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Article 4 of 15 in Sample Disability Insurance Policy and Provisions Review |
Disability insurance data page |
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The following is sample wording of a typical individual disability income insurance policy with comments that explain the provisions. This typical policy is just an example and does not include all possible policy provisions. This part looks at the Data Page, which summarizes your individual information in the policy. In effect, it summarizes the terms you have agreed to for your policy.
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DATA PAGE |
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| INSURED |
Robert Green |
ISSUE AGE 37 |
| POLICY NUMBER |
987654321 |
POLICY Disability Income |
| POLICY DATE |
May 10, 2008 |
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| BENEFITS |
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| POLICY |
ELIMINATION PERIOD - MAXIMUM MONTHLY BENEFIT |
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DI510038
Disability Income Policy |
Disability Benefit
90 Days - $6,275.00
Social Security Substitute Benefit not included
Maximum Benefit Period – to Age 65 Policy Anniversary.
If this policy is renewed between the Age 65 and Age 74 Policy
Anniversaries, the maximum Benefit Period is 2 years. Beyond the
Age 74 Policy Anniversary, the Maximum Benefit Period is 1 year.
Capital Sum Benefit - $75,300.00
Special Death Benefit - $18,825.00
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| RIDERS |
DI684EU Automatic Benefit Increase Rider
Minimum Index Percent 4%
Maximum Index Percent 10%
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| DI661EU Business Earning Benefit Rider |
PREMIUMS |
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POLICY -
Disability Benefit
Social Security Substitute Benefit
RIDERS
Automatic Benefit Increase Rider
Business Earnings Benefit Rider
PAYMENT OPTIONS
Total Annual Premium
Semi-Annual Premium
Quarterly Premium
Monthly Premium
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2,523.61
0.00
0.00
0.00
$2,523.61
$1,293.35
$662.45
$220.82
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