LIMITATIONS and EXCLUSIONS

DISABILITY INCOME POLICY AND OPTIONAL RIDERS
Policy Form # I D0710, Critical Illness Benefit Rider Form # R I0711,
Retroactive Injury Benefit Rider Form # R I0712 and Return of Premium Benefit Rider Form # R I0713

LIMITATIONS AND CONDITIONS

Foreign Travel – Assurity will make only three monthly benefit payments for any total disability sustained or continued outside the United States or Canada.

Preexisting Condition – Assurity will pay no benefits for a total disability that is caused by a preexisting condition unless the total disability starts after the policy has been in force for 12 months from the issue date or last reinstatement date. This provision also applies to riders attached to the policy, if any.

Elimination Period – The policy contains an elimination period. Assurity will not pay benefits during the elimination period.

Waiting Period – The Critical Illness Benefit Rider has a waiting period. Assurity will not pay benefits during the waiting period.

 Renewal – The policy is guaranteed renewable to age 67 with a qualified right to renew to age 70.

 Right to Cancel – The policy has a 30-day free look period.

Termination – Coverage will terminate the earliest of the following: when premiums are not paid by the end of the grace period; the date Assurity receives written notice to terminate; the date the insured person establishes residence in a foreign country; upon the death of the insured person; or the due date of the first renewal premium following the insured person’s 67 th birthday, or, if the insured person continues to be employed on a full-time basis after age 70, the date the insured person ceases to be employed on a full-time basis. However, in no case will coverage extend past the first renewal premium following the insured person’s 70 th birthday. For the Critical Illness and Retroactive Injury Benefit Riders, the rider will terminate the date the policy terminates for any reason or the due date of the first renewal premium following the insured person’s 65 th birthday

EXCLUSIONS

Assurity will not pay benefits for total disability that is caused by or the result of the insured person: being pregnant, or experiencing pregnancy-related conditions. Complications of pregnancy are deemed to be a sickness; operating, learning to operate, or serving as a crew member of any aircraft; engaging in hang-gliding, hot air ballooning, bungee jumping, parachuting, scuba diving, sail gliding, parasailing, parakiting or any similar activities; riding in or driving any motor-driven vehicle in a race, stunt show or speed test; being exposed to war or any act of war, declared or undeclared; actively serving in any of the armed forces, or units auxiliary thereto, including the National Guard or Army Reserve; being addicted to drugs or suffering from alcoholism; being under the influence of an excitant, depressant, hallucinogen, narcotic, or any other drug or intoxicant, including those prescribed by a physician that are misused; receiving injuries caused directly or indirectly while under the influence of a controlled substance or by intoxication as defined by the laws and jurisdiction of the geographical area in which the loss or cause of loss was incurred; having cosmetic surgery; having other elective procedures that are not medically necessary, including but not limited to organ donation and elective sterilization; having a mental and/or nervous disorder (A mental and/or nervous disorder is considered any disorder listed in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric

Association, excluding Alzheimer’s disease, dementia, and organic brain damage caused by an accident

or head trauma.); participating in or attempting to commit a felony; being incarcerated or is caused while incarcerated in a penal institution or government detention facility; engaging in an illegal occupation; self-inflicting an Injury intentionally; or committing or attempting to commit suicide, while sane or insane.

Assurity will not pay benefits under the Critical Illness Benefit Rider for conditions caused by or as the result of the insured person: being addicted to drugs or suffering from alcoholism; b eing under the influence of an excitant, depressant, hallucinogen, narcotic, or any other drug or intoxicant, including those prescribed by a physician that are misused; receiving injuries caused directly or indirectly while under the influence of a controlled substance or by intoxication as defined by the laws and jurisdiction of the geographical area in which the loss or cause of loss was incurred; participating in or attempting to commit a felony; being exposed to war or any act of war, declared or undeclared; actively serving in any of the armed forces, or units auxiliary thereto, including the National Guard or Army Reserve; being incarcerated in a penal institution or government detention facility; engaging in an illegal occupation; self-inflicting an injury intentionally; or committing or attempting to commit suicide, while sane or insane.

Policy and rider availability, features and rates may vary by state. This policy may not be approved in all states. There may be other reductions of benefits, limitations and exclusions. If this description conflicts in any way with the terms of the policy, the terms of the policy prevail. For costs and complete details of the coverage, please contact your agent or Assurity Life Insurance Company.