Exhibit A5F
Rider--Disability Waiver of Monthly Deduction Agreement
The Penn Mutual Life Insurance Company agrees, subject to the provisions of this
supplemental agreement, to provide the Waiver of Monthly Deductions Benefit.
This supplemental 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.
Waiver of Monthly Deductions Benefit--This benefit provides for the waiver of
the Monthly Deductions for this policy. The Monthly Deductions will be waived as
stated below upon receipt by Penn Mutual of due proof of the total disability of
the Insured and due proof that the total disability:
(a) began while this agreement was in force prior to the anniversary of this
policy which is nearest to the Insured's 65th birthday;
(b) has continued without interruption for four months during the life of the
Insured; and
(c) if this agreement was issued prior to the Insured's age five, began on or
after the anniversary of this policy which is nearest to the Insured's
fifth birthday.
The Monthly Deductions will be waived as follows:
(1) If the total disability of the Insured begins prior to the anniversary of
this policy which is nearest to the Insured's 60th birthday, the Monthly
Deductions will be waived during the continuance of the disability.
(2) If the total disability of the Insured begins on or after the anniversary
of this policy which is nearest to the Insured's 60th birthday, the Monthly
Deductions will be waived during the continuance of the disability until
the anniversary of this policy which is nearest to the Insured's 65th
birthday or, if longer, during the first two years after the date that the
disability begins.
Monthly Deductions after the date that the total disability of the Insured
begins but before it has continued for four months will be deducted from the
Cash Value as stated in this policy. If Monthly Deductions are waived because of
the total disability of the Insured, Monthly Deductions for the period beyond
the end of the policy month in which that disability began will be credited to
the Cash Value. However, no Monthly Deductions for a period more than one year
prior to the time that the notice of claim is given to Penn Mutual at its Home
Office will be waived or credited to the Cash Value unless it is shown that the
notice of claim was given as soon as was reasonably possible.
If the total disability of the Insured begins during a grace period, a premium
sufficient to cover the Monthly Deductions for the grace period must be paid to
Penn Mutual before any Monthly Deductions will be waived.
If, at the time that a claim for waiver of Monthly Deductions is approved by
Penn Mutual, the Specified Amount under this policy includes the Cash Value, it
will be changed so that the Specified Amount does not include the Cash Value.
Such change will be in accordance with the provisions in the Policy Changes
section of this policy.
Total Disability Defined--As used in this agreement, total disability of the
Insured means an incapacity of the Insured which:
(a) results from bodily injury or disease; and
(b) prevents the Insured from performing substantially all of the work which
pertains to an occupation.
The term occupation means:
(a) during the first 24 months of the disability, the Insured's own occupation;
and
(b) after the first 24 months of the disability, any occupation for which the
Insured is suited by education, training or experience.
The total and irrecoverable loss by the Insured of any of the following will be
considered to be total disability even though the Insured may be able to work at
an occupation:
(a) the sight of both eyes;
(b) the use of both hands or of both feet;
(c) the use of one hand and one foot;
(d) speech; or
(e) hearing.
Risks Not Assumed--Monthly Deductions will not be waived if the total disability
of the Insured results from:
(a) war or an act of war while the Insured is in the military, naval or air
force of any country, group of countries or international organization; or
Disability Waiver of Monthly Deduction Agreement (continued)
(b) injuries which were willfully and intentionally self-inflicted.
The term war, as used above, includes declared war and armed aggression by one
or more countries which is resisted on the orders of any other country, group of
countries or international organization.
Notice of Claim and Proof of Total Disability--Monthly Deductions will be
waived only if a written notice of claim and due proof of the total disability
of the Insured are given to Penn Mutual at its Home Office. The notice and the
proof must be given:
(a) during the life of the Insured and during the continuance of the disability;
and
(b) not more than one year after the time that this agreement terminates.
The failure to give the notice and the proof will not invalidate or reduce a
claim if it is shown that the notice and the proof were given as soon as was
reasonably possible.
Penn Mutual may require due proof of the continuance of the total disability of
the Insured. At reasonable intervals, a medical examination of the Insured by a
medical examiner who is named by Penn Mutual may be required. Any such
examination will be at Penn Mutual's expense. Such proof or examination will not
be required more often than once a year after the total disability of the
Insured has continued for two years. The failure to give such proof or to submit
to such examinations will cause the benefit under this agreement to cease.
If the Insured is totally disabled on the anniversary of this policy which is
nearest to the insured's 65th birthday and if the Monthly Deductions for the
five years prior to that anniversary have been waived under this agreement, no
further proof will be required. Penn Mutual will then waive all future Monthly
Deductions under this policy.
Cost of Insurance--The Cost of Insurance for the Waiver of Monthly Deductions
Benefit is determined on a monthly basis. The Cost of Insurance for a policy
month is calculated as (a) multiplied by the result of (b) minus (c), where:
(a) is the Cost of Insurance Rate for this benefit;
(b) is the Basic Death Benefit under this policy at the beginning of the policy
month divided by 1.0032737; and
(c) is the Cash Value of this policy at the beginning of the policy month.
The Cost of Insurance Rate for this benefit is based on the attained age, sex
and rate class of the Insured. Cost of Insurance Rates will be determined by
Penn Mutual based on expectations as to future experience. However, these rates
will not exceed those shown in the Additional Policy Specifications.
Incontestability--This agreement will be incontest-able after it has been in
force during the life of the Insured for two years from its date of issue except
as to total disability of the Insured which begins prior to the end of such two
year period.
Termination--This agreement will terminate upon:
(a) the anniversary of this policy which is nearest to the Insured's 65th
birthday; provided that such termination will not affect any benefit which
is payable because of a total disability of the Insured which began prior
to that anniversary;
(b) lapse of this policy;
(c) the date of the death of the Insured;
(d) surrender of this policy;
(e) expiry of this policy; or
(f) the Monthly Anniversary that coincides with or next follows (i) the receipt
at the Home Office of a written request by the Owner to terminate this
agreement, and (ii) the return of this policy for appropriate endorsement.
Date of Issue--The date of issue of this agreement is the same as the Date of
Issue of this policy unless another date of issue is shown below.
/s/ Xxxxxx X. Xxxxxxxx
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Xxxxxx X. Xxxxxxxx
Chairman and
Chief Executive Officer
