prosperity TERM RIDER Renewable and Convertible 10 Year Term
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1 ADDITIONAL COVERAGE RIDER forming a part of Policy JZPRT4006 issued by Transamerica Life Canada Life Insured: DIEKDIKK WOODS Rider Issue Date: FEBRUARY 24, 2014 Definitions For the purposes of this Rider: prosperity TERM RIDER Renewable and Convertible 10 Year Term Life Insured means a person designated by you as a Life Insured in respect of this Rider as specified in the Schedule of Benefits and Premiums. Lives Insured means more than one Life Insured. Policy means the insurance policy to which this Rider is attached. Rider Issue Date means the date specified above as being the Rider Issue Date. determine the rider anniversaries. This date is used to Sum Insured means the amount of insurance for this Rider as specified in the Schedule of Benefits and Premiums. All capitalized terms in this Rider shall have the respective meanings assigned to them in the Policy unless otherwise defined in this Rider. General Provisions and Settlement Options This Rider is subject to the General Provisions and Settlement Options of the Policy. This Rider does not participate in any distribution of our profits or surplus. Date Rider Takes Effect This Rider does not take effect unless all of the following conditions are satisfied: a) this Rider is delivered to you or a Beneficiary during the lifetime of all Lives Insured and; b) the full amount of the first premium in respect of this Rider is received by us during the lifetime of all Lives Insured; and c) no change has taken place in the insurability of any of the Lives Insured between the time that the Application for this Rider was completed and the time that this Rider was delivered to you or a Beneficiary as provided above. Provided that all of the foregoing conditions are satisfied, this Rider will take effect on the later of the following dates such date being referred to as the "Rider Effective Date": Benefit a) the Effective Date of the Policy; b) the date the full amount of the first premium in respect of this Rider is received by us; and c) the Rider Issue Date. Subject to the terms of this Rider and of the Policy, upon the death of the Life Insured we will pay an amount equal to the Sum Insured provided by this Rider. Print date: April 3, 2014 JZPRT4006 PRT304 Page 2
2 Term of Rider The term period of this Rider is specified in the Schedule of Benefits and Premiums. The initial term period begins on the Rider Effective Date and terminates on the rider anniversary at the end of the term period, at which time another term period will automatically begin unless you provide written instructions to us prior to such time. No term period will include the rider anniversary at the end of the period and no term period will include or extend beyond the Coverage Expiry Date for this Rider. This Rider is convertible and renewable in accordance with its provisions. Rider Renewal If this Rider is in force at the end of a term period, this Rider will automatically be renewed for a further term period of the same duration, (unless it would otherwise extend to or beyond the Coverage Expiry Date for this Rider, in which case, it will end immediately before such Coverage Expiry Date), provided that the first Premium for the new term period is paid to us when due. The Renewal Premium is specified in the Renewal Premiums Schedule in the Schedule of Benefits and Premiums. If you have selected Pre-Authorized Debit as your mode of Premium payment, then the renewal will be automatic. We will continue to present your pre-authorized instructions until the Pre-Authorized Debit is terminated in accordance with the provisions of the Pre-Authorized Debit Agreement. Premium for Rider The premium for this Rider is specified in the Schedule of Benefits and Premiums and is payable as provided in the Policy. Renewal Premiums Renewal Premiums will be calculated based on the underwriting class specified on the Schedule of Benefits and Premiums and the Age of the Life Insured at the date of renewal. Non-Payment of Premiums If any Policy Premium is not paid by the end of the Grace Period, then the Policy and this Rider will lapse and our liability will cease. Cash and Loan Values This Rider has no cash or loan values and cannot be exchanged or commuted for cash. Rider Conversion While this Rider is in force and prior to the conversion option expiry date, it may be converted without providing evidence of insurability to a prosperity universal life policy or a successor product as deemed eligible by us. The conversion option expiry date for this Rider is specified in the Schedule of Benefits and Premiums. The Owner must make a written application for conversion to us on our then current conversion form. This Rider and the Policy must be in force at the date of conversion, and all past due premiums must have been paid. This Rider will terminate immediately prior to the effective date of the new policy. Once converted, this Rider may not be reinstated. The following conditions for conversion of this Rider will apply: a) the life insured for the new policy will be the Life Insured under this Rider; Print date: April 3, 2014 JZPRT4006 PRT304 Page 3
3 b) the sum insured for the life insured in the new policy will not exceed the Sum Insured in effect for the Life Insured under this Rider on the date when the conversion is exercised, and may not be less than the plan minimum for the plan selected at the time of conversion; c) the issue date for the new policy will be the conversion date; d) the premiums for the new policy will be based on the rates in effect for the plan selected at the time of conversion, using: (1) the Life Insured's Age at the date of the conversion, and (2) the Life Insured's class of risk and smoking status comparable to the class of risk and smoking status as at the Rider Issue Date or the date of this policy's last reinstatement or change, and as determined by us. e) the new policy will not contain any further conversion privilege; f) the Incontestability and Suicide and Self Destruction provisions of the new policy will not be extended beyond the period specified in the Policy; g) the new policy will be subject to any limitations on death or disability benefits that are contained in the Policy for the Life Insured; h) the Policy Date of the new policy will be the date on which the conversion to the new policy becomes effective; i) in addition to the annual premium in respect of the new coverage, an annual policy fee, as well as a one-time administrative fee will be payable to us; and j) any Riders may be continued or converted only as provided by the Rider and as described below: If immediately before the conversion, this Rider contains: a) Waiver of Premium on Total Disability Rider, then such Rider may be continued only if: (1) the Age of the Life Insured at the date of the conversion is 55 years or less; and (2) the Life Insured is not totally disabled as defined in the Waiver of Premium on Total Disability Rider at the date of the conversion; b) Accidental Death and Dismemberment Rider, then such Rider may be continued if the Age of the Life Insured at the date of conversion is 55 years or less. Transamerica may impose other conditions on the conversion to the extent that they do not conflict with any of the foregoing provisions of this conversion option. Notwithstanding that this Rider may have terminated as a result of the death of the Life Insured under the Primary Coverage, this option will survive for 30 days thereafter. Term 10 Exchange Program During the exchange period, this Rider may be exchanged without providing evidence of insurability to a new coverage of eligible term insurance then offered by us. The exchange period commences on the first anniversary of the Rider and ends on the fifth anniversary of the Rider. The Owner must make a written application for exchange to us. This Rider must be in force at the date of exchange, and all past due Premiums must have been paid. This Rider will terminate immediately prior to the effective date of the new coverage. Once exchanged, this Rider may not be reinstated. Print date: April 3, 2014 JZPRT4006 PRT304 Page 4
4 The following conditions for exchange will apply: a) the life insured for the new coverage will be the Life Insured under this Rider; b) the sum insured for the life insured of the new coverage may not exceed the Sum Insured in effect for the Life Insured under this Rider on the date of exchange and may not be less than the plan minimum for the plan selected at the time of exchange; c) each coverage must satisfy the applicable minimum premium amounts for the plan selected; d) the premiums for the new coverage will be based on the rates in effect for the plan selected at the time of exchange, using: (1) the Life Insured's Age at the date of exchange, and (2) the Life Insured's class of risk and smoking status comparable to the class of risk and smoking status as at the Rider Issue Date or the date of this policy's last reinstatement or change, and as determined by us; e) the Policy Date of the new coverage (if exchanging to a standalone coverage) or Rider Issue Date (if exchanging to a Rider) will be the date on which the exchange to the new coverage becomes effective; f) the new coverage will not contain any further exchange privileges; g) the Incontestability and Suicide and Self Destruction provisions of the new coverage will not be extended beyond the period specified for this Rider; h) the new coverage will be subject to any limitations on death or disability benefits that are contained in this Rider for the Life Insured; i) in addition to the annual premium in respect of the new coverage, an annual policy fee, if applicable, as well as a one-time administrative fee will be payable to us; and j) any Riders may be continued only as described below: If immediately before the exchange, this policy contains: a) Waiver of Premium on Total Disability Rider, then such Rider may not be included in the new coverage. b) Accidental Death and Dismemberment Rider, then such Rider may be included in the new coverage if the Age of the Life Insured at the date of exchange is 55 years or less. Transamerica may impose other conditions on the exchange to the extent that they do not conflict with any of the foregoing provisions of this exchange option. Change in Sum Insured Any time after the first anniversary of this Rider you may submit a written application to increase or decrease the Sum Insured subject to all of the following conditions: a) you must make written application for such change and the request must be received and approved by us at the Head Office; b) the policy must be in force and the Life Insured must be living on the date of your application and continue to be in good health until the date we decide whether the request is approved; c) the Sum Insured requested may not be less than the minimum required by us; Print date: April 3, 2014 JZPRT4006 PRT304 Page 5
5 d) any increase in the Sum Insured is subject to evidence of insurability satisfactory to us; e) if an increase in a Sum Insured is requested, then the Life Insured must continue to be in good health and otherwise insurable by our standards and we must receive evidence satisfactory to us of such good health and insurability; f) any increase or decrease of a Sum Insured may cause a change in the Premiums payable; g) any increase or decrease of a Sum Insured may result in an administrative charge; h) any increase in the Sum Insured may not be less than $50,000; i) any decrease in the Sum Insured may not be less than $25,000; j) any increase in Sum Insured will be contestable for two years from the effective date of such increase but only with respect to the answers given in respect of such increase and will renew the Suicide and Self Destruction provision of the policy for two years from the effective date of the increase, but only as to the increased portion of the Sum Insured; k) for any increase or decrease in Sum Insured, the effective date will be the anniversary date that falls on or next follows the date the application is approved by us; l) such other condition as we may now or hereafter impose. Severance Option At any time while this Rider is in force, it may, at your option, be exchanged for a new policy of life insurance issued by us without providing evidence of insurability, subject to all of the following conditions: a) The request to exercise this option must be made in writing. b) The Sum Insured in the new policy will be the same as the Sum Insured in effect under this Rider. c) The life insured for the new policy will be the Life Insured under this Rider. d) The type of coverage under the new policy will be the same as the type of coverage under this Rider. e) The date used to determine the policy anniversaries, policy years and policy months in respect of the new policy will be the same as the Rider Issue Date. f) The annual premium for the new policy will be determined by us in accordance with: (1) the class of risk for the Life lnsured at the Rider Issue Date; (2) the Age of the Life Insured at the Rider Issue Date; (3) the rates charged for the Rider; and (4) the same renewal dates as the Rider. g) In addition to the annual premium in respect of the new policy, an annual policy fee as well as a one-time administrative fee will be payable to us in respect of the new policy. Such policy fee will be equal to the Guaranteed Annual Policy Fee specified in the Schedule of Benefits and Premiums. Such administrative fee will be equal to the administrative fee then charged by us for similar transactions, but no fee will be charged by us in the event that this option is being exercised as a result of the death of the Life Insured under the Primary Coverage. Such other conditions as we may now or hereafter impose will also apply to the extent that the same do not conflict with any of the foregoing provisions of this option. Print date: April 3, 2014 JZPRT4006 PRT304 Page 6
6 Notwithstanding that this Rider may have terminated as a result of the death of the Life Insured under the Primary Coverage, this option will survive for 30 days thereafter. Termination This Rider will automatically terminate upon the earliest of the following: a) the date specified as being the Coverage Expiry Date for this Rider in the Schedule of Benefits and Premiums; b) the effective date of the lapse of the policy and / or this Rider; c) the date that the policy terminates; d) the Premium Due Date after we receive at our Head Office your written request to cancel this Rider; e) the date prior to the effective date of the new policy resulting from the conversion of this Rider; f) the date the policy or Rider conversion option is exercised; and g) the date of death of the Life Insured. Signed for Transamerica Life Canada at Toronto, Ontario, on the Rider Issue Date. Douglas W. Brooks President and Chief Executive Officer Glenn Daniels Corporate Secretary Print date: April 3, 2014 JZPRT4006 PRT304 Page 7
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