whole life insurance policy

Whole life insurance is a form of permanent insurance that provides lifetime insur-ance coverage at a level premium rate that does not increase as the insured ages. Thefollowing sample whole life insurance policy provides a $100,000 death benefit, and,as noted on the policy face page, is a participating policy that gives the policyownerthe right to share in the insurer’s divisible surplus by receiving policy dividends.

As you can see by the length of this policy compared to the length of the sampleone-year term life insurance policy, a whole life insurance policy is a much morecomplicated document than is a term life policy. The additional provisions includedin a whole life insurance policy are required to specify how the policy’s cash value willbuild-up and the policyowner’s rights in that cash value. Page 3, for example, includesa “Table of Guaranteed Values,” which lists the minimum guaranteed cash values atthe end of specified policy years. Other provisions also describe the policy’s cash valuefeatures, including the provisions on pages 7 and 8 under the heading “Cash Valueand Loans.” Additionally, many of the provisions on page 6 concerning “Premiums”are included to describe the options a policyowner has to stop paying policy premi-ums and to either receive the accumulated cash value or use that cash value to providecontinued insurance coverage.

Included along with the sample whole life insurance policy are five sample policyriders that may be attached to such a policy. The sample riders included here are asfollows:

An accidental death benefit (ADB) rider that provides a benefit if the insured’sdeath is caused by accidental bodily injury while the rider is in effect. (See page13.) The amount of the accidental death benefit provided is stated as $100,000

(continued on next page)

SampleWhole Life Insurance

Policy with Riders

on the policy data page. (See page 2.) The rider specifies a number of exclusionsfor which the ADB will not be payable and states that the rider has no cash valueor loan value.

A disability waiver of premium (WP) rider under which the insurer agrees towaive the payment of renewal premiums if the insured becomes totally disabled.(See pages 15 and 16.) The rider defines the term “total disability” and specifies anumber of disabilities that are excluded from coverage.

A policy purchase option (PPO) rider that gives the policyowner the right topurchase a new policy on the life of the insured on specified future option dates.(See pages 17 and 18.) The face amount of the new policy must be at least $10,000and may not be more than the option amount of $50,000 as specified on page 2.The new policy may be any life insurance or endowment insurance plan theinsurer is offering for the selected face amount on the specified option date. Thepremiums payable for the new policy will be based on the insured’s age and theinsurer’s premium rates on the option date.

An option to purchase paid-up additions (OPP) rider that gives the policyownerthe right to purchase new paid-up life insurance coverage on the insured. (Seepages 19-21.) Note that the coverage purchased under this rider is paid-up lifeinsurance that increases the amount of the death benefit payable under the policy.In addition, the paid-up additions purchased have a cash value and a loan value.By contrast, the coverage purchased under the aforementioned PPO rider is pro-vided by a separate policy, and the rider does not have a cash value or a loanvalue.

An acceleration of death benefits rider under which the insurer agrees to pay aspecified lump-sum amount, known as the accelerated death benefit, if the in-sured is terminally ill. (See pages 23-26.) In order to receive the accelerated deathbenefit, the insured must meet a number of requirements, including providingthe insurer with evidence that the insured has a life expectancy of 12 months orless as determined by a qualified physician. The rider specifies how the acceler-ated death benefit is calculated and guarantees that the benefit will never be lessthan a stated amount based on the amount of the policy cash value. The paymentof an accelerated death benefit reduces the amount of the benefit, if any, that willbe payable following the insured’s death.

Whole Life Insurance Policy with Riders L-27

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INSURED – JOHN DOE

POLICY NUMBER – 36 000 000

POLICY DATE – AUGUST 8, 1999

ABC Life Insurance Company123 Main Street, Anytown, USA

ABC Life Insurance Company will pay the benefits ofthis policy in accordance with its provisions. The pageswhich follow are also a part of this policy.

10 Day Right To Examine Policy. Please examine yourpolicy. Within 10 days after delivery, you can return itto ABC Life Insurance Company or to the agentthrough whom it was purchased, with a written re-quest for a full refund of premium. Upon such re-quest, the policy will be void from the start, and a fullpremium refund will be made.

Premiums. The premiums for this policy are shownin the Premium Schedule on the Policy Data page.They are payable in accordance with the Premiumssection.

This policy is executed as of the date of issue shownon the Policy Data page.

President

Secretary

Whole Life Policy.

Life Insurance Proceeds Payable at Insured’s Death.

Premiums Payable During Insured’s Lifetime,as shown on the Policy Data page.

Policy is Eligible for Dividends.

ABCLIFE

John Johnson

Mary Smith

L-28 LOMA’s Handbook of Insurance Policy Forms

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INSURED — JOHN DOE AGE 37 MALE

POLICY NUMBER — 36000000 CLASS OF RISK - STANDARD(NON-SMOKER DISCOUNT)

POLICY DATE — AUGUST 8, 1999 DATE OF ISSUEAUGUST 15,1999

OWNER — INSURED

PLAN WHOLE LIFE WITHOPTION TO PURCHASE PAID-UP ADDITIONS (OPP) ANDACCIDENTAL DEATH BENEFIT (ADB) ANDDISABILITY WAIVER OF PREMIUM (WP) ANDPOLICY PURCHASE OPTION (PPO) - OPTION AMOUNT IS $50,000.00 ANDACCELERATION OF DEATH BENEFITS

AMOUNT FACE AMOUNT $100,000.00ACCIDENTAL DEATH BENEFIT $100,000.00(ADB, WHEN PAYABLE, IS IN ADDITION TOANY OTHER INSURANCE BENEFIT)

BENEFICIARY(subject to change) FIRST - ESTATE OF THE INSURED

PREMIUM SCHEDULEPREMIUMS PAYABLE AT MONTHLY INTERVALS, AS FOLLOWS (SEE ENDORSEMENT HEREON)

(Premium includes the following amounts for any supplementary benefits)

BEGINNING AS OF TOTALMO. DAY YR. PREMIUM8- 8- 1999 $144.008- 8- 2008 $134.008- 8- 2027 $130.008- 8- 2032 $123.00 PAYABLE FOR REMAINDER OF INSURED’S LIFE.**

ADB WP PPO8- 8- 1999 $7.00 $5.50 $8.508- 8- 2008 $7.00 $4.008- 8- 2027 $7.008- 8- 2032

PREMIUM PAYING PERIOD MAY BE SHORTENED BY USING DIVIDEND VALUES TO MAKE POLICY FULLYPAID-UP.

THE EXPENSE CHARGE APPLIED TO ALL PAYMENTS MADE UNDER THE OPTION TO PURCHASE PAID-UPADDITIONS (OPP) RIDER WILL NOT EXCEED 3%.

THE INTEREST RATES, REFERRED TO IN THE BASIS OF COMPUTATION SECTION, ARE AS FOLLOWS:

A)6.25% PER YEAR FOR THE CALCULATION OF CASH VALUES, EXTENDED INSURANCE AND PAID-UPINSURANCE FOR THE FIRST 20 POLICY YEARS.

B) 5% PER YEAR FOR THE COMPUTATION OF ALL OTHER VALUES.

DIVIDENDS ARE NOT GUARANTEED. WE HAVE THE RIGHT TO CHANGE THE AMOUNT OF DIVIDENDS TO BE CREDITED TO THEPOLICY WHICH MAY RESULT IN LOWER DIVIDEND VALUES, OR, IF APPLICABLE, MORE PREMIUMS TO BE PAID, THAN WEREILLUSTRATED.

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TABLE OF GUARANTEED VALUES*

Alternatives to Cash Value

End of End ofPolicy Year Cash Value Paid-Up Insurance or Extended Insurance Policy Year

Years Days

1 ***** *** ** *** 12 ***** *** ** *** 23 $400.00 $2,400 1 18 34 1,400.00 7,900 3 114 45 2,400.00 12,900 5 62 56 3,500.00 17,900 6 328 67 4,500.00 22,000 8 55 78 5,600.00 26,200 9 109 89 6,800.00 30,400 10 121 9

10 8,000.00 34,300 11 50 1011 9,300.00 38,100 11 321 1112 11,000.00 43,200 12 325 1213 12,900.00 48,500 13 323 1314 14,800.00 53,300 14 239 1415 16,700.00 57,700 15 91 1516 18,700.00 61,900 15 287 1617 20,700.00 65,800 16 73 1718 22,700.00 69,300 16 187 1819 24,800.00 72,800 16 291 1920 26,900.00 75,900 16 358 20

AGE 60 32,300.00 69,400 14 319 AGE 60AGE 65 41,700.00 77,300 13 198 AGE 65

*This table assumes premiums have been paid to the end of the policy year shown. Thesevalues do not include any dividend accumulations, paid-up additions, or policy loans.

POLICY DATA ABC LIFE INSURANCE COMPANY

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WE & YOUIn this policy, the words “we,”“our” or “us” refer to ABC LifeInsurance Company, and thewords “you” or “your” refer tothe owner of this policy.

CONTENTS

POLICY DATA PAGES Policy Identification and Specifications; Table of GuaranteedValues / 2–3

LIFE INSURANCE PROCEEDS Life Insurance Proceeds I 5

POLICY OWNERSHIP Owner; Successor Owner; Change of Ownership I 5

BENEFICIARY Naming of Beneficiary; Change of Beneficiary; Death ofBeneficiary / 5

PREMIUMS Payment of Premiums; Grace Period; Nonpayment of Premium;Options Upon Lapse; Reinstatement; Premium Adjustment atDeath / 6–7

CASH VALUE AND LOANS Cash Value; Loan Value; Loan Interest; Loan Interest Rate;Automatic Premium Loan (APL); Loan Repayment; WhenUnpaid Loan Exceeds Loan Value / 7–8

DIVIDENDS Annual Dividend; Dividend Options; Automatic DividendOption; Dividend Values; Fully Paid-up Policy; Dividend atDeath / 9

PAYMENT OF POLICY PROCEEDS Payment; Election of Optional Method of Payment; Change ofOption; Payees; Minimum Payment; Options lAand lB. Proceedsat Interest; Options 2A and 2B. Elected Income; Options 3A, 3Band 3C. Life Income / 9–11

GENERAL PROVISIONS Entire Contract; Application; Incontestability; Suicide Exclusion;Dates; Age and Sex; Policy Changes; Assignment; ProtectionAgainst Creditors; Payments to Company; Basis of Computation;Conformity with Law; Voting Rights / 12

APPLICATION Attached to the Policy.

RIDERS OR ENDORSEMENTS (IF ANY) Attached to the Policy.

Note: This policy is a legal contract between the policyowner and the Company.

READ YOUR POLICY CAREFULLY FOR FULL DETAILS.

When you write to us, pleaseinclude the policy number, theInsured’s full name, and yourcurrent address.

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LIFE INSURANCE PROCEEDS

Life Insurance Proceeds We will pay the life insur-ance proceeds to the beneficiary promptly when wehave proof that the Insured died, if premiums havebeen paid as called for in the Premiums section.These proceeds will include the face amount and

POLICY OWNERSHIP

Owner In this policy, the words “you” and “your”refer to the owner of this policy. As the owner, youhave all rights of ownership in this policy while theInsured is living. To exercise these rights, you do notneed the consent of any successor owner or beneficiary.

Successor Owner A successor owner can be namedin the application, or in a notice you sign which givesus the facts that we need. The successor owner willbecome the new owner when you die, if you diebefore the Insured. If no successor owner survivesyou and you die before the Insured, your estate be-comes the new owner.

Change of Ownership You can change the owner

BENEFICIARY

Naming of Beneficiary One or more beneficiariesfor any life insurance proceeds can be named in theapplication, or in a notice you sign which gives usthe facts that we need. If more than one beneficiaryis named, they can be classed as first, second, andso on. If 2 or more are named in a class, their sharesin the proceeds can be stated.

The stated shares of the proceeds will be paid to anyfirst beneficiaries who survive the Insured. If no firstbeneficiaries survive, payment will be made to anybeneficiary surviving in the second class, and so on.Beneficiaries who survive in the same class have anequal share in the proceeds, unless the shares arestated otherwise.

Change of Beneficiary While the Insured is living,you can change a beneficiary in a notice you sign

any other benefits from riders or dividends whichare payable because of the Insured’s death, all asstated in the policy. When we determine these pro-ceeds, there may be an adjustment for the last pre-mium. We will deduct any unpaid loan.

of this policy, from yourself to a new owner, in anotice you sign which gives us the facts that we need.When this change takes effect, all rights of owner-ship in this policy will pass to the new owner.

When we record a change of owner or successorowner, these changes will take effect as of the dateyou signed the notice, subject to any payment wemade or action we took before recording thesechanges. We may require that these changes beendorsed in the policy. Changing the owner ornaming a new successor owner cancels any priorchoice of successor owner, but does not change thebeneficiary.

which gives us the facts that we need. When werecord a change, it will take effect as of the date yousigned the notice, subject to any payment we madeor action we took before recording the change.

Death of Beneficiary If no beneficiary for the lifeinsurance proceeds, or for a stated share, survivesthe Insured, the right to these proceeds or this sharewill pass to you. If you are the Insured, this right willpass to your estate. Unless stated otherwise in thepolicy or in your signed notice which is in effect atthe Insured’s death, if any beneficiary dies at the sametime as the Insured, or within 15 days after the In-sured but before we receive proof of the Insured’sdeath, we will pay the proceeds as though that ben-eficiary died first.

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PREMIUMS

Payment of Premiums Each premium is payable,while the Insured is living, on or before its due dateas shown in the Premium Schedule on the PolicyData page. Premiums are payable at our Home Of-fice or at one of our service offices.

The premium for this policy can be paid at intervalsof 3 months or 6 months, or once each year. Themethod we use to determine the premium rate foreach of these intervals is the method that was in ef-fect as of the policy date shown on the Policy Datapage. The interval can be changed by paying thecorrect premium for the new interval. Premiums canbe paid by any other method we make available.

Grace Period We allow 31 days from the due datefor payment of a premium. All insurance coveragecontinues during this grace period.

Nonpayment of Premium If a premium is not paidby the end of the grace period, this policy will lapse.All insurance will end at the time of lapse, if the policyhas no cash value and no dividend values. If thepolicy has cash value or dividend values, insurancecan be continued only as stated in Options 1 or 2 ofthe Options Upon Lapse provision, but any insur-ance or benefits from riders or dividends will end atthe time of lapse.

Options Upon Lapse If the policy has cash value ordividend values at the time of lapse, it will continueas extended insurance, if available. It may happenthat the amount of extended insurance would beless than or equal to the amount of paid-up insur-ance available, or the Table of Guaranteed Valueson the Policy Data page shows that extended insur-ance is not available. In these cases, the policy willcontinue under the paid-up insurance option instead.

Instead of extended insurance, paid-up insurancecan be elected or you can surrender the policy forcash. The paid-up insurance option can be electedin the application or in your signed notice. We mustreceive this notice no later than 3 months after thedue date of the overdue premium.

1. Extended Insurance Extended insurance islevel term insurance for which no more premiumsare due. It is payable to the beneficiary when we

have proof that the Insured died after the end of thegrace period and before the end of the term period.The amount of extended insurance will equal theface amount of this policy, plus the amount of anypaid-up additions and dividend accumulations, lessany unpaid loan. No insurance or benefits from rid-ers or dividends will be provided after the end of thegrace period.

We calculate the term period as of the due date ofthe overdue premium. We do this by applying thesum of the cash value and dividend values, less anyunpaid loan, at the net single premium rate for terminsurance for the Insured’s age on that date. The termperiod is measured from that due date.

This insurance can be surrendered at any time for itscash value, but it has no loan value and is not eligiblefor dividends. All insurance will end when you sendus your signed request for the cash value proceeds.

2.Paid-up Insurance Paid-up life insurance be-gins as of the date we record your notice electing it,or begins at the end of the grace period if later. Nomore premiums are due for this insurance. It is pay-able to the beneficiary when we have proof that theInsured died while this paid-up insurance option wasin effect.

We calculate the amount of paid-up insurance as ofthe due date of the overdue premium. We do thisby applying the sum of the cash value and dividendvalues, less any unpaid loan, at the net single pre-mium rate for the Insured’s age on that date. In mostcases, this amount will be less than the face amountof this policy. No insurance or benefits from riderswill be provided after this paid-up insurance optiongoes into effect.

This insurance can be surrendered at any time. Ithas cash value and loan value, and is eligible for divi-dends. All insurance will end when you send us yoursigned request for the cash value proceeds.

3. Surrender for Cash Instead of extended insur-ance or paid-up insurance, you can surrender thispolicy for its cash value and dividend values, lessany unpaid loan, as stated in the Cash Value provi-sion. All insurance will end when you send us yoursigned request for the cash value proceeds.

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PREMIUMS (continued)

Reinstatement Within 5 years after lapse, you mayapply to reinstate the policy if you have not surren-dered it. We must have evidence of insurability thatis acceptable to us. All overdue premiums must bepaid, with interest at 6% per year from each of theirdue dates, unless we declare a policy loan interestrate of less than 6%. In that case, the interest rate forall overdue premiums at the time of reinstatementwill be the same as the policy loan interest rate, butnot more than 6%. Any unpaid loan, and any loandeducted when we determined the extended orpaid-up insurance, must also be repaid. Interest onthe loan will be compounded once each year andwill be based on the loan interest rate or rates thatwere in effect since the time of lapse.

CASH VALUE AND LOANS

Cash Value Cash values for this policy at the end ofselected policy years are as shown in the Table ofGuaranteed Values on the Policy Data page, if pre-miums have been paid as called for in the Premiumssection. These values do not include dividend val-ues, and they do not reflect any unpaid loan. Cashvalues at other times depend on the date to whichpremiums have been paid, and on how much timehas passed since the last policy anniversary. Whenyou ask us, we will tell you how much cash valuethere is.

The cash value on the due date of an unpaid pre-mium will not decrease during the 3 months after thatdate. Also, the cash value of any extended or paid-upinsurance on a policy anniversary will not decreaseduring the next 31 days after that anniversary.

At any time after the policy has cash value or divi-dend values, you can surrender it for the sum of thesevalues, less any unpaid loan. All insurance will endwhen you send us your signed request for these sur-render proceeds.

We may defer paying these proceeds for up to 6months after the date of surrender. Interest will bepaid from the date of surrender on any paymentdeferred more than 10 days. We set the interest rateeach year. This rate will be at least 3.5% per year orthe rate required by law.

Loan Value You can borrow any amount up to theloan value, using this policy as sole security.

All or part of these payments can be charged as anew unpaid loan if there is enough loan value.

We do not need evidence of insurability if we re-ceive the required payment within 31 days after theend of the grace period, but the Insured must beliving when we receive it.

Premium Adjustment at Death We will increase thelife insurance proceeds by any part of a premiumpaid for the period after the policy month in whichthe Insured dies.

If the Insured dies during a grace period, we willreduce the proceeds by an amount equal to the pre-mium for one policy month.

On a policy anniversary, on a premium due date, orduring the grace period, the loan value is the cashvalue, plus any dividend values, less any unpaid loanand accrued interest. At any other time, the loanvalue is the amount which, with interest, will equalthe loan value on the next anniversary or on the nextpremium due date, if earlier. Extended insurance hasno loan value.

We may require that you sign a loan agreement. Wemay defer a loan, except to pay a premium due usfor this policy, for as long as 6 months after we re-ceive your loan request. Interest will be paid on anyamount deferred if that amount is not mailed within10 days after we receive the necessary informationto complete the loan transaction. We will set the in-terest rate to be at least 3.5% per year or the raterequired by law.

Loan Interest Loan interest accrues each day. Inter-est is due on each anniversary, or on the date ofdeath, surrender, a lapse, a loan increase or loan re-payment, or on any other date we specify. Interestnot paid when due becomes part of the loan andwill also bear interest.

Loan Interest Rate The loan interest rate for thispolicy may go up or down as described in this provi-sion. However, the rate at any given time will applyto the entire amount of an unpaid loan. We will re-view this rate once every 3 months and, if necessary,adjust it.

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CASH VALUE AND LOANS (continued)

The loan interest rate will not be more than theMonthly Average Corporates yield shown in Moody’sCorporate Bond Yield Averages published byMoody’s Investors Services, Inc., or any successor tothat service (the published monthly average), for thesecond calendar month prior to the date when weset an interest rate for this policy. If the rate, at thistime, as determined by the published monthly aver-age, is 0.5% or more above the current loan interestrate, we have the right to increase the loan interestrate to reflect this. However if the rate, at this time,as determined by the published monthly average, is0.5% or more below the current loan interest rate,we will reduce the loan interest rate to reflect this.The loan interest rate will never be less than the in-terest rate shown on the Policy Data page plus 1%.

We will tell you the interest rate in effect when aloan, including an Automatic Premium Loan (APL),is made and when we send you notice of loan inter-est due. If a loan is outstanding 40 days or morebefore the effective date of an increase in the inter-est rate, we will notify you of that increase at least30 days prior to its effective date. We will notify youof any increase in the interest rate when a loan ismade during the 40 days before the effective dateof the increase.

It may happen that the published monthly averageceases to be published. In this case, we will use anew basis approved by the insurance supervisoryofficial of the state or district in which the policy isdelivered.

Automatic Premium Loan (APL) If elected, APL pro-vides an automatic loan which pays an overdue pre-mium at the end of the grace period, subject to 2conditions. First, the loan value must be enough topay that premium.

Second, if premiums have been paid by APL for 2years in a row, the next premium will not be paid byAPL. After a premium is paid other than by APL,before the end of the grace period, premiums canagain be paid by APL.

APL can be elected in the application. You can alsoelect APL in your signed notice which we must re-ceive before the end of the grace period. You cancancel this election for future premiums by telling usin your signed notice.

Loan Repayment All or part of an unpaid loan andaccrued interest can be repaid before the Insured’sdeath or before you surrender the policy. We willdeduct any unpaid loan when policy proceeds arepayable.

If the policy is being continued as extended or paid-up insurance, any loan which we deducted in deter-mining that insurance may be repaid only if the policyis reinstated. If that loan is not repaid, we will notdeduct it again when policy proceeds are payable.

When Unpaid Loan Exceeds Loan Value In a givenpolicy year it may happen that an unpaid loan andaccrued interest will exceed the sum of the cash valueand any dividend values. In this case, we will mail anotice to you at your last known address, and a copyto any assignee on our records. All insurance willend 31 days after the date on which we mail thatnotice, if the excess of the unpaid loan and accruedinterest over the sum of the cash value and any divi-dend values is not paid within that 31 days.

We will not terminate this policy in a given policyyear as the sole result of a change in the loan interestrate during that policy year.

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DIVIDENDS

Annual Dividend While this policy is in force, exceptas extended insurance, it is eligible to share in ourdivisible surplus. Each year we determine the policy’sshare, if any. This share is payable as a dividend onthe policy anniversary, if all premiums due beforethen have been paid. We do not expect a dividendto be payable before the second anniversary.

Dividend Options Each dividend can be appliedunder one of the 4 options listed below. An optioncan be elected in the application. You can also elector change the option for future dividends if you tellus in your signed notice.

1. Paid-up Addition Applied to provide paid-uplife insurance at the net single premium rate for theInsured’s age at that time. No more premiums aredue for this insurance. It has cash value and is eli-gible for dividends. Before the Insured’s death, youcan surrender paid-up additions for their cash valuethat has not been borrowed against. The amount ofthis insurance in force at the Insured’s death will bepart of the life insurance proceeds.

2. Dividend Accumulation Left with us toaccumulate at interest. On each policy anniversary,we credit interest at the rate we set each year. Thisrate will be at least 3.5% per year. Before the Insured’sdeath, you can withdraw accumulations that havenot been borrowed against, with interest to the dateof withdrawal. Any accumulations which we still haveat the Insured’s death will be part of the life insur-ance proceeds.

PAYMENT OF POLICY PROCEEDS

Payment We will pay the life insurance proceeds inone sum or, if elected, all or part of these proceedsmay be placed under one or more of the optionsdescribed in this section. If we agree, the proceedsmay be placed under some other method of pay-ment instead.

Any life insurance proceeds paid in one sum willbear interest compounded each year from theInsured’s death to the date of payment. We set theinterest rate each year. This rate will be at least 3.5%per year, and will not be less than required by law.

3.Premium Payment Applied toward paymentof a premium, provided any balance of that premiumis also paid when due. Any part of the dividend notneeded to pay the premium will be used to pay anyloan interest due, unless you have asked to have thatpart paid in cash. Any part of the dividend not usedto pay a premium or loan interest will be paid in cash.

4.Cash Paid in cash.

Automatic Dividend Option If no other option is ineffect when a dividend becomes payable, we willapply it as a paid-up addition. If we pay a dividendin cash, and the dividend check is not cashed withinone year after that dividend became payable, wewill apply the dividend as a paid-up addition instead.

Dividend Values Dividend values are any dividendaccumulations plus the cash value of any paid-upadditions.

Fully Paid-up Policy You may shorten the premiumpaying period for this policy by having it made fullypaid-up with no more premiums due. This may bedone on any premium due date, if the sum of thecash value and dividend values equals the total singlepremium for the policy and any riders, based on theInsured’s age on that date. We must receive yoursigned notice within 31 days of that date.

Dividend at Death The part of any annual dividendearned from the last policy anniversary to the end ofthe policy month in which the Insured dies will bepart of the life insurance proceeds.

Election of Optional Method of Payment While theInsured is living, you can elect or change an option.You can also name or change one or more benefi-ciaries for the life insurance proceeds who will bethe payee or payees under that option.

After the Insured dies, any person who is to receiveproceeds in one sum (other than an assignee) canelect an option and name payees. The person whoelects an option can also name one or more succes-sor payees to receive any unpaid amount we have atthe death of a payee. Naming these payees cancelsany prior choice of successor payee.

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PAYMENT OF POLICY PROCEEDS (continued)

A payee who did not elect the option does not havethe right to advance or assign payments, take thepayments in one sum, or make any other change.However, the payee may be given the right to doone or more of these things if the person who electsthe option tells us in writing and we agree.

Change of Option If we agree, a payee who electsOption 1A, 1B, 2A or 2B may later elect to have anyunpaid amount we still have, or the present value ofany elected payments, placed under some otheroption described in this section.

Payees Only individuals who are to receive paymentsin their own behalf may be named as payees or suc-cessor payees, unless we agree to some other payee.We may require proof of the age or the survival of apayee.

It may happen that when the last surviving payeedies, we still have an unpaid amount, or there aresome payments which remain to be made. If so, wewill pay the unpaid amount with interest to the dateof payment, or pay the present value of the remain-ing payments, to that payee’s estate in one sum. Thepresent value of any remaining payments is basedon the interest rate used to compute them, and isalways less than their sum.

Minimum Payment When any payment under anoption would be less than $20, we may pay anyunpaid amount or present value in one sum.

Options 1 A and 1 B. Proceeds at Interest

The policy proceeds may be left with us at interest.We set the interest rate each year. This rate will be atleast 3.5% per year.

1A. Interest Accumulation

We credit interest each year on the amount we stillhave. This amount can be withdrawn at any time insums of $100 or more. We pay interest to the dateof withdrawal on sums withdrawn.

1B. Interest Payment

We pay interest once each month, every 3 monthsor every 6 months, or once each year, as chosen,based on the amount we still have.

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Options 2A and 2B. Elected Income

We make equal payments once each month, every3 months or every 6 months, or once each year, aschosen, for an elected period of years or for anelected amount. We set the interest rate for theseoptions each year. This rate will be at least 3.5% peryear. If the rate is more than 3.5%, we will increaseeach payment to reflect this.

2A.Income for Elected Period

We make the payments for the number of yearselected. Monthly payments based on 3.5% interestare shown in the Option 2A Table.

OPTION 2A TABLEMinimum Monthly Payment per $1,000 of ProceedsYears Years Years Years1 $84.65 5 $18.12 9 $10.75 15 $7.102 43.05 6 15.35 10 9.83 20 5.753 29.19 7 13.38 11 9.09 25 4.964 22.27 8 11.90 12 8.46 30 4.45

When asked, we will state in writing what each pay-ment would be, if made every 3 months or every 6months, or once each year.

2B.Income of Elected Amount

We make payments of the elected amount until allproceeds and interest have been paid. The total pay-ments made each year must be at least 5% of the pro-ceeds placed under this option. Each year we creditinterest of at least 3.5% on the amount we still have.

Options 3A, 3B, and 3C. Life Income

We make equal payments each month during thelifetime of the named payee or payees. We deter-mine the amount of the monthly payment by apply-ing the policy proceeds to purchase a correspondingsingle premium life annuity policy which is being is-sued when the first payment is due. Payments arebased on the appropriately adjusted annuity pre-mium rate in effect at that time, but will not be lessthan the corresponding minimum amount based onthe tables for Options 3A, 3B, and 3C in this policy.The minimum amounts are based on the “1983Table a” mortality table with projection, and withinterest compounded each year at 4%.


GAT111

PAYMENT OF POLICY PROCEEDS (continued)

When asked, we will state in writing what the minimumamount of each monthly payment would be underthese options. It is based on the sex and the adjustedage of the payee or payees in the year the first paymentis due. To find the adjusted age, we increase or decreasethe payee’s age at that time, as follows:

1987–91 1992–98 1999–2006 2007–2013 2014–20 2021–28 2029++3 +2 +1 0 –1 –2 –3

3A. Life Income–Guaranteed Period

We make a payment each month during the lifetimeof the payee. Payments do not change, and are guar-anteed for 5, 10, 15, or 20 years, as chosen, even ifthat payee dies sooner.

OPTION 3A TABLEMinimum Monthly Payment per $1,000 of ProceedsPayee’s MALE FEMALEAdjusted Guaranteed Period Guaranteed PeriodAge 5 Yrs 10 Yrs 15 Yrs 20 Yrs 5 Yrs 10 Yrs 15 Yrs 20 Yrs

60 $5.14 $5.08 $4.98 $4.84 $4.68 $4.85 $4.61 $4.54

61 5.25 5.18 5.07 4.91 4.76 4.73 4.68 4.63

62 5.36 5.28 5.15 4.97 4.84 4.81 4.75 4.67

63 5.48 5.39 5.24 5.04 4.93 4.89 4.83 4.73

64 5.61 5.50 5.33 5.10 5.03 4.99 4.91 4.80

65 5.75 5.62 5.42 5.17 5.13 5.08 5.00 4.87

66 5.89 5.75 5.52 5.23 5.25 5.19 5.09 4.94

67 6.05 5.88 5.62 5.30 5.36 5.30 5.18 5.01

68 6.21 6.02 5.72 5.36 5.49 5.41 5.28 5.08

69 6.39 6.16 5.82 5.42 5.63 5.54 5.38 5.16

70 6.57 6.31 5.92 5.48 5.78 5.67 5.48 5.23

71 6.77 6.46 6.02 5.54 5.94 5.81 5.59 5.30

72 6.97 6.62 6.13 5.60 6.11 5.95 5.70 5.37

73 7.19 6.78 6.23 5.65 6.29 6.11 5.81 5.44

74 7.42 6.95 6.33 5.69 6.49 6.27 5.93 5.50

75 7.66 7.12 6.42 5.74 6.70 6.44 6.04 5.58

76 7.91 7.29 6.52 5.78 6.92 6.61 6.15 5.62

77 8.18 7.46 6.60 5.81 7.16 6.80 6.27 5.67

78 8.47 7.84 6.69 5.84 7.42 6.98 6.37 5.72

79 8.77 7.82 6.77 5.87 7.69 7.18 6.48 5.76

80 9.08 8.00 6.84 5.90 7.98 7.37 6.58 5.80

81 9.41 8.17 6.91 5.92 8.29 7.57 6.67 5.84

82 9.74 8.34 6.97 5.94 8.62 7.77 6.75 5.87

83 10.10 8.51 7.03 5.95 8.96 7.97 6.83 5.89

84 10.46 8.67 7.08 5.96 9.33 8.16 6.91 5.92

85 10.84 8.82 7.13 5.97 9.71 8.34 6.97 5.94& over

3B.Life Income–Guaranteed Total Amount

We make a payment each month during the lifetimeof the payee. Payments do not change, and are guar-anteed until the total amount paid equals the amountplaced under this option, even if that payee dies sooner.

OPTION 3B TABLEMinimum Monthly Payment per $1,000 of ProceedsPayee’s Payee’sAdjusted AdjustedAge Male Female Age Male Female60 $4.93 $4.57 73 $6.47 $5.87

61 5.02 4.64 74 6.84 6.01

62 5.11 4.71 75 6.81 6.17

63 5.20 4.79 76 7.00 6.34

64 5.30 4.87 77 7.19 6.51

65 5.40 4.96 78 7.40 6.70

66 5.52 5.05 79 7.62 6.90

67 5.63 5.14 80 7.85 7.11

68 5.75 5.25 81 8.09 7.33

69 5.88 5.36 82 8.35 7.57

70 6.02 5.47 83 8.61 7.81

71 6.16 5.60 84 8.89 8.07

72 6.31 5.73 85&over 9.19 8.35

3C. Life Income–Joint and Survivor

We make a payment each month while both or one ofthe two payees are living. Payments do not change,and are guaranteed for 10 years, even if both payeesdie sooner.

OPTION 3C TABLE10 YEAR GUARANTEED PERIOD

Minimum Monthly Payment per $1,000 of ProceedsMale Payee’s Female Payee’s Adjusted AgeAdjusted Age 60 65 70 75 8060 $4.32 $4.50 $4.67 $4.82 $4.93

65 4.42 4.66 4.91 5.15 5.34

70 4.81 4.81 5.14 5.49 5.80

75 4.57 4.92 5.34 5.81 6.27

80 4.61 4.99 5.49 6.07 6.69

Page 11


GAT111

GENERAL PROVISIONS

Entire Contract The entire contract consists of thispolicy, any attached riders or endorsements and theattached copy of the application. Only our Chair-man, President, Secretary, or one of our Vice Presi-dents can change the contract, and then only in writ-ing. No change will be made in the contract withoutyour consent. No agent is authorized to change thiscontract.

Application In issuing this policy, we have relied onthe statements made in the application. All suchstatements are deemed to be representations andnot warranties. We assume these statements are trueand complete to the best of the knowledge and be-lief of those who made them.

No statement made in connection with the applica-tion will be used by us to void the policy or to denya claim unless that statement is a material misrepre-sentation and is part of the application.

Incontestability We will not contest this policy afterit has been in force during the lifetime of the In-sured for 2 years from the date of issue.

Please refer to the Incontestability of Rider provi-sion that may be in any rider or riders attached tothis policy.

Suicide Exclusion Suicide of the Insured within oneyear of the date of issue, is not covered by this policy.In that event, this policy will end and the only amountpayable will be the premiums paid to us, less anyunpaid loan. (SEE ENDORSEMENT HEREON)

Dates Policy years, months, and anniversaries aremeasured from the policy date.

Age and Sex In this policy when we refer to a person’sage on any date, we mean his or her age on thebirthday which is nearest that date. If a date on thePolicy Data page is based on an age that is not cor-rect, we may change the date to reflect the correctage.

If the age or sex of an insured person is not correctas stated, any amount payable under this policy willbe what the premiums paid would have purchasedat the correct age and sex.

Policy Changes If we agree, you may have ridersadded to this policy, or have it changed to anotherplan or to a smaller amount of insurance.

Assignment While the Insured is living, you can as-sign this policy or any interest in it. If you do this,your interest, and anyone else’s is subject to that of

the assignee. As owner, you still have the rights ofownership that have not been assigned.

An assignee may not change the owner or thebeneficiary, and may not elect or change an optionalmethod of payment of proceeds. Any policy pro-ceeds payable to the assignee will be paid in onesum.

We must have a copy of any assignment. We will notbe responsible for the validity of an assignment. Itwill be subject to any payment we make or otheraction we take before we record it.

Protection Against Creditors Except as stated in theAssignment provision, payments we make under thispolicy are, to the extent the law permits, exemptfrom the claims, attachments, or levies of anycreditors.

Payments to Company Any payment made to us bycheck or money order must be payable to ABC LifeInsurance Company. When asked, we will give acounter-signed receipt, signed by our President orSecretary, for any premium paid to us.

Basis of Computation All cash values and net singlepremium rates referred to in this policy are based onthe 1980 CSO Tables of Mortality. All extended in-surance rates and cash values are based on the cor-responding 1980 CET Insurance Tables. The interestrate is shown on the Policy Data page. Continuousfunctions are used.

At the end of each policy year not shown in the Tableon the Policy Data page, the cash value is the re-serve based on the Commissioner’s Reserve Valua-tion Method. At any time, the cash value of any ex-tended or paid-up insurance or paid-up additions isthe reserve on each of these.

We have filed a statement with the insurance officialin the state or district in which this policy is deliv-ered. It describes, in detail, the method we used tocompute these cash values. Each value is at least asmuch as the law requires.

Conformity with Law This policy is subject to all lawswhich apply.

Voting Rights Each year there is an election of per-sons to our Board of Directors. You have the right tovote in person or by mail if your policy is in force,and has been in force for at least one year after thedate of issue. To find out more about this, write tothe Secretary at our Home Office, 100 OrdinaryAvenue, New York, New York 00000.

Page 12


RIDER

ACCIDENTAL DEATH BENEFIT (ADB)

Benefit We will pay this benefit to the beneficiarywhen we have proof that the Insured’s death wascaused directly, and apart from any other cause, byaccidental bodily injury, and that death occurredwithin one year after that injury and while this riderwas in effect.

When Benefit Not Payable We will not pay thisbenefit if death is caused or is contributed to by anyof these items.

1. Disease or infirmity of mind or body.

2. Suicide.

3. Travel in or descent from an aircraft, if the In-sured at any time during the aircraft’s flight actedin any role other than as a passenger.

4. Any kind of war, declared or not, or by any actincident to a war or to an armed conflict involv-ing the armed forces of one or more countries.

We will not pay this benefit if the Insured dies priorto his or her first birthday, or dies after the anniver-sary on which he or she is age 70.

Values This rider does not have cash or loan values.

Contract This rider, when paid for, is made a part ofthe policy, based on the application for the rider.

Incontestability of Rider We will not contest thisrider after it has been in force during the lifetime ofthe Insured for 2 years from its date of issue.

Dates and Amounts When this rider is issued at thesame time as the policy, we show the amount of ADBand the rider premium amount on the front page ofthe policy. The rider and the policy have the samedate of issue.

When this rider is added to a policy which is alreadyin force, we also put in an add-on rider. The add-onrider shows the date of issue and the amount of ADB.The rider premium amount is shown in a new Pre-mium Schedule for the policy.

When Rider Ends You can cancel this rider as of thedue date of a premium. To do this, you must sendthe policy and your signed notice to us within 31days of that date. If this rider is still in effect on theanniversary on which the Insured is age 70, it willend on that date.

This rider ends if the policy ends or is surrendered.Also, this rider will not be in effect if the policy lapsesor is in force as extended or paid-up insurance.

When this rider is part of an endowment policy, therider will end on the day just before the endowmentdate, and will not be in effect if that date is deferred.

ABC LIFE INSURANCE COMPANY

Secretary President

GAR011 Page 13

Mary Smith John Johnson


THIS PAGE INTENTIONALLY LEFT BLANK

GAR011 Page 14


RIDER

DISABILITY WAIVER OF PREMIUM (WP)

Waiver of Premiums We will start to waive the pre-miums for this policy when proof is furnished thatthe Insured’s total disability, as defined in this rider,has gone on for at least 6 months in a row.

If a total disability starts on or prior to the anniver-sary on which the Insured is age 60, we will waiveall of the premiums which fall due during that totaldisability. If it goes on until the anniversary on whichthe Insured is age 65, we will make the policy fullypaid-up as of that date, with no more premiums due.

If a total disability starts after the anniversary on whichthe Insured is age 60, we will waive only those pre-miums which fall due during that total disability, andprior to the anniversary on which the Insured is age65.

Premiums are waived at the interval of payment ineffect when the total disability started. While wewaive premiums, all insurance goes on as if they hadbeen paid. We will not deduct a waived premiumfrom the policy proceeds.

Definition of Total Disability “Total Disability”means that, because of disease or bodily injury, theInsured can not do any of the essential acts and du-ties of his or her job, or of any other job for which heor she is suited based on schooling, training, or ex-perience. If the Insured can do some but not all ofthese acts and duties, disability is not total and pre-miums will not be waived. If the Insured is a minorand is required by law to go to school, “Total Dis-ability” means that, because of disease or bodily in-jury, he or she is not able to go to school.

“Total Disability” also means the Insured’s total loss,starting while this rider is in effect, of the sight ofboth eyes or the use of both hands, both feet, orone hand and one foot.

Total Disabilities For Which Premiums Not WaivedWe will not waive premiums in connection with anyof these total disabilities.

1. Those that start prior to the fifth birthday ofthe Insured, or start at a time when this rider isnot in effect.

2. Those that are caused by an injury that is self-inflicted on purpose.

3. Those that are caused by any kind of war, de-clared or not, or by any act incident to a waror to an armed conflict involving the armedforces of one or more countries while the In-sured is a member of those armed forces.

Proof of Total Disability Written notice and proofof this condition must be given to us, while the In-sured is living and totally disabled, or as soon as itcan reasonably be done. As long as we waive premi-ums, we may require proof from time to time. Afterwe have waived premiums for 2 years in a row, wewill not need to have this proof more than once eachyear. As part of the proof, we may have the Insuredexamined by doctors we approve.

Payment of Premiums Premiums must be paid whendue, until we approve a claim under this rider. If atotal disability starts during a grace period, the over-due premium must be paid before we will approveany claim.

Refund of Premiums If a total disability starts after apremium has been paid, and if it goes on for at least6 months in a row, we will refund the part of thatpremium paid for the period after the policy monthwhen that disability started. Any other premium paidand then waived will be refunded in full.

GAR012 Page 15


DISABILITY WAIVER OF PREMIUM (WP)

(continued)



Incontestability of Rider We have no right to con-test this rider after it has been in force during thelifetime of the Insured for 2 years from its date ofissue, unless the Insured is totally disabled at sometime within 2 years of the date of issue.

Dates and Amounts When this rider is issued at thesame time as the policy, we show the rider premiumamount on the front page of the policy. The riderand the policy have the same date of issue.

When this rider is added to a policy which is alreadyin force, we also put in an add-on rider. The add-onrider shows the date of issue. The rider premiumamount is shown in a new Premium Schedule forthe policy.

When Rider Ends You can cancel this rider as of thedue date of a premium. To do this, you must sendthe policy and your signed notice to us within 31days of that date. If this rider is still in effect on theanniversary on which the Insured is age 65, it willend on that date.

This rider ends if the policy ends or is surrendered.Also, this rider will not be in effect if the policy lapsesor is in force as extended or paid-up insurance.


Secretary President

GAR012 Page 16



RIDER

POLICY PURCHASE OPTION (PPO)

Benefit The Owner can purchase a new policy onthe Insured on each Scheduled Option Date or Spe-cial Option Date, without proof of insurability. Thenew policy will take effect as of the option date, withpremiums based on the Insured’s age and theCompany’s premium rates on that date. The faceamount of the new policy may not be less than$10,000 or more than the Option Amount of therider, except when a larger amount can be purchasedon a Special Option Date.

During the 3 months prior to a Special Option Date,the Company provides term insurance on the In-sured. The amount of this insurance is equal to thelargest face amount of the new policy that can bepurchased under this rider on that date.

Scheduled Option Dates The Scheduled OptionDates are the anniversaries on which the Insured isage 22, 25, 28, 31, 34, 37, 40, 43, and 46, and onwhich this rider is in effect. No new policy can bepurchased on any Scheduled Option Date which hasbeen cancelled by a prior Special Option Date pur-chase.

Special Option Dates A Special Option Date is thedate 3 months after any of the events listed below.

1. The marriage of the Insured.2. The birth of a living child to the Insured.3. The legal adoption of a child by the Insured.

This rider must be in effect on the date the mar-riage, birth, or adoption takes place. Proof accept-able to the Company, that the event took place, maybe required.

Each purchase of a new policy as of a Special Op-tion Date cancels the next available Scheduled Op-tion Date, except where 2 or more children are bornor adopted on the same date. In this case, an amountof insurance can be purchased which equals theOption Amount times the number of these children.

The number of Scheduled Option Dates cancelledby this amount of purchase is equal to the numberof these children.

Savings Allowance The Company provides a sav-ings allowance when a new policy is purchased. Theamount of this allowance is on file with the insur-ance official in the state or district in which the policyis delivered. This allowance is used to reduce pre-miums that are due during the first policy year of thenew policy. At the time of purchase, the Companywill tell the Owner how much the total allowance isfor the new policy.

Purchase of Policy The Owner’s application for thenew policy must also be signed by the Insured. Theapplication and the first premium for the new policy,less the savings allowance, may be submifted to theCompany during the 60 days before or the 31 daysafter the option date. However, these must be re-ceived by the Company while the Insured is living.

On an option date, if the Owner does not have aninsurable interest in the life of the Insured that isacceptable to the Company, the Insured may pur-chase the new policy instead.

If the Insured dies prior to the option date, any newpolicy which has been applied for will not take ef-fect, and the Company will refund any premium paidfor it.

New Policy The new policy may be on any life, term-life, or endowment plan offered on the option date,for the face amount being purchased.

The new policy may not be on a plan which pro-vides only term insurance or provides an increasingamount of insurance. It will have the same provi-sions and be subject to the same limitations on theCompany’s liability as are generally in the seriesof policies being issued on that date. The Insured’sclass of risk will be the same as it was for the rider.

GAR013 Page 17


POLICY PURCHASE OPTION (PPO)

(continued)

However, if this rider was issued with a policy in apreferred risk class, the new policy will be on a pre-ferred risk basis only if it meets the Company’s mini-mum amount and age limits for that class.

The time periods of the new policy, which relate toa suicide exclusion or to a contest of that policy, willstart on the date of issue of this rider. However, insome cases the new policy may be issued with a rideror an additional amount of insurance which theOwner requested, and which required theCompany’s agreement. If this happens, the timeperiods for that rider or amount will start instead onthe date of issue of the new policy.

Availability of Riders A waiver of premium rider canbe made a part of the new policy if one is in effectunder this policy on an option date. However, if theInsured has recovered from a total disability that hadgone on for at least 6 months in a row, that rider canonly be in a new policy for which premiums are pay-able for the rest of the Insured’s life.

An accidental death benefit rider can be made a partof the new policy if one is in effect under this policyon an option date. The amount of that rider may notbe more than the face amount of the new policy.

No other riders can be made a part of the new policy,unless the Company agrees.

Waiver of Premiums for New Policy If, on an op-tion date, this policy has a waiver of premium riderin effect, and if the Insured is totally disabled and allconditions for waiver of premiums in that rider havebeen met, the Company will waive the premiums

for the new policy which fall due during that disabil-ity. The new policy must be on a plan with premi-ums payable for the rest of the Insured’s life, andwith the same premium interval as this policy.



Incontestability of Rider The Company will not con-test this rider after it has been in force during thelifetime of the Insured for 2 years from its date ofissue.

Dates and Amounts When this rider is issued at thesame time as the policy, the Company shows theOption Amount and the rider premium amount onthe front page of the policy. The rider and the policyhave the same date of issue.

When this rider is added to a policy which is alreadyin force, the Company also puts in an add-on rider.The add-on rider shows the date of issue and theOption Amount. The rider premium amount is shownin a new Premium Schedule for the policy.

When Rider Ends The Owner can cancel this rideras of the due date of a premium. To do this, thepolicy and the Owner’s signed notice must be sentto the Company within 31 days of that date. If thisrider is still in effect on the anniversary on which theInsured is age 46, it will end on that date.

This rider ends if the policy ends or is surrendered.Also, this rider will not be in effect if the policy lapsesor is in force as extended or reduced paid-upinsurance.


Secretary President

GAR013 Page 18



RIDER

OPTION TO PURCHASE PAID-UP ADDITIONS (OPP)

Benefit This rider provides you with the right to pur-chase new paid-up life insurance on the Insured. Anypaid-up life insurance purchased under this rider isa paid-up addition, and no more premiums are duefor this insurance. The amount of this insurance inforce at the Insured’s death will be part of the lifeinsurance proceeds of the policy to which this rideris attached.

However, if the policy lapses or is surrendered, thevalues of any paid-up insurance under this rider willbe included in the determination of any proceedsunder the Options Upon Lapse provision in thepolicy.

Scheduled Payments Payments made on a sched-uled basis must be received by us while the Insuredis living and within 31 days of each of their due dates.Upon receipt of a scheduled payment, the new in-surance will take effect as of its due date. If a sched-uled payment is not received within 31 days of itsdue date, payments can no longer be made on ascheduled basis, unless we agree. However, this riderwill remain in force, and unscheduled payments canstill be made.

It may happen that you make a scheduled paymentwhich is less than the scheduled amount. If this oc-curs, the amount of any subsequent scheduled pay-ments cannot exceed that reduced payment, unlesssatisfactory evidence of insurability is furnished.However, we will not require this evidence of insur-ability if the total of all payments made during thepolicy year do not exceed the limitations stated inthe What Insurance May be Purchased provision.

Unscheduled Payments Unscheduled paymentsmay be made from time to time under this rider, butmust be received while the Insured is living. Uponreceipt of an unscheduled payment, the new insur-ance will take effect as of the date we receive thepayment.

What Insurance May Be Purchased The amount ofthe payments made each year to purchase the newinsurance is in addition to the premium payable forthe policy. The amount of paid-up additions pur-chased by each payment is based on the net singlepremium rate for the Insured’s age as of the most

recent policy anniversary. Prior to the purchase ofany insurance, all payments made under this riderare subject to an expense charge shown on the policydata page of the policy. Any payments made morethan 31 days after a policy anniversary are subject toa reduction based on the amount of time since theanniversary and an interest rate which we set at thebeginning of each calendar year. For the calendaryear 1993, the rate is 9.5%. In each subsequent year,the rate will be equal to the Monthly AverageCorporates yield shown in the Moody’s InvestorsServices, Inc. or any successor to that service (thepublished monthly average), for the month of Octo-ber of the prior calendar year. It may happen thatthe published monthly average ceases to be pub-lished. In this case, we will use a new basis approvedby the insurance supervisory official in the state ordistrict in which the policy is delivered. This reduc-tion is in addition to the expense charge.

Unless we agree otherwise, the total of all paymentsin any given policy year cannot be more than 100%of the annual premium amount for the basic plan ofinsurance (excluding premiums for any riders andexcluding the policy fee), based on a standard classof risk. In addition, unless we agree otherwise, eachunscheduled payment or the total of all scheduledpayments in a policy year must be at least $100, butin no event can a single scheduled payment be lessthan $10. Additional payments can be made fromtime to time, subject to the Excess Purchases provi-sion of this rider. No insurance may be purchasedunder this rider after it ends, or while it is not ineffect.

Waiver of Premium Benefit Not Applicable Sched-uled payments for this rider will not be included inany amount being waived under any rider providingwaiver of premiums in case of total disability. As longas premiums continue to be waived under any waiverrider, any insurance under this rider will continue,but no scheduled or unscheduled payments will beaccepted to purchase new paid-up insurance.

Values The paid-up insurance under this rider hascash value and loan value, and is eligible for divi-dends. Cash values and net single premiums arebased on the 1980 CSO Tables of Mortality (the male

GAR014 Page 19



(continued)

table if the Insured is a male or the female table ifthe Insured is a female). Continuous functions areused. Interest is compounded at 4%. During thepolicy year in which a payment is made under thisrider, the cash value of paid-up insurance purchasedby that payment will be limited to the amount ofthat payment.

Reinstatement If this rider is reinstated, new paid-up insurance can be purchased only as of a datewhich is on or after the date of the reinstatement.Evidence of insurability acceptable to us will be re-quired with any such reinstatement.

Contract This rider is made a part of the policy, basedon the application for the rider.

Incontestability We will not contest this rider, or anynew insurance which does not exceed the limita-tions specified in this rider, after the rider has beenin force during the lifetime of the Insured for 2 yearsfrom its date of issue.

We will not contest any excess amount of paid-upinsurance purchased in accordance with the ExcessPurchases provision of this rider, for which we re-quired evidence of insurability, after such insurancehas been in force for 2 years from the date of pur-chase.

Suicide Exclusion Suicide of the Insured within 2years of the date of issue of this rider, is not coveredby this rider. In that event, this rider will end and theonly amount payable will be all payments madeunder this rider, less any unpaid loan.

Excess Purchases You can make a payment underthis rider which exceeds the limits stated in the rider,if we agree. Satisfactory evidence of insurability maybe required for the excess amount of insurance. Theapplication used to apply for this excess amount of

insurance will be attached to and made a part of thepolicy. The excess amount of insurance will be sub-ject to the Incontestability and Suicide Exclusion pro-visions of this rider beginning as of the date that in-surance is purchased.

Dates This rider and the policy have the same dateof issue, unless the rider is added to a policy whichis already in force. In this case, the date of issue ofthis rider is shown in an add-on rider which we putin the policy.

When Rider Ends You can cancel this rider as of anydate. To do this, a signed notice must be sent to uswithin 31 days of that date.

This rider ends when no premium for paid-up insur-ance is paid by the second anniversary or for 3 anni-versaries in a row, unless premiums for the policyare being waived on account of total disability. Anypaid-up insurance in force when this rider ends willcontinue, if the policy continues, but no new insur-ance can be purchased unless this rider is reinstated.It may happen that the policy to which this rider isattached also includes a Dividend Option Term(DOT) rider. In this event, if this rider has ended forany of the reasons mentioned in this paragraph, thisrider will automatically be restored after the fifth yearthe DOT rider has been in effect.

This rider will not be in effect if the policy is in forceas paid-up insurance. In this case, the in force paid-up insurance under this rider will continue, exceptthat the amount may be reduced to offset any out-standing policy loan.

Also, this rider will not be in effect if the policy is inforce as extended insurance or if the policy lapses,ends or is surrendered.

GAR014 Page 20



(continued)

Table of Cash Values(per $1,000 of paid-up life insurance in force at attained age indicated)

ATTAINEDAGE

CASHM VALUE1 $ 872 903 924 955 986 1017 1048 1089 111

10 11511 11912 12313 12714 13115 13516 14017 14418 14819 15220 15721 16222 16623 17124 17725 18226 18827 19428 20029 20730 21431 22132 22833 236

ATTAINEDAGE

CASHM VALUE34 $ 24435 25236 26137 26938 27839 28840 29741 30742 31743 32744 33745 34846 35947 37048 38149 39350 40551 41752 42953 44254 45555 46856 48157 49458 50759 52160 53461 54862 56263 57664 59065 60466 61767 631

ATTAINEDAGE

CASHM VALUE68 $ 64569 65970 67371 68672 70073 71374 72675 73976 75177 76378 77479 78680 79781 80882 81883 82884 83885 84786 85687 86488 87289 88090 88791 89592 90393 91194 92095 93196 94397 95398 97099 986

100 1,000

ATTAINEDAGE

CASHF VALUE1 $ 722 743 764 795 816 847 868 899 92

10 9511 9812 10113 10514 10815 11216 11617 11918 12319 12720 13221 13622 14023 14524 15025 15526 16027 16528 17129 17730 18331 18932 19533 202

ATTAINEDAGE

CASHF VALUE34 $ 20935 21636 22337 23038 23839 24640 25441 26242 27143 28044 28945 29846 30747 31748 32649 33750 34751 35752 36853 37954 39155 40256 41457 42658 43859 45160 46461 47762 49163 50564 51965 53366 54867 563

ATTAINEDAGE

CASHF VALUE68 $ 57769 59270 60871 62372 63973 65474 67075 68576 70177 71578 73079 74580 75981 77382 78683 80084 81285 82586 83687 84788 85889 86890 87891 88892 89893 90894 91895 92996 94197 95398 97299 986

100 1,000


By Mary SmithSecretary

John JohnsonPresident

GAR014 Page 21


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ACCELERATION OF DEATH BENEFITS

This rider is attached to and is a part of the entire policy. Please read carefully.

NOTICE: The benefits paid under this rider may effect eligibility for Medicaid or other public assistanceprograms. The benefits paid may be taxable. If so, you or your beneficiary may incur a tax obligation. Aswith all tax matters you should consult your personal tax advisor to access the impact of this benefit.

The benefit paid under this rider will reduce the death benefit or amount due upon the death of theinsured and other values in your policy.

This rider is non-participating.

DEFINITIONS

“Eligible amount” is the total of the following:

1. the Specified Amount, if death benefit Option 1 is in effect; or

2. the Specified Amount plus the cash value, if death benefit Option 2 is in effect.

“Accelerated amount” is the portion of the eligible amount you request:

1. The accelerated amount may not be more than the lesser of:

(a) 75% of the eligible amount; or(b) $250,000.

2. The accelerated amount may never be less than $10,000.

“Accelerated death benefit” is the amount we pay under this rider. This amount is the accelerated amountadjusted for the following:

1. An interest discount factor will be applied to the accelerated amount based on the insured’sreduced life expectancy not to exceed 12 months. The interest rate will be the rate used by usand will not exceed the rate charged on policy loans.

2. Future monthly deductions corresponding to the accelerated amount are based on the insured’slife expectancy.

3. A portion or any outstanding policy loan balance will be deducted. The portion will be theoutstanding policy loan balance multiplied by the ratio of the accelerated amount to the eligibleamount.

4. The administrative fee in use by us on the date we receive your written request to pay anaccelerated benefit. The administrative fee will not exceed $500.00.

However, the accelerated death benefit will never be less than the cash surrender value of the policy, if any,multiplied by the ratio of the accelerated amount to the eligible amount.

The “effective date” is the Policy Date unless a later date is shown for this rider in the Policy Data.

The “insured” is the primary insured named in the Policy Data.

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“Qualified Physician” is a person who is duly qualified, legally licensed in the United States and practicingwithin the scope of the license who is:

1. a physician or surgeon practicing medicine and surgery, and authorized to and uses the designa-tion MD (Doctor of Medicine); or

2. a physician of osteopathy who uses the designation D.O. (Doctor of Osteopathy).

A qualified physician must be someone other than you or the insured, or a spouse, or step or adoptive ornatural brother, sister, parent, grandparent, mother-in-law, father-in-law, or child of yours or the insured’sor insured’s spouse.

“You, your” is the Owner of this policy.

“We”, us” is ABC Life Insurance Company.

“Terminally ill” means having a life expectancy of 12 months or less as determined by a Qualified Physician.

BENEFIT

Subject to the provisions of this rider and the policy, we will pay the accelerated death benefit to you if theinsured is terminally ill. The eligible amount is determined as of the date we pay the accelerated deathbenefit.

EFFECT ON POLICY

If an accelerated death benefit is pard under this rider, the policy will stay in force according to the policyprovisions. The following will be reduced in the same proportion as the ratio of the accelerated amount tothe eligible amount:

1. the Specified Amount;2. the policy fund;3. the table of future surrender charges;4. the minimum monthly premium.

The outstanding policy loan balance will be reduced by the portion deducted from the accelerated amountas described in the Definitions section of this rider.

A new Policy Data page showing the accelerated benefit payment will be issued and become part of thepolicy.

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GENERAL PROVISIONS AND CONDITIONSYour right to be paid under this rider is subject to the following:

1. You must submit a written request for the accelerated amount.

2. The accelerated amount is requested while the policy and this rider are in force.

3. The accelerated amount is requested after the incontestability period of the policy.

4. You provide evidence that satisfies us in a written statement signed by a qualified physician that:

(a) the insured is terminally ill; and(b) the insured’s life expectancy is not more than 12 months due to the severity and nature of the

terminal illness; and(c) the diagnosis of the terminal illness was made after the effective date of this rider.

5. We receive consent that the benefit may be paid to you from any irrevocable beneficiary or as-signee.

6. The policy must not be assigned except to us as security for a loan.

7. The main purpose of life insurance is to meet your estate planning needs. This rider provides for theaccelerated payment of life insurance proceeds. It is not meant to cause you to involuntarily invadeproceeds ultimately payable to the named beneficiary. Accelerated death benefits will be madeavailable to you on a voluntary basis only. Therefore, you are not eligible for the benefit providedby this rider if you are required:

(a) by law to use this option to meet the claims of creditors, whether in bankruptcy or otherwise; or

(b) by a government agency to use this option in order to apply for, obtain, or keep a governmentbenefit or entitlement.

8. We have the right to have the insured examined at our expense by a physician we choose.

9. This rider does not apply if the insured’s illness is the result of an attempt to commit suicide, whileany policy suicide exclusion provision is in effect.

10. The payment provided by this rider will be made only once under this policy.

11. The payment will be made in one lump sum to you. The total accelerated amounts under allpolicies issued by The ABC Life Insurance Company or its subsidiaries or affiliates on the life of theinsured will not exceed $250,000.

12. If the death of the insured occurs before approval of the benefit or before the approved benefit ispaid, no benefit will be payable under this rider. Our liability will discharged to the extent of anypayment made or action taken prior to receipt of proof of the death of the insured.

13. This rider is subject to the terms of the policy incontestability provision.

14. This rider is subject to all the conditions and provisions of the policy, except as otherwise providedin this rider.

15. Only the insured under the base policy is covered by this rider. No coverage is provided for anyother person covered by riders attached to the base policy.

16. Any refund of premiums payable as a result of the insured’s suicide will not include the premiumsfor any accelerated amount paid under this rider.

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TERMINATION

This rider will terminate if and when any of the following takes place:

1. the policy terminates; or2. the policy lapses at the end of the Grace Period; or3. a benefit is paid under this rider; or4. we receive a written request to cancel this rider.

THE ABC LIFE INSURANCE COMPANY

Secretary

President

Mary Smith

John Johnson

GAR015 Page 26

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