the Table of Guaranteed Maximum Monthly Cost of Insurance Rates page for that coverage. Any change in the cost of insurance rates will apply to all persons of the same Attained Age, sex, and risk class whose coverage has been in force for the same length of time.
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Charge Applied to Your Premium Payments We will deduct a “Percent of Premium Charge” from each premium we receive. This Charge covers premiums received for the Initial Face Amount and each Requested Increase. The Charge for each piece of coverage is equal to: the amount of premium allocated to the piece of coverage; times the Percent of Premium Charge for that piece of coverage. The Maximum Percent of Premium Charge for each piece of coverage is shown on that coverage’s Policy Specifications page. Premiums will be allocated to each piece of coverage in the following order: 1. In succession starting with the most recent Requested Increase up to and including its Target Premium amount; and then 2. To the coverage provided by the Initial Face Amount up to and including its Target Premium amount; and then 3. Any remaining premium will be allocated to each piece of coverage based on the percentage allocated to it in items 1. and 2. above. If the Policy is reinstated, any time that the Policy was not in force will not be counted when we determine the applicable Percent of Premium Charge. Surrender Charges Assessed on Your Policy The Surrender Charges and the length of time they will be assessed are shown on the Surrender Charge Schedule. There will be a separate Surrender Charge Schedule for each piece of coverage. During the applicable surrender charge period, a Surrender Charge will apply upon: 1. Surrender; 2. Lapse; 3. A Withdrawal that decreases the Face Amount; 4. A change in Death Benefit Option that decreases the Face Amount; and 5. A requested decrease in Face Amount.
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Charges Applied to Your Policy
General Provisions of Your Policy
(continued)
General Provisions Unless any rider made a part of the Policy states otherwise, a Surrender Charge will be applied: 1. First, with respect to each Requested Increase in succession based on the number of months from the Date of Coverage for that increase, starting with the most recent increase; and then 2. Second, with respect to the Initial Face Amount (excluding any increase in Face Amount resulting from a Death Benefit Option change), based on the number of months from the Policy Start Date. If the Surrender Charge for a rider is to be included for the purposes of determining the Surrender Charge applicable to the Policy, it will be indicated in the rider. If the Policy is reinstated, any time that the Policy was not in force will not be counted when we determine the Surrender Charge. Interest We Charge on Policy Loans We charge interest on any loans. The rate we charge will not exceed the Maximum Fixed Loan Interest Rate based on the policy year as shown on the Policy Specifications page. The Loan Interest is due each year on the policy anniversary. If Loan Interest is not paid when it is due, we will add it to your existing Policy Loan. Illustration of Benefits You may request In Writing that we send you an illustration of benefits. We may charge a small fee for any requested illustration after the first in each policy year. This fee will not exceed [$25.00].
The Contract We have issued the Policy in consideration of the Application and payment of premiums. The Policy includes the attached Application, any riders, and any endorsements. Together they comprise the entire contract and are made a part of the Policy when the insurance applied for is accepted. The Policy may be changed by mutual agreement. Any change must be In Writing and approved by our President, Vice President or Secretary. Our representatives have no authority to alter or change any terms, conditions, or agreements of the Policy, or to waive any of its provisions. If we make any payment or any policy changes in good faith, relying on our records or evidence supplied to us, our duty will be fully discharged. We have the right to correct any errors in the Policy. Statements Made in the Application for the Policy All statements made in the Application for the Policy will be deemed representations and not warranties. Material misstatements will not be used to void the Policy or any rider or to deny a claim unless made in the Application for the Policy. Claims of Creditors To the extent permitted by law, neither the Policy nor any payment under it will be subject to the claim of creditors or to any legal process. Misstatement of Age or Sex If we determine while the Insured is living that there was a misstatement of age or sex reflected in the Policy, the policy values will be recalculated from the Policy Start Date based on the correct information. If we determine after the Insured’s death that there was a misstatement of age or sex reflected in the Policy, the amount of the Death Benefit will be that which would be purchased by the most recent Monthly Cost of Insurance at the correct age and sex. Unisex Basis If the Policy is issued on a unisex basis, all rates, benefits and values that contain differences based on sex are modified to provide the same for males and females. See bottom of page 3 for the indication of whether the Policy is issued on a sex-distinct or unisex basis.
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General Provisions of Your Policy (continued)
Incontestability Period The insurance issued under the Policy will not be contestable after it has been in force during the lifetime of the Insured: 1. With respect to the initial coverage, for two years from the Policy Issue Date. 2. With respect to a Requested Increase, for two years from the Date of Coverage of the Requested Increase. 3. With respect to a Death Benefit increase caused by a premium payment that required evidence of insurability, for two years from the date we received the premium payment. 4. With respect to a Death Benefit increase caused by a change in Death Benefit Option that required evidence of insurability, for two years from the Date of Coverage of the Death Benefit increase.
Tax Withholding We will deduct any withholding taxes required by applicable law upon Policy surrender, withdrawal of proceeds, or upon payment of the Policy Proceeds.
This provision will not apply to any rider that contains its own incontestability clause.
Annual Report Each year, or more often if required by law or regulation, we will send you a report that shows: the Death Benefit; current policy values; surrenders; premiums paid and deductions made since the last report; any Policy Loan Balance; and any other information required by law or regulation.
If the Policy was issued as the result of the exercise of an option given in another policy and proof of insurability was not required, the contestable period applicable to the coverage resulting from the option exercise will end at the same time that it would have ended under the original policy.
Tax Regulation of Life Insurance This Policy is intended to qualify as a life insurance contract under applicable tax law. In order to have the Policy continue to qualify, we have the right to: 1. Restrict certain changes to the Policy, such as Death Benefit increases; 2. Make changes to the Policy; 3. Require the issuance of a new policy in connection with such changes; and 4. Refuse a premium payment. We will give you written notice of any of the above actions.
Suicide Exclusion If the Insured dies by suicide, while sane or insane, within two years from the Policy Issue Date, the amount payable will be limited to the amount of premiums paid (without interest) less any Withdrawals or, if greater and required by law, the reserve. The amount payable will be reduced by any Policy Loan Balance on the date of death. If the Insured dies by suicide, while sane or insane, after the first two policy years and within two years of the Date of Coverage of any Requested Increase: the increase will not be in effect; and the portion of each Monthly Deduction attributable to the increase will be added to the Cash Value prior to the calculation of the Death Benefit. If the Policy was issued as the result of the exercise of an option given in another policy and proof of insurability was not required, the suicide period applicable to the coverage resulting from the option exercise will end at the same time that it would have ended under the original policy.
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General Provisions of Your Policy (continued)
Owner and Beneficiary Owner of the Policy The Owner can be a person, corporation, partnership, trust or charity. The initial Owner of the Policy is named in the Application. Before the death of the Insured, you can change the Owner. The new Owner will have all of the rights of the Owner, including the right to make a further change of Owner. A change of Owner will void any prior Beneficiary designation unless there is an irrevocable Beneficiary. Irrevocable Beneficiaries must consent to any change of Beneficiary. If there is more than one Owner, all Owners must exercise the rights of ownership by joint action. At the death of an Owner who is a natural person, his or her estate will be the Owner, unless a successor Owner has been named. The rights of the Owner will end at the death of the Insured, except as provided in the Beneficiary of Your Policy provision. Beneficiary of Your Policy Your Beneficiary can be a person, corporation, partnership, trust or charity. The initial Beneficiary is named in the Application. After the Policy Issue Date but before the death of the Insured, you can change the Beneficiary; however, an irrevocable Beneficiary cannot be changed without his or her consent. The Beneficiary has no interest in the Policy until the death of the Insured. A person must survive the Insured to qualify as Beneficiary. If no Beneficiary survives, the proceeds will be paid to the Owner.
Procedure for Changing the Owner or Beneficiary You must make a request In Writing during the Insured’s lifetime to change the Beneficiary or Owner. Once the request is recorded, the change will take effect as of the date you signed the request, whether or not the Insured is living when we receive your request. The change will be subject to any legal restrictions. It will also be subject to any payment we made or action we took before we recorded the change. Interpretation of Owner and Beneficiary Designations A numbered sequence can be used to name successive Owners or Beneficiaries. Co-beneficiaries will receive equal shares unless otherwise stated. In naming (designating) Owners or Beneficiaries, unless otherwise stated, if you use the terms below, they will be interpreted as stated in this provision: 1. A general designation of unnamed children as a group of Beneficiaries includes all future children born to or adopted by the Insured after the date of the designation. 2. “Provision for issue” means that if a Beneficiary does not survive the Insured, the share of the Policy Proceeds for that Beneficiary will go to his or her living issue by right of representation. 3. A designation that specifies a family relationship such as “wife”, “husband” or “child” refers to their relationship to the Insured. At the time of payment of benefits, we can rely on an affidavit of any Owner or other responsible person to determine family relations or members of a class. Assignments If you make an absolute assignment of the Policy, the assignee will be the new Owner and Beneficiary. If you make a collateral assignment of the Policy, there is no change of Owner or Beneficiary. However, the rights of the Owner and Beneficiary will be subject to the terms of the collateral assignment. Assignments will be subject to all payments made and actions taken by us before a signed copy of the assignment form is recorded by us at our Designated Office. We will not be responsible for determining whether or not an assignment is valid.
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See next page.
Flexible Premium Adjustable Life Insurance Policy
This is a flexible premium life insurance policy where premiums can be paid until Attained Age 121. It does not pay dividends. You may continue the coverage provided by the Policy beyond Attained Age 121. If the Insured dies while the Policy is in force, we will pay the Policy Proceeds to the Beneficiary. We must receive due proof of the Insured’s death. Any payment will be subject to all of the provisions of the Policy.
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