EX-99.(D)(6) 7 a22-6648_1ex99dd6.htm EX-99.(D)(6)

Exhibit 99.(d)(6)

 

American United Life Insurance Company®

[One American Square

Indianapolis, IN  46206]

(Hereafter, referred to as “AUL”, “Company” or “We”)

 

ACCELERATED DEATH BENEFIT FOR CHRONIC ILLNESS RIDER

 

To inquire or to obtain information about coverage or for assistance in resolving complaints, You may contact the Company at: [800-437-4692] or at [www.oneamerica.com].

 

This Rider is attached to and made a part of Your policy.  This Rider is effective as of its Policy Date.  The Policy Date of the Rider is the same as the Policy Date of the policy to which it is attached unless otherwise stated on the Rider Data Page. This Rider will not change, waive or extend any part of the policy, other than as stated herein. This Rider’s provisions shall control where there is a conflict between this Rider and the policy.

 

BENEFIT

 

Subject to the terms of this Rider, upon receipt of the Owner’s written request and due proof, AUL will advance a portion of the Death Benefit as a lump sum to the Owner when the Insured has been certified as Chronically Ill as defined in this Rider, and the conditions described in this Rider are met.

 

DISCLOSURES

 

·                  This Rider provides for the accelerated payment of life insurance Death Benefit Proceeds.  This is not meant to cause the Owner to involuntarily access Death Benefit Proceeds ultimately intended to be payable to the designated beneficiary.  An Accelerated Death Benefit payment will be made available to the Owner on a voluntary basis only.  Therefore, the Owner is not eligible to receive an Accelerated Death Benefit payment if he/she is:

 

·                  Required by law to use this payment to meet the claims of any creditor(s), whether in bankruptcy or not; or

 

·                  Required by a government agency to use this payment in order to apply for, obtain, or keep Medicaid benefits or any other government benefit or entitlement.

 

·                  Although the payments made under this Rider are intended to qualify for favorable tax treatment under section 101(g) of the Federal Internal Revenue Code of 1986, as amended, payments made under this Rider may be taxable.  This Rider is not intended to be a qualified long-term care insurance contract under section 7702B(b). The Owner should consult a competent tax adviser to determine the current tax consequences before requesting any accelerated proceeds.

 

·                  The Cash Value, loan value and Death Benefit payable under the policy will

 

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be reduced by any lien outstanding due to the payment of an Accelerated Death Benefit under this Rider.

 

DEFINITIONS

 

Additional terms not defined in this section, or elsewhere in this Rider, are explained in the base policy.

 

Accelerated Death Benefit.  The prepayment(s) of a portion of the Death Benefit to the Owner when the conditions described in this Rider are met. This prepayment reduces the Death Benefit otherwise payable under the life insurance policy.

 

Activities of Daily Living (ADL).  There are six (6) basic functional abilities which measure the Insured’s ability for self care and ability to live independently without Substantial Assistance from another individual. They are:

 

1.                    Bathing: The Insured’s ability to wash himself or herself by sponge bath, or in either a tub or shower, including the task of getting into or out of the tub or shower.

 

2.                    Continence:  The Insured’s ability to maintain control of bowel and bladder function.  Additionally, when unable to maintain control of bowel and bladder function, the ability to perform associated personal hygiene (including caring for a catheter or colostomy bag).

 

3.                    Dressing: The Insured’s ability to put on and take off all items of clothing and any necessary braces, fasteners or artificial limbs.

 

4.                    Eating: The Insured’s ability to feed oneself by getting food into the body from a receptacle, such as a plate, cup, or table, or by feeding tube or intravenously.

 

5.                    Toileting: The Insured’s ability to get to and from the toilet, getting on and off the toilet, and performing associated personal hygiene.

 

6.                    Transferring: The Insured’s ability to move into or out of a bed, chair or wheelchair.

 

Chronically Ill or Chronic Illness. The Insured has been certified by a Licensed Health Care Practitioner during the preceding twelve-month (12) period as:

 

(a)         Being unable to perform (without Substantial Assistance from another individual) at least two (2) Activities of Daily Living due to loss of functional capacity for a period of at least 90 consecutive days; or

 

(b)         Requiring substantial supervision to protect the Insured from threats to health and safety due to Severe Cognitive Impairment.

 

Elimination Period. The period of time beginning on the date the Licensed Health Care Practitioner certifies that the Insured meets the definition of Chronic Illness before benefits can be paid.  The Elimination Period is shown on the Rider Data Page.

 

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Immediate Family Member.  An Insured’s spouse, civil union or domestic partner and anyone who is related to the Insured or the Insured’s spouse, civil union or domestic partner, including a parent, grandparent, child, foster child, grandchild, brother, sister, aunt, uncle, first cousin, nephew or niece. This includes adopted, in-law and step-relatives.

 

Insured. The person covered under the base policy. This term does not include other persons covered under other riders which are part of the policy.

 

Licensed Health Care Practitioner. Any Physician, registered professional nurse, licensed social worker, or other individual who meets such requirements as may be prescribed by the U.S. Secretary of the Treasury. It does not include an Insured or Owner under this policy or an Immediate Family Member of either the Insured or Owner.

 

Net Amount at Risk. On a given date, it is the Death Benefit of the base policy less the Account Value of the base policy as of the date to which premiums have been paid.

 

Physician. A doctor of medicine or osteopathy legally authorized to practice medicine and surgery by the State in which he or she performs such function or action (including a Physician within the meaning of Section 1861(r)(1) of the Social Security Act). It does not include an Insured or Owner under this policy or an Immediate Family Member of either the Insured or Owner.

 

Severe Cognitive Impairment. A deterioration or loss of intellectual capacity that is:

 

(a) comparable to (and includes) Alzheimer’s disease and similar forms of irreversible dementia; and

 

(b) measured by clinical evidence and standardized tests that reliably measure impairment in the following areas:

 

1. Short-term or long-term memory; or

 

2. Orientation to people, places, or time; or

 

3. Deductive or abstract reasoning; or

 

4. Judgment as it relates to safety awareness; and

 

(c) clinically evidenced with test measurement(s) greater than moderate.

 

Substantial Assistance. It is either:

 

(a)         Hands-on assistance: requires the physical assistance of another person without which the Insured would be unable to perform an Activity of Daily Living; or

 

 

(b)         Standby Assistance: requires the presence of another person within arm’s reach of the Insured that is necessary to prevent, by physical intervention, injury to the Insured while he or she is performing an Activity of Daily Living.

 

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PAYMENT OF THE ACCELERATED DEATH BENEFIT

 

Accelerated Death Benefit Amount

 

The amount of the Accelerated Death Benefit which is paid to the Owner will generally equal the amount requested. However, the amount of the Accelerated Death Benefit may be limited by the following:

 

1.              If the amount of the Accelerated Death Benefit requested, when added together with any other Accelerated Death Benefits previously paid during the same calendar year exceeds the Maximum Annual Limit, we will only pay an amount that, when added to the previously paid Accelerated Death Benefits, adds up to the Maximum Annual Limit.

 

2.              If the amount of the requested Accelerated Death Benefit plus any previous outstanding lien, plus lien charges on the entire amount to the next Policy Anniversary, exceeds the total Maximum Lien Limit, then we will reduce the amount payable so that the Maximum Lien Limit is not violated.

 

3.              An Administrative Fee may be deducted. See the Administrative Fee provision.

 

Maximum Annual Limit

 

There is a maximum limit on the amount of the Accelerated Death Benefit the Owner may receive in a single calendar year.  The maximum annual limit is the Per Diem Limitation declared each year by the Internal Revenue Service as referenced in section 7702B(d)(4), multiplied by 365. The Company will prorate this amount in the first year in which Accelerated Death Benefits are paid for the portion of the calendar year in which the Insured is eligible for benefits.

 

Eligibility for Accelerated Death Benefit

 

Subject to all other terms and conditions of this Rider, the owner may request an Accelerated Death Benefit payment provided the following conditions are satisfied:

 

1.              The Accelerated Death Benefit is only available to the Owner of the policy upon written request on a form provided by AUL. We will provide such claim form within fifteen (15) days of the Owner’s request for Accelerated Death Benefit payment.  If the claim form is not provided to the Owner within fifteen (15) days, it is considered that the Owner has complied with the claim form requirements if written proof of Chronic Illness for the Insured has been provided.

 

2.              Written proof must include a certification by a Licensed Health Care Practitioner that the Insured is Chronically Ill as defined in this Rider.  The certification must have been made within the preceding 12-month period.

 

3.              The Elimination Period, as shown on the Rider Data Page, must be satisfied before the Accelerated Death Benefit may be paid.

 

4.              The Owner(s) is not eligible for an Accelerated Death Benefit which results from attempted suicide or an intentionally self-inflicted injury that occurs during the Suicide Provision period specified in the base policy.

 

Physical Examination

 

We have the right to require a second or third medical opinion to confirm eligibility for payment of the Accelerated Death Benefit.  The second or third opinion is at Our expense

 

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and may include a physical examination by a Physician designated by Us.  If there are conflicting opinions, eligibility for benefits shall be determined by a third medical opinion that is mutually acceptable to the Owner and Us.

 

Limitations or Conditions of the Accelerated Death Benefit

 

The Company will pay the Accelerated Death Benefit to the Owner, subject to the following conditions:

 

1.                          The Company must receive, at its Home Office, the Owner’s written request for the Accelerated Death Benefit. Any such request must be in a form acceptable to Us. Such written request must include the certification by a Licensed Health Care Practitioner that the Insured is Chronically Ill.

 

2.                          The Death Benefit Option under the policy must be Option 1 at the time an Accelerated Death Benefit payment is made.  If the Death Benefit Option is not Option 1 at the time of the Accelerated Death Benefit Payment, the Death Benefit Option will be changed to Option 1.

 

3.                    The Accelerated Death Benefit is limited to maximum amounts as described in the Rider.

 

4.                    The Insured must be at least the Attained Age as shown on the Rider Data Page as of the date of the certification.

 

5.                    Any assignee and any irrevocable beneficiary must consent in writing, on a form acceptable to the Company, to the payment of the Accelerated Death Benefit. Such written consent must be received by the Company at its Home Office.

 

6.                    If the Insured dies before a request for Accelerated Death Benefit has been paid, the request will be canceled and the Death Benefit Proceeds, as defined in the policy, will be paid to the beneficiary.

 

7.                    We will pay the Accelerated Death Benefit to the Owner or Owner’s estate while the Insured is living, unless the Accelerated Death Benefit has been otherwise assigned or designated in writing by the Owner.

 

8.                    The Company will pay the Accelerated Death Benefit immediately upon receipt of due proof of written request as described in the Eligibility for Accelerated Death Benefit provision and all requirements as described in this Rider have been satisfied.

 

9.                    While a lien is outstanding under this policy, no changes may be made to the plan or Face Amount of the policy.

 

10.             We reserve the right to limit Accelerated Death Benefit payments to two (2) per year.

 

11.             We reserve the right to include in the lien any due and unpaid Monthly Deductions.

 

Liens

 

When an Accelerated Death Benefit is paid under this Rider, a lien is created against the death benefit of the policy.  The lien is the amount of the Accelerated Death Benefit that We pay per the Owner’s written request (subject to the limitations and amounts permitted for the Accelerated Death Benefit as described in this Rider), plus lien charges to the next Policy Anniversary.  The lien is added to any previous existing liens on the policy. Any outstanding lien will continue against the policy until the policy terminates.

 

The lien does not reduce the Cash Value of the policy. However, the portion of the Cash

 

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Value that is supporting the lien is not available for surrender, withdrawal or to pay any Monthly Deductions due on the policy.  The portion of the Cash Value that is supporting the lien will be transferred to the Fixed Account at the time of the Accelerated Death Benefit payment. The amount of all outstanding liens and accrued lien charges will be deducted from any proceeds ultimately payable at death, maturity or upon surrender of the policy.

 

Lien Charges

 

Any lien created for payment of the Accelerated Death Benefit will incur lien charges at the current applicable loan interest rate. The interest rate used to determine the lien charge for the portion of the lien equal to or exceeding the Cash Value will equal the loan interest rate as described in the Loan section of the policy.

 

Lien charges are payable in advance on the day the lien is created to the next Policy Anniversary. Each year, thereafter, the lien charges are added to the outstanding lien on the Policy Anniversary. If the lien charges cause the outstanding lien to exceed the policy’s Death Benefit, the policy and Rider will terminate.

 

Maximum Lien Limit

 

The maximum amount available to have in total for liens on the policy is equal to the policy’s Cash Value as of the date to which premiums have been paid, plus a percentage of the Net Amount at Risk. The Net Amount at Risk percentage is shown on the Rider’s Data Page.

 

Sample calculation of Maximum Lien Limit:

 

Policy Death Benefit:

   $200,000

Policy Account Value:

   $75,000

Insured’s Net Amount at Risk percentage:

   50%

 

= $75,000 + [(200,000 – 75,000) x 50%]

 

= $75,000 + $62,500

Maximum Lien Amount

= $137,500

 

Loan Repayment

 

An Accelerated Death Benefit payment may be requested, and therefore a lien established, while a policy loan is outstanding on the policy. On the day that we process your request for an Accelerated Death Benefit, any current loan and loan interest due will be added to the lien amount and the loan will be satisfied.

 

Administrative Fee

 

A one-time Administrative Fee may be charged when an Accelerated Death Benefit is paid under this Rider. This charge is associated with the Company’s administrative costs for processing an Accelerated Death Benefit payment for the Owner. This charge is deducted from the Accelerated Death Benefit payable, and it is included in the lien that is created as a result of that payment.  The Administrative Fee is shown on the Rider Data Page.

 

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Effect of Lien on Other Policy Provisions

 

While a lien is in effect against the policy, it will impact the policy’s benefits and provisions as follows:

 

1.        The Death Benefit Proceeds payable if the Insured dies while the policy is in force will be reduced by the amount of any outstanding lien.

 

2.              The Cash Value available upon surrender of the policy will be reduced by the amount of any outstanding lien. However, the Cash Value will include a refund of any lien charge paid past the effective date of the policy surrender.

 

3.              The loan value available under the policy will be reduced by the amount of any outstanding lien and accrued lien charge.

 

4.              If the policy lapses while a lien is outstanding and is later reinstated, the lien must first either be repaid or reinstated.  If the Rider is not reinstated, the lien, plus any lien charges due, must be repaid.

 

5.              Upon the Owner’s request for Accelerated Death Benefit and upon payment, the Company will provide to the Owner, and any irrevocable beneficiary, a statement demonstrating the effect of the Accelerated Death Benefit on the Cash Value, Death Benefit and loan value of the base policy.

 

GENERAL PROVISIONS

 

Incontestability

 

In the absence of fraud, We will not contest this Rider after it has been in force during the lifetime of the Insured for two (2) years from the Policy Date.  After two (2) years We may contest this Rider for non-payment of premium of the base policy or fraud in the procurement of the policy when permitted by applicable state law where the Rider is delivered or issued for delivery.

 

Premium Requirement

 

There is no separate premium required for this benefit. However, this Rider does not eliminate the need to pay premiums to keep the base policy in force. The Owner must continue to pay any premiums necessary to cover Monthly Deductions and avoid policy lapse as described in the policy or in any applicable riders attached to the policy.

 

Reinstatement

 

If the policy to which this Rider is attached is reinstated, this Rider will also be reinstated provided the maximum Accelerated Death Benefit has not been paid under this Rider.  Any previous lien created against the Death Benefit of the policy must be repaid or reinstated.

 

Termination

 

This Rider terminates on the earliest of:

 

1.        The date the policy to which this Rider is attached terminates;

 

2.        The date of the Insured’s death;

3.        The date the amount of loan(s) plus total lien, including lien charges, exceeds the

 

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policy Face Amount. If this happens, the policy and any other riders attached also terminate;

 

4.        Upon written request of the Owner; or

 

5.        Upon the Owner exercising the Overloan Protection Rider.

 

Termination of the Rider will not prejudice the payment of the Accelerated Death Benefit for any claim that occurred while the Rider was in force.

 

Signed for American United Life Insurance CompanyÒ by,

 

 

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