Accidental Death Benefit Rider
Based on the application for this rider and the payment of its monthly
deduction, this rider is made a part of the policy. The rider is subject
to all policy terms and provisions unless this rider changes them. This
rider does not increase your policy values.
What benefit does this rider provide?
We pay the Accidental Death Benefit shown under Policy Data if we receive
proof satisfactory to us that the insured's death:
1. resulted, directly and independently of all other causes, from
accidental bodily injury; and
2. occurred while this rider was in force; and
3. occurred within 90 days of the injury.
This benefit is in addition to any other benefits payable under the policy.
If payable, it will be included in the proceeds of the policy.
What risks are not covered by this rider?
The benefits of this rider are not payable if death resulted from or was
contributed to by any of the following:
1. suicide or attempted suicide;
2. bodily or mental infirmity, illness, or disease;
3. infection of any nature not resulting from accidental bodily injury;
4. poison, gas, or fumes taken, administered, or inhaled voluntarily or
otherwise, except in the course of the insured's occupation;
5. the voluntary taking of drugs or narcotics unless prescribed by a
licensed physician;
6. the insured's commission of or attempt to commit a felony;
7. an act or incident of war, declared or not, or any type of military
conflict;
8. travel in or descent from any kind of aircraft if:
a. the insured was taking part in training or had duties
aboard the aircraft; or
b. the aircraft was operated by or for the armed forces of any
country.
Is there a monthly deduction for the cost of this rider?
Yes. While this rider is in force, a monthly deduction is taken from the
policy's value for the cost of this rider. The amount can be determined
from the Rider Cost of Insurance Table shown below.
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.
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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 date the policy terminates; or
3. the insured's age 70 anniversary.
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
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Rider Cost of Insurance Table
The monthly deduction for the cost of this rider is equal to A x B where:
1,000
A is the Accidental Death Benefit; and
B is the ADB Rate from the table below based on the then attained age of the
insured.
Attained Attained
Age of Monthly ADB Rate* Age of Monthly ADB Rate*
Insured Male Female Insured Male Female
5 $.07 $.04 40 $.08 $.04
6 .07 .04 41 .08 .04
7 .07 .04 42 .08 .04
8 .07 .05 43 .08 .04
9 .08 .05 44 .08 .04
10 .08 .05 45 .08 .04
11 .08 .05 46 .08 .04
12 .09 .05 47 .08 .04
13 .09 .06 48 .08 .04
14 .10 .06 49 .08 .04
15 .10 .06 50 .08 .04
16 .10 .06 51 .08 .04
17 .11 .07 52 .08 .04
18 .12 .07 53 .09 .05
19 .12 .07 54 .09 .05
20 .12 .07 55 .09 .05
21 .12 .07 56 .09 .05
22 .11 .06 57 .09 .05
23 .10 .06 58 .10 .06
24 .10 .05 59 .10 .06
25 .09 .05 60 .10 .06
26 .09 .05 61 .10 .06
27 .08 .04 62 .11 .06
28 .08 .04 63 .11 .07
29 .08 .04 64 .11 .07
30 .08 .04 65 .12 .07
31 .08 .04 66 .13 .08
32 .08 .04 67 .14 .09
33 .08 .04 68 .15 .10
34 .08 .04 69 .16 .11
35 .08 .04
36 .08 .04
37 .08 .04
38 .08 .04
39 .08 .04
*If this rider is issued with other than a standard rating classification, the
ADB Rates will be adjusted by multiplying the above monthly rates by the ADB
Rating Factor shown under Policy Data.
