New York Life Insurance Company. TWENTY-PAYMENT LIFE POLICY ANNUAL DIVIDENDS AMOUNT, $10,000. DISABILITY BENEFIT. ANNUAL PREMIUM, $389. AGE, 35, New York Life Insurance Company, by this policy of insurance agrees to pay (face amount of the policy) ten thousand dollars at the home office of the company in the city and State of New York to (beneficiary) Mary Doe, wife of the insured, beneficiary, (with the right on the part of the insured to change the beneficiary as hereinafter provided), upon receipt at said home office of due proof of the death, during the continuance of this contract, (insured) of John Doe, the insured. PREMIUM. HOW AND WHEN PAYABLE. This insurance is granted in consideration of the payment of the first premium of three hundred eighty-nine dollars, the receipt of which is hereby acknowledged, constituting payment for the period terminating on the fifteenth day of January, in the year nineteen hundred and fourteen, and the payment of a like sum on said date and on the fifteenth day of January in every year thereafter during the continuance of this policy until premiums shall have been paid for twenty full years from January 15th, 1913 or until the prior death of the insured. INCONTESTABILITY. This policy is free of conditions as to residence, travel, occupa tion, or military or naval service, and shall be incontestable after one year from its date of issue except for non-payment of premium. (Date policy takes effect.) After its delivery to and receipt by the insured this policy takes effect as of the fifteenth day of January, 1913. The benefits and provisions printed or written by the company on the following pages are a part of this contract as fully as if they were recited at length over the signatures hereto affixed. In witness whereof the New York Life Insurance Company has caused this contract to be signed this fifteenth day of January, 1913. SECTION 1-PARTICIPATION IN SURPLUS. The proportion of divisible surplus accruing upon this policy shall be ascertained and distributed annually and will not be conditioned upon the payment of the next premium. At the option of the insured such dividend shall each year, on the anniversary of the policy, be either (a) paid in cash; or, (b) applied toward the payment of any premium or premiums; or, (c) applied to the purchase of a participating paid-up addition to the sum insured; or, (d) left to accumulate to the credit of the policy at such rate of interest as the company may declare on such funds, and payable on the maturity of the policy or withdrawable in cash on any anniversary date of the insurance. The rate of interest shall not be less than three per cent compounded and credited annually. If the insured fails to notify the company in writing, within three months after the company shall have mailed to him a written notice of the amount of said dividend and the options available as aforesaid, which option he selects, the company shall then apply said dividend to the purchase of a paid-up addition to the sum insured. Such paid-up addition may be surrendered for cash at any time, and the cash value thereof shall not be less than the original cash dividend. SECTION 2-CASH LOANS AND BENEFITS ON SURRENDER OR LAPSE. CASH LOANS. At any time after two full years' premiums have been paid, and while this policy is in force, the company shall advance to the insured on the sole security of this policy as duly evidenced in writing, any sum desired, the total indebtedness to the company, including any advance then made, shall, however, not exceed that sum which with six per cent interest shall equal the cash surrender value at the end of the then current insurance year. Interest on the loan shall be at the rate of six per cent per annum, payable annually on the premium paying anniversary date of the policy. All or any part of the sum advanced may be repaid at any time. Failure to repay such advance or to pay interest thereon shall not avoid the policy, but if the interest is not paid when due it shall be added to the indebtedness; and whenever the amount of the total indebtedness equals the cash surrender value, the policy shall become void one month after the company shall have mailed notice of such fact to the last known address of the insured and of the assignee of record, if any. BENEFITS ON SURRENDER OR LAPSE. After two full annual premiums shall have been paid, the insured may within three months after any default in payment of premium, but not later, surrender the policy, and, (a) receive its cash surrender value less any indebtedness to the company hereon. The cash surrender value shall be the reserve on this policy, at the date of default (omitting fractions of a dollar per thousand of insurance) and the reserve on any paid-up additions thereto, and any dividends standing to the credit of this policy, less a surrender charge which in no case shall be more than one and one-half per cent of the sum insured. After premiums have been paid for ten years or more there will be no surrender charge. The reserve will be computed according to the American Table of Mortality and interest at the rate of three per cent per annum; or, (b) receive non-participating paid-up insurance payable at the same time and on the same conditions as this policy except as to disability benefits. The insured Lay at any time obtain a loan on such paid-up insurance in accordance with the provisions contained in this section, or surrender such paid-up insurance for its cash surrender value. (c) If the policy be not surrendered for cash, or for paid-up insurance as above, the insurance shall be automatically continued for the face amount of this policy plus any dividend additions and less any indebtedness to the company hereon, from the date of default, for such term in years and months as is hereinafter provided, but without future participation and without the right to loans or cash surrender value and without disability benefits. The amount of paid-up insurance, or the term for which the insurance will be continued, shall be such as the cash surrender value less any indebtedness to the company hereon will purchase as a net single premium at the age of the insured at the date of default, according to the American Table of Mortality and interest at the rate of three per cent per annum. TABLE OF LOAN AND SURRENDER VALUES.-The figures contained in this table represent the maximum amounts available, assuming that premiums have been paid in full for the number of years stated in the table, and that there is no indebtedness to the company hereon and that there are no outstanding dividends. Values for later years shall be computed upon the above basis, and will be furnished on request. *The loan values in the above table are the maximum amounts available at the end of the policy year indicated. Loans may also be obtained during the policy year as set forth in this section under "cash loans." SECTION 3-DISABILITY BENEFITS. A. WAIVER OF PREMIUMS.-If, after this policy shall have been in force one full year and before default in the payment of any premium, the company receives due proof that the insured before attaining the age of sixty years has become wholly disabled by bodily injury or disease so that he is and will be presumably, thereby permanently and continuously prevented from engaging in any occupation whatsoever for remuneration or profit, the company shall waive payment of each premium as it thereafter becomes due during the insured's said disability. In making any settlement under this policy the company shall not deduct any part of the premiums so waived, and the loan and cash surrender values provided for under Section 2 shall increase from year to year in the same manner as if the premiums so waived had been paid in cash. Under all the conditions aforesaid, except that the insured shall have attained the age of sixty years before becoming disabled, the company shall waive payment of each premium thereafter becoming due during such disability, but the face amount of the policy shall be reduced by the amount of each such waived premium, and the loan and cash surrender values as provided for under Section 2 shall be based upon said reduced amount of insurance in the same manner as if the premiums for such reduced amount of insurance had been duly paid. ment. B. INSTALMENT PAYMENTS.-In addition to waiving payment of premiums as aforesaid, if such disability shall have occurred before the insured attained the age of sixty years, the company, one year after said proof of such disability, shall pay to the insured one-tenth of the face amount of the policy and a like amount in each insurance year thereafter during the continuance of such disability prior to the maturity of the policy; the policy must be returned to the company for the endorsement thereon of each payAt the insured's option any such payment or payments may be left with the company to accumulate until the maturity of the policy at such rate of interest as the company may declare on funds so held by it but at a rate not less than three per cent, compounded annually. Each instalment shall reduce to that extent the amount of insurance in force, and the loan and cash surrender values provided for under Section 2 shall be calculated for the reduced amount insured on the basis provided in said Section 2. If at the time when any such instalment becomes payable there shall be an indebtedness on the policy in excess of the cash surrender value of the reduced amount of insurance, the company shall apply such part of the instalment as may be necessary to reduce the indebtedness to the amount secured by such cash surrender value. When ever the total amount of said instalments, together with the amount of any remaining indebtedness to the company, shall equal the face amount of the policy, plus any paidup dividend additions, unpaid dividends and dividends left to accumulate to the credit of the policy, then the company's obligations under the policy shall thereby be fully satisfied and discharged without further action. C. RECOVERY FROM DISABILITY. Should the company accept under this policy proofs of disability, it may nevertheless at any time thereafter, and from time to time, but not oftener than once a year, demand of the insured proof of the continuance of such disability, and upon failure to furnish such proof, or, if it appears that the insured has become able to engage in any occupation whatsoever for remuneration or profit, no further premiums shall be waived and no further instalment payments will be made by the company. But if the amount of the insurance shall then have been reduced under any of the foregoing provisions such reduced amount of insurance shall thereafter be the face amount of the policy, and the premiums thereafter falling due will be reduced in proportion to the reduced amount of insurance, and all benefits under the policy will be reduced accordingly. Without prejudice to any other cause of disability, the entire and irrecoverable loss of the sight of both eyes, or the severance of both hands above the wrists, or of both feet above the ankles, or of one entire hand and one entire foot shall be considered as total and permanent disability within the meaning of this section. SECTION 4-LOAN INSURANCE. Any indebtedness to the company against this policy may be covered by loan insurance, and, upon due proof of the death of the insured, such loan insurance shall be applied to the cancellation of any such indebtedness. Loan insurance shall be subject to the following conditions: FIRST.-Evidence of insurability satisfactory to the company shall be required. No loan insurance shall take effect until the insured shall have received from the company a certificate thereof. SECOND.-Premiums must be paid in accordance with the rates in the following table. The premium for loan insurance shall be computed at the attained age of the insured at the time when such loan insurance is made or renewed. For periods of less than one year, the premium shall be at the rate of one-tenth of the one year's premium for each month and fraction of a month. THIRD.-Loan insurance shall not be granted for any period extending beyond the next premium paying anniversary date of this policy, but may be renewed from year to year subject to evidence of insurability satisfactory to the company and payment of premium at the attained age, but no loan insurance shall be granted or renewed after age sixty-five. FOURTH.-Whenever the loan insurance exceeds the indebtedness the company may cancel that portion of the loan insurance in excess of the indebtedness, and refund the unearned premium. PREMIUMS FOR EACH $100 OF LOAN INSURANCE. SECTION 5 OTHER BENEFITS AND PROVISIONS. AGE-If the age of the insured has been misstated the amount payable hereunder shall be such as the premium paid would have purchased at the correct age. ASSIGNMENT. Any assignment of this policy must be made in duplicate and one copy filed with the company at its home office. The company assumes no responsibility as to the validity of any assignment. CHANGE OF BENEFICIARY. When the right of revocation has been reserved, or in case of the death of any beneficiary under either a revocable or irrevocable designation, the insured, if there be no existing assignment of the policy made as herein provided, may, while the policy is in force, designate a new beneficiary, with or without reserving right of revocation, by filing written notice thereof at the home office of the company accompanied by the policy for suitable endorsement thereon. Such change shall take effect when endorsed on the policy by the company and not before. If any beneficiary shall die before the insured, the interest of such beneficiary shall vest in the insured. GRACE.-A grace of one month (not less than thirty days) subject to an interest charge of five per cent per annum shall be allowed for the payment of every premium after the first, during which time the insurance shall continue in force. If death occurs within the period of grace the unpaid premium for the then current policy year shall be deducted from the amount payable hereunder. PAID-UP AND ENDOWMENT OPTIONS.-Whenever the reserve on this policy together with the reserve on existing dividend additions, if any, at the end of any policy year shall equal or exceed the net single premium for the attained age of the insured by the American Experience Table of Moratlity and interest at three per cent, for an amount of insurance equal to the face amount of this policy, payable at the same time and under the same conditions as this policy, the company, at the written request of the insured, will endorse the policy as participating paid-up insurance for such amount as the said reserve will purchase when thus applied, any indebtedness to the company to be a lien against said paid-up insurance upon the same terms and conditions as in Section 2; or, whenever said reserve at the end of any policy year shall equal or exceed the face amount of this policy, the company, upon surrender of the policy and all claims thereunder, shall pay in cash the face amount of the policy and any excess of said reserve, less any indebtedness to the company. PAYMENT OF PREMIUMS. All premiums are payable on or before the date due, at the home office of the company or to an agent of the company upon delivery of a receipt signed by the president, a vice-president, a second vice-president, a secretary or the treasurer of the company, and countersigned by said agent. The premium is always considered as payable annually, in advance, but by agreement in writing and not otherwise may be made payable in semi-annual or quarterly payments. Any unpaid premiums required to complete the payments for the current policy year in which death occurs shall be deducted from the amount payable hereunder. The payment of a premium shall not maintain the policy in force beyond the date when the next payment is due, except as herein provided. PRIVILEGE OF CHANGE TO OTHER FORMS OF POLICIES.-At any time, and while in full force, and provided the insured is then less than sixty years of age, this policy may be changed without medical re-examination for a policy of the same amount, upon any form of insurance issued by the company at the time this policy takes effect and having a higher rate of premium but without disability benefits. Such change shall be effective upon payment of a sum equal to the difference between the premiums on the new policy and the premiums paid on this policy (exclusive of the premiums paid for disability benefits), with compound interest at the rate of six per cent per annum from the due date of each payment to the date when the change is made, and upon the surrender of this policy. The new policy shall take effect as of the date of this policy, and the premium shall be based upon the same age as this policy. The cash value of any dividends standing to the credit of this policy, as well as any additional cash value of such dividends that would have been credited under the new policy, may be used in the settlement of the difference of premiums. REINSTATEMENT.-At any time after any default, upon written application by the insured and upon presentation at the home office of evidence of insurability satisfactory to the company, this policy may be reinstated together with any indebtedness in accordance with the loan provisions of the policy, upon payment of arrears of premiums with interest thereon at the rate of five per cent per annum. SELF-DESTRUCTION.-In event of self-destruction during the first insurance year, whether the insured be sane or insane, the insurance under this policy shall be a sum equal to the premiums thereon which have been paid to and received by the company, and no more. MISCELLANEOUS PROVISIONS.-The policy and the application therefor, a copy of which was attached to this policy when delivered, constitute the entire contract between the parties. All statements made by the insured shall, in absence of fraud, be deemed representations and not warranties, and no such statement shall avoid this policy or be used in defense to a claim hereunder unless it be contained in said written application. The insured may, without the consent of the beneficiary, receive every nefit, exercise every right and enjoy every privilege conferred upon the insured by policy. No agent is authorized to waive forfeitures, or to make, modify or disge contracts, or to extend the time for paying a premium. SECTION 6-INSTALMENT OPTIONS. If there is no assignment of this policy, the insured, or in case the insured shall not have done so, the beneficiary after the insured's death may, by written notice to the company at its home office, make the proceeds of this policy payable under one of the following options instead of in one sum, to wit: OPTION 1.-The proceeds of the policy, or any part thereof, may be left with the comy subject to withdrawal in whole or in part at any time on demand, in sums of not than one hundred dollars. The company shall pay interest on the proceeds so left with it at such rate as it may each year declare on such funds, at a rate, however, never less than three per cent per annum and credited annually. OPTION 2.In equal instalments for an agreed number of years, payable immediately upon approval of proofs of death of the insured, and annually, semi-annually, quarterly, or monthly thereafter as may be agreed. The amount of each instalment shall be in ccordance with the instalment table on the last page of this policy. Unless other-ise agreed in writing, the company, upon due demand, shall pay in one sum the value of all unpaid instalments commuted at three per cent compound interest. OPTION 3. In equal instalments for twenty years, and for as many years thereafter |