John Doe
5678 Elm Street
Nowhere, FL 67890

 

January 1, 2000 

The Life Insurance Company
1234 Main Street
Anytown, ST 12345-6789 

Re:      Policy Number 12-3456-789
            Insured            John Doe

 

Dir Sir or Madam:  

Please furnish an illustration of hypothetical policy values for the above referenced life insurance policy as follows:

·         A Ledger Illustration based on current pricing assumptions as to mortality, expenses, and interest crediting rates and/or dividend scales, and showing year-by-year hypothetical policy values as to planned periodic premiums and/or policy loan interest paid in cash (if any), net cash surrender values (net of any policy loans), net policy account values (if different from cash surrender values), net death benefits, and policy loans (if any). 

·         Detailed accounting/expense pages corresponding to the above Ledger Illustration showing projected policy pricing elements including, but not limited to, premium-based loads (if any), cash-value-based expenses (if any), fixed-type charges (if any), projected current cost of insurance charges, and dividends (if any).  If the illustration system for the above referenced product does not provide detail for one or more of these policy expenses, please also furnish a product guide and/or prospectus that summarizes these charges.  

In both cases, please calculate hypothetical policy values and expenses assuming the current planned periodic premium is continued until such time as cash values are projected to endow for the original policy face amount (e.g. calculate the earliest point at which the current planned periodic premium may be stopped such that the projected cash value at endowment is equal to or greater than the original policy face amount). 

In addition, if the policy pays a declared interest rate and/or dividend scale, please illustrate this current rate/scale.  If policy earnings are based on performance of variable life separate accounts, please illustrate a 10 % net earnings rate (i.e. net of investment advisory/management fees and fund operating expenses, but before mortality and expense risk charges or other policy level cash-value-based charges are deducted).

Please send a hard copy of the above information to directly to the address of record, and send a fax copy to (877) 847-1613.  Thank you in advance for your prompt and courteous response. 

 

Sincerely,  

John Doe

Policyowner