DISABILITY INSURANCE POLICY SUMMARY
Policy 1 |
Policy 2 |
Policy 3 |
Policy 4 |
|
| Name of Insured | ||||
| Policy Number | ||||
| Insurance Company | ||||
| Issue Date | ||||
| Definition of Disability: Income replacement | ||||
| Cannot perform "own" occupation | ||||
| Cannot perform "any" occupation | ||||
| Combination of above based on a time period | ||||
| Waiting Period: Accident | ||||
| Sickness | ||||
| Maximum Benefit Period: Accident | ||||
| Sickness | ||||
| Cost-of-living Rider? Pre-disability | ||||
| During Claim | ||||
| Waiver of Premium? | ||||
| Noncancellable and Guaranteed Renewable? | ||||
| Monthly Benefit - Total Disability: Accident | $ | $ | $ | $ |
| Sickness | $ | $ | $ | $ |
| Partial Disability Benefit: for Accident | $ | $ | $ | $ |
| Sickness | $ | $ | $ | $ |
| Elimination Period | days |
days |
days |
days |
| Indexing of Pre-claim Income? | ||||
| Annual Premium | $ | $ | $ | $ |