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ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE - ADDITIONAL BENEFIT: SEAT BELT USE GCERT2000 52 add/seatbelt If You die as a result of an accidental injury, We will pay this additional Seat Belt Use benefit if: 1. We pay a benefit for loss of life under the ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE section; 2. this benefit is in effect on the date of the injury; and 3. We receive Proof that the deceased person: · was in an accident while driving or riding as a passenger in a Passenger Car; · was wearing a Seat Belt which was properly fastened at the time of the accident; and · died as a result of injuries sustained in the accident. A police officer investigating the accident must certify that the Seat Belt was properly fastened. A copy of such certification must be submitted to Us with the claim for benefits. Passenger Car means any validly registered four-wheel private passenger car. It does not include any commercially licensed car or any private car being used for commercial purposes. Seat Belt means any restraint device that: · meets published United States Government safety standards; · is properly installed by the car manufacturer; and · is not altered after the installation. BENEFIT AMOUNT The Seat Belt Use benefit is an additional benefit equal to 10% of the Full Amount shown in the SCHEDULE OF BENEFITS . However, the amount We will pay for this benefit will not be less than $1,000 or more than $25,000 . BENEFIT PAYMENT For loss of Your life, We will pay benefits to Your Beneficiary.

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