Service Office: [One Sun Life Executive Park Wellesley Hills, MA 02481 Home Office: [60 East 42nd Street Suite 1115 New York, NY 10165]
[One Sun
Life Executive Park
Wellesley
Hills, MA 02481
000-000-0000]
Home
Office:
[00 Xxxx
00xx
Xxxxxx
Suite
1115
New York,
NY 10165]
SUN
LIFE INSURANCE AND ANNUITY
COMPANY
OF NEW YORK
|
[Sun
Prime VUL Survivorship], a Group Last Survivor Variable
Universal Life Insurance
Policy
|
|
Policy
Holder - [M Financial Trust]
|
|
Policy
Number - [VL0000001]
|
|
Date
of Issue - [January 1, 2008]
|
|
Issued
In - New York (and subject to its
jurisdiction)
|
|
This
is a legal contract between the Policy Holder and Us, Sun Life Insurance
and Annuity Company of New York (“the Company”, “we”,
“our”). We agree to pay the benefits under this Group Policy
according to its provisions. The Certificate Owner and Insured
are named in each certificate.
We
agree to pay the Death Benefit proceeds to the beneficiary upon receipt of
due proof of the Insured’s death.
|
Signed
for the Company:
[[Missing
Graphic Reference]]
[Xxxxxxx X.
Xxxxxxxx],
[President]
[Missing Graphic Reference]
[ ]
[Xxxxxxx
X. Xxxxx, Secretary]
|
|
|
To
the extent any benefit, payment, or value under this Group Policy
(including the Account Value) is based on the investment experience of a
Separate Account, such benefit, payment, or value may increase or decrease
in accordance with the investment experience of the Separate Account and
is not guaranteed as to a fixed dollar amount.
|
The
Death Benefit Proceeds are payable at the death of Insured and may be
fixed or variable.
This
is a Group Last Survivor Flexible Premium Variable Universal Life
Insurance Policy.
The
Face Amounts of the Certificates are adjustable.
Nonparticipating.
|
[Missing Graphic Reference]
[Missing Graphic Reference]
MSVUL-2009-GP
NY
Page
Eligibility
A person
who meets the eligibility requirements for the group may become a Certificate
Owner and/or Insured upon our approval of a certificate application and receipt
of the Minimum Initial Premium.
Certificates
We will
issue a certificate to each Certificate Owner. The certificate will
state the terms, conditions, and benefits of coverage.
Incorporation
A sample
certificate and sample riders attached hereto are made a part of this
contract. Nothing in this Group Policy shall invalidate any rights
granted the Certificate Owner by law or the Certificate.
Entire
Contract
The
written application for the Group Policy is attached at issue. The entire
contract between the Policy Holder and Us consists of the Group Policy, the
sample certificate, such application, and any riders and
endorsements. All statements made in any application shall be deemed
representations and not warranties. We will use no statement made by or on
behalf of the applicant or an Insured to defend a claim under the Policy unless
it is in a written application.
We
reserve the right to make any changes necessary in order to keep this Group
Policy in compliance with any changes in federal or state tax laws. Other
changes in this Group Policy and certificates may be made by agreement between
the Policy Holder and us with the Certificate Owner’s consent. Only the
President, Vice President, the Secretary, or an Assistant Secretary of the
Company has authority to waive or agree to change in any respect any of the
conditions or provisions of the Group Policy, or to extend credit or to make an
agreement for us.
Specifications
The
Certificate Specifications will be completed based upon the information
contained in the certificate application and the terms of this Group
Policy.
Discontinuance
and Termination
This
Group Policy will terminate when no persons are insured under any certificate
issued under it.
MSVUL-2009-GP
NY
Page
[One Sun
Life Executive Park
Wellesley
Hills, MA 02481
000-000-0000]
Home
Office:
[00 Xxxx
00xx
Xxxxxx
Suite
1115
New York,
NY 10165]
SUN
LIFE INSURANCE AND ANNUITY
COMPANY
OF NEW YORK
|
[Sun
Prime VUL Survivorship], a Group Last Survivor Variable
Universal Life Insurance
Policy
|
To
the extent any benefit, payment, or value under this Group Policy (including the
Account Value) is based on the investment experience of a Separate Account, such
benefit, payment, or value may increase or decrease in accordance with the
investment experience of the Separate Account and is not guaranteed as to a
fixed dollar amount.
We
agree to pay the Death Benefit proceeds to the beneficiary upon receipt of due
proof of the Surviving Insured’s death.
This
is a Group Last Survivor Flexible Premium Variable Universal Life Insurance
Policy.
The
Face Amounts of the Certificates are adjustable.
Nonparticipating
[Missing Graphic Reference]
[Missing Graphic Reference]
.
MSVUL-2009-GP
NY
Page
