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Double Indemnity for Fatal Accident as Described

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If the death of the insured occurs before the first anniversary of date of the policy which follows the age of seventy years, all premiums previously due having been paid, and such death results directly and independently of all other causes from bodily injuries effected solely through external, violent and accidental means within ninety days from the occurrence of such accident, and if such accident is evidenced by a visible contusion or wound on the exterior of the body (except in case of drowning and internal injuries revealed by an autopsy), and if such death does not result from suicide, while sane or insane, nor from military or naval service in time of war, nor

from an aeronautic flight or submarine descent, nor directly or indirectly from disease in any form, then the Company will pay a sum equal to the sum described in the policy as the sum insured in addition thereto.

The above provision for double indemnity may be annulled upon written request, and the return of the policy for proper endorsement.

(3)

.35

Illustration Extra Annual Premiums Per $1,000
Age

25

35 Kind of Policy

Dis. Dis.

Dis. Dis.

(1) (3) (1)
Com'l. Ord. Life...

$.25
$1.36 $.45

$2.17 Com'l. 20 Pay Life..

.25
1.46

2.04
Endt. at age 85:
Cont. Payt...

25 1.34 .45 2.13 10 Payt..

.25 2.19 .35 3.04 15 Payt..

.25 1.70 .35 2.36 20 Payt..

.25 1.46

2.04 10 Yr. Endow..

.25

.35 1.38 15 Yr. Endow.

.25 .91 .35 1.50 20 Yr. Endow.

25 .96 .35 1.67

.35

.89

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Age

45 Kind of Policy

Dis. Dis.

(1) (3)
Com'l. Ord. Life.... $1.00 $3.71
Com'l. 20 Pay Life... .50 2.78
Endt. at age 85:
Cont. Payt.

1.00 3.60
10 Payt..

.50 3.89 16 Payt.

.50

3.09 20 Payt.

.50 2.78 10 Yr. Endow.

.50 2.70 15 Yr. Endow.

.50 3.22 20 Yr. Endow.

.50 2.88

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OF AMERICA.-Continued

General Provisions.-The provision for disability benefits shall immediately terminate either (a) it the written request of the Insured for cancellation thereof be received at the Home Office of the Com. pany, together with the policy for endorsement, or, (b) if the insured shall voluntarily or involuntarily engage in military or naval service in time of war, or in work as a civilian in any capacity whatever in connection with actual warfare.

In addition to or independently of all other cases of total and permanent disability, the Company will consider the entire and irrecoverable loss of the sight of both eyes or the severance of both hands at or above the wrists, or of both feet at or above the ankles, or of one entire hand and one entire foot at or above the wrist and ankle, respectively, as total and permanent disability within the meaning of this provision.

Double Indemnity. It is hereby agreed that during the premium paying period of this policy and excluding time while the same may be in force as continued insurance, all premiums having been duly paid, and this policy being then in force, in the event of the death resulting from bodily injury, sustained and effected directly through external, violent and accidental means (murder or suicide, sane or insane, not included) exclusively and independently of all other causes, provided such death shall

within ninety (90) days from the date of the accident, the Company will pay the beneficiary or beneficiaries hereunder, in addition to the amount otherwise due, under this Policy, the sum of dollars...

This agreement, to pay an increased amount in the event of death from bodily injury, does not cover death resulting from participation in aeronautics or submarine expeditions; death caused di. rectly or indirectly, wholly or partly, by war, riot, or insurrection, or any act incident thereto, either on land or water; death resulting from any violation of law or from military or naval service of any kind, or from police duty in any military, naval or police organization; or death resulting directly or indirectly from bodily or mental infirmity, ptomaines, or bacterial infections other than infection occurring simultaneously with or in consequence of an accidental cut or wound.

The insurance under this Double Indemnity Rider shall not cover any person under the age of fifteen (15) years nor over the age of sixty (60) years. Any premium paid to the Company for any period not covered by this Double Indemnity Rider will be returned upon request.

occur

OF AMERICA.-Continuod

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Illustration Extra Annual Premiums per $1000
Age

25 35 45 65 Kind of Policy

Disability Benefits Ordinary Life...... $.81 $1.25 $2.07 $3.98 20 Pay. Life.. 1.12 1.36 2.06 4.03 20 Year Endow..... 1.12 1.36 2.06 4.03

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Limits—No fixed maximum: will retain only $5000.

-8 11

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BIRMINGHAM, ALA.

Began business April 28, 1908; stock company; issues guaranteed dividend and non-participating policies.

Extracts Annual Statement

Year Ending December 31, 1921 Admitted assets

$1,293,432 Outstanding insurance

8,516,398 Dis. and D. I. premiums received

726 Dis. and D. I. benefits paid

135 Dis. and D. I. reserve

1,636

Total and Permanent Disability

(Clause "A")

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After two full premiums shall have been paid and before a default in the payment of any subsequent premiums, if the Insured prior to attaining the age of sixty shall furnish satisfactory proof that physically he has become wholly disabled by the loss of limbs, total blindness or paralysis, and will be permanently, continuously and wholly prevented thereby from pursuing any and all gainful occupations, the Company, at the end of six months from acceptance of such proofs, by an endorsement in writing upon this contract, will agree

that it will advance to the Insured, account of this policy, annually one-tenth of the amount insured hereunder, less the premiums due, during such disability, until the amount insured, less premiums due, and other indebtedness. is paid in full. If, however, the Insured shall recover, the annual advance shall cease and the advances already made may be returned in cash

remain charges against this policy, subject to the Table of Loans and Guaranteed Surrender Values herein, During disability claim, the Insured shall submit at any time to examination by the Company's physician.

No extra premium charged for the above.

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Double Indemnity and Total and Permanent Dis

ability Benefits

(Rider attached) Double Indemnity for Accidental Death Alabama National

Life Insurance Company agrees to pay

Dollars (double the original amount of the policy) in lieu of all other benefits under the policy, to the beneficiary, if, before the Insured attains the age of sixty, and during the premium paying period of the policy and before default in the payment of any premium, the death of the Insured shall, within ninety days from the

occurrence of such injury, result from bodily injury (except in case of self-destruction whether the Insured be sane or insane)

-Continued

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of any

provided such death result directly and independently of all other causes, effected solely through external, violent and accidental means, not

intentionally inflicted by another person or by the Insured himself, of all of which affirmative proof must be furnished to the Company, along with this policy duly discharged: and

Disability Life Income

(Clause "B") To pay Ten Dollars per month to the Insured if, Vefore he attains the age of sixty and after the expiration of the period covered by the first full annual premium, and before default in the payment

annual premium, he shall furnish proof satisfactory to the Company of his total and perma nent disability as defined and limited below and that such disability has then existed for not less than 60 days. The Life Income shall be payable during the lifetime and the continuance of such disability of the Insured, commencing one year after the anniversary of the policy next succeeding the receipt of due proof of such disability: and

Waiver of Premium To waive payment of any premiums which may fall due so long as the disability life income continues to be payable.

The Company's liability for double indemnity for accidental death shall cease on the due date of the first premium so waived in respect of accidents occurring on or after said date.

Such Income Payments and waiver of premiums shall not reduce the original amount of the policy in any settlement, and the guaranteed values in the policy shall be the same as if such waived premiums had been paid in cash as they fell due.

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Disability Defined
Total and
permanent disability shall

be construed to mean physical and incurable disablement by bodily injury (not resulting from actual or attempted violation of law, nor self-inflicted) or disease originating after delivery of this contract. so that the Insured is and will be thereby permanently. continuously and wholly prevented from engaging not only in his usual occupation, but also in any and every other occupation whatsoever, and from performing work of every kind for compensation of any kind whatsoever.

Recovery The Company may at any time and from time i to time demand due proof of the continuance of such disability, and that the Insured submit to an examination by a physician or physicians se

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