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Previous: WRL SERIES LIFE ACCOUNT, 485APOS, 2000-09-08 |
Next: WRL SERIES LIFE ACCOUNT, 485APOS, EX-99.C6, 2000-09-08 |
EXHIBIT 99.A9
Exhibit (5)(j)
Form of Adjustable Term Insurance Rider
<PAGE>
WESTERN RESERVE LIFE ASSURANCE CO. OF OHIO
(A STOCK COMPANY)
Home Office: Columbus, Ohio
Administrative Office: Clearwater, Florida
ADJUSTABLE TERM INSURANCE RIDER
================================================================================
IN THIS RIDER the Insured, for a Single Life Policy, will be the Insured shown
on the Policy Schedule Page of the Policy to which this Rider is attached. The
Insured for a Joint Last Survivor Policy will be the Surviving Insured of the
Joint Insureds shown on the Policy Schedule Page of the policy to which this
Rider is attached. The Insured will be referred to as YOU or YOUR. Western
Reserve Life Assurance Co. of Ohio will be referred to as WE, OUR or US.
================================================================================
BENEFIT Upon Our receipt of due proof that Your death
occurred while this Rider was in force, We will
determine the death benefit payable under this
Rider as described below.
The amount of the death benefit payable under
this Rider will be equal to:
(a) the Target Death Benefit as shown on the
Target Death Benefit page attached to the
Policy; increased by
(b) the Face Amount of any Primary Insured
Rider Plus or Joint Insured Rider which
terminated due only to Your attainment of
the age specified in the Termination
provision of the Rider; reduced by
(c) the excess of the Death Benefit as defined
in the Death Benefit Provisions of the
Policy over the Policy's then current
Specified Amount, if the Death Benefit was
required to be determined in accordance
with the Limitation Percentage provision
of the Policy.
Notwithstanding the above, the amount of the
death benefit payable under this Rider will not
be less than zero.
INCONTESTABILITY This Rider shall be incontestable after it has
been in force while You are still alive, for
two years after the effective date of this
Rider.
If the Policy is reinstated, a new two year
contestability period (apart from any remaining
contestability period) shall apply to this
Rider and shall be measured from the date of
application for reinstatement, and will only
apply to statements made in the application for
reinstatement.
SUICIDE If this Rider is issued on the same date as the
Policy, the Suicide Provision of the Policy is
applicable to this Rider. If this Rider is
issued after the Policy and if You die by
suicide, while sane or insane, within two years
after the effective date of this Rider, Our
liability for this Rider shall be limited to an
amount equal to the excess of the total monthly
deductions for this Rider less any premiums
being refunded under the Suicide Provision of
the Policy to which this Rider is attached.
Page 1
<PAGE>
CHANGE IN AMOUNT Subject to Our approval, and upon Written
OF COVERAGE Notice, on any Policy Anniversary after this
Rider has been in force for one year, the
Owner may request that the Maximum Target
Death Benefit be changed. The Maximum Target
Death Benefit may be increased or decreased.
Only one change in Maximum Target Death Benefit
is permitted each year. Any change is subject
to the following:
1. If the Maximum Target Death Benefit is
reduced, any future scheduled increases,
other than interest payable on premiums
received prior to the effective date of
the reduction, will be discontinued.
2. Any requested increase in the amount of
the Maximum Target Death Benefit or the
interest rate used to accumulate premiums
will be subject to Our receipt of
satisfactory evidence of insurability and
Our acceptance of the risk.
3. Any decrease in the Maximum Target Death
Benefit will become effective on the
Monthiversary on or next following our
receipt of Written Notice.
4. Any increase in the Target Death Benefit
will become effective on the Monthiversary
on or next following our acceptance of
Your satisfactory evidence of
insurability.
Following any change in the Target Death
Benefit, We will provide the Owner with a new
Target Death Benefit Schedule reflecting all
changes.
DECREASE IN Any future scheduled increases in the amount of
SPECIFIED AMOUNT the Target Death Benefit will be
OF RIDER COVERAGE discontinued if:
(a) the Specified Amountof the Policy is
reduced through a requested decrease or
partial withdrawal; or
(b) coverage under any Primary Insured Rider
Plus or Joint Insured Rider is reduced or
terminated prior to Your attainment of the
age specified in the Termination provision
of the Rider.
TERMINATION This Rider will terminate on the earliest of:
1. The Anniversary nearest the Maturity Date;
2. The date the Policy terminates;
3. The effective date of any change in the
Death Benefit Option Type under the
Policy;
4. The Monthiversary on which this Rider is
terminated by Written Notice from the
Owner.
Despite any provision or amendment to the
contrary, this Rider will remain in force if
the Maturity Date under the Policy is extended.
In no event will this Rider continue beyond the
date the Policy terminates.
GENERAL This Rider is part of the Policy. It is subject
to all the terms of this Rider and the Policy.
This Rider has no cash value.
Page 2
<PAGE>
The monthly deduction for this Rider for the
first Policy Month following the Effective Date
is shown on page 4 of the Policy. Monthly
deductions after the first Policy Month will be
based upon rates not exceeding the rates shown
in the Table of Maximum Insurance Rates and
applied to the amount of death benefit payable
under this Rider.
EFFECTIVE DATE This Rider becomes effective on the same date
as the Policy unless a later date is shown
here.
WESTERN RESERVE LIFE ASSURANCE CO. OF OHIO
/s/ WILLIAM H. GEIGER
Secretary
Page 3
<PAGE>
WESTERN RESERVE LIFE ASSURANCE CO. OF OHIO
CLEARWATER, FLORIDA
POLICY NUMBER: 01-23456789
TARGET DEATH BENEFIT
<TABLE>
<CAPTION>
POLICY YEAR MAXIMUM POLICY YEAR MAXIMUM
----------- TARGET DEATH BENEFIT ----------- TARGET DEATH BENEFIT
-------------------- --------------------
<S> <C> <C> <C>
AT ISSUE $ XXX,XXX 33 $ XXX,XXX
1 $ XXX,XXX 34 $ XXX,XXX
2 $ XXX,XXX 35 $ XXX,XXX
3 $ XXX,XXX 36 $ XXX,XXX
4 $ XXX,XXX 37 $ XXX,XXX
5 $ XXX,XXX 38 $ XXX,XXX
6 $ XXX,XXX 39 $ XXX,XXX
7 $ XXX,XXX 40 $ XXX,XXX
8 $ XXX,XXX 41 $ XXX,XXX
9 $ XXX,XXX 42 $ XXX,XXX
10 $ XXX,XXX 43 $ XXX,XXX
11 $ XXX,XXX 44 $ XXX,XXX
12 $ XXX,XXX 45 $ XXX,XXX
13 $ XXX,XXX 46 $ XXX,XXX
14 $ XXX,XXX 47 $ XXX,XXX
15 $ XXX,XXX 48 $ XXX,XXX
16 $ XXX,XXX 49 $ XXX,XXX
17 $ XXX,XXX 50 $ XXX,XXX
18 $ XXX,XXX 51 $ XXX,XXX
19 $ XXX,XXX 52 $ XXX,XXX
20 $ XXX,XXX 53 $ XXX,XXX
21 $ XXX,XXX 54 $ XXX,XXX
22 $ XXX,XXX 55 $ XXX,XXX
23 $ XXX,XXX 56 $ XXX,XXX
24 $ XXX,XXX 57 $ XXX,XXX
25 $ XXX,XXX 58 $ XXX,XXX
26 $ XXX,XXX 59 $ XXX,XXX
27 $ XXX,XXX 60 $ XXX,XXX
28 $ XXX,XXX 61 $ XXX,XXX
29 $ XXX,XXX 62 $ XXX,XXX
30 $ XXX,XXX 63 $ XXX,XXX
31 $ XXX,XXX 64 $ XXX,XXX
32 $ XXX,XXX 65+ $ XXX,XXX
</TABLE>
The Target Death Benefit is the lesser of the Maximum Target Death Benefit shown
above, or the total of all premiums actually paid while this Rider is in force
credited with interest at an annual effective interest rate of [10%] from the
premium payment date to the policy anniversary date following the date of Your
death.
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