EXHIBIT 99.a5c
CHILDREN'S INSURANCE RIDER (CIR)
This rider is a part of the base policy whose number is shown below. If not
shown below, the Base Policy Number is shown on the Policy Data Page.
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BASE POLICY NUMBER
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DEFINITIONS
THE INSURED
The person upon whose life the base policy is issued.
YOU, YOUR
The current owner of the base policy.
WE, US, OUR
ReliaStar Life Insurance Company at our Home Office in Minneapolis, Minnesota.
WRITTEN, IN WRITING
A written request or notice, signed and dated, and received at our Home Office.
The form and content of the request or notice must be acceptable to us.
INSURED CHILD
A child of the insured who is at least 15 days old, and one of the following:
1.
A child named in the application for this rider who is less than 19 years old on
the Rider Issue Date and for whom you give written proof of insurability we
accept;
2.
A stepchild or legally adopted child who is named in a later application and is
less than 19 years old on the date of that application. You must give written
proof of insurability for each child which we accept;
3.
A child born on or after the Rider Issue Date and while this rider is in force;
or
4.
A child born after the date of application for this rider but before this rider
is in force.
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BENEFITS
We will pay the CIR Face Amount shown on the Policy Data Page when we receive
written proof that an Insured Child died while this rider was in force.
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[LOGO] RELIASTAR
RELIASTAR LIFE INSURANCE COMPANY
Box 20
Minneapolis
Minnesota 55440
Executed at our Home Office
John H. Flittie President
/s/ John H. Flittie
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Susan M. Bergen Secretary
/s/ Susan M. Bergen
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BENEFICIARY
The insured, if living, is the beneficiary. If the insured has died, the
insured's spouse, if living, is the beneficiary. If both have died, the spouse
of the deceased Insured Child, if living, is the beneficiary. If none of these
people are living, we pay the proceeds to the estate of either the Insured Child
or the Insured Child's spouse, whoever died last.
No one can change this beneficiary designation. None of the following affect
this beneficiary designation:
1.
The beneficiary designation of the base policy;
2.
The beneficiary provisions of the base policy; or
3.
An assignment of the base policy.
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FACE AMOUNT CHANGE
While the base policy and this rider are in force, you may change the CIR Face
Amount by notifying us in writing.
INCREASES
You may increase the CIR Face Amount for all insured children who have not
reached Age 19 if:
1.
The increase is at least $500;
2.
After the increase the CIR Face Amount does not exceed $10,000;
3.
You give us written proof of the insured's insurability and written proof that
each Insured Child is insurable at standard rates under our underwriting rules
then in effect; and
4.
You make the increase on or before the policy anniversary on or next following
the insured's 55th birthday.
An increase will go into effect on the date shown on a new Policy Data Page.
You may not make any increases while we are paying the cost of insurance for
this rider due to the death or disability of the insured.
DECREASES
You may also request in writing to decrease the CIR Face Amount but you may not
decrease it to less than $1,000. At least six months must elapse between
decreases. Any decrease will go into effect on the first Monthly Anniversary
after the day we receive your written request.
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COST OF RIDER BENEFITS
The cost of this rider's benefits is in addition to the cost for the base policy
and is included in the Monthly Deduction. This cost is shown on the Policy Data
Page.
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WAIVER OF COST OF RIDER BENEFITS
If the insured dies while this rider is in force, we will pay the cost of this
rider's benefits until the Rider Expiry Date. We will not pay the cost of these
benefits if the insured commits suicide, whether sane or insane, within two
years of the Rider Issue Date.
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WAIVER OF COST OF RIDER BENEFITS (CONTINUED)
Also, we will not pay the cost of insurance for any increase in the CIR Face
Amount if the insured commits suicide within two years of the effective date of
that increase. In this case, we will refund the cost of insurance for the
increase amount.
CONVERSION
The insurance on the life of an Insured Child may be converted to a new
individual life insurance policy without proof of insurability. This insurance
may only be converted while the Insured Child is alive and:
1.
While this rider is in force;
2.
Within 31 days after this rider terminates; or
3.
On or within 31 days after coverage on that Insured Child terminates.
We will pay the CIR Face Amount if an Insured Child dies within the 31 day
period.
Application for conversion must be in writing. On or within 31 days after the
Insured Child's 25th birthday, on ly he or she may apply for the conversion.
Before this time, the insured, if living, may apply for the conversion. If the
insured is not living, the Insured Child may apply for the conversion, if not
too young to contract for life insurance. If the insured is not living, and the
Insured Child cannot apply for the conversion, the court appointed guardian of
the Insured Child may apply. If there is no court appointed guardian, the
surviving natural parent of the Insured Child, if any, may apply for the
conversion.
THE NEW POLICY
The new policy may only be for an amount up to the CIR Face Amount for that
Insured Child, unless it is converted on one of the dates below. The new policy
may be for an amount up to five times the CIR Face Amount for that Insured Child
if it is converted on one of these dates:
1.
On or within 31 days after the Insured Child's 25th birthday;
or
2.
On or within 31 days after the Rider Expiry Date.
The coverage for each Insured Child under this rider may only be converted once
for that Insured Child.
The date of the new policy will be the date of the conver sion. The Insured
Child's coverage may be converted to a flexible premium variable life insurance
policy. If not, the new policy may be on any of our plans in use at the time of
the conversion that:
1.
We would normally issue;
2.
Provides for a level amount of insurance;
3.
Has level premiums that are at least equal to those of the whole life plan we
offer that has the lowest level premiums; and
4.
Does not participate in our surplus.
We base the premiums for the new policy on the plan chosen and the Insured
Child's age and sex on the date of the conversion.
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CONVERSION (CONTINUED)
WAIVER OF PREMIUM BENEFITS FOR THE NEW POLICY
We will include a disability waiver benefit provision in the new policy without
proof of insurability if all of these are true:
1.
The premiums are payable to at least Age 85 under the new policy. If such a plan
is not available, then the new policy must be on the lowest level premium plan
available upon conversion of this rider. We require written proof of
insurability to include this provision in a policy issued on a higher level
premium plan;
2.
This provision is chosen when the new policy is applied for; and
3.
The Insured Child is not disabled at the time of the application for the new
policy.
Insured Child's age and sex on the date of the conversion.
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TERMINATION
This rider's coverage of an Insured Child terminates:
1.
When this rider terminates;
2.
On the Insured Child's 25th birthday; or
3.
When the insurance on that Insured Child is converted.
This rider terminates:
1.
On the Rider Expiry Date;
2.
On the Monthly Anniversary Date on or after we receive your written request to
terminate this rider. We may ask you to return the policy and this rider so that
we can endorse them;
3.
If the base policy is surrendered or terminates, other than at the insured's
death. However, this rider terminates if the insured commits suicide, while sane
or insane, within two years after the Rider Issue Date. We will refund the cost
of insurance for this rider if the insured commits suicide within the two-year
period; or
4.
When the base policy is in force as paid-up life insurance.
After this rider terminates, we are not liable for its benefits. If we deduct
the cost of this rider's benefits after it terminates, it is not considered a
reinstatement of this rider. The deduction will be added back to the
Accumulation Value of the base policy as of the date of the deduction.
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REINSTATEMENT
If this rider and the base policy lapse, you can reinstate the rider if:
1.
You reinstate the base policy;
2.
The rider was in effect until it lapsed; and
3.
This rider would not otherwise have expired during the time it lapsed.
To reinstate this rider and the base policy, you must:
1.
Give us proof of insurability for the insured and each child whom you wish to
be insured on the reinstatement date; and
2.
Pay a premium large enough to keep the policy and this rider in force for at
least two months.
The base policy may be reinstated without this rider, in which case proof and
payment for this rider are not needed.
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SUICIDE
This rider's benefits are not payable for an Insured Child if that child commits
suicide, while sane or insane, within two years after he or she becomes insured
under this rider. Also, if the Insured Child commits suicide within two years
after an increase in the CIR Face Amount, the amount of that increase is not
payable for that child.
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INCONTESTABILITY
This rider has a two-year contestable period starting on the Rider Issue Date.
During this period, we may ask for information that could lead to our contesting
this rider or refusing to pay its benefits. After this rider has been in force
during the Insured Child's and the insured's lifetime for two years from the
Rider Issue Date, we cannot claim this rider is void or refuse to pay its
benefits unless this rider has lapsed.
If this rider lapses and is then reinstated, this provision will be measured
from the reinstatement date with respect to statements made in the application
for reinstatement.
This provision applies separately for each Insured Child.
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OTHER PROVISIONS
This rider does not increase the Accumulation Value, Cash Surrender Value, or
Loan Value of the base policy. All base policy provisions apply to this rider,
unless changed by the rider.
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