LIBERTY LIFE ASSURANCE COMPANY OF BOSTON
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PRIMARY
INSURED
TERM
INSURANCE
BENEFIT
AGREEMENT
THE BENEFIT
We will pay a Death Benefit upon receipt of proof, satisfactory to Us, of the
death of the Primary Insured while this Agreement is in force.
The Death Benefit for this Agreement will be equal to the Face Amount for the
Primary Insured shown on the Contract Information page of this Agreement.
DEFINITION OF PRIMARY INSURED
Primary Insured means the person named in the application for this Agreement and
shown on the Contract Information page of this Agreement. The Primary Insured is
the Insured named on the Application for this contract.
OWNER
The Owner of this contract will be the Owner of this Agreement.
BENEFICIARY
The Beneficiary of this contract will be the Beneficiary of this Agreement.
COST OF THE BENEFIT
A Monthly Deduction is made from the Account Value of this contract for the cost
of this Agreement. The Monthly Deduction for this Agreement is computed as
follows:
o Divide the Face Amount of this Agreement, shown on the Contract Information
page, by 1 plus the Guaranteed Monthly Equivalent Interest Rate, also shown on
the Contract Information page;
o Multiply the above result by the Cost of Insurance Rate for this Benefit
Agreement for that month divided by 1000.
COST OF INSURANCE RATE
The Cost of Insurance Rate is based on the sex, attained age, and rating
classification of the Primary Insured. Attained age means the Primary Insured's
age last birthday on the last contract anniversary. We have the right to change
the Cost of Insurance Rates as provided in this contract. However, the rates
will not be greater than the Guaranteed Maximum Monthly Cost of Insurance Rates
shown on the Contract Information page of this Agreement.
CONVERSION BENEFIT
You may convert this Agreement into a new contract on the life of the Primary
Insured, provided:
o this Agreement is in force; and
o the Primary Insured has not attained age 75.
To exercise the Conversion Benefit, You must submit a written application which
satisfies Us and pay the first premium for the new contract. We will not require
any evidence of insurability.
You may make the conversion on any premium due date which occurs on or before
the contract anniversary following the 75th birthday of the Primary Insured. You
will be eligible for conversion credit if You make the conversion on any Monthly
Date on or after the first anniversary and on or before the fourth anniversary
of this Agreement. We will apply a credit toward the premium for the new
contract. That credit will equal 100% of this Agreement's Cost of Insurance
charges for the most recently completed contract year. If You convert only a
portion of the amount of insurance provided by this Agreement, We will prorate
the credit. Conversion must be made while this contract is in force.
THE NEW CONTRACT
The Date of Issue of the new contract will be the date of conversion.
You may select the amount of life insurance for the new contract. It may not
exceed the Face Amount of this Agreement at the time of conversion.
You may also select the plan of insurance for the new contract. It may be any
permanent plan of insurance plan then being issued by Us, or an increase to the
face amount of the current contract, for the amount of insurance selected. It
will be in the same Rating Class as shown for the Primary Insured on the
Contract Information page of this Agreement. The premium for the new contract
will be based on Our then established rate for the attained age of the person to
be insured.
The contestable and suicide periods for the new contract will be measured from
the Effective Date of this Agreement. The contestable and suicide periods for
any Additional Benefit Agreement included in the new contract will be measured
from the Effective Date of the new contract. If You wish to include any
Additional Benefit Agreements in the new contract, evidence of insurability
satisfactory to Us will be required.
TERMINATION
This Agreement will terminate on the earliest of:
o the Monthly Date on or next following the date We receive Your Written Request
to cancel this Agreement;
o the date this contract matures; is surrendered; or terminates for any reason;
o the Termination Date of this Agreement, shown on the Contract Information
page; or
o the date of conversion as provided in this Agreement.
THIS AGREEMENT AND THE CONTRACT
This Agreement is made a part of Your contract if We have listed it on the
Contract Information page of this contract. All contract provisions consistent
with this Agreement will apply to this Agreement. The values in the contract
will not be increased by this Agreement.
INCONTESTABILITY AFTER TWO YEARS
This Agreement will be incontestable after it has been in force during the
Primary Insured's lifetime for two years from its Effective Date.
SUICIDE WITHIN TWO YEARS
If the Primary Insured dies by suicide, while sane or insane, within two years
from the Effective Date of this Agreement, the amount payable will be limited to
the total of the Monthly Deductions made to pay for the Primary Insured's
insurance.
MISSTATEMENT OF AGE OR SEX
If the age or sex of the Primary Insured has been misstated, any Death Benefit
will be adjusted to that amount which would be purchased by the most recent Cost
of Insurance Rate at the correct age and sex.
REINSTATEMENT
If You wish to reinstate this Agreement with this contract, We will require You
to submit evidence of insurability satisfactory to Us for the Primary Insured.
This is in addition to any requirements for the reinstatement of the contract.
EFFECTIVE DATE
This Agreement takes effect on the Date of Issue shown on the Contract
Information page of this Agreement. Months, years and their anniversaries will
be computed from the date this Agreement takes effect.
/s/ Xxxxxx X. Xxxxx
PRESIDENT
