6. BENEFIT PROVISIONS What benefits are payable? We will pay you a lump-sum benefit for the insurance in force when any eligible Insured, on or after the effective date of insurance, is Diagnosed with a Critical Illness condition as defined in the Covered Conditions section of this Certificate. Any benefits payable are subject to the limitations, exclusions and other conditions stated in the Policy. How is the amount of the benefit determined? We will multiply the Insured’s Insurance Amount by the Benefit Percentage for the applicable Covered Condition as shown in the Benefit Highlights to determine the benefit to be paid. If benefits for a particular Critical Illness have been paid, an Insured is not eligible for any additional benefits if the Insured is ever Diagnosed with that Critical Illness again except as described in Recurrence Benefit. If an Insured is Diagnosed with more than one Critical Illness on the same date, we will pay only the benefit for the Critical Illness with the largest Benefit Percentage. Additional Occurrence When is an additional benefit payable? If we pay benefits for a particular Critical Illness, we will pay benefits for a different Critical Illness listed in the Benefit Highlights, if there are more than 6 consecutive months between Diagnoses. Recurrence Benefit When is a Recurrence Benefit payable? We will pay a Recurrence Benefit, as shown in the Benefit Highlights, if: · benefits have been paid under this Policy because an Insured was Diagnosed with a Critical Illness; and · an Insured is Diagnosed with the same Critical Illness more than 12 consecutive months later; and · the Insured has not received Treatment for the same Critical Illness for 12 consecutive months after the Diagnosis for the Critical Illness. For the purposes of this provision, we will not consider follow-up visits to a Physician or prescription medications other than cytotoxic medications (cancer chemotherapy) to be Treatment. How is the amount of the Recurrence Benefit determined? We will multiply the Insured’s Insurance Amount by the Recurrence Benefit Percentage for the applicable Covered Condition as shown in the Benefit Highlights to determine the benefit to be paid. What is the maximum benefit payable under the Recurrence Benefit? We will pay the Recurrence Benefit for an Insured only once for each applicable Covered Condition. 16-SD-C-01 Page19
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