policy are in force, is wholly disabled and prevented from performing every duty pertain ing to any business or occupation and solely by reason of such sickness, is necessarily and continuously confined within the house; provided that no indemnity shall be paid for more than six consecutive months, nor for the first seven days unless such disability continues for twenty-eight consecutive days; or.

(J) CONVALESCENT INDEMNITY.-If during convalescence immediately following at least seven days confinement within the house, for sickness covered under Paragraph 1, the insured shall be wholly and continuously disabled from performing every duty pertaining to any business or occupation, but is not necessarily and continuously confined within the house, the Company will pay indemnity at one-half of the rate provided in Paragraph I, for a period not exceeding two consecutive months; or,

(K) NON-CONFINING SICKNESS INDEMNITY.-If the insured is wholly and continuously disabled from performing every duty pertaining to any business or occupation on account of any sickness covered by Paragraph I, is not necessarily and continuously confined within the house, the Company will pay indemnity at one-half of the rate provided in Paragraph I for the period of such disability, not exceeding two consecutive months, provided that no indemnity shall be allowed for the first week of such sickness, unless such disability continues for twenty-eight consecutive days; or,

(L) BOILS, FELONS, OR ABSCESSES.-For the period during which the insured shall be wholly and continuously disabled and prevented from performing any and every duty pertaining to any business or occupation by reason of boils, felons or abscesses, whether or not confined within the house, the Company will pay sickness indemnity at the rate per month specified in Paragraph I;

Provided that no indemnity shall be paid for more than six consecutive months, nor for the first seven days unless such disability continues for twenty-eight consecutive days; or third: under the

SPECIAL PROVISIONS.

(M) IMMEDIATE SETTLEMENTS.-If such injury as described in Paragraph C causes one or more of the specific injuries named in Schedule of Optional Advance Settlements, and the insured so elects in writing within twenty days from date of the accident, he may take an immediate settlement, in lieu of all indemnity that might otherwise accrue under Paragraph C or D hereof, for the largest amount specified in column 1 of said schedule for any one of the specific injuries so sustained; or, if such injury as described in Paragraph C, is sustained solely under conditions specified in Paragraph G, he may so elect to receive the corresponding amount specified in column 2 of said schedule; provided that not more than one such indemnity shall be payable as the result of any one accident, and

Provided always, that the amounts specified therein shall be payable only in case the Monthly Accident Indemnity is $50.00; if such monthly indemnity is greater or less than $50.00, then the amounts to be paid shall be increased or reduced proportionately.

SCHEDULE OF OPTIONAL ADVANCE SETTLEMENTS.

OPTIONAL WITH INSURED.-For loss by severance of one or more fingers (at least one entire phalanx), $50; of one or more entire toes, $50. For complete hernia caused solely and directly by such injury as described in Paragraph C, $35. For complete dislocation of the shoulder, $50; elbow, $50; wrist, $50; hip, $90; knee, $60; of two or more bones of foot (not toes), $50; of the ankle, $50; of two or more toes, $15; of two or more fingers, $15. For complete fracture of the skull, both tables, $160; of the lower jaw, $35; of the collar bone, $70; of the pelvis, $115; of the thigh, $140; of the leg (tibia and fibula), $90; of the knee cap, $90; of the arm, between elbow and shoulder, $80; of the forearm (both bones), $75; of two or more ribs, $35; of the foot (two or more bones-not toes), $55; of the hand (two or more bones-not fingers), $50; of two or more toes, $25; of two or more fingers, $25; of the scapula, $75.

(N) BLOOD POISONING.-Blood poisoning and septicaemia due solely to such injury as described in Paragraph C, shall be considered as covered by the accident clauses of this policy.

(0) SURGICAL ATTENDANCE.-In the event of the insured receiving accidental bodily injury as described in Paragraph C, and such injury does not cause loss as provided in the policy, the Company will pay for the dressing of injury by a legally qualified physician or surgeon, the sum of $2.00, upon receipt of the surgeon's statement.

(P) IDENTIFICATION.-There will be furnished to the insured with this policy, an identification badge bearing the number of this policy. If the insured shall, by reason of injury or sickness during the time this policy is in force be physically unable to communicate with friends, the Company will upon receipt of a telegram or other message giving policy number, immediately transmit to the relatives or friends of the insured any information respecting him, and will defray all expenses necessary to put the insured in communication with, and in care of, friends, provided such expense shall not exceed twenty-five dollars ($25.00).

(Q) INCREASE IN BENEFITS.-The benefits provided by this policy shall be increased ten per cent. on any claim accruing hereunder if at the date of the accident or inception of sickness the premium hereon has been paid annually in advance; or, five per cent. if at the date of the accident or inception of sickness the premium hereon has been paid quarterly in advance.

GENERAL PROVISIONS.

(R) No indemnity shall be payable under this policy unless the insured has been regularly attended by a legally qualified physician at least once in each seven days during the time for which claim is made.

(S) The Company is not liable for any loss caused by or from the use of intoxicants or narcotics, or resulting from violation of law by the insured, or from venereal diseases, or from accidents to or diseases of organs not common to both sexes; or from assault, or from unnecessary exposure to obvious risk or injury, or from disability originating or

suffered outside of the States of the United States, the District of Columbia, or Canada, (T) If, at the date of this policy, the insured is over forty and under fifty years of age the sickness indemnity, when the insured reaches the age of fifty years, will be reduced to one-half of the amounts named, and to one-fourth of the amounts named when the insured reaches the age of sixty years. If the insured at the date of this policy is over fifty and under sixty years of age the sickness indemnity, when the insured reaches the age of sixty years, will be reduced to one-half of the amounts named.

(U) No provision of the charter, constitution or by-laws of the Company not included herein shall avoid the policy or be used in evidence in any legal proceeding hereunder. FOR STANDARD PROVISIONS, SEE PAGE 11.

In witness whereof, the said Company has caused this policy to be signed by its president and secretary, but the same shall not be binding upon the Company unless countersigned by its Policy Inspector.

AGREEMENT IN APPLICATION.

I hereby apply to the Massachusetts Accident Company for a policy to be based upon the following representation of facts, and understand and agree that the right to recover under any policy which may be issued upon the basis of this application shall be barred in the event that any one of the following statements, material either to the acceptance of the risk or to the hazard assumed by the Company, is false, or in the event that any one of the following statements is false and made with intent to deceive. I further understand and agree that the agents and solicitors of the Company are not authorized to extend credit, or waive, extend or change any of the terms, conditions or provisions of this application or of the policy.

POLICY FORM—“Non-Cancellable Disability Policy"

AGE 35.

WEEKLY INDEMNITY, $50.

PREMIUM, $109.70.

Massachusetts Accident Company, Boston, Mass. (herein called the Company), in consideration of the representations and agreements contained in the application for this policy (a copy of which application is endorsed hereon and is made a part hereof), and of the payment in advance of one hundred nine dollars and seventy cents,

Does hereby insure under classification No. 1, subject to all the provisions, conditions and limitations herein contained or endorsed hereon, John Doe by occupation, lawyer, being the person described in said application and herein called the insured, for a term of twelve months, beginning on the first day of January, 1915, at 12 o'clock noon, Standard time, at the place where this policy is countersigned, against disability as herein defined, resulting from bodily injuries through accidental means (suicide, sane or insane, or any attempt thereat, sane or insane, is not covered); and against disability by disease, as herein defined, as follows:

PART I. TOTAL ACCIDENT OR ILLNESS DISABILITY.-(a) If the insured suffers a disability from accidental injury or disease which neccessarily, wholly, and continuously disables him from the performance of any and every kind of duty pertaining to his occupation or business, the Company will pay a weekly indemnity at the rate of fifty dollars ($50) per week, during the continuance of such disability, until such time as the Insured may engage in a gainful occupation, but no indemnity shall be payable for the first two weeks of disability, as above described.

PART II. PARTIAL INDEMNITY FOLLOWING TOTAL DISABILITY.-If the insured suffers a disability for which indemnity is payable under Part I and if immediately following such a disability during which the insured is entitled to be paid indemnity, the insured is able to engage in a gainful occupation, but on account of the continuation of disability is necessarily and continuously partially disabled and suffers a loss of business time, the Company will pay as follows:

(a) For such time as the insured suffers a partial disability as defined above and because thereof sustains a three-quarters loss of his business time the Company will pay a weekly indemnity at the rate of seventy-five per cent of the weekly indemnity provided for total disability.

(b) For such time as the insured suffers a partial disability as defined above and because thereof sustains one-half loss of his business time the Company will pay a weekly indemnity at the rate of fifty per cent of the weekly indemnity provided for total disability.

(c) For such time as the insured suffers a partial disability as defined above and because thereof sustains one-quarter loss of his business time the Company will pay a weekly indemnity at the rate of twenty-five per cent of the weekly indemnity provided for total disability.

NO INDEMNITY PAYABLE FOR FIRST TWO WEEKS OF DISABILITY

PART III. TOTAL INDEMNITY FOLLOWING PARTIAL INDEMNITY.-If the insured suffers

a disability for which indemnity is payable under Part II and if immediately following such a disability and solely on account of the continuation of disability the insured is necessarily unable to engage in any occupation or business from which profit may be derived, the Company will pay indemnity as provided in Part I paragraph (b).

PART IV. FIXED INDEMNITIES.-The insured, if he so elect in writing within twenty days from date of injury, may take, in lieu of the weekly indemnity hereinbefore provided, indemnity in one sum according to the Schedule of Fixed Indemnities, if the injury is one set forth in such schedule, but not more than one fixed indemnity shall be paid for injuries resulting from one and the same accident.

SCHEDULE OF FIXED INDEMNITIES. (See Part IV.)-If the weekly indemnity provided by this policy is twenty-five dollars ($25), the following amounts will be paid. If said weekly indemnity is greater or less than $25, the amounts to be paid shall be increased or reduced proportionately. For the complete fracture of bones, viz.-of the skull, both tables, $250; lower jaw, $50; clavicle (collar bone), $75; scapula (shoulder blade), $125; scapula (shoulder blade with complications), $175; thigh, $250; thigh (involving the hip joint), $300; leg (below the knee) both bones, $150; leg (below the knee) one bone, $100; patella (knee cap) $150; patella (with serious knee joint complications), $200; arm, between elbow and shoulder, $250; forearm, both bones, $100; forearm, one bone, $75; two or more ribs, $50; hand, $50; fingers, two or more, $50; one finger, $25; foot, $.0; toes, two or more, $50; one toe, $25. Colles' fracture, $100; Pott's fracture, $150. 1 or complete dislocation, viz.:-of the shoulder, $37.50; elbow, $37.50; wrist, $50; hip, $250; knee, $150; one or more bones of foot, $75; one toe, $25; ankle. $75. For loss by severance, within ninety days from date of accident, viz.: of one or more fingers (at least one entire phalanx), $50; of one or more entire toes, $100.

FOR STANDARD PROVISIONS SEE PAGE 11

OTHER PROVISIONS.

This policy does not cover (1) any disability for which the insured is not necessarily and regularly attended by a legally qualified physician other than the insured; (2) women; (3) any illness contracted or suffered outside the limits of the States of the United States, Canada, or Europe; (4) bodily injury, sustained by the insured while participating or in consequence of having participated in aeronautics.

The copy of the application endorsed hereon is hereby made a part of this contract. No provision of the charter, constitution or by-laws of the Company not included herein shall avoid the policy or be used in evidence in any legal proceeding hereunder.

TRAVEL-TO entitle the insured to receive indemnity after the first six months of disability, he must reside within the States of the United States unless a permit in writing to reside elsewhere is granted by the Company.

PREMIUMS-All premiums shall be payable in advance either at the home office in the city of Boston, or, to an authorized agent of the company. No premium receipt unless signed by the secretary or assistant secretary or treasurer is valid.

RENEWAL RIGHT.-The insured will have the right to renew this policy from year to year upon payment of the premium on or before the anniversary date.

SURRENDER AGREEMENT.-At any time during the life of this policy, if the insured's occupation or business changes to one different than that stated in the policy, the Company hereby agrees upon the surrender of this policy to issue in lieu thereof, upon the written request of the insured, a new policy containing the same provisions as this policy except a change in the amount of the weekly indemnity, the new policy to provide such an amount of weekly indemnity as the premium will purchase in accordance with the Company's published rates and classification of risks and within the limits fixed by the Company filed with the Insurance Department, said rates to be based upon the occupation of the insured at the time of surrender, but so far as age may affect the rates, they are to be based upon the insured's age at the date of issue of the surrendered policy in accordance with said rates and classification.

In witness whereof, the Massachusetts Accident Company, of Boston, Mass., by its president and secretary, has executed these presents, but this policy shall not be valid unless countersigned by an authorized representative of the Company.

Massachusetts Bonding and Insurance Co.

BOSTON, MASS.

Commenced Business 1907. T. J. Falvey, President. John T. Burnett, Sec. and Tres

The Massachusetts Bonding issues a variety of accident and health contracts. The forms in most general use, however, are: the "Improved" Combination Accident-Form A3A, premium $25, and the "Improved" Disability-Form D3A, premium $60, age 18 to 50: and $70, age 51 to 60.

POLICY FORM-"IMPROVED" COMBINATION ACCIDENT PRINCIPAL SUM, $7500-$15000.

WEEKLY INDEMNITY, $25-$50.

ANNUAL PREMIUM, $25.

Massachusetts Bonding and Insurance Company in considertion, of the representations in the applications for this policy, a copy of which is endorsed hereon, and made a part hereof, and of twenty-five dollars premium, Massachusetts Bonding and Insurance Company Boston, Massachusetts.

Hereby insures John L. Johnson, by occupation a lawyer, subject to all conditions and limitations hereinafter contained in the principal sum of seventy five hundred dollars, and for a weekly indemnity of twenty-five dollars, for the term of twelve months from the first day of January, 1914, commencing and ending at twelve o'clock noon, standard time at the place where this policy is countersigned, against bodily injury sustained directly and independently of all other causes through accidental means (suicide or any attempt thereat, sane or insane, not included) as follows:

ACCIDENT INDEMNITIES

PART 1. DEATH, DISMEMBERMENT, LOSS OF SIGHT, SPEECH OR HEARING.-(a) If such injuries shall immediately, continuously and wholly disable and prevent the insured from the date of accident from performing any and every kind of duty pertaining to his occupation and during the period of such continuous disability shall independently and exclusively of all other causes result in any one of the losses specified in Part 1, the company will pay the sum set opposite such loss and in addition weekly indemnity as provided in Part 2, paragraph (a) to the date of such loss.

(B) Or, if within ninety days from the date of the accident irrespective of total disability such injury shall independently and exclusively of all other causes result in any one of the losses specified in Part 1, the company will pay the sum set opposite such loss and in addition weekly indemnity from the date of the accident to the date of such loss at the rate provided in this policy for total disability. For loss of life, or both hands by severance at or above the wrists, or both feet by severance at or above the ankle, or one hand at or above the wrist and one foot at or above the ankle, by severance, or entire sight of both eyes, if irrecoverably lost, or entire sight of one eye, if irrecoverably lost, and one hand at or above the wrist, by severance, or entire sight of one eye, if irrecoverably lost, and one foot at or above the ankle, by severance, or speech and hearing, if entire and irrecoverable, the principal sum; either arm by severance at or above the elbow, or either leg by severance at or above the knee, two-thirds of principal sum; speech or hearing, if entire and irrecoverable, or either hand by severance at or above the wrist, or either foot by severance at or above the ankle, one-half of principal sum; entire sight of one eye, if irrecoverably lost, thumb and index finger of either hand, by severance at or above metacarpo-phalangeal joints, one-third of principal sum.

WEEKLY INDEMNITY

PART 2. TOTAL OR PARTIAL DISABILITY. (a) If such injury shall not result in any of the losses enumerated in Part 1, but shall immediately, continuously, and wholly disable and prevent the insured from performing any and every kind of duty pertaining to his occupation, the company will pay the insured the weekly indemnity above specified so long as the insured suffers said total disability; or,

(b) If such injury shall not wholly disable the insured, as above, but shall immediately

and continuously disable and prevent him from attending to one or more important daily duties pertaining to his occupation, either from date of accident, or following total disability, the company will pay one-half the weekly indemnity above specified for a peri of such partial disability not exceeding fifty-two consecutive weeks.

PART 3. DOUBLE INDEMNITY.-Ifthe insured shall sustain such injuries (1) while in or on a public conveyance provided by a common carrier for passenger service, including platforn, steps and running board thereof; (2) or, while within a passenger elevator (excluding elevators in mines); (3) or, in consequence of the burning of a building while the insured is therein; (4) or, by the explosion of a steam boiler; (5) or, by being struck by lightning; (6) or, in consequence of the collapse of the outer walls of a building while the insured is therein; (7) or, caused by a cyclone or tornado, then and in such event only. the company will pay double the amount otherwise payable under the preceding parts, PART 4. OPTIONAL INDEMNITY. If the insured shall sustain bodily injury received as set forth in this policy and named in the following "Schedule of Optional Indemnities,' he may elect, subject to all the terms and conditions of this policy, to receive the amount of indemnity specified opposite such injury in lieu of all other indemnity for either total or partial disability provided written notice of his choice is given to the company at Boston, within twenty days from the date of the accident. No claim for more than one of the indemnities named in said schedule shall be payable for injuries sustained in any one accident.

SCHEDULE OF OPTIONAL INDEMNITIES.-The amounts stated in the following Schedule of Optional Indemnities are payable under this policy if issued for $25 weekly indemnity' Proportionate amounts are payable if this policy is issued for a larger or smaller sum. Ordinary Accidents, Part 2. For loss of one or more fingers (at least one entire phalanx), $160; one or more entire toes, $200. For complete hernia caused solely and directly by accidental injury, $80. For complete dislocation, viz.: Of the shoulder, $100; elbow, $100; wrist, $120; hip, $300; knee, $160; any bones of foot (not toes), $160; ankle, $160; two or more toes, $60; two or more fingers, $60. For complete fracture of bones, viz.: Of the skull, both tables, $325; lower jaw, $80; clavicle (collar bone), $160; pelvis, $250; thigh, $300; leg (one or both bones), $200; patella (knee cap), $200; arm between elbow and shoulder, $175; forearm between the wrist and elbow, $160; two or more ribs, $100; two or more bones of the foot (not toes), $120; two or more bones of the hand (not fingers), $120; two or more toes, $100; two or more fingers, $100. For travel, etc. accidents, Part 3, the amounts will be double those for ordinary accidents, Part 2.

PART 5. FEES FOR NON-DISABLING INJURIES.-If the insured sustains a bodily injury as set forth in this policy that does not result in any disability, but shall require treatment by a physician, oculist, optician or graduate nurse, the company will reimburse the insured for the cost thereof, to an amount not exceeding one week's indemnity as specified in Part 2, Paragraph (a), provided the receipted bill for such treatment is filed with the company within thirty days from the date of the accident.

PART 6. SPECIAL INDEMNITY.-Blood poisoning resulting directly from bodily injuries insured against, sunstroke as a direct result of exposure to the rays of the sun, freezing caused by involuntary exposure, hydrophobia, and involuntary asphyxiation, shall be deemed bodily injuries within the meaning of this policy.

PART 7. HOSPITAL CHARGES.-If a bodily injury, for which indemnity is payable under this policy, is sustained by the insured, and if on account of said bodily injury, and within ninety days from the date of the accident, the insured is removed to a hospital, the company, provided that no claim is made under Part 8, will pay the insured (in addition to the indemnity payable for said bodily injury) for the period, not exceeding thirteen weeks, during which the insured is necessarily confined in the hospital, one-half of the weekly indemnity specified.

PART 8. INDEMNITY FOR SURGICAL OPERATIONS.-If a bodily injury, for which indemnity is payable under this policy, is sustained by the insured, and if on account of said bodily injury, and within ninety days from the date of the accident, the insured undergoes a surgical operation named in the following "Schedule of Operations," the company will pay the insured in addition to any other indemnity herein provided, the sum set opposite such operation in said schedule; but payment shall not be made for more than one operation resulting from any one accident.

SCHEDULE OF OPERATIONS.-The amounts stated in the following Schedule of Operations are payable under this policy if issued for $25 weekly indemnity. Proportionate amounts are payable if this policy is issued for a larger or smaller sum. Amputation of foot, hand or forearm, $25; leg or arm, $50; thigh, $100; thumb, finger or fingers, $10; toe or toes, $10. Dislocations, reduction of shoulder, elbow, hip, knee or ankle, $25; wrist or lower jaw, $15; thumb, finger or fingers, $10; toe or toes, $10. Excision of shoulder, hip or knee joint, $100; elbow, wrist or ankle joint, $50; toe or toes, $25. Fractures, reduction of nose, lower jaw, collar bone or shoulder blade, $25; breast bone, $10; rib or ribs, $10; upper arm, $35; forearm (one or both bones), $25; wrist or hand, $15; fingers, $10; any of the bones of the pelvis, $50; coccyx, $10; thigh, $75; knee cap or leg bones (one or both), $50; bones of foot (not toes), $15; toe or toes, $10. Gunshot woundsremoval of shot or bullet not necessitating amputation or laparotomy, $25. Laparotomy-opening of the abdominal cavity for an operation on any organ contained therein, $100. Skull trephining for fracture of both tables, $100. Tetanus-injection of antitetanic serum into frontal lobe of brain, $100. Wounds of scalp or other parts-suturing, $5.

PART 9. IDENTIFICATION.-If the insured by reason of such injury shall be physically unable to communicate with relatives or friends, the company, upon receipt of a telegram or message giving the number of this policy, will immediately transmit to relatives or friends any information it may possess respecting him, and will defray the expense necessary to place the insured in their care, but liability for such service and expense shall not be an amount in excess of four weeks' indemnity, as specified in Part 2, Paragraph A.