OCR Text |
Show wrw'T"! p'""" rr,," r"j""i pT-'T'l l Fvl f "7 1 ..'-.;,:' -I Fill out NOW and mail with your payment to the Central National yPI f PLAF Insurance Company 700 S. 72nd Street, Omaha, Nebraska 68114 lj u f i m f , . NAME (.nsured) nI Li .1 hereby apply to Central National Life Insurance Company of Omaha, Nebraska, for a Hospital Indem- ADDRESS -,. nity "Tri-Five Plan" Form AH 6SGRI-I250. btreet r- - .Ja Enclosed is the initial enrollment premium of $1 " f ..' .1 " Please indicate your preference: AGE BIRTH DATE SEX . ' J I I Bill me monthly, hereafter for the regular pre- Mo- Da Yr- I I mium according to the following rate schedule: BENEFICI ARY . E AGE MONTHLY RENEWAL PREMIUMS: Please enroll the following members of my family-l understand each is P"! ;1 50 and over $5.00 eligible for the special $1 enrollment: ? j A thrH"49; SPOUSE: BIRTH LlJ J 39 and under 3.50 NAME AGE DATE Dependents 18 and under 1.50 First Middle Last Mo. Day Yr. Em NO CHANGE AS AGE INCREASES CHILDREN: BIRTH Fl "Add the premiums for each person covered by your "Tri- NAME AGE DATE -SEX I -1 M Five Plan" policy to compute your total monthly premium. First Middle BIRTH M" Day Yr' V. I 1 I desire to use the Automatic Bank Plan to pay NAME . AGE DATE SEX my monthly premiums. First Middle BRTH Mo- DaV Yr- n I understand my "Tri-Five Plan" coverage will begin NAME AGE DATE SEX fi-l on the date this application is approved and my poli- First Middle Mo. Day Yr. r is cy is issued, and that pre-existing conditions are cov- BIRTH f.-, Ir',. ered after 24 months. NAME AGE DATE SEX Stal First Middle Mo. Day Yr. Bsa I DATE SIGNATURE "j ' 'm j ' ' ' "- f - Central 'National llife'$ "Tri-Five Man" is Guaranteed Renewable for life pays, up to 555 daysf more tban $9,Q0Q, eacb time you me hospitalized at the rate of $560 per month you and eash member of your family may enr&ll now for only $1. . . THE "TRI-FIVE PLAN" IS A VITAL ADDITION TO YOUR PRESENT INSURANCE PROGRAM In this age of increasingly high expenses, ordinary ordi-nary hospital insurance, even Medicare, simply does not cover everything. And what about all your other expenses, such as rent or mortgage, monthly payments, insurance payments, food for the family, utility bills? You probably know friends and neighbors who met with financial fi-nancial disaster when hit by an expensive accident acci-dent or lengthy illness. THE"'TRI-FIVE PLAN" PAYS TAX-FREE, EXTRA CASH WHEN YOU NEED IT MOST Central National Life has seen many instances of great financial hardship and we are determined deter-mined to provide a plan at the lowest cost possible, that will give you EXTRA CASH to use any way you desire. The TRI-FIVE PLAN is the unbeatable answer. THE "TRI-FIVE PLAN" PAYS ACCIDENTAL DEATH BENEFITS, TOO Accidents are on the rise. Today, the greatest number of accidental deaths take place in: 1. Cars; 2. Homes; 3. Farms. The HOSPITAL INDEMNITY "TRI-FIVE PLAN" recognizes this situation by including; $1,000.00 Accidental death benefit, or $3,000.00 for common carrier (regularly scheduled plane, train, bus, etc.) travel accidental death. CHECK THESE IMPORTANT FEATURES You get $500 per month for up to 555 days each time you are hospitalized. Pays in addition to Medicare or other insurance. $1,000 accidental death benefits or $3,000 common carrier travel accidental death benefit (world wide coverage). At age 65 and over 50 benefits are still in effect Guaranteed renewable for life (as long as premiums are paid). Your policy cannot be cancelled or modified by the Company for health reasons. Pre-existing health problems are covered after the policy has been in effect 24 months. You can receive benefits for over one and a-half years, or more than $9,000, for any one sickness or accident under this plan! One policy, with one monthly payment, can cover a single individual, a husband and wife, or husband, wife and children. Children are covered by this one family policy until age 19. EXCEPTIONS AND LIMITATIONS are standard stand-ard for policies of this kind. Exclusions include only these few items: 1) War or act of war 2) Suicide or intentionally self-inflicted injury 3) Active duty in Armed Services 4) Confinement in any veteran's administration, ad-ministration, state, county, or municipal hospital hospi-tal which confinement the Covered Person is entitled en-titled to receive free of charge 5) Workmen's Compensation 6) Pregnancy 7) Dental care or treatment except that necessitated by injury to sound natural teeth. No benefit will be payable under this policy with respect to any hospital confinement which is not recommended and approved by a physician. ,r: MONEY BACK GUARANTEE If for any reason whatsoever you are not completely satisfied with your "TRI-FIVE" policy, you may return the policy in 10 days and we will promptly refund your money. .r"T "',rnn '.r it n 2-- li V- r' n -,.-.-- -n rr i -i - ,r i: n .t "B "r ,.r -i h n w3-",.'' HIT " 7--, 'IP 'J ' "V X :' "i "J .' ,ni- ; THE 'TRI-FIVE PLAN" PAYS IN ADDITION TO OTHER INSURANCE OR MEDICARE. . . When you need it most, Central National Life's HOSPITAL INDEMNITY "TRI-FIVE PLAN" pays you $500 per month for up to 555 days (almost a year and six months, or more than $9,000) each time you are hospitalized. You may receive this welcome extra cash whether whe-ther you are insured by other companies or not. As soon as your policy is in force, you are covered cov-ered for accidents. And even if some companies say you are uninsurable because of an ailment or other condition that keeps coming back, the "TRI-FIVE PLAN" covers a pre-existing ailment ail-ment after your policy has been in force 24 months! THE "TRI-FIVE PLAN" COVERS THOSE OVER AGE 65 ... . Statistics show that people over 65 go to hospitals hos-pitals more often and have bigger medical bills than any other group. That's why some hospital hospi-tal plans won't accept Senior Citizens, or else raise rates so high they can't afford extra cash protection just when they need it most. Central Cen-tral National life's HOSPITAL INDEMNITY "TRI-FIVE PLAN" not only accepts applicants regardless of age over 65, it pays 100 of the monthly benefit in every detail after the first 7 days of hospitalization. (After the first 14 days if you are over 75). BENEFITS PAID TO SENIOR CITIZENS IN ADDITION TO MEDICARE Senior Citizens get this vital extra cash in addition to Medicare or any other insurance and they too, can enroll now at the special $1.00 rate. AMAZINGLY LOW COST t Membership in Central National Life's HOSPITAL HOSPI-TAL INDEMNITY "TRI-FIVE PLAN" costs only $1.00 for the first premium. Then the following low premiums according to age: AGE MONTHLY RENEWAL PREMIUMS 50 and over i , . $5.00 I 40 thru 49 4.50 " 39 and under . . . . 3.50 Dependents 18 and under 1.50 NO CHANGE AS AGE INCREASES If you wonder how a plan can offer so much for so little, the answer is simple: Central National Life's "TRI-FIVE PLAN" is a group-type group-type enrollment plan. All business is conducted directly between you and the company by mail, or through the local representative we have appointed in your area. NO SALESMAN WILL CALL UNLESS REQUESTED This means low administrative and sales costs-substantial costs-substantial savings that are passed on to you and your family. PREMIUMS AUTOMATICALLY PAID THROUGH YOUR BANK ACCOUNT IF YOU DESIRE On the enclosed Enrollment Form, you may authorize your bank to deduct the premium monthly from your account, If you wish this convenience. LIMITED ENROLLMENT PERIOD Accidents do not wait to happen. Illness does not wait to strike. So Act Now!! Your application appli-cation will have to be in Central National Life's office before expiration of the special enroll-ment enroll-ment period in order for you to become eligible f at the low $1.00 initial fee .....u.. i .... iii 1 1. . , .. muim, - ui ll.m ,j WM. jj.-if 1 , ,il.nil THIS PROGRAM IS BEING OFFERED THROUGH CENTRAL UTAH IHSUMHC5 AGEHCY OUR 19lh YEAR OF SERVICE fe- J Automobile Homeowners Fire Business Liability Bonds ' I j Motorcycle Mobile Homes Life Sickness & Accident I Livestock Farm Coverages ; J Moab Dave Bc'ley Ag3nt I qi iiiwm.. 1 iiiw ji'h mu iiiwl i.inmn.Biu,. ...u n , 1 ...i..MiUuf' 'i Jinj'..t' n ....i.. , , I. ' t ... , . , ,,. . .W : . . . .- , ' - '- ff j ..fa iTtHli-". 4- ' ' "-'y- , f,' , f,, , , " ' ju j'.". -f.' -.' j ? . ' " t ..,,,,,...-- 1 |