EXECUTIVE SUPPLEMENTAL RETIREMENT PLAN
AGREEMENT
This Agreement, made and entered into this 6th day of May, 1999, by and
between Ameriana Bank of Indiana, FSB, a Bank organized and existing under the
laws of the State of Indiana, hereinafter referred to as "the Bank", and Xxx
Xxxxx, a Key Employee and the Executive of the Bank, hereinafter referred to as
"the Executive".
The Executive has been in the employ of the Bank and has now and for years
past faithfully served the Bank. It is the consensus of the Board of Directors
of the Bank (the Board) that the Executive's services have been of exceptional
merit, in excess of the compensation paid and an invaluable contribution to the
profits and position of the Bank in its field of activity. The Board further
believes that the Executive's experience, knowledge of corporate affairs,
reputation and industry contacts are of such value and his continued services
are so essential to the Bank's future growth and profits that it would suffer
severe financial loss should the Executive terminate his services.
Accordingly, it is the desire of the Bank and the Executive to enter into
this Agreement under which the Bank will agree to make certain payments to the
Executive upon the Executive's retirement and, alternatively, to the Executive's
beneficiary(ies) in the event of the Executive's premature death while employed
by the Bank.
It is the intent of the parties hereto that this Agreement be considered an
arrangement maintained primarily to provide supplemental retirement benefits for
the Executive, as a member of a select group of management or highly-compensated
employees of the Bank for purposes of the Employee Retirement Security Act of
1974 (ERISA). The Executive is fully advised of the Bank's financial status and
has been fully advised to his satisfaction regarding the design and operation of
this benefit plan.
Therefore, in consideration of the Executive's services performed in the
past and those to be performed in the future and based upon the mutual promises
and covenants herein contained, the Bank and the Executive, agree as follows:
I. DEFINITIONS
A. Effective Date:
--------------
The Effective Date of this Agreement shall be February 23, 1999.
B. Plan Year:
---------
Any reference to "Plan Year" shall mean a calendar year from
January 1 to December 31. In the year of implementation, the
term "Plan Year" shall mean the period from the effective date
to December 31 of the year of the effective date.
C. Retirement Date:
---------------
Retirement Date shall mean retirement from service with the
Bank which becomes effective on the first day of the calendar
month following the month in which the Executive reaches the
Executive's sixty-fifth (65) birthday, or such earlier or
later date as the Board may approve as the Executive's
Retirement Date.
D. Termination of Service:
----------------------
Termination of Service shall mean voluntary resignation of
service by the Executive or the Bank's discharge of the
Executive without cause ("cause" defined in Subparagraph III
(D) hereinafter), prior to the Normal Retirement Age
(described in Subparagraph I (J) hereinafter).
E. Pre-Retirement Account:
----------------------
A Pre-Retirement Account shall be established as a liability
reserve account on the books of the Bank for the benefit of
the Executive. Prior to termination of service or the
Executive's retirement, such liability reserve account shall
be increased or decreased each Plan Year (including the Plan
Year in which the Executive ceases to be employed by the Bank)
by an amount equal to the annual earnings or loss for that
Plan Year determined by the Index (described in Subparagraph I
(G) hereinafter), less the Cost of Funds Expense for that Plan
Year (described in Subparagraph I (H) hereinafter).
F. Index Retirement Benefit:
------------------------
The Index Retirement Benefit for the Executive for any year
shall be equal to the excess of the annual earnings (if any)
determined by the Index [Subparagraph I (G)] for that Plan
Year over the Cost of Funds Expense [Subparagraph I (H)] for
that Plan Year.
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G. Index:
------
The Index for any Plan Year shall be the aggregate annual
after-tar income from the life insurance contracts described
hereinafter as defined by FASB Technical Bulletin 85-4. This
Index shall be applied as if such insurance contracts were
purchased on the effective date hereof.
Insurance Company: Xxxxxxxxx Xxxxxxxx
Policy Form: Flexible Premium Adjustable Life
Policy Name: Executive Security Plan IV
Insured's Age and Sex: 48, Male
Riders: None
Ratings: According to health of proposed
insured
Option: Level Death Benefit
Face Amount: $620,000
Premiums Paid: $235,000
Number of Premium Payments: One
Assumed Purchase Date: February 23, 1999
Insurance Company: Security Life of Denver
Policy Form: Whole Life
Policy Name: Corp IV
Insured's Age and Sex: 48, Male
Riders: None
Ratings: According to health of proposed
insured
Option: Level Death Benefit
Face Amount: $546,350
Premiums Paid: $235,000
Number of Premium Payments: One
Assumed Purchase Date: February 23, 1999
If such contracts of life insurance are actually purchased by
the Bank then the actual policies as of the dates they were
purchased shall be used in calculations under this Agreement.
If such contracts of life insurance are not purchased or are
subsequently surrendered or lapsed, then the Bank shall
receive annual policy illustrations that assume the
above-described policies were purchased from the above named
insurance company(ies) on the Effective Date from which the
increase in policy value will be used to calculate the amount
of the Index.
In either case, references to the life insurance contract are
merely for purposes of calculating a benefit. The Bank has no
obligation to purchase such life insurance and, if purchased,
the Executive and the Executive's beneficiary(ies) shall have
no ownership interest in such policy and shall
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always have no greater interest in the benefits under this
Agreement than that of an unsecured general creditor of the
Bank.
H. Cost of Funds Expense:
---------------------
The Cost of Funds Expense for any Plan Year shall be
calculated by taking the sum of the amount of premiums set
forth in the Indexed policies described above plus the amount
of any after-tax benefits paid to the Executive pursuant to
this Agreement (Paragraph III hereinafter) plus the amount of
all previous years after-tax Costs of Funds Expense, and
multiplying that sum by the average after-tax cost of funds as
published in the third quarter Office of Thrift Supervision
Annual Thrift Financial Report of the Ameriana Bank of
Indiana, FSB.
I. Change of Control:
-----------------
A Change of Control shall be deemed to have occurred if, at
any time during the period of employment of the Executive,
more than twenty five percent (25%) of the Parent's or Bank's
outstanding Common Stock, or equivalent in voting power of any
class or classes of outstanding securities of the Parent or
Bank ordinarily entitled to vote in elections of directors of
Parent or Bank, shall be acquired by any other corporations or
other person or group. "Group" shall mean persons who act in
concert as described in Section 13 (d) of the Securities
Exchange Act of 1934, as amended.
J. Normal Retirement Age:
-----------------------
Normal Retirement Age shall mean the date on which the
Executive attains age sixty-five (65).
II. EMPLOYMENT
No provision of this Agreement shall be deemed to restrict or limit any
existing employment agreement by and between the Bank and the
Executive, nor shall any conditions herein create specific employment
rights to the Executive nor limit the right of the Employer to
discharge the Executive with or without cause. In a similar fashion, no
provision shall limit the Executive's rights to voluntarily sever his
employment at any time.
III. INDEX BENEFITS
The following benefits provided by the Bank to the Executive are in the
nature of a fringe benefit and shall in no event be construed to effect
nor limit the
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Executive's current or prospective salary increases, cash bonuses or
profit-sharing distributions or credits.
A. Retirement Benefits:
-------------------
Should the Executive continue to be employed by the Bank until
"Normal Retirement Age" defined in Subparagraph I (J), the
Executive shall be entitled to receive the balance in his
Pre-Retirement Account [as defined in Subparagraph I (E)] in
ten (10) equal annual installments commencing thirty (30) days
following the Executive's Retirement Date. In addition to
these payments, commencing with the Plan Year in which the
Executive attains the Executive's Retirement Date, the Index
Retirement Benefit (as defined in Subparagraph I (F) above)
for each year shall be paid to the Executive until the
Executive's death.
B. Termination of Service:
----------------------
Subject to Subparagraph III (D) hereinafter, should the
Executive suffer a Termination of Service [defined in
Subparagraph I (D)], the Executive shall be entitled to
receive five percent (5%) times the number of full years the
Executive has served the Bank from the Executive's fifth
anniversary of service from the Effective Date of this
Agreement (to a maximum of 100%), times the balance in the
Pre-Retirement Account paid over ten (10) years in equal
installments commencing at the Normal Retirement Age
[Subparagraph I (J)]. In addition to these payments and
commencing in the Plan Year in which the Executive attains
Normal Retirement Age, five percent (5%) times the number of
full years the Executive has served the Bank from the
Executive's fifth anniversary of service from the Effective
Date of this Agreement (to a maximum of 100%), times the Index
Retirement Benefit for each year shall be paid to the
Executive until the Executive's death.
C. Death:
-----
Should the Executive die prior to having received the full
balance of the Pre-Retirement Account, the unpaid balance of
the Pre-Retirement Account shall be paid in a lump sum to the
beneficiary selected by the Executive and filed with the Bank.
In the absence of or a failure to designate a beneficiary, the
unpaid balance shall be paid in a lump sum to the personal
representative of the Executive's estate.
D. Discharge for Cause and Termination of Service:
----------------------------------------------
Should the Executive be discharged prior to five (5) full
years of employment from the Effective Date of this Agreement
or be discharged for cause at any time, all Benefits under
this Agreement shall be forfeited.
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A termination for "cause" shall include termination because of
the Executive's personal dishonesty, incompetence, willful
misconduct, breach of fiduciary duty involving personal
profit, intentional failure to perform stated duties, willful
violation of any law, rule or regulation (other than traffic
violations or similar offenses) or final cease-and-desist
order, or material breach of any provision of this Agreement.
E. Disability Benefit:
------------------
In the event the Executive becomes disabled prior to
Termination of Service, and the Executive's employment is
terminated because of such disability, he shall immediately
begin receiving the benefits in Subparagraph III (A) above.
Such benefit shall begin without regard to the Executive's
Normal Retirement Age and the Executive shall be one hundred
percent (100%) vested in the entire benefit amount. The term
"disability" shall mean the complete inability of the
Executive to perform the Executive's duties as determined by
an independent physician selected with the approval of the
Bank and the Executive.
F. Death Benefit:
-------------
Except as set forth above, there is no death benefit provided
under this Agreement.
IV. RESTRICTIONS UPON FUNDING
The Bank shall have no obligation to set aside, earmark or entrust any
fund or money with which to pay its obligations under this Agreement.
The Executive, the Executive's beneficiary(ies) or any successor in
interest to the Executive shall be and remain simply a general creditor
of the Bank in the same manner as any other creditor having a general
claim for matured and unpaid compensation.
The Bank reserves the absolute right, at its sole discretion, to either
fund the obligations undertaken by this Agreement or to refrain from
funding the same and to determine the exact nature and method of such
funding. Should the Bank elect to fund this Agreement, in whole or in
part, through the purchase of life insurance, mutual funds, disability
policies or annuities, the Bank reserves the absolute right, in its
sole discretion, to terminate such funding at any time, in whole or in
part. At no time shall the Executive be deemed to have any lien or
right, title or interest in or to any specific funding investment or to
any assets of the Bank.
If the Bank elects to invest in a life insurance, disability or annuity
policy upon the life of the Executive, then the Executive shall assist
the Bank by freely submitting to a physical exam and supplying such
additional information necessary to obtain such insurance or annuities.
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V. CHANGE OF CONTROL AND COVENANT NOT TO COMPETE
(i) Change of Control:
------------------
Upon a Change of Control (as defined in Subparagraph I (I)
herein), if the Executive's employment is subsequently
terminated, except for cause, or the present capacity or
circumstances in which the Executive is employed is changed or
is reduced the Executive's responsibilities or authority or
compensation or other benefits provided under this Agreement
without the Executive's written consent, then the Executive
shall receive the benefits promised in this Agreement upon
attaining Normal Retirement Age, as if the Executive had been
continuously employed by the Bank until the Executive's Normal
Retirement Age. The Executive will also remain eligible for
all promised death benefits in this Agreement. In addition, no
sale, merger or consolidation of the Bank shall take place
unless the new or surviving entity expressly acknowledges the
obligations under this Agreement and agrees to abide by its
terms.
(ii) Covenant Not to Compete:
-----------------------
Executive agrees during the term hereof and for five (5) years
after the termination of this Agreement that he will not
directly or indirectly engage in or become an owner, agent,
officer, director or shareholder, as defined hereinafter, of
any business which competes with any of the businesses
conducted by Employer, Ameriana Bancorp or any of the
subsidiaries of either in any of the following states, to-wit:
Indiana, Ohio, Kentucky, Illinois, and/or Michigan. Employer
and Employee agree that the term of this Covenant against
Competition and the geographical area described here are
reasonable, given the nature of the businesses being conducted
by Employer, its parent and their subsidiaries, and given the
plans for the conduct of business which are being made by
Employer in its strategic plans. In the event Executive
breaches this provision, Employer may cancel all benefits
provided herein upon giving Executive twenty-one (21) days
written notice and an opportunity to cure said breach. For
purposes of this paragraph, the Executive shall be deemed a
shareholder if the Executive acquires five percent (5%) or
more of any publicly traded or privately held entity.
VI. MISCELLANEOUS
A. Alienability and Assignment Prohibition:
---------------------------------------
Neither the Executive, his/her surviving spouse nor any other
beneficiary under this Agreement shall have any power or right
to transfer, assign, anticipate, hypothecate, mortgage,
commute, modify or otherwise
7
encumber in advance any of the benefits payable hereunder nor
shall any of said benefits be subject to seizure for the
payment of any debts, judgments, alimony or separate
maintenance owed by the Executive or the Executive's
beneficiary(ies), nor be transferable by operation of law in
the event of bankruptcy, insolvency or otherwise. In the event
the Executive or any beneficiary attempts assignment,
commutation, hypothecation, transfer or disposal of the
benefits hereunder, the Bank's liabilities shall forthwith
cease and terminate.
B. Binding Obligation of Bank and any Successor in Interest:
--------------------------------------------------------
The Bank expressly agrees that it shall not merge or
consolidate into or with another bank or sell substantially
all of its assets to another bank, firm or person until such
bank, firm or person expressly agrees, in writing, to assume
and discharge the duties and obligations of the Bank under
this Agreement. This Agreement shall be binding upon the
parties hereto, their successors, beneficiary(ies), heirs and
personal representatives.
C. Revocation:
----------
It is agreed by and between the parties hereto that, during
the lifetime of the Executive, this Agreement may be amended
or revoked at any time or times, in whole or in part, by the
mutual written assent of the Executive and the Bank.
D. Gender:
------
Whenever in this Agreement words are used in the masculine or
neuter gender, they shall be read and construed as in the
masculine, feminine or neuter gender, whenever they should so
apply.
E. Effect on Other Bank Benefit Plans:
----------------------------------
Nothing contained in this Agreement shall affect the right of
the Executive to participate in or be covered by any qualified
or non-qualified pension, profit-sharing, group, bonus or
other supplemental compensation or fringe benefit plan
constituting a part of the Bank's existing or future
compensation structure.
F. Headings:
--------
Headings and subheadings in this Agreement are inserted for
reference and convenience only and shall not be deemed a part
of this Agreement.
8
G. Applicable Law:
--------------
The validity and interpretation of this Agreement shall be
governed by the laws of the State of Indiana.
VII. ERISA PROVISION
A. Named Fiduciary and Plan Administrator:
--------------------------------------
The "Named Fiduciary and Plan Administrator" of this Plan
shall be Ameriana Bank of Indiana, FSB until its removal by
the Board. As Named Fiduciary and Administrator, the Bank
shall be responsible for the management, control and
administration of the Salary Continuation Agreement as
established herein. The Named Fiduciary may delegate to others
certain aspects of the management and operation
responsibilities of the plan including the employment of
advisors and the delegation of ministerial duties to qualified
individuals.
B. Claims Procedure and Arbitration:
--------------------------------
In the event a dispute arises over benefits under this
Agreement and benefits are not paid to the Executive (or to
his beneficiary in the case of the Executive's death) and such
claimants feel they are entitled to receive such benefits,
then a written claim must be made to the Plan Administrator
named above within ninety (90) days from the date payments are
refused. The Plan Administrator shall review the written claim
and if the claim is denied, in whole or in part, they shall
provide in writing within ninety (90) days of receipt of such
claim their specific reasons for such denial, reference to the
provisions of this Agreement upon which the denial is based
and any additional material or information necessary to
perfect the claim. Such written notice shall further indicate
the additional steps to be taken by claimants if a further
review of the claim denial is desired. A claim shall be deemed
denied if the Plan Administrator fails to take any action
within the aforesaid ninety-day period.
If claimants desire a second review they shall notify the Plan
Administrator in writing within ninety (90) days of the first
claim denial. Claimants may review this Agreement or any
documents relating thereto and submit any written issues and
comments they may feel appropriate. In its sole discretion,
the Plan Administrator shall then review the second claim and
provide a written decision within ninety (90) days of receipt
of such claim. This decision shall likewise state the specific
reasons for the decision and shall include reference to
specific provisions of this Agreement upon which the decision
is based.
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If claimants continue to dispute the benefit denial based upon
completed performance of this Agreement or the meaning and
effect of the terms and conditions thereof, then claimants may
submit the dispute to a Board of Arbitration for final
arbitration. Said Board shall consist of one member selected
by the claimant, one member selected by the Bank, and the
third member selected by the first two members. The Board
shall operate under any generally recognized set of
arbitration rules. The parties hereto agree that they and
their heirs, personal representatives, successors and assigns
shall be bound by the decision of such Board with respect to
any controversy properly submitted to it for determination.
Where a dispute arises as to the Bank's discharge of the
Executive "for cause", such dispute shall likewise be
submitted to arbitration as above described and the parties
hereto agree to be bound by the decision thereunder.
IN WITNESS WHEREOF, the parties hereto acknowledge that each has
carefully read this Agreement and executed the original thereof on the 6th day
of May, 1999 and that, upon execution, each has received a conforming copy.
AMERIANA BANK OF
INDIANA, FSB
New Castle, Indiana
/s/ Dauena X. Xxxxxxxx By: /s/ Xxxxx Xxxxxx
---------------------------------- -------------------------------------
Witness President Title
/s/ Xxxxxxx X. Xxxxxxx By:/s/ Xxxxxxx X. Xxxxx
----------------------------------- -------------------------------------
Witness Xxx Xxxxx
10
LIFE INSURANCE
ENDORSEMENT METHOD SPLIT DOLLAR PLAN
AGREEMENT
Insurer: Xxxxxxxxx Xxxxxxxx Life Insurance Company
Security Life of Denver
Policy Number: AH5058511
001078399
Bank: Ameriana Bank of Indiana, FSB
Insured: Xxx Xxxxx
Relationship of Insured to Bank: Executive
The respective rights and duties of the Bank and the Insured in the
above-referenced policy shall be pursuant to the terms set forth below:
I. DEFINITIONS
Refer to the policy contract for the definition of all terms in this
Agreement.
II. POLICY TITLE AND OWNERSHIP
Title and ownership shall reside in the Bank for its use and for the
use of the Insured all in accordance with this Agreement. The Bank
alone may, to the extent of its interest, exercise the right to borrow
or withdraw on the policy cash values. Where the Bank and the Insured
(or assignee, with the consent of the Insured) mutually agree to
exercise the right to increase the coverage under the subject Split
Dollar policy, then, in such event, the rights, duties and benefits of
the parties to such increased coverage shall continue to be subject to
the terms of this Agreement.
III. BENEFICIARY DESIGNATION RIGHTS
The Insured (or assignee) shall have the right and power to designate a
beneficiary or beneficiaries to receive the Insured's share of the
proceeds payable upon the death of the Insured, and to elect and change
a payment option for such
beneficiary, subject to any right or interest the Bank may have in such
proceeds, as provided in this Agreement.
IV. PREMIUM PAYMENT METHOD
The Bank shall pay an amount equal to the planned premiums and any
other premium payments that might become necessary to keep the policy
in force.
V. TAXABLE BENEFIT
Annually the Insured will receive a taxable benefit equal to the
assumed cost of insurance as required by the Internal Revenue Service.
The Bank (or its administrator) will report to the Insured the amount
of imputed income each year on Form W-2 or its equivalent.
VI. DIVISION OF DEATH PROCEEDS
Subject to Paragraph VII herein, the division of the death proceeds of
the policy is as follows:
A. Should the Insured be employed by the Bank, retired from the
Bank, or terminated from the Bank due to disability at the
time of his or her death, the Insured's beneficiary(ies),
designated in accordance with Paragraph III, shall be entitled
to an amount equal to eighty percent (80%) of the net at risk
insurance portion of the proceeds. The net at risk insurance
portion is the total proceeds less the cash value of the
policy.
B. Should the Insured not be employed by the Bank at the time of
his or her death, the Insured's beneficiary(ies), designated
in accordance with Paragraph III, shall be entitled to the
following percentage of the proceeds described in Subparagraph
VI (A) hereinabove that corresponds to the number of full
years the Insured has been employed with the Bank from the
date of this Agreement:
Total Years
of Employment
with the Bank Vested
------------- ------
0-4 0%
5 or more 5% per year
(to a maximum of 100%)
C. The Bank shall be entitled to the remainder of such proceeds.
D. The Bank and the Insured (or assignees) shall share in any
interest due on the death proceeds on a pro rata basis as the
proceeds due each respectively bears to the total proceeds,
excluding any such interest.
2
VII. DIVISION OF THE CASH SURRENDER VALUE OF THE POLICY
The Bank shall at all times be entitled to an amount equal to the
policy's cash value, as that term is defined in the policy contract,
less any policy loans and unpaid interest or cash withdrawals
previously incurred by the Bank and any applicable surrender charges.
Such cash value shall be determined as of the date of surrender or
death as the case may be.
VIII. RIGHTS OF PARTIES WHERE POLICY ENDOWMENT OR ANNUITY
ELECTION EXISTS
In the event the policy involves an endowment or annuity element, the
Bank's right and interest in any endowment proceeds or annuity
benefits, on expiration of the deferment period, shall be determined
under the provisions of this Agreement by regarding such endowment
proceeds or the commuted value of such annuity benefits as the policy's
cash value. Such endowment proceeds or annuity benefits shall be
considered to be like death proceeds for the purposes of division under
this Agreement.
IX. TERMINATION OF AGREEMENT
This Agreement shall terminate upon the occurrence of any one of the
following:
1. The Insured shall leave the employment of the Bank(voluntarily
or involuntarily) prior to five (5) full years of employment
with the Bank from the date of this Agreement, or
2. The Insured shall be discharged from employment with the Bank
for cause. A termination for "cause" shall include termination
because of the Executive's personal dishonesty, incompetence,
willful misconduct, breach of fiduciary duty involving
personal profit, intentional failure to perform stated duties,
willful violation of any law, rule or regulation (other than
traffic violations or similar offenses) or final
cease-and-desist order, or material breach of any provision of
this Agreement.
Upon such termination, the Insured (or assignee) shall have a
forty-five (45) day option to receive from the Bank an absolute
assignment of the policy in consideration of a cash payment to the
Bank, whereupon this Agreement shall terminate. Such cash payment
referred to hereinabove shall be the greater of:
1. The Bank's share of the cash value of the policy on the date
of such assignment, as defined in this Agreement; or
2. The amount of the premiums which have been paid by the
Bank prior to the date of such assignment.
3
If, within said forty-five (45) day period, the Insured fails to
exercise said option, fails to procure the entire aforestated cash
payment, or dies, then the option shall terminate, and the Insured (or
assignee) agrees that all of the Insured's rights, interest and claims
in the policy shall terminate as of the date of the termination of this
Agreement.
Except as provided above, this Agreement shall terminate upon
distribution of the death benefit proceeds in accordance with Paragraph
VI above.
X. INSURED'S OR ASSIGNEE'S ASSIGNMENT RIGHTS
The Insured may not, without the written consent of the Bank, assign to
any individual, trust or other organization, any right, title or
interest in the subject policy nor any rights, options, privileges or
duties created under this Agreement.
XI. AGREEMENT BINDING UPON THE PARTIES
This Agreement shall bind the Insured and the Bank, their heirs,
successors, personal representatives and assigns.
XII. NAMED FIDUCIARY AND PLAN ADMINISTRATOR
Ameriana Bank of Indiana, FSB is hereby designated the "Named
Fiduciary" until resignation or removal by the Board of Directors. As
Named Fiduciary, the Bank shall be responsible for the management,
control, and administration of this Split Dollar Plan as established
herein. The Named Fiduciary may allocate to others certain aspects of
the management and operation responsibilities of the Plan, including
the employment of advisors and the delegation of any ministerial duties
to qualified individuals.
XIII. FUNDING POLICY
The funding policy for this Split Dollar Plan shall be to maintain the
subject policy in force by paying, when due, all premiums required.
XIV. CLAIM PROCEDURES FOR LIFE INSURANCE POLICY AND SPLIT DOLLAR PLAN
Claim forms or claim information as to the subject policy can be
obtained by contacting The Benefit Marketing Group, Inc.
(770-952-1529). When the Named Fiduciary has a claim which may be
covered under the provisions described in the insurance policy, they
should contact the office named above, and they will either complete a
claim form and forward it to an authorized representative of the
Insurer or advise the named Fiduciary what further requirements are
necessary. The Insurer will evaluate and make a decision as to payment.
If the claim is payable, a benefit check will be issued to the Named
Fiduciary.
4
In the event that a claim is not eligible under the policy, the Insurer
will notify the Named Fiduciary of the denial pursuant to the
requirements under the terms of the policy. If the Named Fiduciary is
dissatisfied with the denial of the claim and wishes to contest such
claim denial, they should contact the office named above and they will
assist in making inquiry to the Insurer. All objections to the
Insurer's actions should be in writing and submitted to the office
named above for transmittal to the Insurer.
XV. GENDER
Whenever in this Agreement words are used in the masculine or neuter
gender, they shall be read and construed as in the masculine, feminine
or neuter gender, whenever they should so apply.
XVI. INSURANCE COMPANY NOT A PARTY TO THIS AGREEMENT
The Insurer shall not be deemed a party to this Agreement, but will
respect the rights of the parties as herein developed upon receiving an
executed copy of this Agreement. Payment or other performance in
accordance with the policy provisions shall fully discharge the Insurer
for any and all liability.
Executed at New Castle, Indiana this 6th day of May, 1999.
AMERIANA BANK OF
INDIANA, FSB
New Castle, Indiana
/s/ Dauena X. Xxxxxxxx By: /s/ Xxxxx Xxxxxx
---------------------------------- -------------------------------------
Witness President Title
/s/ Xxxxxxx X. Xxxxxxx By:/s/ Xxxxxxx X. Xxxxx
----------------------------------- -------------------------------------
Witness Xxx Xxxxx
5
