Insurance, Principles and Practices

400 INSURANCE PRINCIPLES AND PRACTICES

XVIII-Continued
Standard Provisions

1. This policy includes the endorsements and attached papers, if any, and contains the entire contract of insurance except as it may be modified by the Company's classification of risks and premium rates in the event that the Insured is injured or contracts sickness after having changed his occupation to one classified by the Company as more hazardous than that stated in the policy, or while he is doing any act or thing pertaining to any occupation so classified, except ordinary duties about his residence or while engaged in recreation, in which event the Company will pay only such portion of the indemnities provided in the policy as the premium paid would have purchased at the rate but within the limits so fixed by he Company for such more hazardous occupation.

If the law of the state in which the Insured resides at the time this policy is issued requires that prior to its issue a statement of the premium rates and classification of risks pertaining to it shall be filed with the state official having supervision of insurance in such state, then the premium rates and classification of risks mentioned in this policy shall mean only such as have been last filed by the Company in accordance with such law, but if such filing is not required by such law then they shall mean the Company's premium rates and classification of risks last made effective by it in such state prior to the e occurrence of the loss for which the Company is liable.

2. No statement made by the applicant for insurance not included herein shall avoid the policy or be used in any legal proceeding hereunder. No agent has authority to change this policy or to waive any of its provisions. No change in this policy shall be valid unless approved by an executive officer of the Company and such approval be endorsed hereon.

3. If default be made in the payment of the agreed premium for this policy, the subsequent acceptance of a premium by the Company or by any of its duly authorized agents shall reinstate the policy but only to cover accidental injury thereafter sustained and such sickness as may begin more than ten days after the date of such acceptance.

4. Written notice of injury or of sickness on which claim may be based must be given to the Company within twenty days after the date of the accident causing such injury or within ten days after the commencement of disability from such sickness. In event of accidental death immediate notice thereof must be given to the Company.

5. Such notice given by or in behalf of the Insured or beneficiary, as the case may be, to the Company at its Home Office, in the city of or to any authorized agent of the Company, with particulars sufficient to identify the Insured, shall be deemed a be notice to the Company. Failure to give notice within the time provided in this policy shall not invalidate any claim if it shall be shown not to have been reasonably possible to give such notice and that notice was given as soon as was reasonably possible.

6. The Company upon receipt of such notice, will furnish to the claimant such forms as are usually furnished by it for filing proofs of loss. If such forms are not so furnished within fifteen days after the receipt of such notice, the claimant shall be deemed to have complied with the requirements of this policy as to proof of loss upon submitting within the time fixed in the policy for filing proofs of loss, written proof covering the occurrence, character and extent of the loss for which claim is made.

7. Affirmative proof of loss must be furnished to the Company at its said office in case of claim for loss of time from disability within ninety days after the termination of the period for which the Company is liable, and in case of claim for any other loss, within ninety days after the date of such loss.

8. The Company shall have the right and opportunity to examine the person of the Insured when and so often as it may reasonably require during c the pendency of claim hereunder, and also the right and opportunity to make an autopsy in case of death where it is not forbidden by law.

9. All indemnities provided in this policy for loss other than that of time on account of disability will be paid immediately after receipt of due proof.

0. Upon request of the Insured and subject to due proof of loss all of the accrued indemnity for loss of time on account of disability will be paid at piration of each month during the continuance of the period for which the Company is liable, and any balance remaining unpaid at the termination of 1 such period will be paid immediately upon receipt of due proof.

11. Indemnity for loss of life of the Insured is payable to the beneficiary if surviving the Insured, and otherwise to the estate of the Insured. Al other indemnities of this policy are payable to the Insured.

12. If the Insured shall at any time change his occupation to one classified by the Company as less hazardous than that stated in the policy, the Company, upon written request of the Insured and surrender of the policy, will cancel the same and will return to the Insured the unearned premium.

13. Consent of the beneficiary shall not be requisite to surrender or assignment of this policy, or to change of beneficiary, or to any other changes in the policy.

14. No action at law or in equity shall be brought to recover on this policy prior to the expiration of sixty days after proof of loss has been filed in accordance with the requirements of this policy, nor shall such action be brought at all unless brought within two years from the expiration of the time within which proof of loss is required by the policy.

15. If any time limitation of this policy with respect to giving notice of claim or furnishing proof of loss is less than that permitted by the law of the state in which the Insured resides at the time this policy is issued, such limitation is hereby extended to agree with the minimum period permitted by such law.

18. Upon the payment of claim hereunder any premium then due and unpaid or covered by any note or written order may be deducted therefrom.

19. If a like policy or policies, previously issued by the Company to the Insured be in force concurrently herewith, making the aggregate indemnity for loss other than that of time on account of disability in excess of $50,000.00, or the aggregate indemnity for loss of time on account of disability in excess of $250.00 weekly, the excess insurance of either kind shall be void and all premiums paid for such excess shall be returned to the Insured.

20. The insurance under this policy shall not cover any person under the age of eighteen years nor over the age of sixty-five years. Any premium paid to the Company for any period not covered by this policy will be returned upon request.

21. This insurance does not cover, (1) any disability for which the Insured is not necessarily and regularly attended by a legally qualified physician other than the Insured; provided, however, that this requirement shall be waived in the event such attendance is declared by medical authority satisfactory to the Company to be unnecessary; (2) suicide, sane or insane, or any attempt thereat, sane or insane; (3) women; (4) loss of life or disability resulting wholly or partly, directly or indirectly from (a) bodily injury sustained or sickness contracted while the Insured is engaged in military or naval service in time of war; (b) bodily injury or sickness caused by war or by any act of war; (c) bodily injury sustained or sickness contracted from riding or being in or upon any aerial device or conveyance; (d) bodily injury sustained or sickness contracted while the Insured is outside Canada or Europe or the United States (not including Alaska, Panama Canal Zone or the insular possessions of the United States).

22. No recovery shall be had on account of disability from sickness for any period of time for which the Insured is entitled to indemnity for bodily injury under any policy in this Company, except in the event of payment of claim for indemnity on a percentage basis as provided in Parts D or E, but in no event shall indemnity be payable under this policy at a rate per month in excess of that specified in Part B. Failure to comply with any of the provisions of this policy shall render invalid any claim under this policy.

23. After the first twelve months of disability, no indemnity shall be payable for any period of disability during which the Insured is not continuously within the United States (not including Alaska, the Panama Canal Zone or the insular possessions of the United States) unless a written permit to reside elsewhere be granted by the Company.

24. Until the Insured becomes sixty-six years of age he shall have the right to renew this policy from year to year by the payment of the premium as herein provided. All premiums are due and payable on or before the anniversary date of this policy either at the Home Office of the Company in the City of or to any authorized agent of the Company, but

a grace of thirty-one days shall be granted for the payment of every premium after the first, during which time the insurance hereunder, shall continue in force. No premium receipt is valid unless signed by the President or a Vice President or the Secretary or an Assistant Secretary of the Company. After any default in payment of premium this policy may be reinstated as provided in Standard Provision Number 3 at any time within six months from the date of such default on written application by the Insured to the Home Office of the Company and the payment of the defaulted premium, provided the Insured shall with such application submit evidence of insurability satisfactory to the Company. This policy shall be incontestable after one year from its date as to the time of the happening of bodily injury or sickness causing disability commencing after such year and while this policy is in force.

25. At any time during the life of this policy, if the Insured changes his occupation to one different from that stated in this policy, the Company hereby agrees upon the surrender of this policy to issue in lieu thereof upon the written request of the Insured, a new policy containing the same provisions as this policy except a change in the amount of the benefits payable, the new policy to provide such an amount payable for loss of life and disability as the premium paid for this policy will pur chase at the rates but within the limits fixed by the Company for such different occupation.

policy and no change of beneficiary shall bind the Company unless consent thereto, duly signed by an executive officer of the Company, is formally endorsed hereon. The Company shall not be responsible for the validity of any assignment or change of beneficiary.

28. This insurance is effective in consideration of the payment in advance of the premium

and of the payment of a like premium on the

day of

Dollars

in each year

during the continuance of this Policy, and in further consideration of the statements made in the application for this policy, copy of which application is endorsed hereon or attached hereto, and is hereby made a part of this Policy. The falsity of any statement in the application, materially affecting either the acceptance of the risk or the hazard assumed hereunder, or made with intent to deceive shall bar all right to recovery under this policy. No provision of the charter, constitution or by-laws of the Company not herein set forth shall be used in defense of any claim arising under this policy.

IN WITNESS WHEREOF, THE COMPANY has, by its proper officers, signed this Contract in the City of and caused same to be countersigned by its authorized Agent or Manager, as of the