EX-99.1A5G 10 ex-99_1a5g.txt EXHIBIT-99.1A5G AMERICAN FAMILY LIFE INSURANCE COMPANY 6000 AMERICAN PKWY MADISON, WISCONSIN 53783-0001 888-428-5433 WAIVER OF MONTHLY DEDUCTIONS BENEFIT RIDER FOR THE PRIMARY INSURED FLEXIBLE PREMIUM VARIABLE UNIVERSAL LIFE INSURANCE This RIDER is attached to and becomes a part of the BASE POLICY and is subject to the conditions and provisions of the BASE POLICY. All such conditions and provisions apply to this RIDER unless changed by this RIDER. DEFINITIONS TOTAL DISABILITY/TOTALLY DISABLED. The inability of the PRIMARY INSURED to perform the material and substantial duties of his/her regular occupation for pay or profit. Such inability must: 1. be the result of an injury or disease; 2. start after the ISSUE DATE and between the ATTAINED AGES of five and 60 inclusive; 3. exist for six consecutive months. If the PRIMARY INSURED is TOTALLY DISABLED for 24 months or more, the PRIMARY INSURED will be considered to be TOTALLY DISABLED only if he/she is unable to perform the material and substantial duties of any occupation for which he/she is reasonably fitted by means of: 1. education; 2. training; and 3. experience. Occupation includes: 1. if the PRIMARY INSURED is a homemaker who is not otherwise employed, the performance of household duties; or 2. if the PRIMARY INSURED has not reached the age when he/she is legally permitted to end formal education, regular attendance at school. TOTAL DISABILITY also includes the following total and irrecoverable losses even if the PRIMARY INSURED is able to work: 1. the sight of both eyes; 2. the use of both hands; 3. the use of both feet; or 4. the use of one hand and one foot. GENERAL PROVISIONS BENEFIT. WE will waive certain MONTHLY DEDUCTIONS for the BASE POLICY and any RIDERS to which this RIDER applies if: 1. WE receive written proof, satisfactory to US, of the PRIMARY INSURED'S TOTAL DISABILITY; 2. the PRIMARY INSURED becomes TOTALLY DISABLED while this RIDER is in force; and 3. the PRIMARY INSURED is TOTALLY DISABLED for six consecutive months If, while the BASE POLICY and this RIDER are in force, the PRIMARY INSURED becomes TOTALLY DISABLED again after having been TOTALLY DISABLED before, the new TOTAL DISABILITY will be considered a continuation of the old TOTAL DISABILITY unless: 1. the TOTAL DISABILITY is due to an entirely different cause; and 2. the PRIMARY INSURED has performed all of the material and substantial duties of a gainful occupation for six consecutive months or more between the periods of TOTAL DISABILITY. EXCLUSIONS AND LIMITATIONS. WE will not waive MONTHLY DEDUCTIONS if the TOTAL DISABILITY results directly or indirectly from: 1. intentionally self-inflicted injury; 2. any attempt at suicide, while sane or insane; 3. war; or service in the military, naval or air forces of any country or international organization at war, whether declared or undeclared; or any conflict between armed forces. Page 1 of 3 WE will not waive MONTHLY DEDUCTIONS if the TOTAL DISABILITY begins within five years from the ISSUE DATE shown in the Schedule or on an endorsement if later changed if: 1. such TOTAL DISABILITY resulted from injury or disease sustained or contracted before the ISSUE DATE; and 2. the PRIMARY INSURED received medical or surgical treatment for such condition before the date of his/her APPLICATION; and 3. the PRIMARY INSURED did not disclose such treatment on his/her APPLICATION. Certain provisions of the BASE POLICY will be limited during the PRIMARY INSURED'S TOTAL DISABILITY, as follows: 1. the DEATH BENEFIT Option may not be changed; and 2. the SPECIFIED AMOUNT may not be changed, except as provided by any Guaranteed Purchase Option Rider of the BASE POLICY. PROOF OF DISABILITY. Before WE waive any MONTHLY DEDUCTION, We must receive written proof of a TOTAL DISABILITY at the ADMINISTRATIVE SERVICE CENTER during: 1. the PRIMARY INSURED'S lifetime; or 2. the continuance of the PRIMARY INSURED'S TOTAL DISABILITY. WE must receive proof within one year from the date that the PRIMARY INSURED'S TOTAL DISABILITY began. WE may still waive certain MONTHLY DEDUCTIONS even if WE do not receive such proof in the time allowed, if the PRIMARY INSURED shows US that it was not reasonably possible to provide proof in the time allowed. Proof must however, be provided as soon as reasonably possible. PROOF OF CONTINUANCE OF TOTAL DISABILITY. At OUR request, the PRIMARY INSURED must furnish periodic written proof that his/her TOTAL DISABILITY has continued without interruption. Upon receiving such proof, WE have the right to request that the PRIMARY INSURED be examined by a physician of OUR choice. After two years of TOTAL DISABILITY, WE may require proof of such TOTAL DISABILITY not more than once a year. WE will pay the cost of any exam that WE require. If WE do not receive such proof, WE will not continue to waive MONTHLY DEDUCTIONS. PREMIUM. The OWNER must pay an amount sufficient to keep the BASE POLICY in force until WE receive proof that the PRIMARY Insured is TOTALLY DISABLED. Any MONTHLY DEDUCTION covered by this RIDER that is taken while the PRIMARY INSURED is TOTALLY DISABLED, will be credited to the CASH VALUE when WE receive proof satisfactory to US of the PRIMARY INSURED'S TOTAL DISABILITY. If TOTAL DISABILITY begins prior to the end of the grace period, WE will allow this benefit even though the premium is not paid on time. Waiver of MONTHLY DEDUCTIONS under this RIDER may not keep the BASE POLICY in force, if on any MONTHLY DEDUCTION DAY the SURRENDER VALUE is not enough to cover any MONTHLY DEDUCTION not covered under this RIDER and any loan interest due. INCONTESTABILITY. WE cannot contest this RIDER after it has been in force during the lifetime of the PRIMARY INSURED for two years from the Rider Effective Date shown on the Schedule, excluding any period of time that the PRIMARY INSURED has been TOTALLY DISABLED. WE cannot contest any reinstatement of this RIDER after it has been in force during the lifetime of the PRIMARY Insured for two years from the date WE approve a reinstatement. REINSTATEMENT. Within five years after the date this RIDER terminated, the OWNER may apply for reinstatement if: 1. the BASE POLICY is also being reinstated; 2. WE receive proof satisfactory to US that the PRIMARY INSURED is insurable by OUR standards; 3. premium is paid as required by the BASE POLICY'S Reinstatement provision; 4. the PRIMARY INSURED is alive on the date WE approve the request for reinstatement. If the PRIMARY INSURED is not alive, such approval is void and of no effect. Page 2 of 3 RIDER EFFECTIVE DATE. This RIDER takes effect as of the Rider Effective Date shown on the Schedule. If this RIDER is subsequently added to the BASE POLICY, the Rider Effective Date will be shown on an endorsement. The Rider Effective Date determines each: 1. RIDER year; 2. RIDER anniversary; and 3. RIDER month. RIDER TERMINATION DATE. This RIDER terminates on the earliest of: 1. 12:00 AM on the RIDER anniversary date nearest the PRIMARY INSURED'S ATTAINED AGE 60; 2. the date the BASE POLICY terminates subject to the conditions and provisions of the BASE POLICY; or 3. the date the BASE POLICY is surrendered by the OWNER. If the PRIMARY INSURED was TOTALLY DISABLED prior to ATTAINED AGE 60, WE will continue to waive the MONTHLY DEDUCTION until the PRIMARY INSURED is no longer TOTALLY DISABLED or he/she reaches ATTAINED AGE 95. The OWNER may cancel this RIDER at any time by sending a written request to the ADMINISTRATIVE SERVICE CENTER. Such cancellation takes effect on the MONTHLY DEDUCTION DAY following the date the written request is received at the ADMINISTRATIVE SERVICE CENTER, unless a later date is requested. PRESIDENT SECRETARY Page 3 of 3