Exhibit 99.A5m
MINNESOTA MUTUAL LIFE SHORT TERM AGREEMENT
Agreement Date Applicable Coverage Short Term Premium
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GENERAL
In consideration of the payment of the Short Term Premium shown above, the
Company hereby agrees to pay the death benefit provided by this agreement upon
receipt of due proof that an Insured Person has died while this agreement is in
effect.
APPLICABLE COVERAGE
This short term agreement provides temporary protection preceding another
coverage which shall be known as the Applicable Coverage. If the Applicable
Coverage is a policy, it shall be identified by the words "Entire Policy" in the
space above. If the Applicable Coverage is an agreement being added to a policy
already in force, it shall be identified by its form number in the space above.
INSURED PERSON
An Insured Person shall be that person or those persons to be insured under the
Applicable Coverage.
SHORT TERM PERIOD
This agreement shall take effect at the same time and subject to the same
conditions as those stated in the application for the Applicable Coverage
provided that wherever the words "first premium" appear therein, the words
"Short Term Premium" are substituted. This agreement shall terminate on the day
preceding the date of issue of the Applicable Coverage. However, a grace period
of 31 days will be allowed for payment of the first regular premium required
under the Applicable Coverage. This agreement shall continue in force during
the grace period. If death occurs during the grace period the unpaid premium
shall be deducted from the amount otherwise payable.
DEATH BENEFIT
This agreement applies to the life coverage on the lives of all Insured Persons.
The death benefit provided by this agreement shall be those benefits which would
have been payable under the Applicable Coverage had death taken place on its
date of issue, except that if an infant insured dies before attaining the age of
32 days, the amount shall be reduced to one-fourth the amount otherwise payable.
DISABILITY
Any total and permanent disability benefits provided under the Applicable
Coverage shall be included under this agreement.
E324 3-65
CONTESTABLE AND SUICIDE PERIODS
The contestable and suicide periods for the Applicable Coverage shall be
measured from the date of this agreement.
This agreement is not in force unless countersigned by a Registrar.
/s/ Xxxxxxx Xxxxxxxxxx
President
/s/ Xxxxxx X. Xxxxxxx
Secretary
Registrar
