foot, and if, wholly because of such loss of sight or such paralysis, the Insured shall be continuously and wholly disabled and prevented from performing any and every duty pertaining to his occupation for a period of one year, and at the end of said period of one year shall still survive and shall be declared, by medical authority satisfactory to the company, to have totally and irrecoverably lost the sight of both eyes or the entire use of both hands or both feet or of one hand and one foot and to be permanently unable to perform any and every duty pertaining to his occupation, the company will pay the full principal sum above specified.

CLAUSE 2. TOTAL DISABLEMENT WITH CONFINEMENT.-If such disease or sickness, alone and independently of all others causes and while this insurance is in force and effect, shall continuously and wholly disable and prevent the Insured from performing any and every duty pertaining to his occupation and shall continuously and necessarily confine the Insured to the house under the continuous care and regular treatment of a legally authorized physician, the company will pay the weekly indemnity above specified for the period of such total disablement and confinement, not exceeding 52 consecutive weeks. CLAUSE 3. TOTAL DISABLEMENT FOLLOWING CONFINEMENT.-If such disease or sickness, alone and independently of all other causes and immediately following such confinement to house, shall continously and wholly disable and prevent the Insured from performing any and every duty pertaining to his occupation and shall require and receive the continuous care and regular treatment of a legally authorized physician, the company will pay three-fifths of the weekly indemnity above specified for the period of such total disablement, not exceeding 26 consecutive weeks.

CLAUSE 4. TOTAL DISABLEMENT WITHOUT MEDICAL TREATMENT.-If such disease or sickness, alone and independently of all other causes and immediately following such confinement to house, shall continously and wholly disable and prevent the insured from performing any and every duty pertaining to his occupation, but shall not require such medical care and treatment, the company will pay two-fifths of the weekly indemnity above specified for the period of such total disablement which shall be certified to as neces sary by the physician or physicians in attendance throughout the entire sickness, not ex ceeding 10 consecutive weeks.

CLAUSE 5. PARTIAL DISABLEMENT.-If such disease or sickness, alone and independently of all other causes and immediately following such confinement to house, shall continuously and wholly disable and prevent the insured from performing some one or more important daily duty or duties pertaining to his occupation and shall require and receive the continuous care and regualr treatment of a legally authorized physician, the company will pay three-tenths of the weekly indemnity above specified for the period of such partial disablement, not exceeding 10 weeks.

CLAUSE 6. DOUBLE HOSPITAL INDEMNITY.-In such disease or sickness, alone and independently of all other causes and while this insurance is in force and effect, and within ninety days from the beginning of such disease or sickness, shall necessitate the removal of the insured to any regular hospital, the weekly indemnity payable for the period, not exceeding 10 consecutive weeks, during which he shall be continuously and necessarily confined in said hospital, shall be double the amount provided in Clause 2.

CLAUSE 7. SURGICAL OPERATIONS.-If such disease or sickness, alone and independently of all other causes and while this insurance is in force and effect, shall necessitate the performance upon the Insured, within ninety days from the contraction of such disease or sickness, of any surgical operation specified in the schedule endorsed hereon, the company will pay the sum set opposite the said operation in the said schedule, provided always that if more than one such operation shall be necessitated as the result of any one disease or sickness, payment shall be made for the first one only, and provided that the Insured shall not make claim under clauses 6 on account of the same disease or sickness.

POLICY FORM-"GOLD MEDAL DISABILITY"

PRINCIPAL SUM, $7500-$15,000. WEEKLY INDEMNITY, $25-$50. ANNUAL PREMIUM TO AGE 50, $65; AGE 51-55, $75

The Metropolitan Casualty Insurance Company of New York, in consideration of the premium and of the statements in the application, copy of which is endorsed hereon, hereby insures the person named in Statement 1 of the said application, for the period hereinafter stated, (A) against the effects of bodily injuries sustained directly, solely and exclusively through accidental means (not including suicide or any attempt thereat, while sane or insane, or injuries, fatal or otherwise, sustained while engaged in aviation or aeronautics) and (B) against the effects of disease or sickness contracted while this insurance is in force and effect, as hereinafter limited and provided, to wit:

ACCIDENT BENEFITS

CLAUSE 1. LOSS OF LIFE, LIMB, SIGHT.-If such injuries, directly, solely, exclusively and independently of all other causes, shall, from the date of the accident, wholly and continuously disable and prevent the insured from performing any and every kind of duty pertaining to his occupation and if, during the period of such total and continuous disablement and within 200 weeks from the date of the accident, such injuries shall,

directly, solely, exclusively and independently of all other causes, result in any one of the losses named in the following schedule, the Company will pay the amount set opposite such loss and, in addition thereto, the weekly indemnity from the date of the accident to the date of such loss.

Or, if such injuries shall not so disable the insured, but shall, directly, solely, exclusively and independently of all other causes and within 90 days from the date of the accident, result in any one of the losses named in the following schedule, the Company will pay the amount set opposite such loss.

SCHEDULE REFERRED TO IN CLAUSE 1.-For loss of life, for total and irrecoverable loss of sight of both eyes, for loss of both hands by severance at or above the wrist, or both feet by severance at or above the ankle, or one hand and one foot by severance at or above wrist and ankle, or one hand by severance at or above the wrist and the total and irrecoverable loss of sight of one eye, or one foot by severance at or above the ankle and the total and irrecoverable loss of sight of one eye, the full principal sum. For loss of one hand by severance at or above the wrist, or one foot by severance at or above the ankle, three-fifths of the principal sum. For total and irrecoverable loss of sight of one eye, or for loss of the right thumb and index finger by severance at or above the metacarpo-phalangeal joint, one-half of the principal sum. For loss of the left thumb and index finger by severance at or above the metacarpo-phalangeal joint, onethird of the principal sum. Provided always that, if more than one of the losses enumerated in the above schedule shall result from any one accident, payment shall be made only for the one for which the largest amount is specified and, in the event of loss of sight of one or both eyes or of loss of one or more hands or feet, this insurance shall immediately cease and upon payment of claim therefor, if any, the policy shall be surrendered to the Company.

CLAUSE 2. TOTAL DISABLEMENT.-If such injuries shall not result as specified in Clause 1, but, directly, solely, exclusively and independently of all other causes, shall, immediately or within two weeks from the date of the accident, 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 for the entire period of such total disablement.

CLAUSE 3. PARTIAL DISABLEMENT.-If such injuries shall not result as specified in Clause 1, but, directly, solely, exclusively and independently of all other causes, shall, immediately or within two weeks from the date of the accident or immediately following total disablement, continuously disable and prevent the insured from performing some one or more important daily duty or duties pertaining to his occupation, the Company will pay the insured one-half of the weekly indemnity for the period of such partial disablement, not exceeding 52 weeks.

CLAUSE 4. DOUBLE INDEMNITIES.-If such injuries be received (a) while the insured is riding as a passenger in or on any public conveyance of a common carrier regularly provided for passenger service (including the platform, steps or running board of such conveyance, but not while or in consequence of attempting to enter or leave such conveyance); or (b) while a passenger in a regular passenger elevator; or (c) in consequence of the burning of any building while the insured is therein or in which the insured shall be at the commencement of the fire; or (d) in consequence of a stroke of lightning; or (e) in consequence of the collapse of the outer walls of a completed building while the insured is therein; or (f) in consequence of the explosion of a steam boiler; or (g) in consequence of a cyclone or tornado; or (h) in consequence of a collision at a public crossing between any private vehicle in which the insured shall be riding and a moving engine, car or train propelled by steam or electricity over a railroad upon which trains are regularly operated by steam as a motive power, the amounts payable for any of the losses enumerated in the preceding clauses shall be doubled; or (i) if such injuries be received while the insured is absent from his home and shall alone necessarily prevent his removal to his home, the weekly indemnity payable for the period of total disablement during which the insured shall be continuously and necessarily confined to the house and necessarily prevented, solely by such injuries, from being removed to his home, shall be doubled; or (j) if such injuries shall necessitate the removal of the insured to any regular hospital, the weekly indemnity payable for the period not exceeding ten consecutive weeks, during which the insured shall be confined in said hospital, shall be doubled, provided that the insured shall not make claim under Clause 13 on account of the same injuries. CLAUSE 5. SPECIAL INDEMNITIES.-Sunstroke, freezing, hydrophobia or septicemia, exclusively due to bodily injury caused by accidental means, or the involuntary and unconscious taking or inhalation of any gas or poisonous vapor, shall be fully covered under the foregoing provisions.

CLAUSE 6. MEDICAL ATTENDANCE. If any injury covered by this policy and sustained by the insured does not cause an effect for which an indemnity is provided by this policy, but requires and receives treatment by a legally authorized physician, the Company will reimburse the insured for the cost of such treatment, not exceeding one week's indemnity.

CLAUSE 7. IDENTIFICATION.-If the insured shall, wholly by reason of injury sustained during the time this policy is in force, be rendered physically unable to communicate with friends, the Company will, upon receipt of a telegram or other message giving this policy number, immediately transmit to the relatives or friends of the insured any information respecting him, and defray all expenses necessary to put the insured in communication with and in the care of friends, not exceeding a sum equal to four weeks' indemnity.

CLAUSE 8. OPTIONAL INDEMNITIES.-If the insured shall, within the terms of this policy, sustain any injury specified in the following schedule, he may, subject to all the provisions and agreements of this policy, elect to receive, in lieu of all other sums herein provided, the amount set opposite such injury, provided he signifies such choice in writ

ing and delivers the same to the Company at New York City within twenty days from the date of such injury, and provided always that if more than one such injury shall result from any one accident, payment shall be made only for the one for which the largest amount is specified.

SCHEDULE REFERRED TO IN CLAUSE 8.-If the rate of weekly indemnity be $50, the amounts below shall be payable; if more or less than $50, the amounts shall be increased or reduced proportionately. If such injuries shall be received as provided in sub-divisions (a) to (h) inclusive, of Clause 4, then the amounts shall be doubled.

For the complete fracture of: skull, both tables, $600; lower jaw, $150; collar bone, $200; shoulder blade, $200; thigh, $400; thigh (involving the hip joint), $600; leg, $400; knee cap, $400; arm, between elbow and shoulder, $300; arm, between wrist and elbow, $300; two or more ribs, $100; hand or finger, $200; foot or toe, $200; Colles' fracture, $300; Pott's fracture, $400. For the complete dislocation of: shoulder, $100; elbow, $200; wrist, $200; hip, $500; knee, $300; any bone of foot or toe, $150; ankle, $300. For loss by severance, within ninety days from date of the accident, of: one or more entire fingers, $200; one or more entire toes, $300.

SICKNESS BENEFITS

CLAUSE 9. BLINDNESS OR PARALYSIS.-If such disease or sickness, alone and independently of all other causes and while this insurance is in force and effect, shall result in the total and irrecoverable loss of sight of both eyes, or permanent paralysis whereby the insured shall entirely lose the use of both hands or of both feet or of one hand and one foot, and if, wholly because of such loss of sight of such paralysis, the insured shall be continuously and wholly disabled and prevented from performing any and every kind of duty pertaining to his occupation for a period of one year, and at the end of said period of one year shall still survive and shall be declared, by medical authority satisfactory to the Company, to have totally and irrecoverably lost the sight of both eyes or the entire use of both hands or of both feet or of one hand and one foot and to be permanently unable to perform any and every kind of duty pertaining to his occupation, the Company will pay a sum equal to the weekly indemnity for 150 weeks. But the right to make claim under this clause shall exclude all other claims based upon the same disease, sickness or disablement.

CLAUSE 10. TOTAL DISABLEMENT.-If such disease or sickness, alone and independently of all other causes and while this insurance is in force and effect, shall continuously and wholly disable and prevent the insured from performing any and every kind of duty pertaining to his occupation and shall require and receive the continuous care and regular treatment of a legally authorized physician, the Company will pay the weekly indemnity above specified for the period of such total disablement, not exceeding 52 consecutive weeks.

CLAUSE 11. PARTIAL DISABLEMENT.-If such disease or sickness, alone and independently of all other causes and immediately following such total disablement, shall continuously and wholly disable and prevent the insured from performing some one or more important daily duty or duties pertaining to his occupation, and shall require and receive the continuous care and regular treatment of a legally authorized physician, the Company will pay one-half of the weekly indemnity above specified for the period of such partial disablement, not exceeding 10 weeks.

CLAUSE 12. DOUBLE HOSPITAL INDEMNITY.-If such disease or sickness, alone and independently of all other causes and while this insurance is in force and effect, and within ninety days from the beginning of such disease or sickness, shall necessitate the removal of the insured to any regular hospital, the weekly indemnity payable for the period not exceeding 10 weeks, during which he shall be continuously and necessarily confined in the said hospital, shall be doubled, provided that the insured shall not make claim under Clause 13 on account of the same disease or sickness.

ACCIDENT OR SICKNESS BENEFITS

CLAUSE 13. SURGICAL OPERATIONS. If any injury or disease covered by this policy shall, within ninety days from the date of the accident or of the contraction of the disease, alone and necessarily require any surgical operation named in the following schedule, the Company will pay the insured the sum set opposite the said operation in the said schedule, provided always that if more than one such operation shall be necessitated as the result of any one accident or disease, payment shall be made for the first one only. SCHEDULE REFERRED TO IN CLAUSE 13.-If the rate of weekly indemnity be $50 or over, the amounts below shall be payable; if less than $50, the amounts shall be reduced proportionately.

Abscess-incision, $10. Abdomen-cutting into for diagnosis or treatment of organs therein, $200. Amputation of: entire hand, forearm or foot, $50; leg or arm, $100; thigh, $200; finger or fingers, $20; toe or toes, $30. Aneurism operation for, by tying of artery, $100. Appendicitis (see Abdomen). Bone-removal of diseased portion of bone, $50. Carbuncle-incision, $10. Chest-cutting into for diagnosis or treatment of organs therein, $70. Cancer-lip, removal of, by cutting operation, $30. Dislocation -reduction of: hip or knee, $50; shoulder, elbow or ankle, $30; wrist or lower jaw, $20; thumb or finger, $10. Excision-shoulder, hip or knee joint, $100; elbow, wrist or ankle joint, $100; toe joint, $20. Eye, ear, nose any cutting operation, $20. Eye, removal of, $100. Fractures, reduction of: nose, lower jaw, collar bone, or shoulder blade, $30; breast bone or ribs, $10; upper arm. $50; forearm, $30; wrist, $30; hand, $30; finger, $20; bones of pelvis, $100; coccyx, $20; thigh, $50; knee cap or leg, $50; bones of foot, $20; toes, $20. Gangrene amputation of: fingers or toes, $20; foot or hand, $50. Goitre -cutting operation for permanent cure, $100. Gunshot wounds-removal of shot or bullet, $39. Hydrocele-incision and treatment of sac, $20. Hydrophobia-Pasteur

treatment, $100. Inflammation of joint-incision into joint, $30. Intestinal obstruction (see Abdomen). Kidney (see Abdomen). Lockjaw-injection of antitoxin into skull, $100; injection of antitoxin into spinal canal, $100. Mastoiditis-cutting operation for removal of diseased bone, $100. Nerve cutting operation for stretching, $50. Rectum cutting operation for: hemorrhoids, external, $20; hemorrhoids, internal, $20; prolapsed, $30; fistula in ano, $30; malignant stricture, $100. Rupture cutting operation for complete and permanent cure, $100. Skull-cutting into cranial cavity, $200. Spine or spinal cord-operation with removal of fractured vertebra, $200. StrictureOesophagus. Cutting operation (external) for, $100. Stone in bladder-removal of, by cutting or crushing operation, $100. Tapping of: abdomen, $50; bladder, $30; chest, $30; ear drum, $20; hydrocele, $20; joints, $20. Trachea-cutting into for removal of foreign bodies or for relief of difficult breathing, $70. Throat-any cutting operation, $20. Tumors-removal of, by cutting operation, malignant, $100; benign, $20. Varicocele cutting operation for permanent cure, $50. Veins-varicose. Cutting operation for permanent cure, $50. Wounds-suturing, $10.

CLAUSE 14. LIMIT OF INSURANCE. The insurance under Clauses 1 to 8, inclusive, of this policy shall not cover any loss or disablement caused wholly or partly by disease, or by bodily or mental infirmity, or by bacterial infection (excepting only septic infection of and through a visible wound accidentally sustained). The insurance under Clauses 9 to 13, inclusive, of this policy shall not cover any disease, sickness or disablement contracted or suffered while engaged in military or naval service, or while in Alaska, the insular possessions of the United States, the British possessions in America north of the 60th degree of north latitude, or elsewhere outside of the limits of the United States, Canada and Europe; nor shall it cover any disease, sickness or disablement which is caused wholly or partly by the use of intoxicants or narcotics or which results from or is the sequel of any disease contracted prior to the date of this policy; nor shall it cover disablement for any period for which the insured may claim or be entitled to claim indemnity from this or any other company or association for or on account of injuries caused by accidental violence.

CLAUSE 15. SPECIAL PROVISIONS.-The copy of the application endorsed hereon is hereby made a part of this contract. No provisions of the charter, constitution, or bylaws of the Company not included herein shall avoid the policy or be used in evidence in any legal proceedings hereunder. This policy is issued by the Company and accepted by the insured subject to the following provisions prescribed by law and shall be void if any of the statements or answers in the application are false and such false statements or answers are made with intent to deceive or if such false statements or answers materially affect either the acceptance of the risk or the hazard assumed by the Company. Failure of the insured or beneficiary to comply with any of the provisions or requirements of this policy shall invalidate all claims.

FOR STANDARD PROVISIONS SEE PAGE 11

Subject to the foregoing provisions, this policy shall continue in force for the period of twelve months from January 1, 1916, noon, standard time at the place where the insured resides, for which the premium is $65, and may be renewed for any subsequent period, with the consent of the Company, by the payment of the premium in advance, subject, however, to all the conditions and provisions of the policy. The occupation of the insured is accountant, classified select.

In witness whereof, The Metropolitan Casualty Insurance Company of New York has caused this policy to be signed by its president and secretary in the City of New York, but the same shall not be binding upon the Company until countersigned by a duly authorized representative of the Company, and delivered to the insured while he is in good health.

National Life and Accident Insurance Company

NASHVILLE, TENN.

Commenced Business 1900. C. A. CRAIG, Pres. C. R. CLEMENTS, Sec'y and Treas.

The National issues an industrial policy on the basis of 5 cents, weekly premium and multiples thereof up to 35 cents weekly. The age limits are 2 to 54. Males or females 9 and under next birthday are not insured for more than 10 cents per week. Males or females 14 and under next birthday not insured for more than 15 cents. Males not insured for more than 25 cents on females for more than 15 cents except under special authority from the home office. The benefits per 5 cents weekly premium, class A policy are as follows:

Weekly

Weekly

Weekly

Ages next Death Sick and Ages next Death Sick and Ages next Death Sick and Birthday Benefit Accident Birthday (Benefit Accident Birthday

[Benefit Accident Benefit

Benefit

Benefit

Benefits under higher rates are in exact proportion to the premium.

POLICY FORM-CLASS A, MALE RISK.

The National Life and Accident Insurance Company, Nashville, Tennessee, in consideration of the application for this policy, which is hereby referred to and made a part of this contract, and in further consideration of the payment in advance of the premium stated in schedule below, on or before every Monday hereafter during the life of the insured, twenty (20) per cent of which premium is for life insurance, and eighty (80) per cent of which is for insurance against disability from sickness or accident, The National Life and Accident Insurance Company doth hereby agree, subject to the conditions herein, to pay to the beneficiary the amount of death benefit provided herein within twenty-four (24) hours after due proof of death has been furnished the Company, and in case of sickness or accident to pay to the insured the weekly benefits named in schedule below according to the terms hereof: