IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF ARKANSAS NORTHERN DIVISION JULIE A. WITT PLAINTIFF v. CASE NO. 3:21-CV-00212-BSM CHANTILLY S. REDDMANN DEFENDANT ORDER This case was tried to the bench on January 8, 2024. Having listened to the testimony
and reviewed the exhibits introduced into evidence, judgment is entered for Chantilly S. Reddmann, and the Clerk of Court is directed to send the $9,970.68, plus interest accrued, deposited in the registry of the court by the Baltimore Life Insurance Company for Policy Number A 1073088 to Chantilly S. Reddmann. I. FINDINGS OF FACT AND CONCLUSIONS OF LAW
John S. Reddmann purchased a whole life insurance policy with Baltimore Life Insurance Company on January 15, 2009, and named Chantilly S. Reddmann, his only daughter, as his beneficiary. Exhibit 1. On April 24, 2018, John named Chantilly as his power of attorney. Exhibit 2. On April 20, 2020, Baltimore Life received a Beneficiary/Name/Address Change Form purporting to change John’s beneficiary
designation, and naming Julie A. Witt as the beneficiary of the policy. This designation form was not authenticated at trial and is therefore not in evidence. In addition to trial exhibits 1 and 2 (the only documents received into evidence at trial), the uncontested testimony of Chantilly is that John did not possess the intent or mental capacity to strike her as a beneficiary of his policy or to name Witt as the beneficiary. The rights of designated beneficiaries of insurance policies are determined according to contractual law. Allen v. First Nat. Bank of Fort Smith, 261 Ark. 230, 235, 547 S.W.2d
118, 120 (1977). When the holder of a life insurance policy expresses his intention in a written instrument in clear and unambiguous language, the agreement is construed according to its plain meaning. See Acklin v. Riddell, 42 Ark. App. 230, 234, 856 S.W.2d 322, 324 (1993) (citing C. & A. Constr. Co. v. Benning Constr. Co., 256 Ark. 621, 509 S.W.2d 302
(1974)). The holder of a life insurance policy may change the beneficiary in the manner and mode prescribed by the policy. Nunnenman v. Est. of Grubbs, 2010 Ark. App. 75, at 3, 374 S.W.3d 75, 78. Substantial compliance with the policy’s procedures is required to change a beneficiary. James v. Mounts, 2023 Ark. 53, at 11, 660 S.W.3d 801, 808. In a bench trial, the court bases its findings on admissible evidence only. See Williams
v. Illinois, 567 U.S. 50, 69–70 (2012). The only evidence received at trial are exhibits 1 and 2 and the uncontested testimony of Chantilly S. Reddmann. Based on this evidence, Chantilly S. Reddmann is the beneficiary of Policy Number A 1073088, John B. Reddmann’s life insurance policy with the Baltimore Life Insurance Company. II. CONCLUSION
For the foregoing reasons, judgment is entered for Chantilly S. Reddmann. The Clerk of Court is directed to pay the $9,970.68, plus interest accrued, deposited into the registry of the court by the Baltimore Life Insurance Company, to Chantilly S. Reddmann.
2 IT IS SO ORDERED this 8th day of January, 2024. Birr A IVe_ UNITED STATES DISTRICT JUDGE
The Baltimore Life COMPANIES Whole Life Insurance Policy This policy insures the life of the Insured. This is a Whole Life Insurance Policy. It also gives important benefits to you, the Insurance is payable at the Insured's Policy Owner. The Baltimore Life death. Premiums are payable for the Insurance Company (we) will pay the period shown on the Policy Data Page. death benefit to the Beneficiary when we This policy is nonparticipating and is not receive proof of the Insured's death. eligible to receive dividends. This policy is a legal contract between > you and us. Please read it carefully. AP □ baer TAKE A_10 DAY FREE LOOK. YOU President CAN RETURN THIS POLICY TO THE AGENT WHO SOLD IT TO YOU OR TO OUR HOME OFFICE WITHIN 10 DAYS ’ AFTER YOU RECEIVE IT. IF YOU DO, Sf WE’LL REFUND ANY PREMIUM PAID. “a THE POLICY WILL THEN BE TREATED Secretary AS IF IT WERE NEVER ISSUED. In the event you have questions, need information concerning this coverage or if you need assistance in_ resolving complaints, please contact us at: ae ee) ada at Od am eced □□ seem □□□ OC elas | eM Tri: ie Bd Pleo | ys. tay KX) Reled ete) □□□ PALL
FORM 7870(AR) □□□□□□□ 1
Policy Guide Major Sections Page Policy Data and ValUe@S ..............c □□□□□□□□□□□□□□□□□□□□□□□□□□□□□□ I Basic Policy Facts □□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□ D Beneficiary & OWNED oo...... □□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□ © Settlement at Death of the Insured ........ ee Premium PayMentS □□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□ | Cash Value Benefits for YOU... cceeeeetttteeeeeeeee O Other Important Terms □□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□ D Riders/Endorsements Copy of Application(s)
The Baltimore Life COMPANIES
NOTICE TO POLICYOWNERS: On the cover of this policy is a notice about your "Free Look." The free look period begins the day you receive your policy. During this period you can return the policy to your agent or to the home office and we will refund any premium paid. The policy will be treated as if it was never issued. If this policy replaces a policy from another company or an existing policy with Baltimore Life, your free look period is 30 days, even though a shorter time period may be shown on the cover of your policy. PENNSYLVANIA POLICYOWNERS ONLY: If this policy replaces a policy from another company, your free look period is 30 days. However, under Pennsylvania law, if this policy replaces an existing Baltimore Life policy, your free look period is 45 days. These provisions apply even though a shorter time period may be shown on the cover of your policy. If you have any questions about your policy, please contact your agent or our Customer Service Department in the home office at 1-800-628-5433.
Form 8050
01/05/09 THE BALTIMORE LIFE INSURANCE COMPANY
POLICY DATA PAGE THIS PAGE SHOWS SPECIFIC INFORMATION ABOUT THIS POLICY AND IS REFERRED TO THROUGH- OUT THE POLICY. INSURED JOHN B REDDMANN MALE 64 SEX/ISSUE AGE POLICY DATE JANUARY 15, 2009 A 1073088 POLICY NUMBER FACE AMOUNT $14,000.00 STANDARD PREMIUM CLASS OWNER JOHN B REDDMANN SCHEDULE OF BENEFITS AND PREMIUMS
DESCRIPTION OF POLICY PLAN ANNUAL PAYABLE AND ATTACHED AGREEMENTS PREMIUM FOR WHOLE LIFE INSURANCE POLICY $1,150.00 36 YEARS TOBACCO $14,000 - ACCIDENTAL DEATH BENEFIT RIDER $22.68 6 YEARS JOHN B REDDMANN
TOTAL ANNUAL PREMIUM AS OF JANUARY 15, 2009 - $1,172.68 TOTAL PREMIUM ON OTHER MODES IS AS FOLLOWS: MONTHLY BANK ANNUAL SEMI-ANNUAL QUARTERLY DRAFT* $1,172.68 $621.52 $316.62 $105.54 * MONTHLY BANK DRAFT - A RATE AVAILABLE IF WE ARE AUTHORIZED BY YOU TO RECEIVE PREMIUM PAYMENTS DIRECTLY FROM YOUR BANK ACCOUNT. IF WE DO NOT RECEIVE PAYMENT FROM YOUR ACCOUNT DUE TO INSUFFICIENT FUNDS, WE MAY CHANGE YOUR MODE OF PREMIUM PAYMENT TO MONTHLY DIRECT BILL. IN THAT EVENT, YOUR MONTHLY PREMIUM WILL BECOME $117.27. THE PREMIUMS FOR A BENEFIT ARE PAYABLE FOR THE NUMBER OF YEARS SHOWN, BUT NOT BEYOND THE END OF THE POLICY MONTH IN WHICH THE INSURED'S DEATH OCCURS.
FORM 7870 L50NT 1 WHOLE LIFE INSURANCE POLICY TOBACCO
INSURED JOHN B REDDMANN $14,000.00 FACE AMOUNT POLICY NUMBER _ A 1073088
TABLE OF GUARANTEED CASH VALUE BENEFITS
END OF REDUCED YEAR AGE JANUARY 15 VALUE* INSURANCE* YEARS DAYS ENDOWMENT 1 65 2010 $ 0.00 $ 0.00 0 0 $ 0.00 2 66 2011 $ 0.00 $ 0.00 0 0 $ 0.00 3 67 2012 $ 378.00 $ 751.58 1 127. $ 0.00 4 68 2013 $ 784.00 $ 1,513.57 2 204. $ 0.00 5 69 2014 $ 1,204.00 $ 2,257.79 3 209 $ 0.00 6 70 2015 $ 1,624.00 $ 2,959.25 4 132 $ 0.00 7 71 2016 $ 2,058.00 $ 3,645.74 5 7 $ 0.00 8 72 2017 $ 2,492.00 $ 4,294.72 5 199 $ 0.00 9 73 2018 $ 2,926.00 $ 4,909.80 5 346 $ 0.00 10 74 2019 $ 3,360.00 $ 5,493.40 6 90 $ 0.00 11 75 2020 $ 3,780.00 $ 6,025.50 6 158 = §$ 0.00 12 76 2021 $ 4,214.00 $ 6,553.55 6 210 0.00 13 77 2022 $ 4,648.00 $ 7,057.13 6 243 $ 0.00 14 78 2023 $ 5,068.00 $ 7,518.59 6 254 $ 0.00 15 79 2024 $ 5,488.00 $ 7,962.79 6 255 $ 0.00 16 80 2025 $ 5,894.00 $ 8,372.32 6 240 $ 0.00 17 81 2026 $ 6,286.00 $ 8,750.76 6 213 $ 0.00 18 82 2027 $ 6,664.00 $ 9,100.79 6 176 §$ 0.00 19 83 2028 $ 7,028.00 $ 9,423.85 6 129 $ 0.00 20 84 2029 $ 7,392.00 $ 9,740.51 6 81 $ 0.00 21 85 2030 $ 7,742.00 $ 10,034.35 6 28 $ 0.00 22 86 2031 $ 8,078.00 $ 10,308.12 5 343 $ 0.00 23 87 2032 $ 8,386.00 $ 10,546.47 5 292 $ 0.00 24 88 2033 $ 8,680.00 $ 10,769.21 5 243, $ 0.00 25 89 2034 $ 8,960.00 $ 10,977.37 5 195 $ 0.00 26 90 2035 $ 9,226.00 $ 11,171.39 5 147 §$ 0.00 27 91 2036 $ 9,478.00 $ 11,349.28 5 100 $ 0.00 28 92 2037 $ 9,730.00 $ 11,524.47 5 57 $ 0.00 29 93 2038 $ 9,996.00 $ 11,710.86 5 27 $ 0.00 30 94 2039 $ 10,262.00 $ 11,888.10 5 1 $ 0.00
FORM 7870 L5ONT 1.4
INSURED JOHN B REDDMANN $14,000.00 FACE AMOUNT POLICY NUMBER A 1073088
END OF REDUCED . POLICY CASH PAID UP EXTENDED TERM INSURANCE YEAR AGE JANUARY 15 VALUE* INSURANCE* YEARS DAYS ENDOWMENT 1 65 2010 $ 0.00 $ 0.00 0 0 $ 0.00 6 70 2015 $ 1,624.00 $ 2,959.25 4 132 § 0.00 10 74 2019 $ 3,360.00 $ 5,493.40 6 90 $ 0.00 20 84 2029 $ 7,392.00 $ 9,740.51 6 81 0.00
AMOUNTS CHANGE PROPORTIONATELY DURING POLICY YEARS. *THESE NUMBERS WILL CHANGE IF THERE ARE ANY LOANS. THE AMOUNT OF ANY REDUCED PAID-UP INSURANCE AND THE PERIOD AND ENDOWMENT OF ANY EXTENDED TERM INSURANCE WILL BE DETERMINED BY APPLYING THE NET CASH VALUE OF THIS POLICY AS A NET SINGLE PREMIUM FOR SUCH INSURANCE. CASH VALUE, REDUCED PAID-UP, AND EXTENDED TERM INTEREST RATE: 5.0% ANNUALLY. MORTALITY TABLE: CASH VALUES AND REDUCED PAID-UP - 2001 CSO, ALB, MALE EXTENDED TERM - 2001 CSO, ALB, MALE
FORM 7870 L5ONT 1.2
BASIC POLICY FACTS This section gives important information about your policy. This policy is the entire agreement between you and us. The policy includes the attached copy of the application and any attached riders or endorsements. All agreements made by us must be signed by our President, a Vice President or the Secretary. No other person, including an insurance agent, can: * change any of this policy's terms; * extend the time for paying premiums; or * make any agreement binding on us. Policy date is the date this policy goes into effect. Policy months and years are measured from the policy date. A policy anniversary occurs each year on the month and day of the policy date. THE INSURED This policy provides insurance coverage on the life of the Insured whose name is on the Policy Data Page. ISSUE AGE is based on the actual age of the Insured on the policy date. It is shown on the Policy Data Page. In this policy, age means actual age on the Insured's last birthday. BENEFICIARY & OWNER THE BENEFICIARY is the person entitled to receive the death benefit. CONTINGENT BENEFICIARY We will pay the death benefit to the primary Beneficiary if living at the Insured's death. If the primary Beneficiary has died, the death benefit will be paid to any contingent beneficiary. IRREVOCABLE BENEFICIARY if named, cannot be changed. This policy cannot be assigned without the consent of an irrevocable Beneficiary. CHANGE IN BENEFICIARY Unless the Beneficiary is irrevocable, you can change Beneficiary or contingent Beneficiary while the Insured is alive. A request to change must be in a form satisfactory to us and recorded at our Home Office. We may require the policy to note the change on it. Once the change is recorded by us, it FORM 7870(AR)
will take effect as of the date the request was signed. We will not be responsible for the validity of the change or any payment made or other action taken by us before we record the change at our Home Office. THE OWNER The Insured will be the Owner of this policy unless the application names another Owner. You may change the Owner. While this policy is in effect, unless otherwise provided, you as the Owner have all the rights in this policy. If you die while this policy is in effect your estate becomes the Owner. ASSIGNMENT You can assign this policy. You will need the consent of all irrevocable Beneficiaries. An assignment does not change the ownership. We will not be responsible for the validity of the assignment or any payment we make before we receive notice of the assignment at our Home Office. The assignment is subject to any policy debt. SETTLEMENT AT DEATH OF THE INSURED If the Insured dies, we'll pay the death benefit to the Beneficiary in a single lump sum. The death benefit is payable as provided in this policy from our Home Office when we receive due proof of the death of the Insured while this policy is in effect. A death benefit not paid within thirty days of receipt of due proof of death of the insured shall earn interest at the rate not less than required by Arkansas law. Determining the Death Benefit The death benefit will include: * the face amount provided by this policy, as shown on the Policy Data Page; * any insurance provided by riders; and * the part of any premium paid for a period beyond the month of death.
We will subtract: * any policy debt; and * one month's premium if death occurs during the grace period.
FORM 7870(AR)
PREMIUM PAYMENTS The first premium is due on or before the policy date. After that, a premium is due on the first day of the period it covers. Premiums are payable during the Insured’s lifetime for the number of years shown on the Policy Data Page. Where and When to Pay Premiums All premiums after the first are payable at our Home Office. Premiums can also be paid to an authorized agent who will give you a receipt signed by our President, a Vice President or the Secretary. The Policy Data Page shows the period and frequency of premium payment. On any policy anniversary, you can request a change in the payment frequency. Grace Period If any premium after the first is not paid when due, this policy will continue in effect for 31 days. This is called the grace period. If the Insured dies during the grace period, the unpaid premium will be deducted from the death benefit. Continuation of Coverage Under Automatic Premium Loan You may request this option in the application. You may also request this option in writing, in which case it must be recorded at our Home Office before the end of the grace period for an unpaid premium. Unless you request this option, it will not be in effect. If. apremium remains unpaid on the last day of the grace period, and e the net cash value of this policy exceeds the unpaid premium, we will automatically loan the amount needed to pay the premium (see Cash Value Benefits For You). You may notify us in writing at any time if you do not wish coverage continued in this manner. If the net cash value is less than the amount needed to pay the premium, and the premium is payable annually, semiannually, or quarterly, the next smaller modal premium will be paid by automatic premium loan. If the net cash value is less than a monthly premium, no automatic premium loan will be made and the policy will end unless continued under a cash value benefit. How to Reinstate This Policy If any premium remains unpaid after the grace period, you may request reinstatement of this policy. You must do this within five years from the due date of the first unpaid premium. You'll have to provide evidence satisfactory to us that the Insured's insurability has not changed since this policy was issued. You'll also have to pay all unpaid premiums plus interest at the annual rate of 6%. Any policy debt will be reinstated if not repaid.
CASH VALUE BENEFITS FOR YOU This policy has cash value benefits while the Insured is alive. These benefits may be used by you. The Table of Guaranteed Cash Value Benefits shows the first policy year for which there is cash value. When a premium has been paid in that year, your cash value benefits start. Cash values in the Table assume that premiums have been paid to the end of the policy year, and that there is no policy debt. On request, we'll tell you the cash value for any date not in the Table. The net cash value at any time equals the cash value of the policy, less any policy debt. You Can Borrow Money Against the Policy You can borrow money against the policy whenever it has a net cash value. The most we'll loan is an amount that, together with interest and any unpaid premiums to the end of the current policy year, will not exceed the net cash value of the policy at the end of that current policy year. You cannot borrow money against this policy if it is being continued as extended term insurance. We can delay making the loan for up to 6 months after we receive your request, except for any portion to be used to pay premiums on policies with us. Loan interest will not exceed an annual rate of 8% and is added to the loan balance at the end of each policy year while the loan is outstanding. We will not increase the loan rate more than once in a 12 month period. If you have any policy debt outstanding, we will give you 30 days notice before any loan interest rate change. Any interest not paid will become part of the loan and will accrue interest. We call the total amount of all outstanding loans (with accrued interest) the policy debt. You can repay the policy debt in part or in full at any time while the Insured is alive and this policy is in effect. The minimum loan repayment is $25, except that you can always pay any amount that fully repays the policy debt. If the policy debt exceeds the cash value of this policy, this policy will end 31 days after we send you notice. We'll send notice to anyone to whom you have assigned this policy. All coverage will end even if you send a loan repayment after that time. This policy may then only be reinstated by application. See Premium Payments. Any policy debt outstanding at the Insured's death will reduce the death benefit payable under this policy. See Settlement at Death of the Insured. You Can Return the Policy for Cash This policy can be returned with a written request for its net cash value. The policy will end when we pay this amount. We can delay payment of this policy's net cash value for up to 6 months after we receive your request. FORM 7870(AR)
You Can Continue Coverage as Reduced Paid-Up Insurance This policy's net cash value can be used to purchase Reduced Paid-Up Insurance. The Table of Guaranteed Cash Value Benefits shows the cash value and how much Reduced Paid-Up Insurance it can purchase. Your net cash value may be different from the cash value shown. After this benefit starts, this policy will continue to have a cash value while the Insured is alive but will not include any additional benefits or riders. The cash value will be the single premium for the amount of insurance provided. The cash value of any Reduced Paid-Up Insurance within 30 days after a policy anniversary shall not be less than the cash value on that anniversary. You can borrow against the cash value of any Reduced Paid-Up Insurance. You Can Continue Coverage as Extended Term Insurance If this policy is in a standard premium class, its net cash value can be used to purchase Extended Term Insurance. The amount of such insurance will be the face amount of this policy less any policy debt. This policy's net cash value will determine how long the Extended Term Insurance will last. If the net cash value is more than sufficient to purchase Extended Term Insurance to the Insured’s age 100, the excess net cash value will be applied to purchase an endowment at that age. The Table of Guaranteed Cash Value Benefits shows the cash value and the period of Extended Term Insurance it can purchase. Your net cash value may be different from the cash value shown. After this benefit starts, this policy will continue to have a cash value while the Insured is alive and the extended term period has not ended, but it will not include any additional benefits or riders. The cash value will be the single premium for the amount of insurance and any endowment provided. The cash value of any Extended Term Insurance within 30 days after a policy anniversary shall not be less than the cash value on that anniversary. You cannot borrow against the cash value of any Extended Term Insurance. Using Cash Value After A Premium Remains Unpaid If a premium remains unpaid at the end of a grace period, coverage will end as of the due date of that premium unless the policy has a net cash value. If so, and you have not requested a cash value benefit, coverage under this policy may be continued under automatic premium loan (see Continuation of Coverage Under Automatic Premium Loan). You may select a cash value benefit during the 60 days following the due date of the unpaid premium. If no option is elected, we will continue coverage under the Reduced Paid-Up Insurance option (see You Can Continue Coverage as Reduced Paid-Up Insurance).
Basis of Computations We use the mortality table shown in the Table of Guaranteed Cash Value Benefits in computing cash values, Reduced Paid-Up Insurance amounts, and Extended Term Insurance benefit periods and endowments. In our computation of these values, we assume interest at an annual rate shown in the Table of Guaranteed Cash Value Benefits. We also assume that premiums are received at the start of each policy year and that death occurs at the end of the policy year. Cash values and paid-up insurance values for policy anniversaries after those shown in the Table of Guaranteed Cash Value Benefits are calculated in accordance with the Standard Nonforfeiture Value Method using the adjusted premium as defined in the laws of the state in which this policy was delivered. We have filed a detailed statement of the method we use to compute cash value benefits with the state where this policy was delivered. All values are greater than or equal to those required by the laws of the state. OTHER IMPORTANT TERMS Nonparticipating This policy is nonparticipating and is not eligible to receive dividends. This Policy Is a Contract This policy is a contract. In entering into this contract, we relied on the accuracy of the statements made in the application. In the absence of fraud, these statements are considered representations and not warranties. We can contest this policy and use statements made in the application in defense of a claim if the application contains a material misstatement and a copy of the application was attached to this policy when it was issued. Contesting This Policy We will not contest this policy after it has been in effect while the Insured is living for two years from the policy date. However, we can end the policy whenever a premium is not paid within the grace period, unless the policy is continued under a cash value benefit (see Cash Value Benefits for You). Mistake in Age or Sex If the Insured's age or sex is misstated in the application, the death benefit will be based on the face amount of insurance that the premium paid would have bought at the true age and sex.
Suicide If the Insured commits suicide, while sane or insane, within two years after the policy date, our liability payable under this policy will be limited to the sum of all premiums paid less any policy debt. This amount will be paid to the Beneficiary in a single sum. Written Notices Send any required written notices to our Home Office at: The Baltimore Life Insurance Company 10075 Red Run Boulevard Owings Mills, Maryland 21117-4871 Please include the policy number. lf we at The Baltimore Life Insurance Company fail to provide you with reasonable and adequate service, you should feel free to contact: Arkansas Insurance Department Consumer Services Division 1200 West Third Street Little Rock, Arkansas 72201 1-800-852-5494
THE BALTIMORE LIFE INSURANCE COMPANY 10075 Red Run Boulevard Owings Mills, Maryland 21117-4871
ACCIDENTAL DEATH BENEFIT RIDER Basic Rider Facts This rider provides accidental death insurance on the Insured. The rider includes the attached copy of the application for it. The rider adds a benefit to and is part of the policy to which it is attached. The rider date is the date this rider goes into effect. It is the policy date unless a different rider date is shown on the Policy Data Page. A rider anniversary occurs each year on the anniversary of the rider date. The rider expiry date is the date all insurance under this rider ends. It is shown on the Policy Data Page. Insurance under this rider ends when the first of the following occurs: e the rider expiry date arrives; e you request to end the rider; e the rider anniversary next following the Insured’s 70" birthday arrives; e arider premium is not paid when due (subject to the grace period); e the policy ends; or e the policy is continued as extended term insurance or reduced paid-up insurance. The Insured is the person insured under this policy. You, the Owner of this policy, are also the Owner of this rider. ACCIDENTAL DEATH BENEFIT We will pay the accidental death benefit to the Beneficiary when we receive proof of the accidental death of the Insured occurring: e while this policy and this rider are in effect; e onor after the rider date; e before the rider expiry date; and e solely through external, violent, and accidental bodily injury; and e within 90 days after the injury that caused the Insured’s death.
FORM 7922
We will pay the accidental death benefit under this rider in addition to the death benefit of this policy. The amount of the accidental death benefit is shown on the Policy Data Page. When we pay the accidental death benefit, this rider will end. PREMIUM PAYMENTS The first premium for this rider is due on the rider date. After that, a rider premium is due on the first day of the period it covers. (See the Policy Data Page.) DEATH NOT COVERED BY THIS RIDER We will not pay the accidental death benefit under this rider if the death of the Insured results solely or partially from: e suicide, or attempted suicide, while sane or insane; e injury that occurred before the rider date; e mental or bodily infirmity, illness, disease, or infection (except where death results from an infection which occurs directly as the consequence of an accidental cut or wound); e the voluntary taking, administering, absorbing, or inhaling of poisons, gases, or fumes (except for on-the-job accidents); e the voluntary taking of any drug not prescribed for the Insured by a doctor; e the voluntary taking of any drug prescribed for the insured by a doctor and intentionally not taken as prescribed; e abusive use of alcohol by the Insured, including having a blood alcohol concentration above the maximum level permitted by the law of the state in which this rider was issued for operation of a motor vehicle (whether or not death results from operating a motor vehicle); e medical or surgical treatment; e committing or attempting to commit a misdemeanor or a felony; e war (declared or undeclared) or other armed conflict, insurrection, or participation in a riot; e service in any armed force engaged in a military conflict, whether or not declared; or e travel or flight in or descent from any kind of aircraft, if the Insured has any duties on board, or if the Insured is flying in the course of any training or instruction, or in maneuvers of any armed force.
PHYSICAL EXAMINATION To determine if the death is accidental, we can authorize an autopsy or examination of the body at our own expense and where permitted by law.
A [tan President
cy The Baltimore Life COMPANIES Whole Life Insurance Policy This is a Whole Life Insurance Policy. Insurance is payable at the Insured's death. Premiums are payable for the period shown on the Policy Data Page. This policy is nonparticipating and is not eligible to receive dividends. The Baltimore Life Insurance Company 10075 Red Run Boulevard Owings Mills, Maryland 21117-4871 1-800-628-5433 A Stock Company
= The Baltimore Life Insurance Company □ The Baltimore Life 10075 Red Run Boulevard » Owings Mitls, MO 21117-4871 COMPANIES. |. 800.628.5433-www.baltlife.com AN questions in this application are important. Please read and complete carefully. □ ‘ □ a : LO Aste Th Meee UTE □□□ □□□ CoRR SN CAE) i eee Te acre DRTE EES) Gat er if Pee Pe IF Chi ae Be UR Ev Peeps Se AE: 3 Hee sei . is ee Ue ERNE a So ST cesnon $ 14000 renin § 105'54 □□ PRET OSS □□□ Ge 7 : 7 SPP hs oie rere ep pa RL’ hak a EP □□ Applied For ASilver Guard LifePay ©. i ae Tie eeree hy eee aay a cas ite □□ Peer A Ne ee ae er ae ea as sah I uimitesipay, WNutiber of Years ee Bora eae List □□□ a ans ea MIREINC 0 Se Lg ae ae ecormam Mode (Crest Monthly. Bene Oran Rroposed □□□□□□□□□□□□□□□□□□□□□□□ Yast-Name ).or? Seis eas SA pare anche sett □□□ A Re ie ac eg as sca RSE Wirece Bill: □□□□□□□□□□□□□□□□□□□□□□□□ (Quarter . . ti “Feo eeia | = □□□□□□□□□□□□□□□□□□□□□□□□□□□ }Not Applica eo a □□□ oreangAR licginiyereiand lus) He □□□□□□□□□□□□□□□□□□□□□ 7 sid tolownersee Le ohei ic aR eae es ED asso Baldo RelA □□□ acca VE ah □□ one To rid □□ □□ PRTG ee SMe, (8 eL)Premium Reduction (only, onannual modes) ,0/:5 (1); it GresentAgegO° jy SDAeeomulaioneiees ameetiedeasl acre □□ gE ie mmm Eee] lmbeeneaatesara cai matinee a □□ fesekdm Buméignt Weigh Fess) [ase Ose ee eee □□□ □□ Ena ee Renae canard 2 tk SD neers PAULON atc □□ eat Ne LJ) Or ate re □□ EsodelSeci) No CEH Gi dba os eerie unt si lly el □□ MStiseLAddressit mad eee 2 ene □ coe a =, riiary sy Sgt es se eae taser □□ Ege dente oiel give she eo Salah te econ ts : pl □ oe | Teeaeieey, ChantillyReddmann oR eree PaEea varste fet ee AGL Bega yp a Tce aa, Stale: Zipeateed| | Tee Mec jDaughter, 100% i, ee eal mas | Baie acpeap el RTTRESIECSS □ pea | □□ ARBRE at ae ae : □□ Eoneiclephen □□ ESOC EISCCUNVNG teri irae ER) □□□ A eats SP ee Perennial □□□□□□ ieee) EContngely aS nen ean ee yori is ae □□□ Weenie = Mail Address, cit □ | (Onan Ee: a ee pe lone eae ae. fSocaiSecunvioy SA ELE ee Pe ited erg pepr ens te gets! peng Me par Prat patents, te ARs io a ler See ey hala Huber hay VT □□□□ Eee anes ES te] [ORE Pen tes ep eee een poe aera ea je ne ht Pee cee (aCRnr a Daum ERM AAcqquune ont □□□ oley Winer inane opseedintectuatare| [Onsen olfer han propdseainseuy □□□ ~ i □ qo ia | IMOR EEG Sa Abe cir BSAC CESAR EASES) fp RS earner [ering ek go cltal haa : A Fe Se ate ee See ae | elocengs emer] (Rearend Ce ee FA Social Security:No. □□ SRE fit ee Perea tam rabtnty eet eb a ek ahs title ty 1 Wa Sree cannes betes hae vhpcitoat ROD Ae ETEK □□□□ my maa aaa IO Coreen aa OREN a a Ripe eae SETAE ee gts age | | Se ees — talus He he a “ye □□□ as soa # eCityiStateZipvice d . i Reivisitezips4 . | Weleph tl] PHOMEN Cleon □□□ □□ et PRET MeN Spree bd aie feed te ee Mail ociaian Fan □ Ra OR aaa CP agra ie NR ea One Sees pie eS rer or ER IEE Form 7430(AR) □□ oe
Please read and sign: This application is complete and true to the best of my knowledge and belief. The Company is deemed to know only the facts contained in this application. Any policy issued with this application shail not go into force unless the application is completed. the first premium is paid in full, and the application is approved by the Company while the Proposed Insured’s condition of health is unchanged from the date of the application. Authorization and Acknowledgement authorize any physician, medical practitioner, hospital. clinic, other medical or medically-retated facility, insurance or reinsuring company, or the Medical Information Bureau, Inc. having information available as to diagnosis, treatment and/or prognosis of me with respect to any physical or mental condition, including alcoholism and/or use of drugs. and any other nonmedical information about me to give to the Company any and all such information. | understand the information obtained by use of this authorization will be used by the Company to determine eligibility for insurance and/or benefits. Any information obtained will not be released by the Company to any person or organization except to reinsuring companies, the Medical Information Bureau, Inc., or other persons or organizations performing business or legal services in connection with my application or claim, or as may be otherwise lawfully required or as | may further authorize. | understand that ! may request a copy of this authorization and agree that a photographic copy of this authorization shall be as valid as the original. This authorization shall remain valid for a period of two years and six months from the date itis signed. | acknowledge receipt of the Applicant(s) Pre-Notice. Fraud Warning 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 is guilty of a crime and may be subject to fines and confinement in prison.
Important Tax Notice for Policyowner Under Federal Tax law, the Company is required to ask you to certify your correct Taxpayer !dentification Number (TIN) and to include it in any reports of taxable income it makes to the IRS. If you are an individual, your Social Security number is your Taxpayer Identification Number. Certification: | certify that 1am []1 am not subject to a backup withholding order under Section 3406(a)(1)(c) of the Internal Revenue Code and | am a U.S. person (including a U.S. resident alien). | also certify that the Taxpayer Identification Number on this form is true, correct and complete. The Internal Revenue Service does not require your consent to any provisions of this document other than the certification to avoid backup withholding. | certify that | have reviewed the health questions contained on this application and that my responses to these questions have been accurately recorded. | understand that no agent is authorized to advise me that any inaccurate answer is acceptable. Applicationmade at HarisburgAR this 02 dayof_ January, 2009 (City. State) (Day) (Month) (Year) John 8 Reddmann - Signed Electronically- ‘ 01/02/2009 05:32 PM Signature of Proposed Insured Signature of Proposed Owner, if other than Proposed Insured Form 7430(AR) EAE OAT OPE RF ORATION Conditional Receipt Received from John B Reddmann The sum of $ 105.54 (eDraft) This receipt is given and accepted with the understanding that the insurance applied for shall go into force when the application is completed, the first premium is paid in full, and the application is approved by the Company while the Proposed Insured’s condition of health is unchanged from the date of the application. John B Reddmann - Signed Electronically- 01/02/2009 05:32 PM Proposed Insured Date 01/02/2009 JAMIE D STEELE - Signed Electronically- 01/02/2009 05:32 PM Agent ee THE PREMIUM CHECK MUST BE MADE PAYABLE TO THE BALTIMORE LIFE INSURANCE COMPANY. ‘ DO NOT MAKE THE CHECK PAYABLE TO THE AGENT OR LEAVE THE PAYEE BLANK. Form 7430(AR)
ISIS ree KALLE poa +2018R-O01075 43 2018R-01075 POINSETT COUNTY, AR 5 FILED _ J CERTIFY THES INSTRUMENT WA lar ee, 04/24/2018 — 01:50:48PH DURABLE POWER TOR MISTY RICHARDSON-RUSSELL SDs □□□ te es a CIRCUIT C Ea Beppe Se py: □ STATE OF ARKANSAS / Ree 3 / % yn pie ,° “ec? % Penaee” ny COUNTY OF POINSETT / “aa, aR sans zapike KNOW ALL MEN BY THESE PRESENTS: THAT I, John Bruno Reddmann, Sr., being an adult resident citizen of Poinsett County, Arkansas, and being more than twenty-one (21) years of age, and also being in all respects fully capable, competent and of sound mind, have, and by these presents, do hereby make, constitute and appoint my daughter, Chantilly S. Reddmann, as my true and lawful attorney, with full power and authority to act in my name, place and stead as follows:
To exercise, do, or perform any act, right, power, duty, or obligation whatsoever that I now have or may acquire the legal right, power, or capacity to exercise, do, or perform in connection with, arising out of, or relating to any person, item, thing, transaction, business property, real or personal, tangible or intangible, or matter whatsoever, To ask, demand, sue for, recover, collect, receive, and hold and possess all such sums of money, debts, dues, bonds, notes, checks, drafts, accounts, deposits, legacies, bequests, devises, interests, dividends, stock certificates, certificates of deposit, annuities, pension and retirement benefits, insurance benefits and proceeds, documents of title, choses in action, personal and real property, intangible and tangible property and property rights, and demands whatsoever, liquidated or unliquidated, as are now, or shall hereafter become due, owing, payable, owned, or belonging to me or in which J have or may acquire an interest, and to have, use, and take all lawful ways and means and legal and equitable remedies, procedures, and writs in my name for the collection and recovery thereof, and to compromise,
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settle and agree for the same, and to make, execute and deliver for me and in my name all endorsements, acquittances, releases, recepts, or other sufficient discharges for the same; To lease, purchase, exchange and acquire, and to bargain, contract and agree for the lease, purchase, exchange and acquisition of, and to take, receive and possess any real or personal property whatsoever, intangible or tangible, or interest therein, on such terms and conditions and under such covenants ag said attorney-in-fact shall deem proper, To improve, repair, maintain, manage, insure, rent, lease, sell, release, convey, subject to liens, mortgage, and hypothecate, and in any way = or manner deal with all or any part of any real or personal property, intangible and tangible, whatsoever, or any interest therein, which J now own or may hereafter acquire, for me and in my name, and under such terms and conditions, and under such covenants as said attorney shal} deem proper; To engage in and transact any and all lawful business of whatever nature or kind for me and in my name; To sign, endorse, execute, acknowledge, deliver, receive and possess such applications, contracts, agreements, options, covenants, deeds, conveyances, trust deeds, security agreements, bills of sale, leases, mortgages, assignments, insurance policies, federal and state tax returns, bills of lading, warehouse receipts, documents of title, bills, bonds, debentures, checks, drafts, bills of exchange, notes, stock certificates, proxies, warrants, commercial paper, receipts, withdrawal receipts and deposit instruments relating to accounts, or deposits in, or certificates of deposit of, banks, savings and loan, or other institutions or associations, proofs of loss, evidences of debts, releases, and satisfaction of mortgages, judgments, liens, security agreements and other debts and obligations, and such other instruments in writing of whatever kind and nature as may be necessary or proper in the exercise of the rights and powers herein granted,
POINSETT COUNTY 2018R-D 1075 PAGE 2 OF 4
I grant to my said attorney-in-fact full power and authority to do and perform all and every act and thing whatsoever requisite, necessary and proper to be done in the exercise of any of the rights and powers herein granted as fully to all intents and purposes as I might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that my said attorney-in-fact, or substitute or substitutes, shall Jawfully do or cause to be done by virtue of this Power of Attorney and the rights and powers herein granted. This instrument is to be construed and interpreted as a general power of attorney. The enumeration of specific items, acts, rights, or powers herein does not limit or restrict, and is not to be construed or interpreted as limiting or restricting the general powers herein granted to my attarney-in-fact, This Power of Attorney shall not be affected by my subsequent disability or incapacity. I intend that this Power of Attorney be a durable power of attomey and shall be interpreted and construed in accordance with Arkansas Code Annotated §28-68-201, et seq. and all amendments thereto,
3. POINSETT COUNTY 2018R-01075 PAGE 3 OF 4
ACKNOWLEDGMENT STATE ARKANSAS / COUNTY OF POINSETT BE IT REMEMBERED, that on this day before the undersigned, a Notary Public within and for the County and State aforesaid, duly commissioned, qualified and acting, personally appeared the within named John Bruno Reddmann, Sr., to me personally wel! known, and slated and acknowledged to me that he had signed and executed the within and foregoing Durable Power of Attomey for the consideration, uses and purposes therein set forth. IN WITNESS WHEREOF, I have hereunto set my hand and official seal this 12" day of March, 2018.
My Commission Expires: NOTARY puANDA R SCOTT RKANSAS _4-R9-BORO My Commission Bape S0-2020 Commission # 12378488
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