13 C. The payment will be made in one lump sum to You or to the payee You appropriately assign. D. The Living Benefit will not be available if: 1. You have any portion of any Life Insurance or ownership rights thereof absolutely or irrevocably assigned or transferred; 2. You have made an irrevocable beneficiary designation; 3. the insurance proceeds are subject to a court order under a divorce decree, separate maintenance agreement or property settlement agreement; 4. You have filed for bankruptcy, unless You give Us written approval from the bankruptcy court for payment of the Living Benefit. E. No payment will be made under this election unless and until We receive and approve of all of the following: 1. Your signed and notarized election of this option on a form furnished by Us; 2. signed and witnessed written statements of all irrevocable beneficiaries and assignees (and Spouse in marital property states) consenting to Your election of this option; and 3. satisfactory written proof from a Physician other than Yourself or a member of Your or Your Spouse's immediate family that You have been diagnosed as being Terminally Ill and that You are of sound mind and under no constraint or undue influence. F. We may require a second opinion and examination of Your condition at Our own expense by a Physician of Our choice. G. Payment of the Living Benefit will reduce correspondingly the face amount of Your life insurance benefits under the Group Policy. This will result in reduced life insurance proceeds payable to Your beneficiary at Your death. Furthermore, any amount of insurance that would otherwise be continued will be reduced proportionately, as will the maximum face amount available under the “Life Insurance Conversion Benefit” section. H. Premium payments must continue to be paid for Your life insurance unless You qualify to have Your life insurance premium waived. The premium due will be based on the amount of insurance remaining in force after deducting the amount of the Living Benefit. I. Payment of the Living Benefit will not affect the amount of, or change an existing beneficiary designation for, the AD&D Benefit, if any, in effect and kept in force under the Group Policy. J. Your election together with Our payment of the Living Benefit constitute a valid and effective beneficiary designation change, but only with respect to the specified life insurance benefits, and only to the extent affected by the Living Benefit payment, and applicable interest and fees, if any, charged thereon. K. Payment of the Living Benefit will be exempt from the claims of creditors and from legal process to the extent permitted by law. L. All other provisions of the Group Policy, including the effective date provisions of any benefit increases and the provisions on benefit reductions because of amendments to the plan or benefit classification changes or Your attained age, remain valid and in effect. Any such life insurance benefit reduction will be calculated based on Your life insurance amount in effect immediately before the Living Benefit payment. M. You are responsible for any tax consequences related to this benefit.
Life Certificate - All Other Employees Page 13 Page 15