DISABILITY INCOME PROTECTION

DISABILITY INCOME PROTECTION Item 235 Safe. Sound. Secure.

P eople work hard to afford what they enjoy in life, and to pay their continuing expenses such as food, clothing, shelter, utilities, insurance premiums, and entertainment. Their ability to earn an income is their most valuable asset. If that ability is interrupted because of an accident or sickness, they may find it difficult to maintain their standard of living and impossible to plan for the future. Unfortunately, the chance of a disabling accident or sickness is greater than most people think. 1 out of 4 workers, age 35-65, will be disabled for 90 days. ** Disability is the cause of nearly 50% of all home foreclosures. ** Before age 65, if a disability lasts 90 days, it is expected to last an average of 2 1/2 years. *** 80% of U.S. workers will exhaust their savings in only two months without the ability to earn an income. *** * Society of Acturaries ** National Association of Life Underwriters *** Commissioner s Disability Table Auto-Owners Disability Income Policy Will Provide Money to Replace Loss of Earned Income While Totally Disabled from Sickness or an Accident 1. Worldwide, 24-hour-a-day coverage while on or off the job. 2. Benefit periods of 2 years, 5 years, or to age 65. 3. Waiting periods (the number of days before benefits begin) are 30, 60, 90 or 180 days. 4. Coverage is guaranteed renewable to age 65. 5. Premium rates can be changed on a class basis only. Any change will apply to all policies of this type and having a common policy form number. 6. A non-smoker discount is given to those who have not smoked cigarettes for 12 months or more. 7. Premiums are waived retroactively after 90 consecutive days of total disability. 8. First Day Disability Income Benefit may be added to provide a daily income while hospital confined. 9. An optional Accidental Death and Dismemberment Benefit may be added for any amount from $10,000 to $100,000. 10. A Partial Disability Benefit is included at no additional premium. Partial disability must follow a period of total disability for which benefits were paid. The Partial Disability Benefit equals one half the monthly benefit paid while totally disabled, for up to six months or until the end of the benefit period, whichever is less.

Determining Maximum Disability Benefit Available MAXIMUM MONTHLY BENEFIT AVAILABLE Use Net Annual Income Table Subject to Maximum by Occupation Less: $ Existing Disability Income Benefit * $ Less: Unearned Income ** $ Equals: Maximum Monthly Benefit Available *** $ The MINIMUM Disability Benefit which can be purchased is $300 per month. * Other Disability policies, salary continuation or sick pay benefits likely to last more than 26 weeks. ** Unearned income includes rents, pensions, investment income, etc. Ignore unearned income less than 10% of gross income. Use 50% of unearned income if it is 10-50% of gross income. Not eligible if unearned income is 50% or more of gross earnings. *** The maximum monthly benefit which can be purchased is the lessor of the maximum amount listed in the Net Annual Income Table or the maximum based on the Occupation Table below. Net Annual Income Table Net Maximum Net Maximum Annual Income * Mo. Benefit Annual Income * Mo. Benefit $20,000 $1,250 $46,000 $2,650 20,500 1,280 48,000 2,760 21,500 1,310 50,000 2,830 21,500 1,340 52,000 2,950 22,000 1,380 54,000 3,060 22,500 1,410 56,000 3,170 23,000 1,440 58,000 3,240 23,500 1,470 60,000 3,300 24,000 1,480 65,000 3,520 24,500 1,510 70,000 3,790 25,000 1,540 75,000 4,000 25,500 1,570 80,000 4,200 26,000 1,600 85,000 4,390 26,500 1,630 90,000 4,500 27,000 1,670 95,000 4,670 27,500 1,700 100,000 4,750 28,000 1,730 110,000 5,040 28,500 1,740 120,000 5,200 29,000 1,760 130,000 5,530 29,500 1,790 140,000 5,720 30,000 1,830 150,000 6,000 31,000 1,890 160,000 6,270 32,000 1,950 170,000 6,520 33,000 1,980 180,000 6,900 34,000 2,040 190,000 7,130 35,000 2,100 200,000 7,330 36,000 2,160 220,000 7,880 37,000 2,220 240,000 8,000 38,000 2,250 260,000 8,450 39,000 2,310 280,000 8,870 40,000 2,330 300,000 9,500 42,000 2,420 320,000 10,000 44,000 2,530 Occupation Table Occupation Subject to Monthly Maximum Maximum Benefit of Benefit Period $10,000 To 65 AAA 8,000 To 65 * Net Annual Income for self employed individuals = Gross income from employment less business deductions before personal exemptions. Gross income includes wages (not overtime pay), salaries, bonuses, commissions, fees or other payments for personal services. Use 2 year average for commissioned sales personnel. NOTE: Should the actual net annual income fall between the listed amounts, use the maximum for the next highest listed net annual income amount. AA 6,000 To 65 A 4,000 5 Years B 3,000 5 Years

1 Disability Income Premium Item 235 Annual non-cigarette smoker premium per each $100 unit of monthly benefit Benefit Period - Male 2 Year 5 Year To 65 Waiting Waiting Period Period (Days) (Days) 30 60 90 30 60 90 30 60 90 180 Benefit Period - Female 2 Year 5 Year To 65 Waiting Waiting Period Period (Days) (Days) 30 60 90 30 60 90 30 60 90 180 18-29 $18 $14 $13 $25 $21 $19 $32 $27 $24 $21 AAA 20 16 14 28 23 21 36 30 27 23 AA 23 19 16 32 27 23 40 34 30 26 A 28 23 20 37 31 27 B 34 28 24 45 38 33 18-29 $24 $19 $16 $35 $28 $24 $46 $39 $33 $28 AAA 27 21 18 39 31 27 51 43 37 31 AA 32 25 21 45 36 30 59 49 42 35 A 39 31 26 53 43 37 B 47 38 32 64 53 45 30-34 19 15 14 29 24 21 39 33 29 25 AAA 21 17 15 32 27 23 43 37 32 28 AA 25 20 17 36 30 26 48 41 36 31 A 29 24 20 41 35 30 B 36 30 25 50 42 36 30-34 26 21 17 40 32 27 55 46 41 33 AAA 29 23 19 44 35 30 61 51 45 37 AA 34 26 22 51 41 34 71 58 51 42 A 41 33 28 58 49 41 B 50 40 34 71 60 50 35-39 22 17 15 33 28 24 45 38 34 29 AAA 24 19 17 37 31 27 50 42 38 32 AA 27 22 19 41 35 30 56 48 42 36 A 32 27 23 47 40 35 B 39 33 28 57 48 42 35-39 28 23 19 44 36 32 62 53 46 39 AAA 31 25 21 49 40 35 69 59 51 43 AA 37 29 24 57 46 39 80 67 58 48 A 45 36 31 66 55 48 B 54 44 37 79 67 58 40-44 23 19 16 38 32 28 51 44 39 32 AAA 26 21 18 42 36 31 57 49 43 36 AA 30 24 21 48 40 35 64 55 48 41 A 35 29 25 54 45 40 B 43 36 31 65 55 49 40-44 30 23 20 50 40 35 68 56 50 42 AAA 33 25 22 55 44 39 76 62 56 47 AA 39 31 26 64 52 44 88 74 64 53 A 45 37 33 70 61 54 B 55 46 40 84 74 65 45-49 27 23 19 47 40 34 59 51 45 38 AAA 30 25 21 52 44 38 66 57 50 42 AA 35 28 24 59 49 43 75 64 56 47 A 41 35 30 66 56 50 B 50 42 36 79 68 61 45-49 32 25 23 56 45 41 70 59 52 43 AA 36 28 25 62 50 45 78 66 58 48 AA 43 34 28 72 60 51 91 77 67 54 A 49 41 37 79 69 63 B 59 50 45 95 85 76 50-54 31 25 22 58 49 42 65 56 49 41 AAA 34 28 24 64 54 47 72 62 54 45 AA 40 32 28 73 62 54 84 71 62 51 A 47 41 34 81 69 62 B 57 49 41 97 83 75 50-54 33 27 23 61 52 46 70 59 52 43 AAA 37 30 26 68 58 51 78 66 58 48 AA 43 35 30 79 66 57 91 77 67 54 A 52 44 39 88 78 70 B 63 54 47 106 95 84 55-60 47 40 34 67 56 49 70 59 51 42 AAA 52 44 38 74 62 54 78 66 57 47 AA 60 50 43 86 72 62 90 76 65 52 A 72 63 55 95 82 72 B 87 77 67 114 99 87 55-60 47 40 35 67 56 50 70 59 52 43 AAA 52 44 39 74 62 55 78 66 58 48 AA 61 51 44 86 73 63 91 77 67 54 A 73 64 58 96 85 77 B 88 78 70 116 103 93 See back panel for Premium Calculation Worksheet

2 First Day Disability Income Benefit While Hospital Confined Item 236 Benefit amount must equal base policy s monthly disability benefit. Annual non-cigarette smoker premium per each $100 of monthly benefit. 18-29 30-34 35-39 40-44 45-49 50-54 55-60 Occupation Benefit Period - Male Base Policy Waiting Period (Days) 30 60 90 180 $2.70 $2.80 $2.90 $3.10 3.00 3.10 3.20 3.40 3.30 3.50 3.60 3.50 3.60 3.70 3.90 3.90 4.00 4.30 4.20 4.40 4.30 4.60 4.80 5.10 5.20 4.70 4.90 5.20 5.20 5.40 5.50 5.90 5.40 5.60 6.20 6.40 6.70 6.70 6.80 7.00 6.40 6.60 6.80 7.10 7.10 7.30 7.50 7.90 7.80 8.00 8.20 7.40 7.60 8.20 8.20 8.40 8.60 9.10 9.00 9.30 9.50 18-29 30-34 35-39 40-44 45-49 50-54 55-60 Occupation Benefit Period - Female Base Policy Waiting Period (Days) 30 60 90 180 $3.70 $3.80 $3.90 $ 4.20 4.30 4.40 4.60 4.80 4.60 4.80 5.10 5.10 5.30 5.50 5.70 5.60 5.40 5.60 5.70 6.20 6.30 6.70 6.60 6.80 6.90 6.20 6.40 6.60 6.90 6.90 7.10 7.30 7.80 8.00 7.20 7.50 8.10 8.00 8.30 8.50 9.00 8.90 9.10 9.30 8.60 8.70 8.90 9.50 9.50 9.70 9.90 10.50 10.40 10.70 10.90 9.80 10.10 10.40 10.90 10.90 11.20 11.50 12.10 12.00 12.30 12.70 3 Accidental Death and Dismemberment Benefit Item 237 Minimum benefit, $10,000; Maximum benefit, $100,000 Annual non-cigarette smoker premium per $1,000 of coverage. Male and Female Occupation Rate 18-49 AAA AA A B $1.30 1.40 1.90 2.30 3.20 50-60 AAA AA A B $1.40 1.60 2.10 2.70 3.70

PREMIUM CALCULATION Annual Premium per each $100 of Monthly Benefit Name Monthly Disability Benefit $ Male Female Occupation : Benefit Period: Waiting Period: 2 Year 30 Day AAA 5 Year 60 Day AA To 65 90 Day A B 180 Day 1 Item 235 Individual Disability Income: $ x = $ Non-smoker premium per $100 unit Number of Units Non-smoker premium per $100 unit Same number of units as above 2 Item 236 Optional First Day Disability Income Benefit While Hospital Confined: $ x = $ 3 Item 237 Optional Accidental Death and Dismemberment Benefit: $ x $ = $ Non-smoker premium per $100 unit Amount Subtotal = $ Cigarette smoker surcharge, if applicable: Add 10% of Subtotal = $ Add Annual Premium Adjustment Factor = $ All States Except KY add $1 KY add $20.00 TOTAL ANNUAL PREMIUM = $ $ Semiannual Premium.52 $ Quarterly Premium.265 $ Monthly EFT Premium.086 Determining Monthly Benefits To Be Paid To determine the monthly disability benefit, we will divide the monthly loss of income by the pre-loss income and multiply the result by the Monthly Benefit purchased, as shown on the Policy Data Page. Monthly Loss of Earned Income Example: $2,000* Pre-Loss Earned Income $3,000 x Monthly Disability Benefit Purchased $2,000 = Monthly Disability Benefit Paid $1,333.33 *$3,000 Pre-loss earned income minus $1,000 per month workers compensation benefit being paid = $2,000 Monthly Loss of Earned Income. Earned Income is gross income from employment less business expenses before personal deductions. Definition of Total Disability Monthly Loss of Earned Income is Pre-Loss Earned Income less the amount actually received while totally disabled from: - Own occupation to age 65 AAA & AA - Own occupation for 5 years A&B - Own occupation for 2 years Wages, salaries, bonuses, commissions, fees or other payments for personal services; and Social Security, workers compensation, or other federal or state cash sickness plans; and Then any occupation for which you are qualified or may become qualified by reason of education, training or experience; and with due regard to Any lump sum payments that are greater than Preyour vocation and economic status at the time total disability begins. Loss Earned Income. These will be considered income during future months at a rate not exceeding Pre-Loss Earned Income until exhausted. Pre-Loss Earned Income is monthly Earned Income averaged for the 12 months just prior to becoming totally disabled. 50200 (5-04) WWW.AUTO-OWNERS.COM