Exhibit (5)(c)
Living Benefit Rider
WESTERN RESERVE LIFE ASSURANCE CO. OF OHIO
(A STOCK COMPANY)
Home Office: Columbus, Ohio
Administrative Office: Clearwater, Florida
LIVING BENEFIT RIDER
(AN ACCELERATED DEATH BENEFIT)
DEATH BENEFITS, CASH VALUES AND LOAN VALUES WILL BE REDUCED
IF AN ACCELERATED DEATH BENEFIT IS PAID.
AN ACCELERATED DEATH BENEFIT MAY BE TAXABLE.
AS WITH ALL TAX MATTERS, A PERSONAL TAX ADVISOR SHOULD BE CONSULTED.
The Owner may elect to receive a portion of this Policy's Death Benefit, in a
Single Sum, when the Insured has incurred a Terminal Condition, subject to the
terms and conditions defined below.
DEFINITIONS
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In addition to the definitions contained in this Policy, the following
definitions apply to this Rider:
DEATH BENEFIT For purposes of this Rider, Death Benefit means
the amount payable upon the death of the
Insured under the base Policy, plus:
(a) in the case of a single life policy, the
benefit payable under a Primary Insured
Rider, if any; or
(b) in the case of a joint last survivor
policy, the benefit payable under a Joint
Insured Term Rider, if any.
Death Benefit does not include amounts payable
under any other Riders not expressly named
above, including, but not limited to, any
Individual Insured Rider, Accidental Death
Benefit Rider, Other Insured Rider or
Disability Waiver Rider.
ELECTION PERCENTAGE A percentage, selected by the Owner, not to
exceed 100% of this Policy's Death Benefit.
In no event will the Election Percentage result
in a Single Sum Benefit greater than $500,000.
IMMEDIATE FAMILY A spouse, child, brother, sister, parent,
grandparent or grandchild of the Insured or
Owner.
INSURED The Insured for a single life policy will be
the Insured as shown on the Policy Schedule
page of the Policy. The Insured for a joint
last survivor policy will be the Surviving
Insured of the two Insureds shown on the Policy
Schedule page of the Policy.
PHYSICIAN A Doctor of Medicine or a Doctor of Osteopathy
licensed to practice medicine and treat injury
or illness in the state in which treatment is
received and who is acting within the scope of
that license. A Physician must be someone other
than:
(a) the Insured;
(b) the Owner;
(c) a person who lives with the Insured or
Owner; or
(d) a person who is part of the Insured's or
Owner's Immediate Family.
PHYSICIAN'S STATEMENT A written statement acceptable to Us and signed
by a Physician which:
(a) provides the Physician's diagnosis and
prognosis of the Insured's noncorrectable
medical condition; and
(b) states with reasonable medical certainty
that the noncorrectable medical condition
will result in the death of the Insured
within 12 months from the date of the
Physician's Statement. This statement must
take into consideration the ordinary and
reasonable medical care, advice and
treatment available in the same or similar
communities.
TERMINAL CONDITION A condition resulting from injury or illness
which, as determined by a Physician, has
reduced life expectancy to not more than 12
months from the date of the Physician's
statement
BENEFITS
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SINGLE SUM BENEFIT We will pay the Single Sum Benefit to the Owner
when We receive proof satisfactory to Us that
the Insured has incurred a Terminal Condition
while this Policy and Rider are In Force. We
will make payment when all of the terms and
conditions have been met, subject to the
conditions and limitations contained in this
Rider.
The Single Sum Benefit provided by this Rider
may only be elected once.
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The Single Sum Benefit is equal to:
(a) the Death Benefit in effect on the date
the Single Sum Benefit is paid;
multiplied by
(b) the Election Percentage;
divided by
(c) (1+i) where i equals the greater of:
(1) the current yield on 90 day Treasury
Bills; or
(2) the policy loan interest rate;
minus
d) Indebtedness, if any, at the time the
Single Sum Benefit is paid, multiplied by
the Election Percentage.
BENEFIT AND VALUE REDUCTION This Policy's benefits and values, as those
amounts exist on the date the Single Sum
Benefit is paid, will be reduced by the
Election Percentage. If the Election Percentage
is 100%, this Policy will terminate without
further value.
At the time of payment, We will provide the
Owner with revised Policy Specification pages
and any other pertinent information which
reflect the reduction of all values applicable
to this Policy and all benefits it provides.
RIDER CLAIMS PROVISIONS
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NOTICE OF CLAIM The Owner may give Us written notice of a claim
for this Benefit any time after the Insured
incurs a Terminal Condition as defined in this
Rider. Notice of Claim must be signed by the
Owner, identify the Insured, the Policy and the
Election Percentage and be sent to Us at Our
Administrative Office.
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CLAIM FORMS We will send the Owner claim forms within 15
days of the date We receive written notice of
claim. If We do not do so, the Owner will be
considered to have complied with the Proof of
Terminal Condition requirements by giving Us a
Physician's Statement acceptable to Us and a
written statement of the nature and extent of
the Terminal Condition.
PROOF OF TERMINAL CONDITION Written proof of the Insured's Terminal
Condition must be received by Us at Our
Administrative Office before We will make a
Single Sum Benefit payment. This proof must
include a properly completed claim form and a
Physician's Statement acceptable to Us. We may
request additional medical information from the
Physician submitting the statement.
PHYSICAL EXAMINATION At Our expense, We reserve the right to have a
Physician of Our choosing examine the Insured
prior to making a Single Sum Benefit payment.
In the event the Physician We choose provides a
different prognosis of the Insured's medical
condition, We reserve the right to rely on the
statement from the Physician of Our choosing
for claim purposes.
TIME PAYMENT OF CLAIMS All benefits described in this Rider will be
available as soon as We receive satisfactory
Proof of Terminal Condition.
CONSENT FOR BENEFIT PAYMENT We must obtain consent of any irrevocable
beneficiary and any assignee of record before
the Single Sum Benefit is paid. An assignee's
consent is required only to the extent that
benefits paid would reduce this Policy's values
and benefits below the amounts assigned.
RIDER GENERAL PROVISIONS
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ANNUAL STATEMENT The Annual Statement for this Policy will
reflect payment of the Single Sum Benefit, if
paid during the prior year, as well as
resulting reductions and remaining benefits and
values.
CONTESTABILITY This Rider will be contestable, on the same
basis as the Policy, during the lifetime of the
Insured, for two years from the Rider Effective
Date.
CHARGES No charges are payable for this Rider.
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SELF-INFLICTED INJURY If the Insured suffers a Terminal Condition
which results from a bodily injury which was
intentionally self-inflicted, within the period
specified in the Suicide Provision of this
Policy, no benefits will be payable under this
Rider.
TERMINATION This Rider will terminate at the earliest of:
(a) the date the Policy terminates;
(b) the effective date of a settlement option
elected under the Policy; (c) the date the
Single Sum Benefit is paid; or (d) the date the
Owner elects to terminate this Rider.
RIDER EFFECTIVE DATE Rider months, years and anniversaries are
measured from the Rider Effective Date. The
Rider Effective Date is the Policy effective
date unless a different Rider Effective Date is
shown here.
WESTERN RESERVE LIFE ASSURANCE CO. OF OHIO
/s/ WILLIAM H. GEIGER