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AMERICAN FAMILY LIFE INSURANCE COMPANY
6000 AMERICAN PKWY
MADISON, WI 53783-0001
888 428 5433
This RIDER is attached to and becomes part of the BASE POLICY and is subject
to the conditions and provisions of the BASE POLICY. All such conditions and
provisions apply to this RIDER unless changed by this RIDER.
ADDITIONAL INSURED RIDER
FLEXIBLE PREMIUM VARIABLE UNIVERSAL LIFE INSURANCE
DEFINITIONS
ADDITIONAL INSURED. The person so named in the Application for this RIDER.
BENEFICIARY(IES). The person(s) named as the BENEFICIARY(IES) in the
APPLICATION unless later changed. If none of the BENEFICIARIES survive the
ADDITIONAL INSURED, or no BENEFICIARY designation is effective at the death
of the ADDITIONAL INSURED, the OWNER is the BENEFICIARY, if he/she is then
living, otherwise the BENEFICIARY is the estate of the OWNER.
OWNER. During the lifetime of the PRIMARY INSURED, the OWNER of the BASE
POLICY is the OWNER of this RIDER, subject to the conditions and provisions
of the BASE POLICY.
GENERAL PROVISIONS
BENEFITS PAYABLE. WE will pay the benefit amount in force on the life of the
ADDITIONAL INSURED as shown on the Schedule, to the BENEFICIARY when WE
receive at the ADMINISTRATIVE SERVICE CENTER:
1. due written proof satisfactory to US of the ADDITIONAL INSURED'S
death;
2. due written proof that the death of the ADDITIONAL INSURED occurred
while coverage under this RIDER was in force on such ADDITIONAL
INSURED.
If this RIDER is added subsequent to the ISSUE DATE of the BASE POLICY, the
benefit amount is shown on the endorsement for coverage issued for this RIDER.
PREMIUM. The premium for this RIDER is shown on the Schedule. If this RIDER
is added subsequent to the ISSUE DATE of the BASE POLICY, the premium will be
shown on the endorsement for coverage issued for this RIDER. (For additional
information, see the Premiums provision in the BASE POLICY.)
CONVERSION. The OWNER may convert all or a portion of the coverage under this
RIDER during the lifetime of the PRIMARY INSURED, if the ADDITIONAL INSURED
is ATTAINED AGE 60 or less, without evidence of insurability to any plan of
insurance permitted under OUR rules then in effect. If the OWNER of the
Policy is the PRIMARY INSURED and the PRIMARY INSURED dies, then the
ADDITIONAL INSURED may exercise the conversion right under this RIDER. If the
OWNER of the Policy is someone other than the PRIMARY INSURED and the PRIMARY
INSURED dies, then the OWNER may exercise the conversion right under this
RIDER. The APPLICATION for conversion must be in writing and be received at
the ADMINISTRATIVE SERVICE CENTER while this RIDER is in effect. If WE do not
receive an APPLICATION for conversion, coverage under this RIDER will
terminate on the RIDER anniversary date nearest the ADDITIONAL INSURED'S
ATTAINED AGE 65.
The amount of coverage for the Conversion Policy must be at least $10,000 but
not more than the benefit amount in force under this RIDER. The new policy
will be issued:
1. without evidence of insurability;
2. at the premium rate then in effect for the ATTAINED AGE of the
ADDITIONAL INSURED being covered;
3. without a change in the ADDITIONAL INSURED'S UNDERWRITING CLASS, if
the current UNDERWRITING CLASS is offered by US for that policy. If
the same UNDERWRITING CLASS is not offered by US for that policy,
the OWNER may convert to the UNDERWRITING CLASS most closely related
to the ADDITIONAL INSURED'S current UNDERWRITING CLASS, according to
OUR current company policy.
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CONVERSION (CONTINUED). The Conversion Policy will be dated as of the date
coverage under this RIDER terminates. RIDERS and supplemental benefits may be
included in the Conversion Policy only if evidence of insurability
satisfactory to US is provided. If a portion of the coverage under this RIDER
is converted, benefits for the converted portion will not be payable under
both this RIDER and the Conversion Policy. If the full conversion right is
exercised under this RIDER, the ADDITIONAL INSURED may not be covered under
this RIDER at a later date and benefits will not be payable under both this
RIDER and the Conversion Policy.
CONTINUATION UPON DEATH OF THE PRIMARY INSURED. If the PRIMARY INSURED dies,
coverage under this RIDER will continue for 90 days from the date of the
PRIMARY INSURED'S death, unless terminated earlier under the Termination of
This Rider provision.
less, this RIDER may be converted without evidence of insurability by:
1. the ADDITIONAL INSURED if the PRIMARY INSURED was the OWNER of the
Policy; or
2. the OWNER if the OWNER is someone other than the PRIMARY INSURED.
The application for conversion must be in writing and be received at the
ADMINISTRATIVE SERVICE CENTER within the continuation period after the date
of the PRIMARY INSURED's death. If WE do not receive an APPLICATION for
conversion within the continuation period, coverage under this RIDER will
terminate at the end of the continuation period.
The INCONTESTABILITY, SUICIDE, and MISSTATEMENT OF AGE OR GENDER provisions
of the BASE POLICY are hereby modified to include any ADDITIONAL INSURED
covered under this RIDER. If this RIDER is included on the ISSUE DATE of the
Policy, the Incontestability and Suicide provisions will be measured from the
ISSUE DATE of the Policy. If this RIDER is added subsequent to the ISSUE DATE
of the Policy, the Incontestability and Suicide provisions will be measured
from the Rider Effective Date.
REINSTATEMENT. If the OWNER applies to reinstate the Policy, WE must receive
evidence of insurability satisfactory to US for each Insured. If the evidence
of insurability is not satisfactory to US, then the Policy and this RIDER
will not be reinstated.
WAIVER. Benefits under the Waiver of Monthly Deductions Rider will apply
while the BASE POLICY and this RIDER are in full force and the Waiver of
Monthly Deductions Rider is in effect for this RIDER.
RIDER EFFECTIVE DATE. This RIDER takes effect as of the Rider Effective Date
shown on the Schedule. If this RIDER is subsequently added to the BASE
POLICY, the Rider Effective Date will be shown on an endorsement. The Rider
Effective Date determines each:
1. RIDER year;
2. RIDER anniversary; and
3. RIDER month.
RIDER TERMINATION DATE. Coverage for the ADDITIONAL INSURED under this RIDER
will terminate on the earliest of:
1. the date of any full conversion of coverage under this RIDER;
2. the end of the continuation period following the date of death of
the PRIMARY INSURED;
3. 12:00 AM on the RIDER anniversary date nearest the ADDITIONAL
INSURED'S ATTAINED AGE 65;
4. the date the BASE POLICY terminates, subject to the conditions and
provisions of the BASE POLICY;
5. the date the Base Policy is surrendered by the Owner.
PRESIDENT SECRETARY
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