loss of the sight of both eyes, or in the entire and irrecoverable loss of the use of both hands, or of both feet, or of one hand and one foot, and shall be wholly disabled thereby from engaging in any work or occupation for wages and profit, the company will pay, in lieu of any other indemnity, during the period of such total disability but not exceeding fiftytwo weeks from the commencement thereof, a weekly indemnity at the rate prescribed above for total disability and confinement to the house; and at the expiration of the aforesaid period of fifty-two weeks if the insured shall then survive, the company will pay him a further sum which, together with any indemnity theretofore paid for the disease which shall have caused such disability, shall be equal to the sum of dollars; but no payment shall be made for permanent disability resulting from any disease for which the insured is not treated by a physician, nor from disease beginning within fifteen days from noon of the date of this policy.

The payment for permanent disability shall end this policy.

to

PART G. SURGICAL BENEFITS. ACCIDENT AND HEALTH INSURANCE.-If an operation named in the Schedule of Operations which forms part of this policy shall be performed by a surgeon on account of a bodily injury or disease covered by this policy and within ninety days from the date of accident or commencement of disability by disease, the company will pay the surgical benefit specified in the schedule for such operation in addition to any other indemnity to which the insured may be entitled. If more than one such operation shall be performed on account of injury sustained in one accident or on account of one illness the insured shall receive the largest surgical benefit specified in the schedule for any one of the operations so performed. If an accidental bodily injury shall be sustained which shall not result in death or other disability, or necessitate an operation named in the schedule, but which shall require surgical treatment the company will pay the amount actually expended for such treatment, but not exceeding the amount of the single indemnity hereunder for total loss of time for one week.

PART H. REIMBURSEMENT FOR HOSPITAL CHARGES. ACCIDENT AND HEALTH INSURANCE.-Provided no claim shall be made for surgical benefits under the Schedule of Operations, if a bodily injury or disease for which weekly indemnity is payable under this policy, necessitates the removal of the insured to a hospital within ninety days from the date of accident, or commencement of disability by disease the company will (in addition to the weekly indemnity payable) pay the amount expended weekly by him for hospital charges, but not in excess of fifty per cent (50%) of the single weekly indemnity provided in the policy for total disability, or for a period of more than ten weeks.

PART I. IDENTIFICATION AND REGISTRATION.-If the insured by reason of injury or illness shall be physically unable to communicate with friends, the company, upon receipt of a telegram or other message giving the number of this policy, will immediately transmit to his relatives or friends any information respecting him, and will defray all expenses necessary to put the insured in the care of friends, provided such expense shall not exceed the sum of one hundred dollars.

FOR STANDARD PROVISIONS SEE PAGE 11
ADDITIONAL PROVISIONS

(a) The insurance hereunder shall not cover any injury fatal or non-fatal sustained by the insured while participating in or in consequence of having participated in æro

nautics.

(b) The insurance under Part F shall not cover disease contracted, or sickness or disability sustained, in the tropics or in any part of Alaska or the British possessions in America, north of the sixtieth degree of north latitude; nor shall it cover disability by disease while engaged in military or naval service, nor shall it cover disability for any period for which the insured has either made claim or may become entitled to indemnity from this or any other company or association, for or on account of injuries by accidental violence; nor shall it cover disability, temporary or permanent, unless the disease is contracted and the disability begins while the policy is in force.

(c) A copy of any assignment shall be given within thirty (30) days to the company which shall not be responsible for its validity.

(d) The copy of the application endorsed hereon is hereby made a part of this contract which is made subject thereto. No provision of the charter, constitution or by la s of the company shall avoid the insurance hereunder or be used in evidence or in defense of any claim arising under this policy.

(e) This policy is issued in consideration of the premium of dollars, for the term of months, to commence on the day this policy is dated against accidental bodily injuries, and for the term of days to commence on the fifteenth day after the day this policy is dated against disability by disease and beginning and ending in each case at twelve o'clock noon, standard time, of the place where insured resides, but it may be renewed with the consent of the company, from term to term of months each, by the payment of the aforesaid premium in advance until the insured shall be fifty-one years of age. If the policy shall be renewed thereafter, the renewal premium shall be dollars. SCHEDULE OF OPERATIONS. SURGICAL BENEFITS. If the single weekly indemnity for total loss of time in this policy is $50, the amounts named below shall be payable. If such weekly indemnity is greater or less than $50, the amounts to be paid shall be increased or reduced proportionately. Abscess-incision, $10. Abdomen-cutting into abdominal cavity for diagnosis or treatment of organs therein, $200. Amputation of entire hand, forearm, or foot, $50;leg or arm, $100; thigh, $150; finger or fingers, $20. Aneurism-operation for tying of artery, $70. Appendicitis-abdomen, $200. BoneInjuries to or disease of, removal of diseased portion of bone, $50. Carbuncle-incision, $10. Chest-cutting into thoracic cavity for diagnosis or treatment of organs therein, $50. Cancer of lip-removal of by cutting operation, $50. Dislocation-reduction of hip or knee, $70; shoulder, elbow, or ankle, $50; wrist or lower jaw, $30; thumb, $20;

fingers, $10. Eye, ear, nose or throat-any cutting operation, $20. Eye-removal, $100. Excision-removal of shoulder or hip joint, $200; knee joint, $150; elbow, wrist or ankle joint, $100; toe or toes, $20. Fractures-reduction of nose, lower jaw, collar bone, or shoulder blade, $50; breast bone, or ribs, $20; upper arm, $70; forearm, $50; wrist, $50; hand, $30; fingers, $10; bones of the pelvis (except coccyx), $150; coccyx, $20; thigh, $150; knee cap or leg, $100; bones of foot, $30; toes, $20. Goitre-cutting operation for permanent cure, $150. Gunshot wounds-treatment of, not necessitating amputation or any cutting operation into abdominal cavity, $30. Hydrocele-incision and treatment of sac, $50. Hydrophobia-Pasteur treatment, $100. Inflammation of jointincision into joint, $50. Intestinal obstruction-see abdomen, Kidney see abdomen. Lockjaw,-injection of anti-toxin into skull, $200; injection of anti-toxin into spinal canal, $100. Mastoiditis cutting operation for removal of diseased bone, $100. Nervecutting operation for stretching, $50. Rectum cutting operation for hemorrhoids, external, $30; internal, $50; prolapsed, $50; fistula in ano, $40; malignant stricture, $200. Skull cutting into cranial cavity, $200. Spine or spinal cord-operation with removal of fractured vertebra, $200. Stricture Esophagus cutting operation (external) for permanent cure of, $200. Stone in bladder removal of by cutting or crushing operation, $150. 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. Tumors-removal of by cutting operation, malignant, $100; benign, $30. Varicocele-cutting operation for permanent cure, $50. Veins, varicose cutting operation for permanent cure, $50. Wounds-suturing, $10.

HEALTH INSURANCE (AGES 18 TO 55)

The Limited Health policy issued by the company provides indemnity during twenty-six weeks for illness caused by thirtyseven specified diseases. Also provides one hundred weeks' indemnity should disease result in permanent blindness or incurable paralysis causing loss of the use of two limbs. The annual cost of this policy is $2 for each $5 weekly indemnity, select to ordinary classes; $3.00, medium to hazardous.

POLICY FORM-"GENERAL HEALTH"FORM HD.

ANNUAL PREMIUM, $35, AGES 18 To 5); $15, AGES 51 TO 55. WEEKLY INDEMNITY, $25.

The Travelers Insurance Company, Hartford, Connecticut. In consideration of the application for this policy signed by the insured (a copy of which is endorsed hereon) and of the premium of thirty-five dollars and sunject to all the provisions, and limitations hereinafter contained, does hereby insure James Wilson, by occupation a broker, against disability by disease, as specified in the schedule of indemnities, for the term of 350 days to commence on the 15th day after the day this policy is dated and beginning and ending at twelve o'clock noon, standard time, of the place where the insured resides.

This policy may be renewed with the consent of the company, by payment of the aforesaid premium in advance, from term to term of twelve months each until the insured shall be 51 years of age. If the policy shall be renewed thereafter, the renewal premium shall be forty-five dollars. The date of this policy is January first, 1914.

PART A. SCHEDULE OF INDEMNITIES. TEMPORARY DISABILITY.-For the period of continuous disability during which the insured shall independently of all other causes be necessarily confined to the house and wholly disabled and prevented by bodily disease not hereinafter excepted, from performing any and every kind of duty pertaining to his occupation, the company will pay a weekly indemnity of dollars, and if following such a period of total disability and confinement to the house, he shall be continuously wholly disabled and prevented from performing any and every kind of duty pertaining to his occupation, but shall not be necessarily confined to the house, one-half of said amount per week will be paid to the insured; but no payment shall be made for disability resulting from any disease for which the insured is not treated by a physician, nor from disease beginning within fifteen days from noon of the date of this policy, nor for disability in excess of fifty-two consecutive weeks' duration.

PERMANENT DISABILITY.-If the insured shall contract any disease not hereinafter excepted which shall not result in death but shall result in the entire and irrecoverable loss of the sight of both eyes, or in the entire and irrecoverable loss of the use of both hands, or of both feet, or of one hand and one foot, and shall be wholly disabled thereby from engaging in any work or occupation for wages and profit, the company will pay, in lieu of any other indemnity, during the period of such total disability but not exceeding fifty-two weeks from the commencement thereof, a weekly indemnity at the rate pre

scribed above for total disability and confinement to the house; and at the expiration of the aforesaid period of fifty-two weeks if the insured shall then survive, the company will pay to him a further sum which, together with any indemnity theretofore paid for the disease which shall have caused such disability, shall be equal to the sum of dollars; but no payment shall be made for permanent disability resulting from any disease for which the insured is not treated by a physician, nor from disease beginning within fifteen days from noon of the date of this policy. Payment for permanent disability shall end this policy.

PART B. REIMBURSEMENT FOR HOSPITAL CHARGES.-Provided no claim shall be made for surgical benefits under the Schedule of Operations, if a disease for which weekly indemnity is payable under this policy, necessitates the removal of the insured to a hospital within ninety days from the date of commencement of disability by disease the company will (in addition to the weekly indemnity payable) pay the amount expended weekly by him for hospital charges, but not in excess of fifty per cent (50%) of the weekly indemnity provided in the policy for temporary disability, or for a period of more than ten

weeks.

PART C. SURGICAL BENEFITS.-If an operation named in the Schedule of Operations shall be performed by a surgeon on account of a disease covered by this policy and within ninety days from the date of the commencement of disability the company will pay the surgical benefit specified in the schedule for such operation in addition to any other indemnity to which the insured may be entitled. If more than one such operation shall be performed on account of one illness the insured shall receive the largest surgical benefit specified in the schedule for any one of the operations so performed.

SCHEDULE OF OPERATIONS. SURGICAL BENEFITS.-If the rate of weekly indemnity for temporary disability under this policy is $50, the amounts below shall be payable; if greater or less than $50; the payments shall be increased or reduced proportionately. Abscess-incision, $10. Abdomen-cutting into abdominal cavity for diagnosis or treatment of organs therein, $200. Aneurism-non-traumatic-operation for, by tying of artery, $70. Appendicitis-see abdomen. Bone disease of removal of diseased portion of bone, $50. Carbuncle-incision, $10. Chest-cutting into thoracic cavity for diagnosis or treatment of organs therein, $50. Cancer, lip-removal of, by cutting operation, $50. Eye, ear, nose or throat-any cutting operation, $20. Eye-removal of. $100. Gangrene-amputation of fingers or toes, $20; foot or hand, $50. Goitrecutting operation for permanent cure, $150. Hydrocele-incision and treatment of sac, $50. Inflammation of joint-incision into joint, $50. Intestinal obstruction-see abdomen. Kidney-see abdomen. Mastoiditis cutting operation for removal of diseased bone, $100. Nerve cutting operation for stretching, $50. Rectum-cutting operation for hemorrhoids, external, $30; internal, $50; prolapsed $50; fistula in ano, $40; malignant stricture, $200. Skull-cutting into cranial cavity for non-traumatic lesions, $200. Stricture Esophagus, cutting operation (external) for, $200. Stone in bladder-removal of, by cutting or crushing operation, $150. 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. Tumors -removal of, by cutting operation-malignant, $100; benign, $30. Varicocele-cutting operation for permanent cure, $50. Veins-varicose-cutting operation for permanent cure, $50.

FOR STANDARD PROVISIONS SEE PAGE 11
ADDITIONAL PROVISIONS

(a) This insurance shall not cover disease contracted, or sickness or disability sustained, in the tropics, or in any part of Alaska or the British Possessions in America, north of the sixtieth degree of north latitude; nor shall it cover disability by disease while engaged in military or naval service; nor shall it cover disability for any period for which the insured has either made claim or may become entitled to indemnity from this or any other company or association, for or on account of injuries by accidental violence; nor shall it cover disability, temporary or permanent, unless the disease is contracted and the disability begins while the policy is in force.

(b) The copy of the application endorsed hereon is hereby made a part of this contract which is made subject thereto. No provision of the charter, constitution or bylaws of the company shall avoid the insurance hereunder or be used in evidence or in (defense of any claim arising under this policy.

United States Casualty Company

NEW YORK CITY.

Commenced Business May, 1895.

EDSON S. LOTT, Pres. and Gen. Mgr.

D. G. LUCKETT, Secretary.

The United States Casualty Company issues separate accident and separate health policies for all classifications in any amount, also accident and health policies combined in one form. The following forms are issued:

The "Income" Disability policy, premium $40, covers all accidents and all diseases. The accident and health portions of this policy are not sold separately. Covers weekly indemnity only. Does not cover death or dismemberment. Policy is effective immediately. House confinement is not required. Total disability indemnity is payable, for either accident or illness, for 100 weeks, and partial disability indemnity is payable for 20 weeks. Double indemnity is payable for 15 weeks while the insured is confined in a hospital, through either accident or illness, and surgeon's fees are payable in addition to extra hospital indemnity. Double indemnity for traveling accidents includes injuries sustained while on the platform, steps, or running board of railway or street railway cars. Doctor's bills paid for non-disabling injuries.

The "Complete" Disability policy, premium $60, covers all accidents and all diseases. The accident portion of the policy is issued separately at a premium of $25. Under its accident portion it provides a $7,500-$15,000 death benefit with proportionately large indemnities for dismemberment; double indemnity for traveling accidents includes injuries sustained while on the platform, steps or running board of railway or street railway cars; total disability indemnity is paid during the lifetime of the insured; the policy also provides for surgeons' fees, medical attendance, optional "lump sum" payments, etc. Under the health portion it provides specified indemnities for loss of leg, arm or eye by any disease; it pays total disability indemnity for 52 weeks; it pays full indemnity during convalescence; it pays double weekly indemnity while the insured is confined in a hospital; it also provides additional surgeon's fees.

The "Standard" Disability policy, premium $60, covers all accidents and all diseases. The accident portion of the policy is sold separately at a premium of $25. The health portion of the policy is sold separately at a premium of $35. Under its accident portion it provides an accumulation feature; double indemnity for traveling accidents includes injuries sustained while on the platform, steps or running board of railway or street railway cars; total disability indemnity is paid during the lifetime of the insured; the policy also provides for additional hospital indemnity, surgeons' fees, medical attendance, optional "lump sum" payments, etc. Under the health portion it provides specific indemnities for loss of leg, arm or eye by any disease (these indemnities increase 10 per cent each year for five years); it pays total disability indemnity for 52 weeks; it pays full indemnity during convalescence; it pays additional indemnity while the insured is confined in a hospital; it pays full indemnity during convalescence; it also provides additional surgeons' fees.

The "Perfect" Disability policy, premium $60, covers all accidents and all diseases. The accident portion of the policy is issued separately at a premium of $25. The health portion of the policy

is issued separately at a premium of $35. Under its accident portion it provides an accumulation feature; double indemnity for traveling accidents includes injuries sustained while on the platform, steps or running board of railway or street railway cars; total disability indemnity is paid for two hundred weeks; the policy also provides for surgeons' fees, medical attendance, optional 'lump sum" payments, etc. Under the health portion it provides specific indemnities for loss of leg, arm or eye by any disease (these indemnities increase 10 per cent each year for five years); it pays total disability indemnity for 52 weeks; it pays full indemnity during convalescence; it also provides additional surgeons' fees. POLICY FORM-“INCOME DISABILITY POLICY"

WEEKLY INDEMNITY, $25-$50.

ANNUAL PREMIUM, $40.

United States Casualty Company does hereby insure, under classification No. 1, John Doe of New York City, by occupation a bookkeeper in office, herein called the Insured, for twelve months, beginning at noon, standard eastern time, on the fifth day of January, 1916, subject to the provisions and conditions and limits herein, against loss resulting from bodily injury effected solely through accidental means, herein called such injury, and against loss resulting from sickness or disease, herein called such sickness, as follows:

ACCIDENT INSURANCE

SECTION I. TOTAL DISABILITY INDEMNITY.-If such injury shall, from the date of accident, immediately, continuously and totally disable and prevent the insured from performing any and every duty pertaining to his occupation, the Company will pay for the period of such disability, not exceeding one hundred consecutive weeks, an indemnity per week of twenty-five dollars ($25).

PARTIAL DISABILITY INDEMNITY. If such injury shall, from the date of accident, or immediately following a period of total disability as above defined, continuously partially disable and prevent the insured from performing one or more of the important duties pertaining to his occupation, the Company will pay for the period of such disability, not exceeding twenty consecutive weeks, an indemnity per week of one-half of the weekly indemnity specified in this section for total disability.

SECTION II. DOUBLE INDEMNITY.—If such injury shall result as aforesaid and is sustained (1) while the insured is a passenger and is in or on a public conveyance provided by a common carrier for passenger service (including the platform, steps or running board of railway or street railway cars); or (2) while the insured is a passenger within a passenger elevator (mine elevators excepted); or (3) in consequence of the collapse of the outer walls of a building while the insured is therein; or (4) in consequence of the destruction of a building by fire while the insured is therein, then the amount payable as provided in Sections I or VI shall be doubled.

SECTION III. ADDITIONAL HOSPITAL INDEMNITY.-If such injury shall necessitate the removal of the insured to a hospital and shall require continuous confinement therein, the Company will pay, in addition to any other indemnity to which the insured may be entitled, for the period of such confinement, not exceeding fifteen consecutive weeks, an indemnity per week equal in amount to the weekly indemnity specified in Section I for total disability. SECTION IV. MEDICAL ATTENDANCE INDEMNITY.-If such injury shall not result in any one of the losses enumerated herein but shall require treatment by a physician, the Company will reimburse the insured for the cost thereof, not exceeding an amount equal to the indemnity for one week specified in Section I for total disability, provided the physician's receipt and affidavit on the Company's form be furnished the Company at its Home Office in New York City within ninety days from the date of accident.

SECTION V. ADDITIONAL INDEMNITY FOR SURGICAL OPERATIONS.-If such injury shall, within ninety days from the date of accident, necessitate one of the surgical operations enumerated in "Schedule A of Surgical Operations" endorsed hereon, the Company will pay in addition to any other indemnity to which the insured may be entitled, the amount provided in said schedule for such operation, but payment shall not be made for more than, one operation resulting from any one accident, nor for any operation not enumerated in said schedule. The amounts specified in said schedule are payable if the total disability indemnity specified in Section I is $25 per week; if such indemnity is greater or less, the amounts payable under said schedule shall be increased or decreased proportionately.

SECTION VI. ELECTIVE INDEMNITY.-If the insured shall be entitled to indemnity for an injury and such injury shall result in a loss enumerated in the "Schedule of Elective Indemnities" endorsed hereon, he may elect to receive in lieu of all other indemnity (but not excluding any additional indemnity that may be due under Section V) the amount provided in said schedule for such loss, provided he shall signify his choice in writing to the Company at its Home Office in New York City within thirty days from the date