Arkansas, Hawaii, Iowa, Rhode Island, South Carolina, West Virginia and Wisconsin

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry  point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.



ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit to Age 100 Rider

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Alaska

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States or Canada;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  12. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  13. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  14. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  15. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoiditis, tonsillitis, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  16. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  17. An elective abortion;
  18. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  19. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.



ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  14. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  15. Medical mishap or negligence, including malpractice;
  16. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  17. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  18. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.


Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be  confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Alabama

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the twelve months prior to the policy or rider effective date (6 months prior to the Cancer Treatment policy effective date). The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry  point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated  under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.



ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.



INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Arizona

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  4. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  5. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  6. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

 

CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.



ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two  years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be  confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
California

FOR ALL APPLICABLE POLICES AND RIDERS:

PRE-EXISTING CONDITION(S): Any sickness for which an insured person received medical advice or treatment, care or services including diagnostic measures, took prescribed drugs or medicines from a qualified medical professional within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first six months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This six month period is measured from the policy and rider effective date for each insured person.

 

SUPPLEMENTAL LUMP SUM CANCER POLICY/RIDER AND SUPPLEMENTAL CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer or Carcinoma in situ as defined;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



SUPPLEMENTAL LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND SUPPLEMENTAL HEART ATTACK AND STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; 
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Qualified medical professional and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


SUPPLEMENTAL Hospital and Intensive Care Unit Indemnity Benefit Rider

Benefits are only payable for the first 30 days for any one period of confinement. Once you reach age 65, coverage will be reduced by 50%.

This Rider is subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this Rider for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission of or active participation in a riot, insurrection, rebellion or police action;
  4. Mental or emotional disorders;
  5. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  6. Travel or activity outside the United States;
  7. Participation in any motorized race or contest of speed on sea, land or air;
  8. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  9. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting;
  10. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  11. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  12. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  13. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  14. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  15. An elective abortion;
  16. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  17. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.  surgery as the result an Injury; or
b.  surgery to restore a normal bodily function; or
c.  surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.  breast reconstruction following mastectomy.

Also, no benefits will be payable under this Rider for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.

Intoxicants and controlled substances: We shall not be liable for any loss sustained or contracted in consequence of the insured’s being intoxicated or under the influence of any controlled substance unless administered on the advice of a physician.

Colorado

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 

LUMP SUM HEART ATTACK AND STROKE POLICY AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider

 

CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a  result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.

 

INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.

 

 

Connecticut

FOR ALL APPLICABLE POLICES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; 
  2. loss that begins prior to the policy and/or rider effective date;
  3. diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: Benefits will not be paid for a diagnosis of cancer during the first 30 days immediately following your policy or rider effective date.

In the event of a diagnosis of cancer within the first 30 days following the policy or rider effective date, your coverage will be void from its beginning as though coverage was never issued. Any applicable premium paid for such coverage will be refunded.


LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. loss caused be the voluntary use of any controlled substance as defined in Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, as now or hereafter amended, unless prescribed by his or her physician for the insured person; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 31 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

This Rider is subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this Rider for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Loss caused by the commission of a felony for which you have been convicted under state or federal law; Commission of or active participation in a riot, insurrection, rebellion or police action;
  4. Voluntary use of any controlled substance as defined in Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, as now or hereafter amended, unless prescribed by his or her Physician for the Insured Person;
  5. Operating any type of vehicle while intoxicated;
  6. Mental or emotional disorders, alcoholism and drug addiction;
  7. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  8. Travel or activity outside the United States;
  9. Aviation;
  10. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  11. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  12. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  13. An elective abortion;
  14. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  15. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.  surgery as the result an Injury; or
b.  surgery to restore a normal bodily function; or
c.  surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.  breast reconstruction following mastectomy.

Also, no benefits will be payable under this Rider for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.

 

INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused by the voluntary use of any controlled substance as defined in Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, as now or hereafter amended, unless prescribed by his physician for the insured.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a civil commotion, rising against civil or governmental authority.
Delaware

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 6 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 6-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 

LUMP SUM HEART ATTACK AND STROKE POLICY AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.

 

CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.


WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.

 

ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.

District of Columbia

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider.

 

LUMP SUM CANCER POLICY AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER


If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.



CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.

 

ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.


Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.


Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of Premiums, this Policy will be incontestable after it has been in force for two years from the Policy Effective Date. This provision does not apply to any rider that contains its own incontestability clause.


TERMINAL ILLNESS ACCELERATED BENEFIT RIDER

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.


ACCIDENTAL DEATH BENEFIT TO AGE 100 RIDER

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by: a) the voluntary use of illegal drugs; b) the intentional taking of over the counter medication not in accordance with recommended dosage and warning instructions; and c) intentional misuse of prescription drugs.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Florida

Approved Form Numbers In Florida: LY-LSC-BA-B-FL, LY-LSH-BA-B-FL, LY-HR-RD-FL, LY-LSC-RD-FL, LY-LSH-RD-FL, LY-HICU-RD-FL

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person.

 

LUMP SUM CANCER POLICY/RIDER
If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point
are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this
policy or rider, and any applicable portion of premiums will be refunded.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

This Rider is subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this Rider for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared, excludes acts of terrorism);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any of the following high risk activities: bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, or parakiting;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under this Rider for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.
Georgia

The Lump Sum Cancer Policy/Rider is named First Diagnosis Cancer Lump Sum Limited Benefit Insurance Policy/Rider.

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the First Diagnosis Cancer Lump Sum Limited Insurance Policy/Rider, Accident Expense Insurance Policy, Parent Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)



FIRST DIAGNOSIS CANCER LUMP SUM LIMITED INSURANCE POLICY/RIDER

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.


WAITING PERIOD: If diagnosed with cancer or carcinoma in situ during the 30-day waiting period, you have the option to cancel the policy and receive a refund of the initial premium or you can continue your policy to provide for payment of benefits for cancer or carcinoma in situ diagnosed after the 30-day waiting period.

 

CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.


WAITING PERIOD:
If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

This Rider is subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this Rider for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Any loss to which a contributing cause was the insured's commission of or attempt to commit a felony or to which a contributing cause was the insured's being engaged in an illegal occupation;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under this Rider for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.



ACCIDENT EXPENSE POLICY


In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. any loss to which a contributing cause was the insured's commission of or attempt to commit a felony or to which a contributing cause was the insured's being engaged in an illegal occupation;;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of written proof within thirty-one (31) days of entering military service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless administered on the advice of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  15. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  16. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay from a military, Veteran's, or government hospital contracted for, or operated by, the federal government or its agency;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except as provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or 
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Parent Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.

 

INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force
for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Idaho

Approved Form Numbers In Idaho: LY-ACC-BA-B-ID, LY-PRT-RD, LY-VEH-RD-ID, LY-CAT-RD-ID, LY-DED-RD, LY-LSC-BA-B-ID, LY-LSH-BA-B-ID, LY-CR-RD-ID, LY-LSC-RD-ID, LY-LSH-RD-ID, LY-CT-BA-B-ID, ICC14-LY-WLP, ICC14-LY-TIABR, ICC14-LY-ADBR

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER


If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 

LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined
  2. loss that begins prior to the policy effective date;
  3. diagnosis received outside the United States or its territories, unless otherwise specified in this policy;
  4. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  5. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  6. any illness specifically excluded from the definition of Qualifying Events listed in this policy.

 

CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined;
  2. diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  3. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



ACCIDENT EXPENSE POLICY


In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Participation in a felony, riot or insurrections;;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States unless otherwise specified in the policy;
  9. Travel or activity outside the United States;
  10. Participation in any professional motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  13. Participation in any high risk activities such as professional bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  14. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  15. Medical mishap or negligence, including malpractice;
  16. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  17. Practicing for or participating in any professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  18. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.
  19. Intoxicants and narcotics: We shall not be liable for any loss sustained or contracted in consequence of the insured's being intoxicated or under the influence of any narcotic unless administered on the advice of a Physician.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic surgery, except that “cosmetic surgery” shall not include reconstructive surgery when the service is incidental to or follows surgery resulting from trauma, infection or other diseases of the involved part, and reconstructive surgery because of congenital disease or anomaly of a covered dependent child; or
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.

 

INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Illinois

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)

 

LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 

LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  6. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.

 

CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly by:

  1. War or act of war (whether declared or undeclared);
  2. Commission of or attempt to commit a felony or engagement in illegal occupation;
  3. Commission of or active participation in a riot, insurrection, rebellion or police action;
  4. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  5. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  6. Mental or emotional disorders, alcoholism and drug addiction;
  7. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  8. Travel or activity outside the United States;
  9. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  10. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: all types of hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  11. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  12. An elective abortion;
  13. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  14. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery. Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.

 

ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. War or act of war (whether declared or undeclared);
  2. Commission of or attempt to commit a felony or engagement in illegal occupation;
  3. Commission of or active participation in a riot, insurrection, rebellion or police action;
  4. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States unless otherwise specified in the policy;
  9. Travel or occupation outside the United States;
  10. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  11. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline; or
  12. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental injury, or infection which results from accidental, involuntary or unintentional ingestion of a contaminated substance;.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.


Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.

 

INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Indiana

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)

 

LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  3. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 

LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. a Qualifying Event Diagnosed during the Waiting Period;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  4. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  5. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  6. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly) or caused by Cancer;
  2. diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  3. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

CANCER(S) DIAGNOSED WITHIN THE WAITING PERIOD: The benefits of this policy will not be payable during the first twelve (12) months that coverage is in force with respect to any Cancer diagnosed within the Waiting Period. The twelve (12) month period is measured from the Policy Effective Date for each Insured Person.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery. Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Treatment for which no charges are made by the provider of same;
  2. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  3. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.

 

ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.

 

INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Kansas

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. If, as of the date of application for the Lump Sum Cancer Policy, Lump Sum Heart Attack and Stroke Policy, and/or Cancer Treatment Policy, you are replacing or have an existing specified disease policy, you shall be given credit for the expired portion of any pre-existing conditions limitation of that policy. (Pre-existing conditions(s) do not apply to the Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)

LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 


LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded. If, as of the date of application, you are replacing or have an existing specified disease policy, you shall be given credit for the expired portion of any Waiting Period limitation of that policy.

 

CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired. If, as of the date of application, you are replacing or have an existing specified disease policy, you shall be given credit for the expired portion of any Waiting Period limitation of that policy.

 

INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Kentucky

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 

LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.

 

CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.


WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability law or similar law.

 

INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force
for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the
Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal
Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Louisiana

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)

 

LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.

 

CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  3. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability law or similar law.

 

ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.


Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Maine

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first six months (12 months for the Intensive Care Unit Indemnity Benefit Rider and Hospital and Intensive Care Unit Indemnity Benefit Rider) that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This six month period (12 months for the Intensive Care Unit Indemnity Benefit Rider and Hospital and Intensive Care Unit Indemnity Benefit Rider) is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)

 

LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 


LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.



CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability law or similar law.

 

ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Maryland

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A sickness or injury diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. A condition that is revealed on the application for insurance will not be considered a pre-existing condition unless excluded by a signed waiver. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any sickness or injury caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. diagnosis received outside the United States or its territories, unless the diagnosis is confirmed in the United States or its territories; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.


LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER


If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date; 
  3. diagnosis received outside the United States or its territories, unless the diagnosis is confirmed in the United States or its territories;
  4. intentionally self-inflicted Injury, suicide or any attempt while sane or insane; or
  5. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy effective date;
  3. diagnosis received outside the United States or its’ territories, unless the diagnosis is confirmed in the United States or its territories; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

This Rider is subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this Rider for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  4. Travel or activity outside the United States;
  5. Participation in any motorized race or contest of speed on sea, land or air;
  6. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  7. Participation in bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, base jumping, off piste skiing, heliskiing, bullriding, rodeo clownsmanship, parakiting, or mountaineering;
  8. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  9. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  10. Payment of any claim, bill, or other demand or request for payment for health care sevices that the appropriate regulatory board determines were provided as a result of a prohibited referral;
  11. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  12. An elective abortion;
  13. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  14. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:
    a.    surgery as the result an Injury; or
    b.    surgery to restore a normal bodily function; or
    c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
    d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under this Rider for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.



INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force
for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.


TERMINAL ILLNESS ACCELERATED BENEFIT RIDER

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the
Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal
Illness must be confirmed by a physician practicing within the United States or its territories.


ACCIDENTAL DEATH BENEFIT TO AGE 100 RIDER

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Massachusetts and Virginia

INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.


TERMINAL ILLNESS ACCELERATED BENEFIT RIDER

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.


ACCIDENTAL DEATH BENEFIT TO AGE 100 RIDER

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Michigan

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 

LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.



CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Mental or emotional disorders, alcoholism and drug addiction;
  6. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  7. Travel or activity outside the United States;
  8. Participation in any motorized race or contest of speed on sea, land or air;
  9. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  10. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  11. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  12. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  13. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  14. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  15. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  16. An elective abortion;
  17. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  18. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability law or similar law.

 

ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States unless otherwise specified in the policy;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Medical mishap or negligence, including malpractice;
  15. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  16. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  17. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force
for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Minnesota

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 

LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; 
  5. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  6. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.



HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

This Rider is subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this Rider for Confinement or loss caused directly or indirectly by:

  1. War or act of war (whether declared or undeclared);
  2. Commission or attempt to commit an illegal activity or a felony;
  3. Commission of or active participation in a riot, insurrection, rebellion or police action;
  4. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  5. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  6. Mental or emotional disorders, alcoholism and drug addiction;
  7. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  8. Travel or activity outside the United States;
  9. Participation in any motorized race or contest of speed on sea, land or air;
  10. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  11. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  12. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  13. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  14. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  15. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  16. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  17. An elective abortion;
  18. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  19. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability law or similar law.

 

INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

 

TERMINAL ILLNESS ACCELERATED BENEFIT RIDER

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

 

ACCIDENTAL DEATH BENEFIT TO AGE 100 RIDER

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.

Mississippi

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)

LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 

LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.

 

CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.


WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability law or similar law.



ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide

If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Missouri

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date; 
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  4. intentionally self-inflicted Injury, suicide or any attempt while sane;
  5. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  6. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

 

CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer; 
  2. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  3. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Montana

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person.

 

CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.


Mammogram Limitations:

  1. one mammogram for an insured woman ages 35 to 39;
  2. one mammogram every two years for an insured woman ages 40-49, or more frequently, if recommended by a physician; and
  3. one mammogram per year for an insured woman age 50 or older.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date; 
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  4. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  5. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  6. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.



HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability law or similar law.
Nebraska

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER


If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any illegal drug, poison, gas or fumes, or being under the influence of any narcotic unless administered on the advice of a physician; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY


In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. committing or attempting to commit a felony or engaging in an illegal occupation;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. voluntary self-administration of any illegal drug, poison, gas or fumes, or being under the influence of any narcotic unless administered on the advice of a physician;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any organized motorized race or organized contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding or parakiting;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability law or similar law.

 

ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission of or attempt to commit a felony or engagement in an illegal occupation;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant unless administered on the advice of a physician. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any organized motorized race or organized contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.

 

INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Nevada

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): Means a condition(s), regardless of the cause of the condition(s), for which medical advice or treatment, diagnosis or care was recommended or received during the six (6) months preceding the policy or rider effective date of the new coverage. The term does not include genetic information in the absence of a diagnosis of the condition related to such information. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 

LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.


WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.


WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Mental or emotional disorders;
  7. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  8. Travel or activity outside the United States;
  9. Participation in any motorized race or contest of speed on sea, land or air;
  10. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  11. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  12. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  13. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  14. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  15. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  16. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  17. An elective abortion;
  18. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  19. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability law or similar law.

 

ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; 
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States unless otherwise specified in the policy;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Medical mishap or negligence, including malpractice;
  15. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  16. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  17. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.

 

INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
New Hampshire

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions for which medical advice, diagnosis, care or treatment was recommended by or received from a physician within the six month period preceding the effective date of coverage of an insured person. The benefits of the policy and any attached rider will not be payable during the first six months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This six month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 

LUMP SUM HEART ATTACK AND SEVERE STROKE POLICY/RIDER AND HEART ATTACK AND SEVERE STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

 

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.

 

INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.



TERMINAL ILLNESS ACCELERATED BENEFIT RIDER

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.



ACCIDENTAL DEATH BENEFIT TO AGE 100 RIDER

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.

New Jersey

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first six months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This six month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry  point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  4. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  5. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  6. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

 

INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide

If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
New Mexico

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first six months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This six month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 

LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.


WAITING PERIOD: The first 30 days following an Insured Person's policy or rider effective date. If any Insured Person is diagnosed with a Qualifying Event during the waiting period, that person's coverage will be terminated under this policy or rider, and any applicable portion of premiums paid for that person's coverage will be refunded.

CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: Benefits will not be paid if any Insured Person is diagnosed with cancer during the first 30 days immediately following the effective date of the Cancer Treatment policy. If an Insured Person is diagnosed with cancer within the first 30 days immediately following the effective date of the Cancer Treatment policy, their coverage will be void from its beginning as though coverage was never issued. Any applicable premium paid for that person's coverage will be refunded.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability law or similar law.

 

ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.


The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

 If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
North Carolina

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions for which medical diagnosis, care, advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. Pre-Existing Condition(s) do not apply to insured person(s) age 65 or older on the policy or rider effective date. The policy or rider shall not exclude coverage for any pre-existing conditions of a newborn or newly adopted child whose coverage begins after the policy or rider effective date. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 

LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.


WAITING PERIOD:
The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid during the first 12 months.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of declared or undeclared war (not to include acts of terrorism);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. services or supplies for the treatment of an occupational injury or sickness which are paid under the North Carolina Workers’ Compensation Act only to the extent such services or supplies are the liability of the employee, employer or workers’ compensation insurance carrier according to a final adjudication under the North Carolina Workers’ Compensation Act or an order of the North Carolina Industrial Commission approving a settlement agreement under the North Carolina Workers’ Compensation Act.

 

ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared, excludes acts of terrorism);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services (excludes due to congenital anomalies) treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
North Dakota

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)

LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

 

LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry  point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability law or similar law.



ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting, base jumping, off piste skiing, heliskiing, bullriding, rodeo clownsmanship and mountaineering;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Declining Deductible Benefit Rider
The exclusions and limitations that apply to this rider are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within one year from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Ohio

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.



INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Oklahoma

Approved Form Numbers In Oklahoma: LY-ACC-BA-OK, LY-PRT-RD-OK, LY-VEH-RD-OK, LY-CAT-RD-OK, LY-DED-RD-OK, LY-LSC-BA-OK, LY-LSH-BA-OK, LY-CR-RD-OK, LY-HR-RD-OK, LY-LSC-RD-OK, LY-LSH-RD-OK, LY-HICU-RD-OK, LY-ICU-RD-OK, LY-CT-BA-OK, ICC14-LY-WLP, ICC14-LY-TIABR, ICC14-LY-ADBR

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.


WAITING PERIOD:
The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coveragDAe will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared) while serving in the military or an auxiliary unit attached to the military or working in an area of war whether voluntarily or as required by the employer;
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Mental or emotional disorders, alcoholism and drug addiction;
  7. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  8. Travel or activity outside the United States;
  9. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  10. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  11. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  12. An elective abortion;
  13. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  14. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability law or similar law.



ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared) while serving in the military or an auxiliary unit attached to the military or working in an area of war whether voluntarily or as required by the employer;
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; 
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States unless otherwise specified in the policy;
  9. Travel or activity outside the United States;
  10. Aviation;
  11. Medical mishap or negligence, including malpractice;
  12. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  13. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program; or
  14. Liable for any loss sustained or contracted in consequence of the insured’s being under the influence of any narcotic unless administered on the advice of a physician.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Oregon

Approved Form Numbers in Oregon: LY-ACC-BA-B-OR, LY-CAT–RD, LY-CRI-RD, LY-DED-RD, LY-PRT-RD-OR, LY-VEH-RD, LY-LSC-BA-B-OR, LY-LSH-BA-B-OR, LY-CR-RD-OR, LY-HR-RD-OR, LY-LSC-RD-OR, LY-LSH-RD-OR, LY-HICU-RD-OR, LY-ICU-RD-OR, LY-CT-BA-B-OR, ICC14-LY-WLP, ICC14-LY-TIABR, ICC14-LY-ADBR

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane; or
  6. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Mental or emotional disorders;
  6. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  7. Travel or activity outside the United States;
  8. Participation in any motorized race or contest of speed on sea, land or air;
  9. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  10. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  11. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  12. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  13. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  14. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  15. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  16. An elective abortion;
  17. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  18. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability law or similar law.

 

ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy and/or rider section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Mental or emotional disorders;
  7. Treatment outside the United States unless otherwise specified in the policy;
  8. Travel or activity outside the United States;
  9. Participation in any professional motorized race or contest of speed on sea, land or air;
  10. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  11. Participation in any high risk activities such as professional bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  12. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  13. Medical mishap or negligence, including malpractice;
  14. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  15. Practicing for or participating in any professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  16. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic service, treatment that is not medically necessary, or treatment, services and supplies for experimental, investigational or unproven purposes; Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  4. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, meditation, aromatherapy and relaxation therapy;
  5. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome; or
  6. Any services, treatments or conditions occurring while the policy is not in force

In addition to the policy exclusions:

CATASTROPHIC ACCIDENTAL INJURY BENEFIT RIDER
No benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period

VEHICULAR ACCIDENTAL INJURY CASH BENEFIT RIDER
No benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

CRITICAL ILLNESS BENEFIT RIDER

No benefits will be payable for:

  1. Conditions diagnosed outside of the United States, unless the diagnosis is confirmed by a physician in the United States;
  2. Any illness, loss or condition specifically excluded from the rider definition of any covered critical illness;
  3. Any covered critical illness that was incurred, manifested or diagnosed prior to an insured person’s rider effective date; or
  4. Any covered critical illness incurred, manifested or diagnosed during the critical illness waiting period.



INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide

If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider
If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider
No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Pennsylvania

The Cancer Treatment Policy is named Supplemental Insurance Policy Limited Benefit Specified Disease Coverage for Cancer Treatment.

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy effective date. The benefits of the policy will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s), subject to the Time Limit on Certain Defenses Provision. This 12-month period is measured from the policy effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


SUPPLEMENTAL INSURANCE POLICY LIMITED BENEFIT SPECIFIED DISEASE COVERAGE FOR CANCER TREATMENT

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer; 
  2. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  3. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: the first 30 days following an insured person’s policy effective date.

CANCER(S) DIAGNOSED WITHIN THE WAITING PERIOD: The benefits of this policy will not be payable during the first 12 months that coverage is in force with respect to any cancer diagnosed within the waiting period. This 12 month period is measured from the policy effective date for each insured person.


ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit a felony;
  4. participation in a riot or insurrection;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days; 
  6. Mental or emotional disorders;
  7. Participation in any motorized race or contest of speed on sea, land or air;
  8. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  9. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  10. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  11. Medical mishap or negligence, including malpractice;
  12. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  13. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  14. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.
  15. Loss sustained or contracted in consequence of the insured’s being intoxicated, or under the influence of any narcotic unless administered on the advice of a physician.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred. 
  3. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider and Catastrophic Accidental Injury Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability
Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
South Dakota

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)

LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated  under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Mental or emotional disorders;
  7. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  8. Travel or activity outside the United States;
  9. Participation in any motorized race or contest of speed on sea, land or air;
  10. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  11. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  12. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  13. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  14. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  15. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date and medical advice, diagnosis, care or treatment was recommended or received during the twelve months preceding the rider effective date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  16. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  17. An elective abortion;
  18. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  19. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation;
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability law or similar law; or
  5. Treatment for alcoholism and drug addiction.



ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States unless otherwise specified in the policy;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Medical mishap or negligence, including malpractice;
  15. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  16. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  17. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.



INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Tennessee

Approved Form Numbers In Tennessee: LY-ACC-BA-B-TN, LY-PRT-RD, LY-VEH-RD, LY-CAT-RD, LY-DED-RD, LY-LSC-BA-B-TN, LY-LSH-BA-B-TN, LY-CR-RD-TN, LY-HR-RD-TN, LY-LSC-RD, LY-LSH-RD, LY-CT-BA-B-TN, ICC14-LY-WLP, ICC14-LY-TIABR, ICC14-LY-ADBR

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal
Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Texas

Approved Form Numbers in Texas: LY-LSC-BA.V3-B-TX, LY-LSH-BA.V3-B-TX, LY-CR-RD-TX, LY-HR-RD, LY-LSC-RD.V3-TX, LY-LSH-RD.V2-TX, LY-HICU-RD.V2-TX, LY-ICU-RD.V2-TX, LY-CT-BA.V2-B-TX, ICC14-LY-WLP, ICC14-LY-TIABR, ICC14-LY-ADBR

Rates are illustrative only. Do not send money to the company in response to this advertisement. A completed application is required before any coverage is obtained. Rates are subject to change.

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. If you are age 64 or under on the policy/rider effective, the benefits of this policy/rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s).  This 12 month period is measured from the policy/rider effective date for each insured person.  If you are age 65 or over on the policy/rider effective date, the benefits of this policy/rider will not be payable during the first six months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s), unless specifically excluded from coverage by name or specific description. (Pre-existing conditions(s) do not apply to the Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date; or
  3. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry  point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. intentionally self-inflicted Injury, suicide or any attempt or threat to commit suicide while sane; or
  5. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.



CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. care and treatment, when the care and treatment has not been funded by the National Cancer Institute or when the care and treatment are not subjects of ongoing clinical studies by the United States Food and Drug Administration for the treatment of cancer; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 31 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

These Riders are subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under these Riders for Confinement or loss caused directly or indirectly by:

  1. Intentionally self-inflicted Injury, suicide or any attempt or threat to commit suicide while sane;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders without demonstrable organic disease, alcoholism and drug addiction;
  8. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  9. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  10. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  11. An elective abortion;
  12. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  13. Cosmetic care, except when the Hospital Confinement is due to reconstructive plastic surgery.  Reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under these Riders for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.



INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Vermont

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the 12 months (six months for the Cancer Treatment Policy) prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. Diagnosis received outside the United States or its territories, unless the diagnosis is confirmed by a qualified physician within the United States, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless diagnosis is confirmed by a qualified physician within the United States, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. Diagnosis received outside the United States or its’ territories, unless the diagnosis is confirmed by a qualified physician within the United States, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


HOSPITAL AND INTENSIVE CARE UNIT INDEMNITY BENEFIT RIDER

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

This Rider is subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this Rider for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Treatment outside the United States, unless the diagnosis is confirmed by a qualified physician within the United States, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  8. Travel or activity outside the United States;
  9. Participation in any motorized race or contest of speed on sea, land or air;
  10. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  11. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  12. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  13. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  14. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  15. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  16. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  17. An elective abortion;
  18. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  19. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:

a.    surgery as the result an Injury; or
b.    surgery to restore a normal bodily function; or
c.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
d.    breast reconstruction following mastectomy.

Also, no benefits will be payable under this Rider for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.

 

ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; 
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program; or
  20. Any covered accident and/or covered injury which is proximately caused by mental or emotional disorders.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not Medically Necessary, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Washington

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date. The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date;
  3. diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.


LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane; or
  6. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. diagnosis received outside the United States or its’ territories, unless otherwise specified in this policy; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force
for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.


TERMINAL ILLNESS ACCELERATED BENEFIT RIDER

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.


ACCIDENTAL DEATH BENEFIT TO AGE 100 RIDER

No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.
Wyoming

FOR ALL APPLICABLE POLICIES AND RIDERS:

PRE-EXISTING CONDITION(S): A condition/conditions diagnosed or for which medical advice or treatment was recommended by or received from a physician within the six months prior to the policy or rider effective date (or as to pregnancy existing on the rider effective date for the Intensive Care Unit Indemnity Benefit and Hospital and Intensive Care Unit Indemnity Benefit Riders). The benefits of the policy and any attached rider will not be payable during the first 12 months that coverage is in force with respect to an insured person for any loss caused by pre-existing condition(s). This 12-month period is measured from the policy and rider effective date for each insured person. (Pre-existing conditions(s) do not apply to the Accident Expense Insurance Policy, Catastrophic Accidental Injury Benefit Rider, Vehicular Accidental Injury Cash Benefit Rider, Parent Benefit Rider, Declining Deductible Benefit Rider, Individual Whole Life Insurance Policy, Terminal Illness Accelerated Benefit Rider and Accidental Death Benefit to Age 100 Rider)


LUMP SUM CANCER POLICY/RIDER AND CANCER RECURRENCE BENEFIT RIDER

If you happen to be diagnosed within the first 30 days following the effective date of the policy and/or rider, the benefit amount payable will be reduced to 10% of the selected benefit amount, and your coverage will be terminated. (not applicable on Cancer Recurrence Benefit Rider)

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the policy and/or rider effective date; or
  3. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.



LUMP SUM HEART ATTACK AND STROKE POLICY/RIDER AND HEART ATTACK & STROKE RESTORATION BENEFIT RIDER

If you happen to be diagnosed with two or more qualifying events on the same day or have two or more surgical treatments at the same time (through a common incision or entry  point are considered one operation), we will pay only one benefit amount for the diagnosis and one benefit amount for the surgical treatment, the larger of the qualifying event benefits.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy and rider for:

  1. any disease, Sickness or incapacity other than Qualifying Events as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by a Qualifying Event;
  2. loss that begins prior to the policy and/or rider effective date;
  3. a Qualifying Event Diagnosed during the Waiting Period;
  4. Diagnosis received outside the United States or its territories, unless otherwise specified in this policy and/or rider;
  5. intentionally self-inflicted Injury, suicide or any attempt while sane or insane;
  6. voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; or
  7. any illness specifically excluded from the definition of Qualifying Events listed in this policy and/or rider.

WAITING PERIOD: The first 30 days following your policy or rider effective date. If diagnosed with a Qualifying Event during the waiting period, your coverage will be terminated under this policy or rider, and any applicable portion of premiums will be refunded.


CANCER TREATMENT POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this policy for:

  1. any disease, Sickness or incapacity other than Cancer as defined; this is so even though such disease, Sickness or incapacity may have been complicated, affected (directly or indirectly) or caused by Cancer;
  2. loss that begins prior to the expiration of the Waiting Period;
  3. care and treatment, when the care and treatment has not been funded by the National Cancer Institute or when the care and treatment are not subjects of ongoing clinical studies by the United States Food and Drug Administration for the treatment of cancer.; or
  4. any illness specifically excluded from the definition of Cancer or Carcinoma in Situ.

WAITING PERIOD: If you are diagnosed with cancer within the first 30 days after the effective date of the Cancer Treatment policy, no benefits will be paid until such waiting period has expired.

Hospital and Intensive Care Unit Indemnity Benefit Rider and Intensive Care Unit Indemnity Benefit Rider

Benefits are only payable for the first 30 days for any one period of confinement.

Once you reach age 65, coverage will be reduced by 50%.

This Rider is subject to the following Exclusions and Limitations, in addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable under this Rider for Confinement or loss caused directly or indirectly by:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted Injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity or a felony;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  6. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant.  “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Injury occurred;
  7. Mental or emotional disorders, alcoholism and drug addiction;
  8. Treatment outside the United States except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure;
  9. Travel or activity outside the United States;
  10. Participation in any motorized race or contest of speed on sea, land or air;
  11. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  12. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  13. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  14. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration;
  15. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program;
  16. The following conditions if they are diagnosed within six (6) months after the Rider Effective Date unless Confinement is on an emergency basis: a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  17. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  18. An elective abortion;
  19. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with an Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Injury.  Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch; or
  20. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery.  Medically necessary reconstructive surgery is defined as:
  21. surgery as the result an Injury; or

a.    surgery to restore a normal bodily function; or
b.    surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or
c.    breast reconstruction following mastectomy.

Also, no benefits will be payable under this Rider for:

  1. Loss that begins prior to the Rider Effective Date;
  2. Treatment for which no charges are made by the provider of same;
  3. Services which are primarily for rest care, convalescent care or for rehabilitation; or
  4. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.



ACCIDENT EXPENSE POLICY

In addition to any benefit-specific conditions, limitations, or exclusions, benefits will not be paid for any Covered Accident and/or Covered Injury which, directly or indirectly, in whole or in part, is caused by or results from any of the following, unless coverage is specifically provided for by name in the applicable policy section:

  1. Suicide (while sane or insane), attempted suicide or intentionally self-inflicted injury;
  2. War or act of war (whether declared or undeclared);
  3. Commission or attempt to commit an illegal activity;
  4. Commission of or active participation in a riot, insurrection, rebellion or police action;
  5. Active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, We will refund any Premium paid during the Insured Person’s time of active duty. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) days;
  6. Voluntary self-administration of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
  7. Operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant. “Under the influence of alcohol”, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident or Covered Injury occurred;
  8. Mental or emotional disorders, alcoholism and drug addiction;
  9. Treatment outside the United States unless otherwise specified in the policy;
  10. Travel or activity outside the United States;
  11. Participation in any motorized race or contest of speed on sea, land or air;
  12. Travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;
  13. Intoxication as determined according to the laws of the jurisdiction in which the Covered Accident and/or Covered Injury occurred;
  14. Participation in any high risk activities such as bungee jumping, parachuting, skydiving, parasailing, hang-gliding, deep-sea scuba diving, parkour, free running, sail gliding, parakiting or any similar activity;
  15. Flight in, boarding, or alighting from an aircraft or any craft designed to fly above the Earth’s surface, except as a fare-paying passenger on a regular-scheduled commercial or charter airline;
  16. Medical mishap or negligence, including malpractice;
  17. Sickness, disease, bodily or mental infirmity bacterial or viral infection or any condition resulting from insect, arachnid or other arthropod bites or stings, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  18. Practicing for or participating in any semiprofessional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; or
  19. Operating a motor vehicle without a valid motor vehicle operator’s license, except while participating in a driver’s education program.

The following conditions, treatment and/or services are not covered in the Policy:

  1. Care, services or supplies received without charge or legal obligation to pay;
  2. Prescription and over-the-counter products, drugs or medicines, even if prescribed by a doctor; except as described in the policy;
  3. Cosmetic services, treatment that is not prescribed by a physician, or treatment, services and supplies for Experimental, Investigational or Unproven purposes;
  4. Dental treatment of the teeth, gums or structures directly supporting the teeth, including dental x-rays, examinations, repairs, orthodontics, periodontics, casts, splints and services for dental malocclusion, for any condition are not covered, except if provided for or in connection with a Covered Injury to sound natural teeth and a continuous course of dental treatment is started within six (6) months of the Covered Injury. Sound natural teeth are defined as natural teeth that are free of active clinical decay, have at least 50% bony support and are functional in the arch;
  5. Treatment or services from a masseur, massage therapist, or rolfer, massage therapy and any type of holistic therapy which include, but are not limited to, mediation, aromatherapy and relaxation therapy; or
  6. Repetitive or cumulative motions or stress traumas, which include, but are not limited to, carpal tunnel syndrome, tennis elbow, and thoracic outlet syndrome.

Catastrophic Accidental Injury Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable for:

  1. a Covered Loss that is not sustained throughout the Catastrophic Accident Waiting Period, as shown on the policy schedule page.

Vehicular Accidental Injury Cash Benefit Rider
In addition to the policy exclusions and limitations, no benefits will be payable:

  1. if the Insured Person was the driver, operator or passenger and was not wearing a helmet, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  2. if the Insured Person was the driver, operator or passenger and was not wearing a seatbelt, as required by the laws of the state in which the Covered Vehicular Accident occurred.
  3. for a Covered Vehicular Accident that occurs during the Vehicular Accidental Injury Cash Benefit Waiting Period, as shown on the Policy Schedule Page.
  4. for no more than one Vehicular Accidental Injury Cash Benefit Amount will be paid per the lifetime of each Insured Person.

Parent Benefit Rider and Declining Deductible Benefit Rider
The exclusions and limitations that apply to these riders are the same as the exclusions and limitations of the policy.


INDIVIDUAL WHOLE LIFE INSURANCE POLICY

Suicide
If the insured dies by suicide, while sane or insane, within two years from the policy effective date, our liability under this policy is limited to the premiums paid.

Incontestability

Except for non-payment of premiums or for fraud if permitted in the state where the policy is delivered or issued for delivery, this policy will be incontestable after in force for two years from the policy effective date. This provision does not apply to any rider that contains its own incontestability clause.

Terminal Illness Accelerated Benefit Rider

If the Insured dies after the claim is presented for a Terminal Illness Accelerated Benefit, but before any such benefits are received, the request is cancelled and the Death Benefit will be paid pursuant to the policy. We will not pay a benefit amount for any condition that is not diagnosed as a Terminal Illness. The diagnosis of a Terminal Illness must be confirmed by a physician practicing within the United States or its territories.

Accidental Death Benefit To Age 100 Rider


No Accidental Death Benefit will be payable if the Insured’s death results within 180 days directly or indirectly from any of these causes:

  1. Suicide: while the Insured is sane or insane.
  2. War: declared or undeclared, or any act of war. War is defined as armed conflict between nations, or between factions in the same nation.
  3. Military Service: in the military forces of any country at war or in any civilian noncombatant unit serving with those forces.
  4. Natural Causes: Bodily or mental illness, disease or infirmity of any kind, or medical or surgical treatment for any of these.
  5. Death caused or materially contributed to by voluntary intake or use by any means of any drug, unless prescribed or administered by a physician and taken in accordance with the physician’s instructions.
  6. Speed contest: Fatal Injury which is incurred as the result of taking part in any speed contest.
  7. Blood Alcohol: Death while the Insured is operating a motor vehicle and is determined to have a blood alcohol level exceeding the legal limit as defined by state law.
  8. Felony: Injury received while committing a felony or incarcerated.
  9. Participation in a riot, civil commotion, terrorist activity or rising against civil or governmental authority.