Term Life Insurance Accelerated Benefit Summary and Disclosure Notice Accelerated Benefit Summary and Disclosure Notice • Policy proceeds which are payable on the death of the Insured/ THIS DOCUMENT SERVES ONLY AS A SUMMARY AND A DISCLOSURE Covered Person will be reduced by the amount of the Accelerated NOTICE. PLEASE REFER TO YOUR POLICY OR RIDER FOR ACTUAL Benefit, any outstanding policy loans, and any premiums paid by us CONTRACT PROVISIONS. on your behalf. • Cash values, if any, will continue to accumulate as specified THE POLICY/RIDER PROVIDES AN ACCELERATED BENEFIT OPTION. in your policy or rider. Access to the policy cash value may be YOU SHOULD CONSULT WITH A PERSONAL TAX ADVISOR IF YOU ARE restricted to the excess of the cash value over the sum of the CONSIDERING ELECTING PAYMENT UNDER AN ACCELERATED BENEFIT amount accelerated and any premiums paid by us and any other PROVISION. BENEFITS AS SPECIFIED IN THE POLICY/RIDER WILL BE outstanding policy loans. REDUCED UPON RECEIPT OF AN ACCELERATED BENEFIT PAYMENT. • Any outstanding loan, including interest will not be deducted from RECEIPT OF ACCELERATED BENEFIT PAYMENTS: 1) MAY BE TAXABLE; 2) the Accelerated Benefit payment. MAY AFFECT YOUR ELIGIBILITY FOR BENEFITS UNDER STATE OR FEDERAL • This Accelerated Benefit will be treated as a lien against the LAW; AND, 3) DO NOT AND ARE NOT INTENDED TO QUALIFY AS LONG- death benefit and applied at time of death. TERM CARE INSURANCE. The policy and/or rider you are applying for has an Accelerated Benefit Accelerated Benefit for Long Term Illness (optional rider) provision. The provision allows a portion of the death benefits to be Prior to the payment of any Accelerated Benefit, the Insured must advanced if certain conditions are met. Please see policy/rider for have a Long Term Illness, which means the Insured has been certified conditions and definitions, as applicable. within the last 12 months by a Licensed Health Care Practitioner as Prior to the payment of any Accelerated Benefit, the following conditions permanently unable to perform, without Substantial Assistance from must be met: another individual, at least two out of five Activities of Daily Living for a • The maximums vary by policy/rider (see specific information below) period of at least 90 days due to a loss of functional capacity; or requiring Substantial Supervision due to permanent Severe Cognitive Impairment. and shall not exceed the Benefit Amount for the policy shown on the The maximum payable is the lesser of 50% of the Eligible Proceeds Policy Schedule. available at the time of claim payable in two equal annual payments • Only one Accelerated Benefit election will be made under the up to a maximum of 25% of the Eligible Proceeds per year for two policy and/or each rider even if the Owner does not elect the full consecutive years; or $100,000 payable in two equal annual payments up acceleration amount. to a maximum of $50,000 per year for two consecutive years. Premium is • If two or more Accelerated Benefits are payable on behalf of the required to keep this rider in force. Insured/Covered Person under the policy or any attached riders for the same or related sickness, injury or loss, benefits will be paid in the Payment of an Accelerated Benefit for Long Term Illness, if elected, will following order: have the following effect on your contract: 1) Accelerated Benefit for Long Term Illness, if this optional rider is • Upon payment of the Accelerated Benefit, the rider will terminate attached to the policy; and and no additional benefits will be due under the rider, even for 2) Accelerated Benefit for Terminal Condition. recurrence. The policy will remain in force and premiums will • Additional limitations and exclusions may apply, please read your continue to be billed and payable as due. policy/rider carefully. • Policy proceeds which are payable on the death of the Insured will Upon request to accelerate the policy/rider proceeds, and upon the be reduced by the amount of the Accelerated Benefit. payment of the accelerated benefit, the Owner and any irrevocable • Cash values, if any, will continue to accumulate as specified in your beneficiary shall be given a statement demonstrating the effect of the policy or rider. The cash values will be adjusted proportionally by acceleration on the payment of policy proceeds, cash value, death the percent accelerated. benefit, premium, and policy loans, as applicable. • Any outstanding policy loan, including interest, will be proportionally reduced by the percent accelerated and will be Accelerated Benefit for Terminal Condition deducted from the Accelerated Benefit payment. Prior to the payment of any Accelerated Benefit, the Insured/Covered • The Accelerated Benefit will reduce the Benefit Amount and Person must have a Terminal Condition, defined as an imminent death will be applied immediately upon acceleration. ICC18 DN111 expected as a result of a non-correctable medical condition that with This brochure does not constitute the full policy and is intended to reasonable medical certainty will result in a drastically limited life span of provide basic information about American Fidelity Assurance Company’s the Insured/Covered Person of 12 months or less. The maximum payable Renewable and Convertible Term Life Insurance product, ICC14 RCTL14 / is the lesser of: 50% of the eligible proceeds as defined in the policy/rider, RCTL14 Series. For specific details, limitations and exclusions, please refer or $100,000. There is no premium associated with this provision. to your policy, riders. Please consult your tax advisor for your specific Payment of an Accelerated Benefit, if elected, will have the following situation. This policy is not eligible under Section 125. Rider availability effect on your contract: may vary by state. • Upon payment of the Accelerated Benefit, the policy/rider will remain in force. Any premiums due to keep the policy/rider in force We will not pay the policy proceeds if the insured commits suicide, while will be paid by us, and will be deducted from the policy proceeds sane or insane for the period of time as described in the insured’s policy, upon death, unless you are currently exercising the Automatic from the Effective date. Instead, we will return all premiums paid. Premium Loan option. If you are currently exercising the Automatic Premium Loan option, any premiums will continue to be paid under this option, until such time as this option is exhausted or discontinued. American Fidelity Assurance Company americanfidelity.com AF-2229(Education)-0523 051-536, 051-537, 051-546, 051-547, 051-556, 051-557