Simplified Benefits

Assurity Critical Illness Benefits

AssurityBalance® Simplified Critical Illness Insurance
Policy Highlights

Issue Ages 18 through 59, age last birthday
Simplified Issue A short application is used. If client is within the build charts and can answer “no” to health questions, qualification is probable.

Rates Male/Female, Tobacco/Non-tobacco
Minimum/Maximum

Face Amounts (Benefit)
$5,000 – $50,000 for each category

Multiple Benefits Across Categories
The first benefit is paid to you upon the initial diagnosis of a condition or procedure (see detailed list) in any one of the three categories. If you continue to pay the premiums and are diagnosed
with a condition or procedure in a different category, you will again receive the benefit payment indicated. Your maximum benefit is up to three times the critical illness policy benefit amount. The multiple conditions must be diagnosed at least 180 days apart.
Multiple Benefits Within Categories
If you have received a partial benefit within a category (e.g., 25 percent of the benefit for coronary bypass surgery) and you have another illness in the same category that pays 100 percent of
the benefit (e.g., heart attack), you will receive the remainder of the total benefit for that category
(e.g., 75 percent).
Renewability Policy is guaranteed to age 75.
Waiting Period Coverage begins immediately for all conditions in Category II – Heart/Stroke and Category III –
Other Illnesses and Conditions. Category I – Cancer has a waiting period. See specifics below.

Category I –Cancer Definitions
• Invasive cancer is a malignant tumor with uncontrolled growth beyond its original site (includes leukemias and lymphomas).
• Non-invasive cancer (cancer in situ) is a malignant tumor that has not invaded surrounding tissue.

Category I –Cancer Waiting Period
Invasive and non-invasive cancers have a reduced benefit for the first 90 days of the policy. If cancer is diagnosed during the policy’s first 90 days, the policy pays 10 percent of the maximum benefit for invasive cancer or 2.5 percent of the maximum benefit for non-invasive (in situ) cancer. If cancer is diagnosed after the policy’s first 90 days, the invasive cancer benefit is 100 percent and non-invasive cancer is 25 percent. Survival Period Requirements
There are no survival period requirements. If you die of a covered illness and meet the criteria (including first-ever diagnosis), your beneficiaries receive the maximum benefit less any benefits
previously received within that category for that illness.
Family Coverage Your spouse and/or children may receive critical illness insurance through riders on your policy with additional premium. Benefit Payment The benefit payment goes directly to you and may be used for anything you wish (e.g., medical bills, mortgage or credit card payments, travel, experimental treatments, etc.)
Return of Premium upon death If you die of any cause, 100 percent of the premiums paid by you less any benefits received are paid to your beneficiary. If you die of a covered illness and meet the criteria (including first-ever diagnosis), your beneficiaries receive the maximum benefit less any benefits previously received within the category for that illness. There is no extra charge for this provision.
Riders Available Expand your protection with these riders for additional premium:
• Return of Premium Rider – 100 percent of premiums paid less any benefits received are returned when policy terminates at age 75. If terminated before then, a percentage of premiums paid less any benefits received are returned (see table in rider contract) .
• Disability Waiver of Premium Rider
• Accidental Death Benefit Rider
• Spouse Critical Illness Benefits Rider
• Children’s Critical Illness Benefits Rider

Category I –Cancer
Percentage of benefit payable for illness
Category I
Maximum benefit
Invasive Cancer 100%
100%Non-Invasive Cancer (cancer in situ) 25% (payable once
per lifetime)

Covered Critical Illnesses,
Conditions and Procedures

Multiple Benefits Across
Categories

All of the conditions in each category are covered by your critical illness policy and trigger payment of the benefit indicated. If you collect a benefit for a first-ever diagnosed illness or procedure in one category and then have a first-ever diagnosis of a condition or procedure in another category, this policy will pay the maximum benefit shown to you again. You may receive 100 percent of your benefit for a condition in each of three categories. There must be at least 180 days between the dates of diagnosis of multiple conditions or procedures across categories.

Multiple Benefits Within
Categories

You may receive 100 percent of the benefit within each category.

If you receive a partial benefit for a condition or procedure in a category

Category II –
Heart/Stroke

Percentage of benefit payable for illness
Category II
Maximum benefit
Heart Attack 100%
Heart Transplant (or combination transplant including heart)100% Stroke 100%
Coronary Bypass Surgery 25% (payable once per lifetime)
Angioplasty 10% (payable once per lifetime)

Category III –
Other Illnesses and Conditions

Percentage of benefit payable for illness
Category III
Maximum benefit
Advanced Alzheimer’s Disease 100%
Coma (not as a result of a stroke) 100%
End-Stage Renal (kidney) Failure 100%
Major Burns 100%
Major Organ Transplant (other than heart) 100%
Paralysis (not as a result of a stroke) 100%

15-027-02291 (Rev. 9/07)
This policy has limitations and exclusions. For costs and complete
details of the coverage, please contact your agent, Assurity Life Insurance Company, or ask to review the policy contract.
Policy availability, features and rates may vary by state. Critical
illness insurance is not a substitute for health insurance. This
policy may not be appropriate for Medicaid recipients.
Policy Form Nos. CI005
Rider Form Nos:
CIR 018 – Return of Premium Rider
CIR 016 – Disability Waiver of Premium Rider
A-R130 – Accidental Death Benefit Rider
CIR 010 – Spouse Critical Illness Benefits Rider
CIR 014 – Children’s Critical Illness Benefits Rider
PO Box 82533 • Lincoln, NE 68501-2533
(800) 869-0355 • www.assurity.com
(see Category I and II) and then are diagnosed with an additional
condition or procedure in the same category, you will receive the benefit for that condition or procedure, up to 100 percent for that category.