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On Ordinary Life and Endowment policies the extra rate for the Double Indemnity Benefit Benefit is $1.25 per $1000.

CHICAGO, ILL.

Began business October 21, 1908; stock company; issues non-participating policies only.

Extracts Annual Statement

Year Ending December 31, 1921

Admitted assets..

Outstanding insurance.

Dis. and D. I. premiums received....
Dis. and D. I. benefits paid.

Dis. and D. I. reserve..

$801,300

7,177,693

52

Total and Permanent Disability Benefit: Monthly Income. Premium Waiver

(Rider attached)

If the Company shall receive due proof that the Insured has become Totally and Permanently Disabled, as hereinafter defined, before the anniversary hereof nearest the sixtieth anniversary of the Insured's birthday and while this policy is in force, except while it is in force under a surrender benefit following default in the payment of a premium, provided such disability has at the time of the receipt of such proof existed for not less than sixty days, then

(1)

The Company will waive the payment of each premium as it may thereafter become payable under the policy, and in addition (2) The Company will pay to the Insured a monthly income of 1% of the face amount of the policy, the first payment being due six months after receipt of proof of such disability, and subsequent payments on the tenth of each succeeding month during the continuance of such disability.

The premiums waived and the monthly payments made shall not be deducted in any settlement and the loan and surrender values shall increase though the premiums were paid in cash.

as

Disability of the Insured within the meaning of this policy shall exist if the Insured, as the result of accident or disense, shall become totally, permanently and incurably disabled so as to be continuously prevented thereby from engaging in any

all gainful occupations. The permanent and complete loss of the sight of both eyes, or the loss by severance of both hands at or above the wrists, or of both feet at or above the ankles, or such loss of one entire hand and foot, shall constitute total and permanent disability within the meaning of this policy. It is specifically provided that no benefits shall accrue hereunder on account of disability incurred as a result of or while engaging in military service in time of war hereafter occurring.

The Company shall be furnished, upon demand but not oftener than once a year, proof of the continuance of such disability. If such proof is not furnished or if it shall appear that such disability

has ceased to exist, no further premiums will b waived and no further income payments will b made.

th

The premium for the disability benefit, in amoun $... is included in the premium on policy. On the anniversary of this policy neares the sixtieth anniversary of the Insured's birthda the premium on this policy will be reduced by the above amount.

Double Indemnity Benefit
(Rider attached)

The Company will pay double the face amount of this policy to the beneficiary thereof upon its surrender accompanied by due proof of the interes of the claimant and proof that the death of the Insured occurred during the premium paying period. and before attaining the age of sixty, in direct consequence of bodily injury effected solely through external, violent and accidental means, and that such death occurred within ninety days after such injuries were sustained; provided that no premiur is due and unpaid or has been waived under any disability provision and that this policy is ther in full force.

or

This supplemental agreement to pay an increased amount does not cover self-destruction, sane insane; death resulting from participation in aero nautic or submarine expeditions; death caused di rectly or indirectly by war, riot or insurrection or any act incident thereto; death resulting from any violation of law or from military, naval or police service of any kind; or death resulting directly or indirectly from bodily or mental infirmity, sur stroke, poisons, ptomaines, or bacterial infection other than that occurring simultaneously or in consequence of any accidental wound.

with

The premium for the double indemnity benefit, f amount $2.00 per $1,000, is included in the premium for this policy and shall cease when the Insured attains age sixty, all subsequent premiums being reduced by such amount.

Disability and Double Indemnity Benefits issued on all policies except Term, between ages 15 to 55 on male lives.

Double Indemnity issued on female lives.

Illustration Extra Annual Premiums per $1000

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Extra annual premium for Double Indemnity

Benefit is, $2.00 per $1,000.

FRANKFORT, IND,

Began business in 1906; stock company April 4, 1910; issues non-participating policies only.

Extracts Annual Statement

Year Ending December 31, 1921

Admitted assets.....

Outstanding insurance.

Dis. and D. I. premiums received.
Dis. and D. I. benefits paid..
Dis. and D. I. reserve..

$2,173,844

22,352,116

5,432

2,195

2,209

Total and Permanent Disability Provision No. 1

Should the Insured furnish satisfactory proof to the Company, after this policy has been in force one year and the second premium paid hereon, that he or she, prior to attaining the age of sixty years, has become permanently and totally disabled from pursuing any gainful occupation, the Company agrees to pay all premiums for for the Insured thereafter. But should the insured so far recover as to be able to engage in any gainful occupation, then the obligation on the part of the Insured shall be resumed to pay all future premiums, but prior to this time the Cash, Loan and Surrender values shall increase in the same manner as if the premiums were paid by the Insured.

Or, should the Insured become permanently and totally disabled from any cause as above, the Company will agree by an Endorsement hereon, to pay to the Insured one year from the receipt of satisfactory proof of such disability, one-tenth of the face of this policy in cash, and the same. amount on each anniversary of said date, thereafter, until ten such instalments shall have been paid, which shall be in full of all claims under this policy. Should the Insured so far recover as to be able to engage in any gainful occupation. then the obligation on the part of the Insured shall be resumed to pay all future premiums and the instalments already paid shall stand as a lien against this policy, without interest, until paid by the insured or deducted from any settlement under this policy. In the event of the death of the Insured, before receiving all of the instalments herein provided, the remaining instalments shall be paid in the same manner to the beneficiary named herein.

If the Insured with or without the permission of the Company, engages in Military or Naval Service in time of War the disability provisions hereunder shall be of no effect thereafter at any time. Notwithstanding proofs of disability may have been accepted by the Company as satisfactory, the Insured shall at any time upon demand furnish the Company satisfactory proof of the continuance of such disability

and if the Insured shall fail so to do, or if shall appear to the Company that the Insured able to engage in any gainful occupation, then the Company's obligation to pay premiums or insta ments shall cease as herein provided. No proof disability shall be deemed satisfactory until fo months after the disability has occurred.

This supplementary agreement is issued in co sideration of the payment of an annual premium d Twenty-five cents per Thousand of Insurance during the premium paying period of said policy, and prior to age sixty, said premium is included i and is subject to the regular premium paymen provisions of said policy.

The Insured may, at any time, upon writte request to the Company, accompanied by s policy for endorsement, discontinue this provisin and the payment of the additional premium there for. Default in the payment of the premi under said policy, including said additional pre mium will automatically void this agreement an all rights secured thereby.

Total and Permanent Disability Provision No.

In Event of the permanent and total disabili of the Insured under the attached policy, occurring before age Sixty, the company will pay for the Insured the Premiums required thereon, and wil pay to the Insured a Monthly Income of $10 per $1,000 during said Disability, subject to the follow ing terms and conditions:

Whenever the Company receives due proof that the Insured, prior to attaining the age of years, has become permanently and totally dis abled, in the meaning of the term as hereinafter defined, the Company,

(a) Commencing with the anniversary of the Policy next succeeding the receipt of said proof. will on each anniversary waive payment of the premium for the ensuing insurance year, and i addition thereto,

(b) Beginning six months after the anniver sary of this policy next succeeding the receipt of such proof will pay an annuity of Ten Dollar a month for each One Thousand Dollars Insurance hereunder, during the lifetime and continued dis ability of the Insured.

The provision for benefits on account of total and permanent disability shall become null and vold, if on default in the payment of any premium or instalment thereof, or if paid-up insur ance or extended insurance has been been granted: or during any time, if any, in which the Insured is engaged in Military or Naval service in time of war, or in an aeronautic or submarine expedi tion within two years from date hereof.

If the total and permanent disability referred to is from causes other than the entire and irre

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