2020 LFG LTD Certificate

SECTION 4 - DISABILITY INCOME BENEFITS (Continued)

LONG TERM DISABILITY COVERAGE (Continued) What Happens if You Receive a Lump Sum Payment? Other Income Benefits from a compromise, settlement, award or judgement which are paid to you in a lump sum and are meant to compensate you for any one or more of the following: 1. loss of past or future wages; 2. impaired earnings capacity; 3. lessened ability to compete in the open labor market; 4. any degree of permanent impairment; and 5. any degree of loss of bodily function or capacity; will be prorated on a monthly basis as follows: 1. over the period of time such benefits would have been paid if not in a lump sum; or 2. if such period of time cannot be determined, the lesser of: a. the remainder of the Maximum Benefit Period; or b. 5 years. What Happens if You Receive any Cost of Living Increases? After the first deduction for each of the Other Income Benefits, the Monthly Benefit will not be further reduced due to any cost of living increases payable under the Other Income Benefits and Other Income Earnings provision of this plan. This provision does not apply to increases received from any form of employment. What Happens if Your Benefit Period is Less than a Month? For any period for which a Long Term Disability benefit is payable that does not extend through a full month, the benefit will be paid on a prorated basis. The rate will be 1/30th for each day for such period of Disability. When will Your Long Term Disability Benefits be Discontinued? The Monthly Benefit will cease on the earliest of: 1. the date you fail to provide Proof of continued Disability or Partial Disability and Regular Attendance of a Physician; 2. the date you fail to cooperate in the administration of the claim. Such cooperation includes, but is not limited to, providing any information or documents needed to determine whether benefits are payable or the actual benefit amount due;

ADOC-LTD-27

Long Term Disability

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