Exhibit 99-A(5)(c)
ESTATE PRESERVATION AGREEMENT
This agreement is a part of the policy to which it is attached; it is subject to
all the terms and conditions of the policy.
WHAT DOES THIS AGREEMENT PROVIDE?
This agreement gives you the right to purchase four-year level term insurance,
without evidence of insurability, at the death of the designated insured. This
insurance is payable at the second death.
WHO ARE THE DESIGNATED INSURED AND THE OTHER INSURED?
The designated insured and the other insured are named on page 1. Neither the
designated insured nor the other insured may be changed.
WHAT WILL BE THE MAXIMUM AMOUNT OF THE ADDITIONAL TERM INSURANCE?
The maximum amount of the additional term insurance which you may purchase is
shown on page 1.
WHEN MAY THIS RIGHT BE EXERCISED?
At the death of the designated insured, you may exercise the right to purchase
additional term insurance, within ninety days immediately following the death of
the designated insured. This period ends at the earlier of 90 days after the
death of the designated insured and the date the additional term insurance is
purchased, and is called the Option Period.
HOW DO YOU EXERCISE THIS RIGHT?
You must notify us in writing that you are exercising the right to purchase
additional term insurance. You must also provide us with:
(1) proof satisfactory to us of the death of the designated insured; and
(2) the amount of additional term insurance you wish to purchase; and
(3) the increased premium due for this agreement.
WHEN WILL THE ADDITIONAL TERM INSURANCE BE EFFECTIVE?
If you exercise the right to purchase additional term insurance, that insurance
will be effective at the beginning of the Option Period. The additional term
insurance will remain in effect for four years from the policy anniversary next
following the death of the designated insured.
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WHEN WILL THE ADDITIONAL TERM INSURANCE BE PAYABLE?
We will pay the additional term insurance at the second death, to the
beneficiary of this policy.
CAN YOU RENEW OR CONVERT THE ADDITIONAL TERM INSURANCE PROVIDED BY THIS
AGREEMENT?
No. The additional term insurance provided by this agreement may not be renewed
or converted.
WHAT WILL THE PREMIUM BE FOR THIS AGREEMENT?
The annual premium for this agreement is shown on page 1. If this agreement
terminates, the total annual premium for this policy will be reduced by the
amount shown for this agreement. If you exercise the right to purchase
additional term insurance, we will reissue the policy and send you a new page 1.
The reissued policy will have an increased premium for the term insurance
purchased under this agreement, which will be based on the age of the other
insured of this policy at the time of the exercise and the same premium class
applicable to the other insured at the time this policy was issued.
WHAT IF THE SECOND DEATH OCCURS WITHIN THE OPTION PERIOD?
If the second death occurs within the Option Period, but not simultaneously with
the death of the designated insured, we will pay the maximum amount of
additional term insurance shown on page 1 to the beneficiary of this policy.
WILL WE PAY THE ADDITIONAL TERM INSURANCE IF THE SECOND DEATH AND THE DEATH OF
THE DESIGNATED INSURED OCCUR SIMULTANEOUSLY?
No. If the second death and the death of the designated insured occur
simultaneously or under circumstances which make it impossible to determine the
order of their deaths, we will not pay the additional term insurance under this
agreement.
ARE THIS AGREEMENT AND THE ADDITIONAL TERM INSURANCE SUBJECT TO THE
INCONTESTABILITY AND SUICIDE PROVISIONS OF THE POLICY?
Yes. Those provisions apply. The contestable and suicide periods will be
measured from the date of this agreement.
WHEN WILL THIS AGREEMENT TERMINATE?
This agreement will terminate on the earliest of:
(1) the date any premium due for this policy remains unpaid at the end of the
grace period; or
(2) the date this policy is surrendered or terminates; or
(3) the date this policy is continued as extended term insurance; or
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(4) the date we receive your written request to cancel this agreement; or
(5) the end of the Option Period, if you do not exercise your right to purchase
additional term insurance within the Option Period; or
(6) four years after the policy anniversary next following the death of the
designated insured, if you exercise your right to purchase additional term
insurance within the Option Period; or
(7) the termination date for this agreement shown on page 1; or
(8) the date of the death of the other insured.
This agreement is effective as of the policy date of this policy.
President
Secretary
MHC-95-943 Estate Preservation Agreement Minnesota Life 3
