Indianapolis Life Insurance  |

Male Amount / Ages	0 - 15	16 - 40	41 - 45	46 - 50	51 - 55	56 - 60	61 - 70	71 - 99
0 - 25,000	A	A	A	A	A	A	B	B
25,001 - 50,000	A	A	A	A	A	B	B	B
50,001 - 99,999	A	A	A	A	B	B	B	B
100,000 - 150,000	A	C	C	C	C	C	C	D
150,001 - 250,000	A	C	C	C	C	C	D	D
250,001 - 500,000	F	C	C	C	C	D	D	D
500,001 - 1,000,000	F	C	C	C	D	D	D	D
1,000,001 - 2,000,000	F	C	C	D	D	D	D	D
2,000,001 - 3,000,000	F	C	D	D	D	D	E	E
3,000,001 - 5,000,000	F	D	D	E	E	E	E	E
5,000,001 - 50,000,000	F	E	E	E	G	G	G	G

Female Amount / Ages	0 - 15	16 - 40	41 - 45	46 - 50	51 - 55	56 - 60	61 - 70	71 - 99
0 - 25,000	A	A	A	A	A	A	B	B
25,001 - 50,000	A	A	A	A	A	B	B	B
50,001 - 99,999	A	A	A	A	B	B	B	B
100,000 - 150,000	A	C	C	C	C	C	C	D
150,001 - 250,000	A	C	C	C	C	C	D	D
250,001 - 500,000	F	C	C	C	C	D	D	D
500,001 - 1,000,000	F	C	C	C	D	D	D	D
1,000,001 - 2,000,000	F	C	C	D	D	D	D	D
2,000,001 - 3,000,000	F	C	D	D	D	D	E	E
3,000,001 - 5,000,000	F	D	D	E	E	E	E	E
5,000,001 - 50,000,000	F	E	E	E	G	G	G	G

Requirements Combination Key
A	Non-Medical
B	Paramed, Urinalysis
C	Paramed, Urinalysis, Blood Profile, MVR
D	Paramed, Urinalysis, Blood Profile, EKG, MVR
E	Urinalysis, Blood Profile, EKG, Physician Exam, MVR
F	Underwriter Discretion
G	Urinalysis, Blood Profile, Physician Exam, MVR, Treadmill EKG

Footnote Key
1	A Personal History Interview is required for $500,001 through $3,000,000.
2	A Personal History Interview or Inspection Report will be required for $3,000,001 and up. Home office will order.
3	For amounts OVER $1000000 a Financial Questionnaire (FINQ) is required and a copy of the business financial statement and agent cover letter detailing the need and purpose of insurance is strongly recommended
4	Medical fees may be charged to the agent if medical reqs are completed and found to be NOT needed based on the guidelines.
5	A Blood Profile will be required on proposed insureds age 16 and older if the new application amount PLUS Indy Life in force policy amounts issued less than two years ago are $100,000 or more. Twelve to fourteen hours of fasting is recommended prior to venipuncture. Ages 0 - 15, $250,000 and over...contact your Underwriter for requirements. Blood kits have been supplied to the Field Force and are to be completed by a Physician and sent to LabOne Reference Lab if an authorized Paramedical facility is not used
6	All 12 lead Resting Electrocardiograms should be submitted mounted and UNinterpreted Motor Vehicle Reports (MVR) will be ordered by the Home Office
7	Paramed exam, blood profile and urinalysis are required when applying for PREFERRED underwriting on term policies with face amounts of less than $100,000