SF 622 Page 3 SAMPLE
WAIVER OF MONTHLY POLICY CHARGE RIDER
This rider is part of Your policy. It is issued in consideration of the
application and deduction from Policy Value of the monthly cost of waiver rates
for the benefits provided by this rider. All policy definitions, provisions and
exceptions apply to this rider unless changed by this rider. The Effective Date
is the Policy Date unless another date is shown on the current Data Pages.
DEFINITIONS
Age Policy Anniversary means the policy anniversary on or next following the
birthday designated.
EXAMPLE: If the Policy Date is June 5, 2002, and the Insured is 65
years old on June 4, 2003, the Age 65 Policy Anniversary is June 5,
2003.
TOTAL DISABILITY
TOTAL DISABILITY - means disability which results from injury or sickness and
prevents the Insured from working for pay or profit:
1. In the Insured's regular occupation during the first 2 years of the
disability; and
2. Thereafter, in any occupation for which the Insured is reasonably fitted by
education, training, or experience.
Until the Insured's 25th birthday, "working for pay or profit" includes
attending school full time outside the home.
Total Disability also means (without regard to "working for pay or profit") the
total and irrecoverable loss of:
1. sight of both eyes;
2. use of both hands;
3. use of both feet; or
4. use of one hand and one foot.
WAIVER PERIOD
Once the Insured has remained Totally Disabled for 6 continuous months, the
waiver period begins:
1. On the Insured's Age 5 policy anniversary if the rider was issued and Total
Disability began before and continues to that date; or
2. For all others, on the Monthly Date which follows the date Total Disability
began.
In no event will a waiver period begin earlier than one year prior to Our
receipt of Notice of the Insured's Total Disability.
The waiver period will continue as long as Total Disability continues
uninterrupted, except that the waiver period:
1. Ends on the earlier of the policy Maturity Date or death of the Insured if
Total Disability:
a. Begins prior to the Insured's Age 60 Policy Anniversary; and
b. Continues to the Insured's Age 65 Policy Anniversary.
2. Ends on the Insured's Age 65 Policy Anniversary, if Total Disability:
a. Begins on or after the Insured's Age 60 Policy Anniversary; and
b. Begins before the Insured's Age 63 Policy Anniversary.
3. Ends on the Insured's Age 65 Policy Anniversary, if Total Disability:
a. Begins on or after the Insured's Age 63 Policy Anniversary; and
b. Begins before the Insured's Age 65 Policy Anniversary.
DISABILITY BENEFITS
If the Insured becomes Totally Disabled while this rider is in force, on each
Monthly Date during a waiver period We will waive (or credit to the Policy Value
if already deducted) the Monthly Policy Charge for the policy benefits. If
Monthly Policy Charges for policy benefits are being waived under this rider,
Your policy will remain in force whether or not Your Net Surrender Value is
sufficient to continue the Monthly Policy Charge.
If Death Benefit Option 1 is in effect when We begin to waive Your Monthly
Policy Charges, We will change it to Option 2. You may not change the death
benefit option or increase the Total Face Amount during a waiver period.
You may continue to pay premiums as described in Your policy.
COST OF WAIVER RIDER
The cost for the Waiver of Monthly Policy Charge Rider is deducted on each
Monthly Date. The cost is1 multiplied by the result of 2 minus 3 where:
1. Is the Cost of Waiver Rate as shown on the current Data Pages;
2. Is the death benefit at the beginning of the Policy Month divided by 1 plus
the monthly guaranteed rate (1.0024663); and
3. Is the Policy Value at the beginning of the month.
EXCEPTIONS
In no case will the Monthly Policy Charge be waived or credited under this rider
if the Total Disability results from an intentional self-injury or service in
the military forces of any country at war, declared or undeclared.
PROOF OF DISABILITY
We will require proof which satisfies Us of the Insured's Total Disability
before any Monthly Policy Charge can be waived or credited. Such proof may
include examination at Our expense by doctors We select.
We may require similar proof of the Insured's continued Total Disability from
time to time during the first 2 years of Total Disability and once a year
thereafter.
If such proof is not provided as We require, the waiver period will end and
Monthly Policy Charges will again be deducted from Your Policy Value.
CLAIMS
We will not pay Disability Benefits under this rider unless We receive Notice of
the claim while the Insured is living and remains Totally Disabled. Failure to
comply however, will not invalidate a claim if it was not reasonably possible to
give Notice within such time and Notice was given as soon as reasonably
possible.
Even if Your policy terminates because of the expiration of a grace period,
benefits under this rider may be paid if:
1. The Total Disability for which claim is made began before the end of the
grace period;
2. We receive Notice of the claim within one year after the due date of the
first unpaid Monthly Policy Charge; and
3. All other conditions for this rider are met.
If Total Disability begins within the grace period, You must pay any unpaid
Monthly Policy Charge due prior to the start of the waiver period before We will
pay disability benefits under this rider.
TERMINATION
This rider ends on the first of:
1. The termination of Your Policy;
2. The Insured's Age 65 Policy Anniversary, unless any waiver period is in
effect; or
3. Our receipt of Your Notice to cancel it. The change will be effective on
the Monthly Date on or next following the date We receive Notice. We may
require that You send Your policy to Our office so We can record the
cancellation.
President and Chief Executive Officer