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3. An interest charge calculated as follows: A times B times C divided by 365 = interest charge. A = The amount of the Accelerated Benefit. B = The monthly average of our variable policy loan interest rate. C = The number of days from payment of the Accelerated Benefit to the earlier of(l) the date you die, and (2) the date you have a Right To Convert. Your AD&D Insurance, if any, is not affected by payment of the Accelerated Benefit. E. Exclusions No Accelerated Benefit will be paid if: 1. .All or part of your Insurance must be paid to your Cbild(ren), or your Spouse or former Spouse as part of a court approved divorce decree, separate maintenance agreement, or property settlement agreement. 2. You are married and live in a community property state unless you give us a signed written consent from your Spouse. 3. You have made an assignment of all or part of your Insurance unless you give us a signed written consent from the assignee. 4. You have filed for bankruptcy, unless you give us written approval from the Bankruptcy Court for payment of the Accelerated Benefit. 5. You are required by a government agency to use the Accelerated Benefit to apply for, receive, or continue a government benefit or entitlement. 6. You have previously received an Accelerated Benefit under the Group Policy. F. Definitions For Accelerated Benefit Insurance means your Life Insurance and Supplemental Life Insurance, if any, under the Group Policy. Physician means a licensed M.D. or D.O., other than yourself, acting within the scope of the license. LU\B.110 RIGHT TO CONVERT A. Right To Convert You may buy an individual policy of life insurance without Evidence Of Insurability if: 1. Your Insurance ends or is reduced due to a Qualifying Event; and 2. You apply in writing and pay us the first premium during the Conversion Period. Except as limited under C. Limits On Right To Convert, the ml'lYimum amount you have a Right To Convert is the amount of your Insurance which ended. . B. Definitions For Right To Convert 1. Conversion Period means the 31-day period after the date of any Qualifying Event. 2. Insurance means all your insurance under the Group Policy, including insurance continued under Waiver Of Premium, but excluding AD&D Insurance. 3. Qualifying Event means termination or reduction of your Insurance for any reason except: a. The Member's failure to make a required premium contribution. b. Payment of an Accelerated Benefit. Printed 4196 Revised 4196 -13- SAMPLE LI.AD&D. DLI, Sup. U