Document:

exv10w4

 

Exhibit
10.4

Munich American Reassurance Company

Automatic YRT Second Excess

Reinsurance Agreement

between

Trinity Life Insurance Company

Tulsa, Oklahoma

                     (hereinafter referred to as the “Ceding Company”)

and

Munich American Reassurance Company

Atlanta, Georgia

                    
(hereinafter referred to as “MARC”)

Effective                      February 1, 2007

Treaty #                                3545

 

 

Table of Contents

	 	 	 	 	 	 	 
	 	 	 	 	Page
	ARTICLE 1 - PREAMBLE	 	 	1	 
	 
	 	 	 	 	 	 
	1.1
	 	Parties to the Agreement	 	 	1	 
	1.2
	 	Compliance	 	 	1	 
	1.3
	 	Construction	 	 	1	 
	1.4
	 	Entire Agreement	 	 	1	 
	1.5
	 	Severability	 	 	1	 
	1.6
	 	Third Party Administrator	 	 	1	 
	 
	 	 	 	 	 	 
	ARTICLE 2 - AUTOMATIC REINSURANCE	 	 	2	 
	 
	 	 	 	 	 	 
	2.1
	 	General Conditions	 	 	2	 
	2.2
	 	New Business	 	 	2	 
	2.3
	 	Retained Amounts	 	 	2	 
	2.4
	 	Underwriting Standards	 	 	3	 
	 
	 	 	 	 	 	 
	ARTICLE 3 - FACULTATIVE REINSURANCE	 	 	4	 
	 
	 	 	 	 	 	 
	ARTICLE 4 - COMMENCEMENT OF LIABILITY	 	 	5	 
	 
	 	 	 	 	 	 
	4.1
	 	Automatic Reinsurance	 	 	5	 
	4.2
	 	Facultative Reinsurance	 	 	5	 
	 
	 	 	 	 	 	 
	ARTICLE 5 - REINSURED RISK AMOUNT	 	 	6	 
	 
	 	 	 	 	 	 
	5.1
	 	Life	 	 	6	 
	 
	 	 	 	 	 	 
	ARTICLE 6 - PREMIUM ACCOUNTING	 	 	7	 
	 
	 	 	 	 	 	 
	6.1
	 	Premiums	 	 	7	 
	6.2
	 	Payment of Premiums	 	 	7	 
	6.3
	 	Delayed Payment	 	 	7	 
	6.4
	 	Failure to Pay Premiums	 	 	7	 
	6.5
	 	Premium Rate Guarantee	 	 	8	 
	 
	 	 	 	 	 	 
	ARTICLE 7 - REDUCTIONS, TERMINATIONS AND CHANGES	 	 	9	 
	 
	 	 	 	 	 	 
	7.1
	 	Reductions and Terminations	 	 	9	 
	7.2
	 	Increases	 	 	9	 
	7.3
	 	Risk Classification Changes	 	 	10	 
	7.4
	 	Reinstatement	 	 	10	 
	7.5
	 	Nonforfeiture Benefits	 	 	10	 
	 
	 	 	 	 	 	 
	ARTICLE 8 - CONVERSIONS, EXCHANGES, AND REPLACEMENTS	 	 	11	 
	 
	 	 	 	 	 	 
	8.1
	 	Conversions	 	 	11	 
	8.2
	 	Exchanges and Replacements	 	 	11	 
	 
	 	 	 	 	 	 
	ARTICLE 9 - CLAIMS	 	 	13	 
	 
	 	 	 	 	 	 
	9.1
	 	Notice	 	 	13	 
	9.2
	 	Proofs	 	 	13	 
	9.3
	 	Amount and Payment of Reinsurance Benefits	 	 	13	 
	9.4
	 	Contestable Claims	 	 	13	 
	9.5
	 	Claim Expenses	 	 	14	 

 

 

 

	 	 	 	 	 	 	 
	 	 	 	 	Page
	9.6
	 	Misrepresentation or Suicide	 	 	14	 
	9.7
	 	Misstatement of Age or Sex	 	 	14	 
	9.8
	 	Extra-Contractual Damages	 	 	14	 
	 
	 	 	 	 	 	 
	ARTICLE 10 - RETENTION LIMIT CHANGES	 	 	16	 
	 
	 	 	 	 	 	 
	ARTICLE 11 - RECAPTURE	 	 	17	 
	 
	 	 	 	 	 	 
	ARTICLE 12 - GENERAL PROVISIONS	 	 	18	 
	 
	 	 	 	 	 	 
	12.1
	 	Currency	 	 	18	 
	12.2
	 	Premium Tax	 	 	18	 
	12.3
	 	Inspection of Records	 	 	18	 
	12.4
	 	Forms, Manuals & Issue Rules	 	 	18	 
	12.5
	 	Interest Rate	 	 	18	 
	12.6
	 	Other	 	 	18	 
	 
	 	 	 	 	 	 
	ARTICLE 13 - DAC TAX	 	 	19	 
	 
	 	 	 	 	 	 
	ARTICLE 14 - OFFSET	 	 	20	 
	 
	 	 	 	 	 	 
	ARTICLE 15 - INSOLVENCY	 	 	21	 
	 
	 	 	 	 	 	 
	15.1
	 	Insolvency of a Party to this Agreement	 	 	21	 
	15.2
	 	Insolvency of the Ceding Company	 	 	21	 
	 
	 	 	 	 	 	 
	ARTICLE 16 - ERRORS AND OMISSIONS	 	 	22	 
	 
	 	 	 	 	 	 
	ARTICLE 17 - DISPUTE RESOLUTION	 	 	23	 
	 
	 	 	 	 	 	 
	ARTICLE 18 - ARBITRATION	 	 	24	 
	 
	 	 	 	 	 	 
	ARTICLE 19 - CONFIDENTIALITY	 	 	26	 
	 
	 	 	 	 	 	 
	ARTICLE 20 - DURATION OF AGREEMENT	 	 	28	 
	 
	 	 	 	 	 	 
	ARTICLE 21 - EXECUTION	 	 	29	 

Exhibits

A - Retention Limits of the Ceding Company and First Excess Limits

B - Plans Covered and Binding Limits

C - Forms, Manuals and Issue Rules

D - Reinsurance Premiums

E - Self-Administered Reporting

F - List of Risks Reinsured

G - List of Amendments

H - In Force Summary Form

I - Application for Facultative Reinsurance Form

 

 

Article 1 — PREAMBLE

	1.1	 	Parties to the Agreement
	 
	 	 	This is a second excess YRT agreement for indemnity reinsurance (the “Agreement”)
solely between Trinity Life Insurance Company, Tulsa, Oklahoma (“the Ceding Company”), and
Munich American Reassurance Company of Atlanta, Georgia (“MARC”), collectively referred to
as the “parties”.
	 
	 	 	The acceptance of risks under this Agreement will create no right or legal relationship
between MARC and the insured, owner or beneficiary of any insurance policy or other contract
of the Ceding Company.
	 
	 	 	The Agreement will be binding upon the Ceding Company and MARC and their respective
successors and assigns.
	 
	1.2	 	Compliance
	 
	 	 	This Agreement applies only to the issuance of insurance by the Ceding Company in a
jurisdiction in which it is properly licensed.
	 
	 	 	The Ceding Company represents that, to the best of its knowledge, it is in compliance with
all state and federal laws applicable to the business reinsured under this Agreement. In
the event the Ceding Company is found to be in non-compliance with any law material to this
Agreement, the Agreement will remain in effect and the Ceding Company will indemnify MARC
for any direct loss MARC suffers as a result of the non-compliance, and will seek to remedy
the non-compliance.
	 
	1.3	 	Construction
	 
	 	 	This Agreement will be construed in accordance with the laws of the state of Oklahoma.
	 
	1.4	 	Entire Agreement
	 
	 	 	This Agreement constitutes the entire agreement between the parties with respect to the
business reinsured hereunder. There are no understandings between the parties other than as
expressed in this Agreement. Any change or modification to this Agreement will be null and
void unless made by amendment to this Agreement and signed by both parties.
	 
	1.5	 	Severability
	 
	 	 	If any provision of this Agreement is determined to be invalid or unenforceable, such
determination will not impair or affect the validity or the enforceability of the remaining
provisions of this Agreement.
	 
	1.6	 	Third Party Administrator
	 
	 	 	It is understood that the Ceding Company has appointed
Investor’s Heritage Life Insurance Company, Frankfort, Kentucky,
as its Third Party Administrator (hereinafter referred to as the
“Administrator”). In connection therewith, the
Ceding Company has authorized the Administrator to perform the duties of underwriting,
administration and claim adjudication with the Ceding Company’s oversight and a valid Third
Party Administrative Services agreement by and between the Ceding Company and the
Administrator is on file with MARC.

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Article 2 — AUTOMATIC REINSURANCE

	2.1	 	General Conditions
	 
	 	 	The Ceding Company will automatically cede to MARC new business as defined in Section
2.2 on the life insurance policies, supplementary benefits, and riders listed in Exhibit B
issued on and after the effective date of this Agreement. The basis for the automatic
reinsurance is shown in Exhibit B.
	 
	 	 	MARC will automatically accept its share of the above-referenced policies up to the limits
shown in Exhibit B, provided that:

	 	(a)	 	the insured, at the time of the application, must be a permanent resident of
the United States, United States Protectorates or Canada;
	 
	 	(b)	 	the Ceding Company keeps its full retention, as specified in Exhibit A, or
otherwise holds its full retention on a life under previously issued inforce policies
and applies the same underwriting standards it would have applied if the new policy had
fallen completely within its regular retention;
	 
	 	(c)	 	the Administrator makes all underwriting determination and the Ceding Company,
through the Administrator, applies its normal underwriting guidelines in accordance
with Section 2.4 of this article and Section 12.4;
	 
	 	(d)	 	the total of new ultimate amount of reinsurance required including contractual
increases, and the amount already reinsured on that life under this Agreement and all
other agreements between MARC and the Ceding Company, does not exceed the Automatic
Binding Limits set out in Exhibit B;
	 
	 	(e)	 	the amount of life insurance in force in all companies, including any coverage
to be replaced plus the amount currently applied for on that life in all companies,
does not exceed the Jumbo Limit stated in Exhibit B;
	 
	 	(f)	 	the application is on a life that has not been submitted facultatively to MARC
or any other reinsurer unless the reason for any prior facultative submission was
solely for capacity that may now be accommodated within the terms of this Agreement,
and
	 
	 	(g)	 	MARC’s underwriting manual will be used.

	2.2	 	New Business
	 
	 	 	New business as defined in this article and Article 8.2 are
those policies on which (a) the Ceding Company, through the
Administrator, has obtained complete and current underwriting
evidence on the full amount issued, (b) the full normal
commissions are paid by the Ceding Company, through the
Administrator, for the new plan, and (c) the suicide and
contestable provisions apply from the effective date of the new
plan.
	 
	2.3	 	Retained Amounts
	 
	 	 	The Ceding Company may not reinsure on any basis any portion of the amount it has
retained on the business covered under this Agreement without prior notification to MARC.

2

 

	2.4	 	Underwriting Standards
	 
	 	 	The parties hereby declare and agree that all policies and benefits covered under this
Agreement shall be issued in accordance with MARC’s Life Underwriting Manual, unless the
Ceding Company and MARC agree to use an alternative method. The Ceding Company should
discuss any proposed changes in underwriting standards, requirements, or other criteria with
MARC, and will be subject to the written approval of MARC before being applied to policies
and benefits to be covered by this agreement.

3

 

Article 3 — FACULTATIVE REINSURANCE

	3.1	 	The Ceding Company, through the Administrator, may submit any application on a plan or
rider identified in Exhibit B to MARC for its consideration on a facultative basis.
The Ceding Company, through the Administrator, will apply for reinsurance on a facultative
basis by sending to MARC an Application for Facultative Reinsurance, providing the
information outlined in Exhibit I. Accompanying this Application will be copies of all
underwriting evidence that is available for risk assessment including, but not limited to,
copies of the application for insurance, medical examiners’ reports, attending physicians’
statements, inspection reports, and any other information bearing on the insurability of the
risk. The Ceding Company, through the Administrator, also will notify MARC of any
outstanding underwriting requirements at the time of the facultative submission. Any
subsequent information received by the Ceding Company, through the Administrator, that is
pertinent to the risk assessment will be immediately transmitted to MARC.
	 
	 	 	After consideration of the Application for Facultative Reinsurance and related information,
MARC will promptly inform the Ceding Company, through the Administrator, of its underwriting
decision. MARC’s offer will expire at the end of 120 days, unless otherwise specified by
MARC.
	 
	 	 	If the underwriting decision is acceptable, the Ceding Company, through the Administrator,
will notify MARC in writing of its acceptance of the offer.
	 
	 	 	Unless the Ceding Company, through the Administrator, gives notification before the
expiration date, there shall not be any reinsurance on the risk and errors and omissions, as
stated in Article 16 will not apply.

4

 

Article 4 — COMMENCEMENT OF LIABILITY

	4.1	 	Automatic Reinsurance
	 
	 	 	For automatic reinsurance, MARC’s liability for amounts ceded hereunder will commence
at the same time as the Ceding Company’s liability.
	 
	4.2	 	Facultative Reinsurance
	 
	 	 	For facultative reinsurance, MARC’s liability will commence at the same time as the
Ceding Company’s liability, provided that MARC has made a facultative offer and that offer
was accepted, during the lifetime of the insured, in accordance with the terms of this
Agreement.

5

 

Article 5 — REINSURED RISK AMOUNT

	5.1	 	Life
	 
	 	 	The reinsured net amount at risk of the policy is defined as the policy face amount less the
cash value, account value, or terminal reserve, less the amount retained by the Ceding
Company, less the first excess, and for automatic policies, multiplied by MARC’s share as
stated in Exhibit B. For variable amount plans, the reinsured net amount at risk is
calculated using the account value in effect at the end of the monthly reinsurance billing
period.
	 
	 	 	Any change in the net amount at risk due to changes in the policy’s cash value or account
value will be shared proportionately between the Ceding Company and MARC.

6

 

Article 6 — PREMIUM ACCOUNTING

	6.1	 	Premiums
	 
	 	 	Reinsurance premium rates for life insurance and other benefits reinsured under this
Agreement are shown in Exhibit D. The rates will be applied to the reinsured net amount at
risk.
	 
	 	 	The Ceding Company, through the Administrator, will pay MARC the percentages of the premium
rates shown in Exhibit D.
	 
	6.2	 	Payment of Premiums
	 
	 	 	Reinsurance premiums are payable annually and in advance. The Ceding Company, through
the Administrator, will calculate the amount of reinsurance premium due and, within
forty-five (45) days after the end of the month, will send MARC a statement that contains
the information shown in Exhibit E, showing reinsurance premiums due for that period. If an
amount is due MARC, the Ceding Company, through the Administrator, will remit that amount
together with the statement. If an amount is due the Ceding Company, MARC will remit such
amount within twenty (20) days of receipt of the statement.
	 
	6.3	 	Delayed Payment
	 
	 	 	Premium balances that remain unpaid for more than thirty (30) days after the Remittance
Date will incur interest from the end of the reporting period. The Remittance Date is
defined as thirty (30) days after the end of the reporting period. Interest will be
calculated using the index specified in Article 12.5.
	 
	6.4	 	Failure to Pay Premiums
	 
	 	 	The payment of reinsurance premiums is a condition precedent to the liability of MARC
for reinsurance covered by this Agreement. In the event that reinsurance premiums are not
paid within thirty (30) days of the Remittance Date, MARC will have the right to terminate
the reinsurance under all policies having reinsurance premiums in arrears. If MARC elects
to exercise its right of termination, it will give the Ceding Company, through the
Administrator, thirty (30) days written notice of its intention. Such notice will be sent
by certified mail.
	 
	 	 	If all reinsurance premiums in arrears, including any that become in arrears during the
thirty (30) day notice period, are not paid before the expiration of the notice period, MARC
will be relieved of all liability under those policies as of the last date to which premiums
have been paid for each policy. Reinsurance on policies on which reinsurance premiums
subsequently fall due will automatically terminate as of the last date to which premiums
have been paid for each policy, unless reinsurance premiums on those policies are paid on or
before their Remittance Dates.
 

Terminated reinsurance may be reinstated, subject to approval by MARC, within thirty (30)
days of the date of termination, and upon payment of all reinsurance premiums in arrears
including any interest accrued thereon. MARC will have no liability for any claims incurred
between the date of termination and the date of the reinstatement of the reinsurance. The
right to terminate reinsurance will not prejudice MARC’s right to collect

7

 

	 	 	premiums for the
period during which reinsurance was in force prior to the expiration of the thirty (30) days
notice.
	 
	 	 	The Ceding Company, through the Administrator, will not force termination under the
provisions of this Article solely to avoid the provisions regarding recapture in Article 11,
or to transfer the reinsured policies to another reinsurer.
	 
	6.5	 	Premium Rate Guarantee
	 
	 	 	MARC does not guarantee the premium rates for more than one (1) year; hence deficiency
reserves are not required.

8

 

Article 7 — REDUCTIONS, TERMINATIONS AND CHANGES

Whenever a change is made in the status, plan, amount or other material feature of a policy
reinsured under this Agreement, MARC will, upon receipt of notification of the change, provide
adjusted reinsurance coverage in accordance with the provisions of this Agreement. The Ceding
Company, through the Administrator, will notify MARC of any such change within thirty (30) days of
its effective date.

	7.1	 	Reductions and Terminations
	 
	 	 	In the event of the reduction, lapse, or termination of a policy or policies reinsured
under this Agreement or any other agreement, the Ceding Company, through the Administrator,
will, reduce or terminate reinsurance on that life. The reinsured amount on the life with
all reinsurers will be reduced, effective on the same date, by the amount required such that
the Ceding Company maintains its retention as defined under this Agreement.
	 
	 	 	The reinsurance reduction will apply first to the policy or policies being reduced and then,
on a chronological basis, to other reinsured policies on the life, beginning with the oldest
policy. If a fully retained policy on a life that is reinsured under this Agreement is
terminated or reduced, the Ceding Company, through the Administrator, will reduce the
existing reinsurance on that life by a corresponding amount, with the reinsurance on the
oldest policy being reduced first. If the amount of reduction exceeds the risk amount
reinsured, the reinsurance on the policy or policies will be terminated.
	 
	 	 	MARC will refund any unearned reinsurance premiums net of allowances. However, the
reinsured portion of any policy fee will be deemed earned for a policy year if the policy is
reinsured during any portion of that policy year.
	 
	7.2	 	Increases

	 	(a)	 	Noncontractual Increases
	 
	 	 	 	If the amount of insurance is increased as a result of a noncontractual change, the
increase will be underwritten by the Ceding Company, through the Administrator, in
accordance with its customary standards and procedures and will be considered new
reinsurance under this Agreement. MARC’s approval is required if the original
policy was reinsured on a facultative basis or if the new amount will cause the
reinsured amount on the life to exceed either the Automatic Binding Limits or the
Jumbo Limits shown in Exhibit B.
	 
	 	 	 	MARC will assume its share of the entire amount in excess of the Ceding Company’s
applicable retention and the first excess. Premiums for the additional reinsurance
will be at the new-issue rate from the point of increase.
	 
	 	(b)	 	Contractual Increases
	 
	 	 	 	For policies reinsured on an automatic basis, reinsurance of increases in amount
resulting from contractual policy provisions will be accepted only up to the
Automatic Binding Limits shown in Exhibit B.

9

 

	 	 	 	For policies reinsured on a facultative basis, reinsurance will be limited to the
ultimate amount shown in MARC’s facultative offer. Reinsurance premiums for
contractual increases will be on a point-in-scale basis from the original issue age
of the policy.

	7.3	 	Risk Classification Changes
	 
	 	 	If the policyholder requests a Table Rating reduction or
removal of a Flat Extra, such change will be underwritten
according to the Ceding Company’s, through the Administrator,
normal underwriting practices. Risk classification changes on
facultative policies will be subject to MARC’s approval.
	 
	7.4	 	Reinstatement
	 
	 	 	If a policy reinsured on an automatic basis is reinstated in
accordance with its terms and in accordance with Ceding Company
rules and procedures, MARC will, upon notification of
reinstatement, reinstate the reinsurance coverage. If a policy
reinsured on a facultative basis is reinstated, approval by MARC
will be required prior to the reinstatement of the reinsurance if
the Ceding Company’s regular reinstatement rules, through the
Administrator, indicate that more evidence than a Statement of
Good Health is required.
	 
	 	 	Upon reinstatement of the reinsurance coverage, the Ceding
Company, through the Administrator, will pay the contractual
reinsurance premiums plus accrued interest for the period and at
the interest rate for which it receives premiums in arrears.
	 
	7.5	 	Nonforfeiture Benefits

	 	(a)	 	Extended Term
	 
	 	 	 	If the original policy lapses and extended term insurance is elected under the terms
of the policy, reinsurance will continue on the same basis as under the original
policy until the expiry of the extended term period.
	 
	 	(b)	 	Reduced Paid-up
	 
	 	 	 	If the original policy lapses and reduced paid-up insurance is elected under the
terms of the policy, the amount reinsured will be reduced.
	 
	 	 	 	Reinsurance will be reduced by the full amount of the reduction. The reinsurance
premiums will be calculated in the same manner as reinsurance premiums were
calculated on the original policy. If the amount of reduction exceeds the risk
amount reinsured, the reinsurance on the policy will be terminated.

10

 

Article 8 — CONVERSIONS, EXCHANGES, AND REPLACEMENTS

If a policy reinsured under this Agreement is converted, exchanged or replaced, the Ceding
Company, through the Administrator, will promptly notify MARC. Unless mutually agreed otherwise,
policies that are not reinsured with MARC and that exchange or convert to a plan covered under this
Agreement will not be reinsured hereunder.

	8.1	 	Conversions
	 
	 	 	MARC will continue to reinsure policies resulting from the
contractual conversion of any policy reinsured under this
Agreement, in an amount not to exceed the original amount
reinsured hereunder. If the plan to which the original policy is
converting is reinsured by MARC, either under this Agreement or
under a different Agreement, reinsurance premium rates for the
resulting converted policy will be those contained in the
Agreement that covers the plan to which the original policy is
converting. However, if the new plan is not reinsured by MARC,
reinsurance premiums for a policy resulting from a contractual
conversion will be agreed upon between the parties. Reinsurance
premiums and any allowances for conversions will be on a
point-in-scale basis from the original issue age of the policy.
	 
	 	 	If the conversion results in an increase in the risk amount, the
increase will be underwritten by the Ceding Company, through the
Administrator, in accordance with its customary standards and
procedures. MARC will accept such increases, subject to the new
business provisions of this Agreement. Reinsurance premiums and
any allowances for increased risk amounts will be first-year
premiums at the agreed-upon premium rate.
	 
	8.2	 	Exchanges and Replacements
	 
	 	 	A policy resulting from an internal exchange or replacement will be underwritten by the
Ceding Company, through the Administrator, in accordance with its underwriting guidelines,
standards and procedures for exchanges and replacements. If the Ceding Company’s guidelines
treat the policy as new business, then the reinsurance will also be considered new business.
For purposes of this Article, new business is defined as those policies on which:

	 	(a)	 	the Ceding Company, through the Administrator, has obtained complete and
current underwriting evidence on the full amount; and
	 
	 	(b)	 	the full normal commissions are paid by the Ceding Company, through the
Administrator, for the new plan; and
	 
	 	(c)	 	the Suicide and Contestable provisions apply from the effective date of the new
plan.

	 	 	In the event of an internal exchange, if the state in which a replacement policy is issued
requires waiver of the suicide and/or contestable provisions, then MARC will honor that
obligation and waive the suicide and/or contestable provisions.
	 
	 	 	MARC’s approval to exchange or replace the policy will be required if the original policy
was reinsured on a facultative basis.

11

 

	 	 	If the Ceding Company’s guidelines do not treat the policy as new business, the exchange or
replacement will continue to be ceded to MARC. The rates will be based on the original
issue age, underwriting class and duration since the issuance of the original policy.

12

 

Article 9 — CLAIMS

Claims covered under this Agreement include only death claims, which are those due to the
death of the insured on a policy reinsured under this Agreement, and any additional benefits
specified in Exhibit B, which are provided by the underlying policy and are reinsured under this
Agreement.

	9.1	 	Notice
	 
	 	 	The Ceding Company, through the Administrator, will notify MARC, as soon as reasonably
possible, after it receives a claim on a policy reinsured under this Agreement.
	 
	9.2	 	Proofs
	 
	 	 	The Ceding Company, through the Administrator, will promptly provide MARC with proper
claim proofs, including a copy of the proof of payment by the Ceding Company, a copy of the
claimant statement and a copy of the insured’s death certificate. In addition, for
contestable claims, the Ceding Company, through the Administrator, will send to MARC a copy
of all papers in connection with the claim, including investigation papers, the underwriting
file and underwriter’s notes.
	 
	9.3	 	Amount and Payment of Reinsurance Benefits
	 
	 	 	As soon as MARC receives proper claim notice and proof of the claim, MARC will promptly
examine the claim and pay the reinsurance benefits due the Ceding Company as appropriate.
The Ceding Company’s contractual liability for policies reinsured under this Agreement is
binding on MARC. However, for claims incurred during the contestable period if the total
amount of reinsurance ceded to all Reinsurers on the policy is greater than the amount
retained by the Ceding Company, or if the Ceding Company retained less than its usual
retention on the policy, the Ceding Company, through the Administrator, will consult with
MARC before conceding liability or making settlement to the claimant. The Ceding Company
will wait at least ten (10) business days for MARC’s recommendation.
	 
	 	 	The total reinsurance recoverable from all companies will not exceed the Ceding Company’s
total contractual liability on the policy, less the amount retained. The maximum
reinsurance death benefit payable to the Ceding Company under this Agreement is the risk
amount specifically reinsured with MARC. MARC will also pay its proportionate share of the
interest that the Ceding Company pays on the death proceeds until the date of settlement.
	 
	 	 	Life benefit payments will be made in a single sum, regardless of the Ceding Company’s
settlement options.
	 
	9.4	 	Contestable Claims
	 
	 	 	The Ceding Company, through the Administrator, will promptly notify MARC of its
intention to contest, compromise, or litigate a claim involving a reinsured policy. The
Ceding Company will also promptly and fully disclose all information relating to the claim.
Once notified, MARC will have fifteen (15) business days to notify the Ceding Company,
through the Administrator, in writing of its decision to accept participation in the
contest, compromise, or litigation. If MARC has accepted participation, the Ceding Company,

13

 

	 	 	through the Administrator, will promptly advise MARC of all significant developments in the
claim investigation, including notification of any legal proceedings against it in response
to denial of the claim.
	 
	 	 	If MARC does not accept participation, MARC will then fulfill its obligation by paying the
Ceding Company its full share of the reinsurance amount, and will not share in any
subsequent reduction or increase in liability.
	 
	 	 	If MARC accepts participation and the Ceding Company’s contest, compromise, or litigation
results in a reduction or increase in liability, MARC will share in any such reduction or
increase in proportion to its share of the risk on the contested policy.
	 
	9.5	 	Claim Expenses
	 
	 	 	MARC will pay its share of reasonable claim investigation and legal expenses connected
with the litigation or settlement of contractual liability claims unless MARC has discharged
its liability pursuant to Section 9.4 above. If MARC has so discharged its liability, MARC
will not participate in any expenses incurred thereafter.
	 
	 	 	MARC will not reimburse the Ceding Company, through the Administrator, for routine claim and
administration expenses, including but not limited to the Ceding Company’s home office
expenses, compensation of salaried officers and employees, and any legal expenses other than
third party expenses incurred by the Ceding Company, through the Administrator. Claim
investigation expenses do not include expenses incurred by the Ceding Company, through the
Administrator, as a result of a dispute or contest arising out of conflicting claims of
entitlement to policy proceeds or benefits.
	 
	 	 	Furthermore, MARC will not reimburse the Ceding Company, through the Administrator, for any
expenses, if said expense was not incurred by the Ceding Company, through the Administrator,
while investigating, defending or settling a claim.
	 
	9.6	 	Misrepresentation or Suicide
	 
	 	 	If the Ceding Company, through the Administrator, returns premium to the policyowner or
beneficiary as a result of misrepresentation or suicide of the insured, MARC will refund its
proportionate share of the premium refund to the Ceding Company in lieu of any other form of
reinsurance benefit payable under this Agreement.
	 
	9.7	 	Misstatement of Age or Sex
	 
	 	 	In the event of a change in the amount of the Ceding Company’s liability on a reinsured
policy due to a misstatement of age or sex, MARC’s liability will change proportionately.
The face amount of the reinsured policy will be adjusted from the inception of the policy,
and any difference will be settled without interest.
	 
	9.8	 	Extra-Contractual Damages
	 
	 	 	MARC will not participate in punitive or compensatory damages that are awarded against
the Ceding Company as a result of an act, omission, or course of conduct committed solely by
the Ceding Company, its agents, or representatives in connection with claims covered under
this Agreement. MARC will, however, pay its share of statutory penalties awarded against
the Ceding Company in connection with claims covered under this Agreement if MARC elected in
writing to join in the contest of the coverage in question.

14

 

	 	 	The parties recognize that circumstances may arise in which equity would require MARC, to
the extent permitted by law, to share proportionately in punitive and compensatory damages.
Such circumstances are difficult to define in advance, but would generally be those
situations in which MARC was an active party and, in writing, recommended, consented to, or
ratified the act or course of conduct of the Ceding Company that ultimately resulted in the
assessment of the extra-contractual damages. In such situations, MARC and the Ceding
Company will share such damages so assessed, in equitable proportions.
	 
	 	 	For purposes of this Article, the following definitions will apply.
	 
	 	 	“Punitive Damages” are those damages awarded as a penalty, the amount of which is
neither governed nor fixed by statute.
	 
	 	 	“Compensatory Damages” are those amounts awarded to compensate for the actual
damages sustained, and are not awarded as a penalty, nor fixed in amount by statute.
	 
	 	 	“Statutory Penalties” are those amounts awarded as a penalty, but are fixed in
amount by statute.

15

 

Article 10 — RETENTION LIMIT CHANGES

	10.1	 	If the Ceding Company changes its maximum retention limits as shown in Exhibit A, it will
provide MARC with written notice of the intended changes thirty (30) days in advance of their
effective date.
	 
	 	 	A change to the Ceding Company’s maximum retention limits will not affect the reinsured
policies in force except as specifically provided elsewhere in this Agreement. Furthermore,
unless agreed between the parties, an increase in the Ceding Company’s retention schedule
will not effect an increase in the total risk amount that it may automatically cede to MARC.

16

 

Article 11 — RECAPTURE

	11.1	 	Whenever the Ceding Company increases its maximum retention limits over the maximum
retention limits set forth in Exhibit A, the Ceding Company, through the Administrator, has
the option to recapture certain risk amounts. If the Ceding Company has maintained its
maximum stated retention (not a special retention limit) for the plan and the insured’s issue
age, sex, and mortality classification, it may apply its increased retention limits to reduce
the amount of reinsurance in force as follows.

	 	(a)	 	The Ceding Company, through the Administrator, must give MARC thirty (30) days
written notice prior to the commencement of recapture.
	 
	 	(b)	 	The reduction of reinsurance on affected policies will become effective on the
policy anniversary date immediately following the notice of election to recapture;
however, no reduction will be made until a policy has been in force for at least twenty
(20) years.
	 
	 	(c)	 	If any reinsured policy is recaptured, all reinsured policies eligible for
recapture under the provisions of this Article must be recaptured up to the Ceding
Company’s new maximum retention limits in a consistent manner and the Ceding Company
must increase its total amount of insurance on each reinsured life. The Ceding Company
may not revoke its election to recapture for policies becoming eligible at future
anniversaries.

	 	 	If portions of the reinsured policy have been ceded to more than one reinsurer, the
Ceding Company, through the Administrator, must allocate the reduction in reinsurance so
that the amount reinsured by each reinsurer after the reduction is proportionately the same
as if the new maximum dollar retention limits had been in effect at the time of issue.
	 
	 	 	The amount of reinsurance eligible for recapture is based on the current amount at risk as
of the date of recapture. For a policy issued as a result of exchange, conversion, or
re-entry, the recapture terms of the reinsurance agreement covering the original policy will
apply, and the duration period for the purpose of recapture will be measured from the
effective date of the reinsurance on the original policy.
	 
	 	 	If there is a reinsured waiver of premium claim in effect when recapture takes place, MARC
will continue to pay its share of the waiver claim until it terminates. MARC will not be
liable for any other benefits, including the basic life risk, that are eligible for
recapture. All such eligible benefits will be recaptured as if there were no waiver claim in
effect.
	 
	 	 	After the effective date of recapture, MARC will not be liable for any reinsured policies or
portions of such reinsured policies eligible for recapture that the Ceding Company has
overlooked.
	 
	 	 	No recapture will be permitted if the Ceding Company has either obtained or increased stop
loss reinsurance coverage as justification for the increase in retention limits.

17

 

Article 12 — GENERAL PROVISIONS

	12.1	 	Currency
	 
	 	 	All payments and reporting by both parties under this Agreement will be made in United
States dollars.
	 
	12.2	 	Premium Tax
	 
	 	 	MARC will not reimburse the Ceding Company for premium taxes.
	 
	12.3	 	Inspection of Records
	 
	 	 	MARC and the Ceding Company, or their duly authorized representatives, will have the
right to inspect original papers, records, and all documents relating to the business
reinsured under this Agreement including underwriting, claims processing, and
administration. Such access will be provided during regular business hours at the office of
the inspected party.
	 
	12.4	 	Forms, Manuals & Issue Rules
	 
	 	 	The Ceding Company affirms that its retention schedule,
underwriting guidelines, issue rules, premium rates and policy
forms applicable to the Reinsured Policies and in use as of the
effective date, have been supplied to MARC.
	 
	 	 	It is the Ceding Company’s responsibility to ensure that its
practice and applicable forms are in compliance with current
Medical Information Bureau (MIB) guidelines.
	 
	12.5	 	Interest Rate
	 
	 	 	If, under the terms of this Agreement, interest is accrued on amounts due either party,
such interest will be calculated using the 180 day treasury rate as reported in the Wall
Street Journal on the date the payment becomes due, except as it pertains to Article 9, and
outlined elsewhere in this Agreement.
	 
	12.6	 	Other
	 
	 	 	MARC will not participate in gross annual premiums and
policy fees paid by the policyholder, expense charges, cash
values, accumulation fund amounts, dividends nor any benefits
not expressly referred to herein.

18

 

Article 13 — DAC TAX

	13.1	 	The parties to this Agreement agree to the following provisions pursuant to Section
1.848-2(g)(8) of the Income Tax Regulations effective December 29, 1992, under Section 848 of
the Internal Revenue Code of 1986, as amended:

	 	(a)	 	The term ‘party’ refers to either the Ceding Company or MARC, as appropriate.
	 
	 	(b)	 	The terms used in this Article are defined by reference to Regulation Section
1.848-2, effective December 29, 1992.
	 
	 	(c)	 	The party with the net positive consideration for this Agreement for each
taxable year will capitalize specified policy acquisition expenses with respect to this
Agreement without regard to the general deductions limitation of Section 848(c)(1).
	 
	 	(d)	 	Both parties agree to exchange information pertaining to the amount of net
consideration under this Agreement each year to ensure consistency, or as otherwise
required by the Internal Revenue Service.
	 
	 	(e)	 	The Ceding Company will submit a schedule to MARC by April 1 of each year with
its calculation of the net consideration for the preceding calendar year. This
schedule of calculations will be accompanied by a statement signed by an officer of the
Ceding Company stating that the Ceding Company will report such net consideration in
its tax return for the preceding calendar year. MARC may contest such calculation by
providing an alternative calculation to the Ceding Company in writing within thirty
(30) days of MARC’s receipt of the Ceding Company’s calculation. If MARC does not so
notify the Ceding Company within the required timeframe, MARC will report the net
consideration as determined by the Ceding Company in MARC’s tax return for the previous
calendar year.
	 
	 	(f)	 	If MARC contests the Ceding Company’s calculation of the net consideration, the
parties will act in good faith to reach an agreement as to the correct amount within
thirty (30) days of the date MARC submits its alternative calculation. If the Ceding
Company and MARC reach an agreement on an amount of net consideration, each party will
report the agreed upon amount in its tax return for the previous calendar year.
	 
	 	(g)	 	Both the Ceding Company and MARC represent and warrant that they are subject to
United States taxation under either Subchapter L or Subpart F of Part III of Subchapter
N of the Internal Revenue Code of 1986, as amended.

19

 

Article 14 — OFFSET

	14.1	 	Any debts or credits, in favor of or against either MARC or the Ceding Company with
respect to this Agreement or any other reinsurance agreement between the parties, are deemed
mutual debts or credits and may be offset and only the balance will be allowed or paid.
	 
	 	 	The right of offset will not be affected or diminished because of the insolvency of either
party.

20

 

Article 15 — INSOLVENCY

	15.1	 	Insolvency of a Party to this Agreement
	 
	 	 	A party to this Agreement will be deemed insolvent when it:

	 	(a)	 	applies for or consents to the appointment of a receiver, rehabilitator,
conservator, liquidator or statutory successor of its properties or assets; or
	 
	 	(b)	 	is adjudicated as bankrupt or insolvent; or
	 
	 	(c)	 	files or consents to the filing of a petition in bankruptcy, seeks
reorganization to avoid insolvency or makes formal application for any bankruptcy,
dissolution, liquidation or similar law or statute; or
	 
	 	(d)	 	becomes the subject of an order to rehabilitate or an order to liquidate as
defined by the insurance code of the jurisdiction of the party’s domicile.

	15.2	 	Insolvency of the Ceding Company
	 
	 	 	In the event of the insolvency of the Ceding Company, all reinsurance payments due
under this Agreement will be payable directly to the liquidator, rehabilitator, receiver, or
statutory successor of the Ceding Company, without diminution because of the insolvency, for
those claims allowed against the Ceding Company by any court of competent jurisdiction or by
the liquidator, rehabilitator, receiver or statutory successor having authority to allow
such claims.
	 
	 	 	In the event of insolvency of the Ceding Company, the liquidator, rehabilitator, receiver,
or statutory successor will give written notice to MARC of all pending claims against the
Ceding Company on any policies reinsured within a reasonable time after such claim is filed
in the insolvency proceeding. While a claim is pending, MARC may investigate and interpose,
at its own expense, in the proceeding where the claim is adjudicated, any defense or
defenses that it may deem available to the Ceding Company or its liquidator, rehabilitator,
receiver, or statutory successor.
	 
	 	 	The expense incurred by MARC will be chargeable, subject to court approval, against the
Ceding Company as part of the expense of liquidation to the extent of a proportionate share
of the benefit that may accrue to the Ceding Company solely as a result of the defense
undertaken by MARC. Where two or more reinsurers are participating in the same claim and a
majority in interest elect to interpose a defense or defenses to any such claim, the expense
will be apportioned in accordance with the terms of this Agreement as though such expense
had been incurred by the Ceding Company.
	 
	 	 	MARC will be liable only for the amounts reinsured and will not be or become liable for any
amounts or reserves to be held by the Ceding Company on policies reinsured under this
Agreement.

21

 

Article 16 — ERRORS AND OMISSIONS

	16.1	 	This provision will apply to oversights, misunderstandings or clerical errors relating to
the administration of reinsurance covered by this Agreement. If through unintentional error,
oversight, omission, or misunderstanding (collectively referred to as “errors”), MARC or the
Ceding Company, through their Administrator, fails to comply with the terms of this Agreement
and if, upon discovery of the error by either party, the other is promptly notified, each
thereupon will be restored to the position it would have occupied if the error had not
occurred, including interest, except as provided for in Article 3.
	 
	 	 	If it is not possible to restore each party to the position it would have occupied but for
the error, the parties will endeavor in good faith to promptly resolve the situation in a
manner that is fair and reasonable, and most closely approximates the intent of the parties
as evidenced by this Agreement.
	 
	 	 	However, MARC will not provide reinsurance for policies that do not satisfy the parameters
of this Agreement, nor will MARC be responsible for negligent or deliberate acts or for
repetitive errors in administration by the Ceding Company, through their Administrator.
Upon discovery of such errors, the Ceding Company, through the Administrator, will endeavor
to correct such errors within ninety (90) days; otherwise, there will be no reinsurance on
the affected policies. If either party discovers that the Ceding Company, through the
Administrator, has failed to cede reinsurance as provided in this Agreement, or failed to
comply with its reporting requirements, MARC may require the Ceding Company, through their
Administrator, to audit its records for similar errors and to take the actions necessary to
avoid similar errors in the future. If MARC has received no evidence that the Ceding
Company, through the Administrator, has taken action to remedy such a situation, MARC’s
liability is limited to correctly reported policies only.

22

 

Article 17 — DISPUTE RESOLUTION

	17.1	 	In the event of a dispute arising out of or relating to this agreement, the parties agree
to the following process of dispute resolution. Within thirty (30) days after MARC or the
Ceding Company has first given the other party written notification of a specific dispute,
each party will appoint a designated company officer to attempt to resolve the dispute. The
officers will meet at a mutually agreeable location as soon as possible and as often as
necessary, in order to gather and furnish the other with all appropriate and relevant
information concerning the dispute. The officers will discuss the problem and will negotiate
in good faith without the necessity of any formal arbitration proceedings. During the
negotiation process, all reasonable requests made by one officer to the other for information
will be honored. The designated officers will decide the specific format for such
discussions.
	 
	 	 	If the officers cannot resolve the dispute within thirty (30) days of their first meeting,
the dispute will be submitted to formal arbitration, unless the parties agree in writing to
extend the negotiation period for an additional thirty (30) days.

23

 

Article 18 — ARBITRATION

	18.1	 	It is the intention of MARC and the Ceding Company that the customs and practices of the
life insurance and reinsurance industry will be given full effect in the operation and
interpretation of this Agreement. The parties agree to act in all matters with the highest
good faith. If MARC and the Ceding Company cannot mutually resolve a dispute that arises out
of or relates to this Agreement, and the dispute cannot be resolved through the dispute
resolution process described in Article 17, the dispute will be decided through arbitration.
	 
	 	 	To initiate arbitration, either the Ceding Company or MARC will notify the other party in
writing of its desire to arbitrate, stating the nature of its dispute and the remedy sought.
The party to which the notice is sent will acknowledge to the notification in writing
within fifteen (15) days of its receipt.
	 
	 	 	There will be three arbitrators who will be current or former officers of life insurance or
life reinsurance companies other than the parties to this Agreement, their affiliates or
subsidiaries. Each of the parties will appoint one of the arbitrators and these two
arbitrators will select the third. If either party refuses or neglects to appoint an
arbitrator within sixty (60) days of the initiation of the arbitration, the other party may
appoint the second arbitrator. If the two arbitrators do not agree on a third arbitrator
within sixty (60) days of the appointment of the second arbitrator, then each arbitrator
shall nominate three candidates [within ten (10) days thereafter], two of whom the other
shall decline, and the decision shall be made by drawing lots for the final selection.
	 
	 	 	Once chosen, the arbitrators are empowered to select the site of the arbitration and decide
all substantive and procedural issues by a majority of votes. As soon as possible, the
arbitrators will establish arbitration procedures as warranted by the facts and issues of
the particular case. The arbitrators will have the power to determine all procedural rules
of the arbitration including but not limited to inspection of documents, examination of
witnesses and any other matter relating to the conduct of the arbitration. The arbitrators
may consider any relevant evidence; they will weigh the evidence and consider any
objections. Each party may examine any witnesses who testify at the arbitration hearing.
	 
	 	 	The arbitrators will base their decision on the terms and conditions of this Agreement and
the customs and practices of the life insurance and reinsurance industries rather than on
strict interpretation of the law. The decision of the arbitrators will be made by majority
rule and will be submitted in writing. The decision will be final and binding on both
parties and there will be no appeal from the decision. Either party to the arbitration may
petition any court having jurisdiction over the parties to reduce the decision to judgment.
The arbitrators may not award any exemplary or punitive damages.

24

 

	 	 	Unless the arbitrators decide otherwise, each party will bear the expense of its own
arbitration activities, including its appointed arbitrator and any outside attorney and
witness fees. The parties will jointly and equally bear the expense of the third arbitrator
and other costs of the arbitration.
	 
	 	 	This Article will survive termination of this Agreement.

25

 

Article 19 — CONFIDENTIALITY

	19.1	 	Privacy
	 
	 	 	MARC agrees to treat Customer Information provided by the Ceding Company as confidential, as prescribed under
Federal and State laws and regulations related to privacy. Customer Information includes, but is not limited to,
medical, financial, and other personal information about proposed, current, and former policyowners, insureds,
applicants, and beneficiaries of policies issued by the Ceding Company. MARC may disclose such information to its
retrocessionaires as necessary to perform its internal risk-management functions and to comply with retrocessionaire
requirements. MARC may also disclose such information to its external auditors as necessary to comply with audit
requirements. MARC will take reasonable steps to assure such outside parties maintain the confidentiality of
Customer Information.
	 
	 	 	MARC will furnish to the Ceding Company a copy of MARC’s privacy policy upon request.
	 
	19.2	 	Proprietary Information

	 	(a)	 	The Ceding Company and MARC acknowledge that compliance with the terms of this
agreement requires that they exchange Proprietary Information with each other.
	 
	 	(b)	 	Proprietary Information includes, but is not limited to, business plans, trade
secrets, experience studies, underwriting manuals, guidelines and decisions,
applications, policy forms, quote terms, actuarial data and assumptions, valuations,
financial condition, and the specific terms and conditions of this agreement.
	 
	 	(c)	 	Proprietary Information will not include information that:

	 	(i)	 	is or becomes available to the general public other than as a
result of disclosure by the party receiving the information (hereinafter the
“Recipient”);
	 
	 	(ii)	 	is developed independently by the Recipient;
	 
	 	(iii)	 	is acquired by the Recipient from a third party that is not
known by the Recipient to be bound to keep the information confidential; or
	 
	 	(iv)	 	was already within the possession of the Recipient, and not
subject to a confidentiality agreement, prior to being furnished by the other
party.

	19.3	 	MARC and the Ceding Company shall hold all Proprietary Information received from the other
party in confidence and will not disclose such information except to their own directors,
officers, employees, affiliates, and advisors (collectively the “Representatives”) who need to
know such information in connection with the proper execution of this agreement. MARC and the
Ceding Company shall inform all Representatives of the confidentiality of the Proprietary
Information and will direct such Representatives to treat the information accordingly.
	 
	19.4	 	MARC may disclose Proprietary Information to its retrocessionaires or MIB as necessary to
perform its internal risk-management functions and to comply with retrocessionaire

26

 

	 	 	requirements.The Ceding Company or MARC may disclose Proprietary Information to its
external auditors as necessary to comply with audit requirements. The parties will take
reasonable steps to assure such outside parties maintain the confidentiality of such
Proprietary Information.
	 
	19.5	 	Either party may disclose Proprietary Information when legally compelled to do so. In such
event, the party so compelled will provide the other party with prompt notice prior to
disclosure so that the other party may seek an appropriate remedy.
	 
	19.6	 	The provisions of this Article survive for two years beyond the termination of the last in
force policy reinsured under this Agreement.

27

 

Article 20 — DURATION OF AGREEMENT

	20.1	 	This Agreement is indefinite as to its duration. The Ceding Company or MARC may
terminate this Agreement with respect to the reinsurance of new business by giving thirty (30)
days written notice of termination to the other party, sent by certified mail. The first day
of the notice period is deemed to be the date the document is postmarked.
	 
	 	 	During the notification period, the Ceding Company, through the Administrator, will continue
to cede and MARC will continue to accept policies covered under the terms of this Agreement.
Reinsurance coverage on all reinsured policies will remain in force until the termination
or expiry of the policies or until the contractual termination of reinsurance under the
terms of this Agreement, whichever occurs first.

28

 

Article 21 — EXECUTION

	21.1	 	This Agreement is effective as of February 1, 2007, and applies to all eligible policies
with issue dates on or after such date and to eligible policies applied for on or after such
date that were backdated for up to six (6) months to save age. This Agreement has been made
in duplicate and is hereby executed by all parties.

	 	 	 	 	 	 	 
	Trinity Life Insurance Company	 	Munich American Reassurance Company
	 
	 	 	 	 	 	 
	By:

	 	 	 	By:	 	 
	 

	 	 
	 	 	 	 
	 

	 	(signature)
	 	 	 	(signature)
	 
	 	 	 	 	 	 
	 

	 	 
	 	 	 	 
	 

	 	(print or type name)
	 	 	 	(print or type name)
	 
	 	 	 	 	 	 
	Title:

	 	 	 	Title:	 	 
	 

	 	 
	 	 	 	 
	 
	 	 	 	 	 	 
	Date:

	 	 	 	Date:	 	 
	 

	 	 
	 	 	 	 
	 
	 	 	 	 	 	 
	Location:

	 	 	 	Location:	 	 
	 

	 	 
	 	 	 	 
	 
	 	 	 	 	 	 
	Attest:

	 	 	 	Attest:	 	 
	 

	 	 
	 	 	 	 
	 

	 	(signature)
	 	 	 	(signature)
	 
	 	 	 	 	 	 
	Title:

	 	 	 	Title:	 	 
	 

	 	 
	 	 	 	 

29

 

Exhibit A

RETENTION LIMITS OF THE CEDING COMPANY AND FIRST EXCESS REINSURANCE LIMITS

	A.1	 	Maximum Limits of Retention
	 
	 	 	Trinity Life and the First Excess Reinsurer will retain the first $80,000 between them.
Trinity Life will retain a maximum of $55,000 and the First Excess Reinsurer will retain a
maximum of $25,000.

30

 

Exhibit B

PLANS COVERED AND BINDING LIMITS

The business automatically reinsured under this Agreement is defined as follows. Reinsurance
will only be on the mortality risk portion of the Life Insurance Benefit.

	B.1	 	Plans, Riders and Benefits
	 
	 	 	Policies issued on plans with effective dates within the applicable period shown below may
qualify for automatic reinsurance under the terms of this Agreement.

	 	 	 	 	 	 	 
	 	 	 	 	Commencement	 	Termination
	Plan Identification	 	Form No.	 	Date	 	Date
	Modified Whole Life
	 	TLIC-1 (10/06)
	 	February 1, 2007	 	 
	 	 	 	 	 	 	 
	Riders and Benefits:	 	 	 	 	 	 
	Accidental Death Benefit 

Rider*
	 	TLIC-3
	 	*The ADB Rider is

not covered under

this agreement, but

will be reinsured

on a bulk basis

under a separate

agreement.	 	 

	B.2	 	Basis
	 
	 	 	MARC’s share will be 100% of the second excess over $80,000. This amount will not exceed
MARC’s share of the maximum Automatic Binding Limits specified in Exhibit B.3.

	B.3	 	Automatic Binding Limits

	 	(a)	 	Life

	 	 	 	 	 	 	 
	Issue	 	Standard	 	 	 	 
	Ages	 	(Non Rated)	 	Tables 1 - 8	 	Tables 8+
	0-80
	 	$250,000
	 	$250,000
	 	n/a

	 	 	 	Issue amounts greater than $250,000 may be submitted to MARC for facultative
consideration.
	 
	 	 	 	The maximum autobind amount above includes the Ceding Company’s retention and the
first excess retention.

 

 

Exhibit B

(continued)

	B.4	 	Jumbo Limits
	 
	 	 	The Ceding Company will not cede any risk automatically if, according to information
available to the Ceding Company, the total amount in force and applied for on the life with
all insurance companies, including any amount to be replaced, exceeds the applicable
amounts shown below.

	 	(a)	 	Life: $1,000,000

 

 

Exhibit C

FORMS, MANUALS AND ISSUE RULES

 

 

TRINITY LIFE INSURANCE COMPANY

Age-Amount Medical and Non-Medical Requirements

	 	 	 	 	 	 	 	 	 	 	 	 	 
	INITIAL	 	 
	AMOUNT	 	AGE
	 	 	0-20	 	21-35	 	36-50	 	51-55	 	56-60	 	61-80
	 
	-0-
to

$50,000
	 	Non-medical
	 	Non-medical
	 	Non-medical
	 	Non-medical
	 	Non-medical
	 	Paramedical

HOS
	 	 	 	 	 	 	 	 	 	 	 	 	 
	$50,001

 to

$55,000
	 	Non-medical
	 	Non-medical
	 	Non-medical
	 	Non-medical
	 	HOS
	 	Paramedical

HOS
	 	 	 	 	 	 	 	 	 	 	 	 	 
	$55,001 
to

$99,999
	 	Non-medical
	 	Non-medical
	 	Non-medical
	 	HOS
	 	Paramedical

HOS
	 	Paramedical

HOS
	 	 	 	 	 	 	 	 	 	 	 	 	 
	$100,000 
to

$250,000
	 	HOS
	 	HOS
	 	Paramedical 
HOS

Blood Profile
	 	Paramedical
 HOS

Blood Profile
	 	Paramedical 
HOS

Blood Profile
	 	Paramedical 
HOS
 Blood
Profile
	 	 	 	 	 	 	 	 	 	 	 	 	 
	$250,001 
to

$500,000
	 	Paramedical 
HOS

Blood Profile
	 	Paramedical 
HOS

Blood Profile
	 	Paramedical
 HOS

Blood Profile 
EKG
	 	Paramedical
 HOS

Blood Profile 
EKG
	 	MD Exam 
HOS

Blood Profile
 EKG
	 	MD Exam
 HOS
 Blood Profile

EKG
	 	 	 	 	 	 	 	 	 	 	 	 	 
	$500,001 
To

$1,000,000
	 	MD Exam
 HOS

Blood Profile
 EKG
	 	MD Exam
 HOS

Blood Profile 
EKG
	 	MD Exam
 HOS

Blood Profile
 EKG
	 	MD Exam
 HOS

Blood Profile
 EKG
	 	MD Exam
 HOS

Blood Profile

EKG
	 	MD Exam 
HOS

Blood Profile

EKG
	 	 	 	 	 	 	 	 	 	 	 	 	 
	$1,000,001

plus
	 	Consult

Underwriting
	 	Consult

Underwriting
	 	Consult

Underwriting
	 	Consult

Underwriting
	 	Consult

Underwriting
	 	Consult

Underwriting

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTICE OF INFORMATION PRACTICES

This Notice To Be Detached and Retained by Insured

(Including Medical Information Bureau Notice and Fair Credit Reporting Act Notice)

     In considering your application, information from various sources will be considered.
These include your statements, the results of your physical examination (if required), and reports
we get from doctors or medical facilities which have attended you.

     Information about your insurability will be treated as confidential. We, or our reinsurer(s),
may, however, make a brief report of this to the Medical Information Bureau, a nonprofit membership
organization of life insurance companies, which operates an information exchange on behalf of its
members. If you apply to another Bureau member company for life or health insurance coverage, or a
claim for benefits is submitted to such a company, the Bureau, upon request, will supply such
company with the information in its file.

     Upon the receipt of a request from you, the Bureau will arrange disclosure of any information
it may have in your file. if you question the accuracy of the information in the Bureau’s file, you
may contact the Bureau and seek a correction in accordance with the procedures set forth in the
Federal Fair Credit Reporting Act. The address of the Bureau’s information office is Post Office
Box 105, Essex Station, Boston, Massachusetts 02112, telephone number(617)426-3660.

TLIC 21001 OK (01-2007)

 

 

I (We) represent that all statements and answers in this application are full, complete
and true to the best of my (our) knowledge and belief. I (we) understand that said statements and
answers are submitted as evidence of insurability of each person insured under the policy. It is
agreed that this policy will not be reinstated and the company will have no liability until (1)
all money required for reinstatement of this policy has been paid; (2) this application has been
approved by Trinity Life Insurance Company Home Office during the lifetime of all persons who
would be insured under this policy if reinstated. It is further agreed that with regard to the
statements and answers provided above, any period of contestability provided in the policy shall
run anew from the effective date of reinstatement.

I HEREBY AUTHORIZE any licensed physician, medical practitioner, hospital, clinic or other medical
or medically related facility, insurance company, consumer reporting agency, the Department of
Motor Vehicles (or other appropriate state agency), or the Medical Information Bureau that has any
records or knowledge of me or my health, to give Trinity Life Insurance Company, or its
reinsurer(s), such information as may be needed to consider my application for insurance. Such
information may include records or knowledge of my health, motor vehicle records, aviation
activities, hazardous sports or hobbies or avocations, and occupation. A photographic copy of this
authorization shall be as valid as the original. The purpose for which this information is being
collect is to consider your application for insurance. You or your authorized representative is
entitled to receive a copy of this authorization.

This authorization shall be valid for 24 months from the date shown below. A photographic copy
shall be as valid as the original. I have the right to revoke this authorization at anytime by
sending a revocation in writing to Trinity Life Insurance Company, 7633 East 63rd Place, Suite 230,
Tulsa, OK 74133. Attention: Underwriting Department. I have received a copy of the Notice of
Information Practices.

ANY PERSON WHO KNOWINGLY PRESENTS A FALSE OR FRAUDULENT CLAIM FOR PAYMENT OF A LOSS OR
BENEFIT OR KNOWINGLY PRESENTS FALSE INFORMATION IN AN APPLICATION FOR INSURANCE MAY BE GUILTY OF A
CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN PRISON.

	 	 	 	 	 
	DATE:
	 	 	 	 
	 

	 	 
	 	 
	 

	 	 	 	Signature of Owner (Always Required)
	 
	 	 	 	 
	WITNESS:
	 	 	 	 
	 

	 	 
	 	 
	 

	 	 	 	Signature of Insured, if other than Owner

(or Parent if insured is minor)

TLIC 21001 OK (01-2007)

 

NOTICE OF INFORMATION PRACTICES continued

     We or our reinsurer(s), may also release information to other life insurance companies to
whom you apply for life or health insurance, or to whom a claim is submitted.

     In addition, we may get an investigative report from a consumer reporting agency. This report
requires personal interviews with your neighbors, friends, or other acquaintances for information
as to your general reputation, personal characteristics and mode of living. As part of your
application, you have authorized us to do this. You have the right to be personally interviewed and
to make a written request within a reasonable period about the nature and scope of this
investigation. Upon written request you will be told if such a report has actually been ordered,
and if it has, we will give you the name and address of the consumer reporting agency. You may
contact this consumer reporting agency and ask for a copy of such report. Unless a legitimate
business need exists or we are required to do so by law, the information we get in this report, as
well as any other information which we later acquire, wiil not be disclosed to anyone else without
your consent. You may request a copy of all information acquired by us and have a right to correct
any personal information which you feel is inaccurate. We will, if required by law, give you a more
detailed notice of the types of personal information which we get in considering your application,
as well as any additional rights which you may have.

     If you need any assistance, please feel free to contact your agent or call or write to us at
Investors Heritage Life Insurance Company, Underwriting Department, 200 Capital Avenue, PO Box
717, Frankfort, Kentucky 40602-0717.

TLIC 21001 OK (01-2007)

 

 

7633 East 63rd Place, Suite 230

Tulsa, OK 74133

Phone: (918) 249-2438  Fax: (918) 249-2478

STATEMENT OF HEALTH AND INSURABILITY

COMPLETED AS A CONDITION TO THE DELIVERY OR CHANGE OF

	 	 	 
	 
	 	 
	POLICY NUMBER
	 	PROPOSED INSURED

Since the date of the original application for the above policy, each person proposed for
Life Insurance in such application has continued in good health and no person proposed for Life or
Health Insurance or both:

	 	1.	 	has made application to another company for Life or Health Insurance (2) which
has been issued, declined, postponed or modified, or (b) which is pending at the
present time, or;
	 
	 	2.	 	has consulted or been examined or treated by a physician or practitioner , or;
	 
	 	3.	 	has had any change in health or insurability as a Life or Health Insurance risk
be cause of any event or circumstance.

If there are any exceptions to any of the above statement, give full details in space
provided:

EXCEPTIONS

The person named as the Insured and the Applicant (if other than such person) represent that
the foregoing statements are true and complete and that all exceptions have been stated.

	 	 	 	 	 
	Dated at:
	 	 	 	 
	 

	 	 
	 	 
	 

	 	(City and state)
	 	Signature of the Insured
	 
	 	 	 	 
	This                      of                     ,                     	 	 
	               DAY            MONTH           YEAR	 	 
	 

	 	 	 	 
	 

	 	 	 	Signature of Applicant if Other

Than the Above Person
	 
	 	 	 	 
	 	 	 
	Signature of Agent
	 	 

TLIC 516 (01-2007)

 

 

 

 

	CONFIDENTIAL FINANCIAL QUESTIONNAIRE APPLICATION SUPPLEMENT (continued)

	7. Purpose of Business Insurance
Key Executive Deferred Compensation Buy-Sell Agreement/Stock Repurchase
Is there a written Buy/Sell agreement in effect? (If yes, attach copy.) Yes No
Is there a Buy/Sell agreement contemplated? Yes No
Creditor: Name of Lender
Is insurance requested by lender? Yes            No Coverage Amount required by Creditor: $
-

	Type of loan? Line of Credit            Mortgage Other (explain)
If line of Credit
Amount of credit extended $
-
Amount activated to date $        Duration of loan
-
If other than Line of Credit: Amount of loan $        Duration of loan
-
Purpose of loan:

	Other Purposes – Explain:

	(Use “Remarks” below for further details)
8, Are other Corporate Officers or Partners being insured? Yes No
If Yes, give details. If No, explain:

	9. What Percentage of the business do you own? %
—
10. Estimated Fair Market Value $
-
(In “Remarks,” state how this value was determined)
11. Financial Details of Business: CURRENT FISCAL            PREVIOUS
YEAR TO DATE            FISCAL YEAR

	thru
A. Total Assets.......................................................... $ $
 —  —
B. Total Liabilities.......................................................
C. Gross Sales or Revenue.......................................
D. Net Income (before taxes)........................................
PLEASE SUBMIT A COPY OF THE MOST RECENT BALANCE SHEET AND INCOME STATEMENT (Year or Quarter).

	Remarks (Questions 7 to11):

	I understand that Trinity Life Insurance Company will rely on the above statements in determining the need and justification for the insurance applied for, and I represent that all answers are true and accurate statements
to the best of my knowledge and belief as of the date of the application for life insurance. A photographic copy of this statement may be attached to and made part of any insurance contract issued:

	Signature of Proposed Insured: Date

	Signature of Applicant: Date

	Witnessed by            Date

 

 

	7633 East 63rd Place, Suite 230
Tulsa, OK 74133
Phone: (918) 249-2438 Fax: (918) 249-2478

	AVIATION QUESTIONNAIRE

	Name of Proposed Insured: Date of Birth:
Section I            For Pilots, Students and Crew Members:

	Hours Flown Total of Solo Hours Flown            Total Hours Flown            Estimated Hour Flying

	As Pilot or Crew Member: In Past 12 Months: In Next 12 Months:

	Pilot Certificate
Section II            currently held: Private            Instrument Flight Rating (IFR)

	Student            Commercial

	Airline Transport Rating (ATR) Flight Instructor

	Have you ever been grounded or had your license revoked? Yes No (If “Yes”, give details in Remarks below)

	Section III            Type of Flying:

	Type Pleasure            Freight Carrying or Passenger Service

	Flying Personal Business            Instructor

	Crop Dusting            Other (Give details in Remarks below.)

	Employer Aircraft or Employee Transportation

	Section IV (a) Medical Certificate currently held: class III            class II            class I

	Medical (b) Date of last renewal            Month: Day            Year

	Certificate (c) Was it denied by the Aviation Medical Examiner but eventually issued?........................ Yes No

	(d) Was it necessary to appeal before Certificate was eventually issued?.......................... Yes No

	(e) Was Medical Certificate granted subject to limitations(s) or physical waivers(s)?..... Yes No

	(If any of the above questions is answered “Yes”, please give details in Remarks below.)

	Section V (a) Military Branch or Organization:

	Military (b) Type Aircraft: Date of Last Flight:

	Flying (c) If not pilot, specify capacity in which you fly:

	Section VI            Other Type of Flying:

	Other (a) Have you ever flown or do you intend to fly:

	Flying Ultralight, Biplane, Prototype, experimental or personally built or assembled aircraft? Yes No

	(If “Yes”, complete Avocation Questionnaire, Page 8.)

	(b) Have you within the past 12 months, or do you contemplate flying in the Civil Air Patrol? Yes No

	(c) Do you contemplate a change from your present flying to commercial or military flying? Yes No

	(If “yes”, give details in Remarks below.)

	Section VII Should you not qualify for full coverage at standard rates, do you desire:

	Aviation (a) Full coverage with extra premium, if available? Yes No

	Rates (b) Restricted aviation coverage without extra premium, if available? Yes No

	Remarks:
—

	The above statements and answers are complete and true to the best of my knowledge and belief and will be the basis for and a part of any policy issued based on them.

	Signed at: (X)
—

	City and State            Signature of Proposed Insured

	Date:

 

 

	7633 East 63rd Place, Suite 230
Tulsa, OK 74133
Phone: (918) 249-2438 Fax: (918) 249-2478

	AVOCATION QUESTIONNAIRE

	Name of Proposed Insured: Date of Birth:
Section I            Racing, Auto, Mortorcycle, Snowmobile, Motorboat
Racing Type: midget            stock hotrod drag sportscar snowmobile cycle boat Other
Sports
Vehicle or boat: make & model .............. Class & category...
Displcement....................................... Horsepower............
Timing: vehicle vs. vehicle            vehicle vs. clock            Maximum speed attained            mph
—
Location: oval track closed circuit drag strip hill climb other
Have you ever had a racing accident? Yes No (If “Yes”, explain details in Remarks below.)
Racing organizations affiliated with
Races supervised by
Last 12 1 to 2 Estimate
Frequency (Number of Races) .... Months            Years Ago            Next 12 Months
Section II Type: scuba skin snorkel            Purpose: recreation rescue salvage
Underwater
Sports Locations: oceans lakes rivers pools quarries caves other
Have you received formal diving training? Yes No (If “Yes”, give details in Remarks below.)
Do you use the “buddy system”? Yes No
Number of Dives            Number of Dives            Numbers of Dives
Depth            Average Time            Last 12 Months 1 to 2 years Ago            Est. Next 12 Months
——  ——  ——  —
0-75 ft            Mins.
—
75-125 ft            Mins.
—
Over 125 ft. Mins.
—
Section III Please Identify Which of the Activities You Participate In:
Sky
Sports sky diving hang gliding ultralights biplaning parachuting ballooning other
If sky diving: If ballooning:
Delayed jumping done? ..... Yes No            Gas ballooning..................... Yes No
Any stunting or baton passing? ... Yes No
Are you a member of a club?......... Yes No            Hot air ballooning.................. Yes No
—
What class of license do you hold?.......
Usual location or type of terrain...........
Have you been in an accident connected with this avocation? Yes No
(If “Yes”, give details in Remarks below.)
Number of flights or jumps: Last 12 Mos. 1 to 2 Years Ago            Est. Next 12 Mos.
Average height            Maximum height
Average distance            Maximum distance
Average duration            Maximum duration
Remarks or Other Avocations (Include details regarding nature, locations, frequency, and degree of participation.)
The above statements and answers are complete and true to the best of my knowledge and belief and will be the

	basis for and a part of any policy issued based on them.
City and State            Signature of Proposed Insured
Date

 

 

	7633 East 63rd Place, Suite 230
Tulsa, OK 74133
Phone: (918) 249-2438 Fax: (918) 249-2478

	Military Service Questionnaire

	Proposed Insured Policy Number Date

	If you are on active duty as a member of any state National Guard or as a member, regular or
reserve, of the Army, Navy, Air Force, Marine Corps, or Coast Guard; or if you have been alerted or
called to duty, complete the following:

	1. Branch of Service:

	If branch is Army, indicate arm or component (e.g., Artillery, Infantry, etc.)

	2. Rank and pay grade:

	3. Date of active duty:

	4. Date you will be released:

	5. Where are you stationed:

	Complete military address:

	6. Duties (If in training or attending school, state for what job or duties)

	7. Have you been alerted, received orders, or volunteered for duty outside the United States?

	Yes            No

	Do you expect or have you had any other indication that you will be assigned outside the US?

	Yes            No

	If yes to either of the above questions, explain in detail:

	8. Do you plan to re-enlist? Yes            No

	I hereby represent that all the above statements and answers to all the above questions are
complete and true, and I agree that they shall form a part of my application and become a part of
any contract or insurance issued on such application.

	Dated at            this            day of
Place Day 
Month
Year
Signature of Agent Signature of Proposed Insured

 

 

TRINITY
LIFE INSURANCE COMPANY

Your Privacy at Trinity Life Insurance Company

At Trinity Life Insurance Company (“Trinity,” “we,” “us,” or “our”) keeping nonpublic personal
information (“Information”) about our customers secure and private is a top priority. We are
sending you this Notice to help you understand what Information we collect and how we use and
protect that Information.

While Information is vital to our ability to provide superior service, our most important asset is
your trust. We will limit the collection and use of Information to the minimum we require to
service our customers. This includes advising our customers about our products, services and other
opportunities, and to administer our business.

We apply the same privacy policies to former customers as well as new customers. As required by
law, we will send our current customers our privacy policy at least annually. If we amend our
privacy policy you will be notified.

Our Policies and Practices to Protect Your Personal Information

I. Information Security

Trinity protects the Information it collects about you by maintaining physical, electronic and
procedural safeguards that meet or exceed requirements of applicable federal and state law. Any
affiliates and nonaffiliated third parties to whom Trinity provides your Information must also
agree to follow appropriate standards of security and confidentiality.

II. Categories of Personal Information We Collect and May Disclose

We may collect a wide variety of Information about you and your family from the following sources:

	 	•	 	Information we receive from you on applications or other forms,
such as your name, address, social security number, assets, income and
beneficiaries;
	 
	 	•	 	Information about your transactions with Trinity, our affiliates
or others, such as your policy coverage, premiums, account balances and payment
history;
	 
	 	•	 	Information we receive from nonaffiliated third parties such as consumer reporting agencies.

III. What Information We Disclose and To Whom We Disclose It

The Information obtained from you will only be disclosed with your authorization, as permitted or
required by law, or to conduct our business in administering your policy. The companies affiliated
with Trinity may share your Information among themselves. Additionally, we may disclose all of the
Information to nonaffiliated third parties that perform marketing or other services on our behalf
and with whom we have joint marketing or service agreements.

IV. Verifying the Accuracy of Your Information

Maintaining accurate Information about you is very important to us. You have the right to ask
Trinity to correct, amend or delete any Information about you, which you believe to be incorrect.
If the Information should be corrected, Trinity will update its files. If Trinity does not agree
that the information is incorrect, you have the right to submit a short statement of dispute, which
we will place in your file and include in any future disclosure of Information.

We will not send you any medical information we have received about you from a doctor or other
health care provider. Instead, we will forward the Information to a physician of your choice and
you should contact them directly to obtain the Information you seek. Information relating to a
claim or civil or criminal proceeding is not subject to the rights described above.

	•	 	This Privacy Policy is being provided in accordance with privacy laws. If you
have any questions, please contact us at Trinity Life Insurance Company, 7633 East 63rd Place,
Suite 230, Tulsa, Oklahoma, 74133. Please include your name, address, policy number if
applicable, and some type of personal identification.

 

 

OKLAHOMA GUARANTY ASSOCIATION ACT

NOTICE CONCERNING COVERAGE LIMITATIONS AND EXCLUSIONS UNDER THE

OKLAHOMA LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION ACT

Residents of Oklahoma who purchase life insurance, annuities or health insurance should know that
the insurance companies licensed in this state to write these types of insurance are members of the
Oklahoma Life and Health Insurance Guaranty Associations. The purpose of this association is to
assure that Policyholders will be protected, within limits, in the unlikely event that a member
insurer becomes financially unable to meet its obligations. If this should happen, the Guaranty
Association will assess its other member insurance companies for the money to pay the claims of
insured persons who live in this state and, in some cases, to keep coverage in force. The valuable
extra protection provided by these insurers through the Guaranty Association is not unlimited,
however. And, as noted below, this protection is not a substitute for consumers’ care in selecting
companies that are well-managed and financially stable.

The Oklahoma Life and Health Insurance Guaranty Association may not provide coverage for this
Policy. If coverage is provided, it may be subject to substantial limitations or coverage, and
require continued residency in Oklahoma. You should not rely on coverage by the Oklahoma Life and
Health Insurance Guaranty Association in selecting an insurance company or in selecting an
insurance Policy.

Coverage is NOT provided for your Policy or any portion of it that is not guaranteed by the
insurer or for which you have assumed the risk, such as a variable Contract sold by prospectus.

Insurance companies or their agents are required by law to give or send you this notice. However,
insurance companies and their agents are prohibited by law from using the existence of the
guaranty association to induce you to purchase any kind of insurance Policy.

The
Oklahoma Life and Health Insurance Guaranty Association

201 Robert S. Kerr, Suite 600

Oklahoma City, Oklahoma 73102

Oklahoma Department of Insurance

P.O. Box 53408

Oklahoma City, Oklahoma 73152-3408

The state law that provides for this safety-net coverage is called the Oklahoma Life and Health
Insurance Guaranty Association Act. Below is a brief summary of this law’s coverages, exclusions
and limits. This summary does not cover all provisions of the law; nor does it in any way change
anyone’s rights or obligations under the act or the rights or obligations of the guaranty
association.

COVERAGE

Generally, individuals will be protected by the Life and Health Insurance Guaranty Association if
they live in this state and hold a life or health insurance Contract, or an annuity, or if they
are insured under a group insurance Contract, issued by a member insurer. The beneficiaries,
payees or assignee of insured persons are protected as well, even if they live in another state.

EXCLUSIONS FROM COVERAGE

However, persons holding such Policies are NOT protected by this Association if:

	 	•	 	they are eligible for protection under the laws of another state this may occur
when the insolvent insurer was incorporated in another state whose guaranty association
protects insureds who live outside that state;
	 
	 	•	 	the insurer was not authorized to do business in this state;
	 
	 	•	 	their Policy was issued by an HMO, a fraternal benefit society, a mandatory
state pooling plan, a mutual assessment company or similar plan in which the
Policyholder is subject to future assessments, or by an insurance exchange.

 

 

The Association also does not provide coverage for:

	 	•	 	Policy or portion of a Policy which is not guaranteed by the insurer or for which the
individual has assumed the risk, such as a variable Contract sold by prospectus;
	 
	 	•	 	any Policy of reinsurance (unless an assumption certificate was issued);
	 
	 	•	 	interest rate yields that exceed an average rate;
	 
	 	•	 	dividends;
	 
	 	•	 	credits given in connection with the administration of a Policy by group Contract holder;
	 
	 	•	 	employers’ plans to the extent they are self-funded (that is, not insured by an
insurance company, even if an insurance company administers them);
	 
	 	•	 	unallocated annuity Contracts (which give rights to group Contractholders, not individuals).

LIMITS ON AMOUNT OF COVERAGE

The act also limits the amount the Association is obligated to pay out. The Association cannot pay
more than what the insurance company would owe under a Policy or a Contract. Also, for any one
insured life, the Association will pay a maximum of $300,000 — no matter how many Policies and
Contracts there were with the same company, even if they provided different types of coverages.
Within this overall $300,000 limit, the Association will not pay more than $100,000 in cash
surrender values, $300,000 in health insurance benefits, $300,000 in present value of annuities, or
$300,000 in life insurance death benefits — again, no matter how many Policies and Contracts there
were with the same company, and no matter how many different types of coverages.

 

 

7633 East 63rd
 Place, Suite 230

Tulsa, OK 74133

Phone: (918) 249-2438 Fax: (918) 249-2478

PARENTAL CONSENT AGREEMENT

We, the undersigned, who are the father and mother of

 

(PROPOSED INSURED)

minor, do hereby give our full consent to the issuance, and continuance in force of Policy
Number                      issued by the Trinity Life Insurance Company, on the life of said minor;
said Policy having been issued upon the application made by:

 

(NAME OF APPLICANT)

	 	 	 	 	 	 	 
	 

(STREET ADDRESS)

	 	 

(CITY)
	 	 

(STATE)
	 	 

who is the                      (RELATIONSHIP) of said minor, and we hereby authorize
The Trinity Life insurance Company to pay the benefits and/or proceeds under said policy to the
person or persons entitled thereto according to the terms of said policy, and any riders or
attachments thereto.

Witness our hands this                      (day) of                      (month),___                     (year)

	 	 	 
	 
	 	 
	 

	 	 
	(WITNESS)

	 	(SIGNATURE OF FATHER)
	 
	 	 
	 

	 	 
	(ADDRESS)

	 	(ADDRESS)
	 
	 	 
	 
	 	 
	 

	 	 
	(WITNESS)

	 	(SIGNATURE OF MOTHER)
	 
	 	 
	 

	 	 
	(ADDRESS)

	 	(ADDRESS)

TLIC 64
(01-2007)

 

 

7633 East 63rd
 Place, Suite 230

Tulsa, OK 74133

Phone: (918) 249-2438 Fax: (918) 249-2478

CIGARETTE SMOKING QUESTIONNAIRE

	 	 	 	 	 	 	 	 	 
	PROPOSED INSURED:

	 	 	 	BIRTHDATE	 	 	 	 
	 

	 	 

	 	 	 	 

	 	 

	 	 	 	 	 	 	 
	1.

	 	Are you now a cigarette smoker?
	 	o YES
	 	o NO
	 
	 	 	 	 	 	 
	2.

	 	Have you ever been a cigarette smoker and quit?
	 	o YES
	 	o NO

	 	 	 	 	 	 	 	 	 
	3.

	 	If yes, when did you quit?
	 	Month: ___
	 	Day: ___
	 	Year: ___

	 	 	 	 	 	 	 
	4.

	 	Did, or do, you smoke more than one pack daily?
	 	o YES
	 	o NO
	 
	 	 	 	 	 	 
	5.

	 	Do you use tobacco in any other form?
	 	o YES
	 	o NO

I hereby represent, to the best of my knowledge and belief, that all answers to all the above
questions are complete and true, and I agree that they shall form a part of the application and
become a part of the application and become a part of any contract of insurance issued as a result
of such application.

	 	 	 	 	 	 	 	 	 
	Dated at:

	 	 	 	Date:	 	 	 	 
	 

	 	 

	 	 	 	 

	 	 

	 	 	 
	 

	 	 
	Signature of Agent

	 	Signature of Proposed Insured

TLIC 159
(01-2007)

 

 

	Trinity Life Insurance Company
*’ 7633 East 63rd Place, Suite 230
Tulsa, OK 74133 Phone: (918) 249-2438 Fax: (918) 249-2478
DIABETIC QUESTIONNAIRE — COMPLETED BY PHYSICIAN
NAMEFILE NUMBERDATE
1. Period of Time under your observation as patient? FROM: TO:
2. If known, please give date diabetes diagnosed.
3. Does the patient report regularly for examination and advice? YES            NO
How often? Date of Last Visit?
4.What are the diet and insulin or oral agent prescriptions?
DIETINSULINIORAL AGENT
Carbohydrate            Gms. Type? Kind?
Protein Gms. Total units per day? Tablets per day?
Fat Gms. None? None?
If diet is not calculated in grams of carbohydrate, protein, and fat, or not measured or estimated

from appropriate food exchange lists, what diet program is followed?
Does the patient disregard your advice concerning the diet, and insulin or oral agent
prescriptions,Or make changes without prior discussion with you? YES            NO
Has it been necessary to increase the amount of insulin or oral agent without an
increase in the Diet? YES            NO
5.What levels of blood and urine sugar have been recorded in the past 2 years?
BLOOD SUGARSIURINE SUGARS
DATE: DATE:

FASTING: FASTING:
NON-FAST: NON-FAST:
6.Is there evidence or history of:
Repeated infections? Yes NoImpaired circulation? Yes No
Kidney Disease? Yes NoGain or loss of weight? Yes No
Heart disease? Yes No-Retinitis? Yes No
Elevated blood pressure? Yes NoDiabetic Coma? Yes No
Arteriosclerosis? Yes No
Shock or frequent insulin or hypoglycemic reactions? Yes No
Other Illness?
7.Have any electrocardiograms been made on this patient? Yes No If available, we would
appreciateyour mailing them to use for our review. They will be returned promptly. If
not available, please includefindings under number 8 below or on the reverse side,
8.Please use this space or reverse side to amplify answers to the above and for any comments
your care tomake regarding your patient’s ability to handle this disease.
Date: SIGNATURE: ___

 

 

	Trinity Life Insurance Company
7633 East 63rd Place, Suite 230
Tulsa, OK 74133 Phone:
(918) 249-243 8 Fax: (918)
249-2478
DIABETIC QUESTIONNAIRE — COMPLETED BY APPLICANT
“NAME” 1 FILE NUMBER 1 : DATE
1. (a) Height? Ft. In, (b) Weight? Lbs. (c) Weight one year ago? Lbs.
2. Date diabetes diagnosed?
3. Name and address of Doctor supervising your diabetic program?
NAME
ADDRESS•
How long have you been under his care? Date of Last Visit?
How often do you consult him for examination and advise?
Have you consulted any other doctors about diabetes in the past 3 years?
YES            NO If yes, give names and addresses under 11 below or on reverse
side,
4.What is your daily diet prescription? Carbohydrates gms.
Protein gms.
Fat gms.
Do you measure or estimate your food portions from an exchange list? Measure? Estimate
5.Do you take Insulin? YES            NO If yes, Type? Daily Dose?
Do you take medication? YES            NOList medication Names?
6.How often do you test your urine for sugar? ___At what time of the day do you do so?
What percentage of tests are positive for sugar?
7.How often do you have blood sugar determinations made? Give results of the test made
In the past two years, indicate whether fasting or other times.
DATE IRESULTSDATE [RESULTS
FastingOther TimesFastingOther Times
1. 1.
2 2.
8.Date you last had an electrocardiogram made? An X-ray of Chest?
(Give name and address of physician who made tests under number 11 below)
9.How many times have you been in diabetic coma, or had acidosis severe enough to require
Hospitalizatlon? ___
Have you ever had insulin shock, or do you have frequent insulin reactions?
10.Have you ever had: Elevated Blood Pressure? YES            NO            Heart trouble? YES
NOKidney trouble? YES            NO Recurrent infections? YES            NO
Other Prolonged illness? YES            NO (If yes, give details under 11 below or on reverse side)
11.Use this space for additional explanations. Give complete information, including dates, names
and address\of attending physicians and hospitals. Use reverse side if additional space is
needed.
Date:SIGNATURE:

 

 

	7633 East 63rd Place, Suite 230
Tulsa, OK 74133 Phone: (918)
249-2438 Fax: (918) 249-2478
EPILEPSY (CONVULSIONS’) QUESTIONNAIRE — APPLICANT TO COMPLETE
NAME FILE NUMBERDATE OF BIRTH
1. Has the doctor given you a name for your seizure disorder? (grand ma! epilepsy,
petit malepilepsy, Jacksonian epilepsy, psychomotor or temporal lobe seizures) Does he know
the cause?
2. When did you have your first seizure? Date:
3. When was your last seizure? Date:
4. How often do you have seizures (number weekly, monthly, yearly)?
5. If possible, please describe the seizures. Do you have any warning?
6. What type of treatment? Medications? Hospitalizations?

7. How long have you been taking medication? Any change in medicine?
8. Name and address of doctor who treated or is treating you:
9. Date of last visit?
DATE: Signature of Applicanti

 

 

	7633 East 63rd Place, Suite 230
Tulsa, OK 74133 Phone: (918) 249-2438 Fax: (918) 249-2478
ASTHMA QUESTIONNAIRE — Completed by Applicant
name  date of birth  policy number 
1.(a) Height? ft            in(b) Weight? lbs
(c) Weight one year ago? Ibs
2. Date Asthma diagnosed. Age at onset?

3. Name and address of Doctor supervising your Asthma program?
Name:Address:
How long have you been under his care? Date of Last Visit?
How often do you consult him for examination and advise?
Number tests positive?
4. How many times a year do you have an attack? Date of Last Attack?
5. Are lungs clear between attacks? (Wheezing or rales present? How severe?)
6. What medications are you taking? What is the dosage and frequency? How long have you beentaking
medication for Asthma? Any changes in medication or any other treatments?
7. Has your doctor done any diagnostic studies (Pulmonary function tests, x-rays, allergy
tests,bronchoscopy?) When and what were the findings.
8. Have you ever been hospitalized during an attack? If yes, give details and name and address
ofhospital.
9. Any complications such as loss of weight, high blood pressure, evidence of chronic
bronchitis,other lung disease or fungus infection present?
10.Any history of disability due to Asthma? Loss of time from work due to Asthma? Please
givedetails:
DATE: SIGNATURE;

 

 

	7633 East
63rd Place,
Suite 230 Tulsa, OK 74133
Phone: (918) 249-2438 Fax: (918) 249-2478
DRUG / ALCOHOL QUESTIONNAIRE — COMPLETED BY APPLICANT
NAME FILE NUMBER DATE
SECTION 1: QUESTIONS ON DRUG USE
A. In the past 10 years, have you used:
1. cocaine or other stimulants? YES NO 2. marijuana, LSD, or other hallucinogenics? YES NO 3.
heroin, demerol, or narcotics? YES NO 4. barbiturates, sedatives, or tranquilizers habitually? YES
NO B. List below the drugs taken and the periods of use:
DRUGS DATES USED HOW OFTEN
FROM TO
SECTION 2: QUESTIONS ON ALCOHOL USAGE
A. Have you in the past or do you currently use alcohol to excess? YES NO
1. Identify year that excess usage began:
2. Frequency of episodes?
3. Date of last episode?
4. Duration of last episode?
B. Have you ever been treated for alcoholism? YES NO
1. Dates
2. Number of treatments?
3. Name and address of last facility?
C. Have you attended AA meetings? YES NO
1. Date of last attendance?
2. Number of years attended?
3. Frequency of attendance?
D. Do you use alcohol at this time? YES NO
1. What kind?
2. How much?
3. How often?
I hereby represent, to the best of my knowledge and belief, that all the abov e statements are true,
complete, and correctly stated. I agree they will form a part of the application and become a part of any
contract of insurance.
Date at this day of
Witness Signature of Proposed Insured
(Applicant, if Proposed Insured is a minor)

 

 

	7633 East 63rd Place, Suite 230
Tulsa, OK 74133
Phone: (918) 249-2438 Fax: (918) 249-2478
HIGH BLOOD PRESSURE QUESTIONNAIRE
APPLICANT TO COMPLETE
Name Date of Birth Policy Number
1. (a) Height? ft in (b) Weight? lbs
(c) Weight one year ago? lbs
2. Date high blood pressure diagnosed?
Age at onset?
3. Name and address of doctor supervising your high blood pressure program?
How long have you been under his care? Date of last visit?
How often do you consult him for examination and advice?
4. What was your highest blood pressure reading? Date:
5. What was your recent blood pressure reading? Date:
6. What medications are you taking? (Dosage and frequency) How long have you been taking
medication for high blood pressure. Any changes in medication? Any other treatments?
7. Has your doctor done any diagnostic studies? (EKG, x-rays, blood tests, etc.) When and
What were the findings?
8. When the doctor checks, are your blood pressure readings:
Usually high Usually normal? They vary?
9. Have you ever had: Diabetes? Yes No Heart trouble? Yes No
Eye trouble? Yes No Kidney trouble? Yes No
Recurrent infections? Yes No Other prolonged illness? Yes No
Please give details, if yes.
10. Have you ever been hospitalized for high blood pressure? Yes No If yes, give dates
and name and address of hospital.

 

 

UNDERWRITING REQUIREMENTS

TRINITY LIFE INSURANCE COMPANY

UNDERWRITING GUIDELINES

ORDINARY PLANS

Focus

Requirements for Telephone Interviews (FOCUS)

Ordinary

2 Full Units or $150,000 (whichever is less)       Telephone interview required

All amounts      An interview may be conducted for any amount at the underwriter’s discretion.
Underwriter’s discretion means there is some reason or “red flag” that prompts the interview.

The following are some examples of reasons an underwriter would request an interview for 150,000/2
units or less:

	 	•	 	Amount applied for plus amount in force over 150,000
	 
	 	•	 	MIB code received and the information pertaining to it is not listed on the application;
or if it is listed, needs developing
	 
	 	•	 	Occupation – left blank, disabled, retired at an early age, the occupation is
potentially hazardous
	 
	 	•	 	Medical condition is listed on application but no details given (i.e. dates, meds or
treatment, results, names of physicians or medical facility)
	 
	 	•	 	Medical condition listed on application that may be considered without an APS or paramed
if can develop information needed for a decision from telephone interview (Treatment for
high blood pressure is a common one.)
	 
	 	•	 	Very small amounts of insurance applied for but the medical information given on the
application requires an APS or paramed. The underwriter might conduct a telephone
interview to try to develop enough information to eliminate the APS or paramed.

So that the customer will not be surprised by a call, at the time of sale the agent should prepare
the proposed insured by saying that someone from the home office may call to confirm the
information on the application or to obtain additional information.

 

 

Focus Interview will be ordered on proposed insured’s that are applying for 2 units or $150,000
(whichever is less). I’m not sure they know what the face amount is per unit.

     Here are the death benefits for 2 units for selected issue ages:

	 	 	 	 	 
	Issue Age	 	Death Benefit
	0
	 	 	80,000	 
	5
	 	 	70,000	 
	10
	 	 	60,000	 
	15
	 	 	50,000	 
	20
	 	 	40,000	 
	25
	 	 	220,000	 
	30
	 	 	206,000	 
	35
	 	 	190,000	 
	40
	 	 	176,000	 
	45
	 	 	160,000	 
	50
	 	 	140,000	 
	55
	 	 	100,000	 
	60
	 	 	90,000	 
	65
	 	 	80,000	 
	70
	 	 	50,000	 
	75
	 	 	46,000	 
	80
	 	 	42,000	 

 

 

MOTOR VEHICLE REPORT (MVR)

Ordinary Underwriting Requirements – Motor Vehicle Report

A motor vehicle report is ordered on

	 	•	 	Any application over 100,000.
	 
	 	•	 	Any application indicating driving criticism (speeding tickets, DUI, etc.)
	 
	 	•	 	Any application indicating the proposed insured participates in auto racing as an avocation.
	 
	 	•	 	Younger ages (usually age 25 or younger)

A motor vehicle report may be ordered on any application at the underwriter’s discretion.

 

 

SBSI – INSPECTION REPORTS

A Focus interview is required for 2 units or $150,000 up to $250,000. An inspection report is
required for amounts over $250,000.

Below are the types of inspections reports completed by our vendor.

	 	 	 
	OVER 250,000

	 	AMPLIFIED REPORT
	 

	 	Includes more financial information and a narrative report.
	 
	 	 
	ANY AMOUNT

	 	CRIMINAL REPORT
	 

	 	Would be ordered by the underwriter if any reason to believe there Would be a criminal record.

 

 

ATTENDING PHYSICIAN’S STATEMENT (APS)

An APS is ordered by the underwriter at their discretion.

Examples of why an underwriter would require an APS:

Medical condition listed on application or revealed in the phone interview that would require

Multiple doctors visits, such as diabetes, asthma, etc.

Medical condition indicated by MIB.

A combination of medical conditions.

Children – an APS is required when the proposed insured is a child and the volume is $100,000 and over.

A HIPPA Form is required before ordering an APS.

NON-MEDICAL LIMITS

The non-medical limits are published in the Underwriting Guide – Medical Requirements.

A Notice and Consent Form of AIDS Virus (HIV) Anti-body Testing is required with every blood test.

 

 

Internal Exchange/Replacement Procedures

There are no exchange programs associated with the modified whole life product covered under
this reinsurance agreement; therefore, there are no Internal Exchange/Replacement Procedures to
include in this Exhibit C- Forms, Manuals, and Issue Rules.

 

 

BENEFIT PAYMENTS

Claims Procedure Manual

HOME OFFICE

7633 EAST 63RD PLACE, SUITE 230 Ÿ TULSA, OK Ÿ 74133

Phone: (918) 249-2438

Fax: (918) 249-2478

ADMINISTRATIVE OFFICE

PO BOX 5205 Ÿ FRANKFORT, KY Ÿ 40602-5205

Phone: (866) 440-1357

Primary Fax: (502) 875-7084

Secondary Exclusive Claim Fax: (502) 223-6575

 

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	INTRODUCTION
	 	 	3	 
	DESCRIPTION OF DUTIES
	 	 	4	 
	Senior Claims Analyst:
	 	 	4	 
	Assistant Claims Analyst:
	 	 	5	 
	Claims Clerical Assistant:
	 	 	6	 
	NON-CONTESTABLE CLAIMS
	 	 	7	 
	CONTESTABLE CLAIMS
	 	 	7	 
	COMPUTER SYSTEM TRANSACTIONS
	 	 	9	 
	OBAS — Policy Master — Information by Policy Number
	 	 	9	 
	BCMM — Claim Master Maintenance
	 	 	9	 
	BCIM — Claim Information Maintenance
	 	 	9	 
	BCPM — Benefit Claims Payee Maintenance
	 	 	9	 
	BCPB — Payee Benefit Calculation
	 	 	10	 
	CHECKLIST FOR CLAIMS
	 	 	10	 
	CLAIM DOCUMENTATION REQUIREMENTS
	 	 	11	 
	Memos (OMEM)
	 	 	11	 
	BENEFICIARIES UNDER THE AGE OF 18:
	 	 	11	 
	CLAIMANT’S STATEMENT
	 	 	12	 
	Who signs a claimant statement?
	 	 	15	 
	DIAGNOSTIC CODES
	 	 	16	 

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Introduction

Trinity Life Insurance Company (“Trinity”), Tulsa, Oklahoma has contracted Investors Heritage
Life Insurance Company (“Administrator”), Frankfort, Kentucky to provide life administrative
services for their life products.

Claims will be submitted and processed at the Administrator’s office in Frankfort, Kentucky. Any
benefit checks issued will be printed in another department and mailed with the Explanation of
Benefits. Benefit Payment employees are not authorized to handle checks.

The Administrator can authorize the payment of all claims up to $25,000. Claims over $25,000 are
reported to the Claims Committee monthly for review. Claims over $25,000 must be approved at
Trinity’s Home Office by Gregg Zahn or Sherman Lay.

Members of the Claims Committee at the Administrator’s office are:

Harry Lee Waterfield II — President and CEO

Jane Jackson — Corporate Secretary

Robert M Hardy, Jr. — Legal Counsel

Roland Herzel — Senior Claims Analyst

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Description of Duties

Senior Claims Analyst:

	 	•	 	The senior claims analyst is responsible for:

	 	o	 	Processing all contestable claims and conducting medical inquiries
	 
	 	o	 	Helping with non-contestable claims as time permits
	 
	 	o	 	Processing waiver of premium, life, and reinsurance claims
	 
	 	o	 	Drafting all non-programmed correspondence
	 
	 	o	 	Proofreading all claims before payment
	 
	 	o	 	Filing all reinsurance claims

Processing a Claim:

	 	•	 	As the claim folder is received from the Claims Clerical Assistant, review the claim for
beneficiary information, assignment information, death benefit and any additional
information that is needed.
	 
	 	•	 	If medical records are needed the Senior Claims Analyst will request the records from
the appropriate source and follow up until resolution.
	 
	 	•	 	Once all the information is received and the claim is ready for payment, Senior Claims
Analyst prepares payment and the release of the benefit check.
	 
	 	•	 	If the claim is to be denied or the policy rescinded, the appropriate letter will be
drafted by the Senior Claims Analyst and mailed.

The Senior Claims Analyst can authorize the payment of all claims up to $25,000. Claims over
$25,000 are reported to the Claims Committee monthly for review. Claims over $25,000 must be
approved by Gregg Zahn or Sherman Lay.

Members of the Claims Committee at the Administrator’s office are Harry Lee Waterfield II, Jane
Jackson, Robert M. Hardy, Jr., and Roland Herzel.

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Assistant Claims Analyst:

	 	•	 	The Assistant Claims Analyst is responsible for:

	 	o	 	Processing all non-contestable claims

	 	§ 	 	Inputting claim information onto the computer claims system
	 
	 	§ 	 	Preparing the claim for payment

Processing a Claim:

	 	•	 	As the claim folder is received from the Claims Clerical Assistant, review the claim to
verify the receipt of information needed to process the claim; for example, beneficiary
information, assignment information, and death benefit. Input the claim information on the
claims computer system.
	 
	 	•	 	If other information is needed, this information will be requested from the Claims
Clerical Assistant. Make a note on the claims cover sheet of the information needed and
from whom the information should be requested, and return the claim file to the Claims
Clerical Assistant.
	 
	 	•	 	Incomplete claims are logged in. A letter is generated requesting missing documents. A
letter is generated from a programmed suspense list every 30 days until response.
	 
	 	•	 	Once all information is received and if the claim is ready for payment, forward the
claim to the Senior Analyst for payment and the release of the benefit check.
	 
	 	•	 	If a claim is not approved the appropriate letter will be generated by the Assistant
Claims Analyst and mailed.

The Assistant Claims Analyst prepares all claims for payment, then the Senior Claims Analyst
approves and releases checks to the printer.

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Claims Clerical Assistant:

	 	•	 	The Claims Clerical Assistant is responsible for:

	 	o	 	Date stamping all envelopes
	 
	 	o	 	Date stamping all documents received
	 
	 	o	 	Verifying that the policy number on the claimant statement is the policy
number of the Insured/Deceased by checking the OBAS screen against the claim
	 
	 	o	 	Preparing a file folder for each claim received
	 
	 	o	 	Distributing contestable and non-contestable claims, complete and
incomplete, to the Analysts
	 
	 	o	 	Requesting additional claim information by telephone as instructed by the
Analyst
	 
	 	o	 	Requesting information from microfilm/image as instructed by the Analyst
or as needed
	 
	 	o	 	Imaging paid claim folders
	 
	 	o	 	Reviewing pending drawer for continuing delay notice mailings which come
up on daily programmed suspense list

Processing a Claim:

	 	•	 	As the unopened mail is received in the Benefit Payments Department, the Claims Clerical
Assistant will date stamp the envelopes and each document in the envelope. This is done to
verify when a given document was received in the department.
	 
	 	•	 	After a complete claim has been received and verified, meaning the policy number on the
claim form is the policy number for the deceased, a claim folder will be made for each
claim filed. Contestable claims and non-contestable claims will be put in their
appropriate location for processing by the Analyst.
	 
	 	•	 	If an incomplete claim is received, the Claims Clerical Assistant will request the
additional information as instructed by the Analysts. Additional information requests are
made by using the “Your Claim Was Received Incomplete” form. After the additional
information is requested, the incomplete claim will be filed in the pending claims drawer.
	 
	 	•	 	Upon receipt of the additional information requested, the claim file will be pulled from
the claims pending drawer and put in the appropriate location for processing by the Senior
Claims Analyst or the Assistant Claims Analyst.
	 
	 	•	 	Paid claims are placed daily in the paid claims basket to be imaged for permanent
storage.
	 
	 	•	 	Paid claims are imaged daily. Medical or other confidential records are imaged in a
separate channel accessible only to authorized persons.
	 
	 	•	 	Pending claims need to be reviewed weekly for follow up delay notice mailings.

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Non-contestable claims

	 	•	 	The assistant claims analyst will review all non-contestable
claims. If insured’s death occurred after the first two
policy years, the policy is in force, and all necessary
information has been received to pay the claim, input the
correct claim information into the claim system. If all
requested documents are not received with the initial
notification of loss, but there is sufficient claim
information to enter the claim into the computer, do so on
BCMM and use the memo screen to indicate the reason for the
delay in the processing of the claim.
	 
	 	•	 	Send notification to the Claimant regarding the incomplete
claim. The incomplete claim will be filed in the central
pending drawer alphabetically. Notification of the pending
claim should be sent out every fifteen (15) days until the
needed information is received. The claim system will
generate the delay notices by a suspense list requiring
action by the Analyst.
	 
	 	•	 	Upon receipt of documents needed to complete the
non-contestable claim, pull the incomplete claim file from
the pending drawer. Date stamp the documents upon receipt
and forward the file to the Analyst. The Claims Analyst
reviews the documents for accuracy and completeness and
proceeds with processing the claim.
	 
	 	•	 	The claim folder is then forwarded to the Senior Claims
Analyst for review and release of the benefit check. The
claim folder will be returned to the Claim Clerical Assistant
after payment to await imaging.
	 
	 	•	 	If a non-contestable claim is denied, a letter must be sent
to the claimant explaining the reason(s) for the denial, the
most common reason being that the policy lapsed prior to the
insured’s death. A copy of the letter is placed in the file
and then imaged.

Contestable claims

	 	•	 	The Senior Claims Analyst will review all contestable claims. If the policy is in the contestable period, meaning
that the death of the insured has occurred within the first two policy years, medical records must be requested
from the doctors and/or hospitals listed on the claimant statement or from other sources. The Claims Analyst
requests the medical records through Infolink Services of Kansas City.
	 
	 	•	 	If there is going to be a delay in processing the claim due to incomplete forms or the need to request medical
records, delay notices must be sent to the claimant. Delayed or pending claims should be filed in the
appropriate drawer. Claims pending due to medical records requests should be put in the medical records drawer
and claims pending due to an incomplete claim will be put in a centralized pending drawer.
	 
	 	•	 	All delay notices are in a business-like format and are on the computer in Microsoft Word for easy access.
Various letters can be used depending upon the claim situation. After the initial delay notice, future notices
will be sent out every thirty (30) days until the information is received.

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Benefit Payments Procedure Manual

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	 	•	 	Upon receipt of medical records requested for a contestable claim, the records will be date stamped by the Claims
Clerical assistant and the claim pulled from the claim pending drawer. Medical records must then be reviewed by
the Senior Claims Analyst for a decision to pay the claim or deny the claim and rescind the policy. If the
Analyst has any questions concerning the medical background of the insured, the Company Medical Director can also
review the medical records.
	 
	 	•	 	If a contestable claim is to be rescinded, a letter must be sent to the Claimant explaining the reason(s) for the
rescission. A copy of the letter and enclosures is placed in the claim file.
	 
	 	•	 	After a claim is completed, the file will be imaged and destroyed.
	 
	 	•	 	A rescinded policy is subject to rebuttal and further review if requested by the claimant. The Senior Analyst
will consult General Counsel in such cases, and a meeting of the full Claims Committee may also be called.

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Ordinary Life Claims

Computer System Transactions

Information regarding the claim must be entered into the computer on the following screens:

OBAS — Policy Master — Information by Policy Number

	 	a.	 	Screen should be printed and kept in claim file
	 
	 	b.	 	Contains policy information
	 
	 	c.	 	Identify insured and decedent by name and birthdate
	 
	 	d.	 	Use this screen for assignment and/or beneficiary information

BCMM — Claim Master Maintenance

	 	a.	 	Requires policy number, Social Security number, and claim code

	 	i.	 	P = primary insured
	 
	 	ii.	 	S = secondary/joint
	 
	 	iii.	 	R = rider

	 	b.	 	Zip code and birth date are then cross-checked with policy master

	 
	 	c.	 	Incurred date, death code, and occupation code must then be entered

BCIM — Claim Information Maintenance

	 	a.	 	 Accessed by using ‘F9’ from BCMM

	 
	 	b.	 	 Used to indicate if a certain document has been received or the need for
this document waived
	 
	 	c.	 	 After entering the required information, ‘F2’ will return you to BCMM

BCPM — Benefit Claims Payee Maintenance

	 	a.	 	Accessed by using ‘F10’ from BCMM
	 
	 	b.	 	Used to show to whom the policy proceeds will be paid.

	 	i.	 	Payee type (1) — Used for any portion of the proceeds
payable to an assignee OAGM can be used to complete this screen if the
assignee is an agent of IHLICIf tax ID number on claim form is different
from one on OAGM contact Credit Life Accounting for verification.
	 
	 	ii.	 	Payee type (2) — Used only for premium refund and is
always paid to the owner or the Estate of the Insured.
	 
	 	iii.	 	Payee type (3) — Used when proceeds are payable to the
beneficiary. An ‘X’ will appear under ‘BNF’ on the OBAS if beneficiary
information is available via the computer system (PF23).

	 	c.	 	Fields to be completed on BCPM are payee type, SSN code, attorney,
relationship, and % of proceeds going to the claimant. Typically a dollar amount is
used to pay the assignee and 100% is entered for the beneficiary.
	 
	 	d.	 	It is possible to use any or all of the payee types on one claim.
	 
	 	e.	 	‘F2’ will return you to BCMM.

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BCPB — Payee Benefit Calculation

	 	a.	 	Accessed by using ‘PF14’ from BCMM
	 
	 	b.	 	Screen is already completed
	 
	 	c.	 	Just an informational screen, it describes the amount of proceeds to be
paid
	 
	 	d.	 	Check to see that the amounts appear to be correct
	 
	 	e.	 	F11 will indicate that the claim has been validated for release

Checklist for Claims

	 	1.	 	Make sure date of birth, name, and Social Security number agree on the following
documents:

	 	a.	 	Death certificate
	 
	 	b.	 	Claimant Statement
	 
	 	c.	 	OBAS screen

	 	2.	 	Check for reasonableness of claim amount.
	 
	 	3.	 	Check beneficiary. If no policy or beneficiary change is included in the file or
showing on OBAS, the application or endorsement should be copied from microfiche and placed
in the file.
	 
	 	4.	 	Check for assignment.
	 
	 	5.	 	Verify payee addresses.
	 
	 	6.	 	Return of premium should first go to the owner of the policy, then to the beneficiary
or assignee, in that order.
	 
	 	7.	 	Check for policy loans.
	 
	 	8.	 	Check to see that the agent number or assignment number was used on the payee type 1
screen on BCMM if applicable.

Make sure all FEINs and SSNs are input on the payee screens on BCMM. If TIN/EIN/SSN cannot be
obtained, the default entry is zeroes, and federal tax is withheld and a 1099 issued at year end.

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Claim Documentation Requirements

Exclusive Claim Fax Number: (502) 223-6575

Contestable Policies

(Documents accepted by mail only for accidental death in first two policy years)

	 	•	 	Claimant Statement (TLIC 46C Revised 5/2007)
	 
	 	•	 	Certified death certificate
	 
	 	•	 	Policy or lost policy affidavit required for claims greater than $25,000

Memos (OMEM)

	•	 	All memos to the file must be entered and maintained on the
system. It is imperative that the memo is recorded as the
transaction occurs. It is also important to only enter
relevant information – do not editorialize.
	 
	•	 	The shift-F3 key from OBAS is used for any memos concerning
policy information up to and including reporting the death of
the insured. Any memos after the death claim should be put
on the BCMM memo screen (F11).
	 
	•	 	Memos should contain enough information so that anyone
reviewing the screen will understand circumstances concerning
the claim without having the file in front of them.

Beneficiaries under the Age of 18:

	•	 	When paying any beneficiary under the age of 18, proceeds must be paid to the guardian
of the beneficiary, with proof of appointment. For example: John Doe, Guardian for Jimmy
Doe.

11

 

 

 

Benefit Payments Procedure Manual

Ordinary Life Claims

HIPAA COMPLIANT AUTHORIZATION FOR RELEASE OF MEDICAL INFORMATION

I authorize any health plan, physician, health care professional, hospital, Veterans
Administration, clinic, laboratory, pharmacy or pharmacy benefit manager, medical facility,
insurance company, insurance support organization such as MIB), or other health care provider that
has provided payment, treatment or services to me or on my behalf within the past 10 years
(collectively, “My Providers”) to disclose my entire medical record, medication history, and any
other protected health information concerning me to Trinity Life Insurance Company, or its
designee,

This includes information on the diagnosis or treatment of Human Immunodeficiency Virus (HIV),
Acquired Immune Deficiency Syndrome (AIDS) and Sexually Transmitted Diseases (STDs.) This also
includes information on the diagnosis and treatment of mental illness and the use of alcohol,
drugs, and tobacco, but excludes psychotherapy notes.

By my signature below, I acknowledge that any agreements I have made to restrict my protected
health information do not apply to this authorization and I instruct My Providers to release and
disclose my entire medical record without restriction.

This protected health information is to be disclosed under this Authorization so that Trinity Life
Insurance Company may; (1) underwrite my application for coverage, make eligibility, risk rating,
policy issuance and enrollment determinations; (2) obtain reinsurance; (3) administer claims and
determine or fulfill responsibility for coverage and provision of benefits; (4) administer
coverage; and (5) conduct other legally permissible activities that relate to any coverage I have
or have applied for with Trinity Life Insurance Company.

This authorization shall remain in force for 24 months following the date of my signature below,
and a copy of this authorization is as valid as the original. I understand that I have the right to
revoke this authorization in writing, at any time, by sending a written request for revocation to
Investors Heritage Life Insurance Company, P.O. Box 717, Frankfort, KY 40602, Attn: General
Counsel. I understand that a revocation is not effective to the extent that any of My Providers has
already relied on this Authorization or to the extent that Trinity Life Insurance Company has a
legal right to contest a claim under an insurance policy or to contest the policy itself. I
understand that any information disclosed pursuant to this authorization may be subject to
redisclosure by the recipient and may no longer be protected by federal rules governing privacy and
confidentiality of health information. However, Trinity Life Insurance Company will protect the
privacy of health information in accordance with other applicable state and federal privacy laws
and their own privacy policies.

I understand that My Providers may not refuse to provide treatment or payment for health care
services because I refuse to sign this authorization. I further understand that if I refuse to
sign this authorization to release my complete medical record. Trinity Life Insurance Company may
not be able to process my application, or if coverage has been issued, may not be able to make any
benefit payments. I understand that I am entitled to a copy of this signed authorization.

	 	 	 
	 
	 	 
	 
	Signature of Personal Representative

	 	Date
	 
	 	 
	 
	 	 
	 
	Description of Personal Representative’s Authority or Relationship to
Patient
(For death claims, please attach copy of appointment of
executor of estate.)
	 	 

INSTRUCTIONS FOR COMPLETING PROOFS OF DEATH

It is not necessary to employ any person, firm or corporation for collection of any claim
under this policy. In addition to completing the CLAIMANT’S STATEMENT on the front of this form,
please furnish:

	•	 	Official Death Certificate, certificate with raised seal.
	 
	•	 	The Policy. If the policy(ies) is (are) last or destroyed, you must so certify on a separate sheet of paper.
	 
	•	 	Evidence of change of name of insured or beneficiary (if applicable).

If death was violent or accidental, consideration of such claim can be facilitated by furnishing a
police report, newspaper account, autopsy report and coroner’s verdict, in addition to the
foregoing.

TLIC 46C 05-2007

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Benefit Payments Procedure Manual

Ordinary Life Claims

INSTRUCTIONS FOR COMPLETING CLAIMANT’S STATEMENT

Every question must be distinctly and fully answered.

1. Complete Section A and C for all death claims. Complete Section B only if (1) any policy was
issued within two years of the date of death or (2) any policy contains an Accidental Death
Provision and there is a possibility that death was caused by accidental bodily Injury. If Section
B is completed, the AUTHORIZATION for release of medical and employment information must also be
completed. The Company reserves the right to obtain further information should it be deemed
necessary

2. The form must be completed by the persons to whom the insurance is payable. If the amount
payable is to be divided among several beneficiaries, a separate form for each will be furnished,
or If desired, two beneficiaries may sign one statement. When two beneficiaries join in one
statement, question 8a of Section A pertains to ore of them and question 8b applies to the other.
Both must sign the form.

3. If a claimant is a minor, the Claimant’s Statement is to be completed by the minor’s legally
appointed guardian, a certificate of whose appointment and authority must be furnished. In such
case, question 8a should show the minor’s Information, and question 8b should show the legal
guardians’ Information. Both must sign the form, if possible.

4. When policy proceeds are payable to “children” or others of a class, no names being specified, a
sworn statement must be furnished, giving names and dates of birth of each; and if any died, the
sworn statement must give the date and place of death and must state whether they died without a
will, unmarried and without children.

5. When policy proceeds are payable to the estate of the Insured, this statement must be made by an
executor or administrator, a certificate of whose appointment and authority must be furnished.

6. When a policy has been assigned, this statement must be made by the assignee who must submit the
original assignment. If the assignment of the policy Is collateral In Intent, regardless of whether
absolute In form, the statement must be completed jointly by the Beneficiary showing information in
question 8a and assignee information in question 8b. A statement of the amount claimed by the
assignee, assented to by the beneficiary, must be furnished if separate checks are desired.

7. When policy proceeds are payable to someone who dies before the Insured, a certified death
certificate issued by the State Bureau of Vital Statistics must be furnished, giving the place and
date of death of the deceased person. This requirement may be disregarded when the Company has
received a prior claim on such person.

8. When policy proceeds are payable to a corporation or firm, this statement must be made by a duly
qualified officer who has the power and right to make such claim in the name of the corporation or
firm.

TLIC 46C Instructions (5-07)

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Benefit Payments Procedure Manual

Ordinary Life Claims

Who signs a claimant statement?

	•	 	The primary beneficiary (or contingent beneficiary/estate administrator if primary
is deceased) must sign the claimant statement.
	 
	•	 	If the designated beneficiary is deceased, request a copy of the beneficiary’s death
certificate.
	 
	•	 	If a contingent beneficiary has been named, and is also deceased, request the death
certificate of the contingent and pay the proceeds to the estate or assignee.
	 
	•	 	Request executor or administration papers if paying an estate or if someone designated
as the administrator is assigning the proceeds to a funeral home.

15

 

Benefit Payments Procedure Manual

Ordinary Life Claims

Diagnostic Codes

	 	 	 	 	 
	40

	 	AAV
	 	AIDS
	61

	 	Abcess of lung
	 	Emphysema
	61

	 	Abcess of mediastinum
	 	Emphysema
	72

	 	Abcess of pancreas
	 	Other Digestive Diseases
	54

	 	Abdominal aneurysm
	 	Arteries, Arterioles, Capillaries
	69

	 	Abdominal angina
	 	Gastgro-enteritis, Colitis
	54

	 	Abdominal Aortic Aneurysm
	 	Arteries, Arterioles, Capillaries
	69

	 	Abdominal Fistulas
	 	Gastgro-enteritis, Colitis
	7

	 	Abdominal Infection
	 	Septicemia
	38

	 	Abetalipoproteinemia
	 	Nutritional, Metabolic & Immunity Disorders
	72

	 	Abscess of liver
	 	Other Digestive Diseases
	89

	 	Accident — Aircraft
	 	Aircraft Accidents
	96

	 	Accident — Animal being ridden
	 	Accident — Other
	96

	 	Accident — Animal bite
	 	Accident — Other
	96

	 	Accident — Animal Drawn Vehicle
	 	Accident — Other
	96

	 	Accident — Bicycle
	 	Accident — Other
	96

	 	Accident — Boating
	 	Accident — Other
	93

	 	Accident — Burns
	 	Accidental Fires
	88

	 	Accident — Car vs. Pedestrian
	 	Motor Vehicle Accidents
	88

	 	Accident — Car vs. Train
	 	Motor Vehicle Accidents
	96

	 	Accident — Choking
	 	Accident — Other
	93

	 	Accident — Combustible Material
	 	Accidental Fires
	93

	 	Accident — Corrosive Liquid
	 	Accidental Fires
	95

	 	Accident — Drowning
	 	Accidental Drowning
	90

	 	Accident — Drug Poisoning
	 	Accidental Poisoning
	91

	 	Accident — Fall
	 	Accidental Falls
	93

	 	Accident — Fire
	 	Accidental Fires
	94

	 	Accident — Firearms
	 	Accident — Firearms
	96

	 	Accident — Freezing
	 	Accident — Other
	94

	 	Accident — Guns
	 	Accident — Firearms
	93

	 	Accident — Hot Liquid
	 	Accidental Fires
	93

	 	Accident — House Fire
	 	Accidental Fires
	96

	 	Accident — Involving machinery
	 	Accident — Other
	88

	 	Accident — Motor Vehicle
	 	Motor Vehicle Accidents
	88

	 	Accident — Motor Vehicle Collision
	 	Motor Vehicle Accidents
	88

	 	Accident — Motorcycle
	 	Motor Vehicle Accidents
	96

	 	Accident — Other
	 	Accident — Other
	90

	 	Accident — Poisoning
	 	Accidental Poisoning
	93

	 	Accident — Radiation
	 	Accidental Fires
	96

	 	Accident — Railway
	 	Accident — Other
	96

	 	Accident — Self-inflicted not intentional
	 	Accident — Other
	93

	 	Accident — Steam
	 	Accidental Fires
	95

	 	Accident — Submersion
	 	Accidental Drowning
	96

	 	Accident — Sunstroke
	 	Accident — Other
	96

	 	Accident — Surgical & Medical Procedure
	 	Accident — Other
	96

	 	Accident — Therapeutic misadventure
	 	Accident — Other
	96

	 	Accident — Tree-cutting
	 	Accident — Other
	96

	 	Accident — Venomous bite
	 	Accident — Other
	95

	 	Accidental Drowning
	 	Accidental Drowning
	90

	 	Accidental Poisoning
	 	Accidental Poisoning
	37

	 	Achard-Thiers syndrome
	 	Diabetes Mellitus — Endocrine Disorders
	72

	 	Achlorhydria
	 	Other Digestive Diseases
	38

	 	Acidosis
	 	Nutritional, Metabolic & Immunity Disorders
	40

	 	Acquired Immune Deficiency Syndrome
	 	AIDS
	81

	 	Acrosclerosis
	 	Other Skin & Musculoskeletal Diseases

16

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	17

	 	Actimonycotic infection
	 	Other Infective or Parasitic Diseases
	3

	 	Adbominal Aortic Aneurysm due to Syphilis
	 	Syphilis
	76

	 	Adenofibromatous hypertrophy of prostate
	 	Hyperplasia of Prostate
	76

	 	Adenoma of prostate (benign)
	 	Hyperplasia of Prostate
	35

	 	Adenomatous goiter
	 	Goiter
	52

	 	Adherent pericardium
	 	Other Heart Disease
	52

	 	Adhesive pericarditis
	 	Other Heart Disease
	31

	 	Adrenal Gland Cancer
	 	Cancer — Other
	37

	 	Adrenal gland disorders
	 	Diabetes Mellitus — Endocrine Disorders
	37

	 	Adrenal Infarction
	 	Diabetes Mellitus — Endocrine Disorders
	37

	 	Adrenogenital disorders
	 	Diabetes Mellitus — Endocrine Disorders
	63

	 	Adult respiratory distress syndrome
	 	Other Respiratory
	67

	 	Adynamic ileus
	 	Intestinal Obstruction, Hernia
	41

	 	Affective Disorders
	 	Mental, Drugs, Alcohol
	38

	 	Agammaglobulinemia
	 	Nutritional, Metabolic & Immunity Disorders
	40

	 	AIDS
	 	AIDS
	40

	 	AIDS-related complex
	 	AIDS
	89

	 	Aircraft Accidents
	 	Aircraft Accidents
	38

	 	Alaninemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Albinism
	 	Nutritional, Metabolic & Immunity Disorders
	52

	 	Alcoholic cardiomyopathy
	 	Other Heart Disease
	70

	 	Alcoholic Cirrhosis of Liver
	 	Cirrhosis of Liver
	41

	 	Alcoholic dementia
	 	Mental, Drugs, Alcohol
	70

	 	Alcoholic Fatty Liver
	 	Cirrhosis of Liver
	68

	 	Alcoholic gastritis
	 	Gastritis, Duodenitis
	70

	 	Alcoholic Hepatitis of Liver
	 	Cirrhosis of Liver
	70

	 	Alcoholic Liver Damage
	 	Cirrhosis of Liver
	41

	 	Alcoholic psychoses
	 	Mental, Drugs, Alcohol
	41

	 	Alcoholic Withdrawal
	 	Mental, Drugs, Alcohol
	41

	 	Alcoholism
	 	Mental, Drugs, Alcohol
	37

	 	Aldosteronism
	 	Diabetes Mellitus — Endocrine Disorders
	32

	 	Aleukemic Leukemia
	 	Leukemia
	32

	 	Aleukemic myelosis
	 	Leukemia
	81

	 	Algoneurodystrophy
	 	Other Skin & Musculoskeletal Diseases
	38

	 	Alkalosis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Alkaptonuria
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Alkaptonuric ochronosis
	 	Nutritional, Metabolic & Immunity Disorders
	63

	 	Allergic alveolitis
	 	Other Respiratory
	63

	 	Allergic rhinitis
	 	Other Respiratory
	47

	 	Alper’s disease
	 	Other Nervous System
	38

	 	Alpha 1-antitrypsin deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Alpha-lipoproteinemia
	 	Nutritional, Metabolic & Immunity Disorders
	63

	 	Alveolar capillary block
	 	Other Respiratory
	86

	 	Alzheimer’s Disease
	 	Alzheimer’s Disease
	86

	 	Alzheimer’s Type Dementia
	 	Alzheimer’s Disease
	5

	 	Amebiasis
	 	Intestinal Infections — Other
	5

	 	Amebic dysentery
	 	Intestinal Infections — Other
	5

	 	Amebic nondysenteric colitis
	 	Intestinal Infections — Other
	78

	 	Amnion Infarction
	 	Complications of Pregnancy
	82

	 	Amyelencephalus
	 	Congenital Anomalies
	38

	 	Amyloidosis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Amylopectinosis
	 	Nutritional, Metabolic & Immunity Disorders
	47

	 	Amyotrophic lateral sclerosis
	 	Other Nervous System
	72

	 	Anal abscess
	 	Other Digestive Diseases
	72

	 	Anal fissure
	 	Other Digestive Diseases
	72

	 	Anal fistula
	 	Other Digestive Diseases
	38

	 	Anderson’s lipidoses
	 	Nutritional, Metabolic & Immunity Disorders

17

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	39

	 	Anemia
	 	Anemia, Thalassemia
	82

	 	Anencephalus
	 	Congenital Anomalies
	3

	 	Aneurysm of Abdominal Aorta due to Syphilis
	 	Syphilis
	54

	 	Aneurysm of aorta
	 	Arteries, Arterioles, Capillaries
	50

	 	Aneurysm of coronary vessels
	 	Ischemic & Coronary Heart Disease
	50

	 	Aneurysm of heart
	 	Ischemic & Coronary Heart Disease
	54

	 	Aneurysm of iliac artery
	 	Arteries, Arterioles, Capillaries
	54

	 	Aneurysm of other artery
	 	Arteries, Arterioles, Capillaries
	52

	 	Aneurysm of pulmonary artery
	 	Other Heart Disease
	54

	 	Aneurysm of renal artery
	 	Arteries, Arterioles, Capillaries
	54

	 	Aneurysmal varix
	 	Arteries, Arterioles, Capillaries
	50

	 	Angina
	 	Ischemic & Coronary Heart Disease
	50

	 	Angina decubitus
	 	Ischemic & Coronary Heart Disease
	50

	 	Angina pectoris
	 	Ischemic & Coronary Heart Disease
	71

	 	Angiocholecystitis
	 	Cholelithiasis, Cholecystitis
	38

	 	Angioedema — hereditary
	 	Nutritional, Metabolic & Immunity Disorders
	41

	 	Anorexia
	 	Mental, Drugs, Alcohol
	47

	 	Anoxic Brain Damage
	 	Other Nervous System
	47

	 	Anoxic Brain Injury
	 	Other Nervous System
	47

	 	Anterior horn cell disease
	 	Other Nervous System
	17

	 	Anthrax
	 	Other Infective or Parasitic Diseases
	22

	 	Anus Cancer
	 	Cancer — Rectum, Recto Sigmoid
	54

	 	Aorta-Saddle Embolus
	 	Arteries, Arterioles, Capillaries
	54

	 	Aortic aneurysm
	 	Arteries, Arterioles, Capillaries
	54

	 	Aortic arch arteritis
	 	Arteries, Arterioles, Capillaries
	54

	 	Aortic atherosclerosis
	 	Arteries, Arterioles, Capillaries
	54

	 	Aortic bifurcation syndrome
	 	Arteries, Arterioles, Capillaries
	54

	 	Aortic dissection
	 	Arteries, Arterioles, Capillaries
	50

	 	Aortic insufficiency
	 	Ischemic & Coronary Heart Disease
	50

	 	Aortic stenosis
	 	Ischemic & Coronary Heart Disease
	50

	 	Aortic valve disease
	 	Ischemic & Coronary Heart Disease
	50

	 	Aortic valve insufficiency
	 	Ischemic & Coronary Heart Disease
	50

	 	Aortic valve regurgitation
	 	Ischemic & Coronary Heart Disease
	50

	 	Aortic valve stenosis
	 	Ischemic & Coronary Heart Disease
	54

	 	Aortitis
	 	Arteries, Arterioles, Capillaries
	54

	 	Aortoiliac obstruction
	 	Arteries, Arterioles, Capillaries
	39

	 	Aplastic anemia
	 	Anemia, Thalassemia
	53

	 	Apoplectic attack
	 	Cerebrovascular Diseases
	53

	 	Apoplectic seizure
	 	Cerebrovascular Diseases
	53

	 	Apoplexy
	 	Cerebrovascular Diseases
	66

	 	Appendicitis
	 	Appendicitis
	66

	 	Appendix — other diseases
	 	Appendicitis
	21

	 	Appendix Cancer
	 	Cancer — Colon, Cecum, Sigmoid
	40

	 	ARC
	 	AIDS
	40

	 	ARDs
	 	AIDS
	38

	 	Argininosuccinic aciduria
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Ariboflavinosis
	 	Nutritional, Metabolic & Immunity Disorders
	82

	 	Arnold-chiari syndrome w hydrocephalus
	 	Congenital Anomalies
	52

	 	Arrhythmia
	 	Other Heart Disease
	54

	 	Arterial degeneration
	 	Arteries, Arterioles, Capillaries
	54

	 	Arterial embolism
	 	Arteries, Arterioles, Capillaries
	54

	 	Arterial embolism
	 	Arteries, Arterioles, Capillaries
	54

	 	Arterial infarction
	 	Arteries, Arterioles, Capillaries
	54

	 	Arterial occlusive disease
	 	Arteries, Arterioles, Capillaries
	54

	 	Arterial thrombosis
	 	Arteries, Arterioles, Capillaries
	54

	 	Arterial thrombosis
	 	Arteries, Arterioles, Capillaries
	51

	 	Arteriolar nephritis
	 	Hypertensive Disease

18

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	52

	 	Arteriorsclerotic cardiovascular disease
	 	Arteries, Arterioles, Capillaries
	51

	 	Arteriosclerosis
	 	Hypertensive Disease
	51

	 	Arteriosclerosis of kidney
	 	Hypertensive Disease
	51

	 	Arteriosclerosis of renal arterioles
	 	Hypertensive Disease
	50

	 	Arteriosclerotic Cardiovascular Disease
	 	Ischemic & Coronary Heart Disease
	50

	 	Arteriosclerotic heart disease
	 	Ischemic & Coronary Heart Disease
	51

	 	Arteriosclerotic nephritis
	 	Hypertensive Disease
	54

	 	Arteriosclerotic vascular disease
	 	Arteries, Arterioles, Capillaries
	54

	 	Arteriosclerotic vascular disease
	 	Arteries, Arterioles, Capillaries
	54

	 	Arteriovascular degeneration
	 	Arteries, Arterioles, Capillaries
	54

	 	Arteriovenous aneurysm
	 	Arteries, Arterioles, Capillaries
	54

	 	Arteriovenous fistula
	 	Arteries, Arterioles, Capillaries
	54

	 	Arteritis
	 	Arteries, Arterioles, Capillaries
	52

	 	Arterosclerotic cardiovascular disease
	 	Other Heart Disease
	52

	 	Arterovenous fistula of pulmonary vessels
	 	Other Heart Disease
	17

	 	Arthropod-borne hemorrhagic fever
	 	Other Infective or Parasitic Diseases
	40

	 	ARV
	 	AIDS
	63

	 	Asbestosis
	 	Other Respiratory
	38

	 	Ascorbic aciden deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	52

	 	ASCVD
	 	Other Heart Disease
	50

	 	ASHD
	 	Ischemic & Coronary Heart Disease
	57

	 	Aspiration Bronchopneumonia
	 	Pneumonia
	57

	 	Aspriation Pneumonia
	 	Pneumonia
	98

	 	Assault
	 	Homicide
	63

	 	Asthma
	 	Other Respiratory
	63

	 	Asthmatic bronchitis
	 	Other Respiratory
	63

	 	Atelectasis
	 	Other Respiratory
	54

	 	Atheroma
	 	Arteries, Arterioles, Capillaries
	50

	 	Atherosclerosis
	 	Ischemic & Coronary Heart Disease
	50

	 	Atherosclerotic Cardiovascular Disease
	 	Ischemic & Coronary Heart Disease
	50

	 	Atherosclerotic Heart Disease
	 	Ischemic & Coronary Heart Disease
	50

	 	Atherosclerotic Vascular Disease
	 	Ischemic & Coronary Heart Disease
	47

	 	Athetoid cerebral palsy
	 	Other Nervous System
	77

	 	Atony of bladder
	 	Other Genito-Urinary
	72

	 	Atony of colon
	 	Other Digestive Diseases
	52

	 	Atrial fibrillation
	 	Other Heart Disease
	52

	 	Atrial flutter
	 	Other Heart Disease
	52

	 	Atrioventricular block
	 	Other Heart Disease
	52

	 	Atrioventricular dissociation
	 	Other Heart Disease
	52

	 	Atrioventricular excitation
	 	Other Heart Disease
	82

	 	Atrioventricular malformation
	 	Congenital Anomalies
	50

	 	Atrium infarction
	 	Ischemic & Coronary Heart Disease
	68

	 	Atrophic gastritis
	 	Gastritis, Duodenitis
	77

	 	Atrophy of Prostate
	 	Other Genito-Urinary
	31

	 	Auditory Tube Cancer
	 	Cancer — Other
	41

	 	Autism
	 	Mental, Drugs, Alcohol
	38

	 	Autoimmune disease
	 	Nutritional, Metabolic & Immunity Disorders
	88

	 	Automobile Accident
	 	Motor Vehicle Accidents
	102

	 	Autopsy Pending
	 	Autopsy Pending
	82

	 	Autosomal deleterion syndromes
	 	Congenital Anomalies
	82

	 	AV Malformation
	 	Congenital Anomalies
	38

	 	Avitaminosis
	 	Nutritional, Metabolic & Immunity Disorders
	73

	 	Azotemia
	 	Nephritis, Renal Scleroris
	73

	 	Azotemic osteodystrophy
	 	Nephritis, Renal Scleroris
	5

	 	Bacillary dysentery
	 	Intestinal Infections — Other
	52

	 	Bacterial endocarditis
	 	Other Heart Disease
	5

	 	Bacterial enteritis
	 	Intestinal Infections — Other

19

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	5

	 	Bacterial Food Poisoning
	 	Intestinal Infections — Other
	43

	 	Bacterial meningitis
	 	Meningitis
	57

	 	Bacterial pneumonia
	 	Pneumonia
	77

	 	Bacterimia
	 	Other Genito-Urinary
	77

	 	Bacteriuria
	 	Other Genito-Urinary
	63

	 	Bagassosis
	 	Other Respiratory
	77

	 	Balanitis
	 	Other Genito-Urinary
	77

	 	Balanoposthitis
	 	Other Genito-Urinary
	5

	 	Balantidiasis
	 	Intestinal Infections — Other
	47

	 	Balo’s concentric sclerosis
	 	Other Nervous System
	81

	 	Bamberger-Marie disease
	 	Other Skin & Musculoskeletal Diseases
	38

	 	Barraquer-Simons disease
	 	Nutritional, Metabolic & Immunity Disorders
	37

	 	Bartter’s syndrome
	 	Diabetes Mellitus — Endocrine Disorders
	53

	 	Basal Ganglia Stroke
	 	Cerebrovascular Diseases
	36

	 	Basedow’s disease
	 	Thyrotoxicosis
	53

	 	Basilar artery hemorrhage
	 	Cerebrovascular Diseases
	55

	 	Basilar Artery Ischemia
	 	Veins, Other Circulatory
	53

	 	Basilar artery syndrome
	 	Cerebrovascular Diseases
	38

	 	Bassen-Kornzweign syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	47

	 	Batten Disease
	 	Other Nervous System
	17

	 	Battey Disease
	 	Other Infective or Parasitic Diseases
	2

	 	Bazin’s Disease
	 	Tuberculosis — Nonrespiratory
	51

	 	Benign hypertension
	 	Hypertensive Disease
	47

	 	Benign intracranial hypertension
	 	Other Nervous System
	34

	 	Benign Neoplasms
	 	Benign Neoplasms
	38

	 	Benign paroxysmal peritonitis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Beriberi
	 	Nutritional, Metabolic & Immunity Disorders
	62

	 	Bilateral pleural effusion
	 	Pleurisy
	57

	 	Bilateral Pneumonia
	 	Pneumonia
	31

	 	Bile Duct Cancer
	 	Cancer — Other
	71

	 	Bile Duct Obstruction
	 	Cholelithiasis, Cholecystitis
	70

	 	Biliary cirrhosis
	 	Cirrhosis of Liver
	71

	 	Biliary dyskinesia
	 	Cholelithiasis, Cholecystitis
	83

	 	Birth Injuries
	 	Birth Injuries
	38

	 	Bisalbuminemia
	 	Nutritional, Metabolic & Immunity Disorders
	63

	 	Black lung disease
	 	Other Respiratory
	16

	 	Blackwater Fever
	 	Malaria
	31

	 	Bladder Cancer
	 	Cancer — Other
	77

	 	Bladder fistula
	 	Other Genito-Urinary
	77

	 	Bladder hemorrhage
	 	Other Genito-Urinary
	77

	 	Bladder obstruction
	 	Other Genito-Urinary
	32

	 	Blast Cell Leukemia
	 	Leukemia
	17

	 	Blastomycotic infection
	 	Other Infective or Parasitic Diseases
	72

	 	Blind loop syndrome
	 	Other Digestive Diseases
	30

	 	Bone Cancer
	 	Cancer — Bone, Cartilage
	80

	 	Bone infections
	 	Osteomyelitis, periostitis
	81

	 	Bone Ischemia
	 	Other Skin & Musculoskeletal Diseases
	9

	 	Bordetella pertussis
	 	Whooping Cough
	5

	 	Botulism
	 	Intestinal Infections — Other
	82

	 	Bourneville’s disease
	 	Congenital Anomalies
	69

	 	Bowel Infarction
	 	Gastgro-enteritis, Colitis
	69

	 	Bowel Ischemia
	 	Gastgro-enteritis, Colitis
	52

	 	Brady Tachy Syndrome
	 	Other Heart Disease
	52

	 	Bradycardia-tachycardia syndrome
	 	Other Heart Disease
	31

	 	Brain Cancer
	 	Cancer — Other
	53

	 	Brain Embolism
	 	Cerebrovascular Diseases
	53

	 	Brain Ischemia
	 	Cerebrovascular Diseases

20

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	31

	 	Brain Tumor
	 	Cancer — Other
	53

	 	Brainstem Infarction
	 	Cerebrovascular Diseases
	25

	 	Breast Cancer
	 	Cancer — Breast
	77

	 	Breast Infarction
	 	Other Genito-Urinary
	77

	 	Brewer’s Infarction
	 	Other Genito-Urinary
	15

	 	Brill’s disease
	 	Typhus and Ricketsiosis
	33

	 	Brill-Symmers disease
	 	Lymphosarcoma, Etc
	15

	 	Brill-Zinsser disease
	 	Typhus and Ricketsiosis
	80

	 	Brodie’s abscess
	 	Osteomyelitis, periostitis
	81

	 	Broken bone
	 	Other Skin & Musculoskeletal Diseases
	1

	 	Bronchial Tuberculosis
	 	Tuberculosis — Respiratory System
	63

	 	Bronchiectasis
	 	Other Respiratory
	60

	 	Bronchiolitis
	 	Bronchitis
	60

	 	Bronchitis
	 	Bronchitis
	61

	 	Bronchocutaneous fistula
	 	Emphysema
	63

	 	Broncholithiasis
	 	Other Respiratory
	61

	 	Bronchopleural fistula
	 	Emphysema
	57

	 	Bronchopneumonia
	 	Pneumonia
	38

	 	Bronzed diabetes
	 	Nutritional, Metabolic & Immunity Disorders
	17

	 	Brucellosis
	 	Other Infective or Parasitic Diseases
	38

	 	Bruton’s type agammaglobulinemia
	 	Nutritional, Metabolic & Immunity Disorders
	17

	 	Bubonic Plague
	 	Other Infective or Parasitic Diseases
	55

	 	Budd-Chiari syndrome
	 	Veins, Other Circulatory
	54

	 	Buerger’s disease
	 	Arteries, Arterioles, Capillaries
	81

	 	Bullous dermatoses
	 	Other Skin & Musculoskeletal Diseases
	38

	 	Burger-Grutz syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	33

	 	Burkitt’s tumor
	 	Lymphosarcoma, Etc
	17

	 	Buruli ulcer
	 	Other Infective or Parasitic Diseases
	39

	 	Cachexia
	 	Anemia, Thalassemia
	50

	 	CAD
	 	Ischemic & Coronary Heart Disease
	63

	 	Calcification of Lung
	 	Other Respiratory
	52

	 	Calcification of pericardium
	 	Other Heart Disease
	62

	 	Calcification of pleura
	 	Pleurisy
	38

	 	Calcinosis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Calcium deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	75

	 	Calculous pyelonephritis
	 	Urinary System Infections
	75

	 	Calculus in diverticulum of bladder
	 	Urinary System Infections
	75

	 	Calculus in urethra
	 	Urinary System Infections
	75

	 	Calculus of kidney
	 	Urinary System Infections
	75

	 	Calculus of ureter
	 	Urinary System Infections
	38

	 	Calorie deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	31

	 	Cancer — Adrenal Gland
	 	Cancer — Other
	22

	 	Cancer — Anus
	 	Cancer — Rectum, Recto Sigmoid
	21

	 	Cancer — Appendix
	 	Cancer — Colon, Cecum, Sigmoid
	31

	 	Cancer — Auditory Tube
	 	Cancer — Other
	31

	 	Cancer — Bile Duct
	 	Cancer — Other
	31

	 	Cancer — Bladder
	 	Cancer — Other
	30

	 	Cancer — bone
	 	Cancer — Bone, Cartilage
	31

	 	Cancer — Brain
	 	Cancer — Other
	25

	 	Cancer — Breast
	 	Cancer — Breast
	31

	 	Cancer — Carotid Body
	 	Cancer — Other
	21

	 	Cancer — Cecum
	 	Cancer — Colon, Cecum, Sigmoid
	26

	 	Cancer — Cervix
	 	Cancer — Cervix Uteri
	26

	 	Cancer — Cervix uteri
	 	Cancer — Cervix Uteri
	21

	 	Cancer — Colon
	 	Cancer — Colon, Cecum, Sigmoid
	21

	 	Cancer — Colorectal
	 	Cancer — Colon, Cecum, Sigmoid
	31

	 	Cancer — Corneal
	 	Cancer — Other

21

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	21

	 	Cancer — Duodenum
	 	Cancer — Colon, Cecum, Sigmoid
	26

	 	Cancer — Endocervix
	 	Cancer — Cervix Uteri
	27

	 	Cancer — endometrium
	 	Cancer — Other Uterine
	18

	 	Cancer — Epiglottis
	 	Cancer — Mouth, Throat, Pharynx
	19

	 	Cancer — Esophagus
	 	Cancer — Esophagus
	26

	 	Cancer — Exocervix
	 	Cancer — Cervix Uteri
	31

	 	Cancer — Eye
	 	Cancer — Other
	31

	 	Cancer — Fallopian Tube
	 	Cancer — Other
	31

	 	Cancer — Gallbladder
	 	Cancer — Other
	20

	 	Cancer — Gastric
	 	Cancer — Stomach
	23

	 	Cancer — Glottix
	 	Cancer — Larynx
	18

	 	Cancer — Gums
	 	Cancer — Mouth, Throat, Pharynx
	24

	 	Cancer — Heart
	 	Cancer — Lung, Trachea
	18

	 	Cancer — Hypopharynx
	 	Cancer — Mouth, Throat, Pharynx
	31

	 	Cancer — Intestinal Tract
	 	Cancer — Other
	31

	 	Cancer — Kidney
	 	Cancer — Other
	23

	 	Cancer — Larynx
	 	Cancer — Larynx
	18

	 	Cancer — Lips
	 	Cancer — Mouth, Throat, Pharynx
	31

	 	Cancer — Liver
	 	Cancer — Other
	24

	 	Cancer — Lung
	 	Cancer — Lung, Trachea
	30

	 	Cancer — Mandible
	 	Cancer — Bone, Cartilage
	18

	 	Cancer — Mouth
	 	Cancer — Mouth, Throat, Pharynx
	31

	 	Cancer — Nasal Cavity
	 	Cancer — Other
	18

	 	Cancer — Nasopharynx
	 	Cancer — Mouth, Throat, Pharynx
	18

	 	Cancer — oropharynx
	 	Cancer — Mouth, Throat, Pharynx
	31

	 	Cancer — Ovary
	 	Cancer — Other
	31

	 	Cancer — Pancreas
	 	Cancer — Other
	31

	 	Cancer — Parametrium
	 	Cancer — Other
	31

	 	Cancer — parathyroid
	 	Cancer — Other
	31

	 	Cancer — Peritoneum
	 	Cancer — Other
	18

	 	Cancer — Pharynx
	 	Cancer — Mouth, Throat, Pharynx
	31

	 	Cancer — Pineal Gland
	 	Cancer — Other
	27

	 	Cancer — Placenta
	 	Cancer — Other Uterine
	24

	 	Cancer — Pleura
	 	Cancer — Lung, Trachea
	28

	 	Cancer — Prostate
	 	Cancer — Prostate
	20

	 	Cancer — Pylorus
	 	Cancer — Stomach
	22

	 	Cancer — Recto sigmoid
	 	Cancer — Rectum, Recto Sigmoid
	22

	 	Cancer — Rectum
	 	Cancer — Rectum, Recto Sigmoid
	31

	 	Cancer — Renal Cell
	 	Cancer — Other
	31

	 	Cancer — Retroperitoneum
	 	Cancer — Other
	18

	 	Cancer — Salivary Gland
	 	Cancer — Mouth, Throat, Pharynx
	29

	 	Cancer — Skin
	 	Cancer — Skin, Melanoma
	21

	 	Cancer — Small Intestine
	 	Cancer — Colon, Cecum, Sigmoid
	31

	 	Cancer — Spleen
	 	Cancer — Other
	20

	 	Cancer — Stomach
	 	Cancer — Stomach
	23

	 	Cancer — Subglottis
	 	Cancer — Larynx
	23

	 	Cancer — Supraglottis
	 	Cancer — Larynx
	31

	 	Cancer — Testicular
	 	Cancer — Other
	31

	 	Cancer — Testis
	 	Cancer — Other
	24

	 	Cancer — Thymus
	 	Cancer — Lung, Trachea
	18

	 	Cancer — Tongue
	 	Cancer — Mouth, Throat, Pharynx
	18

	 	Cancer — Tongue
	 	Cancer — Mouth, Throat, Pharynx
	18

	 	Cancer — Tonsil
	 	Cancer — Mouth, Throat, Pharynx
	24

	 	Cancer — Trachea
	 	Cancer — Lung, Trachea
	31

	 	Cancer — Unknown Origin
	 	Cancer — Other
	24

	 	Cancer — Upper Respiratory
	 	Cancer — Lung, Trachea
	31

	 	Cancer — Ureter
	 	Cancer — Other

22

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	31

	 	Cancer — Urethra
	 	Cancer — Other
	27

	 	Cancer — Uterine
	 	Cancer — Other Uterine
	31

	 	Cancer — Vaginal
	 	Cancer — Other
	30

	 	Cancer — Vertebral
	 	Cancer — Bone, Cartilage
	31

	 	Cancer — Vocal Cords
	 	Cancer — Other
	31

	 	Cancer — Vulva
	 	Cancer — Other
	31

	 	Cancer of unknown origin
	 	Cancer — Other
	17

	 	Candidiasis
	 	Other Infective or Parasitic Diseases
	54

	 	Capillary disease
	 	Arteries, Arterioles, Capillaries
	54

	 	Capillary Embolism
	 	Arteries, Arterioles, Capillaries
	54

	 	Capillary hemorrhage
	 	Arteries, Arterioles, Capillaries
	54

	 	Capillary hyperpermeability
	 	Arteries, Arterioles, Capillaries
	60

	 	Capillary pneumonia
	 	Bronchitis
	54

	 	Capillary thrombosis
	 	Arteries, Arterioles, Capillaries
	81

	 	Caplan’s syndrome
	 	Other Skin & Musculoskeletal Diseases
	31

	 	Carcinomatosis
	 	Cancer — Other
	38

	 	Cardiac amyloidosis — Hereditary
	 	Nutritional, Metabolic & Immunity Disorders
	52

	 	Cardiac arrest
	 	Other Heart Disease
	52

	 	Cardiac arrhythmia
	 	Other Heart Disease
	52

	 	Cardiac asthma
	 	Other Heart Disease
	52

	 	Cardiac dilatation
	 	Other Heart Disease
	52

	 	Cardiac dysrhythmia
	 	Other Heart Disease
	50

	 	Cardiac Embolism
	 	Ischemic & Coronary Heart Disease
	52

	 	Cardiac failure
	 	Other Heart Disease
	52

	 	Cardiac hypertrophy
	 	Other Heart Disease
	50

	 	Cardiac Infarcation
	 	Ischemic & Coronary Heart Disease
	50

	 	Cardiac Ischemia
	 	Ischemic & Coronary Heart Disease
	52

	 	Cardiac sarcoidosis
	 	Other Heart Disease
	52

	 	Cardiac tamponade
	 	Other Heart Disease
	87

	 	Cardiogenic shock
	 	Unknown Causes & Ill-Defined Causes
	52

	 	Cardiomegaly
	 	Other Heart Disease
	52

	 	Cardiomyopathy
	 	Other Heart Disease
	52

	 	Cardiopulmonary collapse
	 	Other Heart Disease
	52

	 	Cardiopulmonary disease
	 	Other Heart Disease
	51

	 	Cardiorenal disease
	 	Hypertensive Disease
	52

	 	Cardiorespiratory arrest
	 	Other Heart Disease
	87

	 	Cardiorespiratory collapse
	 	Unknown Causes & Ill-Defined Causes
	52

	 	Cardiovascular Accident
	 	Other Heart Disease
	52

	 	Cardiovascular collagenosis
	 	Other Heart Disease
	87

	 	Cardiovascular collapse
	 	Unknown Causes & Ill-Defined Causes
	52

	 	Cardiovascular disease
	 	Other Heart Disease
	51

	 	Cardiovascular renal disease
	 	Hypertensive Disease
	51

	 	Cardiovascular renal disorder
	 	Hypertensive Disease
	52

	 	Cardiovascular sclerosis
	 	Other Heart Disease
	3

	 	Cardiovascular syphilis
	 	Syphilis
	52

	 	Carditis
	 	Other Heart Disease
	38

	 	Carnosinemia
	 	Nutritional, Metabolic & Immunity Disorders
	53

	 	Carotid Artery Ischemia
	 	Cerebrovascular Diseases
	31

	 	Carotid body Cancer
	 	Cancer — Other
	60

	 	Catarrhal bronchitis
	 	Bronchitis
	101

	 	Cause Not Listed on Certificate
	 	Incomplete Death Certificate
	21

	 	Cecum Cancer
	 	Cancer — Colon, Cecum, Sigmoid
	54

	 	Celiac artery compression syndrome
	 	Arteries, Arterioles, Capillaries
	54

	 	Celiac axis syndrome
	 	Arteries, Arterioles, Capillaries
	72

	 	Celiac disease
	 	Other Digestive Diseases
	79

	 	Cellulitis
	 	Skin Infections
	47

	 	Central pontine myelinosis
	 	Other Nervous System

23

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	47

	 	Cerebellar ataxia
	 	Other Nervous System
	53

	 	Cerebral aneurysm
	 	Cerebrovascular Diseases
	47

	 	Cerebral anoxia
	 	Other Nervous System
	53

	 	Cerebral arteritis
	 	Cerebrovascular Diseases
	53

	 	Cerebral artery occlusion
	 	Cerebrovascular Diseases
	53

	 	Cerebral atherosclerosis
	 	Cerebrovascular Diseases
	47

	 	Cerebral edema
	 	Other Nervous System
	53

	 	Cerebral embolism
	 	Cerebrovascular Diseases
	31

	 	Cerebral Glioblastoma
	 	Cancer — Other
	53

	 	Cerebral infarction
	 	Cerebrovascular Diseases
	53

	 	Cerebral ischemia
	 	Cerebrovascular Diseases
	47

	 	Cerebral lipidoses
	 	Other Nervous System
	47

	 	Cerebral Palsy
	 	Other Nervous System
	53

	 	Cerebral seizure
	 	Cerebrovascular Diseases
	53

	 	Cerebral thrombosis
	 	Cerebrovascular Diseases
	47

	 	Cerebrospinal fluid rhinorrhea
	 	Other Nervous System
	53

	 	Cerebrovascular Accident
	 	Cerebrovascular Diseases
	53

	 	Cerebrovascular Disease
	 	Cerebrovascular Diseases
	53

	 	Cerebrovascular insufficiency
	 	Cerebrovascular Diseases
	53

	 	Cerebrovascular Ischemia
	 	Cerebrovascular Diseases
	53

	 	Cerebrovasuclar lesion
	 	Cerebrovascular Diseases
	26

	 	Cervical Cancer
	 	Cancer — Cervix Uteri
	26

	 	Cervix uteri Cancer
	 	Cancer — Cervix Uteri
	17

	 	Cestode infection
	 	Other Infective or Parasitic Diseases
	17

	 	Chagas’ disease
	 	Other Infective or Parasitic Diseases
	47

	 	Charcot-Marie-Tooth disease
	 	Other Nervous System
	52

	 	CHF
	 	Other Heart Disease
	17

	 	Chickenpox
	 	Other Infective or Parasitic Diseases
	98

	 	Child Abuse
	 	Homicide
	78

	 	Childbirth complications
	 	Complications of Pregnancy
	32

	 	Chloroma
	 	Leukemia
	72

	 	Cholangitis
	 	Other Digestive Diseases
	71

	 	Cholecystitis
	 	Cholelithiasis, Cholecystitis
	71

	 	Cholelithiasis
	 	Cholelithiasis, Cholecystitis
	5

	 	Cholera
	 	Intestinal Infections — Other
	71

	 	Cholesterolisis of gallbladder
	 	Cholelithiasis, Cholecystitis
	27

	 	Choriocarcinoma
	 	Cancer — Other Uterine
	63

	 	Chronic Lung Disease
	 	Other Respiratory
	43

	 	Chronic meningitis
	 	Meningitis
	63

	 	Chronic Obstructive Lung Disease
	 	Other Respiratory
	63

	 	Chronic Obstructive Pulmonary Disease
	 	Other Respiratory
	63

	 	Chronic Obstructive Pulmonary Failure
	 	Other Respiratory
	72

	 	Chronic passive congestion of liver
	 	Other Digestive Diseases
	63

	 	Chronic respiratory disease
	 	Other Respiratory
	70

	 	Chronic yellow atrophy
	 	Cirrhosis of Liver
	70

	 	Cirrhosis of Liver
	 	Cirrhosis of Liver
	72

	 	Cirrhosis of pancreas
	 	Other Digestive Diseases
	38

	 	Citrullinemia
	 	Nutritional, Metabolic & Immunity Disorders
	17

	 	Clonochiasis
	 	Other Infective or Parasitic Diseases
	51

	 	Cocaine Hypertension
	 	Hypertensive Disease
	17

	 	Coccidioidomycosis
	 	Other Infective or Parasitic Diseases
	69

	 	Colitis
	 	Gastgro-enteritis, Colitis
	69

	 	Colitis of large intestine
	 	Gastgro-enteritis, Colitis
	81

	 	Collagen disease
	 	Other Skin & Musculoskeletal Diseases
	81

	 	Collagen disease (progressive)
	 	Other Skin & Musculoskeletal Diseases
	21

	 	Colon Cancer
	 	Cancer — Colon, Cecum, Sigmoid
	69

	 	Colon Infarction
	 	Gastgro-enteritis, Colitis

24

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	69

	 	Colon Ischemia
	 	Gastgro-enteritis, Colitis
	21

	 	Colorectal Cancer
	 	Cancer — Colon, Cecum, Sigmoid
	63

	 	Common cold
	 	Other Respiratory
	63

	 	Compensatory emphysema
	 	Other Respiratory
	78

	 	Complications of Pregnancy
	 	Complications of Pregnancy
	52

	 	Concato’s disease
	 	Other Heart Disease
	52

	 	Conduction disorder
	 	Other Heart Disease
	82

	 	Congenital Anomalies
	 	Congenital Anomalies
	82

	 	Congenital anomalies of repiratory system
	 	Congenital Anomalies
	82

	 	Congenital anomalies of veins, etc.
	 	Congenital Anomalies
	82

	 	Congenital cerebral cyst
	 	Congenital Anomalies
	82

	 	Congenital cystic lung
	 	Congenital Anomalies
	39

	 	Congenital folate malabsorption
	 	Anemia, Thalassemia
	82

	 	Congenital Heart disease
	 	Congenital Anomalies
	39

	 	Congenital hemolytic anemia
	 	Anemia, Thalassemia
	82

	 	Congenital hydrocephalus
	 	Congenital Anomalies
	82

	 	Congenital polycystic disease of liver
	 	Congenital Anomalies
	3

	 	Congenital Syphilis
	 	Syphilis
	82

	 	Congential honeycomb lung
	 	Congenital Anomalies
	52

	 	Congestive cardiomyopathy
	 	Other Heart Disease
	52

	 	Congestive heart disease
	 	Other Heart Disease
	52

	 	Congestive Heart Failure
	 	Other Heart Disease
	37

	 	Conn’s syndrome
	 	Diabetes Mellitus — Endocrine Disorders
	72

	 	Constipation
	 	Other Digestive Diseases
	52

	 	Constrictive cardiomyopathy
	 	Other Heart Disease
	52

	 	Constrictive pericarditis
	 	Other Heart Disease
	39

	 	Cooley’s Anemia
	 	Anemia, Thalassemia
	63

	 	COPD
	 	Other Respiratory
	52

	 	Cor Pulmonale
	 	Other Heart Disease
	31

	 	Corneal Cancer
	 	Cancer — Other
	50

	 	Coronary arteriosclerosis
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary arteritis
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary artery disease
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary artery embolism
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary Artery Infarction
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary artery occlusion
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary artery rupture
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary artery thrombosis
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary atheroma
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary atherosclerosis
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary insufficiency
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary Ischemia
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary occlusion
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary sclerosis
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary stricture
	 	Ischemic & Coronary Heart Disease
	50

	 	Coronary thrombosis
	 	Ischemic & Coronary Heart Disease
	103

	 	Coroner’s Inquiry
	 	Coroner’s Inquiry
	37

	 	Corticoadrenal insufficiency
	 	Diabetes Mellitus — Endocrine Disorders
	8

	 	Corynebacterium diphtheriae
	 	Diptheria
	17

	 	Cowpox
	 	Other Infective or Parasitic Diseases
	17

	 	Coxsackie virus
	 	Other Infective or Parasitic Diseases
	54

	 	Cranial arteritis
	 	Arteries, Arterioles, Capillaries
	82

	 	Craniorachischisis
	 	Congenital Anomalies
	87

	 	Crib death
	 	Unknown Causes & Ill-Defined Causes
	82

	 	Cri-du-chat syndrome
	 	Congenital Anomalies
	38

	 	Crigler-Najjar syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	17

	 	Crimean hemorrhagic fever
	 	Other Infective or Parasitic Diseases

25

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	69

	 	Crohn’s disease
	 	Gastgro-enteritis, Colitis
	63

	 	Croup
	 	Other Respiratory
	63

	 	Croup syndrome
	 	Other Respiratory
	60

	 	Croupous bronchitis
	 	Bronchitis
	82

	 	Crouzon’s disease
	 	Congenital Anomalies
	81

	 	CRST syndrome
	 	Other Skin & Musculoskeletal Diseases
	38

	 	Cryoglobulinemic purpura
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Cryoglobulinemic vasculitis
	 	Nutritional, Metabolic & Immunity Disorders
	43

	 	Cryptococcal meningitis
	 	Meningitis
	37

	 	Cushing’s syndrome
	 	Diabetes Mellitus — Endocrine Disorders
	53

	 	CVA
	 	Cerebrovascular Diseases
	53

	 	CVD
	 	Cerebrovascular Diseases
	38

	 	Cyanocobalamin deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Cystathioninemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Cystathioninuria
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Cystic Fibrosis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Cystinosis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Cystinuria
	 	Nutritional, Metabolic & Immunity Disorders
	77

	 	Cystitis
	 	Other Genito-Urinary
	77

	 	Cystitis cystica
	 	Other Genito-Urinary
	17

	 	Darling’s disease
	 	Other Infective or Parasitic Diseases
	81

	 	Decubitis Ulcers
	 	Other Skin & Musculoskeletal Diseases
	55

	 	Deep vein thrombosis
	 	Veins, Other Circulatory
	52

	 	Degenerative heart disease
	 	Other Heart Disease
	38

	 	Dehydration
	 	Nutritional, Metabolic & Immunity Disorders
	47

	 	Dejerine-Thomas Syndrome
	 	Other Nervous System
	85

	 	Dementia
	 	Senility
	17

	 	Dengue
	 	Other Infective or Parasitic Diseases
	36

	 	deQuervain’s thyroiditis
	 	Thyrotoxicosis
	81

	 	Dermatitis
	 	Other Skin & Musculoskeletal Diseases
	81

	 	Dermatitis medicamentosa
	 	Other Skin & Musculoskeletal Diseases
	17

	 	Dermatophytosis
	 	Other Infective or Parasitic Diseases
	81

	 	Dermatosis herpetiformis
	 	Other Skin & Musculoskeletal Diseases
	32

	 	Di Guglielmo’s disease
	 	Leukemia
	37

	 	Diabetes
	 	Diabetes Mellitus — Endocrine Disorders
	37

	 	Diabetes Mellitus
	 	Diabetes Mellitus — Endocrine Disorders
	37

	 	Diabetic acidosis
	 	Diabetes Mellitus — Endocrine Disorders
	37

	 	Diabetic ketosis
	 	Diabetes Mellitus — Endocrine Disorders
	73

	 	Diabetic nephropathy
	 	Nephritis, Renal Scleroris
	37

	 	Diabets insipidus
	 	Diabetes Mellitus — Endocrine Disorders
	67

	 	Diaphragmatic hernia
	 	Intestinal Obstruction, Hernia
	63

	 	Diaphragmitis
	 	Other Respiratory
	69

	 	Diarheal Illness
	 	Gastgro-enteritis, Colitis
	82

	 	Diastematomyelia
	 	Congenital Anomalies
	38

	 	DiGeorge’s syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	54

	 	Dilatation of aorta
	 	Arteries, Arterioles, Capillaries
	72

	 	Dilatation of colon
	 	Other Digestive Diseases
	13

	 	Diphasic meningoencephalitis
	 	Encephalitis
	8

	 	Diptheria
	 	Diptheria
	54

	 	Disseminated necrotizing periarteritis
	 	Arteries, Arterioles, Capillaries
	69

	 	Diverticulitis of colon or small intestine
	 	Gastgro-enteritis, Colitis
	77

	 	Diverticulum of bladder
	 	Other Genito-Urinary
	72

	 	Diverticulum of esophagus
	 	Other Digestive Diseases
	82

	 	Down’s Syndrome
	 	Congenital Anomalies
	95

	 	Drowning — Accident
	 	Accidental Drowning
	41

	 	Drug Addiction
	 	Mental, Drugs, Alcohol
	41

	 	Drug psychoses
	 	Mental, Drugs, Alcohol

26

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	41

	 	Drug Withdrawals
	 	Mental, Drugs, Alcohol
	38

	 	Dubbin-Johnson syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	81

	 	Duhring’s disease
	 	Other Skin & Musculoskeletal Diseases
	17

	 	Dukes-Filatow disease
	 	Other Infective or Parasitic Diseases
	72

	 	Duodenal ileus
	 	Other Digestive Diseases
	72

	 	duodenal obstruction
	 	Other Digestive Diseases
	72

	 	Duodenal rupture
	 	Other Digestive Diseases
	65

	 	Duodenal Ulcer
	 	Duodenal Ulcer
	68

	 	Duodenitis
	 	Gastritis, Duodenitis
	21

	 	Duodenum Cancer
	 	Cancer — Colon, Cecum, Sigmoid
	38

	 	Dysgammaglobulinemia
	 	Nutritional, Metabolic & Immunity Disorders
	36

	 	Dyshormonogenic goit
	 	Thyrotoxicosis
	72

	 	Dyskinesia of esophagus
	 	Other Digestive Diseases
	72

	 	Dyspepsia
	 	Other Digestive Diseases
	87

	 	Dysphagia
	 	Unknown Causes & Ill-Defined Causes
	41

	 	Dysphagia — Functional
	 	Mental, Drugs, Alcohol
	41

	 	Dysphagia — Hysterical
	 	Mental, Drugs, Alcohol
	41

	 	Dysphagia — Nervous
	 	Mental, Drugs, Alcohol
	41

	 	Dysphagia — Psychogenic
	 	Mental, Drugs, Alcohol
	39

	 	Dysphagia — Sideropenic
	 	Anemia, Thalassemia
	72

	 	Dysphagia — Spastica
	 	Other Digestive Diseases
	37

	 	Dyspituitarism
	 	Diabetes Mellitus — Endocrine Disorders
	82

	 	Ebstein’s anomaly
	 	Congenital Anomalies
	17

	 	Echinococcosis
	 	Other Infective or Parasitic Diseases
	17

	 	ECHO virus
	 	Other Infective or Parasitic Diseases
	47

	 	Edema of spinal cord
	 	Other Nervous System
	82

	 	Edward’s syndrome
	 	Congenital Anomalies
	38

	 	Electrolyte imbalance
	 	Nutritional, Metabolic & Immunity Disorders
	55

	 	Elephantiasis
	 	Veins, Other Circulatory
	54

	 	Embolic infarction
	 	Arteries, Arterioles, Capillaries
	54

	 	Embolism
	 	Arteries, Arterioles, Capillaries
	54

	 	Embolism — Aorta
	 	Arteries, Arterioles, Capillaries
	54

	 	Embolism — Artery
	 	Arteries, Arterioles, Capillaries
	53

	 	Embolism — Basilar artery
	 	Cerebrovascular Diseases
	53

	 	Embolism — Brain
	 	Cerebrovascular Diseases
	54

	 	Embolism — Capillary
	 	Arteries, Arterioles, Capillaries
	50

	 	Embolism — Cardiac
	 	Ischemic & Coronary Heart Disease
	53

	 	Embolism — Carotid artery
	 	Cerebrovascular Diseases
	53

	 	Embolism — Cerebral
	 	Cerebrovascular Diseases
	69

	 	Embolism — Mesenteric
	 	Gastgro-enteritis, Colitis
	69

	 	Embolism — Mesenteric Artery
	 	Gastgro-enteritis, Colitis
	52

	 	Embolism — Pulmonary
	 	Other Heart Disease
	54

	 	Embolism — Thrombosis
	 	Arteries, Arterioles, Capillaries
	55

	 	Embolism — Vein
	 	Veins, Other Circulatory
	53

	 	Embolism — Vertebral Artery
	 	Cerebrovascular Diseases
	61

	 	Emphysema
	 	Emphysema
	77

	 	Emphysematous cystitis
	 	Other Genito-Urinary
	61

	 	Empyema
	 	Emphysema
	71

	 	Empyema of gallbladder
	 	Cholelithiasis, Cholecystitis
	13

	 	Encephalitis
	 	Encephalitis
	47

	 	Encephalitis
	 	Other Nervous System
	47

	 	Encephalitis periaxialis
	 	Other Nervous System
	82

	 	Encephalocele
	 	Congenital Anomalies
	53

	 	Encephalomalacia
	 	Cerebrovascular Diseases
	47

	 	Encephalomyelitis
	 	Other Nervous System
	47

	 	Encephalopathy
	 	Other Nervous System
	72

	 	Encephalopathy — hepatic
	 	Other Digestive Diseases

27

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	56

	 	Encephalopathy due to influenza
	 	Influenza
	77

	 	Encysted hydrocele
	 	Other Genito-Urinary
	77

	 	End Stage Renal Disease
	 	Other Genito-Urinary
	54

	 	Endarteritis
	 	Arteries, Arterioles, Capillaries
	54

	 	Endarteritis deformans
	 	Arteries, Arterioles, Capillaries
	54

	 	Endarteritis obliterans
	 	Arteries, Arterioles, Capillaries
	52

	 	Endocarditis
	 	Other Heart Disease
	26

	 	Endocervix Cancer
	 	Cancer — Cervix Uteri
	63

	 	Endogenous lipoid pneumonia
	 	Other Respiratory
	27

	 	Endometrium Cancer
	 	Cancer — Other Uterine
	52

	 	Endomyocardial fibrosis
	 	Other Heart Disease
	55

	 	Endophlebitis
	 	Veins, Other Circulatory
	87

	 	Endotoxic Shock
	 	Unknown Causes & Ill-Defined Causes
	76

	 	Enlargement of prostate
	 	Hyperplasia of Prostate
	69

	 	Enteritis
	 	Gastgro-enteritis, Colitis
	67

	 	Enterostenosis
	 	Intestinal Obstruction, Hernia
	77

	 	Enterovesical fistula
	 	Other Genito-Urinary
	38

	 	Enzymopathy
	 	Nutritional, Metabolic & Immunity Disorders
	63

	 	Eosinophilic asthma
	 	Other Respiratory
	32

	 	Eosinophilic leukemia
	 	Leukemia
	43

	 	Eosinophilic meningitis
	 	Meningitis
	77

	 	Epididymitis
	 	Other Genito-Urinary
	53

	 	Epidural hemorrhage
	 	Cerebrovascular Diseases
	18

	 	Epiglottis Cancer
	 	Cancer — Mouth, Throat, Pharynx
	63

	 	Epiglottitis
	 	Other Respiratory
	45

	 	Epilepsy
	 	Epilepsy
	82

	 	Epiloia
	 	Congenital Anomalies
	17

	 	Erysipelas
	 	Other Infective or Parasitic Diseases
	17

	 	Erysipelothrix infection
	 	Other Infective or Parasitic Diseases
	81

	 	Erythema nodosum
	 	Other Skin & Musculoskeletal Diseases
	81

	 	Erythema venenatum
	 	Other Skin & Musculoskeletal Diseases
	81

	 	Erythematosquamous dermatosis
	 	Other Skin & Musculoskeletal Diseases
	32

	 	Erythremic myelosis
	 	Leukemia
	19

	 	Esophageal Cancer
	 	Cancer — Esophagus
	72

	 	Esophageal Diseases
	 	Other Digestive Diseases
	19

	 	Esophagus Cancer
	 	Cancer — Esophagus
	77

	 	ESRD
	 	Other Genito-Urinary
	38

	 	Ethanolaminuria
	 	Nutritional, Metabolic & Immunity Disorders
	63

	 	ethmoiditis
	 	Other Respiratory
	46

	 	Eustachian salpingitis
	 	Otitis media and mastoiditis
	46

	 	Eustachian tube disorders
	 	Otitis media and mastoiditis
	30

	 	Ewing’s Sarcoma
	 	Cancer — Bone, Cartilage
	26

	 	Exocervix Cancer
	 	Cancer — Cervix Uteri
	36

	 	Exophthalmic goiter
	 	Thyrotoxicosis
	53

	 	Extradural hemorrhage
	 	Cerebrovascular Diseases
	63

	 	Extrinsic allergic alveolitis
	 	Other Respiratory
	63

	 	Extrinsic asthma
	 	Other Respiratory
	31

	 	Eye Cancer
	 	Cancer — Other
	38

	 	Fabry’s Disease
	 	Nutritional, Metabolic & Immunity Disorders
	87

	 	Failure to Thrive
	 	Unknown Causes & Ill-Defined Causes
	31

	 	Fallopian Tube Cancer
	 	Cancer — Other
	52

	 	Familial cardiomyopathy
	 	Other Heart Disease
	82

	 	Familial dysautonomia
	 	Congenital Anomalies
	38

	 	Familial Mediterranean fever
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Fanconi (-de Toni) (-Debre) syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	63

	 	Farmers lung
	 	Other Respiratory
	17

	 	Fascioliasis
	 	Other Infective or Parasitic Diseases

28

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	72

	 	Fat necrosis of peritoneum
	 	Other Digestive Diseases
	70

	 	Fatty liver
	 	Cirrhosis of Liver
	39

	 	Favism
	 	Anemia, Thalassemia
	67

	 	Fecal impaction
	 	Intestinal Obstruction, Hernia
	81

	 	Felty’s syndrome
	 	Other Skin & Musculoskeletal Diseases
	67

	 	Femoral hernia
	 	Intestinal Obstruction, Hernia
	61

	 	Fibrinopurulent pleurisy
	 	Emphysema
	38

	 	Fibrocystic disease of pancreas
	 	Nutritional, Metabolic & Immunity Disorders
	52

	 	Fibroid myocarditis
	 	Other Heart Disease
	54

	 	Fibromuscular hyperplasia of arteries
	 	Arteries, Arterioles, Capillaries
	54

	 	Fibromuscular hyperplasia of renal artery
	 	Arteries, Arterioles, Capillaries
	72

	 	Fibrosis of pancreas
	 	Other Digestive Diseases
	52

	 	Fiedler’s myocarditis
	 	Other Heart Disease
	54

	 	Fistula of artery
	 	Arteries, Arterioles, Capillaries
	72

	 	Fistula of bile duct
	 	Other Digestive Diseases
	71

	 	Fistula of gallbladder
	 	Cholelithiasis, Cholecystitis
	52

	 	Fistula of pericardium
	 	Other Heart Disease
	38

	 	Fluid Overload
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Fluid retention
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Folic Acid Deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	77

	 	Follicular cystitis
	 	Other Genito-Urinary
	38

	 	Follicular keratoris due to Vitamin A deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	5

	 	Food poisoning
	 	Intestinal Infections — Other
	37

	 	Forbes-Albright syndrome
	 	Diabetes Mellitus — Endocrine Disorders
	38

	 	Fredrickson Type (all) hyperlipoproteinemia
	 	Nutritional, Metabolic & Immunity Disorders
	47

	 	Friedreich’s ataxia
	 	Other Nervous System
	53

	 	Front Lobe Infarction
	 	Cerebrovascular Diseases
	38

	 	Fructosemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Fucosidosis
	 	Nutritional, Metabolic & Immunity Disorders
	69

	 	Fulminant enterocolitis
	 	Gastgro-enteritis, Colitis
	38

	 	Galactose-1-phosphatase deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Galactosemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Galactosuria
	 	Nutritional, Metabolic & Immunity Disorders
	31

	 	Gallbladder Cancer
	 	Cancer — Other
	71

	 	Gallbladder disease
	 	Cholelithiasis, Cholecystitis
	71

	 	Gallbladder disorders
	 	Cholelithiasis, Cholecystitis
	71

	 	Gallbladder Infarction
	 	Cholelithiasis, Cholecystitis
	67

	 	Gallstone ileus
	 	Intestinal Obstruction, Hernia
	47

	 	Gangliosidosis
	 	Other Nervous System
	54

	 	Gangrene — general
	 	Arteries, Arterioles, Capillaries
	69

	 	Gangrene — Intestinal
	 	Gastgro-enteritis, Colitis
	87

	 	Gangrene — Lower Extremities
	 	Unknown Causes & Ill-Defined Causes
	87

	 	Gangrene — Unspecified Site
	 	Unknown Causes & Ill-Defined Causes
	71

	 	Gangrene of gallbladder
	 	Cholelithiasis, Cholecystitis
	71

	 	Gangrenous cholecystitis
	 	Cholelithiasis, Cholecystitis
	61

	 	Gangrenous pneumonia
	 	Emphysema
	38

	 	Gargoylism
	 	Nutritional, Metabolic & Immunity Disorders
	20

	 	Gastric Cancer
	 	Cancer — Stomach
	72

	 	Gastric diverticulum
	 	Other Digestive Diseases
	64

	 	Gastric Hemorhage
	 	Ulcer, Gastric Hemorrhage
	72

	 	Gastric hemorrhage
	 	Other Digestive Diseases
	72

	 	Gastric rupture
	 	Other Digestive Diseases
	64

	 	Gastric Ulcer
	 	Ulcer, Gastric Hemorrhage
	68

	 	Gastritis
	 	Gastritis, Duodenitis
	72

	 	Gastrocolic fistula
	 	Other Digestive Diseases
	64

	 	Gastroduodenal ulcer
	 	Ulcer, Gastric Hemorrhage
	69

	 	Gastroenteritis
	 	Gastgro-enteritis, Colitis

29

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	72

	 	Gastroesophageal reflux disease
	 	Other Digestive Diseases
	72

	 	Gastroesophagel laceration-hemmorhage
	 	Other Digestive Diseases
	72

	 	Gastrointestinal bleeding
	 	Other Digestive Diseases
	72

	 	Gastrointestinal hemorrhage
	 	Other Digestive Diseases
	72

	 	Gastrojejunal ulcer
	 	Other Digestive Diseases
	72

	 	Gastrojejunocolic fistula
	 	Other Digestive Diseases
	72

	 	Gastroptosis
	 	Other Digestive Diseases
	38

	 	Gaucher’s disease
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Gaucher’s splenomegaly
	 	Nutritional, Metabolic & Immunity Disorders
	72

	 	Gee-(Herter) disease
	 	Other Digestive Diseases
	17

	 	Genial herpes
	 	Other Infective or Parasitic Diseases
	17

	 	German Measles
	 	Other Infective or Parasitic Diseases
	72

	 	GI Bleeding
	 	Other Digestive Diseases
	72

	 	GI hemorrhage
	 	Other Digestive Diseases
	54

	 	Giant cell arteritis
	 	Arteries, Arterioles, Capillaries
	5

	 	Giardiasis
	 	Intestinal Infections — Other
	38

	 	Gilbert’s syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	17

	 	Glanders
	 	Other Infective or Parasitic Diseases
	77

	 	Glandularis cystitis
	 	Other Genito-Urinary
	31

	 	Glioblastoma
	 	Cancer — Other
	73

	 	Glomerulitis
	 	Nephritis, Renal Scleroris
	73

	 	Glomerulonephritis
	 	Nephritis, Renal Scleroris
	23

	 	Glottix Cancer
	 	Cancer — Larynx
	38

	 	Glucoglycinuria
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Glucose-6-phosphatase deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	72

	 	Gluten enteropathy
	 	Other Digestive Diseases
	38

	 	Glycinemia (with methylmalonic acidemia)
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Glycinuria (renal)
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Glycogen storage disease
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Glycogenosis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Glycolic aciduria
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Glycoprolinuria
	 	Nutritional, Metabolic & Immunity Disorders
	35

	 	Goiter
	 	Goiter
	36

	 	Goiter — Exophthalmic
	 	Thyrotoxicosis
	36

	 	Goiter — Toxic Diffuse
	 	Thyrotoxicosis
	36

	 	Goiter — Toxic uninodular
	 	Thyrotoxicosis
	36

	 	Goitrous cretinism
	 	Thyrotoxicosis
	17

	 	Gonococcal infections
	 	Other Infective or Parasitic Diseases
	54

	 	Goodpasture’s Syndrome
	 	Arteries, Arterioles, Capillaries
	38

	 	Gout
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Gouty arthropathy
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Gouty iritis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Gouty nephropathy
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Gouty neuritis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Gouty tophi of ear
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Gouty tophi of other sites
	 	Nutritional, Metabolic & Immunity Disorders
	7

	 	Gram-negative septicemia
	 	Septicemia
	45

	 	Grand mal epilepsy
	 	Epilepsy
	32

	 	Granulocytic sarcoma
	 	Leukemia
	36

	 	Graves’ disease
	 	Thyrotoxicosis
	18

	 	Gum Cancer
	 	Cancer — Mouth, Throat, Pharynx
	33

	 	Hairy-cell leukemia
	 	Lymphosarcoma, Etc
	47

	 	Hallervorden-Spatz Disease
	 	Other Nervous System
	63

	 	Hamman-Rich syndrome
	 	Other Respiratory
	38

	 	Hand-Schuller-Christian disease
	 	Nutritional, Metabolic & Immunity Disorders
	17

	 	Hansen’s Disease
	 	Other Infective or Parasitic Diseases
	38

	 	Hartnup disease
	 	Nutritional, Metabolic & Immunity Disorders

30

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	36

	 	Hashimoto’s disease
	 	Thyrotoxicosis
	63

	 	Hay fever
	 	Other Respiratory
	39

	 	Hb-Bart’s Disease
	 	Anemia, Thalassemia
	39

	 	Hb-C disease
	 	Anemia, Thalassemia
	39

	 	Hb-D disease
	 	Anemia, Thalassemia
	39

	 	Hb-S disease
	 	Anemia, Thalassemia
	50

	 	Heart attack
	 	Ischemic & Coronary Heart Disease
	52

	 	Heart block
	 	Other Heart Disease
	24

	 	Heart Cancer
	 	Cancer — Lung, Trachea
	52

	 	Heart Disease
	 	Other Heart Disease
	52

	 	Heart Failure
	 	Other Heart Disease
	52

	 	Heart Failure not otherwise explained
	 	Other Heart Disease
	50

	 	Heart Infarction
	 	Ischemic & Coronary Heart Disease
	50

	 	Heart Ischemia
	 	Ischemic & Coronary Heart Disease
	32

	 	Heilmeyer-Schoner disease
	 	Leukemia
	41

	 	Heller’s Syndrome
	 	Mental, Drugs, Alcohol
	30

	 	Hemangiopericytoma
	 	Cancer — Bone, Cartilage
	72

	 	Hematemesis
	 	Other Digestive Diseases
	47

	 	Hematomyelia
	 	Other Nervous System
	38

	 	Hematoporphyria
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hematoporphyrinuria
	 	Nutritional, Metabolic & Immunity Disorders
	77

	 	Hematuria
	 	Other Genito-Urinary
	47

	 	Hemiballism(us)
	 	Other Nervous System
	47

	 	Hemiplegia
	 	Other Nervous System
	38

	 	Hemochromatosis
	 	Nutritional, Metabolic & Immunity Disorders
	52

	 	Hemopericardium
	 	Other Heart Disease
	72

	 	Hemoperitoneum
	 	Other Digestive Diseases
	43

	 	Hemophilus meningitis
	 	Meningitis
	62

	 	Hemopneumothorax
	 	Pleurisy
	72

	 	Hemorrhage of esophagus
	 	Other Digestive Diseases
	77

	 	Hemorrhage of prostate
	 	Other Genito-Urinary
	72

	 	Hemorrhage of rectum or anus
	 	Other Digestive Diseases
	69

	 	Hemorrhagic enterocolitis
	 	Gastgro-enteritis, Colitis
	69

	 	Hemorrhagic necrosis of intestine
	 	Gastgro-enteritis, Colitis
	54

	 	Hemorrhagic telangiectasia
	 	Arteries, Arterioles, Capillaries
	55

	 	Hemorrhoids
	 	Veins, Other Circulatory
	62

	 	Hemothorax
	 	Pleurisy
	70

	 	Hepatic Cirrhosis
	 	Cirrhosis of Liver
	72

	 	Hepatic coma
	 	Other Digestive Diseases
	72

	 	Hepatic encephalopathy
	 	Other Digestive Diseases
	72

	 	Hepatic failure
	 	Other Digestive Diseases
	72

	 	Hepatic Infarction
	 	Other Digestive Diseases
	70

	 	Hepatitis
	 	Cirrhosis of Liver
	70

	 	Hepatitis C
	 	Cirrhosis of Liver
	31

	 	Hepatoblastoma
	 	Cancer — Other
	72

	 	Hepatocerebral intoxication
	 	Other Digestive Diseases
	38

	 	Hepatolenticular degeneration
	 	Nutritional, Metabolic & Immunity Disorders
	61

	 	Hepatopleural fistura
	 	Emphysema
	77

	 	Hepatorenal Failure
	 	Other Genito-Urinary
	72

	 	Hepatorenal syndrome
	 	Other Digestive Diseases
	38

	 	Hereditary angioedema
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hereditary cardiac amyloidosis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hereditary coproporphyria
	 	Nutritional, Metabolic & Immunity Disorders
	39

	 	Hereditary ellipocytosis
	 	Anemia, Thalassemia
	38

	 	Hereditary Fructose Intolerance
	 	Nutritional, Metabolic & Immunity Disorders
	39

	 	Hereditary leptocytosis
	 	Anemia, Thalassemia
	47

	 	Hereditary spastic paraplegia
	 	Other Nervous System

31

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	67

	 	Hernia
	 	Intestinal Obstruction, Hernia
	17

	 	Herpes zoster
	 	Other Infective or Parasitic Diseases
	17

	 	Herpetic septicemia
	 	Other Infective or Parasitic Diseases
	17

	 	Herpex simplex
	 	Other Infective or Parasitic Diseases
	17

	 	Heterophyiasis
	 	Other Infective or Parasitic Diseases
	38

	 	HG-PRT deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	67

	 	Hiatal hernia
	 	Intestinal Obstruction, Hernia
	51

	 	High Blood Pressure
	 	Hypertensive Disease
	38

	 	High-density lipoid deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Histidinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Histiocycosis X
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Histiocytosis
	 	Nutritional, Metabolic & Immunity Disorders
	17

	 	Histoplasmosis
	 	Other Infective or Parasitic Diseases
	40

	 	HIV
	 	AIDS
	40

	 	HIV Complications
	 	AIDS
	33

	 	Hodgkin’s disease
	 	Lymphosarcoma, Etc
	38

	 	Hoffa’s disease
	 	Nutritional, Metabolic & Immunity Disorders
	98

	 	Homicide
	 	Homicide
	38

	 	Homocystinuria
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Homogentisic acid defects
	 	Nutritional, Metabolic & Immunity Disorders
	54

	 	Horton’s disease
	 	Arteries, Arterioles, Capillaries
	51

	 	HTN
	 	Hypertensive Disease
	40

	 	Human Immunodeficiency virus
	 	AIDS
	40

	 	Human T-Cell Lymphotropic virus
	 	AIDS
	38

	 	Hunter’s syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	47

	 	Huntington’s chorea
	 	Other Nervous System
	38

	 	Hurler’s syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	54

	 	Hyaline necrosis of aorta
	 	Arteries, Arterioles, Capillaries
	77

	 	Hydrocalycosis
	 	Other Genito-Urinary
	77

	 	Hydrocele
	 	Other Genito-Urinary
	77

	 	Hydronephrosis
	 	Other Genito-Urinary
	62

	 	Hydropneumothorax
	 	Pleurisy
	71

	 	Hydrops of gallbladder
	 	Cholelithiasis, Cholecystitis
	62

	 	Hydrothorax
	 	Pleurisy
	77

	 	Hydroureter
	 	Other Genito-Urinary
	77

	 	Hydroureteronephrosis
	 	Other Genito-Urinary
	38

	 	Hydroxprolinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hydroxykynureninuria
	 	Nutritional, Metabolic & Immunity Disorders
	37

	 	Hyperaldosteronism
	 	Diabetes Mellitus — Endocrine Disorders
	38

	 	Hyperammonemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyperbetalipoproteinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyperbilirubinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypercalcemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypercalcinuria
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypercapnia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyperchloremia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypercholesterolemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyperchylomicronemia
	 	Nutritional, Metabolic & Immunity Disorders
	77

	 	Hyperemia of bladder
	 	Other Genito-Urinary
	38

	 	Hypergammaglobulinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypergammaglobulinemic purpura
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyperglyceridemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyperglycinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyperhistidinemia
	 	Nutritional, Metabolic & Immunity Disorders
	37

	 	Hyperinsulinism
	 	Diabetes Mellitus — Endocrine Disorders
	38

	 	Hyperkalemia
	 	Nutritional, Metabolic & Immunity Disorders
	52

	 	Hyperkinetic heart disease
	 	Other Heart Disease

32

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	38

	 	Hyperlipidemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyperlysinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypermagnesemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypermethioninemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypernatremia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyperornithinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyperosmolality
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyperosmolar Coma
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyperoxaluria
	 	Nutritional, Metabolic & Immunity Disorders
	37

	 	Hyperparathyroidism
	 	Diabetes Mellitus — Endocrine Disorders
	38

	 	Hyperphenylalaninemia
	 	Nutritional, Metabolic & Immunity Disorders
	51

	 	Hyperpiesia
	 	Hypertensive Disease
	51

	 	Hyperpiesis
	 	Hypertensive Disease
	37

	 	Hyperplasia of pancreas
	 	Diabetes Mellitus — Endocrine Disorders
	37

	 	Hyperplasia of pancreatic islet beta cells
	 	Diabetes Mellitus — Endocrine Disorders
	76

	 	Hyperplasia of Prostate
	 	Hyperplasia of Prostate
	54

	 	Hyperplasia of renal artery
	 	Arteries, Arterioles, Capillaries
	66

	 	Hyperplasica of appendix
	 	Appendicitis
	38

	 	Hyperpotassemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyperprebetalipoproteinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyperprolinemia
	 	Nutritional, Metabolic & Immunity Disorders
	54

	 	hypersensitivity angiitis
	 	Arteries, Arterioles, Capillaries
	63

	 	Hypersensitivity pneumonitis
	 	Other Respiratory
	51

	 	Hypertension
	 	Hypertensive Disease
	51

	 	Hypertension — Benign
	 	Hypertensive Disease
	51

	 	Hypertension — Uremic
	 	Hypertensive Disease
	51

	 	Hypertensive cardiomegaly
	 	Hypertensive Disease
	51

	 	Hypertensive cardiopathy
	 	Hypertensive Disease
	51

	 	Hypertensive cardiovascular disease
	 	Hypertensive Disease
	51

	 	Hypertensive Disease
	 	Hypertensive Disease
	51

	 	Hypertensive heart disease
	 	Hypertensive Disease
	51

	 	Hypertensive heart & renal disease
	 	Hypertensive Disease
	51

	 	Hypertensive kidney disease
	 	Hypertensive Disease
	51

	 	Hypertensive nephropathy
	 	Hypertensive Disease
	51

	 	Hypertensive nephrosclerosis
	 	Hypertensive Disease
	51

	 	Hypertensive renal disease
	 	Hypertensive Disease
	51

	 	Hypertensive renal failure
	 	Hypertensive Disease
	51

	 	Hypertensive uremia
	 	Hypertensive Disease
	51

	 	Hypertensive vascular degeneration
	 	Hypertensive Disease
	51

	 	Hypertensive vascular disease
	 	Hypertensive Disease
	36

	 	Hyperthyroidism
	 	Thyrotoxicosis
	38

	 	Hypertriglyceridemia
	 	Nutritional, Metabolic & Immunity Disorders
	68

	 	Hypertrophic gastritis
	 	Gastritis, Duodenitis
	52

	 	Hypertrophic obstructive cardiomyopathy
	 	Other Heart Disease
	72

	 	Hypertrophic pyloric stenosis
	 	Other Digestive Diseases
	77

	 	Hypertrophy of Kidney
	 	Other Genito-Urinary
	63

	 	Hypertrophy of nasal turbinates
	 	Other Respiratory
	76

	 	Hypertrophy of prostate (benign)
	 	Hyperplasia of Prostate
	38

	 	Hypertryosinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypervalinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypoalphalipoproteinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypobetalipoproteinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypochloremia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypogammaglobulinemia
	 	Nutritional, Metabolic & Immunity Disorders
	37

	 	Hypoglycemia
	 	Diabetes Mellitus — Endocrine Disorders
	37

	 	Hypoglycemic coma
	 	Diabetes Mellitus — Endocrine Disorders
	37

	 	Hypoinsulinemia
	 	Diabetes Mellitus — Endocrine Disorders

33

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	38

	 	Hypokalemia
	 	Nutritional, Metabolic & Immunity Disorders
	73

	 	Hypokalemic nephropathy
	 	Nephritis, Renal Scleroris
	38

	 	Hypomagnesemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyponatremia
	 	Nutritional, Metabolic & Immunity Disorders
	37

	 	Hypoparathyroidism
	 	Diabetes Mellitus — Endocrine Disorders
	18

	 	Hypopharynx Cancer
	 	Cancer — Mouth, Throat, Pharynx
	38

	 	Hypophosphatasia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypophosphatemia
	 	Nutritional, Metabolic & Immunity Disorders
	37

	 	Hypophysis Infarction
	 	Diabetes Mellitus — Endocrine Disorders
	55

	 	Hypopiesis
	 	Veins, Other Circulatory
	37

	 	Hypopituitarism
	 	Diabetes Mellitus — Endocrine Disorders
	38

	 	Hypopotassemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hyposmolality
	 	Nutritional, Metabolic & Immunity Disorders
	55

	 	Hypotension
	 	Veins, Other Circulatory
	87

	 	Hypotensive Shock
	 	Unknown Causes & Ill-Defined Causes
	36

	 	Hypothroidism
	 	Thyrotoxicosis
	87

	 	Hypoventilation
	 	Unknown Causes & Ill-Defined Causes
	38

	 	Hypovitaminosis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Hypovolemia
	 	Nutritional, Metabolic & Immunity Disorders
	87

	 	Hypoxemia
	 	Unknown Causes & Ill-Defined Causes
	36

	 	iatrongenic thyroiditis
	 	Thyrotoxicosis
	52

	 	Idiopathic cardiomyopathy
	 	Other Heart Disease
	52

	 	Idiopathic myocarditis
	 	Other Heart Disease
	52

	 	idiopathic pericarditis
	 	Other Heart Disease
	72

	 	Idiopathic steatorrhea
	 	Other Digestive Diseases
	47

	 	Idiopathic torsion dystonia
	 	Other Nervous System
	69

	 	Ileitis of small intestine
	 	Gastgro-enteritis, Colitis
	69

	 	Ileocolitis
	 	Gastgro-enteritis, Colitis
	67

	 	Ileus of intestine or bowel or colon
	 	Intestinal Obstruction, Hernia
	87

	 	Illegible death certificate
	 	Unknown Causes & Ill-Defined Causes
	38

	 	Imidazole aminoaciduria
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Iminoacidopathy
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Immunity deficiencies
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Immunoglobulin deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	33

	 	Immunoproliferative neoplasm
	 	Lymphosarcoma, Etc
	67

	 	Impaction of colon
	 	Intestinal Obstruction, Hernia
	67

	 	Impaction of intestine
	 	Intestinal Obstruction, Hernia
	79

	 	Impetigo
	 	Skin Infections
	101

	 	Incomplete Death Certificate
	 	Incomplete Death Certificate
	38

	 	Indicanuria
	 	Nutritional, Metabolic & Immunity Disorders
	63

	 	Induration of lung
	 	Other Respiratory
	82

	 	Inencephaly
	 	Congenital Anomalies
	47

	 	Infantile cerebral palsy
	 	Other Nervous System
	47

	 	Infantile hemiplegia
	 	Other Nervous System
	47

	 	Infantile necrotizing encephalomyelopathy
	 	Other Nervous System
	37

	 	Infarction — Adrenal
	 	Diabetes Mellitus — Endocrine Disorders
	78

	 	Infarction — Amnion
	 	Complications of Pregnancy
	69

	 	Infarction — Bowel
	 	Gastgro-enteritis, Colitis
	53

	 	Infarction — Brainstem
	 	Cerebrovascular Diseases
	77

	 	Infarction — Breast
	 	Other Genito-Urinary
	53

	 	Infarction — Cerebral
	 	Cerebrovascular Diseases
	69

	 	Infarction — Colon
	 	Gastgro-enteritis, Colitis
	50

	 	Infarction — Coronary Artery
	 	Ischemic & Coronary Heart Disease
	54

	 	Infarction — Embolic
	 	Arteries, Arterioles, Capillaries
	53

	 	Infarction — Front Lobe
	 	Cerebrovascular Diseases
	71

	 	Infarction — Gallbladder
	 	Cholelithiasis, Cholecystitis
	50

	 	Infarction — Heart
	 	Ischemic & Coronary Heart Disease

34

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	72

	 	Infarction — Hepatic
	 	Other Digestive Diseases
	37

	 	Infarction — Hypophysis
	 	Diabetes Mellitus — Endocrine Disorders
	69

	 	Infarction — Intestinal
	 	Gastgro-enteritis, Colitis
	77

	 	Infarction — Kidney
	 	Other Genito-Urinary
	72

	 	Infarction — Liver
	 	Other Digestive Diseases
	52

	 	Infarction — Lung
	 	Other Heart Disease
	55

	 	Infarction — Lymph Node
	 	Veins, Other Circulatory
	53

	 	Infarction — Medullary
	 	Cerebrovascular Diseases
	69

	 	Infarction — Mesenteric
	 	Gastgro-enteritis, Colitis
	53

	 	Infarction — Midbrain
	 	Cerebrovascular Diseases
	50

	 	Infarction — Nontransmural
	 	Ischemic & Coronary Heart Disease
	69

	 	Infarction — Omentum
	 	Gastgro-enteritis, Colitis
	77

	 	Infarction — Ovary
	 	Other Genito-Urinary
	72

	 	Infarction — Pancreas
	 	Other Digestive Diseases
	37

	 	Infarction — Pituitary
	 	Diabetes Mellitus — Endocrine Disorders
	53

	 	Infarction — Pontine
	 	Cerebrovascular Diseases
	77

	 	Infarction — Prostate
	 	Other Genito-Urinary
	52

	 	Infarction — Pulmonary
	 	Other Heart Disease
	77

	 	Infarction — renal
	 	Other Genito-Urinary
	47

	 	Infarction — Spinal Cord
	 	Other Nervous System
	39

	 	Infarction — Spleen
	 	Anemia, Thalassemia
	37

	 	Infarction — suprarenal
	 	Diabetes Mellitus — Endocrine Disorders
	77

	 	Infarction — Testis
	 	Other Genito-Urinary
	55

	 	Infarction — Thrombotic
	 	Veins, Other Circulatory
	36

	 	Infarction — Thyroid
	 	Thyrotoxicosis
	77

	 	Infarction of prostate
	 	Other Genito-Urinary
	47

	 	Infarction of Spinal Cord
	 	Other Nervous System
	36

	 	Infarction of thyroid
	 	Thyrotoxicosis
	81

	 	Infection — Joint
	 	Other Skin & Musculoskeletal Diseases
	17

	 	Infectious mononucleosis
	 	Other Infective or Parasitic Diseases
	47

	 	Infective polyneuritis
	 	Other Nervous System
	56

	 	Influenza
	 	Influenza
	56

	 	Influenza A
	 	Influenza
	56

	 	Influenzal Bronchopneumonia
	 	Influenza
	56

	 	Influenzal laryngitis
	 	Influenza
	56

	 	Influenzal pharyngitis
	 	Influenza
	56

	 	Influenzal pneumonia
	 	Influenza
	56

	 	Influenzal respiratory infection
	 	Influenza
	67

	 	Inguinal hernia
	 	Intestinal Obstruction, Hernia
	87

	 	Instantaneous death
	 	Unknown Causes & Ill-Defined Causes
	77

	 	Interstitial cystitis
	 	Other Genito-Urinary
	63

	 	interstitial emphysema
	 	Other Respiratory
	63

	 	Interstitial lung disease
	 	Other Respiratory
	63

	 	Interstitial pneumonia
	 	Other Respiratory
	69

	 	Intestinal Gangrene
	 	Gastgro-enteritis, Colitis
	69

	 	Intestinal Infarction
	 	Gastgro-enteritis, Colitis
	5

	 	Intestinal Infections — Other
	 	Intestinal Infections — Other
	69

	 	Intestinal Ischemia
	 	Gastgro-enteritis, Colitis
	72

	 	Intestinal malabsorption
	 	Other Digestive Diseases
	67

	 	Intestinal Obstruction
	 	Intestinal Obstruction, Hernia
	31

	 	Intestinal Tract Cancer
	 	Cancer — Other
	5

	 	Intestinal trichomoniasis
	 	Intestinal Infections — Other
	77

	 	Intestinoureteral fistula
	 	Other Genito-Urinary
	77

	 	Intestinovesical fistula
	 	Other Genito-Urinary
	53

	 	Intracerebral hemorrhage
	 	Cerebrovascular Diseases
	53

	 	Intracranial hemorrhage
	 	Cerebrovascular Diseases
	67

	 	Intussusception
	 	Intestinal Obstruction, Hernia

35

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	67

	 	Invagination of intestine or colon
	 	Intestinal Obstruction, Hernia
	38

	 	Iodine deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	36

	 	Iodine hypothroidism
	 	Thyrotoxicosis
	77

	 	Irradiation cystitis
	 	Other Genito-Urinary
	72

	 	Irritable colon
	 	Other Digestive Diseases
	55

	 	Ischemia — Basilar Artery
	 	Veins, Other Circulatory
	81

	 	Ischemia — Bone
	 	Other Skin & Musculoskeletal Diseases
	69

	 	Ischemia — Bowel
	 	Gastgro-enteritis, Colitis
	53

	 	Ischemia — Brain
	 	Cerebrovascular Diseases
	50

	 	Ischemia — Cardiac
	 	Ischemic & Coronary Heart Disease
	53

	 	Ischemia — Carotid Artery
	 	Cerebrovascular Diseases
	53

	 	Ischemia — Cerebral
	 	Cerebrovascular Diseases
	53

	 	Ischemia — Cerebrovascular
	 	Cerebrovascular Diseases
	69

	 	Ischemia — Colon
	 	Gastgro-enteritis, Colitis
	50

	 	Ischemia — Coronary
	 	Ischemic & Coronary Heart Disease
	50

	 	Ischemia — Heart
	 	Ischemic & Coronary Heart Disease
	77

	 	Ischemia — Kidney
	 	Other Genito-Urinary
	47

	 	Ischemia — Labyrinth
	 	Other Nervous System
	81

	 	Ischemia — Legs
	 	Other Skin & Musculoskeletal Diseases
	81

	 	Ischemia — Lower Extremities
	 	Other Skin & Musculoskeletal Diseases
	50

	 	Ischemia — Myocardial
	 	Ischemic & Coronary Heart Disease
	77

	 	Ischemia — Renal
	 	Other Genito-Urinary
	47

	 	Ischemia — Retinal
	 	Other Nervous System
	69

	 	Ischemia — Small Bowel
	 	Gastgro-enteritis, Colitis
	47

	 	Ischemia — Spinal Cord
	 	Other Nervous System
	50

	 	Ischemia — Subendocardial
	 	Ischemic & Coronary Heart Disease
	53

	 	Ischemia — Vertebral Artery
	 	Cerebrovascular Diseases
	69

	 	Ischemic — Intestine
	 	Gastgro-enteritis, Colitis
	69

	 	Ischemic Bowel
	 	Gastgro-enteritis, Colitis
	50

	 	Ischemic cardiomyopathy
	 	Ischemic & Coronary Heart Disease
	69

	 	Ischemic colitis
	 	Gastgro-enteritis, Colitis
	50

	 	Ischemic congestive cardiomyopathy
	 	Ischemic & Coronary Heart Disease
	50

	 	Ischemic heart disease
	 	Ischemic & Coronary Heart Disease
	69

	 	Ischemic stricture of intestine
	 	Gastgro-enteritis, Colitis
	72

	 	Ischiorectal fistula
	 	Other Digestive Diseases
	81

	 	Jaccaud’s syndrome
	 	Other Skin & Musculoskeletal Diseases
	17

	 	Jakob-Creutzfeldt disease
	 	Other Infective or Parasitic Diseases
	47

	 	Jansky-Bielschowsky disease
	 	Other Nervous System
	81

	 	Joint Infection
	 	Other Skin & Musculoskeletal Diseases
	81

	 	Juvenile osteochondrosis
	 	Other Skin & Musculoskeletal Diseases
	33

	 	Kahler’s disease
	 	Lymphosarcoma, Etc
	17

	 	Kaposi’s syndrome
	 	Other Infective or Parasitic Diseases
	54

	 	Kawasaki disease
	 	Arteries, Arterioles, Capillaries
	15

	 	Kedani Fever
	 	Typhus and Ricketsiosis
	81

	 	Keratoconjunctivitis sicca
	 	Other Skin & Musculoskeletal Diseases
	31

	 	Kidney Cancer
	 	Cancer — Other
	77

	 	Kidney Infarction
	 	Other Genito-Urinary
	74

	 	Kidney Infection
	 	Kidney Infections
	77

	 	Kidney Ischemia
	 	Other Genito-Urinary
	73

	 	Kidney lesions
	 	Nephritis, Renal Scleroris
	73

	 	Kidney nephritis
	 	Nephritis, Renal Scleroris
	75

	 	Kidney stone
	 	Urinary System Infections
	73

	 	Kimmelstiel-Wilson syndrome
	 	Nephritis, Renal Scleroris
	82

	 	Klinefelter’s syndrome
	 	Congenital Anomalies
	45

	 	Kojevnikov’s epilepsy
	 	Epilepsy
	41

	 	Korsakoff’s psychosis
	 	Mental, Drugs, Alcohol
	47

	 	Krabbe’s disease
	 	Other Nervous System

36

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	77

	 	Kraurosis of penis
	 	Other Genito-Urinary
	47

	 	Kufs’ disease
	 	Other Nervous System
	47

	 	Kugelberg-Welander disease
	 	Other Nervous System
	38

	 	Kwashiorkor
	 	Nutritional, Metabolic & Immunity Disorders
	17

	 	Kyasanur Forest Disease
	 	Other Infective or Parasitic Diseases
	38

	 	Kynureninase defects
	 	Nutritional, Metabolic & Immunity Disorders
	81

	 	Kyphoscoliosis wo heart disease
	 	Other Skin & Musculoskeletal Diseases
	52

	 	Kyphoscolitic heart disease
	 	Other Heart Disease
	47

	 	Labyrinth Ischemia
	 	Other Nervous System
	38

	 	Lactic acidosis
	 	Nutritional, Metabolic & Immunity Disorders
	13

	 	Langat encephalitis
	 	Encephalitis
	63

	 	Laryngitis
	 	Other Respiratory
	63

	 	Laryngopharyngitis
	 	Other Respiratory
	63

	 	Laryngotracheitis
	 	Other Respiratory
	23

	 	Larynx Cancer
	 	Cancer — Larynx
	38

	 	Launois-Bensaude’s lipomatosis
	 	Nutritional, Metabolic & Immunity Disorders
	82

	 	laurence-Moon-Biedl syndrome
	 	Congenital Anomalies
	40

	 	LAV
	 	AIDS
	52

	 	Left bundle branch hemiblock
	 	Other Heart Disease
	81

	 	Leg Ischemia
	 	Other Skin & Musculoskeletal Diseases
	98

	 	Legal execution
	 	Homicide
	30

	 	Leiomysarcoma
	 	Cancer — Bone, Cartilage
	17

	 	Leishmaniasis
	 	Other Infective or Parasitic Diseases
	17

	 	Lepromatous
	 	Other Infective or Parasitic Diseases
	17

	 	Leprosy
	 	Other Infective or Parasitic Diseases
	17

	 	Leptospirosis
	 	Other Infective or Parasitic Diseases
	54

	 	Leriche’s syndrome
	 	Arteries, Arterioles, Capillaries
	38

	 	Lesch-Nyhan syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	54

	 	Lethal midline granuloma
	 	Arteries, Arterioles, Capillaries
	33

	 	Letterer-Siwe disease
	 	Lymphosarcoma, Etc
	38

	 	Leucine-Induced hypoglycemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Leucinosis
	 	Nutritional, Metabolic & Immunity Disorders
	32

	 	Leukemia
	 	Leukemia
	47

	 	Leukodystrophy
	 	Other Nervous System
	77

	 	Leukoplakia of penis
	 	Other Genito-Urinary
	72

	 	Leukoplakiaa of esophagus
	 	Other Digestive Diseases
	33

	 	Leukosarcoma
	 	Lymphosarcoma, Etc
	33

	 	Leumkemis reticuloendotheliosis
	 	Lymphosarcoma, Etc
	81

	 	Libman-Sacks disease
	 	Other Skin & Musculoskeletal Diseases
	18

	 	Lip Cancer
	 	Cancer — Mouth, Throat, Pharynx
	38

	 	Lipidoses
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Lipochondrodystrophy
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Lipodystrophy
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Lipoid dermatoarthritis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Lipoid dermatoarthritis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Lipoid storage disease
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Lipoprotein deficiencies
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Liposynovitis prepatellaris
	 	Nutritional, Metabolic & Immunity Disorders
	17

	 	Listeriosis
	 	Other Infective or Parasitic Diseases
	47

	 	Little’s disease
	 	Other Nervous System
	72

	 	Liver — abscess
	 	Other Digestive Diseases
	31

	 	Liver Cancer
	 	Cancer — Other
	72

	 	Liver Failure
	 	Other Digestive Diseases
	72

	 	Liver Infarction
	 	Other Digestive Diseases
	17

	 	Lobomycosis
	 	Other Infective or Parasitic Diseases
	57

	 	Lobular pneumonia
	 	Pneumonia
	63

	 	Loffler’s syndrome
	 	Other Respiratory

37

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	13

	 	Louping ill
	 	Encephalitis
	15

	 	Louse-borne typhus
	 	Typhus and Ricketsiosis
	81

	 	Lower extremity ischemia
	 	Other Skin & Musculoskeletal Diseases
	52

	 	Lown-Ganong-Levine syndrome
	 	Other Heart Disease
	24

	 	Lung Cancer
	 	Cancer — Lung, Trachea
	52

	 	Lung Infarction
	 	Other Heart Disease
	62

	 	Lung pleurisy
	 	Pleurisy
	63

	 	Lung Sarcoidosis
	 	Other Respiratory
	81

	 	Lupus erythematodes
	 	Other Skin & Musculoskeletal Diseases
	81

	 	Lupus erythematosis
	 	Other Skin & Musculoskeletal Diseases
	81

	 	Lyell’s syndrome
	 	Other Skin & Musculoskeletal Diseases
	55

	 	Lymph Node Infarction
	 	Veins, Other Circulatory
	79

	 	Lymphadenitis
	 	Skin Infections
	40

	 	Lymphadenopathy associated virus
	 	AIDS
	55

	 	Lymphangiectasis
	 	Veins, Other Circulatory
	55

	 	Lymphangitis
	 	Veins, Other Circulatory
	33

	 	Lymphatic Cancer
	 	Lymphosarcoma, Etc
	55

	 	Lymphedema
	 	Veins, Other Circulatory
	17

	 	Lymphocytic choriomeningitis
	 	Other Infective or Parasitic Diseases
	36

	 	Lymphocytic thyroiditis
	 	Thyrotoxicosis
	32

	 	Lymphoid Leukemia
	 	Leukemia
	33

	 	Lymphosarcoma
	 	Lymphosarcoma, Etc
	32

	 	Lymphosarcoma cell leukemia
	 	Leukemia
	38

	 	Macroglobulinemia
	 	Nutritional, Metabolic & Immunity Disorders
	17

	 	Madura foot
	 	Other Infective or Parasitic Diseases
	16

	 	Malaria
	 	Malaria
	51

	 	Malignant hypertension
	 	Hypertensive Disease
	72

	 	Mallory-Weiss syndrome
	 	Other Digestive Diseases
	38

	 	Malnutrition
	 	Nutritional, Metabolic & Immunity Disorders
	30

	 	Mandible Cancer
	 	Cancer — Bone, Cartilage
	41

	 	Manic Depression
	 	Mental, Drugs, Alcohol
	38

	 	Mannosidosis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Maple syrup urine disease
	 	Nutritional, Metabolic & Immunity Disorders
	54

	 	Marable’s syndrome
	 	Arteries, Arterioles, Capillaries
	82

	 	Marcus-Gunn syndrome
	 	Congenital Anomalies
	82

	 	Marfan’s syndrome
	 	Congenital Anomalies
	38

	 	Maroteaux-Lamy syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	33

	 	Mastocytoma
	 	Lymphosarcoma, Etc
	46

	 	Mastoiditis
	 	Otitis media and mastoiditis
	38

	 	McArdle’s disease
	 	Nutritional, Metabolic & Immunity Disorders
	54

	 	MCLS
	 	Arteries, Arterioles, Capillaries
	14

	 	Measles
	 	Measles
	21

	 	Meckel’s Diverticulus
	 	Cancer — Colon, Cecum, Sigmoid
	63

	 	Mediastinal emphysema
	 	Other Respiratory
	63

	 	Mediastinitis
	 	Other Respiratory
	52

	 	Mediastinopericarditis
	 	Other Heart Disease
	53

	 	Medullary Infarction
	 	Cerebrovascular Diseases
	47

	 	Medullary Paralysis
	 	Other Nervous System
	32

	 	Megakaryocytic myelosis
	 	Leukemia
	29

	 	Melanocarcinoma
	 	Cancer — Skin, Melanoma
	29

	 	Melanoma
	 	Cancer — Skin, Melanoma
	72

	 	Melena
	 	Other Digestive Diseases
	17

	 	Melioidosis
	 	Other Infective or Parasitic Diseases
	53

	 	Meningeal hemorrhage
	 	Cerebrovascular Diseases
	43

	 	Meningitis
	 	Meningitis
	10

	 	Meningococcal carditis
	 	Meningococcal Infection
	10

	 	Meningococcal Infection
	 	Meningococcal Infection

38

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	10

	 	Meningococcal meningitis
	 	Meningococcal Infection
	47

	 	Meningoencephalitis
	 	Other Nervous System
	47

	 	Meningomyelitis
	 	Other Nervous System
	41

	 	Mental Retardation
	 	Mental, Drugs, Alcohol
	69

	 	Mesenteric Embolus
	 	Gastgro-enteritis, Colitis
	69

	 	Mesenteric infarction
	 	Gastgro-enteritis, Colitis
	72

	 	Mesenteric saponiication
	 	Other Digestive Diseases
	38

	 	Metabolic acidosis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Metabolic alkalosis
	 	Nutritional, Metabolic & Immunity Disorders
	17

	 	Metagonimiasis
	 	Other Infective or Parasitic Diseases
	31

	 	Metastatic Adenocarcinoma
	 	Cancer — Other
	38

	 	Methioninemia
	 	Nutritional, Metabolic & Immunity Disorders
	50

	 	MI
	 	Ischemic & Coronary Heart Disease
	82

	 	Microcephalus
	 	Congenital Anomalies
	50

	 	Microinfarct of heart
	 	Ischemic & Coronary Heart Disease
	53

	 	Midbrain Infarction
	 	Cerebrovascular Diseases
	2

	 	Miliary tuberculosis
	 	Tuberculosis — Nonrespiratory
	38

	 	Mineral deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	39

	 	Minkowski-chauffad syndrome
	 	Anemia, Thalassemia
	50

	 	Mitral insufficiency
	 	Ischemic & Coronary Heart Disease
	50

	 	Mitral regurgitation
	 	Ischemic & Coronary Heart Disease
	50

	 	Mitral stenosis
	 	Ischemic & Coronary Heart Disease
	50

	 	Mitral valve disorder
	 	Ischemic & Coronary Heart Disease
	49

	 	Mitral valve insufficiency
	 	Rheumatic Heart Disease
	52

	 	Mobitz atrioventricular block
	 	Other Heart Disease
	54

	 	Monckeberg’s sclerosis
	 	Arteries, Arterioles, Capillaries
	55

	 	Mondor’s disease
	 	Veins, Other Circulatory
	82

	 	Mongolism
	 	Congenital Anomalies
	38

	 	Monoclonal gammopathy
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Monoclonal paraproteinemia
	 	Nutritional, Metabolic & Immunity Disorders
	32

	 	Monocytic leukemia
	 	Leukemia
	17

	 	Mononucleosis
	 	Other Infective or Parasitic Diseases
	38

	 	Morbid obesity
	 	Nutritional, Metabolic & Immunity Disorders
	14

	 	Morbilli
	 	Measles
	52

	 	Morbus cordis
	 	Other Heart Disease
	38

	 	Morquio-Brailsford disease
	 	Nutritional, Metabolic & Immunity Disorders
	54

	 	Moschcowitz’s syndrome
	 	Arteries, Arterioles, Capillaries
	13

	 	Mosquito-borne viral encephalitis
	 	Encephalitis
	47

	 	Motor neuron disease
	 	Other Nervous System
	88

	 	Motor Vehicle Accidents
	 	Motor Vehicle Accidents
	18

	 	Mouth Cancer
	 	Cancer — Mouth, Throat, Pharynx
	53

	 	Moyamoya disease
	 	Cerebrovascular Diseases
	17

	 	Mucocormycosis
	 	Other Infective or Parasitic Diseases
	54

	 	Mucocutaneous lymph node syndrome
	 	Arteries, Arterioles, Capillaries
	38

	 	Mucolipidosis III
	 	Nutritional, Metabolic & Immunity Disorders
	37

	 	Mucopolysaccharidosis
	 	Diabetes Mellitus — Endocrine Disorders
	38

	 	Mucopolysaccharidosis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Mucoviscidosis
	 	Nutritional, Metabolic & Immunity Disorders
	31

	 	Multiform Cancer
	 	Cancer — Other
	87

	 	Multiple Medical Conditions
	 	Unknown Causes & Ill-Defined Causes
	33

	 	Multiple myeloma
	 	Lymphosarcoma, Etc
	87

	 	Multiple Organ Failure
	 	Unknown Causes & Ill-Defined Causes
	44

	 	Multiple Sclerosis
	 	Multiple Sclerosis
	63

	 	Multiple Upper Respiratory Infections
	 	Other Respiratory
	63

	 	Multiple URI
	 	Other Respiratory
	87

	 	Multi-System Failure
	 	Unknown Causes & Ill-Defined Causes
	17

	 	Mumps
	 	Other Infective or Parasitic Diseases

39

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	98

	 	Murder
	 	Homicide
	47

	 	Muscular dystrophy
	 	Other Nervous System
	47

	 	Myasthenia gravis
	 	Other Nervous System
	33

	 	Mycosis fungoides
	 	Lymphosarcoma, Etc
	47

	 	Myelitis
	 	Other Nervous System
	47

	 	Myelitis — transverse
	 	Other Nervous System
	32

	 	Myeloid leukemia
	 	Leukemia
	32

	 	Myeloid Sarcoma
	 	Leukemia
	33

	 	Myeloproliferative syndrome
	 	Lymphosarcoma, Etc
	52

	 	Myocardial decompensation
	 	Other Heart Disease
	52

	 	Myocardial decomposition
	 	Other Heart Disease
	52

	 	Myocardial degeneration
	 	Other Heart Disease
	52

	 	Myocardial disease
	 	Other Heart Disease
	52

	 	Myocardial failure
	 	Other Heart Disease
	50

	 	Myocardial Failure — possible infarction
	 	Ischemic & Coronary Heart Disease
	50

	 	Myocardial Failure — with arteriosclerosis
	 	Ischemic & Coronary Heart Disease
	50

	 	Myocardial Infarction
	 	Ischemic & Coronary Heart Disease
	52

	 	Myocardial Insufficiency
	 	Other Heart Disease
	50

	 	Myocardial Ischemia
	 	Ischemic & Coronary Heart Disease
	52

	 	Myocardiopathy
	 	Other Heart Disease
	52

	 	Myocarditis
	 	Other Heart Disease
	52

	 	Myocarditis with arteriosclerosis
	 	Other Heart Disease
	52

	 	Myocarditis without arteriosclerosis
	 	Other Heart Disease
	47

	 	Myoconic epilepsy
	 	Other Nervous System
	52

	 	Myoendocarditis
	 	Other Heart Disease
	47

	 	Myoneural disorder
	 	Other Nervous System
	52

	 	Myopericarditis
	 	Other Heart Disease
	81

	 	Myositis
	 	Other Skin & Musculoskeletal Diseases
	36

	 	Myxedema
	 	Thyrotoxicosis
	31

	 	Nasal Cavity Cancer
	 	Cancer — Other
	63

	 	Nasal polyps
	 	Other Respiratory
	63

	 	Nasopharyngitis
	 	Other Respiratory
	18

	 	Nasopharynx Cancer
	 	Cancer — Mouth, Throat, Pharynx
	87

	 	Natural Causes
	 	Unknown Causes & Ill-Defined Causes
	17

	 	Necrobacillosis
	 	Other Infective or Parasitic Diseases
	54

	 	Necrosis of artery
	 	Arteries, Arterioles, Capillaries
	80

	 	Necrosis of bone
	 	Osteomyelitis, periostitis
	69

	 	Necrosis of intestine
	 	Gastgro-enteritis, Colitis
	72

	 	Necrosis of liver
	 	Other Digestive Diseases
	72

	 	Necrosis of pancreas
	 	Other Digestive Diseases
	61

	 	Necrotic pneumonia
	 	Emphysema
	54

	 	Necrotizing angiitis
	 	Arteries, Arterioles, Capillaries
	73

	 	Nephritis
	 	Nephritis, Renal Scleroris
	73

	 	Nephritis — Kidney
	 	Nephritis, Renal Scleroris
	38

	 	Nephrocalcinosis
	 	Nutritional, Metabolic & Immunity Disorders
	73

	 	Nephrogenic diabetes insipidus
	 	Nephritis, Renal Scleroris
	75

	 	Nephrolithiasis
	 	Urinary System Infections
	73

	 	Nephropathy
	 	Nephritis, Renal Scleroris
	77

	 	Nephroptosis
	 	Other Genito-Urinary
	51

	 	Nephrosclerosis
	 	Hypertensive Disease
	51

	 	Nephrosclerosis — Hypertensive
	 	Hypertensive Disease
	73

	 	Nephrotic syndrome
	 	Nephritis, Renal Scleroris
	87

	 	Nerves
	 	Unknown Causes & Ill-Defined Causes
	47

	 	Neurological disorders
	 	Other Nervous System
	47

	 	Neuromyelitis optica
	 	Other Nervous System
	47

	 	Neuropathic muscular atrophy
	 	Other Nervous System
	3

	 	Neurosyphilis
	 	Syphilis

40

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	32

	 	Neutrophilic leukemia
	 	Leukemia
	54

	 	Nevus Non-neoplastic
	 	Arteries, Arterioles, Capillaries
	38

	 	Nezelof’s syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Nieman-Pick disease
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Nieman-Pick splenomegaly
	 	Nutritional, Metabolic & Immunity Disorders
	101

	 	No Cause Listed
	 	Incomplete Death Certificate
	100

	 	No Death Certificate
	 	No Death Certificate
	36

	 	Nodular Goiter
	 	Thyrotoxicosis
	43

	 	Nonpyogenic meningitis
	 	Meningitis
	35

	 	Nontoxic goiter
	 	Goiter
	50

	 	Nontransmural Infarction
	 	Ischemic & Coronary Heart Disease
	72

	 	Nontropical sprue
	 	Other Digestive Diseases
	38

	 	Nutritional atrophy
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Nutritional dwarfism
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Nutritional marasmus
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Oasthouse urine disease
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Obesity
	 	Nutritional, Metabolic & Immunity Disorders
	52

	 	Obliterative pericarditis
	 	Other Heart Disease
	72

	 	Obstruction of bile duct
	 	Other Digestive Diseases
	72

	 	Obstruction of esophagus
	 	Other Digestive Diseases
	71

	 	Obstruction of gallbladder
	 	Cholelithiasis, Cholecystitis
	67

	 	Obstruction of intestine or colon
	 	Intestinal Obstruction, Hernia
	52

	 	Obstructive cardiomyopathy
	 	Other Heart Disease
	77

	 	Obstructive uropathy
	 	Other Genito-Urinary
	72

	 	Occlusion of bile duct
	 	Other Digestive Diseases
	53

	 	Occlusion of cerebral arteries
	 	Cerebrovascular Diseases
	67

	 	Occulsion of intestine or colon
	 	Intestinal Obstruction, Hernia
	38

	 	Ochronosis
	 	Nutritional, Metabolic & Immunity Disorders
	87

	 	Old age
	 	Unknown Causes & Ill-Defined Causes
	47

	 	Olivopontocerebellar atrophy or degeneration
	 	Other Nervous System
	69

	 	Omentum Infarction
	 	Gastgro-enteritis, Colitis
	17

	 	Omsk hemorrhagic fever
	 	Other Infective or Parasitic Diseases
	17

	 	Opisthorchiasis
	 	Other Infective or Parasitic Diseases
	72

	 	Oral Cavity Diseases
	 	Other Digestive Diseases
	47

	 	Orbital cellulitis
	 	Other Nervous System
	47

	 	Orbital osteomyelitis
	 	Other Nervous System
	47

	 	Orbital periostitis
	 	Other Nervous System
	77

	 	Orchitis
	 	Other Genito-Urinary
	85

	 	Organic Brain Disease
	 	Senility
	41

	 	Organic Brain Syndrome
	 	Mental, Drugs, Alcohol
	52

	 	Organic Heart Disease
	 	Other Heart Disease
	17

	 	Ornithosis
	 	Other Infective or Parasitic Diseases
	18

	 	Oropharyngeal Cancer
	 	Cancer — Mouth, Throat, Pharynx
	18

	 	Oropharynx Cancer
	 	Cancer — Mouth, Throat, Pharynx
	55

	 	Orthostatic hypotension
	 	Veins, Other Circulatory
	81

	 	Osteoarthrosis
	 	Other Skin & Musculoskeletal Diseases
	38

	 	Osteochondrodystrophy
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Osteomalacia
	 	Nutritional, Metabolic & Immunity Disorders
	80

	 	Osteomyelitis
	 	Osteomyelitis, periostitis
	81

	 	Osteoporosis
	 	Other Skin & Musculoskeletal Diseases
	17

	 	Other Infective or Parasitic Diseases
	 	Other Infective or Parasitic Diseases
	46

	 	Otitis media
	 	Otitis media and mastoiditis
	31

	 	Ovarian Cancer
	 	Cancer — Other
	31

	 	Ovary Cancer
	 	Cancer — Other
	77

	 	Ovary Infarction
	 	Other Genito-Urinary
	38

	 	Oxalosis
	 	Nutritional, Metabolic & Immunity Disorders
	25

	 	Paget’s Disease of Breast
	 	Cancer — Breast

41

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	81

	 	Paget’s disease of the bone
	 	Other Skin & Musculoskeletal Diseases
	54

	 	Panarteritis
	 	Arteries, Arterioles, Capillaries
	31

	 	Pancreas Cancer
	 	Cancer — Other
	72

	 	Pancreas Infarction
	 	Other Digestive Diseases
	72

	 	Pancreatic diseases
	 	Other Digestive Diseases
	72

	 	Pancreatic steatorrhea
	 	Other Digestive Diseases
	72

	 	Pancreatitis
	 	Other Digestive Diseases
	72

	 	Pancreatolithiasis
	 	Other Digestive Diseases
	37

	 	Panhypopituitarism
	 	Diabetes Mellitus — Endocrine Disorders
	52

	 	Papillary muscle disorder
	 	Other Heart Disease
	67

	 	Paraesophageal hernia
	 	Intestinal Obstruction, Hernia
	17

	 	Paragonimiasis
	 	Other Infective or Parasitic Diseases
	57

	 	Parainfluenza
	 	Pneumonia
	63

	 	paralysis of diaphragm
	 	Other Respiratory
	67

	 	paralytic ileus
	 	Intestinal Obstruction, Hernia
	31

	 	Parametrium Cancer
	 	Cancer — Other
	41

	 	Paranoid Schizophrenia
	 	Mental, Drugs, Alcohol
	47

	 	Paraplegia
	 	Other Nervous System
	38

	 	Paraproteinemia
	 	Nutritional, Metabolic & Immunity Disorders
	17

	 	parascarlatina
	 	Other Infective or Parasitic Diseases
	31

	 	Parathyroid Cancer
	 	Cancer — Other
	37

	 	Parathyroid gland disorder
	 	Diabetes Mellitus — Endocrine Disorders
	37

	 	Parathyroiditis
	 	Diabetes Mellitus — Endocrine Disorders
	4

	 	Paratyphoid Fever
	 	Typhoid
	72

	 	Parenchymatous degeneration of liver
	 	Other Digestive Diseases
	47

	 	Parkinson’s disease
	 	Other Nervous System
	47

	 	Paroxysmal choreo-athetosis
	 	Other Nervous System
	52

	 	Paroxysmal supraventricular tachycardia
	 	Other Heart Disease
	52

	 	Paroxysmal ventricular tachycardia
	 	Other Heart Disease
	45

	 	Partial epilepsy
	 	Epilepsy
	63

	 	Passive pneumonia
	 	Other Respiratory
	17

	 	Pasteurellosis
	 	Other Infective or Parasitic Diseases
	82

	 	Patau’s syndrome
	 	Congenital Anomalies
	47

	 	Pelizaeus-Merzbaher disease
	 	Other Nervous System
	38

	 	Pellagra
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Pellagra — Alcoholic
	 	Nutritional, Metabolic & Immunity Disorders
	64

	 	Peptic ulcer
	 	Ulcer, Gastric Hemorrhage
	72

	 	Perforation of bile duct
	 	Other Digestive Diseases
	72

	 	Perforation of esophagus
	 	Other Digestive Diseases
	71

	 	Perforation of gallbladder
	 	Cholelithiasis, Cholecystitis
	72

	 	Perforation of intestine
	 	Other Digestive Diseases
	72

	 	Perianal abscess
	 	Other Digestive Diseases
	54

	 	Periarteritis
	 	Arteries, Arterioles, Capillaries
	52

	 	Pericardial effusion
	 	Other Heart Disease
	52

	 	Pericarditis
	 	Other Heart Disease
	52

	 	Periendocarditis
	 	Other Heart Disease
	74

	 	Perinephric abscess
	 	Kidney Infections
	47

	 	Periorbital cellulitis
	 	Other Nervous System
	80

	 	Periostitis
	 	Osteomyelitis, periostitis
	54

	 	Peripheral angiopathy
	 	Arteries, Arterioles, Capillaries
	47

	 	Peripheral neuropathy  — heriditary
	 	Other Nervous System
	54

	 	Peripheral vascular disease
	 	Arteries, Arterioles, Capillaries
	55

	 	Periphlebitis
	 	Veins, Other Circulatory
	72

	 	Perirectal abscess
	 	Other Digestive Diseases
	72

	 	Peritoneal adhesions
	 	Other Digestive Diseases
	67

	 	Peritoneal adhesions with obstruction
	 	Intestinal Obstruction, Hernia
	72

	 	peritoneal cyst
	 	Other Digestive Diseases

42

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	72

	 	Peritoneal effusion
	 	Other Digestive Diseases
	31

	 	Peritoneum Cancer
	 	Cancer — Other
	72

	 	Peritonitis
	 	Other Digestive Diseases
	47

	 	Peroneal muscular atrophy
	 	Other Nervous System
	9

	 	Pertussis
	 	Whooping Cough
	45

	 	Petit mal epilepsy
	 	Epilepsy
	46

	 	Petrositis
	 	Otitis media and mastoiditis
	38

	 	Pharyngeal pouch syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	63

	 	Pharyngitis
	 	Other Respiratory
	17

	 	Pharyngoconjunctival fever
	 	Other Infective or Parasitic Diseases
	18

	 	Pharynx Cancer
	 	Cancer — Mouth, Throat, Pharynx
	38

	 	Phenylketonuria
	 	Nutritional, Metabolic & Immunity Disorders
	55

	 	Phlebitis
	 	Veins, Other Circulatory
	72

	 	Phlebitis of portal vein
	 	Other Digestive Diseases
	55

	 	Phlebosclerosis
	 	Veins, Other Circulatory
	17

	 	Phlebotomus fever
	 	Other Infective or Parasitic Diseases
	73

	 	Phosphate-losing tubular disorder
	 	Nephritis, Renal Scleroris
	17

	 	Phycomycosis
	 	Other Infective or Parasitic Diseases
	47

	 	Pick’s Disease
	 	Other Nervous System
	52

	 	Pick’s disease of heart & liver
	 	Other Heart Disease
	38

	 	Pigmentary cirrhosis (of liver)
	 	Nutritional, Metabolic & Immunity Disorders
	31

	 	Pineal Gland Cancer
	 	Cancer — Other
	38

	 	Pipecolic acidemia
	 	Nutritional, Metabolic & Immunity Disorders
	37

	 	Pituitary disorders
	 	Diabetes Mellitus — Endocrine Disorders
	37

	 	Pituitary Infarction
	 	Diabetes Mellitus — Endocrine Disorders
	38

	 	PKU (Phenylketonuria)
	 	Nutritional, Metabolic & Immunity Disorders
	27

	 	Placenta Cancer
	 	Cancer — Other Uterine
	33

	 	Plasma cell leukemia
	 	Lymphosarcoma, Etc
	33

	 	Plasmacytic leukemia
	 	Lymphosarcoma, Etc
	24

	 	Pleura Cancer
	 	Cancer — Lung, Trachea
	62

	 	Pleural effusion
	 	Pleurisy
	62

	 	Pleural effusion
	 	Pleurisy
	61

	 	Pleurisy
	 	Emphysema
	57

	 	Pleurobronchopneumonia
	 	Pneumonia
	52

	 	Pleuropericarditis
	 	Other Heart Disease
	43

	 	Pneumococcal meningitis
	 	Meningitis
	52

	 	Pneumococcal myocarditis
	 	Other Heart Disease
	72

	 	Pneumococcal peritonitis
	 	Other Digestive Diseases
	62

	 	Pneumococcal pleurisy
	 	Pleurisy
	57

	 	Pneumococcal pneumonia
	 	Pneumonia
	7

	 	Pneumococcal septicemia
	 	Septicemia
	57

	 	Pneumonia
	 	Pneumonia
	52

	 	Pneumopericarditis
	 	Other Heart Disease
	57

	 	Pneumosepsis
	 	Pneumonia
	63

	 	Pneumothorax
	 	Other Respiratory
	12

	 	Polio
	 	Poliomyelitis
	12

	 	Poliomyelitis
	 	Poliomyelitis
	12

	 	Poliovirus
	 	Poliomyelitis
	54

	 	Polyarteritis nodosa
	 	Arteries, Arterioles, Capillaries
	38

	 	Polyclonal hypergammaglobulinemia
	 	Nutritional, Metabolic & Immunity Disorders
	81

	 	Polymyositis
	 	Other Skin & Musculoskeletal Diseases
	38

	 	Pompe’s disease
	 	Nutritional, Metabolic & Immunity Disorders
	53

	 	Pontine infarction
	 	Cerebrovascular Diseases
	38

	 	Porphyria
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Porphyrinuria
	 	Nutritional, Metabolic & Immunity Disorders
	72

	 	Portal pyemia
	 	Other Digestive Diseases
	72

	 	Portal thrombophlebitis
	 	Other Digestive Diseases

43

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	55

	 	Portal vein obstruction
	 	Veins, Other Circulatory
	55

	 	Portal vein thrombosis
	 	Veins, Other Circulatory
	72

	 	Portal-system encephalopathy
	 	Other Digestive Diseases
	52

	 	Postcardiotomy syndrome
	 	Other Heart Disease
	72

	 	Postcholecystectomy syndrome
	 	Other Digestive Diseases
	55

	 	Postmastectomy lymphedema syndrome
	 	Veins, Other Circulatory
	77

	 	Postoperative urethral stricture
	 	Other Genito-Urinary
	37

	 	Postpancreatectomy hyperglycemia
	 	Diabetes Mellitus — Endocrine Disorders
	55

	 	Postphlebitic syndrome
	 	Veins, Other Circulatory
	65

	 	Postpyloric Ulcer
	 	Duodenal Ulcer
	55

	 	Postural hypotension
	 	Veins, Other Circulatory
	77

	 	Postural proteinuria
	 	Other Genito-Urinary
	52

	 	Postvalvulotomy syndrome
	 	Other Heart Disease
	38

	 	Potassium excess, intoxication, overload
	 	Nutritional, Metabolic & Immunity Disorders
	2

	 	Pott’s Disease
	 	Tuberculosis — Nonrespiratory
	13

	 	Powassan encephalitis
	 	Encephalitis
	78

	 	Pregnancy Complications
	 	Complications of Pregnancy
	54

	 	Presenile gangrene
	 	Arteries, Arterioles, Capillaries
	36

	 	Primary thyroid hyperplasia
	 	Thyrotoxicosis
	72

	 	Proctoptosis
	 	Other Digestive Diseases
	40

	 	Prodromal AIDs
	 	AIDS
	47

	 	Progressive bulbar palsy
	 	Other Nervous System
	81

	 	Progressive collagen disease
	 	Other Skin & Musculoskeletal Diseases
	38

	 	Progressive lipodystrophy
	 	Nutritional, Metabolic & Immunity Disorders
	47

	 	Progressive muscular atrophy
	 	Other Nervous System
	77

	 	Prolapse of urethra
	 	Other Genito-Urinary
	72

	 	Proliferative peritonitis
	 	Other Digestive Diseases
	38

	 	Prolinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Prolinuria
	 	Nutritional, Metabolic & Immunity Disorders
	28

	 	Prostate Cancer
	 	Cancer — Prostate
	77

	 	Prostate Infarction
	 	Other Genito-Urinary
	76

	 	Prostatic obstruction
	 	Hyperplasia of Prostate
	77

	 	Prostatitis
	 	Other Genito-Urinary
	77

	 	Prostatocystitis
	 	Other Genito-Urinary
	38

	 	Protocoproporphyria
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Protoporphyria
	 	Nutritional, Metabolic & Immunity Disorders
	5

	 	Protozoal intestinal diseases
	 	Intestinal Infections — Other
	38

	 	Pseudo-Hurler’s disease
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Pseudohypoparathyroidism
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Pseudopseudohypoparathryoidism
	 	Nutritional, Metabolic & Immunity Disorders
	63

	 	Pulmolithiasis
	 	Other Respiratory
	63

	 	Pulmonary alveolar microlithiasis
	 	Other Respiratory
	63

	 	Pulmonary alveolar proteinosis
	 	Other Respiratory
	52

	 	Pulmonary apoplexy
	 	Other Heart Disease
	52

	 	Pulmonary arteritis
	 	Other Heart Disease
	54

	 	Pulmonary atherosclerosis
	 	Arteries, Arterioles, Capillaries
	63

	 	Pulmonary collapse
	 	Other Respiratory
	63

	 	Pulmonary congestion
	 	Other Respiratory
	63

	 	Pulmonary decompensation
	 	Other Respiratory
	63

	 	Pulmonary edema
	 	Other Respiratory
	52

	 	Pulmonary edema due to heart failure
	 	Other Heart Disease
	63

	 	Pulmonary edema (no heart failure)
	 	Other Respiratory
	52

	 	Pulmonary embolism
	 	Other Heart Disease
	63

	 	Pulmonary emphysema
	 	Other Respiratory
	52

	 	Pulmonary endarteritis
	 	Other Heart Disease
	63

	 	Pulmonary eosinophilia
	 	Other Respiratory
	63

	 	Pulmonary Fibrosis
	 	Other Respiratory

44

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	61

	 	Pulmonary gangrene
	 	Emphysema
	52

	 	Pulmonary heart disease
	 	Other Heart Disease
	52

	 	Pulmonary hypertension
	 	Other Heart Disease
	63

	 	Pulmonary infarction
	 	Other Respiratory
	52

	 	Pulmonary Infarction
	 	Other Heart Disease
	63

	 	Pulmonary insufficiency
	 	Other Respiratory
	61

	 	Pulmonary necrosis
	 	Emphysema
	52

	 	Pulmonary thrombosis
	 	Other Heart Disease
	1

	 	Pulmonary Tuberculosis
	 	Tuberculosis — Respiratory System
	50

	 	Pulmonary valve disorders
	 	Ischemic & Coronary Heart Disease
	52

	 	Pulmonary vessel rupture
	 	Other Heart Disease
	54

	 	Pulseless disease
	 	Arteries, Arterioles, Capillaries
	61

	 	Purulent pleurisy
	 	Emphysema
	74

	 	Pyelitis
	 	Kidney Infections
	74

	 	Pyelonephritis
	 	Kidney Infections
	74

	 	Pyeloureteritis cystica
	 	Kidney Infections
	45

	 	Pykno-epilepsy
	 	Epilepsy
	72

	 	Pylephlebitis
	 	Other Digestive Diseases
	72

	 	Pylethrombophlebitis
	 	Other Digestive Diseases
	72

	 	Pylorspasm
	 	Other Digestive Diseases
	20

	 	Pylorus Cancer
	 	Cancer — Stomach
	81

	 	Pyogenic arthritis
	 	Other Skin & Musculoskeletal Diseases
	52

	 	Pyopericardium
	 	Other Heart Disease
	61

	 	Pyopneumothorax
	 	Emphysema
	61

	 	Pyothorax
	 	Emphysema
	38

	 	Pyridoxal deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Pyridoxamine deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Pyridoxine deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Pyrroloporphyria
	 	Nutritional, Metabolic & Immunity Disorders
	77

	 	Pyuria
	 	Other Genito-Urinary
	15

	 	Q Fever
	 	Typhus and Ricketsiosis
	17

	 	Rabies
	 	Other Infective or Parasitic Diseases
	17

	 	Rat-bite Fever
	 	Other Infective or Parasitic Diseases
	54

	 	Raynaud’s syndrome
	 	Arteries, Arterioles, Capillaries
	22

	 	Rectal Cancer
	 	Cancer — Rectum, Recto Sigmoid
	72

	 	Rectal prolapse
	 	Other Digestive Diseases
	22

	 	Recto sigmoid Cancer
	 	Cancer — Rectum, Recto Sigmoid
	72

	 	Rectovaginal fistula
	 	Other Digestive Diseases
	22

	 	Rectum Cancer
	 	Cancer — Rectum, Recto Sigmoid
	70

	 	Recurrent hepatitis
	 	Cirrhosis of Liver
	47

	 	Refsum’s disease
	 	Other Nervous System
	69

	 	Regional enteritis
	 	Gastgro-enteritis, Colitis
	17

	 	Reiter’s disease
	 	Other Infective or Parasitic Diseases
	74

	 	Renal abscess
	 	Kidney Infections
	77

	 	Renal artery embolism
	 	Other Genito-Urinary
	77

	 	Renal artery hemorrhage
	 	Other Genito-Urinary
	77

	 	Renal artery thrombosis
	 	Other Genito-Urinary
	54

	 	Renal atherosclerosis
	 	Arteries, Arterioles, Capillaries
	31

	 	Renal Cell Cancer
	 	Cancer — Other
	38

	 	Renal diabetes
	 	Nutritional, Metabolic & Immunity Disorders
	77

	 	Renal disease
	 	Other Genito-Urinary
	77

	 	Renal Failure
	 	Other Genito-Urinary
	38

	 	Renal glycosuria
	 	Nutritional, Metabolic & Immunity Disorders
	77

	 	Renal infarction
	 	Other Genito-Urinary
	77

	 	Renal insufficiency
	 	Other Genito-Urinary
	77

	 	Renal ischemia
	 	Other Genito-Urinary
	73

	 	Renal osteodystrophy
	 	Nephritis, Renal Scleroris

45

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	73

	 	Renal sclerosis
	 	Nephritis, Renal Scleroris
	51

	 	Renal sclerosis with hypertension
	 	Hypertensive Disease
	75

	 	Renal stone
	 	Urinary System Infections
	54

	 	Rendu-Osler-Weber disease
	 	Arteries, Arterioles, Capillaries
	38

	 	Respiratory acidosis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Respiratory alkalosis
	 	Nutritional, Metabolic & Immunity Disorders
	87

	 	Respiratory arrest
	 	Unknown Causes & Ill-Defined Causes
	63

	 	Respiratory failure
	 	Other Respiratory
	54

	 	Respiratory granulomatosis
	 	Arteries, Arterioles, Capillaries
	1

	 	Respiratory Tuberculosis
	 	Tuberculosis — Respiratory System
	33

	 	Reticulosarcoma
	 	Lymphosarcoma, Etc
	33

	 	Reticulus cell sarcoma
	 	Lymphosarcoma, Etc
	47

	 	Retinal Ischemia
	 	Other Nervous System
	31

	 	Retroperitoneum Cancer
	 	Cancer — Other
	47

	 	Reye’s Syndrome
	 	Other Nervous System
	81

	 	Rhabdomyolysis
	 	Other Skin & Musculoskeletal Diseases
	30

	 	Rhabdomyosarcoma
	 	Cancer — Bone, Cartilage
	49

	 	Rheumatic aortic insufficiency
	 	Rheumatic Heart Disease
	49

	 	Rheumatic aortic stenosis
	 	Rheumatic Heart Disease
	48

	 	Rheumatic chorea
	 	Rheumatic Fever
	49

	 	Rheumatic endocarditis
	 	Rheumatic Heart Disease
	48

	 	Rheumatic Fever
	 	Rheumatic Fever
	49

	 	Rheumatic Heart Disease
	 	Rheumatic Heart Disease
	49

	 	Rheumatic mitral insufficiency
	 	Rheumatic Heart Disease
	49

	 	Rheumatic myocarditis
	 	Rheumatic Heart Disease
	49

	 	Rheumatic pericarditis
	 	Rheumatic Heart Disease
	49

	 	Rheumatic Tricuspid Valve Insufficiency
	 	Rheumatic Heart Disease
	81

	 	Rheumatoid arthritis
	 	Other Skin & Musculoskeletal Diseases
	81

	 	Rheumatoid carditis
	 	Other Skin & Musculoskeletal Diseases
	17

	 	Rhinoscleroma
	 	Other Infective or Parasitic Diseases
	30

	 	Rhomdbomyosarcoma
	 	Cancer — Bone, Cartilage
	38

	 	Riboflavin deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Rickets
	 	Nutritional, Metabolic & Immunity Disorders
	15

	 	Ricketsiosis
	 	Typhus and Ricketsiosis
	15

	 	Rickettsialpox
	 	Typhus and Ricketsiosis
	36

	 	Riedel’s Thyroiditis
	 	Thyrotoxicosis
	52

	 	Right bundle branch hemiblock
	 	Other Heart Disease
	82

	 	Riley-Day syndrome
	 	Congenital Anomalies
	81

	 	Ritter’s disease
	 	Other Skin & Musculoskeletal Diseases
	15

	 	Rocky Mountain spotted fever
	 	Typhus and Ricketsiosis
	38

	 	Rotor’s syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	17

	 	Rubella
	 	Other Infective or Parasitic Diseases
	14

	 	Rubeola
	 	Measles
	54

	 	Rupture of artery
	 	Arteries, Arterioles, Capillaries
	72

	 	Rupture of bile duct
	 	Other Digestive Diseases
	77

	 	Rupture of bladder
	 	Other Genito-Urinary
	52

	 	Rupture of chordae tendineae
	 	Other Heart Disease
	77

	 	Rupture of diverticulum — bladder
	 	Other Genito-Urinary
	69

	 	Rupture of diverticulum — intestine
	 	Gastgro-enteritis, Colitis
	52

	 	Rupture of papillary muscle
	 	Other Heart Disease
	52

	 	Rupture of pulmonary vessel
	 	Other Heart Disease
	53

	 	Ruptured blood vessel in brain
	 	Cerebrovascular Diseases
	38

	 	Saccharopinuria
	 	Nutritional, Metabolic & Immunity Disorders
	54

	 	Saddle embolus
	 	Arteries, Arterioles, Capillaries
	18

	 	Salivary gland Cancer
	 	Cancer — Mouth, Throat, Pharynx
	72

	 	Salivary Gland Diseases
	 	Other Digestive Diseases
	5

	 	Salmonella Infections
	 	Intestinal Infections — Other

46

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	5

	 	Salmonella septicemia
	 	Intestinal Infections — Other
	38

	 	Sanfilippo’s syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	52

	 	Sarcoidosis — cardiac
	 	Other Heart Disease
	63

	 	Sarcoidosis — Lung
	 	Other Respiratory
	38

	 	Sarcosinemia
	 	Nutritional, Metabolic & Immunity Disorders
	6

	 	Scarlet Fever
	 	Scarlet Fever & Strep Throat
	38

	 	Scheie’s syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	47

	 	Schilder’s disease
	 	Other Nervous System
	17

	 	Schistosomiasis
	 	Other Infective or Parasitic Diseases
	41

	 	Schizophrenic disorders
	 	Mental, Drugs, Alcohol
	81

	 	Scleroderma
	 	Other Skin & Musculoskeletal Diseases
	80

	 	Sclerosinmg osteomyelitis of Garre
	 	Osteomyelitis, periostitis
	39

	 	Scorbutic anemia
	 	Anemia, Thalassemia
	67

	 	Scrotal hernia
	 	Intestinal Obstruction, Hernia
	77

	 	Scrotal Infection
	 	Other Genito-Urinary
	38

	 	Scurvy
	 	Nutritional, Metabolic & Immunity Disorders
	57

	 	Segmental pneumonia
	 	Pneumonia
	45

	 	Seizure Disorder
	 	Epilepsy
	97

	 	Self-Inflicted Injury
	 	Suicide
	85

	 	Senescence
	 	Senility
	54

	 	Senile arteritis
	 	Arteries, Arterioles, Capillaries
	85

	 	Senile asthenia
	 	Senility
	85

	 	Senile debility
	 	Senility
	54

	 	Senile endarteritis
	 	Arteries, Arterioles, Capillaries
	85

	 	Senile exhaustion
	 	Senility
	85

	 	Senility
	 	Senility
	47

	 	Sensory neuropathy — heriditary
	 	Other Nervous System
	7

	 	Sepsis
	 	Septicemia
	52

	 	Septic endocarditis
	 	Other Heart Disease
	52

	 	septic myocarditis
	 	Other Heart Disease
	61

	 	Septic pleurisy
	 	Emphysema
	63

	 	Septic tonsillitis
	 	Other Respiratory
	7

	 	Septicemia
	 	Septicemia
	80

	 	Sequestrum of bone
	 	Osteomyelitis, periostitis
	61

	 	Seropurulent pleurisy
	 	Emphysema
	33

	 	Sezary’s disease
	 	Lymphosarcoma, Etc
	5

	 	Shigellosis
	 	Intestinal Infections — Other
	47

	 	Shy-Drager syndrome
	 	Other Nervous System
	81

	 	Sicca syndrome
	 	Other Skin & Musculoskeletal Diseases
	39

	 	Sickle-cell anemia
	 	Anemia, Thalassemia
	39

	 	Sickle-cell thalassemia
	 	Anemia, Thalassemia
	52

	 	Sinoatrial block
	 	Other Heart Disease
	52

	 	Sinoauricular block
	 	Other Heart Disease
	63

	 	Sinusitis
	 	Other Respiratory
	31

	 	Sipple’s Syndrom
	 	Cancer — Other
	81

	 	Sjogren’s disease
	 	Other Skin & Musculoskeletal Diseases
	29

	 	Skin Cancer
	 	Cancer — Skin, Melanoma
	79

	 	Skin Infection
	 	Skin Infections
	69

	 	Small Bowel Ischemia
	 	Gastgro-enteritis, Colitis
	21

	 	Small Intestine Cancer
	 	Cancer — Colon, Cecum, Sigmoid
	17

	 	Smallpox
	 	Other Infective or Parasitic Diseases
	93

	 	Smoke Inhalation — Accidental
	 	Accidental Fires
	60

	 	Smokers Cough
	 	Bronchitis
	53

	 	Spasm of cerebral arteries
	 	Cerebrovascular Diseases
	63

	 	Spasmodic rhinorrhea
	 	Other Respiratory
	47

	 	Spielmeyer-Vogt disease
	 	Other Nervous System
	82

	 	Spina Bifida
	 	Congenital Anomalies

47

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	47

	 	Spinal Cord Infarction
	 	Other Nervous System
	47

	 	Spinal Cord Ischemia
	 	Other Nervous System
	47

	 	Spinal muscular atrophy
	 	Other Nervous System
	47

	 	Spinocerebellar disease
	 	Other Nervous System
	17

	 	Spirillary fever
	 	Other Infective or Parasitic Diseases
	31

	 	Spleen Cancer
	 	Cancer — Other
	39

	 	Spleen Infarction
	 	Anemia, Thalassemia
	83

	 	Splenomegaly — Bengal
	 	Birth Injuries
	39

	 	Splenomegaly — Chronic
	 	Anemia, Thalassemia
	39

	 	Splenomegaly — Cirrhotic
	 	Anemia, Thalassemia
	83

	 	Splenomegaly — Congenital
	 	Birth Injuries
	39

	 	Splenomegaly — Congestive
	 	Anemia, Thalassemia
	39

	 	Splenomegaly — Congestive
	 	Anemia, Thalassemia
	83

	 	Splenomegaly — Cryptogenic
	 	Birth Injuries
	39

	 	Splenomegaly — Neutropenic
	 	Anemia, Thalassemia
	39

	 	Splenomegaly — Siderotic
	 	Anemia, Thalassemia
	17

	 	Splenomegaly — Syphilitic
	 	Other Infective or Parasitic Diseases
	17

	 	Splenomegaly — Tropical
	 	Other Infective or Parasitic Diseases
	81

	 	Spontaneous fracture
	 	Other Skin & Musculoskeletal Diseases
	55

	 	Spontaneous hemorrhage
	 	Veins, Other Circulatory
	75

	 	Staghorn calculus
	 	Urinary System Infections
	5

	 	Staphylococcal food poisoning
	 	Intestinal Infections — Other
	43

	 	Staphylococcal meningitis
	 	Meningitis
	52

	 	Staphylococcal myocarditis
	 	Other Heart Disease
	62

	 	Staphylococcal pleurisy
	 	Pleurisy
	7

	 	Staphylococcal septicemia
	 	Septicemia
	63

	 	Staphylococcal tonsillitis
	 	Other Respiratory
	72

	 	Stenosis of bile duct
	 	Other Digestive Diseases
	72

	 	Stenosis of esophagus
	 	Other Digestive Diseases
	67

	 	Stenosis of intestine or colon
	 	Intestinal Obstruction, Hernia
	20

	 	Stomach Cancer
	 	Cancer — Stomach
	64

	 	Stomach ulcer
	 	Ulcer, Gastric Hemorrhage
	39

	 	Stomatocytosis
	 	Anemia, Thalassemia
	67

	 	Strangulated Inguinal hernia
	 	Intestinal Obstruction, Hernia
	17

	 	Streptobacillary fever
	 	Other Infective or Parasitic Diseases
	6

	 	Streptococal Sore Throat
	 	Scarlet Fever & Strep Throat
	43

	 	Streptococcal meningitis
	 	Meningitis
	62

	 	Streptococcal pleurisy
	 	Pleurisy
	7

	 	Streptococcal septicemia
	 	Septicemia
	64

	 	Stress ulcer
	 	Ulcer, Gastric Hemorrhage
	72

	 	Stricture of anus
	 	Other Digestive Diseases
	54

	 	Stricture of artery
	 	Arteries, Arterioles, Capillaries
	72

	 	Stricture of bile duct
	 	Other Digestive Diseases
	67

	 	Stricture of intestine or colon
	 	Intestinal Obstruction, Hernia
	53

	 	Stroke
	 	Cerebrovascular Diseases
	53

	 	Stroke — Basal Ganglia
	 	Cerebrovascular Diseases
	36

	 	Struma lymphomatosa
	 	Thyrotoxicosis
	53

	 	Subarachnoid hemorrhage
	 	Cerebrovascular Diseases
	53

	 	Subclavian steal syndrome
	 	Cerebrovascular Diseases
	53

	 	Subdural hematoma
	 	Cerebrovascular Diseases
	53

	 	Subdural hemorrhage
	 	Cerebrovascular Diseases
	50

	 	Subendocardial infarction
	 	Ischemic & Coronary Heart Disease
	50

	 	Subendocardial ischemia
	 	Ischemic & Coronary Heart Disease
	23

	 	Subglottis Cancer
	 	Cancer — Larynx
	87

	 	Sudden Death
	 	Unknown Causes & Ill-Defined Causes
	81

	 	Sudeck’s atrophy
	 	Other Skin & Musculoskeletal Diseases
	97

	 	Suicide
	 	Suicide

48

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	47

	 	Sulfatid lipidosis
	 	Other Nervous System
	81

	 	Sunburn
	 	Other Skin & Musculoskeletal Diseases
	55

	 	Suppurative phlebitis
	 	Veins, Other Circulatory
	23

	 	Supraglottis Cancer
	 	Cancer — Larynx
	37

	 	Suprarenal Infarction
	 	Diabetes Mellitus — Endocrine Disorders
	30

	 	Synovial Sarcoma
	 	Cancer — Bone, Cartilage
	3

	 	Syphilis
	 	Syphilis
	3

	 	Syphilitic aortitis
	 	Syphilis
	3

	 	Syphilitic encephalitis
	 	Syphilis
	3

	 	Syphilitic endocarditis
	 	Syphilis
	3

	 	Syphilitic meningitis
	 	Syphilis
	3

	 	Syphilitic Parkinsonism
	 	Syphilis
	3

	 	Syphilitic Retrobulbar neuritis
	 	Syphilis
	47

	 	Syringobulbia
	 	Other Nervous System
	47

	 	Syringomyelia
	 	Other Nervous System
	81

	 	Systemic lups erythematosus
	 	Other Skin & Musculoskeletal Diseases
	81

	 	Systemic sclerosis
	 	Other Skin & Musculoskeletal Diseases
	3

	 	Tabes dorsalis
	 	Syphilis
	52

	 	Tachycardia
	 	Other Heart Disease
	54

	 	Takayasu’s disease
	 	Arteries, Arterioles, Capillaries
	47

	 	Tay-Sachs disease
	 	Other Nervous System
	69

	 	Terminal Hemorrhagic enteropathy
	 	Gastgro-enteritis, Colitis
	54

	 	Termporal arteritis
	 	Arteries, Arterioles, Capillaries
	99

	 	Terrorism
	 	War
	31

	 	Testicular Cancer
	 	Cancer — Other
	31

	 	Testis Cancer
	 	Cancer — Other
	77

	 	Testis Infarction
	 	Other Genito-Urinary
	11

	 	Tetanus
	 	Tetanus
	39

	 	Thalassemia
	 	Anemia, Thalassemia
	62

	 	Thickening of pleura
	 	Pleurisy
	54

	 	Thoracic aneurysm
	 	Arteries, Arterioles, Capillaries
	54

	 	Thromboangiitis obliterans
	 	Arteries, Arterioles, Capillaries
	32

	 	Thrombocytic leukemia
	 	Leukemia
	55

	 	Thrombophlebitis
	 	Veins, Other Circulatory
	55

	 	Thrombophlebitis migrans
	 	Veins, Other Circulatory
	55

	 	Thrombophlebitis of breast
	 	Veins, Other Circulatory
	55

	 	Thrombosis
	 	Veins, Other Circulatory
	55

	 	Thrombosis
	 	Veins, Other Circulatory
	53

	 	Thrombosis of basilar artery
	 	Cerebrovascular Diseases
	53

	 	Thrombosis of carotid artery
	 	Cerebrovascular Diseases
	69

	 	Thrombosis of mesenteric artery
	 	Gastgro-enteritis, Colitis
	47

	 	Thrombosis of Spinal cord
	 	Other Nervous System
	53

	 	Thrombosis of vertebral artery
	 	Cerebrovascular Diseases
	54

	 	Thrombotic infarction
	 	Arteries, Arterioles, Capillaries
	55

	 	Thrombotic Infarction
	 	Veins, Other Circulatory
	54

	 	Thrombotic microangiopathy
	 	Arteries, Arterioles, Capillaries
	54

	 	Thrombotic thrombocytopenic purpura
	 	Arteries, Arterioles, Capillaries
	38

	 	Thymic hypoplasia
	 	Nutritional, Metabolic & Immunity Disorders
	24

	 	Thymus Cancer
	 	Cancer — Lung, Trachea
	37

	 	Thymus gland disorders
	 	Diabetes Mellitus — Endocrine Disorders
	36

	 	Thyroid Hemorrhage
	 	Thyrotoxicosis
	36

	 	Thyroid Infarction
	 	Thyrotoxicosis
	36

	 	Thyroiditis
	 	Thyrotoxicosis
	36

	 	Thyrotoxicosis
	 	Thyrotoxicosis
	33

	 	TIAs
	 	Lymphosarcoma, Etc
	15

	 	Tick Fever
	 	Typhus and Ricketsiosis
	15

	 	Tick-borne rickettsioses
	 	Typhus and Ricketsiosis

49

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	13

	 	Tick-borne viral encephalitis
	 	Encephalitis
	18

	 	Tongue Cancer
	 	Cancer — Mouth, Throat, Pharynx
	18

	 	Tonsil Cancer
	 	Cancer — Mouth, Throat, Pharynx
	63

	 	Tonsillitis
	 	Other Respiratory
	36

	 	Toxic Diffuse Goiter
	 	Thyrotoxicosis
	47

	 	Toxic encephalopathy
	 	Other Nervous System
	81

	 	Toxic epidermal necrolysis
	 	Other Skin & Musculoskeletal Diseases
	69

	 	Toxic gastoenteritis
	 	Gastgro-enteritis, Colitis
	69

	 	Toxic megacolon
	 	Gastgro-enteritis, Colitis
	52

	 	Toxic myocarditis
	 	Other Heart Disease
	47

	 	Toxic myoneural disorder
	 	Other Nervous System
	36

	 	Toxic uninodular goiter
	 	Thyrotoxicosis
	17

	 	Toxoplasmosis
	 	Other Infective or Parasitic Diseases
	24

	 	Trachea Cancer
	 	Cancer — Lung, Trachea
	1

	 	Tracheal tuberculosis
	 	Tuberculosis — Respiratory System
	63

	 	Tracheitis
	 	Other Respiratory
	60

	 	Tracheobronchitis
	 	Bronchitis
	17

	 	Trachoma
	 	Other Infective or Parasitic Diseases
	53

	 	Transient cerebral ischemia
	 	Cerebrovascular Diseases
	17

	 	Trichinosis
	 	Other Infective or Parasitic Diseases
	17

	 	Trichomoniasis
	 	Other Infective or Parasitic Diseases
	50

	 	Tricuspid valve disorders
	 	Ischemic & Coronary Heart Disease
	52

	 	Trifascicular block
	 	Other Heart Disease
	38

	 	Triglyceride storage disease
	 	Nutritional, Metabolic & Immunity Disorders
	77

	 	Trigonitis
	 	Other Genito-Urinary
	82

	 	Trisomy 13, 21, 22, D1, 18, E3, G
	 	Congenital Anomalies
	63

	 	Tropical eosinophilia
	 	Other Respiratory
	17

	 	Tropical pyomyositis
	 	Other Infective or Parasitic Diseases
	17

	 	Tropical Splenomegaly
	 	Other Infective or Parasitic Diseases
	72

	 	Tropical sprue
	 	Other Digestive Diseases
	72

	 	Tropical steatorrhea
	 	Other Digestive Diseases
	17

	 	Trypanosomiasis
	 	Other Infective or Parasitic Diseases
	2

	 	Tuberculosis — Nonrespiratory
	 	Tuberculosis — Nonrespiratory
	1

	 	Tuberculosis — Respiratory System
	 	Tuberculosis — Respiratory System
	2

	 	Tuberculosis of bones and joints
	 	Tuberculosis — Nonrespiratory
	2

	 	Tuberculosis of genitourinary system
	 	Tuberculosis — Nonrespiratory
	1

	 	Tuberculosis of intrathoracic lymph nodes
	 	Tuberculosis — Respiratory System
	2

	 	Tuberculous encephalitis
	 	Tuberculosis — Nonrespiratory
	2

	 	Tuberculous of brain or spinal cord
	 	Tuberculosis — Nonrespiratory
	2

	 	Tuberculous peritonitis
	 	Tuberculosis — Nonrespiratory
	1

	 	Tuberculous pleurisy
	 	Tuberculosis — Respiratory System
	1

	 	Tuberculous pneumonia
	 	Tuberculosis — Respiratory System
	1

	 	Tuberculous pneumothorax
	 	Tuberculosis — Respiratory System
	2

	 	Tubercuous oophoritis
	 	Tuberculosis — Nonrespiratory
	73

	 	Tubular necrosis
	 	Nephritis, Renal Scleroris
	17

	 	Tularemia
	 	Other Infective or Parasitic Diseases
	4

	 	Typhoid
	 	Typhoid
	15

	 	Typhus and Ricketsiosis
	 	Typhus and Ricketsiosis
	38

	 	Tyrosinosis
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Tyrosinuria
	 	Nutritional, Metabolic & Immunity Disorders
	64

	 	Ulcer
	 	Ulcer, Gastric Hemorrhage
	54

	 	Ulcer of artery
	 	Arteries, Arterioles, Capillaries
	72

	 	Ulcer of esophagus
	 	Other Digestive Diseases
	72

	 	Ulcer or rectum or anus
	 	Other Digestive Diseases
	63

	 	Ulcerative tonsillitis
	 	Other Respiratory
	81

	 	Ulcers — Decubitis
	 	Other Skin & Musculoskeletal Diseases
	67

	 	Umbilical hernia
	 	Intestinal Obstruction, Hernia

50

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	87

	 	Unattended death
	 	Unknown Causes & Ill-Defined Causes
	87

	 	Unknown
	 	Unknown Causes & Ill-Defined Causes
	47

	 	Unverricht-Lundborg disease
	 	Other Nervous System
	72

	 	Upper Gastrointestinal bleeding
	 	Other Digestive Diseases
	24

	 	Upper Respiratory Cancer
	 	Cancer — Lung, Trachea
	73

	 	Uremia
	 	Nephritis, Renal Scleroris
	87

	 	Uremia
	 	Unknown Causes & Ill-Defined Causes
	51

	 	Uremic hypertension
	 	Hypertensive Disease
	31

	 	Ureter Cancer
	 	Cancer — Other
	77

	 	Ureteral fistula
	 	Other Genito-Urinary
	74

	 	Ureteritis cystica
	 	Kidney Infections
	31

	 	Urethra Cancer
	 	Cancer — Other
	77

	 	Urethral abscess
	 	Other Genito-Urinary
	77

	 	Urethral caruncle
	 	Other Genito-Urinary
	77

	 	Urethral diverticulum
	 	Other Genito-Urinary
	77

	 	Urethral granuloma
	 	Other Genito-Urinary
	77

	 	Urethral stricture
	 	Other Genito-Urinary
	77

	 	Urethritis
	 	Other Genito-Urinary
	77

	 	Urethrotrigonitis
	 	Other Genito-Urinary
	77

	 	Urethrovesical fistula
	 	Other Genito-Urinary
	38

	 	Uric Acid nephrolithiasis
	 	Nutritional, Metabolic & Immunity Disorders
	75

	 	Urinary bladder stone
	 	Urinary System Infections
	75

	 	Urinary calculus
	 	Urinary System Infections
	77

	 	Urinary obstruction
	 	Other Genito-Urinary
	75

	 	Urinary System Infection
	 	Urinary System Infections
	77

	 	Urinary Tract infection
	 	Other Genito-Urinary
	77

	 	Urinoma
	 	Other Genito-Urinary
	77

	 	Urosepsis
	 	Other Genito-Urinary
	27

	 	Uterine Cancer
	 	Cancer — Other Uterine
	77

	 	UTI
	 	Other Genito-Urinary
	31

	 	Vagina Cancer
	 	Cancer — Other
	50

	 	Valvular heart disease
	 	Ischemic & Coronary Heart Disease
	55

	 	Varicose veins
	 	Veins, Other Circulatory
	54

	 	Vascular degeneration
	 	Arteries, Arterioles, Capillaries
	69

	 	Vascular insufficiency of intestine
	 	Gastgro-enteritis, Colitis
	47

	 	Vascular myelopathies
	 	Other Nervous System
	55

	 	Vein inflammation
	 	Veins, Other Circulatory
	17

	 	Venereal disease
	 	Other Infective or Parasitic Diseases
	55

	 	Venofibrosis
	 	Veins, Other Circulatory
	55

	 	Venous insufficiency
	 	Veins, Other Circulatory
	63

	 	Ventilation pneumonitis
	 	Other Respiratory
	67

	 	Ventral hernia
	 	Intestinal Obstruction, Hernia
	52

	 	Ventricular cardiac arrhythmia
	 	Other Heart Disease
	52

	 	Ventricular failure
	 	Other Heart Disease
	52

	 	Ventricular fibrillation
	 	Other Heart Disease
	52

	 	Ventricular flutter
	 	Other Heart Disease
	53

	 	Ventricular hemorrhage
	 	Cerebrovascular Diseases
	52

	 	Ventricular hypertrophy
	 	Other Heart Disease
	53

	 	Vertebral Artery Ischemia
	 	Cerebrovascular Diseases
	53

	 	Vertebral artery syndrome
	 	Cerebrovascular Diseases
	30

	 	Vertebral Cancer
	 	Cancer — Bone, Cartilage
	81

	 	Vertebral collapse
	 	Other Skin & Musculoskeletal Diseases
	77

	 	Vesicocolic fistula
	 	Other Genito-Urinary
	77

	 	Vesicocutaneous fistula
	 	Other Genito-Urinary
	77

	 	Vesicoenteric fistula
	 	Other Genito-Urinary
	77

	 	Vesicoperineal fistula
	 	Other Genito-Urinary
	77

	 	Vesicorectal fistula
	 	Other Genito-Urinary

51

 

Benefit Payments Procedure Manual

Ordinary Life Claims

	 	 	 	 	 
	77

	 	Vesicoureteral reflux
	 	Other Genito-Urinary
	17

	 	Vincent’s angina
	 	Other Infective or Parasitic Diseases
	17

	 	Viral conjunctivitis
	 	Other Infective or Parasitic Diseases
	17

	 	Viral hepatitis
	 	Other Infective or Parasitic Diseases
	17

	 	Viral hepatitis A
	 	Other Infective or Parasitic Diseases
	17

	 	Viral hepatitis B
	 	Other Infective or Parasitic Diseases
	57

	 	Viral pneumonia
	 	Pneumonia
	57

	 	Viral pneumonitis
	 	Pneumonia
	63

	 	Viral tonsillitis
	 	Other Respiratory
	77

	 	Viral URTI (Urinary Tract Infection)
	 	Other Genito-Urinary
	38

	 	Vitamin A deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Vitamin B deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Vitamin B12 deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Vitamin B6 deficiency syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Vitamin Deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	31

	 	Vocal Cord Cancer
	 	Cancer — Other
	47

	 	Vogt’s Disease
	 	Other Nervous System
	38

	 	Volume Depletion
	 	Nutritional, Metabolic & Immunity Disorders
	67

	 	Volvulus
	 	Intestinal Obstruction, Hernia
	38

	 	von Gierke’s disease
	 	Nutritional, Metabolic & Immunity Disorders
	31

	 	Vulva Cancer
	 	Cancer — Other
	38

	 	Waardenburg syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Waldenstrom’s hypergammaglobulinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Waldenstrom’s macroglobulinemia
	 	Nutritional, Metabolic & Immunity Disorders
	99

	 	War
	 	War
	87

	 	Wasting disease
	 	Unknown Causes & Ill-Defined Causes
	10

	 	Waterhouse-Friderichsen syndrome
	 	Meningococcal Infection
	52

	 	Weak heart
	 	Other Heart Disease
	54

	 	Wegeber’s granulomatosis
	 	Arteries, Arterioles, Capillaries
	54

	 	Wegener’s syndrome
	 	Arteries, Arterioles, Capillaries
	47

	 	Werdnig-Hoffmann disease
	 	Other Nervous System
	37

	 	Wermer’s syndrome
	 	Diabetes Mellitus — Endocrine Disorders
	41

	 	Wernicke-Korsakoff syndrome
	 	Mental, Drugs, Alcohol
	17

	 	Whipple’s disease
	 	Other Infective or Parasitic Diseases
	9

	 	Whooping Cough
	 	Whooping Cough
	38

	 	WIlson’s Disease
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Wiskott-Aldrich syndrome
	 	Nutritional, Metabolic & Immunity Disorders
	63

	 	Woakes’ syndrome
	 	Other Respiratory
	52

	 	Wolff-Parkinson-White syndrome
	 	Other Heart Disease
	38

	 	Wolman’s disease
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Xanthinuria
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Xanthoma tuberosum
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Xerophthalmia due to Vitamin A deficiency
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	X-Linked agammaglobulinemia
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Xylosuria
	 	Nutritional, Metabolic & Immunity Disorders
	38

	 	Xylulosuria
	 	Nutritional, Metabolic & Immunity Disorders
	17

	 	Yaws
	 	Other Infective or Parasitic Diseases
	72

	 	Yellow atrophy of liver
	 	Other Digestive Diseases

52

 

Exhibit D

REINSURANCE PREMIUMS

	 	 	 
	D.1

	 	Life
	 
	 	 
	 

	 	Plans covered under this Agreement will be reinsured on a YRT basis. Reinsurance premiums will be based on the following
percentage of the attached 2001 Select and Ultimate Valuation Basic Table, Male, Smoker Composite, Age Last Birthday.

	 	 	 	 	 	 	 	 	 	 	 	 	 
	Plan(s)/Rider(s)	 	Class	 	Duration 1	 	Duration 2 on
	Modified
Whole Life
	 	Aggregate	 	 	0	%	 	 	110	%

	 	 	 
	D.2

	 	Age Basis
	 
	 	 
	 

	 	Age Last
	 
	 	 
	D.3

	 	Policy Fees
	 
	 	 
	 

	 	MARC will not participate in any policy fees.
	 
	 	 
	D.4

	 	Recapture Period
	 
	 	 
	 

	 	Number of years:                 20     
	 
	 	 
	D.5

	 	Substandard Ratings
	 
	 	 
	 

	 	Premiums will be based on the standard rate increased by an extra 25% per table of assessed rating.
Allowances are the same as those for standard life coverage.
	 
	 	 
	D.6

	 	Flat Extras
	 
	 	 
	 

	 	The total premium remitted to MARC will include the flat extra premium minus the allowances shown below.

	 	 	 	 	 	 	 	 	 
	Type of Flat Extra Premium	 	First Year	 	Renewal
	Temporary (1-5 years)
	 	 	90	%	 	 	90	%
	Permanent (6 years & greater)
	 	 	25	%	 	 	90	%

 

 

 

    Appendix
    A

 

    2001 Valuation Basic Table — Age Last Birthday

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
    2001 Valuation Basic
    Table — Male — Composite — 1000qx

	
    Issue

    
	
 
	
 
	
    Duration
	
 
	
 
	
    Att

    

	
    Age
	
 
	
 
	
    1
	
 
	
    2
	
 
	
    3
	
 
	
    4
	
 
	
    5
	
 
	
 
	
    6
	
 
	
    7
	
 
	
    8
	
 
	
    9
	
 
	
    10
	
 
	
 
	
    11
	
 
	
    12
	
 
	
    13
	
 
	
    14
	
 
	
    15
	
 
	
 
	
    16
	
 
	
    17
	
 
	
    18
	
 
	
    19
	
 
	
    20
	
 
	
 
	
    21
	
 
	
    22
	
 
	
    23
	
 
	
    24
	
 
	
    25
	
 
	
 
	
    Ultimate
	
 
	
 
	
    Age

	
 
	
    0
	
 
	
 
	
 
	
 
	
    0.65
	
 
	
 
	
 
	
    0.39
	
 
	
 
	
 
	
    0.26
	
 
	
 
	
 
	
    0.17
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.16
	
 
	
 
	
 
	
 
	
    0.17
	
 
	
 
	
 
	
    0.21
	
 
	
 
	
 
	
    0.27
	
 
	
 
	
 
	
    0.32
	
 
	
 
	
 
	
    0.44
	
 
	
 
	
 
	
 
	
    0.58
	
 
	
 
	
 
	
    0.70
	
 
	
 
	
 
	
    0.80
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
    0.92
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    0.97
	
 
	
 
	
 
	
 
	
    25
	
 

	
 
	
    1
	
 
	
 
	
 
	
 
	
    0.34
	
 
	
 
	
 
	
    0.24
	
 
	
 
	
 
	
    0.17
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.16
	
 
	
 
	
 
	
 
	
    0.18
	
 
	
 
	
 
	
    0.23
	
 
	
 
	
 
	
    0.28
	
 
	
 
	
 
	
    0.36
	
 
	
 
	
 
	
    0.55
	
 
	
 
	
 
	
 
	
    0.67
	
 
	
 
	
 
	
    0.77
	
 
	
 
	
 
	
    0.84
	
 
	
 
	
 
	
    0.88
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
    0.92
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
 
	
    26
	
 

	
 
	
    2
	
 
	
 
	
 
	
 
	
    0.23
	
 
	
 
	
 
	
    0.16
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.17
	
 
	
 
	
 
	
 
	
    0.21
	
 
	
 
	
 
	
    0.26
	
 
	
 
	
 
	
    0.34
	
 
	
 
	
 
	
    0.49
	
 
	
 
	
 
	
    0.64
	
 
	
 
	
 
	
 
	
    0.74
	
 
	
 
	
 
	
    0.82
	
 
	
 
	
 
	
    0.87
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
    0.92
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    0.99
	
 
	
 
	
 
	
 
	
    1.03
	
 
	
 
	
 
	
 
	
    27
	
 

	
 
	
    3
	
 
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.16
	
 
	
 
	
 
	
    0.20
	
 
	
 
	
 
	
 
	
    0.26
	
 
	
 
	
 
	
    0.33
	
 
	
 
	
 
	
    0.48
	
 
	
 
	
 
	
    0.63
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
 
	
    0.92
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
    1.00
	
 
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
 
	
    28
	
 

	
 
	
    4
	
 
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.16
	
 
	
 
	
 
	
    0.20
	
 
	
 
	
 
	
    0.25
	
 
	
 
	
 
	
 
	
    0.33
	
 
	
 
	
 
	
    0.48
	
 
	
 
	
 
	
    0.63
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
    0.92
	
 
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    0.97
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
 
	
    29
	
 

	
 
	
    5
	
 
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.16
	
 
	
 
	
 
	
    0.19
	
 
	
 
	
 
	
    0.24
	
 
	
 
	
 
	
    0.32
	
 
	
 
	
 
	
 
	
    0.48
	
 
	
 
	
 
	
    0.63
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
    0.92
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    0.95
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
 
	
    30
	
 

	
 
	
    6
	
 
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.19
	
 
	
 
	
 
	
    0.24
	
 
	
 
	
 
	
    0.31
	
 
	
 
	
 
	
    0.47
	
 
	
 
	
 
	
 
	
    0.63
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.88
	
 
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
    0.93
	
 
	
 
	
 
	
    0.95
	
 
	
 
	
 
	
 
	
    0.95
	
 
	
 
	
 
	
    0.95
	
 
	
 
	
 
	
    0.95
	
 
	
 
	
 
	
    0.95
	
 
	
 
	
 
	
    0.95
	
 
	
 
	
 
	
 
	
    0.95
	
 
	
 
	
 
	
 
	
    31
	
 

	
 
	
    7
	
 
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
 
	
    0.18
	
 
	
 
	
 
	
    0.23
	
 
	
 
	
 
	
    0.31
	
 
	
 
	
 
	
    0.46
	
 
	
 
	
 
	
    0.63
	
 
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.88
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
    0.92
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    32
	
 

	
 
	
    8
	
 
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.17
	
 
	
 
	
 
	
 
	
    0.22
	
 
	
 
	
 
	
    0.30
	
 
	
 
	
 
	
    0.46
	
 
	
 
	
 
	
    0.62
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.85
	
 
	
 
	
 
	
    0.87
	
 
	
 
	
 
	
    0.88
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
    0.93
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
 
	
    33
	
 

	
 
	
    9
	
 
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.17
	
 
	
 
	
 
	
    0.22
	
 
	
 
	
 
	
 
	
    0.30
	
 
	
 
	
 
	
    0.46
	
 
	
 
	
 
	
    0.62
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
 
	
    0.85
	
 
	
 
	
 
	
    0.87
	
 
	
 
	
 
	
    0.88
	
 
	
 
	
 
	
    0.88
	
 
	
 
	
 
	
    0.88
	
 
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
    0.93
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
 
	
    34
	
 

	
 
	
    10
	
 
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.14
	
 
	
 
	
 
	
    0.16
	
 
	
 
	
 
	
    0.21
	
 
	
 
	
 
	
    0.29
	
 
	
 
	
 
	
 
	
    0.45
	
 
	
 
	
 
	
    0.62
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.80
	
 
	
 
	
 
	
    0.85
	
 
	
 
	
 
	
 
	
    0.87
	
 
	
 
	
 
	
    0.87
	
 
	
 
	
 
	
    0.87
	
 
	
 
	
 
	
    0.87
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
 
	
    0.92
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
 
	
    35
	
 

	
 
	
    11
	
 
	
 
	
 
	
 
	
    0.13
	
 
	
 
	
 
	
    0.16
	
 
	
 
	
 
	
    0.21
	
 
	
 
	
 
	
    0.28
	
 
	
 
	
 
	
    0.45
	
 
	
 
	
 
	
 
	
    0.62
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.80
	
 
	
 
	
 
	
    0.84
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
 
	
    0.93
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
 
	
    1.06
	
 
	
 
	
 
	
 
	
    36
	
 

	
 
	
    12
	
 
	
 
	
 
	
 
	
    0.15
	
 
	
 
	
 
	
    0.20
	
 
	
 
	
 
	
    0.28
	
 
	
 
	
 
	
    0.44
	
 
	
 
	
 
	
    0.62
	
 
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.80
	
 
	
 
	
 
	
    0.83
	
 
	
 
	
 
	
    0.85
	
 
	
 
	
 
	
    0.85
	
 
	
 
	
 
	
 
	
    0.85
	
 
	
 
	
 
	
    0.85
	
 
	
 
	
 
	
    0.87
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
    0.93
	
 
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
    1.06
	
 
	
 
	
 
	
 
	
    1.13
	
 
	
 
	
 
	
 
	
    37
	
 

	
 
	
    13
	
 
	
 
	
 
	
 
	
    0.19
	
 
	
 
	
 
	
    0.27
	
 
	
 
	
 
	
    0.44
	
 
	
 
	
 
	
    0.62
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
 
	
    0.80
	
 
	
 
	
 
	
    0.82
	
 
	
 
	
 
	
    0.84
	
 
	
 
	
 
	
    0.84
	
 
	
 
	
 
	
    0.84
	
 
	
 
	
 
	
 
	
    0.84
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
    0.93
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
    1.06
	
 
	
 
	
 
	
    1.13
	
 
	
 
	
 
	
 
	
    1.21
	
 
	
 
	
 
	
 
	
    38
	
 

	
 
	
    14
	
 
	
 
	
 
	
 
	
    0.26
	
 
	
 
	
 
	
    0.43
	
 
	
 
	
 
	
    0.62
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.79
	
 
	
 
	
 
	
 
	
    0.82
	
 
	
 
	
 
	
    0.83
	
 
	
 
	
 
	
    0.83
	
 
	
 
	
 
	
    0.83
	
 
	
 
	
 
	
    0.83
	
 
	
 
	
 
	
 
	
    0.85
	
 
	
 
	
 
	
    0.88
	
 
	
 
	
 
	
    0.92
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
    1.06
	
 
	
 
	
 
	
    1.13
	
 
	
 
	
 
	
    1.21
	
 
	
 
	
 
	
 
	
    1.29
	
 
	
 
	
 
	
 
	
    39
	
 

	
 
	
    15
	
 
	
 
	
 
	
 
	
    0.43
	
 
	
 
	
 
	
    0.62
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.79
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.82
	
 
	
 
	
 
	
    0.82
	
 
	
 
	
 
	
    0.82
	
 
	
 
	
 
	
    0.83
	
 
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
    0.93
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
    1.06
	
 
	
 
	
 
	
    1.13
	
 
	
 
	
 
	
    1.21
	
 
	
 
	
 
	
    1.29
	
 
	
 
	
 
	
 
	
    1.40
	
 
	
 
	
 
	
 
	
    40
	
 

	
 
	
    16
	
 
	
 
	
 
	
 
	
    0.62
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.79
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.82
	
 
	
 
	
 
	
    0.84
	
 
	
 
	
 
	
 
	
    0.87
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
    0.93
	
 
	
 
	
 
	
    0.93
	
 
	
 
	
 
	
 
	
    0.93
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
 
	
    1.06
	
 
	
 
	
 
	
    1.13
	
 
	
 
	
 
	
    1.21
	
 
	
 
	
 
	
    1.29
	
 
	
 
	
 
	
    1.40
	
 
	
 
	
 
	
 
	
    1.53
	
 
	
 
	
 
	
 
	
    41
	
 

	
 
	
    17
	
 
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.78
	
 
	
 
	
 
	
    0.80
	
 
	
 
	
 
	
    0.80
	
 
	
 
	
 
	
    0.80
	
 
	
 
	
 
	
 
	
    0.80
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.83
	
 
	
 
	
 
	
    0.85
	
 
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.88
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
    1.06
	
 
	
 
	
 
	
 
	
    1.13
	
 
	
 
	
 
	
    1.21
	
 
	
 
	
 
	
    1.29
	
 
	
 
	
 
	
    1.40
	
 
	
 
	
 
	
    1.53
	
 
	
 
	
 
	
 
	
    1.69
	
 
	
 
	
 
	
 
	
    42
	
 

	
 
	
    18
	
 
	
 
	
 
	
 
	
    0.77
	
 
	
 
	
 
	
    0.78
	
 
	
 
	
 
	
    0.78
	
 
	
 
	
 
	
    0.78
	
 
	
 
	
 
	
    0.78
	
 
	
 
	
 
	
 
	
    0.78
	
 
	
 
	
 
	
    0.79
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.82
	
 
	
 
	
 
	
    0.83
	
 
	
 
	
 
	
 
	
    0.84
	
 
	
 
	
 
	
    0.84
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.88
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
 
	
    0.92
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
    1.06
	
 
	
 
	
 
	
    1.13
	
 
	
 
	
 
	
 
	
    1.21
	
 
	
 
	
 
	
    1.29
	
 
	
 
	
 
	
    1.40
	
 
	
 
	
 
	
    1.53
	
 
	
 
	
 
	
    1.69
	
 
	
 
	
 
	
 
	
    1.88
	
 
	
 
	
 
	
 
	
    43
	
 

	
 
	
    19
	
 
	
 
	
 
	
 
	
    0.74
	
 
	
 
	
 
	
    0.74
	
 
	
 
	
 
	
    0.74
	
 
	
 
	
 
	
    0.74
	
 
	
 
	
 
	
    0.74
	
 
	
 
	
 
	
 
	
    0.76
	
 
	
 
	
 
	
    0.77
	
 
	
 
	
 
	
    0.78
	
 
	
 
	
 
	
    0.79
	
 
	
 
	
 
	
    0.79
	
 
	
 
	
 
	
 
	
    0.80
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.83
	
 
	
 
	
 
	
    0.87
	
 
	
 
	
 
	
    0.92
	
 
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
    1.06
	
 
	
 
	
 
	
    1.13
	
 
	
 
	
 
	
    1.21
	
 
	
 
	
 
	
 
	
    1.29
	
 
	
 
	
 
	
    1.40
	
 
	
 
	
 
	
    1.53
	
 
	
 
	
 
	
    1.69
	
 
	
 
	
 
	
    1.88
	
 
	
 
	
 
	
 
	
    2.10
	
 
	
 
	
 
	
 
	
    44
	
 

	
 
	
    20
	
 
	
 
	
 
	
 
	
    0.69
	
 
	
 
	
 
	
    0.69
	
 
	
 
	
 
	
    0.69
	
 
	
 
	
 
	
    0.69
	
 
	
 
	
 
	
    0.70
	
 
	
 
	
 
	
 
	
    0.72
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.74
	
 
	
 
	
 
	
    0.75
	
 
	
 
	
 
	
    0.75
	
 
	
 
	
 
	
 
	
    0.77
	
 
	
 
	
 
	
    0.79
	
 
	
 
	
 
	
    0.82
	
 
	
 
	
 
	
    0.87
	
 
	
 
	
 
	
    0.95
	
 
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
    1.06
	
 
	
 
	
 
	
    1.13
	
 
	
 
	
 
	
    1.21
	
 
	
 
	
 
	
    1.29
	
 
	
 
	
 
	
 
	
    1.40
	
 
	
 
	
 
	
    1.53
	
 
	
 
	
 
	
    1.69
	
 
	
 
	
 
	
    1.88
	
 
	
 
	
 
	
    2.10
	
 
	
 
	
 
	
 
	
    2.33
	
 
	
 
	
 
	
 
	
    45
	
 

	
 
	
    21
	
 
	
 
	
 
	
 
	
    0.63
	
 
	
 
	
 
	
    0.63
	
 
	
 
	
 
	
    0.63
	
 
	
 
	
 
	
    0.64
	
 
	
 
	
 
	
    0.66
	
 
	
 
	
 
	
 
	
    0.67
	
 
	
 
	
 
	
    0.69
	
 
	
 
	
 
	
    0.69
	
 
	
 
	
 
	
    0.70
	
 
	
 
	
 
	
    0.72
	
 
	
 
	
 
	
 
	
    0.75
	
 
	
 
	
 
	
    0.78
	
 
	
 
	
 
	
    0.82
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
 
	
    1.06
	
 
	
 
	
 
	
    1.13
	
 
	
 
	
 
	
    1.21
	
 
	
 
	
 
	
    1.29
	
 
	
 
	
 
	
    1.40
	
 
	
 
	
 
	
 
	
    1.53
	
 
	
 
	
 
	
    1.69
	
 
	
 
	
 
	
    1.88
	
 
	
 
	
 
	
    2.10
	
 
	
 
	
 
	
    2.33
	
 
	
 
	
 
	
 
	
    2.56
	
 
	
 
	
 
	
 
	
    46
	
 

	
 
	
    22
	
 
	
 
	
 
	
 
	
    0.57
	
 
	
 
	
 
	
    0.57
	
 
	
 
	
 
	
    0.58
	
 
	
 
	
 
	
    0.61
	
 
	
 
	
 
	
    0.63
	
 
	
 
	
 
	
 
	
    0.64
	
 
	
 
	
 
	
    0.65
	
 
	
 
	
 
	
    0.66
	
 
	
 
	
 
	
    0.68
	
 
	
 
	
 
	
    0.71
	
 
	
 
	
 
	
 
	
    0.74
	
 
	
 
	
 
	
    0.77
	
 
	
 
	
 
	
    0.83
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
    1.02
	
 
	
 
	
 
	
 
	
    1.12
	
 
	
 
	
 
	
    1.21
	
 
	
 
	
 
	
    1.29
	
 
	
 
	
 
	
    1.40
	
 
	
 
	
 
	
    1.53
	
 
	
 
	
 
	
 
	
    1.69
	
 
	
 
	
 
	
    1.88
	
 
	
 
	
 
	
    2.10
	
 
	
 
	
 
	
    2.33
	
 
	
 
	
 
	
    2.56
	
 
	
 
	
 
	
 
	
    2.74
	
 
	
 
	
 
	
 
	
    47
	
 

	
 
	
    23
	
 
	
 
	
 
	
 
	
    0.51
	
 
	
 
	
 
	
    0.52
	
 
	
 
	
 
	
    0.55
	
 
	
 
	
 
	
    0.58
	
 
	
 
	
 
	
    0.61
	
 
	
 
	
 
	
 
	
    0.63
	
 
	
 
	
 
	
    0.64
	
 
	
 
	
 
	
    0.65
	
 
	
 
	
 
	
    0.67
	
 
	
 
	
 
	
    0.71
	
 
	
 
	
 
	
 
	
    0.75
	
 
	
 
	
 
	
    0.79
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.95
	
 
	
 
	
 
	
    1.08
	
 
	
 
	
 
	
 
	
    1.19
	
 
	
 
	
 
	
    1.29
	
 
	
 
	
 
	
    1.40
	
 
	
 
	
 
	
    1.53
	
 
	
 
	
 
	
    1.69
	
 
	
 
	
 
	
 
	
    1.88
	
 
	
 
	
 
	
    2.10
	
 
	
 
	
 
	
    2.33
	
 
	
 
	
 
	
    2.54
	
 
	
 
	
 
	
    2.74
	
 
	
 
	
 
	
 
	
    2.88
	
 
	
 
	
 
	
 
	
    48
	
 

	
 
	
    24
	
 
	
 
	
 
	
 
	
    0.43
	
 
	
 
	
 
	
    0.47
	
 
	
 
	
 
	
    0.52
	
 
	
 
	
 
	
    0.57
	
 
	
 
	
 
	
    0.60
	
 
	
 
	
 
	
 
	
    0.62
	
 
	
 
	
 
	
    0.63
	
 
	
 
	
 
	
    0.65
	
 
	
 
	
 
	
    0.69
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
 
	
    0.78
	
 
	
 
	
 
	
    0.83
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
    1.15
	
 
	
 
	
 
	
 
	
    1.28
	
 
	
 
	
 
	
    1.40
	
 
	
 
	
 
	
    1.53
	
 
	
 
	
 
	
    1.69
	
 
	
 
	
 
	
    1.88
	
 
	
 
	
 
	
 
	
    2.10
	
 
	
 
	
 
	
    2.33
	
 
	
 
	
 
	
    2.53
	
 
	
 
	
 
	
    2.72
	
 
	
 
	
 
	
    2.88
	
 
	
 
	
 
	
 
	
    3.06
	
 
	
 
	
 
	
 
	
    49
	
 

	
 
	
    25
	
 
	
 
	
 
	
 
	
    0.37
	
 
	
 
	
 
	
    0.44
	
 
	
 
	
 
	
    0.51
	
 
	
 
	
 
	
    0.57
	
 
	
 
	
 
	
    0.60
	
 
	
 
	
 
	
 
	
    0.62
	
 
	
 
	
 
	
    0.64
	
 
	
 
	
 
	
    0.67
	
 
	
 
	
 
	
    0.71
	
 
	
 
	
 
	
    0.77
	
 
	
 
	
 
	
 
	
    0.82
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
    0.97
	
 
	
 
	
 
	
    1.09
	
 
	
 
	
 
	
    1.23
	
 
	
 
	
 
	
 
	
    1.39
	
 
	
 
	
 
	
    1.53
	
 
	
 
	
 
	
    1.69
	
 
	
 
	
 
	
    1.88
	
 
	
 
	
 
	
    2.10
	
 
	
 
	
 
	
 
	
    2.33
	
 
	
 
	
 
	
    2.53
	
 
	
 
	
 
	
    2.70
	
 
	
 
	
 
	
    2.87
	
 
	
 
	
 
	
    3.06
	
 
	
 
	
 
	
 
	
    3.30
	
 
	
 
	
 
	
 
	
    50
	
 

	
 
	
    26
	
 
	
 
	
 
	
 
	
    0.34
	
 
	
 
	
 
	
    0.43
	
 
	
 
	
 
	
    0.51
	
 
	
 
	
 
	
    0.58
	
 
	
 
	
 
	
    0.62
	
 
	
 
	
 
	
 
	
    0.64
	
 
	
 
	
 
	
    0.67
	
 
	
 
	
 
	
    0.71
	
 
	
 
	
 
	
    0.75
	
 
	
 
	
 
	
    0.82
	
 
	
 
	
 
	
 
	
    0.88
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    1.05
	
 
	
 
	
 
	
    1.19
	
 
	
 
	
 
	
    1.33
	
 
	
 
	
 
	
 
	
    1.52
	
 
	
 
	
 
	
    1.69
	
 
	
 
	
 
	
    1.88
	
 
	
 
	
 
	
    2.10
	
 
	
 
	
 
	
    2.33
	
 
	
 
	
 
	
 
	
    2.52
	
 
	
 
	
 
	
    2.69
	
 
	
 
	
 
	
    2.87
	
 
	
 
	
 
	
    3.06
	
 
	
 
	
 
	
    3.30
	
 
	
 
	
 
	
 
	
    3.61
	
 
	
 
	
 
	
 
	
    51
	
 

	
 
	
    27
	
 
	
 
	
 
	
 
	
    0.33
	
 
	
 
	
 
	
    0.43
	
 
	
 
	
 
	
    0.52
	
 
	
 
	
 
	
    0.59
	
 
	
 
	
 
	
    0.64
	
 
	
 
	
 
	
 
	
    0.66
	
 
	
 
	
 
	
    0.70
	
 
	
 
	
 
	
    0.75
	
 
	
 
	
 
	
    0.80
	
 
	
 
	
 
	
    0.88
	
 
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    1.05
	
 
	
 
	
 
	
    1.16
	
 
	
 
	
 
	
    1.31
	
 
	
 
	
 
	
    1.46
	
 
	
 
	
 
	
 
	
    1.67
	
 
	
 
	
 
	
    1.87
	
 
	
 
	
 
	
    2.09
	
 
	
 
	
 
	
    2.33
	
 
	
 
	
 
	
    2.52
	
 
	
 
	
 
	
 
	
    2.69
	
 
	
 
	
 
	
    2.86
	
 
	
 
	
 
	
    3.06
	
 
	
 
	
 
	
    3.30
	
 
	
 
	
 
	
    3.61
	
 
	
 
	
 
	
 
	
    3.99
	
 
	
 
	
 
	
 
	
    52
	
 

	
 
	
    28
	
 
	
 
	
 
	
 
	
    0.33
	
 
	
 
	
 
	
    0.44
	
 
	
 
	
 
	
    0.53
	
 
	
 
	
 
	
    0.60
	
 
	
 
	
 
	
    0.66
	
 
	
 
	
 
	
 
	
    0.70
	
 
	
 
	
 
	
    0.74
	
 
	
 
	
 
	
    0.80
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.95
	
 
	
 
	
 
	
 
	
    1.05
	
 
	
 
	
 
	
    1.16
	
 
	
 
	
 
	
    1.28
	
 
	
 
	
 
	
    1.44
	
 
	
 
	
 
	
    1.62
	
 
	
 
	
 
	
 
	
    1.85
	
 
	
 
	
 
	
    2.07
	
 
	
 
	
 
	
    2.30
	
 
	
 
	
 
	
    2.52
	
 
	
 
	
 
	
    2.69
	
 
	
 
	
 
	
 
	
    2.86
	
 
	
 
	
 
	
    3.06
	
 
	
 
	
 
	
    3.29
	
 
	
 
	
 
	
    3.61
	
 
	
 
	
 
	
    3.99
	
 
	
 
	
 
	
 
	
    4.46
	
 
	
 
	
 
	
 
	
    53
	
 

	
 
	
    29
	
 
	
 
	
 
	
 
	
    0.32
	
 
	
 
	
 
	
    0.44
	
 
	
 
	
 
	
    0.54
	
 
	
 
	
 
	
    0.61
	
 
	
 
	
 
	
    0.69
	
 
	
 
	
 
	
 
	
    0.74
	
 
	
 
	
 
	
    0.80
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.93
	
 
	
 
	
 
	
    1.04
	
 
	
 
	
 
	
 
	
    1.14
	
 
	
 
	
 
	
    1.26
	
 
	
 
	
 
	
    1.39
	
 
	
 
	
 
	
    1.56
	
 
	
 
	
 
	
    1.78
	
 
	
 
	
 
	
 
	
    2.03
	
 
	
 
	
 
	
    2.27
	
 
	
 
	
 
	
    2.49
	
 
	
 
	
 
	
    2.68
	
 
	
 
	
 
	
    2.86
	
 
	
 
	
 
	
 
	
    3.06
	
 
	
 
	
 
	
    3.29
	
 
	
 
	
 
	
    3.60
	
 
	
 
	
 
	
    3.99
	
 
	
 
	
 
	
    4.44
	
 
	
 
	
 
	
 
	
    5.03
	
 
	
 
	
 
	
 
	
    54
	
 

	
 
	
    30
	
 
	
 
	
 
	
 
	
    0.31
	
 
	
 
	
 
	
    0.44
	
 
	
 
	
 
	
    0.53
	
 
	
 
	
 
	
    0.62
	
 
	
 
	
 
	
    0.71
	
 
	
 
	
 
	
 
	
    0.79
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    0.92
	
 
	
 
	
 
	
    1.01
	
 
	
 
	
 
	
    1.11
	
 
	
 
	
 
	
 
	
    1.22
	
 
	
 
	
 
	
    1.35
	
 
	
 
	
 
	
    1.52
	
 
	
 
	
 
	
    1.72
	
 
	
 
	
 
	
    1.96
	
 
	
 
	
 
	
 
	
    2.22
	
 
	
 
	
 
	
    2.45
	
 
	
 
	
 
	
    2.65
	
 
	
 
	
 
	
    2.85
	
 
	
 
	
 
	
    3.05
	
 
	
 
	
 
	
 
	
    3.28
	
 
	
 
	
 
	
    3.57
	
 
	
 
	
 
	
    3.98
	
 
	
 
	
 
	
    4.42
	
 
	
 
	
 
	
    4.94
	
 
	
 
	
 
	
 
	
    5.66
	
 
	
 
	
 
	
 
	
    55
	
 

	
 
	
    31
	
 
	
 
	
 
	
 
	
    0.30
	
 
	
 
	
 
	
    0.42
	
 
	
 
	
 
	
    0.53
	
 
	
 
	
 
	
    0.63
	
 
	
 
	
 
	
    0.72
	
 
	
 
	
 
	
 
	
    0.81
	
 
	
 
	
 
	
    0.90
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
    1.06
	
 
	
 
	
 
	
    1.15
	
 
	
 
	
 
	
 
	
    1.28
	
 
	
 
	
 
	
    1.45
	
 
	
 
	
 
	
    1.67
	
 
	
 
	
 
	
    1.92
	
 
	
 
	
 
	
    2.18
	
 
	
 
	
 
	
 
	
    2.42
	
 
	
 
	
 
	
    2.63
	
 
	
 
	
 
	
    2.83
	
 
	
 
	
 
	
    3.04
	
 
	
 
	
 
	
    3.27
	
 
	
 
	
 
	
 
	
    3.56
	
 
	
 
	
 
	
    3.95
	
 
	
 
	
 
	
    4.40
	
 
	
 
	
 
	
    4.91
	
 
	
 
	
 
	
    5.49
	
 
	
 
	
 
	
 
	
    6.33
	
 
	
 
	
 
	
 
	
    56
	
 

	
 
	
    32
	
 
	
 
	
 
	
 
	
    0.30
	
 
	
 
	
 
	
    0.42
	
 
	
 
	
 
	
    0.54
	
 
	
 
	
 
	
    0.64
	
 
	
 
	
 
	
    0.75
	
 
	
 
	
 
	
 
	
    0.84
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    1.02
	
 
	
 
	
 
	
    1.10
	
 
	
 
	
 
	
    1.20
	
 
	
 
	
 
	
 
	
    1.35
	
 
	
 
	
 
	
    1.57
	
 
	
 
	
 
	
    1.85
	
 
	
 
	
 
	
    2.12
	
 
	
 
	
 
	
    2.38
	
 
	
 
	
 
	
 
	
    2.61
	
 
	
 
	
 
	
    2.82
	
 
	
 
	
 
	
    3.04
	
 
	
 
	
 
	
    3.27
	
 
	
 
	
 
	
    3.56
	
 
	
 
	
 
	
 
	
    3.95
	
 
	
 
	
 
	
    4.39
	
 
	
 
	
 
	
    4.88
	
 
	
 
	
 
	
    5.44
	
 
	
 
	
 
	
    6.06
	
 
	
 
	
 
	
 
	
    6.96
	
 
	
 
	
 
	
 
	
    57
	
 

	
 
	
    33
	
 
	
 
	
 
	
 
	
    0.32
	
 
	
 
	
 
	
    0.44
	
 
	
 
	
 
	
    0.56
	
 
	
 
	
 
	
    0.67
	
 
	
 
	
 
	
    0.79
	
 
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
    1.00
	
 
	
 
	
 
	
    1.08
	
 
	
 
	
 
	
    1.17
	
 
	
 
	
 
	
    1.28
	
 
	
 
	
 
	
 
	
    1.47
	
 
	
 
	
 
	
    1.72
	
 
	
 
	
 
	
    2.02
	
 
	
 
	
 
	
    2.31
	
 
	
 
	
 
	
    2.56
	
 
	
 
	
 
	
 
	
    2.79
	
 
	
 
	
 
	
    3.03
	
 
	
 
	
 
	
    3.27
	
 
	
 
	
 
	
    3.56
	
 
	
 
	
 
	
    3.94
	
 
	
 
	
 
	
 
	
    4.38
	
 
	
 
	
 
	
    4.86
	
 
	
 
	
 
	
    5.40
	
 
	
 
	
 
	
    6.00
	
 
	
 
	
 
	
    6.63
	
 
	
 
	
 
	
 
	
    7.56
	
 
	
 
	
 
	
 
	
    58
	
 

	
 
	
    34
	
 
	
 
	
 
	
 
	
    0.34
	
 
	
 
	
 
	
    0.46
	
 
	
 
	
 
	
    0.59
	
 
	
 
	
 
	
    0.70
	
 
	
 
	
 
	
    0.82
	
 
	
 
	
 
	
 
	
    0.94
	
 
	
 
	
 
	
    1.05
	
 
	
 
	
 
	
    1.16
	
 
	
 
	
 
	
    1.27
	
 
	
 
	
 
	
    1.42
	
 
	
 
	
 
	
 
	
    1.63
	
 
	
 
	
 
	
    1.90
	
 
	
 
	
 
	
    2.20
	
 
	
 
	
 
	
    2.50
	
 
	
 
	
 
	
    2.76
	
 
	
 
	
 
	
 
	
    3.00
	
 
	
 
	
 
	
    3.27
	
 
	
 
	
 
	
    3.56
	
 
	
 
	
 
	
    3.93
	
 
	
 
	
 
	
    4.36
	
 
	
 
	
 
	
 
	
    4.83
	
 
	
 
	
 
	
    5.36
	
 
	
 
	
 
	
    5.95
	
 
	
 
	
 
	
    6.57
	
 
	
 
	
 
	
    7.20
	
 
	
 
	
 
	
 
	
    8.28
	
 
	
 
	
 
	
 
	
    59
	
 

	
 
	
    35
	
 
	
 
	
 
	
 
	
    0.36
	
 
	
 
	
 
	
    0.48
	
 
	
 
	
 
	
    0.61
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
    1.11
	
 
	
 
	
 
	
    1.25
	
 
	
 
	
 
	
    1.41
	
 
	
 
	
 
	
    1.60
	
 
	
 
	
 
	
 
	
    1.82
	
 
	
 
	
 
	
    2.08
	
 
	
 
	
 
	
    2.38
	
 
	
 
	
 
	
    2.69
	
 
	
 
	
 
	
    2.98
	
 
	
 
	
 
	
 
	
    3.26
	
 
	
 
	
 
	
    3.56
	
 
	
 
	
 
	
    3.92
	
 
	
 
	
 
	
    4.33
	
 
	
 
	
 
	
    4.79
	
 
	
 
	
 
	
 
	
    5.32
	
 
	
 
	
 
	
    5.90
	
 
	
 
	
 
	
    6.51
	
 
	
 
	
 
	
    7.16
	
 
	
 
	
 
	
    7.84
	
 
	
 
	
 
	
 
	
    9.17
	
 
	
 
	
 
	
 
	
    60
	
 

	
 
	
    36
	
 
	
 
	
 
	
 
	
    0.38
	
 
	
 
	
 
	
    0.49
	
 
	
 
	
 
	
    0.63
	
 
	
 
	
 
	
    0.76
	
 
	
 
	
 
	
    0.89
	
 
	
 
	
 
	
 
	
    1.02
	
 
	
 
	
 
	
    1.18
	
 
	
 
	
 
	
    1.38
	
 
	
 
	
 
	
    1.58
	
 
	
 
	
 
	
    1.79
	
 
	
 
	
 
	
 
	
    2.01
	
 
	
 
	
 
	
    2.26
	
 
	
 
	
 
	
    2.57
	
 
	
 
	
 
	
    2.91
	
 
	
 
	
 
	
    3.24
	
 
	
 
	
 
	
 
	
    3.56
	
 
	
 
	
 
	
    3.91
	
 
	
 
	
 
	
    4.31
	
 
	
 
	
 
	
    4.76
	
 
	
 
	
 
	
    5.28
	
 
	
 
	
 
	
 
	
    5.86
	
 
	
 
	
 
	
    6.45
	
 
	
 
	
 
	
    7.11
	
 
	
 
	
 
	
    7.83
	
 
	
 
	
 
	
    8.63
	
 
	
 
	
 
	
 
	
    10.27
	
 
	
 
	
 
	
 
	
    61
	
 

	
 
	
    37
	
 
	
 
	
 
	
 
	
    0.40
	
 
	
 
	
 
	
    0.53
	
 
	
 
	
 
	
    0.67
	
 
	
 
	
 
	
    0.79
	
 
	
 
	
 
	
    0.92
	
 
	
 
	
 
	
 
	
    1.09
	
 
	
 
	
 
	
    1.29
	
 
	
 
	
 
	
    1.53
	
 
	
 
	
 
	
    1.76
	
 
	
 
	
 
	
    1.97
	
 
	
 
	
 
	
 
	
    2.19
	
 
	
 
	
 
	
    2.44
	
 
	
 
	
 
	
    2.77
	
 
	
 
	
 
	
    3.14
	
 
	
 
	
 
	
    3.52
	
 
	
 
	
 
	
 
	
    3.89
	
 
	
 
	
 
	
    4.29
	
 
	
 
	
 
	
    4.73
	
 
	
 
	
 
	
    5.25
	
 
	
 
	
 
	
    5.81
	
 
	
 
	
 
	
 
	
    6.42
	
 
	
 
	
 
	
    7.07
	
 
	
 
	
 
	
    7.80
	
 
	
 
	
 
	
    8.63
	
 
	
 
	
 
	
    9.68
	
 
	
 
	
 
	
 
	
    11.56
	
 
	
 
	
 
	
 
	
    62
	
 

	
 
	
    38
	
 
	
 
	
 
	
 
	
    0.44
	
 
	
 
	
 
	
    0.59
	
 
	
 
	
 
	
    0.73
	
 
	
 
	
 
	
    0.85
	
 
	
 
	
 
	
    0.99
	
 
	
 
	
 
	
 
	
    1.18
	
 
	
 
	
 
	
    1.44
	
 
	
 
	
 
	
    1.70
	
 
	
 
	
 
	
    1.94
	
 
	
 
	
 
	
    2.15
	
 
	
 
	
 
	
 
	
    2.37
	
 
	
 
	
 
	
    2.64
	
 
	
 
	
 
	
    2.99
	
 
	
 
	
 
	
    3.39
	
 
	
 
	
 
	
    3.81
	
 
	
 
	
 
	
 
	
    4.25
	
 
	
 
	
 
	
    4.70
	
 
	
 
	
 
	
    5.22
	
 
	
 
	
 
	
    5.78
	
 
	
 
	
 
	
    6.38
	
 
	
 
	
 
	
 
	
    7.03
	
 
	
 
	
 
	
    7.79
	
 
	
 
	
 
	
    8.63
	
 
	
 
	
 
	
    9.68
	
 
	
 
	
 
	
    10.95
	
 
	
 
	
 
	
 
	
    12.95
	
 
	
 
	
 
	
 
	
    63
	
 

	
 
	
    39
	
 
	
 
	
 
	
 
	
    0.47
	
 
	
 
	
 
	
    0.64
	
 
	
 
	
 
	
    0.79
	
 
	
 
	
 
	
    0.92
	
 
	
 
	
 
	
    1.08
	
 
	
 
	
 
	
 
	
    1.32
	
 
	
 
	
 
	
    1.60
	
 
	
 
	
 
	
    1.87
	
 
	
 
	
 
	
    2.11
	
 
	
 
	
 
	
    2.33
	
 
	
 
	
 
	
 
	
    2.57
	
 
	
 
	
 
	
    2.89
	
 
	
 
	
 
	
    3.27
	
 
	
 
	
 
	
    3.69
	
 
	
 
	
 
	
    4.15
	
 
	
 
	
 
	
 
	
    4.64
	
 
	
 
	
 
	
    5.17
	
 
	
 
	
 
	
    5.75
	
 
	
 
	
 
	
    6.36
	
 
	
 
	
 
	
    7.01
	
 
	
 
	
 
	
 
	
    7.76
	
 
	
 
	
 
	
    8.63
	
 
	
 
	
 
	
    9.67
	
 
	
 
	
 
	
    10.90
	
 
	
 
	
 
	
    12.26
	
 
	
 
	
 
	
 
	
    14.40
	
 
	
 
	
 
	
 
	
    64
	
 

	
 
	
    40
	
 
	
 
	
 
	
 
	
    0.50
	
 
	
 
	
 
	
    0.69
	
 
	
 
	
 
	
    0.86
	
 
	
 
	
 
	
    1.02
	
 
	
 
	
 
	
    1.21
	
 
	
 
	
 
	
 
	
    1.48
	
 
	
 
	
 
	
    1.77
	
 
	
 
	
 
	
    2.04
	
 
	
 
	
 
	
    2.28
	
 
	
 
	
 
	
    2.53
	
 
	
 
	
 
	
 
	
    2.83
	
 
	
 
	
 
	
    3.19
	
 
	
 
	
 
	
    3.60
	
 
	
 
	
 
	
    4.06
	
 
	
 
	
 
	
    4.57
	
 
	
 
	
 
	
 
	
    5.12
	
 
	
 
	
 
	
    5.70
	
 
	
 
	
 
	
    6.32
	
 
	
 
	
 
	
    6.99
	
 
	
 
	
 
	
    7.74
	
 
	
 
	
 
	
 
	
    8.62
	
 
	
 
	
 
	
    9.66
	
 
	
 
	
 
	
    10.87
	
 
	
 
	
 
	
    12.22
	
 
	
 
	
 
	
    13.52
	
 
	
 
	
 
	
 
	
    15.88
	
 
	
 
	
 
	
 
	
    65
	
 

	
 
	
    41
	
 
	
 
	
 
	
 
	
    0.53
	
 
	
 
	
 
	
    0.76
	
 
	
 
	
 
	
    0.96
	
 
	
 
	
 
	
    1.15
	
 
	
 
	
 
	
    1.37
	
 
	
 
	
 
	
 
	
    1.65
	
 
	
 
	
 
	
    1.95
	
 
	
 
	
 
	
    2.22
	
 
	
 
	
 
	
    2.49
	
 
	
 
	
 
	
    2.79
	
 
	
 
	
 
	
 
	
    3.14
	
 
	
 
	
 
	
    3.54
	
 
	
 
	
 
	
    4.00
	
 
	
 
	
 
	
    4.51
	
 
	
 
	
 
	
    5.10
	
 
	
 
	
 
	
 
	
    5.66
	
 
	
 
	
 
	
    6.27
	
 
	
 
	
 
	
    6.95
	
 
	
 
	
 
	
    7.73
	
 
	
 
	
 
	
    8.61
	
 
	
 
	
 
	
 
	
    9.65
	
 
	
 
	
 
	
    10.84
	
 
	
 
	
 
	
    12.15
	
 
	
 
	
 
	
    13.52
	
 
	
 
	
 
	
    14.66
	
 
	
 
	
 
	
 
	
    17.36
	
 
	
 
	
 
	
 
	
    66
	
 

	
 
	
    42
	
 
	
 
	
 
	
 
	
    0.56
	
 
	
 
	
 
	
    0.82
	
 
	
 
	
 
	
    1.05
	
 
	
 
	
 
	
    1.26
	
 
	
 
	
 
	
    1.50
	
 
	
 
	
 
	
 
	
    1.78
	
 
	
 
	
 
	
    2.09
	
 
	
 
	
 
	
    2.39
	
 
	
 
	
 
	
    2.71
	
 
	
 
	
 
	
    3.06
	
 
	
 
	
 
	
 
	
    3.46
	
 
	
 
	
 
	
    3.92
	
 
	
 
	
 
	
    4.46
	
 
	
 
	
 
	
    5.04
	
 
	
 
	
 
	
    5.66
	
 
	
 
	
 
	
 
	
    6.20
	
 
	
 
	
 
	
    6.89
	
 
	
 
	
 
	
    7.68
	
 
	
 
	
 
	
    8.60
	
 
	
 
	
 
	
    9.64
	
 
	
 
	
 
	
 
	
    10.81
	
 
	
 
	
 
	
    12.07
	
 
	
 
	
 
	
    13.41
	
 
	
 
	
 
	
    14.66
	
 
	
 
	
 
	
    15.88
	
 
	
 
	
 
	
 
	
    18.90
	
 
	
 
	
 
	
 
	
    67
	
 

	
 
	
    43
	
 
	
 
	
 
	
 
	
    0.60
	
 
	
 
	
 
	
    0.87
	
 
	
 
	
 
	
    1.12
	
 
	
 
	
 
	
    1.34
	
 
	
 
	
 
	
    1.59
	
 
	
 
	
 
	
 
	
    1.88
	
 
	
 
	
 
	
    2.23
	
 
	
 
	
 
	
    2.58
	
 
	
 
	
 
	
    2.94
	
 
	
 
	
 
	
    3.34
	
 
	
 
	
 
	
 
	
    3.78
	
 
	
 
	
 
	
    4.36
	
 
	
 
	
 
	
    4.99
	
 
	
 
	
 
	
    5.60
	
 
	
 
	
 
	
    6.19
	
 
	
 
	
 
	
 
	
    6.79
	
 
	
 
	
 
	
    7.61
	
 
	
 
	
 
	
    8.54
	
 
	
 
	
 
	
    9.61
	
 
	
 
	
 
	
    10.78
	
 
	
 
	
 
	
 
	
    12.02
	
 
	
 
	
 
	
    13.31
	
 
	
 
	
 
	
    14.59
	
 
	
 
	
 
	
    15.83
	
 
	
 
	
 
	
    17.32
	
 
	
 
	
 
	
 
	
    20.51
	
 
	
 
	
 
	
 
	
    68
	
 

	
 
	
    44
	
 
	
 
	
 
	
 
	
    0.65
	
 
	
 
	
 
	
    0.93
	
 
	
 
	
 
	
    1.18
	
 
	
 
	
 
	
    1.41
	
 
	
 
	
 
	
    1.68
	
 
	
 
	
 
	
 
	
    2.01
	
 
	
 
	
 
	
    2.40
	
 
	
 
	
 
	
    2.81
	
 
	
 
	
 
	
    3.22
	
 
	
 
	
 
	
    3.65
	
 
	
 
	
 
	
 
	
    4.17
	
 
	
 
	
 
	
    4.88
	
 
	
 
	
 
	
    5.54
	
 
	
 
	
 
	
    6.12
	
 
	
 
	
 
	
    6.71
	
 
	
 
	
 
	
 
	
    7.50
	
 
	
 
	
 
	
    8.46
	
 
	
 
	
 
	
    9.54
	
 
	
 
	
 
	
    10.72
	
 
	
 
	
 
	
    11.97
	
 
	
 
	
 
	
 
	
    13.23
	
 
	
 
	
 
	
    14.51
	
 
	
 
	
 
	
    15.76
	
 
	
 
	
 
	
    17.26
	
 
	
 
	
 
	
    19.02
	
 
	
 
	
 
	
 
	
    22.29
	
 
	
 
	
 
	
 
	
    69
	
 

	
 
	
    45
	
 
	
 
	
 
	
 
	
    0.72
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
    1.23
	
 
	
 
	
 
	
    1.48
	
 
	
 
	
 
	
    1.80
	
 
	
 
	
 
	
 
	
    2.17
	
 
	
 
	
 
	
    2.61
	
 
	
 
	
 
	
    3.08
	
 
	
 
	
 
	
    3.55
	
 
	
 
	
 
	
    4.03
	
 
	
 
	
 
	
 
	
    4.65
	
 
	
 
	
 
	
    5.42
	
 
	
 
	
 
	
    6.05
	
 
	
 
	
 
	
    6.61
	
 
	
 
	
 
	
    7.36
	
 
	
 
	
 
	
 
	
    8.34
	
 
	
 
	
 
	
    9.44
	
 
	
 
	
 
	
    10.64
	
 
	
 
	
 
	
    11.89
	
 
	
 
	
 
	
    13.16
	
 
	
 
	
 
	
 
	
    14.42
	
 
	
 
	
 
	
    15.66
	
 
	
 
	
 
	
    17.10
	
 
	
 
	
 
	
    19.02
	
 
	
 
	
 
	
    21.17
	
 
	
 
	
 
	
 
	
    24.34
	
 
	
 
	
 
	
 
	
    70
	
 

	
 
	
    46
	
 
	
 
	
 
	
 
	
    0.78
	
 
	
 
	
 
	
    1.03
	
 
	
 
	
 
	
    1.28
	
 
	
 
	
 
	
    1.57
	
 
	
 
	
 
	
    1.94
	
 
	
 
	
 
	
 
	
    2.37
	
 
	
 
	
 
	
    2.86
	
 
	
 
	
 
	
    3.39
	
 
	
 
	
 
	
    3.90
	
 
	
 
	
 
	
    4.49
	
 
	
 
	
 
	
 
	
    5.17
	
 
	
 
	
 
	
    5.92
	
 
	
 
	
 
	
    6.54
	
 
	
 
	
 
	
    7.19
	
 
	
 
	
 
	
    8.18
	
 
	
 
	
 
	
 
	
    9.32
	
 
	
 
	
 
	
    10.55
	
 
	
 
	
 
	
    11.82
	
 
	
 
	
 
	
    13.09
	
 
	
 
	
 
	
    14.34
	
 
	
 
	
 
	
 
	
    15.54
	
 
	
 
	
 
	
    16.95
	
 
	
 
	
 
	
    18.83
	
 
	
 
	
 
	
    21.17
	
 
	
 
	
 
	
    23.74
	
 
	
 
	
 
	
 
	
    26.89
	
 
	
 
	
 
	
 
	
    71
	
 

	
 
	
    47
	
 
	
 
	
 
	
 
	
    0.85
	
 
	
 
	
 
	
    1.10
	
 
	
 
	
 
	
    1.37
	
 
	
 
	
 
	
    1.69
	
 
	
 
	
 
	
    2.10
	
 
	
 
	
 
	
 
	
    2.56
	
 
	
 
	
 
	
    3.11
	
 
	
 
	
 
	
    3.70
	
 
	
 
	
 
	
    4.28
	
 
	
 
	
 
	
    4.99
	
 
	
 
	
 
	
 
	
    5.65
	
 
	
 
	
 
	
    6.39
	
 
	
 
	
 
	
    7.07
	
 
	
 
	
 
	
    7.94
	
 
	
 
	
 
	
    9.14
	
 
	
 
	
 
	
 
	
    10.44
	
 
	
 
	
 
	
    11.76
	
 
	
 
	
 
	
    13.05
	
 
	
 
	
 
	
    14.28
	
 
	
 
	
 
	
    15.46
	
 
	
 
	
 
	
 
	
    16.79
	
 
	
 
	
 
	
    18.63
	
 
	
 
	
 
	
    20.96
	
 
	
 
	
 
	
    23.74
	
 
	
 
	
 
	
    26.61
	
 
	
 
	
 
	
 
	
    29.88
	
 
	
 
	
 
	
 
	
    72
	
 

	
 
	
    48
	
 
	
 
	
 
	
 
	
    0.91
	
 
	
 
	
 
	
    1.19
	
 
	
 
	
 
	
    1.50
	
 
	
 
	
 
	
    1.86
	
 
	
 
	
 
	
    2.27
	
 
	
 
	
 
	
 
	
    2.76
	
 
	
 
	
 
	
    3.35
	
 
	
 
	
 
	
    4.01
	
 
	
 
	
 
	
    4.65
	
 
	
 
	
 
	
    5.40
	
 
	
 
	
 
	
 
	
    6.10
	
 
	
 
	
 
	
    6.91
	
 
	
 
	
 
	
    7.77
	
 
	
 
	
 
	
    8.85
	
 
	
 
	
 
	
    10.23
	
 
	
 
	
 
	
 
	
    11.67
	
 
	
 
	
 
	
    12.99
	
 
	
 
	
 
	
    14.24
	
 
	
 
	
 
	
    15.39
	
 
	
 
	
 
	
    16.65
	
 
	
 
	
 
	
 
	
    18.44
	
 
	
 
	
 
	
    20.74
	
 
	
 
	
 
	
    23.50
	
 
	
 
	
 
	
    26.61
	
 
	
 
	
 
	
    29.59
	
 
	
 
	
 
	
 
	
    32.99
	
 
	
 
	
 
	
 
	
    73
	
 

	
 
	
    49
	
 
	
 
	
 
	
 
	
    0.98
	
 
	
 
	
 
	
    1.31
	
 
	
 
	
 
	
    1.66
	
 
	
 
	
 
	
    2.04
	
 
	
 
	
 
	
    2.47
	
 
	
 
	
 
	
 
	
    2.98
	
 
	
 
	
 
	
    3.62
	
 
	
 
	
 
	
    4.33
	
 
	
 
	
 
	
    4.99
	
 
	
 
	
 
	
    5.75
	
 
	
 
	
 
	
 
	
    6.59
	
 
	
 
	
 
	
    7.60
	
 
	
 
	
 
	
    8.71
	
 
	
 
	
 
	
    9.98
	
 
	
 
	
 
	
    11.42
	
 
	
 
	
 
	
 
	
    12.92
	
 
	
 
	
 
	
    14.17
	
 
	
 
	
 
	
    15.31
	
 
	
 
	
 
	
    16.43
	
 
	
 
	
 
	
    18.25
	
 
	
 
	
 
	
 
	
    20.53
	
 
	
 
	
 
	
    23.26
	
 
	
 
	
 
	
    26.33
	
 
	
 
	
 
	
    29.59
	
 
	
 
	
 
	
    32.67
	
 
	
 
	
 
	
 
	
    36.34
	
 
	
 
	
 
	
 
	
    74
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
    2001 Valuation Basic
    Table — Male — Composite— 1000qx

	
 
	
 
	
 
	
    Duration

	
    Issue

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Att

    

	
    Age
	
 
	
 
	
    1
	
 
	
    2
	
 
	
    3
	
 
	
    4
	
 
	
    5
	
 
	
 
	
    6
	
 
	
    7
	
 
	
    8
	
 
	
    9
	
 
	
    10
	
 
	
 
	
    11
	
 
	
    12
	
 
	
    13
	
 
	
    14
	
 
	
    15
	
 
	
 
	
    16
	
 
	
    17
	
 
	
    18
	
 
	
    19
	
 
	
    20
	
 
	
 
	
    21
	
 
	
    22
	
 
	
    23
	
 
	
    24
	
 
	
    25
	
 
	
 
	
    Ultimate
	
 
	
 
	
    Age

	

    50
    

	
 
	
 
	
    1.08
    
	
 
	
    1.46
    
	
 
	
    1.85
    
	
 
	
    2.26
    
	
 
	
    2.69
    
	
 
	
 
	
    3.22
    
	
 
	
    3.88
    
	
 
	
    4.62
    
	
 
	
    5.33
    
	
 
	
    6.16
    
	
 
	
 
	
    7.20
    
	
 
	
    8.52
    
	
 
	
    9.87
    
	
 
	
    11.26
    
	
 
	
    12.60
    
	
 
	
 
	
    14.11
    
	
 
	
    15.23
    
	
 
	
    16.30
    
	
 
	
    17.86
    
	
 
	
    20.31
    
	
 
	
 
	
    23.03
    
	
 
	
    26.07
    
	
 
	
    29.28
    
	
 
	
    32.67
    
	
 
	
    35.95
    
	
 
	
 
	
    40.01
    
	
 
	
 
	
    75
    

	

    51
    

	
 
	
 
	
    1.19
    
	
 
	
    1.64
    
	
 
	
    2.08
    
	
 
	
    2.51
    
	
 
	
    2.94
    
	
 
	
 
	
    3.47
    
	
 
	
    4.14
    
	
 
	
    4.91
    
	
 
	
    5.73
    
	
 
	
    6.73
    
	
 
	
 
	
    8.04
    
	
 
	
    9.65
    
	
 
	
    11.14
    
	
 
	
    12.32
    
	
 
	
    13.69
    
	
 
	
 
	
    15.16
    
	
 
	
    16.25
    
	
 
	
    17.67
    
	
 
	
    19.89
    
	
 
	
    22.79
    
	
 
	
 
	
    25.79
    
	
 
	
    28.99
    
	
 
	
    32.34
    
	
 
	
    35.95
    
	
 
	
    39.58
    
	
 
	
 
	
    44.14
    
	
 
	
 
	
    76
    

	

    52
    

	
 
	
 
	
    1.27
    
	
 
	
    1.80
    
	
 
	
    2.30
    
	
 
	
    2.77
    
	
 
	
    3.22
    
	
 
	
 
	
    3.76
    
	
 
	
    4.46
    
	
 
	
    5.33
    
	
 
	
    6.29
    
	
 
	
    7.54
    
	
 
	
 
	
    9.10
    
	
 
	
    10.88
    
	
 
	
    12.19
    
	
 
	
    13.28
    
	
 
	
    14.74
    
	
 
	
 
	
    16.21
    
	
 
	
    17.67
    
	
 
	
    19.67
    
	
 
	
    22.31
    
	
 
	
    25.53
    
	
 
	
 
	
    28.68
    
	
 
	
    32.01
    
	
 
	
    35.59
    
	
 
	
    39.58
    
	
 
	
    43.70
    
	
 
	
 
	
    48.97
    
	
 
	
 
	
    77
    

	

    53
    

	
 
	
 
	
    1.32
    
	
 
	
    1.94
    
	
 
	
    2.51
    
	
 
	
    3.03
    
	
 
	
    3.51
    
	
 
	
 
	
    4.10
    
	
 
	
    4.91
    
	
 
	
    5.94
    
	
 
	
    7.06
    
	
 
	
    8.55
    
	
 
	
 
	
    10.26
    
	
 
	
    11.90
    
	
 
	
    13.13
    
	
 
	
    14.46
    
	
 
	
    16.02
    
	
 
	
 
	
    17.67
    
	
 
	
    19.67
    
	
 
	
    22.07
    
	
 
	
    24.99
    
	
 
	
    28.39
    
	
 
	
 
	
    31.68
    
	
 
	
    35.22
    
	
 
	
    39.18
    
	
 
	
    43.70
    
	
 
	
    48.48
    
	
 
	
 
	
    54.58
    
	
 
	
 
	
    78
    

	

    54
    

	
 
	
 
	
    1.36
    
	
 
	
    2.09
    
	
 
	
    2.74
    
	
 
	
    3.27
    
	
 
	
    3.80
    
	
 
	
 
	
    4.50
    
	
 
	
    5.48
    
	
 
	
    6.69
    
	
 
	
    7.96
    
	
 
	
    9.60
    
	
 
	
 
	
    11.19
    
	
 
	
    12.78
    
	
 
	
    14.30
    
	
 
	
    15.85
    
	
 
	
    17.67
    
	
 
	
 
	
    19.67
    
	
 
	
    22.07
    
	
 
	
    24.72
    
	
 
	
    27.79
    
	
 
	
    31.35
    
	
 
	
 
	
    34.86
    
	
 
	
    38.78
    
	
 
	
    43.26
    
	
 
	
    48.48
    
	
 
	
    54.03
    
	
 
	
 
	
    60.85
    
	
 
	
 
	
    79
    

	

    55
    

	
 
	
 
	
    1.42
    
	
 
	
    2.24
    
	
 
	
    2.94
    
	
 
	
    3.52
    
	
 
	
    4.13
    
	
 
	
 
	
    4.99
    
	
 
	
    6.17
    
	
 
	
    7.54
    
	
 
	
    8.92
    
	
 
	
    10.43
    
	
 
	
 
	
    11.98
    
	
 
	
    13.83
    
	
 
	
    15.67
    
	
 
	
    17.48
    
	
 
	
    19.67
    
	
 
	
 
	
    22.07
    
	
 
	
    24.72
    
	
 
	
    27.50
    
	
 
	
    30.69
    
	
 
	
    34.50
    
	
 
	
 
	
    38.38
    
	
 
	
    42.82
    
	
 
	
    47.99
    
	
 
	
    54.03
    
	
 
	
    60.24
    
	
 
	
 
	
    67.84
    
	
 
	
 
	
    80
    

	

    56
    

	
 
	
 
	
    1.47
    
	
 
	
    2.37
    
	
 
	
    3.14
    
	
 
	
    3.82
    
	
 
	
    4.56
    
	
 
	
 
	
    5.60
    
	
 
	
    6.94
    
	
 
	
    8.43
    
	
 
	
    9.86
    
	
 
	
    11.35
    
	
 
	
 
	
    13.16
    
	
 
	
    15.22
    
	
 
	
    17.29
    
	
 
	
    19.46
    
	
 
	
    22.07
    
	
 
	
 
	
    24.72
    
	
 
	
    27.50
    
	
 
	
    30.36
    
	
 
	
    33.77
    
	
 
	
    37.98
    
	
 
	
 
	
    42.38
    
	
 
	
    47.50
    
	
 
	
    53.49
    
	
 
	
    40.24
    
	
 
	
    67.16
    
	
 
	
 
	
    75.41
    
	
 
	
 
	
    81
    

	

    57
    

	
 
	
 
	
    1.56
    
	
 
	
    2.50
    
	
 
	
    3.36
    
	
 
	
    4.17
    
	
 
	
    5.09
    
	
 
	
 
	
    6.30
    
	
 
	
    7.76
    
	
 
	
    9.29
    
	
 
	
    10.71
    
	
 
	
    12.46
    
	
 
	
 
	
    14.53
    
	
 
	
    16.90
    
	
 
	
    19.25
    
	
 
	
    21.83
    
	
 
	
    24.72
    
	
 
	
 
	
    27.50
    
	
 
	
    30.36
    
	
 
	
    33.40
    
	
 
	
    37.18
    
	
 
	
    41.94
    
	
 
	
 
	
    47.01
    
	
 
	
    52.94
    
	
 
	
    59.64
    
	
 
	
    67.16
    
	
 
	
    74.66
    
	
 
	
 
	
    83.37
    
	
 
	
 
	
    82
    

	

    58
    

	
 
	
 
	
    1.69
    
	
 
	
    2.67
    
	
 
	
    3.62
    
	
 
	
    4.60
    
	
 
	
    5.71
    
	
 
	
 
	
    7.07
    
	
 
	
    8.58
    
	
 
	
    10.09
    
	
 
	
    11.48
    
	
 
	
    13.45
    
	
 
	
 
	
    15.79
    
	
 
	
    18.64
    
	
 
	
    21.59
    
	
 
	
    24.45
    
	
 
	
    27.50
    
	
 
	
 
	
    30.36
    
	
 
	
    33.40
    
	
 
	
    36.78
    
	
 
	
    41.05
    
	
 
	
    46.52
    
	
 
	
 
	
    52.39
    
	
 
	
    59.03
    
	
 
	
    66.49
    
	
 
	
    74.66
    
	
 
	
    82.54
    
	
 
	
 
	
    92.03
    
	
 
	
 
	
    83
    

	

    59
    

	
 
	
 
	
    1.87
    
	
 
	
    2.87
    
	
 
	
    3.93
    
	
 
	
    5.08
    
	
 
	
    6.38
    
	
 
	
 
	
    7.85
    
	
 
	
    9.39
    
	
 
	
    10.86
    
	
 
	
    12.22
    
	
 
	
    14.44
    
	
 
	
 
	
    17.14
    
	
 
	
    20.42
    
	
 
	
    24.05
    
	
 
	
    27.20
    
	
 
	
    30.36
    
	
 
	
 
	
    33.40
    
	
 
	
    36.78
    
	
 
	
    40.61
    
	
 
	
    45.55
    
	
 
	
    51.85
    
	
 
	
 
	
    58.42
    
	
 
	
    65.81
    
	
 
	
    73.91
    
	
 
	
    82.54
    
	
 
	
    91.10
    
	
 
	
 
	
    101.67
    
	
 
	
 
	
    84
    

	

    60
    

	
 
	
 
	
    2.09
    
	
 
	
    3.12
    
	
 
	
    4.28
    
	
 
	
    5.58
    
	
 
	
    7.05
    
	
 
	
 
	
    8.62
    
	
 
	
    10.18
    
	
 
	
    11.62
    
	
 
	
    12.96
    
	
 
	
    15.50
    
	
 
	
 
	
    18.58
    
	
 
	
    22.17
    
	
 
	
    26.15
    
	
 
	
    30.03
    
	
 
	
    33.40
    
	
 
	
 
	
    36.78
    
	
 
	
    40.61
    
	
 
	
    45.06
    
	
 
	
    50.76
    
	
 
	
    57.82
    
	
 
	
 
	
    65.13
    
	
 
	
    73.16
    
	
 
	
    81.71
    
	
 
	
    91.10
    
	
 
	
    100.65
    
	
 
	
 
	
    112.42
    
	
 
	
 
	
    85
    

	

    61
    

	
 
	
 
	
    2.34
    
	
 
	
    3.41
    
	
 
	
    4.66
    
	
 
	
    6.10
    
	
 
	
    7.72
    
	
 
	
 
	
    9.41
    
	
 
	
    10.99
    
	
 
	
    12.42
    
	
 
	
    13.81
    
	
 
	
    16.69
    
	
 
	
 
	
    20.04
    
	
 
	
    23.79
    
	
 
	
    27.92
    
	
 
	
    32.53
    
	
 
	
    36.78
    
	
 
	
 
	
    40.61
    
	
 
	
    45.06
    
	
 
	
    50.22
    
	
 
	
    56.60
    
	
 
	
    64.46
    
	
 
	
 
	
    72.40
    
	
 
	
    80.87
    
	
 
	
    90.19
    
	
 
	
    100.65
    
	
 
	
    111.30
    
	
 
	
 
	
    124.22
    
	
 
	
 
	
    86
    

	

    62
    

	
 
	
 
	
    2.56
    
	
 
	
    3.75
    
	
 
	
    5.13
    
	
 
	
    6.72
    
	
 
	
    8.47
    
	
 
	
 
	
    10.26
    
	
 
	
    11.91
    
	
 
	
    13.43
    
	
 
	
    14.95
    
	
 
	
    18.09
    
	
 
	
 
	
    21.61
    
	
 
	
    25.51
    
	
 
	
    29.89
    
	
 
	
    34.91
    
	
 
	
    40.49
    
	
 
	
 
	
    45.06
    
	
 
	
    50.22
    
	
 
	
    55.99
    
	
 
	
    63.10
    
	
 
	
    71.65
    
	
 
	
 
	
    80.04
    
	
 
	
    89.27
    
	
 
	
    99.64
    
	
 
	
    111.30
    
	
 
	
    122.98
    
	
 
	
 
	
    136.93
    
	
 
	
 
	
    87
    

	

    63
    

	
 
	
 
	
    2.71
    
	
 
	
    4.12
    
	
 
	
    5.71
    
	
 
	
    7.46
    
	
 
	
    9.33
    
	
 
	
 
	
    11.22
    
	
 
	
    13.01
    
	
 
	
    14.70
    
	
 
	
    16.41
    
	
 
	
    19.74
    
	
 
	
 
	
    23.45
    
	
 
	
    27.62
    
	
 
	
    32.41
    
	
 
	
    37.99
    
	
 
	
    44.59
    
	
 
	
 
	
    50.22
    
	
 
	
    55.99
    
	
 
	
    62.42
    
	
 
	
    70.14
    
	
 
	
    79.21
    
	
 
	
 
	
    88.35
    
	
 
	
    98.63
    
	
 
	
    110.18
    
	
 
	
    122.98
    
	
 
	
    135.56
    
	
 
	
 
	
    150.39
    
	
 
	
 
	
    88
    

	

    64
    

	
 
	
 
	
    2.80
    
	
 
	
    4.49
    
	
 
	
    6.32
    
	
 
	
    8.26
    
	
 
	
    10.29
    
	
 
	
 
	
    12.32
    
	
 
	
    14.26
    
	
 
	
    16.16
    
	
 
	
    18.10
    
	
 
	
    21.63
    
	
 
	
 
	
    25.62
    
	
 
	
    30.21
    
	
 
	
    35.56
    
	
 
	
    41.90
    
	
 
	
    49.43
    
	
 
	
 
	
    55.99
    
	
 
	
    62.42
    
	
 
	
    69.39
    
	
 
	
    77.54
    
	
 
	
    87.44
    
	
 
	
 
	
    97.62
    
	
 
	
    109.06
    
	
 
	
    121.74
    
	
 
	
    135.56
    
	
 
	
    148.89
    
	
 
	
 
	
    164.44
    
	
 
	
 
	
    89
    

	

    65
    

	
 
	
 
	
    2.86
    
	
 
	
    4.96
    
	
 
	
    7.01
    
	
 
	
    9.14
    
	
 
	
    11.39
    
	
 
	
 
	
    13.55
    
	
 
	
    15.62
    
	
 
	
    17.70
    
	
 
	
    19.89
    
	
 
	
    23.70
    
	
 
	
 
	
    28.10
    
	
 
	
    33.23
    
	
 
	
    39.32
    
	
 
	
    46.54
    
	
 
	
    54.94
    
	
 
	
 
	
    62.42
    
	
 
	
    69.39
    
	
 
	
    76.72
    
	
 
	
    85.59
    
	
 
	
    96.60
    
	
 
	
 
	
    107.93
    
	
 
	
    120.50
    
	
 
	
    134.20
    
	
 
	
    148.89
    
	
 
	
    162.80
    
	
 
	
 
	
    178.27
    
	
 
	
 
	
    90
    

	

    66
    

	
 
	
 
	
    2.97
    
	
 
	
    5.57
    
	
 
	
    7.82
    
	
 
	
    10.10
    
	
 
	
    12.66
    
	
 
	
 
	
    14.92
    
	
 
	
    17.10
    
	
 
	
    19.32
    
	
 
	
    21.77
    
	
 
	
    25.97
    
	
 
	
 
	
    30.88
    
	
 
	
    36.71
    
	
 
	
    43.64
    
	
 
	
    51.70
    
	
 
	
    61.03
    
	
 
	
 
	
    69.39
    
	
 
	
    76.72
    
	
 
	
    84.68
    
	
 
	
    94.57
    
	
 
	
    106.82
    
	
 
	
 
	
    119.26
    
	
 
	
    132.84
    
	
 
	
    147.39
    
	
 
	
    162.80
    
	
 
	
    176.49
    
	
 
	
 
	
    191.72
    
	
 
	
 
	
    91
    

	

    67
    

	
 
	
 
	
    3.30
    
	
 
	
    6.26
    
	
 
	
    8.71
    
	
 
	
    11.17
    
	
 
	
    13.92
    
	
 
	
 
	
    16.47
    
	
 
	
    18.93
    
	
 
	
    21.40
    
	
 
	
    24.02
    
	
 
	
    28.73
    
	
 
	
 
	
    34.32
    
	
 
	
    40.98
    
	
 
	
    48.73
    
	
 
	
    57.72
    
	
 
	
    67.93
    
	
 
	
 
	
    76.72
    
	
 
	
    84.68
    
	
 
	
    93.56
    
	
 
	
    104.57
    
	
 
	
    118.02
    
	
 
	
 
	
    131.47
    
	
 
	
    145.89
    
	
 
	
    161.16
    
	
 
	
    176.49
    
	
 
	
    189.81
    
	
 
	
 
	
    205.72
    
	
 
	
 
	
    92
    

	

    68
    

	
 
	
 
	
    3.76
    
	
 
	
    7.02
    
	
 
	
    9.72
    
	
 
	
    12.34
    
	
 
	
    14.83
    
	
 
	
 
	
    18.25
    
	
 
	
    20.94
    
	
 
	
    23.55
    
	
 
	
    26.39
    
	
 
	
    31.72
    
	
 
	
 
	
    38.09
    
	
 
	
    45.51
    
	
 
	
    54.13
    
	
 
	
    63.94
    
	
 
	
    74.85
    
	
 
	
 
	
    84.68
    
	
 
	
    93.56
    
	
 
	
    103.45
    
	
 
	
    115.54
    
	
 
	
    130.10
    
	
 
	
 
	
    144.40
    
	
 
	
    159.52
    
	
 
	
    174.72
    
	
 
	
    189.81
    
	
 
	
    204.63
    
	
 
	
 
	
    220.40
    
	
 
	
 
	
    93
    

	

    69
    

	
 
	
 
	
    4.23
    
	
 
	
    7.88
    
	
 
	
    10.83
    
	
 
	
    13.64
    
	
 
	
    15.44
    
	
 
	
 
	
    20.19
    
	
 
	
    22.77
    
	
 
	
    25.40
    
	
 
	
    29.71
    
	
 
	
    35.84
    
	
 
	
 
	
    43.01
    
	
 
	
    51.34
    
	
 
	
    60.83
    
	
 
	
    71.40
    
	
 
	
    83.40
    
	
 
	
 
	
    93.56
    
	
 
	
    103.45
    
	
 
	
    114.31
    
	
 
	
    127.37
    
	
 
	
    142.90
    
	
 
	
 
	
    157.89
    
	
 
	
    172.94
    
	
 
	
    187.90
    
	
 
	
    204.63
    
	
 
	
    220.40
    
	
 
	
 
	
    235.82
    
	
 
	
 
	
    94
    

	

    70
    

	
 
	
 
	
    5.12
    
	
 
	
    8.85
    
	
 
	
    12.07
    
	
 
	
    14.67
    
	
 
	
    17.00
    
	
 
	
 
	
    22.01
    
	
 
	
    24.45
    
	
 
	
    28.99
    
	
 
	
    33.76
    
	
 
	
    40.69
    
	
 
	
 
	
    48.75
    
	
 
	
    57.96
    
	
 
	
    68.25
    
	
 
	
    79.93
    
	
 
	
    93.38
    
	
 
	
 
	
    103.45
    
	
 
	
    114.31
    
	
 
	
    126.01
    
	
 
	
    139.90
    
	
 
	
    156.25
    
	
 
	
 
	
    171.16
    
	
 
	
    185.99
    
	
 
	
    203.53
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
 
	
    250.92
    
	
 
	
 
	
95

	

    71
    

	
 
	
 
	
    6.60
    
	
 
	
    9.94
    
	
 
	
    13.46
    
	
 
	
    16.25
    
	
 
	
    19.53
    
	
 
	
 
	
    23.54
    
	
 
	
    26.57
    
	
 
	
    31.82
    
	
 
	
    36.06
    
	
 
	
    43.60
    
	
 
	
 
	
    52.24
    
	
 
	
    61.94
    
	
 
	
    72.98
    
	
 
	
    85.72
    
	
 
	
    100.42
    
	
 
	
 
	
    114.26
    
	
 
	
    126.01
    
	
 
	
    138.40
    
	
 
	
    152.97
    
	
 
	
    169.39
    
	
 
	
 
	
    184.08
    
	
 
	
    202.44
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
 
	
    265.40
    
	
 
	
 
	
    96
    

	

    72
    

	
 
	
 
	
    8.06
    
	
 
	
    11.69
    
	
 
	
    15.36
    
	
 
	
    18.61
    
	
 
	
    21.73
    
	
 
	
 
	
    24.95
    
	
 
	
    28.45
    
	
 
	
    33.44
    
	
 
	
    37.48
    
	
 
	
    45.45
    
	
 
	
 
	
    54.42
    
	
 
	
    64.68
    
	
 
	
    76.55
    
	
 
	
    90.27
    
	
 
	
    105.97
    
	
 
	
 
	
    123.67
    
	
 
	
    138.40
    
	
 
	
    151.33
    
	
 
	
    165.83
    
	
 
	
    182.17
    
	
 
	
 
	
    201.35
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
 
	
    280.71
    
	
 
	
 
	
    97
    

	

    73
    

	
 
	
 
	
    9.48
    
	
 
	
    13.54
    
	
 
	
    17.31
    
	
 
	
    20.74
    
	
 
	
    23.81
    
	
 
	
 
	
    26.78
    
	
 
	
    31.21
    
	
 
	
    36.12
    
	
 
	
    39.86
    
	
 
	
    48.34
    
	
 
	
 
	
    57.97
    
	
 
	
    69.13
    
	
 
	
    82.07
    
	
 
	
    96.89
    
	
 
	
    113.66
    
	
 
	
 
	
    132.34
    
	
 
	
    151.33
    
	
 
	
    164.06
    
	
 
	
    178.35
    
	
 
	
    200.26
    
	
 
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
 
	
    295.90
    
	
 
	
 
	
    98
    

	

    74
    

	
 
	
 
	
    11.18
    
	
 
	
    14.66
    
	
 
	
    18.83
    
	
 
	
    22.97
    
	
 
	
    26.05
    
	
 
	
 
	
    29.93
    
	
 
	
    34.81
    
	
 
	
    38.88
    
	
 
	
    45.68
    
	
 
	
    55.13
    
	
 
	
 
	
    65.98
    
	
 
	
    78.56
    
	
 
	
    92.99
    
	
 
	
    109.32
    
	
 
	
    127.52
    
	
 
	
 
	
    147.36
    
	
 
	
    164.06
    
	
 
	
    176.44
    
	
 
	
    198.10
    
	
 
	
    220.40
    
	
 
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
 
	
    314.02
    
	
 
	
 
	
    99
    

	

    75
    

	
 
	
 
	
    12.23
    
	
 
	
    15.94
    
	
 
	
    20.55
    
	
 
	
    25.33
    
	
 
	
    28.88
    
	
 
	
 
	
    33.54
    
	
 
	
    37.93
    
	
 
	
    44.50
    
	
 
	
    54.68
    
	
 
	
    65.49
    
	
 
	
 
	
    78.02
    
	
 
	
    92.40
    
	
 
	
    108.67
    
	
 
	
    126.82
    
	
 
	
    146.83
    
	
 
	
 
	
    164.06
    
	
 
	
    176.44
    
	
 
	
    197.02
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
 
	
    332.12
    
	
 
	
 
	
    100
    

	

    76
    

	
 
	
 
	
    12.53
    
	
 
	
    17.43
    
	
 
	
    22.57
    
	
 
	
    27.87
    
	
 
	
    32.33
    
	
 
	
 
	
    37.00
    
	
 
	
    43.34
    
	
 
	
    53.25
    
	
 
	
    62.23
    
	
 
	
    75.93
    
	
 
	
 
	
    90.09
    
	
 
	
    106.14
    
	
 
	
    124.06
    
	
 
	
    143.83
    
	
 
	
    162.59
    
	
 
	
 
	
    176.44
    
	
 
	
    197.02
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
 
	
    351.25
    
	
 
	
 
	
    101
    

	

    77
    

	
 
	
 
	
    13.05
    
	
 
	
    18.72
    
	
 
	
    24.70
    
	
 
	
    31.17
    
	
 
	
    36.10
    
	
 
	
 
	
    42.21
    
	
 
	
    51.87
    
	
 
	
    61.32
    
	
 
	
    72.98
    
	
 
	
    88.40
    
	
 
	
 
	
    104.26
    
	
 
	
    121.98
    
	
 
	
    141.53
    
	
 
	
    160.04
    
	
 
	
    175.44
    
	
 
	
 
	
    197.02
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
 
	
    371.47
    
	
 
	
 
	
    102
    

	

    78
    

	
 
	
 
	
    13.89
    
	
 
	
    20.17
    
	
 
	
    27.24
    
	
 
	
    35.22
    
	
 
	
    41.12
    
	
 
	
 
	
    50.52
    
	
 
	
    60.42
    
	
 
	
    72.19
    
	
 
	
    83.94
    
	
 
	
    99.39
    
	
 
	
 
	
    116.69
    
	
 
	
    135.83
    
	
 
	
    156.17
    
	
 
	
    174.53
    
	
 
	
    197.02
    
	
 
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
 
	
    392.83
    
	
 
	
 
	
    103
    

	

    79
    

	
 
	
 
	
    14.87
    
	
 
	
    22.10
    
	
 
	
    30.51
    
	
 
	
    40.05
    
	
 
	
    49.21
    
	
 
	
 
	
    59.53
    
	
 
	
    71.42
    
	
 
	
    83.10
    
	
 
	
    92.79
    
	
 
	
    109.40
    
	
 
	
 
	
    127.82
    
	
 
	
    147.41
    
	
 
	
    168.07
    
	
 
	
    195.94
    
	
 
	
    220.40
    
	
 
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
 
	
    415.41
    
	
 
	
 
	
    104
    

	

    80
    

	
 
	
 
	
    16.01
    
	
 
	
    24.68
    
	
 
	
    34.66
    
	
 
	
    45.98
    
	
 
	
    58.66
    
	
 
	
 
	
    70.65
    
	
 
	
    82.27
    
	
 
	
    92.15
    
	
 
	
    105.31
    
	
 
	
    123.35
    
	
 
	
 
	
    142.58
    
	
 
	
    165.03
    
	
 
	
    193.68
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
 
	
    439.27
    
	
 
	
 
	
    105
    

	

    81
    

	
 
	
 
	
    17.50
    
	
 
	
    28.03
    
	
 
	
    39.94
    
	
 
	
    53.23
    
	
 
	
    67.92
    
	
 
	
 
	
    81.45
    
	
 
	
    91.51
    
	
 
	
    104.72
    
	
 
	
    114.95
    
	
 
	
    139.87
    
	
 
	
 
	
    162.16
    
	
 
	
    193.11
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
 
	
    464.47
    
	
 
	
 
	
    106
    

	

    82
    

	
 
	
 
	
    19.70
    
	
 
	
    32.43
    
	
 
	
    46.48
    
	
 
	
    61.85
    
	
 
	
    78.53
    
	
 
	
 
	
    90.89
    
	
 
	
    104.13
    
	
 
	
    114.45
    
	
 
	
    133.10
    
	
 
	
    162.09
    
	
 
	
 
	
    193.11
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
    464.47
    
	
 
	
 
	
    491.10
    
	
 
	
 
	
    107
    

	

    83
    

	
 
	
 
	
    23.06
    
	
 
	
    38.05
    
	
 
	
    54.26
    
	
 
	
    71.68
    
	
 
	
    90.27
    
	
 
	
 
	
    103.55
    
	
 
	
    113.95
    
	
 
	
    132.73
    
	
 
	
    162.02
    
	
 
	
    193.11
    
	
 
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
    464.47
    
	
 
	
    491.10
    
	
 
	
 
	
    519.22
    
	
 
	
 
	
    108
    

	

    84
    

	
 
	
 
	
    27.85
    
	
 
	
    44.99
    
	
 
	
    63.24
    
	
 
	
    82.58
    
	
 
	
    102.97
    
	
 
	
 
	
    113.46
    
	
 
	
    132.36
    
	
 
	
    161.86
    
	
 
	
    193.11
    
	
 
	
    220.40
    
	
 
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
    464.47
    
	
 
	
    491.10
    
	
 
	
    519.22
    
	
 
	
 
	
    548.91
    
	
 
	
 
	
    109
    

	

    85
    

	
 
	
 
	
    34.07
    
	
 
	
    53.30
    
	
 
	
    73.48
    
	
 
	
    94.61
    
	
 
	
    112.97
    
	
 
	
 
	
    131.99
    
	
 
	
    161.61
    
	
 
	
    193.11
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
 
	
    439.27
    
	
 
	
    464.47
    
	
 
	
    491.10
    
	
 
	
    519.22
    
	
 
	
    548.91
    
	
 
	
 
	
    580.25
    
	
 
	
 
	
    110
    

	

    86
    

	
 
	
 
	
    41.64
    
	
 
	
    63.17
    
	
 
	
    85.37
    
	
 
	
    108.23
    
	
 
	
    131.62
    
	
 
	
 
	
    161.36
    
	
 
	
    193.00
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
 
	
    464.47
    
	
 
	
    491.10
    
	
 
	
    519.22
    
	
 
	
    548.91
    
	
 
	
    580.25
    
	
 
	
 
	
    613.33
    
	
 
	
 
	
    111
    

	

    87
    

	
 
	
 
	
    50.69
    
	
 
	
    75.07
    
	
 
	
    99.56
    
	
 
	
    131.25
    
	
 
	
    161.12
    
	
 
	
 
	
    192.90
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
    464.47
    
	
 
	
 
	
    491.10
    
	
 
	
    519.22
    
	
 
	
    548.91
    
	
 
	
    580.25
    
	
 
	
    613.35
    
	
 
	
 
	
    648.21
    
	
 
	
 
	
112

	

    88
    

	
 
	
 
	
    61.98
    
	
 
	
    89.70
    
	
 
	
    124.42
    
	
 
	
    160.87
    
	
 
	
    192.79
    
	
 
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
    464.47
    
	
 
	
    491.10
    
	
 
	
 
	
    519.22
    
	
 
	
    548.91
    
	
 
	
    580.25
    
	
 
	
    613.33
    
	
 
	
    648.21
    
	
 
	
 
	
    685.01
    
	
 
	
 
	
    113
    

	

    89
    

	
 
	
 
	
    76.83
    
	
 
	
    116.48
    
	
 
	
    156.29
    
	
 
	
    192.69
    
	
 
	
    220.40
    
	
 
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
    464.47
    
	
 
	
    491.10
    
	
 
	
    519.22
    
	
 
	
 
	
    548.91
    
	
 
	
    580.25
    
	
 
	
    613.33
    
	
 
	
    648.21
    
	
 
	
    685.01
    
	
 
	
 
	
    723.78
    
	
 
	
 
	
    114
    

	

    90
    

	
 
	
 
	
    106.11
    
	
 
	
    150.95
    
	
 
	
    190.74
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
 
	
    250.92
    
	
 
	
    255.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
 
	
    439.27
    
	
 
	
    464.47
    
	
 
	
    491.10
    
	
 
	
    519.22
    
	
 
	
    548.91
    
	
 
	
 
	
    580.25
    
	
 
	
    613.33
    
	
 
	
    648.21
    
	
 
	
    685.01
    
	
 
	
    723.78
    
	
 
	
 
	
    764.63
    
	
 
	
 
	
    115
    

	

    91
    

	
 
	
 
	
    144.00
    
	
 
	
    188.47
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
 
	
    464.47
    
	
 
	
    491.10
    
	
 
	
    519.22
    
	
 
	
    548.91
    
	
 
	
    580.25
    
	
 
	
 
	
    613.33
    
	
 
	
    648.21
    
	
 
	
    685.01
    
	
 
	
    723.78
    
	
 
	
    764.63
    
	
 
	
 
	
    807.62
    
	
 
	
 
	
    116
    

	

    92
    

	
 
	
 
	
    185.53
    
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
    464.47
    
	
 
	
 
	
    491.10
    
	
 
	
    519.22
    
	
 
	
    548.91
    
	
 
	
    580.25
    
	
 
	
    613.33
    
	
 
	
 
	
    648.21
    
	
 
	
    685.01
    
	
 
	
    723.78
    
	
 
	
    764.63
    
	
 
	
    807.62
    
	
 
	
 
	
    852.81
    
	
 
	
 
	
    117
    

	

    93
    

	
 
	
 
	
    220.40
    
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
    464.47
    
	
 
	
    491.10
    
	
 
	
 
	
    519.22
    
	
 
	
    548.91
    
	
 
	
    580.25
    
	
 
	
    613.33
    
	
 
	
    648.21
    
	
 
	
 
	
    685.01
    
	
 
	
    723.78
    
	
 
	
    764.63
    
	
 
	
    807.62
    
	
 
	
    852.81
    
	
 
	
 
	
    900.28
    
	
 
	
 
	
    118
    

	

    94
    

	
 
	
 
	
    235.82
    
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
    464.47
    
	
 
	
    491.10
    
	
 
	
    519.22
    
	
 
	
 
	
    548.91
    
	
 
	
    580.25
    
	
 
	
    613.33
    
	
 
	
    648.21
    
	
 
	
    685.01
    
	
 
	
 
	
    723.78
    
	
 
	
    764.63
    
	
 
	
    807.62
    
	
 
	
    852.81
    
	
 
	
    900.28
    
	
 
	
 
	
    949.93
    
	
 
	
 
	
    119
    

	

    95
    

	
 
	
 
	
    250.92
    
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
 
	
    439.27
    
	
 
	
    464.47
    
	
 
	
    491.10
    
	
 
	
    519.22
    
	
 
	
    548.91
    
	
 
	
 
	
    580.25
    
	
 
	
    613.33
    
	
 
	
    648.21
    
	
 
	
    685.01
    
	
 
	
    723.78
    
	
 
	
 
	
    764.63
    
	
 
	
    807.62
    
	
 
	
    852.81
    
	
 
	
    900.28
    
	
 
	
    949.93
    
	
 
	
 
	
    1000.00
    
	
 
	
 
	
    120
    

	

    96
    

	
 
	
 
	
    265.40
    
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
 
	
    464.47
    
	
 
	
    491.10
    
	
 
	
    519.22
    
	
 
	
    548.91
    
	
 
	
    580.25
    
	
 
	
 
	
    613.33
    
	
 
	
    648.21
    
	
 
	
    685.01
    
	
 
	
    723.78
    
	
 
	
    764.63
    
	
 
	
 
	
    807.62
    
	
 
	
    852.81
    
	
 
	
    900.28
    
	
 
	
    949.93
    
	
 
	
    1000.00
    
	
 
	
 
	
 
	
 
	
 
	
 

	

    97
    

	
 
	
 
	
    280.71
    
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
 
	
    371.47
    
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
    464.47
    
	
 
	
 
	
    491.10
    
	
 
	
    519.22
    
	
 
	
    548.91
    
	
 
	
    580.25
    
	
 
	
    613.33
    
	
 
	
 
	
    648.21
    
	
 
	
    685.01
    
	
 
	
    723.78
    
	
 
	
    764.63
    
	
 
	
    807.62
    
	
 
	
 
	
    852.81
    
	
 
	
    900.28
    
	
 
	
    949.93
    
	
 
	
    1000.00
    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    98
    

	
 
	
 
	
    296.90
    
	
 
	
    314.02
    
	
 
	
    332.12
    
	
 
	
    351.25
    
	
 
	
    371.47
    
	
 
	
 
	
    392.83
    
	
 
	
    415.41
    
	
 
	
    439.27
    
	
 
	
    464.47
    
	
 
	
    491.10
    
	
 
	
 
	
    519.22
    
	
 
	
    548.91
    
	
 
	
    580.25
    
	
 
	
    613.33
    
	
 
	
    648.21
    
	
 
	
 
	
    685.01
    
	
 
	
    723.78
    
	
 
	
    764.63
    
	
 
	
    807.62
    
	
 
	
    852.81
    
	
 
	
 
	
    900.28
    
	
 
	
    949.93
    
	
 
	
    1000.00
    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    99
    

	
 
	
 
	
    313.63
    
	
 
	
    331.70
    
	
 
	
    350.81
    
	
 
	
    371.02
    
	
 
	
    392.37
    
	
 
	
 
	
    414.93
    
	
 
	
    438.77
    
	
 
	
    463.96
    
	
 
	
    490.57
    
	
 
	
    518.68
    
	
 
	
 
	
    548.38
    
	
 
	
    579.71
    
	
 
	
    612.78
    
	
 
	
    647.67
    
	
 
	
    684.48
    
	
 
	
 
	
    723.28
    
	
 
	
    764.16
    
	
 
	
    807.19
    
	
 
	
    852.45
    
	
 
	
    900.01
    
	
 
	
 
	
    949.89
    
	
 
	
    1000.00
    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

Exhibit E

SELF-ADMINISTERED REPORTING

	 	 	 	 	 
	E.1	 	The Ceding Company, through the Administrator, will self-administer all reinsurance reporting. The Ceding Company, through the Administrator, will send MARC the reports listed below at the frequency
specified.

	 	 	Transaction Reports [monthly]

	 	1.	 	New Business
	 
	 	2.	 	First Year – Other than New Business
	 
	 	3.	 	Renewal Year
	 
	 	4.	 	Changes and Terminations
	 
	 	5.	 	Accounting Information

	 	 	Periodic Reports

	 	6.	 	Statutory Reserve Information (quarterly)
	 
	 	7.	 	Policy Exhibit Information (monthly)
	 
	 	8.	 	Inforce (monthly)

	 	 	A brief description of the data requirements follows below.
	 
	 	 	Transaction Reports
 The Ceding Company, through the Administrator, agrees to provide the following policy data in each report as outlined in Exhibits F, G and H, and as referenced below:

	 	1.	 	New Business
 This report will include new issues only, the first time the policy is reported to MARC. Automatic and Facultative business will be identified separately.
	 
	 	2.	 	First Year – Other than New Business
 This report will include policies previously reported on the new business detail and still in their first duration, or policies involved in first year premium adjustments.
	 
	 	3.	 	Renewal Year
 All policies with renewal dates within the Accounting Period will be listed.

 

 

Exhibit E

(continued)

	 	4.	 	Changes and Terminations

Policies affected by a change during the current reporting period will be included
in this report. Type of change or termination activity must be clearly identified
for each policy.
	 
	 	 	 	The Ceding Company, through the Administrator, will identify the following
transactions either by separate listing or unique transaction codes: Terminations,
Reinstatements, Changes, Conversions, and Replacements. For Conversions and
Replacements, the Ceding Company, through the Administrator, will report the
original policy date, as well as the current policy date.
	 
	 	5.	 	Accounting Information

Premiums and allowances will be summarized for Life coverages, Benefits, and Riders
by the following categories: Automatic and Facultative, First Year and Renewals.

	 	 	Periodic Reports

	 	6.	 	Statutory Reserve Information

Statutory reserves will be summarized for Life coverages, Benefits and Riders. The
Ceding Company, through the Administrator, will specify the reserve basis used.
	 
	 	7.	 	Policy Exhibit Information

This is a summary of transactions during the current period and on a year-to-date
basis, reporting the number of policies and reinsured amount.
	 
	 	8.	 	Inforce

This is a detailed report of each policy in force.

 

 

Exhibit F

LIST OF RISKS REINSURED

The “List of Risks Reinsured,” showing all renewing policies, should be prepared and submitted
monthly, quarterly, or annually according to the terms of the Agreement. At least once a year at
the end of each year, a list must be submitted by the Ceding Company to MARC including ALL
risks reinsured under this Agreement. Premiums due should be included only for the period being
reported. The information required to be shown on such lists is set out below.

	 	 	 	 	 
	 

	 	A.
	 	Policy number
	 
	 	 	 	 
	 

	 	B.
	 	Name of insured (minimum is surname and first initial; prefer to have first name and
middle initial as well.)
	 
	 	 	 	 
	 

	 	C.
	 	Sex
	 
	 	 	 	 
	 

	 	D.
	 	Date of birth (month, day, year)
	 
	 	 	 	 
	 

	 	E.
	 	Issue age
	 
	 	 	 	 
	*

	 	F.
	 	Attained age
	 
	 	 	 	 
	 

	 	G.
	 	Policy date (month, day, year) or date of increase/decrease in specified amount
	 
	 	 	 	 
	 

	 	H.
	 	Transaction code (in force)

	 	1.	 	First year, newly reported (i.e., new business)
	 
	 	2.	 	First year, previously reported (i.e., renewal business in first policy year)
	 
	 	3.	 	Renewal

	 	 	 	 	 
	 

	 	I.
	 	Substandard rating (table, mortality percentage, flat extra amount and duration. Show
multiple of standard for ADB or WPD.)
	 
	 	 	 	 
	 

	 	J.
	 	Plan or plan code (if more than one plan is covered by the Agreement)
	 
	 	 	 	 
	 

	 	K.
	 	Underwriting class (smoker, nonsmoker, preferred, etc.)
	 
	 	 	 	 
	 

	 	L.
	 	Specified amount issued (life, ADB, WPD)
	 
	 	 	 	 
	 

	 	M.
	 	Death benefit option (i.e., cash value included in or in addition to the
specified amount)
	 
	 	 	 	 
	*

	 	N.
	 	Current death benefit (under original policy)
	 
	 	 	 	 
	 

	 	O.
	 	Proportion reinsured this policy (where applicable)
	 
	 	 	 	 
	 

	 	P.
	 	Amount reinsured
	 
	 	 	 	 
	 

	 	Q.
	 	Current reinsurance amount at risk
	 
	 	 	 	 
	 

	 	R.
	 	Reinsurance premium (life, ADB, WPD)
	 
	 	 	 	 
	*

	 	S.
	 	Net cash amount due MARC (life, ADB, WPD)
	 
	 	 	 	 
	*

	 	T.
	 	Automatic or facultative
	 
	 	 	 	 
	*

	 	U.
	 	Currency code if not U.S. currency

 

			
	*	 	Desirable but not required

 

 

Exhibit F

(continued)

There should be separate subtotals for all items listed below. Each subtotal should include:

	 	 	 
	Policy count

	 	(life—separately for new business, renewals, and combined)
	 
	 	 
	Reinsurance amount at risk

	 	(separately for new business, renewals, and combined)
	 
	 	 
	Reinsurance premium

	 	(separately for new business, renewals, and combined)
	 
	 	 
	Reinsurance commission

	 	(separately for new business, renewals, and combined)
	 
	 	 
	Net amount due MARC

	 	(separately for new business, renewals, and combined)

The various policy details including reinsurance amount at risk and proportion reinsured shown on
the “List of Risks Reinsured” should correspond to the in force after any changes reported
concurrently on the “List of Amendments.” We need a grand total each reporting period for policy
count in force and reinsurance amount at risk in force (separately for new business, renewals, and
combined). A separate total of ADB in force is needed. This need not be separated into new
business and renewals.

A grand total of reinsurance premium and net amount due MARC, including all in force and
amendments, should be shown (separately for first year, renewals, and combined categories).
Separate totals should be provided for life, ADB, and WPD. This may be shown on the “List of Risks
Reinsured” or may be included in a separate summary.

Where premiums for more than one period are being reported on a single list, the basic
identification (policy number, name of insured, sex, date of birth, age, and policy date) need be
shown only one time on the first line for the policy. Subsequent lines should each relate to a
different period and the period involved should be indicated.

Although an increase or decrease in the specified amount will not, as a rule, result in the
issuance of a new policy, the amount of such increase or decrease should be reported separately
from the base specified amount so that differences in premium rates can be reflected. For example,
the amount of increase in specified amount might involve a substandard rating that differs from the
rating for the base specified amount. In any such case, it might be a good idea to assign a
separate policy number suffix.

Any significant deviations from these reporting guidelines must be agreed to by MARC.

 

 

Exhibit G

LIST OF AMENDMENTS

Each “List of Amendments” (monthly, quarterly, or annual) should show details for each policy for
which any transaction (see codes 4–12 below) occurred which has an effect on either the reinsurance
amount at risk or reinsurance premium. The basic policy details to be shown include the following:

	 	 	 	 	 
	 

	 	a.
	 	Policy number
	 
	 	 	 	 
	 

	 	b.
	 	Name of insured
	 
	 	 	 	 
	*

	 	c.
	 	Date of birth
	 
	 	 	 	 
	 

	 	d.
	 	Transaction code (changes to in force)

	 	 	 	 	 	 	 	 	 
	 

	 	 	 	 	4.	 	 	Termination without value
	 
	 	 	 	 	 	 	 	 
	 

	 	 	 	 	5.	 	 	Policy not placed (NTO)
	 
	 	 	 	 	 	 	 	 
	 

	 	 	 	 	6.	 	 	Surrender (full or partial)
	 
	 	 	 	 	 	 	 	 
	 

	 	 	 	 	7.	 	 	Reinstatement
	 
	 	 	 	 	 	 	 	 
	 

	 	 	 	 	8.	 	 	Increase in specified amount
	 
	 	 	 	 	 	 	 	 
	 

	 	 	 	 	9.	 	 	Decrease in specified amount
	 
	 	 	 	 	 	 	 	 
	 

	 	 	 	 	10.	 	 	Conversion or change of plan (e.g., Option A to Option B)
	 
	 	 	 	 	 	 	 	 
	 

	 	 	 	 	11.	 	 	Death
	 
	 	 	 	 	 	 	 	 
	 

	 	 	 	 	12.	 	 	Other (Please describe.)

Under item 12, we would like you to describe any other amendments such as partial
recapture, full recapture, table rating reduction, etc,

	 	 	 	 	 
	 

	 	e.
	 	Effective date of transaction
	 
	 	 	 	 
	 

	 	f.
	 	Net increase or decrease in reinsurance amount at risk from the reinsurance amount at risk
last reported to MARC before the change
	 
	 	 	 	 
	 

	 	g.
	 	Reinsurance premium adjustment (separately for first year/renewal)
	 
	 	 	 	 
	 

	 	h.
	 	Net adjustment due MARC (separately for first year/renewal)
	 
	 	 	 	 
	 

	 	i.
	 	Currency code if not U.S. currency

Subtotals of policy count and reinsurance amount at risk should be provided for each transaction
code where the transaction is such that the life policy count in force is altered by the
transaction. For items g and h only grand totals are required (separately for first
year/renewal/combined).

The premium adjustments should include adjustments up to the current reporting period
(e.g., month, quarter). Premiums for the current reporting period should appear on the “List of
Risks Reinsured.”

It is not necessary to adhere strictly to the set of transaction codes shown above as long as the
amendments are clearly identified and appropriate subtotals and totals can be provided.

 

			
	*	 	Desirable but not required

 

 

Exhibit H

IN-FORCE SUMMARY FORM

SELF-ADMINISTERED LIFE REINSURANCE

Summary Report

For the Period
                                        
 through

To Munich American Reassurance Company

	 	 	 	 	 	 	 	 	 	 	 
	 

	 	 	 	Account	 	 	 	 	 	 
	Company Name

	 	 	 	Number	 	 	 	 	 	 
	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	Treaty ID:
	 	 	 	 	 	 	 	 	 	 
	 

	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	Plan ID:
	 	 	 	 	 	 	 	 	 	 
	 

	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	Prepared By

	 	 	 	Date
	 	 	 	Phone	 	 
	 

	 	 
	 	 	 	 
	 	 	 	 

I.      Policy Exhibit Summary (Life Reinsurance Only)

	 	 	 	 	 
	 	 	Number of	 	Amount of
	 	 	Policies	 	Reinsurance
	 
	A. In Force As Of Last Report
	 	 	 	 
	B. New Paid Reinsurance Ceded
	 	 	 	 
	C. NTO
	 	 	 	 
	D. Reinstatements
	 	 	 	 
	E. Administrative New Business (Conversions, Etc.)
	 	 	 	 
	F. Lapses
	 	 	 	 
	G. Recaptures
	 	 	 	 
	H. Surrenders (Coinsurance Only)
	 	 	 	 
	I. Death
	 	 	 	 
	J. Expiries
	 	 	 	 
	K. Administrative Lapses
	 	 	 	 
	L. Increase/Decrease

	 	XXXXXX	 	 
	M. In Force As Of Current Report
	 	 	 	 
	N. ADB In Force As of Current Report

	 	XXXXXX	 	 
	 

II.      Accounting Summary

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	Premiums	 	 	Commissions	 	 	 	 	 	 	Net Due	 
	Category	 	First Year	 	 	Renewal Year	 	 	First Year	 	 	Renewal Year	 	 	Other*	 	 	MARC-Life	 
	 
	Life
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	WP
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	ADB
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	Total
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 

 

			
	*	 	If more than one category is included (e.g., surrender benefits,
dividends), please show details on the reverse side
of this form.

RADF61

 

 

Exhibit I Application for Facultative Reinsurance

	Exhibit I Application for Facultative Reinsurance

	| | |
LIFE            WPD            ADB
——  -—  —
Previous In Force
Previous Retained
Issued This Policy
Retained This Policy
Reinsured Amount
—

	Inforce Policies:
—
Policy Number            Issue Amount            Retained Amount
——  ——  —

	Comments

	Policy            Amount
Year            Age            At Risk
====== === =======

	FACULTATIVE-AUTOMATIC SUBMISSION            Munich American Reassurance Company
Ceding Co.: ORIGINAL-ADDITIONAL-MIB Inquiry Only            P. O. Box 3210, Atlanta, GA 30302-3210
——  —
Address: Telephone: (770) 350-3200
——  —
Underwriter’s Name: DATE: Fax: (770) 350-3412
——  ——  —
Underwriting Area:
——  —
Insured’s Name (Lst, Fst, M) Policy Number: Original Pol No.:
——  ——  ——  ——  —
Date of Birth: Issue Age: Sex: Policy Date: Original Pol Date:
——  ——  ——  ——  —

	Birth State: Birth Country: Reins Eff Date: Original Iss Age:

	——  ——  ——  ——  ——  —

	Reside State: Reside Country: Continuation: Duration:

	——  ——  ——  ——  —

	Occupation: Policy Certificate ID:

	——  ——  ——  —

	Second Insured’s Name:

	——  ——  —

	Date of Birth: Issue Age: Sex:

	——  —

	Plan Name: Smoker Code:

	——  ——  —

	Rider Name: Smoker Code:

	——  ——  —

	Life Rates:

	——  ——  —

	Reserve Basis:

	——  ——  —

	Benefit 1: Ben 1 Rating:

	——  ——  —

	Benefit 2: Ben 2 Rating:

	——  ——  —

	Benefit 3: Ben 3 Rating:

	——  ——  —

	Benefit 4: Ben 4 Rating:

	——  ——  —

	Benefit 5: Ben 5 Rating:

	——  ——  —

	Flat Extra 1: Flat Ex 1 Dur:

	Flat Extra 2: Flat Ex 2 Dur:

	Submission Type:Fac            Auto
——  ——  —

	Original Submission Date:

	——  ——  —

	Offer Accepted Date:

	——  ——  —

	Withdrawal Date:

	——  ——  —

	Submitted File Includes:
========================
Application            X-Ray
——  —
Medical Examination            Other Medical Underwriting Data
——  —
Blood Profile            Inspection Report
——  —
Heart Chart            Additional Inspection Report
——  —
Attending Physician’s Report            Aviation Questionnaire
——  —
Microscopic Urinalysis            Other Non-medical Data
——  —
Electrocardiogram
=================

	Circle Withdrawal Reason:

	1. Underwriting Not Complete
2. Policy Not Delivered
3. All Within Our Retention
4. Placed With Automatic Reinsurer
5. Placed With Another Reinsurer:

	a) Rating b) Requirements c) Quicker Responseexv10w1

 

Exhibit 10.1

Novint/Tournabout Intellectual Property Acquisition Agreement

This Intellectual Property Acquisition Agreement (this “Agreement’) is between Novint Technologies,
Inc., a Delaware corporation having offices in Albuquerque, NM (“Novint”) and Tournabout, Inc., a
California corporation having offices in Carpinteria, CA (“Tournabout’), and is effective as of
April 21, 2007 (the “Effective Date”).

	1.	 	Background

	 	1.1.	 	Tournabout owns intellectual property related to computer software, including
without limitation a program called “ContestMaker,” which includes server software,
database software, and API;
	 
	 	1.2.	 	Tournabout has represented to Novint that Tournabout’s computer software can be
adapted to provide capabilities that Novint desires prior to Novint’s planned June 18
product launch, which capabilities are an important part of the value of the
intellectual property to Novint;
	 
	 	1.3.	 	Tournabout desires to sell, and Novint desires to acquire, all the intellectual
property assets of Tournabout, subject to the terms and conditions of this Agreement.

	2.	 	Definitions

	 	2.1.	 	Confidential Information. Confidential and proprietary Information that has
been or will be transferred or disclosed to the other Party, including, without
limitation, the terms of this Agreement. Confidential Information does not include any
information that a Party can demonstrate by competent written evidence is or becomes
any of the following: (i) generally available to the public or otherwise part of the
public domain other than through any act or omission of such Party in breach of this
Agreement; (ii) disclosed to such Party by a third party that has no obligation not to
disclose such information; (iii) independently developed by such Party without use of
Confidential Information of the other Party, and (iv) known by such Party at the time
of disclosure to such Party by the other Party.

	 	2.2.	 	ContestMaker. A system that provides a client-server software application that
runs online game contests, captures player information (both at registration and during
game play) and then analyzes that information for trends and behaviors. The
ContestMakerTM Client is a set of application programmer interfaces (APIs)
that are integrated in previously developed video game software including without
limitation (a) all trade or service marks, and any goodwill associated therewith,
embodied in the system or used to reference the system, including without limitation
“ContestMaker”; (b) all copyrights in the system or any portion thereof; (c) all
versions of computer software implementing the system regardless of programming
language or platform, and regardless of form (e.g., source, object, executable); (d)
all images, sounds, and any other content embodied in the system or used in execution
of any version of the system; (e) all computer software reasonably required for
operation, distribution, maintenance, or improvement of any version of the system,
including tools and libraries, regardless of

 

 

	 	 	 	programming language or platform, and regardless of form (e.g., source, object,
executable), but not including software that meets all of the following conditions:
(a) was not created or authored by Tournabout, and (b) was licensed by Tournabout
from other parties, (c) is generally commercially available, and (d) has been
disclosed by Tournabout to Novint as an exception to this definition.

	 	2.3.	 	Controlling Persons. Ed Zanelli and Michael Musson.
	 
	 	2.4.	 	Demonstration Date. June 18, 2007.
	 
	 	2.5.	 	Information. Information and data of any type and in any tangible or intangible
form, whether or not patentable, including without limitation ideas, inventions
(whether or not patentable), preclinical, clinical and other data, physical, chemical
and biological materials, algorithms, software, works of authorship, plans, designs,
practices, methods, techniques, specifications, production technical operating
procedures, standard operating procedures, protocols under development, formulations,
software, formulae, work product, knowledge, know-how, skill, experience, test data,
analytical and quality control data, stability data, results of studies and patent and
other legal information or descriptions.
	 
	 	2.6.	 	Integration Milestone. Novint will utilize tests after the successful
completion of the milestones outlined in Attachment A, to determine, in Novint’s
reasonable discretion, whether the Intellectual Property of Tournabout, including but
not limited to, Contest Maker, has been effectively integrated into the IP of Novint.
	 
	 	2.7.	 	Integration Plan. The project set forth in Exhibit B.
	 
	 	2.8.	 	Intellectual Property. (i) Patents, applications therefor, and all foreign
counterparts thereof, divisions, continuations, continuations-in-part to the extent
claiming Intellectual Property otherwise licensed or assigned by this Agreement,
reissues, renewals, re-examinations or extensions thereof (“Patent Rights”), (ii)
copyrights, copyright applications and registrations, copyrightable works of
authorship, and all other rights corresponding thereto throughout the world
(“Copyrights”), (iii) Information, and trade secrets, know-how and confidentiality
rights and any other intellectual property or proprietary right associated with
Information.
	 
	 	2.9.	 	License Price. $50,000 in cash.
	 
	 	2.10.	 	Purchase Price. If Ed Zanelli has agreed to enter into full time service to
Novint before the Demonstration Date, and continues full time service to Novint, either
as an employee or as a consultant, for at least one year thereafter, 250,000 shares of
Novint common stock plus $75,000 in cash; otherwise 200,000 shares of Novint common
stock plus $60,000 in cash.
	 
	 	2.11.	 	Subject IP. All Intellectual Property owned, controlled, or licensed by
Tournabout, including without limitation ContestMaker and the Intellectual Property set
forth in Exhibit A.

 

 

	3.	 	Acquisition of Intellectual Property Assets

	 	3.1.	 	Tournabout hereby sells and assigns to Novint all right, title, and interest in
and to the Subject IP.
	 
	 	3.2.	 	Tournabout, for itself and for any party claiming through Tournabout, hereby
releases Novint from any intellectual property claims arising out of Novint’s
use of the Subject IP.

	4.	 	Integration Plan

	 	4.1.	 	Novint and Tournabout will each apply its best efforts toward to the completion
of the Integration Plan set forth in Exhibit B.
	 
	 	4.2.	 	Novint shall own all Intellectual Property developed during the Integration Plan.
	 
	 	4.3.	 	Ed Zanelli will apply his full-time efforts to the completion of the
Integration Plan from the Effective Date until the Demonstration Date, pursuant to the
terms of a Consulting Agreement to be entered between Ed Zanelli and Novint.
	 
	 	4.4.	 	Tournabout will apply its best efforts to ensure that Jeremy Link will apply
his efforts, not less than one half time unless otherwise agreed by Novint, to the
completion of the Integration Plan from the Effective Date until the Demonstration
Date, pursuant to the terms of a Consulting Agreement to be entered between Jeremy Link
and Novint.
	 
	 	4.5.	 	Michael Musson will be available for consultation with Novint regarding the
Subject IP and the Integration Plan from the Effective Date until ninety days
thereafter, for not more than 10 hours per month, at no charge to Novint.

	5.	 	Compensation

	 	5.1.	 	If the Integration Milestone is met by the Demonstration Date, as determined by
Novint’s Board of Directors acting in good faith, then Novint shall pay the Purchase
Price within 30 days of the Demonstration Date.
	 
	 	5.2.	 	If the Integration Milestone is not met by the Demonstration Date, then Novint
shall elect one of the following three alternatives:

	 	5.2.1.	 	Purchase Alternative. Pay the Purchase Price within 30 days of the
Demonstration Date.
	 
	 	5.2.2.	 	License Alternative. Pay the License Price within 30 days of the
Demonstration Date, in which case Novint shall assign all right, title, and
interest in and to the Subject IP acquired from Tournabout to Tournabout, and
Novint’s rights in any derivative works of copyrighted software in the Subject IP,
and Novint shall have the rights set forth under the License provisions.

 

 

	 	5.2.3.	 	Termination Alternative. Only if the failure to meet the Integration
Milestone by the Demonstration Date is principally due to the fault of Tournabout
or the Controlling Persons, Novint may terminate this Agreement by written notice
to Tournabout within 30 days of the Demonstration Date, in which case Novint shall
assign all right, title, and interest in and to the Subject IP acquired from
Tournabout to Tournabout, and Novint’s rights in any derivative works of
copyrighted software in the Subject IP, and Novint shall have no further rights to
the Subject IP and no obligations to Tournabout.

	 	5.3.	 	If Ed Zanelli leaves employment with Novint, either voluntarily or by
termination for cause, after Novint has paid the Purchase Price but before one year
thereafter, then Tournabout shall refund $15,000 in cash and 50,000 shares of Novint
common stock within 30 days of written notice from Novint to Tournabout of such
occurrence.

	6.	 	License Alternative. Tournabout agrees to and hereby grants to Novint, effective on
the date of Novint’s payment of the License Price, an irrevocable, perpetual, worldwide
license to the Subject IP and to any derivative works assigned to Tournabout by Novint
hereunder, for all purposes, and including the right to grant sublicenses to others, and
exclusive in the field of computer games having force feedback capability. Tournabout shall
not grant licenses to the Subject IP, or any derivative works assigned to Tournabout by Novint
hereunder, to any other party for use in connection with computer games having force feedback
capability.

	7.	 	Technology Transfer. Tournabout agrees to provide Novint with all information
reasonably necessary or requested for the exercise of the rights granted herein, including
without limitation copies of documents relating to patent filing and prosecution, electronic
copies of

     software programs, copies of electronic design files, and other embodiments of or documents
describing the Subject IP.

	8.	 	Confidentiality.

	 	8.1.	 	Each Party understands that maintenance of the confidential nature of both
Parties’ Confidential Information is important to the other Party’s future
use, practice, and commercial exploitation thereof. Each Party agrees that it shall use
reasonable efforts to preserve the confidentiality of any and all Confidential
Information of the other Party. For clarity, information in the Subject IP assigned to
Novint is Confidential Information of Novint.
	 
	 	8.2.	 	Permitted Disclosure. A Party may disclose Confidential Information of
the other Party only to current and prospective employees, agents, confidential
advisers, and investors who have reasonable need to know, given the nature of their
relationship to the Party, and shall not disclose Confidential Information of the other
party to any other party or use the Confidential Information for any purpose other than
exercise of the rights granted herein.

	9.	 	Representations and Warranties

	 	9.1.	 	Tournabout, and the Controlling Persons, jointly and severally represent and
warrant to Novint that:

 

 

	 	9.1.1.	 	Tournabout owns all right, title, and interest in and to the Subject IP, free of
any liens or encumbrances of any kind, and Tournabout has the right to make the
assignments and grant the licenses expressed or implied herein,
and the intellectual property rights in the Subject IP are valid and
enforceable against unlicensed use;
	 
	 	9.1.2.	 	Tournabout has not, and will not, assign or license the Subject IP or any part
thereof to any other party;
	 
	 	9.1.3.	 	To the best of the knowledge of Tournabout and the Controlling Persons, the use
of the Subject IP for hosting games that enables Novint to run online game contests
for users of the Falcon and other Novint Products will not infringe the
intellectual property rights of any other party.
	 
	 	9.1.4.	 	Tournabout is duly organized and validly existing under the laws of the state of
its incorporation and has full corporate power and authority to enter into this
Agreement and to carry out the provisions hereof, and after execution and
performance of this Agreement will have sufficient resources to pay its obligations
as they come due;
	 
	 	9.1.5.	 	Tournabout has taken all corporate action necessary to authorize the execution
and delivery of this Agreement and the performance of its obligations under this
Agreement; and such execution, delivery andlor performance does not and will not
violate any law, regulation, permit held by Tournabout, or contract to which
Tournabout is bound;
	 
	 	9.1.6.	 	This Agreement is a legal and valid obligation of Tournabout and the Controlling
Persons, binding upon Tournabout and the Controlling Persons and enforceable
against Tournabout and the Controlling Persons in accordance with its terms, except
as such enforcement may be limited by applicable bankruptcy, insolvency,
reorganization, arrangement, moratorium or other similar laws affecting creditors’
rights, and subject to general equity principles and to limitations on availability
of equitable relief, including specific performance;
	 
	 	9.1.7.	 	Tournabout has disclosed to Novint any written or electronic mail communications
alleging that it has violated or, by conducting its obligations as currently
proposed under this Agreement, would be violating, any of the Intellectual Property
rights of any third party;
	 
	 	9.1.8.	 	All information provided to Novint by Tournabout or the Controlling Persons in
relation to this Agreement is true and accurate in all material respects, all
information necessary to make any information disclosed to Novint not false or
misleading in any material respect has been disclosed to Novint.

	 	9.2.	 	Novint represents and warrants to Tournabout that:

 

 

	 	9.2.1.1.	 	Novint is duly organized and validly existing under the laws of the state of
its incorporation and has full corporate power and authority to enter into this
Agreement and to carry out the provisions hereof;
	 
	 	9.2.1.2.	 	Novint has taken all corporate action necessary to authorize the execution and
delivery of this Agreement and the performance of its obligations under this
Agreement; and such execution, delivery andlor performance does not and will not
violate any law, regulation, permit held by Novint, or contract to which Novint is
bound;
	 
	 	9.2.1.3.	 	this Agreement is a legal and valid obligation of Novint, binding upon Novint
and enforceable against Novint in accordance with its terms, except as such
enforcement may be limited by applicable bankruptcy, insolvency, reorganization,
arrangement, moratorium or other similar laws affecting creditors’ rights, and
subject to general equity principles and to limitations on availability of
equitable relief, including specific performance;

	 	9.3.	 	Each Party shall indemnify and hold harmless the other Party from and against
any and all claims arising out of any breach of the representations, warranties, and
covenants set forth herein.

	10.	 	Noncompetition and Nonsolicitation

	 	10.1.	 	For one year after the Effective Date, Tournabout shall not directly or
indirectly solicit any Novint employees or customers.
	 
	 	10.2.	 	Until the Demonstration Date, Tournabout and the Controlling Persons will not
engage in similar projects for any other party.

	11.	 	Miscellaneous

	 	11.1.	 	Further Assurances. Each Party hereby agrees to execute and deliver
any further assignments and other documents as the other Party reasonably believes to
be necessary to effect the foregoing assignment, license, or other enjoyment of the
rights granted to such other Party hereunder, and each Party hereby grants to the other
Party a limited, irrevocable power of attorney to execute and deliver such further
assignments and other documents in the event that it is unable to obtain such execution
and delivery from the other Party within ten (10) days of requesting the same.

	 	11.2.	 	Limitation of Liability. Neither Party shall be liable to the other
for any consequential, incidental, indirect, special or punitive damages arising from
this Agreement.

	 	11.3.	 	Governing Law. This Agreement shall be governed by the laws of the
State of New Mexico, without giving effect to any of its conflicts of law provisions.

	 	11.4.	 	Entire Agreement. This Agreement constitutes the entire, final and
complete

 

 

	 	 	 	agreement and understanding between the Parties with respect to the subject matter
hereof, and replaces and supersedes all prior discussions and agreements between the
Parties with respect to such subject matter. No amendment, modification or waiver of
any terms or conditions hereof shall be effective unless made in writing and signed
by a duly authorized officer of each Party.

	 	11.5.	 	Headings. All headings are inserted for convenience of reference only
and are not intended to be a part of or to affect the meaning or interpretation of the
terms of this Agreement.
	 
	 	11.6.	 	Notices. All notices required or permitted to be given under this
Agreement shall be in writing and shall be mailed by registered or certified mail, or
delivered by a nationally recognized overnight courier, or delivered by hand to the
address set forth in the first paragraph of this Agreement, or such other address as a
Party may use as its headquarters, provided that such Party has notified the other of
such new address, to the attention of the Party’s President. All notices shall be
deemed to have been given two (2) business days after such notice is mailed, as
evidenced by the postmark at the point of mailing, or on the date of personal delivery,
if not mailed.
	 
	 	11.7.	 	Counterparts. This Agreement may be executed in counterparts, each of
which shall be considered an original and all of which shall constitute together the
same document.
	 
	 	11.8.	 	Severability. If a court of competent jurisdiction declares any
provision of this Agreement invalid or unenforceable, or if any government or other
agency having jurisdiction over any Party deems any provision to be contrary to any
laws, then that provision shall be severed and the remainder of the Agreement shall
continue in full force and effect. The Parties further agree to negotiate in good faith
with the intention of agreeing to and implementing an amendment to replace such void,
invalid, unenforceable, or unlawful provision with a valid and enforceable provision
that will achieve, to the extent possible, the economic, business and other purposes of
such void, invalid, unenforceable or unlawful provision.
	 
	 	11.9.	 	Independent Contractors. Each Party shall act solely as an independent
contractor, and nothing in this Agreement shall be construed to give either Party the
power or authority to act for, bind or commit the other Party in any way. Nothing
herein shall be construed to create the relationship of partnership, principal and
agent or joint venture between the Parties.
	 
	 	11.10.	 	Dispute Resolution. All disputes, claims, and controversies between the
parties arising out of or related to this Agreement or the breach thereof (except for
breach of any obligation of confidentiality or infringement of any intellectual
property right for which an injunction may be sought) will be settled by binding
arbitration. The arbitration will be conducted by a single arbitrator, experienced in
the field of licensing intellectual property related to medical devices or life
sciences, under the then-current Commercial Arbitration Rules of the American
Arbitration Association. The decision and award of the arbitrator will be final and
binding and judgment on the award so rendered may be entered in any court having

 

 

	 	 	 	jurisdiction thereof. The arbitration will be held in Albuquerque, New Mexico, or a
mutually convenient location agreed to by the Parties, and the award will be deemed
to be made in New Mexico.

	 	11.11.	 	Bankruptcy. All rights and licenses granted to each Party under or pursuant
to this Agreement are, and shall be deemed to be, for purposes of Section 365(n) of the
United States Bankruptcy Code, licenses to rights of “intellectual property” as defined
thereunder. Notwithstanding any provision contained herein to the contrary, if either
Party is under any proceeding under the Bankruptcy Code and the trustee in bankruptcy
of such Party, or such Party, as a debtor in possession, rightfully elects to reject
this Agreement, the other Party may, pursuant to 11 U.S.C. Section 365(n) (1) and (2)
retain any and all of such other Party’s rights hereunder, to the maximum extent
permitted by law, subject to the payments specified herein.

(signature page follows)

 

 

signature page to Novint/Tournabout Intellectual Property Acquisition Agreement

	 	 	IN WITNESS WHEREOF, the Parties have executed and delivered this Agreement.

	 	 	 	 	 	 	 
	NOVINT

	 	 	 	TOURNABOUT	 	 
	 
	 	 	 	 	 	 
	/s/ Thomas G. Anderson

	 	7/17/07
	 	/s/ Michael Musson
	 	4/24/07
	 

	 	 
	 	 
	 	 
	Thomas G. Anderson, CEO

	 	date
	 	Michael Musson, CEO
	 	date
	of Novint Technologies, Inc.

	 	 	 	Tournabout, Inc.	 	 
	 
	 	 	 	 	 	 
	 

	 	 	 	/s/ Ed Zanelli
	 	4/24/07
	 

	 	 
	 	 
	 	 
	Michael Musson

	 	date
	 	Ed Zanelli
	 	date

 

 

Exhibit A

	1.	 	All IP associated with the ContestMaker platform including:

	1.1.	 	All MySQL database objects and create scripts, including:

	 	1.1.1.	 	tables
	 
	 	1.1.2.	 	stored procedures
	 
	 	1.1.3.	 	stored functions
	 
	 	1.1.4.	 	stored triggers

	1.2.	 	ContestMaker Server, including:

	 	1.2.1.	 	Registration and Player Accounts Interface (php code)
	 
	 	1.2.2.	 	Alert Engine (php and java code) Note1
	 
	 	1.2.3.	 	Ranking Engine (php code)
	 
	 	1.2.4.	 	Player Statistics and History Interface (php code) Note2
	 
	 	1.2.5.	 	Message Board and Chat (php code) Note3
	 
	 	1.2.6.	 	Administrative Interface (php code) Note2

	1.3.	 	ContestMaker Client API, including:
	 
	1.4.	 	Java version
	 
	1.5.	 	C/C++ version

Note1: Alert Engine extends PHPMailer, a freeware mailer based on the standard AspEmail classes.

Note2: Player Statistics and History Interface and Administrative Interface include Open Source
(java) line graphs from Play-Free-Games.com.

Note3: Message Board and Chat extends Phorum, an Open Source (php/MySQL) message board application.

	2.	 	Patent application and any resulting patents on VIDEO GAME CONTESTS
	 
	2.1.	 	Application Number: 11/086,876
	 
	2.2.	 	Filed Named Inventor: Zanelli, et al.
	 
	2.3.	 	Filing Date: March 22, 2005

 

 

Exhibit B

	 	 	 	 	 
	Date	 	Task/Milestone	 	Who’s Responsible
	4/20/2007

	 	Finalize Novint requirements.
	 	Novint/Tom
	 
	 	 	 	 
	4/20/2007

	 	Provide connection for development MySOL
database server to Ed. Provide connection for
development web server to Ed.
	 	Red 8/Randy
	 
	 	 	 	 
	4/27/2007

	 	Install ContestMaker schema, including tables,
triggers, functions, procedures and seed data on
development MySQL database server.
	 	Tournabout/Ed
	 
	 	 	 	 
	4/27/2007

	 	Install ContestMaker php API on development
web server. Deliver php templates to Red 8.
	 	Tournabout/Ed
	 
	 	 	 	 
	4/27/2007

	 	Deliver ContestMaker C/C++ dll to Novint.
	 	Tournabout/Jeremy
	 
	 	 	 	 
	4/27/2007

	 	Begin integration of ContestMaker php files with
N Touch.
	 	Red 8/Randy
	 
	 	 	 	 
	4/27/2007

	 	Support Red 8 with integration of ContestMakerTM
php API with N Touch. Make all changes or bug
fixes as necessary.
	 	Tournabout/Ed
	 
	 	 	 	 
	4/27/2007

	 	Begin integration of ContestMakerTM C/C++ dll
with Novint games.
	 	Novint/Bill
	 
	 	 	 	 
	4/27/2007

	 	Support Novint with integration of
ContestMakerTM C/C++ dll with Novint games.
Make all changes or bug fixes as necessary.
	 	Tournabout/Jeremy
	 
	 	 	 	 
	5/4/2007

	 	Accept installation of ContestMakerTM schema.
	 	Novint/Tom
	 
	 	 	 	 
	5/4/2007

	 	Accept installation of ContestMakerTM php files.
	 	Novint/Tom
	 
	 	 	 	 
	5/4/2007

	 	Accept installation of ContestMakerT”” C/C++ dll.
	 	Novint/Tom
	 
	 	 	 	 
	5/18/2007

	 	Complete integration of ContestMakerTM php API
with N Touch.
	 	Red 8/Randy
	 
	 	 	 	 
	5/18/2007

	 	Complete integration of ContestMakerTM C/C++
dll with Novint games.
	 	Novint/Bill
	 
	 	 	 	 
	5/18/2007

	 	Begin testing.
	 	All
	 
	 	 	 	 
	6/8/2007

	 	Complete testing.
	 	All
	 
	 	 	 	 
	6/18/2006

	 	Launch.
	 	All

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