FOR
Personal Estate Plans
Income Replacement
Excess Disability
High Limit Disability

Business Estate Plans
Buy-Sell Agreements
Business Overhead Expense
Key Person
Contract Agreement
Bank Loan Indemnification

The Principal Lump Sum Benefit is payable at the expiry of the specified elimination period.

• This is not an aggregate policy! This benefit is payable, in addition to and not reduced by, any other disability benefits provided by this or any other plan.
  
  
• The Principle Sum Benefit will be paid to you or to a designated loss payee, trust or annuity carrier. You may elect to receive the Benefit in any one of the following ways:
  1. Single payment.
  2. Monthly benefits for a certain period of time or to a prescribed age.
  3. Monthly benefits for life.
  4. Interest only for life with Principal Sum paid to beneficiaries at the time of your death.
  
  
• Simple Arbitration is utilized should your physician and our physician not be able to agree that you are permanently totally disabled. Your physician and our physician shall name a third physician to make a decision on the matter which shall be final and binding.
  
  

• Disability must result from an injury or sickness which is first diagnosed or incurred and which results in a loss beginning while the certificate is in force.
  
  
• You must have been totally disabled for the elimination period and at the end of such period you are determined by competent medical authority to be unable to resume the material duties of your regular occupation and that you have suffered a career-ending disability.
  
  

Monthly Benefits are payable while Totally Disabled or Residually Disabled, if applicable, beginning the first day following the Elimination Period and for as long as the Benefit Period for each disability.

• TOTAL DISABILITY MONTHLY BENEFITS are payable when, due to sickness or injury you cannot perform the substantial and material duties of your regular occupation and you are under the regular care of a legally qualified physician.
  
  
• PRESUMPTIVE DISABILITY benefits will be paid for the maximum benefit period even if you are able to return to your own or any other occupation. . Benefits will be paid should you lose the user of both hands, both feet, one hand and one foot, the sight in both eyes, hearing in both ears, or the ability to speak. The medical care requirements and the elimination period will be automatically waived.
  
  
• RECURRENT DISABILITIES resulting from the same cause or causes are considered a new claim with a new benefit period if you have returned to your regular occupation, full-time, for six months or longer.
  
  
• TRANSPLANT BENEFIT means that Total Disability benefits will be paid for disability following surgery if you donate an organ from your body to another person. Benefits will be paid as a sickness benefit. This benefit is applicable after the certificate has been in force for six months or longer.
  
  

• OPTIONAL RESIDUAL DISABILITY RIDER BENEFITS are payable when you are engaged in your regular occupation, or another occupation, and you experience reduced income of 20% or more, due to a disability. The benefit amounts will be calculated by multiplying the Monthly Benefit Amount provided by this Certificate by the percentage of reduced income compared to the average monthly earned income received during the twelve month period preceding the onset date of disability.
  
  
• OPTIONAL COST OF LIVING ADJUSTMENT (COLA) will automatically increase the monthly benefit amount based upon the Consumer Price Index (CPI), but not to exceed 10% per year.
  
  

Sickness means disease or illness which is first diagnosed and results in a disability while this Certificate is in force.
Injury means accidental bodily injury sustained and which results in a disability while the Certificate is in force.

This is a Specified Occupation Plan. It will terminate automatically if you change from the occupation in which you were engaged in at the time the plan was issued, unless an agreement has been obtained in writing from the underwriters and any additional premium required by the underwriters has been paid. The sole liability of the underwriters in the event of an occupation change shall be to return on a pro-rata basis any unearned premiums paid for the balance of the plan term.

TERM OF INSURANCE is the time period during which the terms of the certificate or the rates charged cannot be changed by the Underwriters. On the renewal date following a Term of Insurance the underwriters reserve the right to refuse or to offer renewal with different terms or rates.

A Grace Period of 31 days will be granted for the payment of each premium falling due after the first premium, during which Grace Period the plan shall continue in force.

This plan does not cover sickness, injury or death caused or contributed to by war, declared or undeclared, suicide, self-inflicted injury or poisoning, the taking of illegal or non-prescribed drugs, drunkenness or alcoholism, mental or nervous disorders. It does not cover subjective pain unless supported by objective medical findings or injuries or sickness sustained while committing or attempting to commit a crime.

Petersen International Underwriters want you to understand how they protect the confidentiality of non-public personal information they collected about you.

PIU collects non-public information about you from numerous sources including, but not limited to:

1. Information PIU receives from you on applications and other forms;
2. Information about your transactions with the affiliates, others or PIU;
3. Information PIU receives from consumer-reporting agencies; and
4. Financial and medical sources.

PIU does not disclose any non-public information about you to anyone except as is necessary in order to provide the products or services to you or otherwise as required or permitted by law (e.g. subpoena, fraud investigation, regulatory reporting, etc.).

PIU restricts access to non-public personal information about you to PIU's employees, PIU's affiliates' employees or others who need to know that information to service your account. PIU maintains physical, electronic and procedural safeguards to protect your non-public personal information.

If you have any further questions about this privacy statement or would like to learn more about how PIU protects your privacy, please contact us.

This plan is administered by

Petersen International Underwriters
23929 Valencia Boulevard, Suite 215
Valencia, CA 91355-2186

It is underwritten by Certain Underwriters at Lloyd's that is rated A "Excellent" by A.M. Best.

This is a brief description of the insurance provided by this plan. The Certificate of Insurance is the complete description of coverage.