EXHIBIT 1A(5)(b)(iii)
[LOGO OF SAGE LIFE APPEARS HERE]
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SAGE LIFE ASSURANCE OF AMERICA, INC.
Member of Sage Insurance Group, Inc.
ACCIDENTAL DEATH BENEFIT RIDER
General
This Rider is made part of the Contract to which it is attached. It provides an
additional benefit, the "Accidental Death Benefit," in the event of the
accidental death of the Insured.
Benefit
Subject to the terms and conditions stated below, this Rider provides an
Accidental Death Benefit equal to the purchase payments made minus any
withdrawals (including any associated Market Value Adjustment and surrender
charge incurred) determined as of the date of the Insured's death, up to a
maximum amount shown in the Contract Schedule.
Conditions
1. The Insured's death must be an accidental death.
2. The accidental death must occur while this rider is in force and
prior to the first Contract Anniversary after which the Insured
attains age 80.
3. The accidental death must occur before the Surrender Value is
applied under a Settlement Option.
4. We must receive satisfactory proof of accidental death.
Accidental Death Definition
Accidental death means a death resulting from a bodily injury effected solely
through external, violent, and accidental means independently and exclusively of
all other causes, with death occurring within 90 days after such injury.
Exclusions
This Rider does not provide an additional benefit in the event that death
results from or relates to any of the following:
1. Sickness of mind and/or body, including related medical or surgical
treatment.
2. Overdose due to voluntary ingestion of non-prescribed drugs and/or
alcohol.
3. Suicide, while sane or insane.
4. Air travel, in any type of vehicle, except as a fare-paying
passenger traveling on a regularly scheduled airline.
5. War or any act of war, whether or not the Insured is serving in the
military, naval or air forces of any country or international
organization.
6. Voluntarily committing and/or attempting to commit an assault or
felony, including participation in a riot.
7. Resisting or fleeing from arrest.
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Satisfactory Proof of Claim
We must receive written proof that the Insured died an accidental death while
this Rider is in force.
We will have the right to have the Insured's body examined and to request an
autopsy, at our expense, unless law prohibits us from doing so.
Notice of Claim
Written notice of claim must be given to us within thirty (30) days after an
accidental death or as soon as reasonably possible. Notice given to us at our
Customer Service Center with information sufficient to identify the Insured will
be considered notice to us.
Payment of Claim
The Accidental Death Benefit will be paid to the person or persons entitled to
receive the death benefit according to the Contract upon receipt of the written
proof of accidental death. If we elect to have the Insured's body examined
and/or perform an autopsy, payment may be made after satisfactory conclusion of
the examination.
Charge for this Rider
There is no charge for this Rider.
Termination
This Rider will terminate on the date of the first to occur of the following
events:
1. The Accidental Death Benefit is paid.
2. The Contract is surrendered or the entire Surrender Value is applied
under a Settlement Option.
3. The interest in the Contract is distributed due to the death of the
Insured.
4. You request the termination of this Rider.
Terms
All of the terms used in this Rider have the same meanings as in the Contract
unless otherwise clearly indicated in this Rider.
/s/
Chairman
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