Waiver of Monthly Deduction Rider for Total Disability
Based on the application for this rider and the payment of its monthly
deduction, this rider is made a part of the policy. This rider is subject
to all policy terms and provisions unless this rider changes them. This
rider does not increase your policy values.
Definition of Injury
1. During the first 2 years this rider is inforce:
Accidental bodily injury that occurs while this rider is in force.
2. Thereafter: Accidental bodily injury.
In either event, injury must result, directly and independently of all
other causes, in total disability.
Definition of Sickness
1. During the first 2 years this rider is inforce:
Disease or illness that first appears and causes total disability while
this rider is in force.
2. Thereafter: Disease or illness that causes total disability while this
rider is inforce.
Definition of Total Disability
The inability of the insured, due to injury or sickness, to perform
substantially all of the important duties to his or her principal
occupation for remuneration or profit. After 2 years of such continuous
disability, we will consider the insured to be totally disabled only if he
or she is unable to perform substantially all of the important duties of
any gainful occupation. By "gainful occupation", we mean one for which the
insured is or becomes reasonably fit by education, training, or experience.
Certain losses will be considered "presumptive total disability".
If injury or sickness causes the total and irrecoverable loss of the
following, we will consider the insured totally disabled, even while the
insured performs in an occupation:
1. the sight of both eyes; or
2. the use of both hands; or
3. the use of both feet; or
4. the use of one hand and one foot.
Such loss must occur or first appear after the effective date of this
rider and while this rider is in force.
What benefit does this rider provide?
This rider provides for the waiver of monthly deductions for the policy and
attached riders if the insured becomes totally disabled, and meets the
requirements shown below.
To qualify for this benefit, you must give proof that the insured's
total disability:
1. has been continuous for 6 months or more; and
2. began while this rider was in force; and
3. began after the insured's 5th birthday, but before the Age 60
anniversary.
Provided these requirements are met, we will waive the monthly deductions
as long as total disability lasts. The waiver of monthly deductions will
also apply to this and all other riders attached to the policy.
Until your claim is approved by us, you must pay the premiums needed so
that your policy does not lapse as provided in the grace period provision
of the policy. We will also take monthly deductions as usual.
If we approve your claim, monthly deductions taken during total disability
will be added to the value of the policy, using the premium allocation
percentages then in effect.
<PAGE>
Does coverage under the policy remain the same during disability?
During a period of disability, you may not:
1. increase the specified amount of the policy; or
2. change from death benefit Option 2 to death benefit Option 1; or
3. increase any benefits under the policy or any riders attached to it.
Are there any exclusions?
We will not waive any monthly deductions if total disability results from:
1. intentionally self-inflicted injuries; or
2. war, declared or not, an act of war, or any type of military conflict.
If total disability begins within the grace period for the policy, the
monthly deduction due at the time the policy entered the grace period will
not be waived.
When should you furnish proof of a disability?
We must receive proof of total disability in our home office within one
year after the monthly date of the monthly deduction that you ask us to
waive. If you don't give us proof within this time, your claim will not be
affected if proof was given:
1. as soon as reasonably possible; and
2. within one year after the insured's death or recovery from total
disability;
otherwise, monthly deductions made more than one year before proof was
furnished will not be waived.
How often is proof of disability required to be given?
At reasonable intervals, we have the right to require proof that total
disability is continuing. If such proof is not given when required, no
further monthly deductions will be waived.
Is there a monthly deduction for the cost of this rider?
Yes. While this rider is in force, a monthly deduction for the cost of
this rider is taken from the policy value. The amount can be determined
from the Rider Cost of Insurance Table.
When will this rider become incontestable?
After this rider has been in force during the insured's lifetime for two
years from its effective date, we cannot contest this rider. The two year
period will not include time during which the insured is totally disabled.
<PAGE>
When will this rider terminate?
This rider will terminate on the earliest of the following:
1. the monthly date on or next following receipt of your written request
for coverage to end; or
2. the insured's Age 60 anniversary; or
3. the date the policy terminates.
Termination of this rider will not affect a valid claim for benefits for
total disability that starts before the termination.
What is the effective date of this rider?
This rider is issued as of the policy date of the policy unless a different
date is shown under Policy Data.
IDS Life Insurance Company of New York
(signature of) Eric L. Marhoun
Secretary
<PAGE>
Rider Cost of Insurance Table
The monthly deduction of the cost of this rider is equal to the sum of A + B
described below.
A is the result of 1 x (2 - 3), where:
1000
(1) is the WMD rate from the table below, based on the then attained age of
the insured;
(2) is the base policy's death benefit, divided by the guaranteed interest
rate factor shown under Policy Data;
(3) is the base policy's value at the beginning of the policy month.
B is the monthly cost of this rider for any additional riders attached to the
policy.
<TABLE>
<CAPTION>
SMD Rate* WMD Rate* WMD Rate* WMD Rate*
Male Female Male Female
Attained Std. Std. Attained Std. Std.
Age of Std. Non- Std. Non- Age of Std. Non- Std. Non-
Insured Smoker Smoker Smoker Smoker Insured Smoker Smoker Smoker Smoker
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
5 $0.0100 $0.0100 $0.0100 $0.0100 35 $0.0200 $0.0175 $0.0250 $0.0225
6 0.0100 0.0100 0.0100 0.0100 36 0.0200 0.0175 0.0275 0.0250
7 0.0100 0.0100 0.0100 0.0100 37 0.0225 0.0175 0.0275 0.0250
8 0.0100 0.0100 0.0100 0.0100 38 0.0225 0.0200 0.0300 0.0250
9 0.0100 0.0100 0.0100 0.0100 39 0.0250 0.0200 0.0300 0.0275
10 0.0100 0.0100 0.0100 0.0100 40 0.0275 0.0225 0.0325 0.0275
11 0.0100 0.0100 0.0100 0.0100 41 0.0275 0.0225 0.0325 0.0275
12 0.0100 0.0100 0.0100 0.0100 42 0.0300 0.0250 0.0350 0.0300
13 0.0125 0.0100 0.0125 0.0125 43 0.0325 0.0250 0.0375 0.0300
14 0.0125 0.0125 0.0125 0.0125 44 0.0350 0.0275 0.0375 0.0300
15 0.0150 0.0125 0.0125 0.0125 45 0.0375 0.0300 0.0400 0.0325
16 0.0150 0.0125 0.0125 0.0125 46 0.0400 0.0300 0.0425 0.0325
17 0.0150 0.0125 0.0150 0.0125 47 0.0450 0.0350 0.0450 0.0350
18 0.0150 0.0150 0.0150 0.0150 48 0.0500 0.0375 0.0475 0.0375
19 0.0150 0.0150 0.0150 0.0150 49 0.0550 0.0400 0.0500 0.0400
20 0.0150 0.0150 0.0175 0.0150 50 0.0600 0.0450 0.0550 0.0425
21 0.0150 0.0150 0.0175 0.0150 51 0.0675 0.0525 0.0625 0.0475
22 0.0150 0.0150 0.0175 0.0150 52 0.0775 0.0600 0.0700 0.0525
23 0.0150 0.0150 0.0175 0.0175 53 0.0925 0.0700 0.0800 0.0575
24 0.0150 0.0150 0.0175 0.0175 54 0.1075 0.0825 0.0900 0.0675
25 0.0150 0.0150 0.0200 0.0175 55 0.1300 0.0975 0.1050 0.0775
26 0.0150 0.0150 0.0200 0.0175 56 0.1550 0.1175 0.1225 0.0925
27 0.0150 0.0150 0.0200 0.0200 57 0.1875 0.1400 0.1450 0.1100
28 0.0150 0.0150 0.0200 0.0200 58 0.2275 0.1700 0.1700 0.1300
29 0.0150 0.0150 0.0200 0.0225 59 0.2775 0.2075 0.2000 0.1550
30 0.0150 0.0150 0.0225 0.0200
31 0.0175 0.0150 0.0225 0.0225
32 0.0175 0.0150 0.0225 0.0225
33 0.0175 0.0150 0.0250 0.0225
34 0.0175 0.0175 0.0250 0.0225
</TABLE>
*For insureds with a preferred risk classification, the above standard
non-smoker rates will apply. If other than a preferred or standard risk
classification applies to the specified amount or to this rider, the WMD rate
will be adjusted by multiplying the above monthly rates by the appropriate risk
factor shown under Policy Data.
