TERMINAL ILLNESS RIDER WAIVER OF SURRENDER CHARGES FOR TERMINAL ILLNESS
Exhibit 4.(iv)
0000 Xxxxxxx Xxxxxxx, Xxxx Xxx Xxxxxx, Xxxx 00000
TERMINAL ILLNESS RIDER
WAIVER OF SURRENDER CHARGES FOR TERMINAL ILLNESS
This Rider is part of the Base Contract. Rider(s), Base Contract and attached application make up the entire Contract. Base Contract No.: XXXXXXXX
DEFINITIONS
When We use these words, we mean:
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Rider: |
This Rider |
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Base Contract: |
The Contract to which this Rider is attached. |
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Notice: |
Written proof of Annuitant’s Terminal Illness, a Qualified Physician signs, We receive and accept. Notice must be supported by clinical, radiological, or laboratory evidence of the condition. We may require another exam by a Qualified Physician of our choice at our expense. |
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Qualified Physician: |
Any person, who is licensed as an MD or DO to practice medicine in the United States and who is not the Annuitant, Owner or any member of either family. |
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Terminal Illness: |
Any disease or medical condition which a Qualified Physician expects will result in death within one year. |
Other definitions as used in the Base Contract, apply to this Rider.
RIDER BENEFIT
After the first Contract Year, You may take one additional Penalty-free Withdrawal of up to 100% of the Contract Value under the following circumstances:
1. A Qualified Physician provides Notice s/he has diagnosed the Annuitant as having a Terminal Illness;
2. The diagnosis and Notice occur after the first Contract Year ends; and
3. All other Limitations under the Base Contract apply.
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TERMINATION
Rider terminates on earliest of the date:
1. The Base Contract matures;
2. The Base Contract terminates;
3. You take Your additional Withdrawal under this Rider; or
4. The Annuitant dies.*
* If the Annuitant is the Owner, the beneficiary under the Base Contract is the Annuitant’s spouse, the spouse opts to become the new Owner, and You have not taken Your additional Withdrawal under this Rider, then this Rider will remain in effect under the Ownership of the surviving spouse.
GENERAL
Unless stated otherwise, all provisions and limitations of the Base Contract apply to this Rider.
WEST DES MOINES, IOWA
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/s/ Xxxxx X. Xxxxxxxxxx |
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/s/ Xxxxx X. Xxxxx |
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Xxxxx X. Xxxxxxxxxx |
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Xxxxx X. Xxxxx |
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Secretary |
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President |
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