ICC14 LR14GP-ABR 3 ABR-12995 (11/25) CONFORMITY WITH INTERSTATE INSURANCE PRODUCT REGULATION COMMISSION STANDARDS This rider was approved under the authority of the Interstate Insurance Product Regulation Commission and issued under the Commission standards. Any provision of this rider which, on the provision’s effective date, conflicts with Interstate Insurance Product Regulation Commission standards for this product type, is automatically amended to conform to the Interstate Insurance Product Regulation Commission standards for this product type as of the provision’s effective date. ACCELERATED DEATH BENEFIT Accelerated death benefit proceeds is the amount we pay to you, while a Covered Person is living, if the Covered Person has a Qualifying Event. The accelerated death benefit proceeds are paid only once per Covered Person. This payout is the only settlement option available prior to a Covered Person’s death. The benefit is the amount of the accelerated death benefit shown on the SCHEDULE OF BENEFITS in effect on the date you request accelerated death benefit proceeds. CONDITIONS FOR THE ACCELERATED DEATH BENEFIT To receive a benefit payment under this rider, all of the following conditions must be met: Any required life insurance Premium is paid through the date you request proceeds under this rider. You request proceeds in writing while the Covered Person is living and before the Covered Person attains age 65. If you are unable to request payment yourself, your legal representative may request it on your behalf. The Covered Person is insured for life insurance benefits under the Policy. The Covered Person is insured for the minimum amount of life insurance as shown on the SCHEDULE OF BENEFITS in order to be eligible for benefits under this rider. The benefit percentage elected will equal no less than $5,000. You provide to us written proof from a Doctor that the Covered Person has a Qualifying Event. You provide to us written consent for payment from any irrevocable beneficiary and, in community property states, from your spouse. NOTICE OF CLAIM AND PROOF OF LOSS You must send us written notice of claim while the Covered Person is living and within 90 days of the date the Qualifying Event is diagnosed. Failure to give notice within 90 days will not invalidate or reduce any claim if it is shown not to have been reasonably possible to give such notice and that notice was given as soon as was reasonably possible. Notice of claim includes proof of loss. Proof of loss includes information from the Covered Person’s Doctor, at your expense, regarding the Covered Person’s medical condition. We may require additional information from the Employer in order to verify eligibility. Proof of loss, including any attachments indicated on the claim form(s) as required, should be sent directly to us at the address indicated on the form(s). A claim form is available from the Employer or us. We have the right to request a second or third medical opinion, at our expense, in order to determine if the Covered Person is eligible under the terms of this rider. Any second medical opinion may include a physical examination by a Doctor designated by us. In the case of conflicting medical opinions, eligibility will be determined by a third medical opinion that is provided by a Doctor who is mutually acceptable to the Covered Person and us. When you request proceeds under this rider and upon payment of the benefit proceeds, you will be provided with a disclosure demonstrating the effect of the acceleration on the death benefit and Premium, and any other effects on coverage. This disclosure will also be provided to any assignee of record or irrevocable beneficiary of record. BENEFIT PAYMENT We pay the benefit proceeds to you immediately upon receipt of due written proof of loss. If you are not the current owner of coverage under the Certificate or riders on the date proceeds are requested under this rider, then while you are living the benefit proceeds are payable to the current owner.
Noblesville Schools Group Term Life Insurance Plan Page 38 Page 40