Rider - Flexible Period-Single Life-Supplemental
A001042R
Term Insurance Agreement
The Penn Mutual Life Insurance Company agrees, subject to the provisions of this
supplemental agreement, to provide the Term Insurance Benefit. The Company also
agrees to provide all of the other benefits which are stated in this agreement.
This agreement is a part of the policy to which it is attached. It is subject to
all of the provisions of the policy unless stated otherwise in this agreement.
Term Insurance Benefit --The Company will pay the Term Insurance Benefit upon
receipt of due proof of the death of the Named Insured for Single Life Term
Insurance shown in the Additional Policy Specifications, while this agreement is
in force. The amount of the Term Insurance Benefit is the Specified Amount for
Single Life Term Insurance as shown in the Additional Policy Specifications. The
amount of the Term Insurance Benefit may not at any time exceed the Specified
Amount for this policy.
The Term Insurance Benefit payable on the death of the Named Insured will be
paid to the Single Life Term Insurance beneficiary of the Named Insured in one
sum or, if elected, under an income payment option. If part or all of the
benefit is paid in one sum, the Company will pay interest on this sum from the
date of death to the date of payment. The interest rate will be determined each
year by the Company, but will not be less than a rate of 3% per year compounded
annually, or such higher rate as may be required by state law.
Suicide Exclusion--If the Named Insured dies by suicide while sane or insane
within two years from the effective date of this agreement, the Single Life Term
Insurance Benefit will be limited to the cost of such benefit.
Beneficiary--The Single Life Term Insurance beneficiary of the Named Insured is
as stated in the application for this agreement unless changed by a subsequent
beneficiary designation. If no other provision is made, the interest of a Single
Life Term Insurance beneficiary who dies before the Named Insured will pass to
the Owner.
Change in Specified Amount--The Specified Amount for Single Life Term Insurance
may be decreased subject to the following conditions:
(a) Any decrease in the Specified Amount for Single Life Term Insurance must be
at least $5,000; and
(b) The Specified Amount for Single Life Term Insurance may not be decreased to
less than $10,000
Monthly Deduction--While this agreement is in force, the Monthly Deduction under
this policy will include the Monthly Deduction for this agreement. The Monthly
Deduction for this agreement is the sum of
(a) the Cost of Insurance for the policy month for the Term Insurance Benefit
under this agreement; and
(b) a monthly charge of $0.10 per $1,000 of Specified Amount for Single Life
Term Insurance for the first 12 months following the effective date of this
agreement.
Cost of Insurance--The Cost of Insurance for the Single Life Term Insurance
under this agreement is determined on a monthly basis. It is calculated as (a)
multiplied by (b) where:
(a) is the Cost of Insurance Rate divided by $1,000 for Term Insurance
applicable to this policy, and
(b) is the Specified Amount for Single Life Term Insurance under this agreement.
The Cost of Insurance Rate for Supplemental Term Insurance is based on the
attained age and rate class of the Named Insured. Cost of Insurance Rates will
be determined by the Company based on expectations as to future mortality,
investment, expense and persistency experience. However, these rates will not
exceed those shown for the policy in the Additional Policy Specifications.
Cost of Insurance Rates will not be adjusted by the Company as a means of
recovering prior losses nor as a means of distributing prior profits.
Computation of Values--All values and benefits in this agreement are equal to or
greater than those required by the law of the jurisdiction in which this policy
is delivered.
Flexible Period-Single Life-Supplemental
A001043R
Term Insurance Agreement (continued)
Incontestability--This agreement will be incontestable after it has been in
force during the life of the Named Insured for two years from the effective
date.
This agreement will be incontestable with respect to statements made in an
application for reinstatement after it has been in force during the life of the
Named Insured for two years from the effective date of the reinstatement.
Attained Age -- The attained age of the Named Insured under this agreement is
the age nearest birthday of the Named Insured on the most recent policy
anniversary.
Misstatement of Age -- If the age of the Named Insured has been misstated, the
Single Life Term Insurance benefit will be the amount which would have been
provided by the most recent Cost of Insurance charge at the correct age.
Right to Convert Term Insurance--The term insurance under this agreement for a
Named Insured may be converted to a life or endowment policy without evidence of
insurability at any time while such insurance is in force before the earlier of
(i) the policy anniversary nearest to the Named Insured's 70th birthday, and
(ii) the policy anniversary which is three years prior to the Termination Date
for this agreement shown in the Additional Policy Specifications. The Owner must
make a written request for the conversion. On or before the date of conversion,
the Owner must pay the first premium for the new policy.
The new policy will be:
(a) on a plan which insures only the life of the Named Insured;
(b) in the same rate class and subject to the same limitations of risk as the
term insurance on the Named Insured under this agreement;
(c) issued at the age of the Named Insured on the birthday which is nearest to
the date of the conversion;
(d) on the policy form and at the premium rates in use by the Company on the
date of the conversion; and
(e) subject to the Company's rules as to minimum amount, plan of insurance and
age at issue which are in effect on the date of the conversion.
The inclusion of any supplemental agreements in the new policy will be subject
to the consent of the Company and must comply with the rules of the Company.
Termination of Agreement--This agreement will terminate upon :
(a) the Termination Date for this agreement shown in the Additional Policy
Specifications;
(b) lapse of this policy;
(c) surrender of this policy;
(d) conversion of the term insurance under this agreement; or
(e) the Monthly Anniversary which coincides with or next follows (i) receipt
by the Company of a written request by the Owner to terminate this
agreement, and (ii) return of this policy for appropriate endorsement.
Effective Date--The effective date of this agreement is the same as the Date of
Issue of this policy unless another effective date is shown below.
/s/ Xxxxxx X. Xxxxxxxx
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Chairman and
Chief Executive Officer
