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loss within the time limit stated in the Proofs of Loss Section.

(6) PROOFS OF LOSS: If the policy provides for periodic payment for a continuing loss, written proof of loss must be given Combined within 90 days after the end of each period for which Combined is liable. For any other loss, written proof must be given within 90 days after such loss. If it was not reasonably possible to give written proof in the time required, Combined shall not reduce or deny the claim for this reason if the proof is filed as soon as reasonably possible. In any event, the proof required must be given no later than 1 year from the time specified unless the claimant was legally incapacitated.

(7) TIME OF PAYMENT OF CLAIMS: After receiving written proof of loss, Combined will pay monthly all benefits then due the Insured for disability.
Benefits for any other loss covered by this policy will be paid as soon as Combined written proof. receives proper

(8) PAYMENT OF CLAIMS: Benefits will be paid to the Insured. Loss of life benefits are payable in accordance with the beneficiary designation in effect at the time of payment. If none is then in effect, the benefits will be paid to the Insured's estate. Any other benefits unpaid at death may be paid, at Combined's option, either to the Insured's beneficiary or estate. (9) PHYSICAL EXAMINATIONS: Combined at its expense has the right to have the Insured examined as often as reasonably necessary while a claim is pending.

(10) LEGAL ACTIONS: No legal action may be brought to recover on this policy within 60 days after written-proof of loss has been given as required by this policy. No such action may be brought after 3 years from the time written proof of loss is required to be given.
-(ll) -e0NF0R-MI'f-Y--WI'FH STATE ST A TB'fES: -Any-pTovisiorn,f---this-policr which, on its effective date, is in conflict with the laws of the state in which the Insured resides on that date is amended to conform to the minimum requirements of such laws.

(12) CHANGE OF BENEFICIARY: The Insured can change the beneficiary at any time by giving Combined written notice. Unless irrevocably designated, the beneficiary's consent is not required.
GENERAL PROVISIONS A. This policy becomes effective on the date issued, at 12 :01 A.M., Standard Time, at the place where you reside. This policy is issued for your lifetime. Combined cannot cancel this policy or increase the premium. It continues in force so long as premium is paid on or before the due date or within the grace period. B. This policy is issued in consideration of the first premium paid in advance. first premium is made by check or draft not honored, the policy shall be void. If payment of the

This policy is issued by COMBINED INSURANCE COMPANY OF AMERICA. It shall not be binding on Combined unless the policy has been countersigned by our authorized agent.

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Chairman

Chief Executive

Officer

Issue Date Insured Beneficiary

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Countersigned

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by: Licensed Resident Agent

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NON-CANCELLABLE AND GUARANTEED RENEWABLE FOR LIFE ACCIDENT HOSPITALIZATION INDEMNITY BENEFITS REDUCED 50CYo OVER AGE 70

,.

Policy

G9921163
Home Office: 5050 Broadway Chicago, illinois 60640

(Herein called Combined)

Form 11860WI

Paid $40.00 Premium for Six Months from ISSUE DATE

Combined agrees to pay you, the person named in this policy, subject to the following terms and conditions, for loss resulting, directly and independently of all other causes, from accidental bodily injuries incurred while this policy is in force and which loss or injuries are in no way caused by disease (herein referred to as .. Injury ") as f 0IIows:

SECTION A

HOSPITAL INDEMNITY-ANY

ACCIDENT

If, because of injury, you are confined in a hospital overnight as an inpatient,

Combined will pay you, for each such day, starting with the first day of confinement, if each such confinement starts within 90 days after the date of the accident which caused the injury, a benefit of $60.00 per day ..... $1,800.00 per month, for up to your lifetime, if injury is incurred: By being struck or knocked down or run over; or While drivir.g or riding in any automobile, bus, taxicab or truck; or While on a motorcycle or any recreational While flying or riding in any aircraft; or vehicle; or

At the hands of a burglar or robber; or By drowning; or or

In case of fire or smoke inhalation;

While hunting, fishing or in any sports activity; or While at home, at work, at play, or in any other activity whatsoever. ACCUMULATION: The benefits stated above will be increased 5% for each six months the policy is kept in force up to a total maximum increase of 50% or up to $90.00 per day $2,700.00 per month.

SECTION B

CONVALESCENT BENEFIT-ANY

ACCIDENT

If, because of injury, you are totally disabled following a period of hospital confinement for which benefits are payable under Section A, Combined will pay you while you are so disabled, but not to exceed the number of days of such hospital confinement, a benefit of $30.00 per day $900.00 per month. SECTION C OPTIONAL MEDICAL BENEFIT-ANY ACCIDENT

If, because of injury, you require medical treatment within 90 days after the accident, and you make no other claim under this policy for the same accident, Combined will pay your actual hospital, medical or surgical expense at a hospital, doctor's office, clinic or elsewhere, up to a maximum for each accident of $40.00

NON-CANCELLABLE AND GUARANTEED RENEWABLE BENEFITS REDUCED 50% OVER AGE 70


The premium
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Benefits

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