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POLICY NUMBER: 1262435-9 Type of policy : Risk 1 year The Policyholder The Insured I.D. number Date of birth Occupation : : : : : MAOS by The BrowardPost Jean Robbzilla 1541549 Gender : unknown 1/10/1873 Age : 214 Purveyor of Hate
Sex: ick
Inception date of the insurance : 12/26/2012 Term of the insurance : 1 year Expiration date of the insurance: 1/26/2013 The premium shall be paid until : 01/10/2038 THE BASIC SUM INSURED ILS 100,165 one hundred thousand, one hundred and sixty five New Israeli Shekels
The Basic Sum Insured shall be paid upon the occurrence of the following event: Upon the death of the Insured immediately subsequent to his/her death due to: 1) Spontaneous combustion due to excessive anal bleaching 2) Too much porn 3) Being hit by a canonball that was fired as a salute to her 4) Being crushed or drowned by molasses 5) Being bit by a monkey and/or John Grassi 6) Having a stroke after reading a negative premature obituary 7) Drinking herself to death with prune juice 8) Getting hit in the balls by a tennis ball 9) Clubbed to death with toilet seat 10) Anything related to the Lemon Party The Beneficiary: Upon the death of the Insured as specified in the Insurance Proposal. For the purposes of the Linkage Terms clause in the General Conditions section of the Policy, the base index was set at 9,967.00 points (hereinafter: the Base Index), adjusted to the basic index of 100 points of January 1959 and divided by 1000.
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The inclusive monthly premium The inclusive monthly premium shall be paid on the first of each month. The monthly premium for a first Insured for 5-year risk insurance non-smoking shall be increased, as follows: As of the following date: Premium: 01/10/2008 13.47 01/10/2013 18.07 01/10/2018 26.66 01/10/2023 41.85 01/10/2028 68.33 01/10/2033 111.82 This rider replaces all previous riders.
ILS 60.00
Should the policyholder change the method by which he/she pays the premium, the premium shall change according to the Companys customary procedure at the time. 2
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It is hereby agreed and declared that the following amendments shall apply to appendix 161 or 162: 1. 2. Clause 6 (a) is cancelled. Clause 4 (a) (b) is cancelled and replaced by: If, due to an illness or accident (hereinafter: the Insured Event), the Insured is deprived at the rate of at least 75% - of the ability to continue in the profession he had been engaged in, as specified in the Insurance Proposal, until the Insured Event 3
occurred, and due to which, he was prevented from engaging in any profession or occupation at which he had been engaged during the five years preceding the date of that same illness or accident. (11/99 ) It is hereby agreed and declared that the following amendments shall apply to appendix 161 or 162 or 163: 1. Clause 10 (a) shall be replaced by: The Insured shall be deemed as having partial work incapacity if he fulfills the eligibility requirements for a monthly compensation and/or release from payment of the premiums specified in clause 4 at the rate of 25% of more, and provided that the Insured has been recognized as temporarily or permanently disabled by the National Insurance Institute. Clause 10(e) is cancelled. (11/99 )
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