whole life insurance certificate · certificate will be void as if it had never taken effect, and...

The Independent Order of Foresters

Whole Life Insurance Certificate

Certificate 1234567 on life of

Terry B. Tester

Foresters will pay benefits in accordance with the terms and provisions of this certificate while it is in effect.

This certificate provides you with the insurance protection for which you were approved. It is eligible to participate in our divisible surplus, and may have a cash value if you cancel your coverage.

This certificate includes benefits and options that are guaranteed, and some that are not guaranteed. Please review the certificate carefully to ensure that you are satisfied with its terms and conditions.

President and Chief Executive Officer

You have a right to examine this certificate for 10 days

Please read this certificate carefully. You have the right to return this certificate within 10 days of receiving it, by delivering or mailing it to our address shown below. If returned within 10 days, the certificate will be void as if it had never taken effect, and we will refund the premium paid.

Need help?

If you have any questions about this certificate or otherwise require our assistance, you can:

Contact your insurance advisor David B. Advisor.

Call us toll free at 1-800-828-1540

Write to us at 789 Don Mills Rd, Toronto, Ontario M3C1T9

The Independent Order of Foresters Certificate 1234567 Certificate Specifications Page 1 of 4

Information about this certificate

Certificate number 1234567

Issue date December 18, 2017

Branch number 1234

Monthly processing day The 18th day of every month

Certificate owner Terry B. Tester

Applicable law Ontario

Principal insurance plan

Insured Terry B. Tester

Sex, Insurance Age and Insurance Class Male 35 Standard Non-Smoker

Insurance plan Advantage Plus Whole Life Paid-up at age 100

Basic Insurance Amount $89,285.00

Enhanced Insurance Amount $160,715.00

Total Initial Insurance Amount $250,000.00

Dividend option Enhanced Insurance

Date your premium payments end

for the principal insurance plan

December 18, 2082

Children’s Insurance Benefit Included

Date this coverage ends for an insured child The insured child’s 25th birthday

Riders included in this certificate

Renewable and Convertible Term 10 Rider $125,000.00



Date your conversion privilege expires December 18, 2053

Date this rider expires December 18, 2067







Renewable and Convertible Term 30 Rider

Insured

Sex, Insurance Age and Insurance Class

Date your conversion privilege expires

Date this rider expires

$100,000.00

Terry B. Tester

Male 35 Standard Non-Smoker

December 18, 2053

December 18, 2067


Insured Wilma B. Tester

Sex, Insurance Age and Insurance Class Female 30 Standard Non-Smoker



Children’s Term Insurance Rider $10,000.00

Insured

Date your premium payments for this rider end

Accidental Death Benefit Rider

Insured


Guaranteed Insurability Benefit Rider

Insured


Pebbles Tester

Peter Tester

December 18, 2037

$25,000.00

Terry B. Tester

December 18, 2052

$50,000.00

Terry B. Tester

December 18, 2022

Waiver of Premium Benefit Rider


Date this rider expires July 1, 2042


Premium payment schedule

Premium beginning date Annual premium

$2,835.88

$2,734.38

$3,205.63

$5,380.63

$4,768.56

$8,861.81

$10,356.31

$25,251.56

$31,653.56

$8,493.56

December 18, 2017

December 18, 2022

December 18, 2027

December 18, 2037

December 18, 2042

December 18, 2047

December 18, 2052

December 18, 2057

December 18, 2062

December 18, 2067

December 18, 2072 $1,853.56

Certificate fee included in premiums $50.00

You may change the frequency of premium payments in accordance with the terms of provision C 2

The monthly premium is the annual premium multiplied by 0.09.

The quarterly premium is the annual premium multiplied by 0.26.

The semi-annual premium is the annual premium multiplied by 0.52.


Schedule of guaranteed values

Certificate Anniversary Guaranteed Cash Value Guaranteed Reduced Paid-up Insurance Amount

December 18, 2018 $0.00 $0.00

December 18, 2019 $0.00 $0.00

December 18, 2020 $0.00 $0.00

December 18, 2021 $0.00 $0.00

December 18, 2022 $0.00 $0.00

December 18, 2023 $414.00 $1,212.00

December 18, 2024 $778.00 $2,008.00

December 18, 2025 $1,260.00 $2,953.00

December 18, 2026 $1,760.00 $3,859.00

December 18, 2027 $2,697.00 $5,430.00

December 18, 2028 $3,391.00 $6,522.00

December 18, 2029 $4,203.00 $7,744.00

December 18, 2030 $5,216.00 $9,204.00

December 18, 2031 $6,314.00 $10,724.00

December 18, 2032 $8,432.00 $13,517.00

December 18, 2033 $11,368.00 $17,167.00

December 18, 2034 $14,210.00 $20,522.00

December 18, 2035 $17,430.00 $24,165.00

December 18, 2036 $20,841.00 $27,879.00

December 18, 2037 $24,630.00 $31,865.00

December 18, 2042 at age 60 $33,345.00 $40,604.00

December 18, 2047 at age 65 $41,779.00 $48,631.00

December 18, 2082 at age 100 $89,285.00 Not available $0.00

Guaranteed values shown here are subject to the provisions of this certificate, based on the assumption that all premiums are paid as due and that no changes are made to this certificate. Paid-up additional insurance, dividends on deposit or debt, if any, will not affect the cash values shown. The Guaranteed Reduced Paid-up Insurance Amount is described in provision E 4. Paid-

up additional insurance or dividends on deposit, if any, will increase the reduced paid-up insurance amounts shown and debt will decrease those amounts. Values for certificate years not shown above will be provided upon request.

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The Independent Order of Foresters ADVPLUS CDN ENG 11.2017 Page 1 of 22

Table of Contents

Table of Contents................................................................................................................................................... 1

A Terms used in this certificate......................................................................................................................... 3

B Coverage provided by this certificate........................................................................................................... 5

B 1 When coverage under this certificate begins............................................................................ 5

B 2 When this certificate ends......................................................................................................... 5

B 3 Death benefit under the principal insurance plan.......................................................................... 5

B 4 B 4.1

Children's Insurance Benefit............................................................................................................ Conversion privilege under the Children’s Insurance Benefit.........................................................

66

B 5 Juvenile Guaranteed Insurability Benefit......................................................................................... 7

B 6 When we will pay a death benefit................................................................................................ 9

B 7 When we will adjust a death benefit............................................................................................ 9

B 8 B 9

When we will not pay a death benefit…….………………………………………………………….. Charity Benefit................................................................................................................................

99

C Paying premiums................................................................................................................................... 10

C 1 Our premium guarantee.................................................................................................................. 10

C 2 When premiums must be paid........................................................................................................ 10

C 3 Grace period for paying premiums….....................................................…………………….… 10

C 4 Automatic premium loan......................................................………………………………………..… 11

C 5 Reinstating this certificate after it has ended................................................………………….… 11

D Dividend options and certificate values.............................................................…………………….... 12

D 1 Dividends.....................................................…………………………………………….………….…... 12

D 2 Paid-Up Additional Insurance Option..............................................................…………………….... 12

D 3 Dividends on Deposit Option...........................................................................…………………..….. 12

D 4 Premium Reduction Option..............................................................................…………………..…. 12

D 5 Cash Payment Option.......................................................................................…………………….. 12

D 6 Enhanced Insurance Option............................................................................…………………..….. 13

D 6.1 The Enhanced Insurance Option Guarantee................................................………………………... 13

D 7 Changing the dividend option.......................................................................……………… 14

D 8 Surrender value..................................................................................................……………….….. 15

D 9 Borrowing money against this certificate…...................................................……………………….. 15

E Making changes to this certificate..............................................................................……………………….. 16

E 1 Changing the insurance class applicable to an insured person.................................................... 16

E 2 Quit Smoking Incentive Privilege.....................................................................……………..……..... 16

E 3 Reducing the basic insurance amount.........................................................………………….… 17

E 4 Reduced Paid-up Insurance Privilege……………………………………………………………….…. 17

E 5 Surrendering paid-up additional insurance………………………………………………………….… 17

E 6 Cancelling this certificate or a rider……………………………………………………………………... 18

F More information about this certificate………………………………………………………………………...… 19

F 1 This certificate is a contract between you and The Independent Order of Foresters………….…... 19

F 2 When we will contest the validity of this certificate……………………………………………………. 19

F 3 Naming the beneficiary……………………………………………………………………………...…… 19

F 4 Your rights and privileges as the certificate owner……………………………………………………. 20

F 5 Certificate ownership when the designated insured person is a juvenile….………………….……… 20

F 6 Assigning or transferring ownership of this certificate…………………………………………….…... 20

F 7 Maintaining the tax exempt status of this certificate……………………………………………..... 21

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Table of Contents

F 8 Income tax reporting……………………………………………………………………………….…… 21

F 9 Maintenance of reserves………………………………………………………………………….……. 21

F 10 Currency…………………………………………………………………………………..……….…..... 21

F 11 Applicable law……………………………………………………………………………………….….. 22

F 12 Limitation of action………………………………………………..……...…………….……………..... 22

F 13 Notifications……………………………………………………………………………………………… 22

Appendix A - Premiums in Advance Account…………………………………………………….…………….…. 1

Appendix B - Expert Medical Opinion Program.............................................................................................. 1

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A Terms used in this certificate

The following terms have specific meanings for the purposes of this certificate.

We, us, our and the Company mean The Independent Order of Foresters.

You and your mean each owner named in the application, subject to change as described in this certificate.

Administrative rules means the rules and procedures we establish to facilitate the administration of this certificate.

We may amend our administrative rules from time to time. Changes we make to our administrative rules will not alter a guarantee or benefit provided by this certificate.

Application means the application that was signed in relation to this certificate and each rider listed in the Certificate Specifications.

Attained age means an insured person's insurance age plus the number of completed certificate years.

Basic insurance amount means the amount of life insurance on the life of the designated insured person,

excluding the enhanced insurance amount, paid-up additional insurance, or insurance provided by a rider. The basic insurance amount is shown in the Certificate Specifications, unless changed as shown in our records.

Beneficiary means each person or entity named, if any, to receive their share of the death benefit payable under this

certificate.

Certificate means the written contract between you and us that describes the insurance coverage on each insured person.

This certificate consists of the cover page of this document bearing the signatures of our authorized officers, the Certificate Specifications, sections A to F of this document, and each rider.

Certificate anniversary means the same day and month as the issue date in each subsequent calendar year that this certificate remains in effect.

Certificate year means a year that begins on the later of the issue date or a certificate anniversary.

Certificate Specifications means the pages entitled Certificate Specifications within this certificate at the time it was delivered to you, unless changed as shown in our records.

Death benefit means the amount payable when an insured person dies. The death benefit payable under the principal insurance plan is described in provision B 3. An additional death benefit may also be payable under the Charity Benefit

or under a rider if it is attached to this certificate.

Debt means unpaid loans and loan interest, as described in provisions D 9 and F 9. We will reduce any settlement under

this certificate, such as the death benefit or surrender value when it is payable, by the amount of the debt. We will not reduce the benefit payable under the terms of a rider.

Designated insured person means the insured person under the principal insurance plan.

Enhanced insurance amount means the minimum amount of enhanced insurance that is guaranteed under the Enhanced Insurance Option described in provision D 6. If your dividend option is the Enhanced Insurance Option, this amount is shown in the Certificate Specifications, unless changed as shown in our records.

Evidence of insurability means the information relied upon by us to determine if an insured person is eligible for

insurance or changes described in this certificate. It may include medical examinations, doctors' reports, blood and fluid tests, and other evidence of the insured person's health, lifestyle, or financial circumstances.

Guaranteed cash value means the only portion of this certificate’s surrender value that is guaranteed. Guaranteed cash values are shown in the Certificate Specifications as at each certificate anniversary.

Insurance age means the age of an insured person at his or her birthday nearest to the issue date.

Insurance class applies to the group of individuals that satisfy our underwriting criteria related to their health, lifestyle,

tobacco usage, family history and other personal history. Based on these criteria, an insured person may be classified as a juvenile, a smoker or a non-smoker. An insured person under a term insurance rider attached to this certificate may be further classified as in a preferred plus, preferred or standard insurance class. We determine the insurance class applicable to each insured person and use it to establish the premium. It is shown in the Certificate Specifications.

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A Terms used in this certificate

Insured person means a person whose life is insured under this certificate. Every insured person is named in the Certificate Specifications.

Issue date means the date that is used to determine other dates or periods of time such as each certificate

anniversary, certificate year, month, monthly processing day, and premium due date. It is shown in the Certificate Specifications.

Monthly processing day means the same day of the month as the issue date. A change you request to this certificate

may take effect on the monthly processing day following the date we receive and approve your request. Once set, the

monthly processing day cannot be changed.

Non-guaranteed cash value means the cash value of paid-up additional insurance or dividends on deposit, as described in provisions D 2 and D 3. Non-guaranteed cash value forms part of this certificate’s death benefit and surrender value.

Premium means the amount you pay to us in consideration for this certificate.

Principal insurance plan means insurance coverage excluding riders, as shown in the Certificate Specifications at the time this certificate is issued, unless changed as shown in our records.

Rider means additional insurance coverage that is shown in the Certificate Specifications or added to this certificate

after the issue date, as shown in our records. A rider forms part of the certificate, and each reference to certificate includes all riders, except as expressly indicated otherwise.

Rating class means a classification that we assign to an insured person based on a broad range of criteria we use to

determine whether applicants are insurable and under what terms we will make insurance coverage available. The terms under which we offer insurance may include a change in the amount of insurance, the payment of an extra premium, restrictions on the types of benefits we offer and exclusion of payments based on certain risks or circumstances. If this certificate is assigned a rating class that results in an extra premium, it will be shown in the Certificate Specifications.

Surrender value means the amount that is payable to you if you cancel this certificate as set out in provisions D8. The

surrender value of this certificate must be greater than or equal to zero for this certificate to remain in effect.

Written request or written notice means a request or notice signed by you and received by us, in a form that is

satisfactory to us. Changes permitted under this certificate will not be effective until approved by us. Any certificate change you request is subject to each payment made or other action taken by us before your request was received at our office.

There may be additional definitions provided in the provisions of this certificate and each rider.

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B Coverage provided by this certificate

B 1 When coverage under this certificate begins

This certificate must be in effect for coverage or privileges to be provided under it. The insurance coverage and privileges under this certificate begin, and come into effect, on the issue date, if each of the following conditions are met:

a) At least the first premium was provided on or before the date we delivered this certificate to you and that premium is honoured when presented for payment, by the financial institution from which it is to be collected;

b) There is no change in the insurability of an insured person between the date the application was signed by that insured person and the issue date; and

c) When required by us, you accept, and if applicable sign and return to us, each amendment, addendum and exclusion, if any, required for this certificate to take effect.

B 2 When this certificate ends

This certificate is no longer in effect and all coverage ends on the earliest of the following dates:

a) The date the designated insured person dies;

b) The end of the grace period, if a premium is then still unpaid, as described in provision C 3;

c) The date this certificate’s surrender value falls below zero, as described in provisions C 4, D 8 and D 9;

d) The effective date of your cancellation, as described in provision E 6.

Additionally, this certificate will be voided, as if never issued, if voided in accordance with provision F2.

B 3 Death benefit under the principal insurance plan

Upon the death of the designated insured person, each beneficiary will be paid their share of the death benefit payable. If no beneficiary is living when the designated insured person dies, and the beneficiary designation then in effect does not state otherwise, the death benefit payable will be paid to you or your estate. Payment of the death benefit is subject to the terms and provisions of this certificate.

We will calculate the amount of the death benefit as of the date we determine it is payable, in accordance with our administrative rules. The death benefit will be equal to:

The basic insurance amount

plus the enhanced insurance amount, if the dividend option is the Enhanced Insurance Option described in provision D 6

plus other paid-up additional insurance purchased with dividends, as described in provisions D 2 and D 6, or purchased under a rider, as described in that rider

plus dividends on deposit, as described in provision D 3

plus unused premiums

minus outstanding debt

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B 4 Children’s Insurance Benefit

If the insurance age of the designated insured person is between eighteen (18) and fifty-five (55) years, the Children’s Insurance Benefit will be included in this certificate and shown in the Certificate Specifications. This benefit provides insurance coverage as follows and is subject to our administrative rules and the following conditions:

1. Under the Children’s Insurance Benefit, an insured child means a child who is at least fifteen (15) days old, and is:

a) A child, step-child or legally adopted child of the designated insured person, who has not reached his or her 18th birthday on the date of the application for this certificate; or

b) Born to the designated insured person after the date of the application for this certificate; or

c) Legally adopted by, or becomes a step-child or comes under the legal guardianship of, the designated insured person after the date of the application for this certificate but prior to the child's eighteenth (18th) birthday.

2. No evidence of insurability is required to become an insured child under the Children’s Insurance Benefit. However, under no circumstances will this benefit be extended to a child who is insured under two (2) such Children’s Insurance Benefits under all certificates issued by us.

3. We will pay a death benefit of $3,000 if an insured child dies before that child’s twenty-fifth (25th) birthday and while this benefit is in effect on the life of that child.

4. Insurance for an insured child under this Children’s Insurance Benefit ends on the earliest of the following dates:

a) The child’s twenty-fifth (25th) birthday;

b) The date a new permanent insurance certificate is issued on the life of that child under the conversion privilege described in provision B 4.1;

c) The date the child dies; and

d) The date insurance under this certificate ends, as described in provision B 2.

B 4.1 Conversion privilege under the Children’s Insurance Benefit

While the Children’s Insurance Benefit is in effect, you can convert an insured child’s coverage to a permanent life insurance certificate, without evidence of insurability, subject to the following conditions:

1. The conversion must occur while this certificate is in effect and premiums are paid to the effective date of conversion.

2. You must submit a written request for conversion to us within sixty (60) days of the earliest of the following dates:


b) The date the insured child is legally married; and

c) The date the designated insured person dies.

3. Upon our request, you must provide evidence that the insured child consents to the requested conversion.

Coverage for an insured child under the Children’s Insurance Benefit will end on the date the new certificate on the life of that insured child takes effect under this conversion privilege. The following conditions will apply to the new certificate:

1. The new certificate will be a permanent life insurance plan we then offer you for conversion. However, we reserve the right to exclude from the new plan each provision or rider that provides for an increasing insurance risk amount without evidence of insurability.

2. The amount of insurance under the new certificate cannot be less than the minimum amount we allow for the new plan of insurance, and it cannot exceed $10,000.

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3. Riders may be included in the new certificate only with our consent, and may be subject to evidence of insurability.

4. Certificate years under the new certificate will be calculated from the issue date of the new certificate.

5. The conditions and provisions of the new certificate will apply from the date the new certificate takes effect.

6. The premium rates applicable to the insured child under the new certificate will be based on the following:

a) The amount of insurance under the new certificate;

b) The insured child’s age at the time of conversion;

c) The premium rates then in effect for the new insurance plan; and

d) The insured child’s applicable insurance class used in calculating the premiums for the new certificate. The insured child’s applicable class will be the standard smoker class unless you submit evidence we consider satisfactory as to the smoking habit of the insured child. The insured child must meet our definition of a non-smoker at the time of the request.

B 5 Juvenile Guaranteed Insurability Benefit

If the designated insured person’s insurance age is less than eighteen (18) and the designated insured person is not subject to a rating class extra premium, the Juvenile Guaranteed Insurability Benefit will be included in this certificate and shown in the Certificate Specifications. This benefit provides the right to purchase new permanent insurance on the life of the designated insured person without evidence of insurability on certain option dates, subject to our administrative rules and the following conditions:

1. You must submit a written request to us within ninety (90) days of a regular or special option date as described in this provision and pay the first premium for the new insurance. Upon our request, you must provide evidence that the designated insured person consents to the requested purchase.

2. A regular option date is a certificate anniversary on which the designated insured person’s attained age is twenty-five (25), twenty-eight (28) or thirty-one (31).

3. A special option date is a date when:

a) The designated insured person is legally married;

b) A living child is born to the designated insured person;

c) The designated insured person legally adopts a child prior to the child’s eighteenth (18th) birthday;

d) The designated insured person purchases a home which he or she intends to use as his or her primary residence; or

e) The designated insured person graduates from an accredited post-secondary educational institution.

4. If you purchase insurance in connection with a special option date, we will require proof that meets our standards of any legal marriage, birth, adoption, home purchase or graduation before we issue a new certificate.

5. If you purchase insurance as a result of a regular option date, you cannot purchase insurance in connection with a special option date that occurs in the three-hundred and sixty-five (365) days following the date of the regular option date purchase.

6. If you purchase insurance with respect to a special option date, then the next available regular option date will be cancelled, and you will not be able to purchase insurance on that regular option date. However, if all future regular option dates have been cancelled, you can still request insurance with respect to any subsequent special option dates that occur while this Juvenile Guaranteed Insurability Benefit is in effect.

7. The Juvenile Guaranteed Insurability Benefit ends on the earliest of the following dates:

a) The certificate anniversary nearest the designated insured person’s fortieth (40th) birthday;

b) The date insurance under this certificate ends, as described in provision B 2.

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When you exercise the Juvenile Guaranteed Insurability Benefit, the following conditions will apply to each new certificate:

1. The new certificate will be a permanent life plan we then offer you for this purpose on the option date. However, we reserve the right to exclude from the new plan each certificate provision or rider that provides for an increasing insurance risk amount without evidence of insurability. The new certificate will include any restriction in effect on this certificate on the effective date.

2. The new certificate will take effect on the applicable option date described above. We will not provide any insurance under the new certificate before this effective date. If a written request is made for a new certificate but the designated insured person dies before its effective date, we will refund any premiums paid for the new certificate.


4. The conditions and provisions of the new certificate will apply from the date the new certificate takes effect, except that our right to contest the validity of the new certificate and the two (2) year exclusion for suicide, described in provisions F 2 and B 8 respectively of this certificate, will continue to apply from the later of the effective date or the

last date of reinstatement of this certificate.

5. The evidence of insurability as well as each exclusion that applies to this certificate on or before the effective date of the new certificate will become part of the new certificate.

6. The amount of insurance under the new certificate cannot be less than the minimum amount we allow for the new plan of insurance, and it must equal or exceed $10,000.

7. The amount of insurance for each new certificate can be up to $25,000. The overall maximum that can be purchased under all option dates under this Juvenile Guaranteed Insurability Benefit is the lesser of:

a) $100,000, and

b) 300% of the sum of the basic insurance amount and the enhanced insurance amount, if any, in effect on the applicable option date.


9. The premium rates applicable to the insured person under the new certificate will be based on:


b) The designated insured person's age on the effective date of the new certificate;

c) The premium rates then in effect for the new insurance plan;

d) The designated insured person's rating class used in calculating the premiums for this certificate; and

e) The designated insured person's applicable insurance class used in calculating the premiums for the new certificate. The designated insured person's applicable insurance class will be the standard class that corresponds to the designated insured person's smoking habit.

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B 6 When we will pay a death benefit

Subject to the terms and provisions of this certificate, we will pay the death benefit payable upon the death of an insured person only after we receive the information we request to evaluate and approve the claim. This includes completed claim forms required by us in addition to evidence we consider satisfactory to establish:

a) That the insured person died while this certificate was in effect;

b) The cause and circumstances of the death;

c) The age of the insured person;

d) The smoking habit of the insured person on the date this certificate took effect; and

e) The right of the claimant to be paid.

These requirements also apply to the benefit payable under each rider and the Children’s Insurance Benefit if it is included in this certificate.

B 7 When we will adjust a death benefit

If premium is due at the time of death, we will deduct it from the death benefit. If the date of birth or sex of an insured person has been stated incorrectly, we reserve the right to increase or decrease the death benefit payable to the amount that would have been provided by the premium paid using the correct age or sex. We may calculate the correct amount payable at any time after the misstatement of age or sex is discovered.

B 8 When we will not pay a death benefit

We will not pay a death benefit if an insured person commits suicide, while sane or insane, within two (2) years from the date this certificate took effect or within two (2) years from the last reinstatement date. We will instead refund the premiums paid for this certificate, from the later of the issue date of this certificate or the date of the last reinstatement, without interest, to you. We will not pay a death benefit or other certificate benefit if we contest as described in provision F 2.

B9 Charity Benefit

Eligible beneficiary means an organization registered as a charity with the Canada Revenue Agency.

Subject to the terms and conditions of the entire contract, if the death benefit under the principal insurance plan is payable we will also pay a Charity Benefit under this provision. Payment of the Charity Benefit will be made to the eligible beneficiary designated for this benefit. The Charity Benefit amount will be equal to the lesser of 1% of the basic insurance amount in effect on the date of death of the designated insured and $100,000. The Charity Benefit will only be paid if an eligible beneficiary for this benefit has been designated, as shown in our records, prior to, and is in effect on, the date of death of the designated insured. An eligible beneficiary can be designated, or if designated can be changed, at any time prior to the date of death of the designated insured. We may, but are not obligated to, confirm that the designated organization meets the eligible beneficiary definition. If this benefit becomes payable and we determine that the beneficiary designated for this benefit either no longer exists or is no longer an eligible beneficiary, then we will allow the owner or, if the owner is the designated insured, the owner’s representative, the opportunity to designate another organization, that meets the eligible beneficiary definition, to receive this benefit. We reserve the right to determine the owner’s representative for purposes of this provision. If the owner or owner’s representative, as applicable, does not make this designation within 90 days of our notifying them of this opportunity, then no Charity Benefit will be paid. If an eligible beneficiary designation is not in effect on the date of death of the designated insured, then no Charity Benefit will be paid.

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C Paying premiums

C 1 Our premium guarantee

We will provide you with the coverage and benefits described in this certificate if you pay each premium by its due date. Premium amounts are shown in the Certificate Specifications and are guaranteed provided this certificate remains in effect and you do not request a material change to this certificate. We may offer you different guaranteed rates if you exercise one of the following options:

1. You request a change to the insurance class applicable to an insured person, as described in provision E 1, and we

approve it;

2. The designated insured person’s insurance class is smoker when this certificate is issued, and you do not meet the requirements to change the insurance class to non-smoker as described in provision E 2; or

3. You reduce the basic insurance amount of this certificate as described in provision E 3.

Each premium includes a certificate fee for the administration of this certificate. The certificate fee is shown in the Certificate Specifications and is guaranteed not to change unless you change the premium payment frequency.

C 2 When premiums must be paid

The first premium is due on the issue date. If we do not receive the first premium while each insured person is alive, or if the first premium is not honoured, this certificate will not come into effect.

Subsequent premium due dates are determined by the premium payment frequency in effect, as requested in the application or as shown in our records. Other than the first premium, each premium must be paid on, or before, its due date. Subject to our administrative rules, you can change the frequency of premium payments by written request and with our consent. Contact us to find out what payment frequencies are available. We reserve the right to charge an administrative fee when a premium payment is returned unpaid by your bank. Premiums for the principal insurance plan are payable either to the certificate anniversary nearest the designated insured person’s one-hundredth (100th) birthday, or for ten (10) years or twenty (20) years, as shown in the Certificate Specifications. Premiums for riders are payable in addition to the premium for the principal insurance plan, and may be payable beyond the premium period that is guaranteed for the principal insurance plan.

C 3 Grace period for paying premiums

Other than the first premium, we allow a grace period of thirty-one (31) days after the premium due date for payment of each premium. If a premium is not paid by its due date, we will take the following steps to maintain this certificate in effect:

1. We will withdraw the amount due from the Premiums in Advance Account described in Appendix A.

2. If any remaining premium remains unpaid thirty-one (31) days after its due date and the surrender value of this certificate is greater than zero, then an automatic premium loan will be initiated by us as described in provision C 4.

3. If the premium is still unpaid at the end of the grace period and the surrender value of this certificate equals zero at the end of the grace period, then this certificate will automatically end and no longer be in effect.

If the insured person dies during a grace period and before the premium is paid, we will deduct the overdue premium from the death benefit payable.

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C Paying premiums

C 4 Automatic premium loan

Subject to our administrative rules, a premium that remains unpaid at the end of the thirty-first (31st) day of the grace

period will automatically be paid through a loan against this certificate if, on that day, the surrender value is greater

than zero. Payment of an overdue premium through an automatic premium loan is subject to the following conditions:

1. If the surrender value equals or exceeds the overdue premium the entire overdue premium will be paid through a

loan. 2. If the surrender value is less than the overdue premium then we will apply the remaining surrender value as

premium. This premium will be prorated over the month to continue this certificate for part of the month. If the premium is still unpaid after this period this certificate ends and is no longer in effect.

3. If the premium payment frequency is not monthly, we will change it to monthly while the premium is paid through an automatic premium loan. You can resume premium payments at any time while this certificate is in effect.

4. An automatic premium loan is subject to the same loan interest and repayment terms and conditions as a requested cash loan, as described in provision D 9.

C 5 Reinstating this certificate after it has ended

If this certificate ends due to non-payment of premium as described in provision C 3, or ends due to insufficient surrender value as described in provisions C 4, D 8 or D 9, you can reinstate it by paying the overdue premiums to us

within thirty (30) days of the date this certificate ends, if each insured person is still living when we receive this payment. Subsequently, this certificate may be reinstated subject to all of the following conditions:

1. You must make a written request for reinstatement, received by our office within two (2) years after the certificate ends. You cannot request reinstatement if you have surrendered this certificate as described in provision E 6.

2. You must submit evidence of insurability for each insured person. We may decline to reinstate if an insured person does not qualify for the insurance class or rating class under which they were originally approved, as determined by us.

3. You must pay each overdue premium from the due date of the first overdue premium to the reinstatement date, with interest at a rate we determine.

4. We may at our discretion require you to repay some or all of the debt that was outstanding when the certificate went into default.

5. We reserve the right to request payment of a fee we set from time to time for underwriting expenses. We will advise you of the amount of this fee before we process your request.

6. Insurance amounts under the principal insurance plan, the Enhanced Insurance Amount Guarantee, and the benefits provided by each rider, will be in the same amount as they were on the date this certificate ended. If it has not been repaid, any unpaid loan amount outstanding on the date of lapse will be reinstated including accrued interest.

7. If this certificate is reinstated, the two (2) year period for the suicide exclusion and for contesting the validity of this certificate begin anew from the date of reinstatement, as described in provisions B 8 and F 2 respectively.

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D Dividend options and certificate values

D 1 Dividends

This is a participating certificate, which means that it is eligible to participate in our divisible surplus and earn dividends. A dividend is a portion of our earnings available for distribution annually to the certificate owners. Dividends are not guaranteed. On each certificate anniversary, we may credit a dividend to this certificate in an amount determined by us.

The dividend options available under this certificate are described in this section. The dividend option you have elected is shown in the Certificate Specifications. If you do not elect a dividend option in the application for insurance, we will automatically elect the Paid-Up Additional Insurance Option on your behalf.

D 2 Paid-Up Additional Insurance Option

Under the Paid-Up Additional Insurance Option, dividends will be used to buy life insurance in addition to the basic insurance amount. The cost of this insurance will be based on the designated insured person’s rating class, insurance class and attained age on the day we credit the dividend to this certificate. No further premiums are required to keep paid-up additional insurance in effect.

Paid-up additional insurance is eligible to earn dividends and has a cash value. The amount of this cash value is not guaranteed and forms part of the surrender value of this certificate, as described in provision D 8. We calculate the

cash value of paid-up additional insurance as of the date we determine it is payable. You may surrender paid-up additional insurance for its cash value at any time by written request, subject to the terms of provision E 5.

Paid-up additional insurance in effect when the designated insured person dies will be paid as part of the death benefit as described in provision B 3.

D 3 Dividends on Deposit Option

Under the Dividends on Deposit Option, we will deposit the dividend to this certificate each year and we may pay interest on the accumulated dividends. We will set the interest rate for dividends on deposit from time to time, and this interest rate will never be less than 0%.

You can withdraw these dividends and any accumulated interest at any time by written request. The dividends on deposit form part of the surrender value of this certificate, as described in provision D 8.

Dividends that remain on deposit when the designated insured person dies will be paid as part of the death benefit, as described in provision B 3.

D 4 Premium Reduction Option

Under the Premium Reduction Option, we will credit the dividend toward the premium each year. The premiums payable may vary from year to year. If the dividend is less than the premiums due in that year, the balance of the premium will be payable by you. If the dividend is greater than the premiums due in that year, the balance of the dividend will be payable as described in provision D 3.

The premium payment frequency must be annual to exercise the Premium Reduction Option. If the premium payment frequency is not annual and you request a change to the Premium Reduction Option, we will change the premium payment frequency to annual.

D 5 Cash Payment Option

Under the Cash Payment Option, we will mail the value of the dividend to you at the last mailing address we have on file. If the cheque is returned to us undelivered, or if the cheque is not cashed while it is valid, we will change the dividend option to the Dividends on Deposit Option and will deposit the dividend to this certificate as if it had been paid under that dividend option. We may, at our discretion, offer to pay dividends under this option by another method, such as electronic payment to a bank account.

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D 6 Enhanced Insurance Option

You can choose the Enhanced Insurance Option only at the time you purchase this certificate. If you choose the Enhanced Insurance Option, dividends will be used to purchase additional coverage called enhanced insurance through a combination of paid-up additional insurance and one-year term insurance, subject to our administrative rules and the following conditions.

1. Paid-up additional insurance is purchased as described in provision D 2. It can remain in effect for the lifetime of this certificate unless you surrender it as described in provision E 5, or it is automatically surrendered as described

this provision. One-year term insurance remains in effect for one (1) year from the date it is purchased. It is not eligible to earn dividends and has no cash value.

2. In the first (1st) certificate year, we will provide one-year term insurance equal to the enhanced insurance amount shown in the Certificate Specifications.

3. On every certificate anniversary, any dividend we credit will be used to purchase a combination of paid-up additional insurance and one-year term insurance. The amount of one-year term insurance will be the lesser of:

a) the amount that the dividend will purchase; and b) the enhanced insurance amount minus any paid-up additional insurance in effect.

4. Once the enhanced insurance amount minus any paid-up additional insurance in effect is equal to zero, the purchase of one-year term insurance is no longer required and any dividend we credit will be used to purchase paid-up additional insurance as described in provision D 2.

5. If, on a certificate anniversary, the dividend is not sufficient to ensure that the sum of the paid-up additional insurance and one-year term insurance is equal to the enhanced insurance amount, we will surrender some or all of the existing paid-up additional insurance and use its cash value to purchase enough one-year term insurance to maintain the enhanced insurance amount while your Enhanced Insurance Option Guarantee is in effect as described in provision D 6.1.

6. If the Enhanced Insurance Option Guarantee described in provision D 6.1 is no longer in effect and the dividend

option is still the Enhanced Insurance Option, this certificate will continue to provide enhanced insurance but the amount of enhanced insurance may be lower than the enhanced insurance amount.

D 6.1 Enhanced Insurance Option Guarantee

The amount of one-year term insurance is guaranteed to equal the enhanced insurance amount shown in the Certificate Specifications less any existing paid-up additional insurance, provided that all required premiums are paid and you do not request a material change to this certificate. This guarantee will end on the earliest of the following dates:

a) The date this certificate lapses, as described in provision C 3, unless you reinstate this certificate as described in provision C 5;

b) The date you change the dividend option to an option other than the Enhanced Insurance Option, as described in provision D 7;

c) The date you exercise the Reduced Paid-up Insurance Privilege, as described in provision E 4; and

d) The date you surrender paid-up additional insurance for its cash value, as described in provision E 5;

If you request that we decrease the basic insurance amount, the enhanced insurance amount shown in the Certificate Specifications will be reduced accordingly. A new Enhanced Insurance Option Guarantee will take effect, and we will advise you of the lower enhanced insurance amount that this Enhanced Insurance Option Guarantee will provide.

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D 7 Changing the dividend option

You can change the dividend option at any time, subject to all of the following:

1. The new dividend option will apply to future dividends only.

2. The premium payment frequency must be annual to exercise the Premium Reduction Option. If the premium payment frequency is not annual and you request a change to the Premium Reduction Option, we will change the premium payment frequency to annual.

3. You cannot change the dividend option to the Enhanced Insurance Option after this certificate takes effect. If you change the dividend option from the Enhanced Insurance Option to another option:

a) The Enhanced Insurance Option Guarantee ends immediately;

b) Paid-up additional insurance purchased under the Enhanced Insurance Option remains in effect;

c) One-year term insurance under the Enhanced Insurance Option remains in effect until the day before the next certificate anniversary.

D 8 Surrender value

The surrender value of this certificate must be greater than or equal to zero for this certificate to remain in effect. If the

surrender value falls below zero, this certificate will end. In that event, you may be able to reinstate this certificate as described in provision C 5.

If you cancel this certificate, we will calculate the amount of the surrender value as of the date we determine it is payable, in accordance with our administrative rules and the terms of provision E 6. At any time, this certificate’s surrender value will be equal to:

The guaranteed cash value

plus the cash value of paid-up additional insurance, as described in provision D 2, or if purchased under a

rider, as described in that rider

plus dividends on deposit, as described in provision D 3

plus unused premiums

minus outstanding debt

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D 9 Borrowing money against this certificate

You can request a cash loan against the surrender value of this certificate at any time by written request, subject to our administrative rules and the following conditions:

1. The effective loan date is the date the loan request is approved by us, as shown in our records. We reserve the right to defer payment of a requested loan for up to six (6) months from the date we receive your request.

2. The minimum cash loan amount is $500.

3. The maximum available cash loan amount is calculated as (A + B + C – D) × 0.90 – (E + F) where:

A is the guaranteed cash value

B is the cash value of paid-up additional insurance described in provision D 2, or if purchased under a rider, as described in that rider

C is dividends on deposit and accumulated interest described in provision D 3

D is outstanding loan principal

E is outstanding loan interest

F is one monthly premium

4. We determine the applicable loan interest rate annually.

5. On every certificate anniversary, you are required to pay the loan interest accrued since the last certificate anniversary. If you do not pay loan interest when it is due, we will process a new certificate loan on the same terms and conditions as the existing certificate loan.

6. The loan amount reduces this certificate’s surrender value and can therefore cause this certificate to end, as described in provision D 8.

7. You can make loan repayments at any time while this certificate is in force, subject to a minimum repayment amount under our administrative rules.

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E Making changes to this certificate

E 1 Changing the insurance class applicable to an insured person

If an insured person’s insurance class is smoker when this certificate is issued as shown in the Certificate Specifications, he or she may be eligible for a change to a non-smoker insurance class without evidence of insurability, as described in provision E 2.

Otherwise, you can submit a written request at any time after this certificate is in effect to change an insured person's insurance class from a smoker class to a non-smoker class. If we approve the change, it will take effect on the monthly processing day following the date we have approved your request. This request is subject to our administrative rules and all of the following conditions:

1. We offer non-smoker premium rates at the time of your request.

2. You submit evidence we consider satisfactory as to the smoking habit of the insured person, including our smoking habits declaration. The insured person must meet our definition of a non-smoker at the time of the request.

3. You submit a completed non-medical declaration of health for the insured person in a form acceptable to us, as well as other medical evidence we might request, and such form and evidence is satisfactory to us.

4. We reserve the right to request payment of a fee we set from time to time for underwriting expenses. We will advise you of the amount of this fee before we process your request.

5. A change of insurance class will be effective on the monthly processing day following the date we have approved your request. We will adjust the premiums effective on that day, based on the insurance age on the issue date and the insured person’s rating class on the date the change is processed.

6. A change of insurance class will result in a reduction of the guaranteed values shown in the Schedule of guaranteed values in the Certificate Specifications, and may result in a reduction of future dividends and non-guaranteed cash value when the premium is reduced. It may also require us to make adjustments to this certificate on the date we process the request to maintain the certificate’s tax exempt status, as described in provision F 7.

For a term rider attached to this certificate, you can also request that we change the insurance class applicable to an insured person to a preferred or preferred plus class, subject to our administrative rules and the conditions listed above. We will consider such a request after the first (1st) certificate anniversary and no more than once per year.

E 2 Quit Smoking Incentive Privilege

If the designated insured person’s insurance class is smoker when this certificate is issued as shown in the Certificate Specifications, we will charge non-smoker premium rates for the principal insurance plan for the first two (2) certificate years. We will continue to charge non-smoker premiums for the principal insurance plan after the second (2nd) certificate anniversary subject to our administrative rules and all of the following conditions:

1. We offer non-smoker premium rates at the time of your request.

2. At any time before the second (2nd) certificate anniversary, you request that we change the designated insured person's insurance class to a non-smoker class and submit evidence we consider satisfactory as to the smoking habit of the designated insured person, including our smoking habits declaration. The designated insured person must meet our definition of a non-smoker at the time of the request.

3. If we approve the change, it will take effect on the monthly processing day following the date we have approved your request. Subsequent non-smoker premiums will be based on the insurance age in effect on the issue date and the designated insured person’s rating class on the date the change is processed.

4. Approval of this change will result in a reduction of the guaranteed values shown in the Schedule of guaranteed values in the Certificate Specifications, and may result in a reduction of future dividends and non-guaranteed cash value when the premium is reduced. It may also require us to make adjustments to this certificate on the date we process the request to maintain the certificate’s tax exempt status, as described in provision F 7.

If these conditions are not met, we will begin charging smoker premiums on the second (2nd) certificate anniversary.

A request to change the insurance class of a term rider attached to this certificate will be subject to the conditions described in provision E 1.

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E 3 Reducing the basic insurance amount

You can request that we reduce the basic insurance amount, subject to our administrative rules and all of the following conditions:

1. Premiums are paid to the effective date of the reduction.

2. The reduced basic insurance amount will be effective on the monthly processing day nearest to the date we have received and recorded your written request. We will adjust the premiums effective on that day. The minimum decrease allowed is $10,000, and the remaining basic insurance amount must not be less than the minimum specified in our administrative rules.

3. The premium rate is guaranteed based in part on the insurance class and the basic insurance amount applicable to each insured person under this certificate. If you reduce the basic insurance amount of this certificate at any time, we may increase the premium rate in accordance with our administrative rules.

4. If the dividend option is the Enhanced Insurance Option, reducing the basic insurance amount will reduce the enhanced insurance amount that is guaranteed under this option as described in provision D 6.1.

5. Reducing the basic insurance amount will result in a reduction of the guaranteed values shown in the Schedule of guaranteed values in the Certificate Specifications, and may result in a reduction of future dividends and non-guaranteed cash value. It may also require us to make adjustments to this certificate on the date we process the request to maintain the certificate’s tax exempt status, as described in provision F 7.

E 4 Reduced Paid-up Insurance Privilege

You can reduce the basic insurance amount to an amount that will not require further premium payments, at any time by written request to us, subject to our administrative rules and the following conditions:

1. We will process your request if the surrender value is sufficient to purchase the minimum amount of reduced paid-up insurance permitted under our administrative rules. Once this Reduced Paid-up Insurance Privilege has been exercised, it cannot be changed.

2. We will calculate the amount of reduced paid-up insurance available based on the surrender value and the designated insured person’s attained age, insurance class and rating class at the time we process the request.

3. The dividend option will be set to the Paid-Up Additional Insurance Option and this certificate will remain eligible to receive dividends. If the dividend option was the Enhanced Insurance Option at the time of the change, the Enhanced Insurance Option Guarantee will end as described in provision D 6.1.

4. If applicable, the Children’s Insurance Benefit and the Juvenile Guaranteed Insurability Benefit will continue without change.

5. Every rider included in this certificate will end.

E 5 Surrendering paid-up additional insurance

You can surrender paid-up additional insurance under this certificate for its cash value, at any time by written request to us, subject to our administrative rules and the following conditions:

1. The minimum amount that may be surrendered is the lesser of the balance of the cash value of paid-up additional insurance and $500.

2. We reserve the right to reduce the cash value of paid-up additional insurance by the amount of outstanding debt.

3. The effective date of surrender will be the date we process your request and calculate the cash value of paid-up additional insurance after we receive and record your written request at our office. We reserve the right to defer the payment of the amount due on surrender for up to six (6) months from the date we receive your request for surrender.

4. If the dividend option in effect is the Enhanced Insurance Option, the Enhanced Insurance Option Guarantee will end on the date you surrender paid-up additional insurance as described in provision D 6.1.

5. A death benefit will no longer be payable with respect to the surrendered paid-up additional insurance.

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E 6 Cancelling this certificate or a rider

You can cancel this certificate for its surrender value, or cancel a rider attached to this certificate, at any time by written request to us. The effective date of your cancellation will be the date we process your request and calculate the surrender value in accordance with the terms of provision D 8. We reserve the right to defer the payment of the amount due on surrender for up to six (6) months from the date we receive your request for surrender.

If you cancel a rider attached to this certificate, we will reduce the premium accordingly as of the effective date of your cancellation. We will determine the effective date of your cancellation, which will be no later than the monthly processing day following the date we receive your written request and record it at our office.

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F More information about this certificate

F 1 This certificate is a contract between you and The Independent Order of Foresters

The entire life insurance contract between you and us includes:

a) This certificate;

b) The Act or instrument of incorporation of The Independent Order of Foresters, its Constitution, by-laws and rules;

c) The application and the evidence of insurability you provided;

d) Each subsequent application we approve for reinstatement, to add a rider, or to exercise an option under thiscertificate; and

e) Any amendment, endorsement, exclusion or other documents we attach to, or that form part of, this certificate.

Any statement that is not attached to, or does not form part of, this certificate does not bind us, and no agent or person other than an authorized officer of The Independent Order of Foresters can modify this certificate. Each such modification must be clearly expressed in writing and signed by two of our officers authorized for this purpose.

If we fail to enforce a certificate provision, we reserve the right to enforce that provision in the future.The benefitsprovided under this certificate will not be reduced, nor will this certificate end, by any provision in our Constitution notstated or referred to in this certificate, as the case may be.

F 2 When we will contest the validity of this certificate

We have the right to contest the validity and void this certificate, and to deny the payment of the death benefit or other certificate benefit or privilege, if you or an insured person have incorrectly stated, misrepresented or failed to disclose a fact in any of the following:

a) The application;

b) A medical examination; or

c) A written statement or answer provided as evidence of insurability.

If this certificate has been in effect for two (2) years during the lifetime of every insured person then we will not contestthe validity of this certificate on the basis stated above except for fraud. If this certificate is reinstated, this provision will also apply from the date this certificate is reinstated with respect to statements and representations made in the application for reinstatement, a medical examination, or a statement provided as evidence of insurability in respect ofthat reinstatement.

Similarly, except for fraud, we will not contest insurance coverage that has been added, increased or changed, on the basis of statements and representations made in the application for that addition, increase or change, a medicalexamination, or a statement provided as evidence of insurability in respect of that addition, increase or change afterthat addition, increase, or change has been in effect for two (2) years during the lifetime of the insured person.

We can contest and void this certificate at any time for fraud. We can also contest at any time a benefit based on total disability due to injury or sickness. If the certificate is contested for fraud, we will not refund premiums paid.

F 3 Naming the beneficiary

Each initial beneficiary, if any, is named in the application. You can name a new beneficiary for this certificate, where applicable, by filing a written change of beneficiary request with us. If you have named an irrevocable beneficiary, you will need his or her written consent to change that beneficiary designation except where otherwise prescribed by law. Once the change is received at our office, the change will be effective as of the date you signed the request, whether or not each insured person is alive when we received the request.

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F 4 Your rights and privileges as the certificate owner

As the owner of this certificate, you can exercise the rights and privileges this certificate provides to you while it is in effect. These rights include:

a) Exercising the conversion privilege described in provision B 4.1 or the Juvenile Guaranteed Insurability Benefitdescribed in provision B 5;

b) Changing the frequency of premium payments as described in provision C 2;

c) Withdrawing dividends from this certificate, or receiving dividends in cash, as described in provisions D 3 and D 5;

d) Changing the dividend option as described in provision D 7;

e) Borrowing money against this certificate as described in provision D 9;

f) Changing an insured person’s insurance class as described in provisions E 1 and E 2;

g) Reducing the basic insurance amount under this certificate as described in provision E 3;

h) Exercising the Reduced Paid-up Insurance Privilege described in provision E 4;

i) Surrendering paid-up additional insurance as described in provision E 5;

j) Cancelling this certificate for its surrender value as described in provision E 6;

k) Naming a beneficiary as described In provision F 3; and

l) Transferring ownership of this certificate as described in provision F 6.

If there is more than one owner, the owners must exercise their rights and privileges unanimously. Your rights and privileges may be limited by the terms and provisions of this certificate, by applicable law, or by the rights of an assignee or irrevocable beneficiary.

If you are not an insured person and you die while this certificate is in effect, your interest in this certificate will transfer to the person identified, if any, as your contingent owner in the later of the application and the last change of contingent owner filed with us. You can name or change a contingent owner while this certificate is in effect by filing a written request with us.

F 5 Certificate ownership when the designated insured person is a juvenile

If the designated insured person is under the age of sixteen (16) on the issue date, ownership of this certificate and the rights of ownership described in provision F 4 will automatically transfer to the designated insured person on his or her

sixteenth (16th) birthday, even if ownership of this certificate was previously transferred or this certificate was assigned as collateral, and even if an irrevocable beneficiary has been named. If there is no surviving contingent owner, your estate or successor in interest, as applicable, will become the owner.

F 6 Assigning or transferring ownership of this certificate

You can assign this certificate as security for a loan. This is known as a collateral assignment. You can also transfer ownership of this certificate to another person or entity by filing a form with us that changes the ownership, subject to legislation in effect at that time. This is known as an absolute assignment. If you have named an irrevocable beneficiary, you will need his or her written consent to transfer ownership except where otherwise prescribed by law. We are not bound by an assignment until we receive the form at our office, and we are not responsible for its effect or validity.

Once received at our office, it will be effective the date you signed the form, subject to a different effective date specified in that form, whether or not you and each insured person is alive when we receive the form and is subject to each payment or action taken by us before we received that form.

Under current income tax provisions, transferring ownership of this certificate constitutes a taxable disposition, as described in provision F 8.

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F 7 Maintaining the tax exempt status of this certificate

So long as the provisions and regulations of the Income Tax Act allow this certificate to remain exempt from accrual taxation, we may make adjustments to this certificate to maintain its exempt status subject to the terms and provisions of this certificate and our administrative rules. We reserve the right to refuse any requested transaction that would jeopardize this certificate’s exempt status unless we can also make an appropriate adjustment to maintain its status.

We will review the status of this certificate at every certificate anniversary and every time you request a certificate change that may trigger a taxable event. If we determine that this certificate would otherwise fail to maintain its exempt status, we may make one or more of the following adjustments without prior notice. These adjustments may trigger a taxable disposition, as described in provision F 8:

1. We may transfer funds from this certificate to the Premiums in Advance Account described in Appendix A.

2. We may pay a portion of the surrender value to you.

F 8 Income tax reporting

Any transaction processed under the terms of this certificate is subject to tax legislation in effect at that time. While we make every effort to maintain this certificate as exempt from accrual taxation, we will inform you of any amount you are required to include in your income for tax purposes. Under current income tax provisions this may occur as a result of a partial or total disposition of this certificate, including but not limited to:

a) Withdrawing dividends from this certificate, or receiving dividends in cash, as described in provisions D 3 and D 5;

b) Borrowing money against this certificate, as described in provision D 9;

c) Changing an insured person’s insurance class to a non-smoker class, as described in provisions E 1 and E 2;

d) Reducing the amount of insurance under this certificate, as described in provision E 3;

e) Surrendering paid-up additional insurance, as described in provision E 5;

f) Cancelling this certificate for its surrender value, as described in provision E 6;

g) Transferring ownership of this certificate, as described in provision F 6; and

h) Paying a portion of this certificate’s surrender value to you, as described in provision F 7.

Other transactions may also have tax consequences. Please consult your own tax advisors before requesting any transaction.

F 9 Maintenance of reserves

If our reserves become impaired, you may be assessed an equitable proportion of the shortage which must be paid to us. If payment is not made, your assessment will either stand as a debt against this certificate and be subject to interest calculated in the same manner as a loan provided under provision D 9, or the benefits under this certificate will be reduced proportionately to reflect the assessment, at our discretion.

F 10 Currency

The amounts payable under this certificate, either to us or by us, are payable in Canadian dollars.

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F 11 Applicable law

The rights and obligations under this certificate will be governed by the laws of the province or territory where the certificate was made, as well as applicable federal laws. This certificate is made in the jurisdiction where you signed the application in the absence of evidence to the contrary. This certificate will be governed by the laws of Quebec where the owner resides in Quebec and that owner either signed the application in Quebec or the certificate was delivered in Quebec to that owner. Conflict of laws rules will not apply.

F 12 Limitation of action

No action shall be taken with respect to this certificate in a court of law unless the action is started within two (2) years from the date the cause of action arose, or three (3) years in Quebec, or such longer time period provided by applicable law.

F 13 Notifications

Notifications we send to you about this certificate will be deemed received by you if sent to your last address shown in our records. You must notify us of a change in address. Notifications about this certificate may, with your consent, be sent or provided to you by electronic means. Every notification, designation and request that you make to us must be signed by you, in a form acceptable to us, and received, by a method acceptable to us, at our head office or any other office we designate for the purpose of receiving it. If permitted by and subject to our administrative practices in effect at that time, notifications, designations and requests made by you to us may be by electronic means.

The Independent Order of Foresters Appendix A ENG 11.2017 Page 1of 1

Appendix A – Premiums in Advance Account

AA 1 The Premiums in Advance Account is not part of the certificate

The Premiums in Advance Account provisionally holds funds that cannot be held within the certificate while maintaining its status as a certificate exempt from accrual taxation. It is does not form part of the certificate's death benefit or surrender value.

We will credit interest to any amount held in the Premiums in Advance Account, earned and compounded daily at a rate we determine from time to time. As the Premiums in Advance Account is held outside the certificate, any interest earned on monies held in the Premiums in Advance Account is taxable. We will inform you of any amount you are required to include in your income for tax purposes.

If you transfer ownership of the certificate or assign the certificate as a security for a loan, we will consider that assignment to exclude the Premiums in Advance Account unless the assignment documents explicitly include it in the assignment. However, you cannot collaterally or absolutely assign the Premiums in Advance Account without assigning the certificate.

We reserve the right to make changes to the Premiums in Advance Account to comply with any applicable legislative or regulatory requirements. No agent or person other than an officer of The Independent Order of Foresters can modify the terms and conditions governing the Premiums in Advance Account. Any such modification must be clearly expressed in writing and signed by two of our officers.

AA 2 When we allocate money to the Premiums in Advance Account

Subject to the provisions of the certificate, we may allocate money to the Premiums in Advance Account, without your prior consent, under the following circumstances:

1. If you make a premium payment that exceeds the sum of two (2) annual premiums, we will deposit that amount to the Premiums in Advance Account. We reserve the right to limit the amount that can be deposited to the Premiums in Advance Account, and to refund the balance to you.

2. If you request a certificate change or transaction that would jeopardize the certificate’s exempt status, we may transfer funds from the certificate to the Premiums in Advance Account, as described in certificate provision F 7.

AA 3 When we allocate money to the certificate

We will automatically transfer money from the Premiums in Advance Account to the certificate, without your prior consent, under the following circumstances, and any such transfer will be treated as a premium payment:

1. At any certificate anniversary when an annual premium is due.

2. If a premium is not paid by its due date, as described in certificate provision C 3.

AA 4 Withdrawing money from the Premiums in Advance Account

You may withdraw money from the Premiums in Advance Account at any time, by written request, subject to our administrative rules and the following conditions:

1. The minimum withdrawal allowed is the lesser of the balance of the Premiums in Advance Account and $500. The maximum withdrawal allowed is the balance of the Premiums in Advance Account.

2. We will process one withdrawal from the Premiums in Advance Account per certificate year, free of charge. For any additional withdrawals in a certificate year, we may charge a transaction fee, set by us from time to time.

AA 5 Termination of the Premiums in Advance Account

The Premiums in Advance Account ends when insurance under the certificate ends, as described in certificate provision B 2. On termination, we will pay the balance of the Premiums in Advance Account to you, or to your estate, or

to any assignee as applicable.

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The Independent Order of Foresters Appendix B ENG 11.2017 Page 1of 1

Appendix B – Expert Medical Opinion Program

AB 1 Eligibility for expert medical opinion

While the designated insured person is the certificate owner, they may be eligible to receive an expert medical opinion upon request to Advance Medical, Inc. The designated insured person’s immediate family, including that person’s spouse or domestic partner and dependent children up to age 18 may also be eligible to receive such an expert medical opinion upon request to Advance Medical, Inc. There will be no cost for this opinion.

Additional information about this program and Advance Medical may be obtained by calling 1-888-218-9029.

AB 2 This program is not part of the certificate

This program is provided solely by Advance Medical, Inc., subject to eligibility requirements and limitations and may be changed or cancelled at any time without notice. This program is not a certificate benefit and accordingly The Independent Order of Foresters is not responsible for this program and has no liability in relation to the expert medical opinion or any of the services provided, or functions performed, under the program.

SAMPLE

Renewable and Convertible Term Insurance RiderThis rider forms part of the certificate, and comes into effect when the certificate comes into effect as described in certificate provision B1, or as shown in the notification we sent to you with this rider if it is added to the certificate after the issue date. If a

provision of this rider is inconsistent with another certificate provision, the provision of this rider will prevail.

The Independent Order of Foresters WLTERMRIDERENG 11.2017 Page 1 of 3

Terms used in this rider

Beneficiary means each person or entity named, if any, to receive their share of the rider benefit payable, as described in this

rider’s Death Benefit provision.

Death benefit means the amount paid under this rider when the insured person dies. It is the amount shown under this rider for

the insured person in the Certificate Specifications, unless changed as shown in our records.

Insured person means a person whose life is insured under this rider, as shown in the Certificate Specifications.

Rider anniversary means the same day and month as the issue date in each subsequent calendar year, or the same day and

month as the effective date of this rider in each subsequent calendar year if it is added to the certificate after the issue date.

Death benefit

Subject to the certificate provisions, we will pay to each beneficiary, if any, their share of this rider’s death benefit when the insured person dies while this rider is in effect.

You may request that we reduce this rider’s death benefit, subject to our administrative rules and the following conditions:

1. Premiums are paid to the effective date of the reduction.

2. The reduced death benefit will be effective on the monthly processing day following the date we have received andrecorded your written request. We will adjust the premiums effective on that day. The minimum decrease allowed is$10,000, and the remaining death benefit must not be less than the minimum specified in our administrative rules.

3. If you reduce the death benefit to less than $250,000, the applicable insurance class will be the standard class thatcorresponds to the smoking habit of the insured person.

4. The premium rate is guaranteed based in part on the insurance class and the death benefit amount applicable to the insuredperson. If you reduce this rider’s death benefit, we may increase or decrease the premium rate in accordance with ouradministrative rules.

Conversion Privilege

You may convert this rider, in whole or in part, to a permanent life insurance plan without evidence of insurability, subject to our administrative rules and the following conditions:

1. You must submit a written request for conversion to us.

2. Premiums must be paid to the effective date of the conversion.

3. The conversion must occur prior to the rider anniversary nearest the insured person's seventy-first (71st) birthday. The datethis Conversion Privilege expires is specified in the Certificate Specifications.

4. This rider cannot be converted while premiums are being waived under a Waiver of Premium Benefit rider, unless theconversion takes place on the date this Conversion Privilege ends. In that event, the new certificate will be the permanentplan with the lowest annual premium that we then offer you for conversion. The new plan will include a Waiver of PremiumBenefit rider if offered by us at the time of conversion.

If you convert this entire rider, it will end on the date the new certificate takes effect under this Conversion Privilege. If you exercise a partial conversion, we will reduce this rider’s death benefit by the amount you convert to a new certificate.

The following conditions will apply to the new certificate:

1. The new certificate will be a permanent life plan we then offer you for conversion. However, we reserve the right to excludefrom the new plan each certificate provision or rider that provides for an increasing insurance risk amount without evidenceof insurability.


3. The conditions and provisions of the new certificate will apply from the date the new certificate takes effect, except that ourright to contest the validity of the new certificate and the two (2) year exclusion for suicide, described in provisions F 2 and B 8

respectively of this certificate, will continue to apply from the later of the effective date or the last date of reinstatement of thisrider.

4. The evidence of insurability that applies to this rider, as well as each exclusion that applies to this rider, on or before theeffective date of conversion, will become part of the new certificate.

SAMPLE

Renewable and Convertible Term Insurance Rider


5. The death benefit under the new certificate cannot exceed the death benefit under this rider at the time of conversion and is subject to the minimum amount we allow for the new insurance plan.

6. A new rider may be included in the new certificate only with our consent and may be subject to evidence of insurability.



b) The insured person's age on the effective date of conversion;


d) The insured person's rating class used in calculating the premiums for this rider; and

e) The insured person's applicable insurance class used in calculating the premiums for the new certificate.

8. An insured person's applicable insurance class will be the standard class that corresponds to the insured person's smoking habit if:

a) The new plan does not offer preferred classes; or

b) The insured person's applicable insurance class under this rider is standard; or

c) The conversion occurs at least ten (10) years after the effective date of this rider.

If the new insurance plan offers preferred classes and the conversion occurs within ten (10) years of the effective date of this rider, the insured person's premium rate under the new certificate will be based on the insurance class for which the underwriting criteria are most similar to the insurance class applicable under this rider, as determined by us.

Exchange Privilege

If this rider is a Term 10 insurance plan, you may exchange it in its entirety for a Term 20 or Term 30 certificate if offered by us at the time of exchange. If this rider is a Term 20 insurance plan, you may exchange it in its entirety for a Term 30 certificate if offered by us at the time of exchange. Alternatively, you may partially exchange this rider as described above, if the balance of this rider is being converted under the terms of the Conversion Privilege.

This Exchange Privilege is available on or after the second (2nd) rider anniversary, and will be processed without evidence of insurability, subject to our administrative rules and the following conditions:

1. You must submit a written request for exchange to us, no sooner than thirty (30) days before the second (2nd) rider anniversary.

2. Premiums must be paid to the effective date of the exchange.

3. If you are requesting an exchange for a Term 20 certificate, the exchange must occur prior to the earlier of the fifth (5th) rider anniversary, and the rider anniversary nearest the insured person's sixtieth (60th) birthday.

4. If you are requesting an exchange for a Term 30 certificate, the exchange must occur prior to the earlier of the fifth (5th) rider anniversary, and the rider anniversary nearest the insured person's fifty-fifth (55th) birthday.

5. This rider cannot be exchanged while premiums are being waived under a Waiver of Premium Benefit rider. This Exchange Privilege cannot be extended should the privilege expire while premiums are being waived.

This rider will end on the date the new certificate takes effect under this Exchange Privilege. The following conditions will apply to the new certificate:

1. The new certificate will be the Term 20 or Term 30 insurance plan we offer at the time of the exchange.


3. The conditions and provisions of the new certificate will apply from the date the new certificate takes effect, except that our right to contest the validity of the new certificate and the two (2) year exclusion for suicide, described in provisions F 2 and B 8

respectively of this certificate, will continue to apply from the later of the effective date or the last date of reinstatement of this certificate.

4. The evidence of insurability that applies to this certificate, as well as each exclusion that applies to this rider, on or before the effective date of exchange, will become part of the new certificate.

5. The death benefit under the new certificate cannot exceed the death benefit under this rider at the time of exchange and is subject to the minimum amount we allow for the new insurance plan.

6. A new rider may be included in the new certificate only with our consent, and may be subject to evidence of insurability.


a) The death benefit under the new certificate;

SAMPLE

Renewable and Convertible Term Insurance Rider


b) The insured person's age on the effective date of the exchange;


d) The insured person's rating class used in calculating the premiums for this rider; and

e) The insured person's applicable insurance class used in calculating the premiums for the new certificate.

If the preferred classes under the new insurance plan differ from those available with this insurance plan, the insured person's premium rate under the new certificate will be based on the insurance class for which the underwriting criteria are most similar to the insurance class applicable under this rider, as determined by us.

Survivor Privilege

If the insured person survives the designated insured person, the surviving insured person may, upon the death of the designated insured person, exercise the Conversion Privilege described above, subject to its terms and the following conditions:

a) This privilege must be exercised prior to the rider anniversary nearest the surviving insured person’s seventy-first (71st) birthday.

b) The surviving insured person must submit a written request to us for this conversion, within sixty (60) days of the death of the designated insured person. The first premium for the new certificate must also be paid within this period.

When this rider ends

This rider ends, and is no longer in effect, on the earliest of the following dates:

a) The date this rider expires, as shown in the Certificate Specifications;

b) The date the insured person dies;

c) The date this rider ends as described under this rider’s Conversion Privilege;

d) The date this rider ends as described under this rider’s Exchange Privilege;

e) The date you exercise the Reduced Paid-up Insurance Privilege described in certificate provision E 4;

f) The effective date of your cancellation, as described in certificate provision E 6; and

g) The date the certificate ends, as described in certificate provision B 2.

SAMPLE

Children’s Term Insurance RiderThis rider forms part of the certificate, and comes into effect when the certificate comes into effect as described in certificate provision B1, or as shown in the notification we sent to you with this rider if it is added to the certificate after the issue date. If a

provision of this rider is inconsistent with another certificate provision, the provision of this rider will prevail.

The Independent Order of Foresters WLCTRENG 11.2017 Page 1 of 2

Insured child

An insured child means a child who is at least fifteen (15) days old, and is:

a) A child, step-child or legally adopted child of the designated insured person, who has been named in the application for thisrider, and has not been excluded from coverage under this rider by an endorsement to the certificate; or

b) Born to the designated insured person after the date of the application for this rider; or

c) Legally adopted by, or becomes a step-child or comes under the legal guardianship of, the designated insured person afterthe date of the application for this rider but prior to the child's eighteenth (18th) birthday.

A child born to, or legally adopted by, the designated insured person, or who becomes a step-child or comes under the legal guardianship of the designated insured person while this rider is in effect, is automatically covered from the age of fifteen (15) days upon written request advising us while the child is alive of the child’s name and date of birth. The premium for this rider does not change when additional children are insured.

Death benefit

This rider’s death benefit is shown in the Certificate Specifications, or in the notification we sent to you with this rider if it is added to the certificate after the issue date, unless changed as shown in our records.

Subject to the certificate provisions, we will pay this rider’s death benefit to the designated insured person, when an insured child dies while insurance for that insured child is in effect under this rider.

When we will not pay a death benefit under this rider

We will not pay this rider’s death benefit if the death of an insured child results, either directly or indirectly, from suicide, attempted suicide or intentionally self-inflicted injury, whether sane or insane, within two (2) years from the date this rider took effect or within two (2) years from the last reinstatement date. This rider will remain in effect, according to its terms, for each surviving insured child.

Conversion Privilege

You may convert an insured child’s coverage under this rider to a permanent certificate insuring the life of that insured child, without evidence of insurability, subject to the following conditions:

1. The conversion must occur while this rider is in effect and premiums are paid to the effective date of conversion.

2. You must submit a written request for conversion to us after that insured child’s twentieth (20th) birthday, but no later thanthat insured child’s twenty-fifth (25th) birthday.

3. If the designated insured person dies before that insured child’s twenty-fifth (25th) birthday, you must submit a writtenrequest for conversion to us within sixty (60) days of the death of the designated insured person.

Coverage for an insured child under this rider will end on the date the new certificate, on the life of that insured child, takes effect under this Conversion Privilege.

The following conditions will apply to the new certificate:

1. The new certificate will be a permanent life insurance plan we then offer you for conversion. However, we reserve the rightto exclude from the new certificate each provision or rider that provides for an increasing insurance risk amount withoutevidence of insurability.


3. The conditions and provisions of the new certificate will apply from the date the new certificate takes effect, except that thetwo (2) year exclusion for suicide, described above in this rider, will continue to apply in regard to the insured child from the laterof the effective date or the last date of reinstatement of this rider.

4. The evidence of insurability as well as each exclusion that forms a part of this rider on or before the date of conversion willbecome part of the new certificate.

SAMPLE

Children’s Term Insurance Rider

The Independent Order of Foresters WLCTRENG 11.2017 Page 2 of 2

5. The death benefit under the new certificate cannot be less than the minimum amount we allow for the new plan of insurance, and it cannot exceed the lesser of ten (10) times this rider’s death benefit and $250,000. The combined death benefit for conversions issued by us under the Children’s Term Insurance riders on an insured child cannot exceed $250,000.

6. The premium rates applicable to the insured child under the new certificate will be based on the following:


b) The insured child’s age at the time of conversion;

c) The premium rates then in effect for the new insurance plan; and

d) The insured child’s applicable insurance class used in calculating the premiums for the new certificate. The insured child’s applicable class will be the standard smoker class unless you submit evidence we consider satisfactory as to the smoking habit of the insured child. The insured child must meet our definition of a non-smoker at the time of the request.


When insurance for an insured child ends

Insurance for an insured child under this rider ends on the earliest of the following dates:


b) The date the child is approved for a new certificate under the Conversion Privilege;

c) The date the child dies; and

d) The date this rider ends.



a) The date you exercise the Reduced Paid-up Insurance Privilege described in certificate provision E 4; b) The effective date of your cancellation, as described in certificate provision E 6; and c) The date the certificate ends, as described in certificate provision B 2.

SAMPLE

Accidental Death Benefit RiderThis rider forms part of the certificate, and comes into effect when the certificate comes into effect as described in certificate provision B1. If a provision of this rider is inconsistent with another certificate provision, the provision of this rider will prevail.

The Independent Order of Foresters WLADBENG 11.2017 Page 1 of 2


Accident means a violent, external incident that is sudden, involuntary and unforeseen, causing bodily injury directly and

independently of another cause.

Insured person means a person whose life is insured under this rider, as shown in the Certificate Specifications.

Accidental Death Benefit

The Accidental Death Benefit is the amount shown under this rider for the insured person in the Certificate Specifications, unless changed as shown in our records.

Subject to the certificate provisions, we will pay the Accidental Death Benefit to the beneficiary upon the death of the insured person when the death occurs:

a) Solely as a direct result of an accident that occurs while this rider is in effect;

b) Within three hundred and sixty-five (365) days of that accident; and

c) While insurance under this rider is in effect for that insured person.

The Accidental Death Benefit payable is in addition to the death benefit payable under the certificate.

If the basic insurance amount is reduced under certificate provision E 3, we reserve the right to reduce the Accidental Death

Benefit in accordance with our administrative rules.

When we will not pay a death benefit under this rider

We will not pay the Accidental Death Benefit if the death of the insured person results, either directly or indirectly, from any of the following:

a) A natural cause, illness, disease, bodily or mental infirmity, or medical or surgical treatment;

b) An injury where there is no visible contusion or wound on the exterior of the body, except in the case of drowning or internalinjuries revealed by an autopsy;

c) Suicide, attempted suicide or intentionally self-inflicted injury, whether sane or insane;

d) The commission or attempted commission by the insured person of a criminal offence, whether or not the insured person ischarged with an offence, or for provocation of an assault;

e) An event related to the operation of heavy machinery, a motor vehicle or other conveyance by the insured person while theconcentration of a drug, hypnotic or narcotic in the blood exceeds the legal limit;

f) An event related to the operation of heavy machinery, a motor vehicle or other conveyance by the insured person while theconcentration of alcohol in the blood exceeds 80 milligrams of alcohol per 100 millilitres of blood or the legal limit, whicheveris lower;

g) An event, illness or treatment related to the excessive or repeated or persistent use of alcohol or marijuana;

h) An event, illness or treatment related to the voluntary ingestion of an illegal drug, hypnotic or narcotic, or to the use,inhalation or ingestion of an illicit substance;

i) An event, illness or treatment related to the administration, injection or taking of a drug, hypnotic or narcotic, unlessadministered, injected or taken on the advice of, and at the frequency and dosage prescribed by, a physician or, in the caseof a legal non-prescribed drug, as recommended by the drug manufacturer;

j) Poisoning or inhalation of gas or fumes, whether voluntary or involuntary;

k) Travel in an aircraft other than as a fare-paying passenger on a fully licensed passenger carrying aircraft on a regularlyscheduled flight. Descent from an aircraft in flight will be deemed to be part of such a flight; or

l) War or act of war, whether declared or not, or service as a combatant or non-combatant in the military, naval or air force ofany country.

SAMPLE

Accidental Death Benefit Rider

The Independent Order of Foresters WLADBENG 11.2017 Page 2 of 2




b) The date the insured person dies;

c) The date you exercise the Reduced Paid-up Insurance Privilege described in certificate provision E 4;

d) The effective date of your cancellation, as described in certificate provision E 6; and

e) The date the certificate ends, as described in certificate provision B 2.

SAMPLE

Guaranteed Insurability Benefit RiderThis rider forms part of the certificate, and comes into effect when the certificate comes into effect as described in certificate provision B1. If a provision of this rider is inconsistent with another certificate provision, the provision of this rider will prevail.

The Independent Order of Foresters WLGIRENG 11.2017 Page 1 of 2


Insured person means the person who is insured under this rider, as shown in the Certificate Specifications.

Regular option date means a certificate anniversary on which the insured person’s attained age is 25, 28, 31, 34, 37 or 40.

Special option date means a date when:

a) The insured person is legally married;

b) A living child is born to the insured person;

c) The insured person legally adopts a child prior to the child’s eighteenth (18th) birthday;

d) The insured person purchases a home which he or she intends to use as his or her primary residence; or

e) The insured person graduates from an accredited post-secondary educational institution.

Guaranteed Insurability Benefit

The Guaranteed Insurability Benefit provides the right to purchase new permanent insurance on the life of the insured person without evidence of insurability on certain option dates, subject to our administrative rules and the terms of this rider.

When you can purchase new life insurance

You can purchase new life insurance on the life of the insured person within ninety (90) days prior to a regular option date.

You can also purchase new life insurance on the life of the insured person within ninety (90) days after a special option date.

If you purchase insurance in connection with a special option date, the next available regular option date will be cancelled and you will not be able to purchase insurance on that regular option date. However, if all future regular option dates have been cancelled, you can still purchase insurance in connection with any subsequent special option dates that occur while this rider is in effect.

How you can purchase new life insurance

You must submit a written request to us within ninety (90) days prior to a regular option date, or within ninety (90) days after a special option date, and pay the first premium for the new insurance. Upon our request, you must provide evidence that the insured person consents to the requested purchase of new insurance.

If you purchase insurance in connection with a special option date, we will require proof that meets our standards of any legal marriage, birth, adoption, home purchase or graduation before we issue a new certificate.

Conditions that will apply to the new certificate

When you purchase new life insurance under this rider, the following conditions will apply to each new certificate:

1. The new certificate will be a permanent life insurance plan we then offer you for this purpose on the option date. However,we reserve the right to exclude from the new plan each certificate provision or rider that provides for an increasinginsurance risk amount without evidence of insurability.

2. The evidence of insurability as well as each exclusion that applies to this certificate will become part of the new certificate.

3. For a purchase in connection with a regular option date, the new certificate will take effect on that option date. For apurchase in connection with a special option date, the new certificate will take effect on the date we approve the specialoption date purchase. We will not provide any insurance under the new certificate before this effective date. If a writtenrequest is made for a new certificate but the insured person dies before its effective date, we will refund any premiums paidfor the new certificate.


5. The conditions and provisions of the new certificate will apply from the date the new certificate takes effect, except that ourright to contest the validity of the new certificate and the two (2) year exclusion for suicide, described in provisions F 2 and B 8

respectively of this certificate, will continue to apply from the later of the effective date or the last date of reinstatement of thiscertificate.

6. The amount of insurance for the new certificate can be up to the amount shown for this rider in the CertificateSpecifications. It cannot be less than the minimum amount we allow for the new plan of insurance, and it must equal orexceed $10,000.

SAMPLE

Guaranteed Insurability Benefit Rider

The Independent Order of Foresters WLGIRENG 11.2017 Page 2 of 2

7. A new rider may be included in the new certificate only with our consent and may be subject to evidence of insurability.



b) The insured person's age on the effective date of the new certificate;


d) The insured person's rating class used in calculating the premiums for this certificate; and

e) The insured person's applicable insurance class used in calculating the premiums for the new certificate. The insured person's applicable insurance class will be the standard class that corresponds to the insured person's smoking habit.




b) The date you exercise the Reduced Paid-up Insurance Privilege described in certificate provision E 4;

c) The effective date of your cancellation, as described in certificate provision E 6; and

d) The date the certificate ends, as described in certificate provision B 2.

SAMPLE

Waiver of Premium Benefit RiderThis rider forms part of the certificate, and comes into effect when the certificate comes into effect as described in certificate provision B1. If a provision of this rider is inconsistent with another certificate provision, the provision of this rider will prevail.

The Independent Order of Foresters WLWPENG 11.2017 Page 1 of 3


Appropriate physician’s care means the most appropriate treatment by a physician, according to existing standards of medical

practice, for the injury or sickness which is the cause of the insured person’s total disability.

Injury means bodily harm, loss or damage sustained as a direct result of an accident while this rider is in effect.

Insured person means the person who is insured under this rider, as shown in the Certificate Specifications.

Physician means an individual who is legally licensed to practice medicine or surgery in Canada or the United States or other

jurisdiction we may approve, and who is acting within the scope of that license. Physician cannot be the insured person, an owner, or a relative or business associate of either the insured person or an owner.

Sickness means an illness or disease that first manifests itself while this rider is in effect, or before this rider takes effect but only if

we have been fully and accurately advised, as determined in our sole discretion, in the application, or otherwise in writing, as shown in our records, before this rider takes effect, of the information known or reasonably available to you or the insured person regarding the insured person’s sickness, including his or her symptoms.

Total disability or totally disabled mean that, due directly to injury or sickness and independently of another cause, the

insured person is unable to perform the essential duties of his or her regular occupation, is not engaged in another gainful occupation, and is receiving appropriate physician’s care.

After the payment of premiums has been waived for a period of twenty-four (24) months during any one period of total disability, then total disability means that, due directly to injury or sickness and independently of another cause, the insured person is unable to engage in a gainful occupation for which he or she is reasonably fitted by education, training or experience, and continues to be under appropriate physician’s care.

Waiver of Premium Benefit

When the insured person has been totally disabled for six (6) consecutive months, we will waive the monthly premiums while the insured person is totally disabled, starting with the first monthly premium due after the date total disability began. Total disability must begin while this rider is in effect and prior to the certificate anniversary nearest the insured person’s sixtieth (60th) birthday.

We must receive proof of the insured person’s total disability before we waive a premium. To keep the certificate in effect, you should continue to pay premiums on each premium due date while the insured person is totally disabled and before a premium may be waived. If a claim is approved, the total premium paid during this six (6) month period will be refunded.

Claiming the Waiver of Premium Benefit

We must receive written notice of claim within sixty (60) days from the onset of total disability, while this rider is in effect and while the insured person is still living. We must then receive, within six (6) months from the onset of total disability, evidence we consider sufficient to establish the total disability. We will supply the forms required for notice of claim and proof of claim upon request.

Failure to give notice of claim or to provide evidence to support a claim within the periods of time prescribed above does not necessarily invalidate that claim if notice and proof of claim are submitted within one (1) year of the onset of total disability, and it can be demonstrated to us that it was not reasonably possible to provide these within the prescribed periods.

If, while the insured person is totally disabled, the certificate ends due to non payment of premium as described in certificate provision C 3, or ends due to insufficient surrender value as described in provisions C 4, D 8, or D 9, a claim under this rider will

not be invalid because the certificate ends. However, you must reinstate the certificate before we will approve the claim, as described in certificate provision C 5. If the claim under this rider is otherwise valid, it will be allowed on reinstatement.

Proof of continuing total disability

We may request proof that the insured person continues to be totally disabled as often as we require. As part of this proof, we may require the insured person to be examined by a physician of our choice, as often as we require. After the first two (2) years of total disability, if we deem the total disability to be permanent, proof and a medical examination will not be required more than once a year.

SAMPLE



When the Waiver of Premium Benefit begins and ends

Subject to the certificate provisions, we will waive the monthly premiums starting with the first monthly premium due after the date total disability began. If the premium payment frequency is not monthly, we will change it to a monthly premium payment frequency.

Waiver of premium will end on the monthly processing day following the earliest of:

a) The date the insured person is no longer totally disabled;

b) The date we determine that the insured person has failed to attend a medical exam when we requested it; and

c) The date we determine that the insured person has failed to provide proof that he or she is totally disabled when we requested it.

Recurrence of total disability

If the insured person ceases to be totally disabled, and subsequently becomes totally disabled within ninety (90) days of the last total disability, we will consider this a recurrence of total disability only if we determine that the subsequent total disability is related to the last total disability. If we approve a claim for a recurrence of total disability, we will waive premiums effective the next monthly processing day. If we determine that the subsequent total disability is not a recurrence of the last total disability, the insured person will be required to give notice and proof of disability as if no prior total disability had existed. No premiums will be waived until the insured person has again been continuously totally disabled for six (6) months, as described in this rider.

Continuing benefits beyond age sixty (60)

If the insured person is totally disabled and we are waiving the monthly premium at the certificate anniversary nearest his or her sixtieth (60th) birthday, we will continue to waive the premium under the terms of this rider while the insured person remains totally disabled and the certificate remains in effect.

When we will not waive premiums

We will not waive premiums if the insured person’s total disability resulted, either directly or indirectly, from any of the following:

a) Attempted suicide or intentionally self-inflicted injury, whether sane or insane;

b) The commission or attempted commission by the insured person of a criminal offence, whether or not the insured person is charged with an offence, or for provocation of an assault;

c) An event related to the operation of heavy machinery, a motor vehicle or other conveyance by the insured person while the concentration of a drug, hypnotic or narcotic in the blood exceeds the legal limit;

d) An event related to the operation of heavy machinery, a motor vehicle or other conveyance by the insured person while the concentration of alcohol in the blood exceeds 80 milligrams of alcohol per 100 millilitres of blood or the legal limit, whichever is lower;

e) An event, illness or treatment related to the excessive or repeated or persistent use of alcohol or marijuana;

f) An event, illness or treatment related to the voluntary ingestion of an illegal drug, hypnotic or narcotic, or to the use, inhalation or ingestion of an illicit substance;

g) An event, illness or treatment related to the administration, injection or taking of a drug, hypnotic or narcotic, unless administered, injected or taken on the advice of, and at the frequency and dosage prescribed by, a physician or, in the case of a legal non-prescribed drug, as recommended by the drug manufacturer;

h) Poisoning or inhalation of gas or fumes, whether voluntary or involuntary;

i) Normal pregnancy or childbirth, not including disabling complications of pregnancy or childbirth; or

j) A condition, sickness or activity that we have excluded by name or specific description in an endorsement or amendment to the certificate.

We will not waive or refund the premiums that became due more than one (1) year prior to our receipt of written notice of claim.

If total disability begins during the grace period, as described in certificate provision C 3, and a premium is in default, we will not

waive the payment of that premium.

SAMPLE





a) The date this rider expires, as shown in the Certificate Specifications, subject to the Continuing benefits beyond age sixty (60) provision;

b) The date you exercise the Reduced Paid-up Insurance Privilege described in certificate provision E 4;

c) The effective date of your cancellation, as described in certificate provision E 6; and

d) The date this certificate ends, as described in certificate provision B 2.

SAMPLE

whole life insurance certificate · certificate will be void as if it had never taken effect, and...

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