LIFETIME BENEFIT – ACCIDENT & GRADED SICKNESS RIDER

Terms Used This rider is issued by us as part of the policy to which it is attached and is subject to the
provisions of the policy, except as may be modified or amended by this rider. Any
modification or amendment made by this rider is only in effect while this rider is in force.
The terms used in this rider have the same meaning as indicated in the policy, unless
otherwise specified or required in the context of the following rider provisions.

Rider Date The Rider Date will be the same as the Policy Date, if this rider is included in the policy
when it is first issued by us. Otherwise, the Rider Date will be such later date as
established by the amendment to the contract to include this rider. The Rider Date is used
to determine duration, premium due dates, anniversaries and your age with respect to this
rider.

Lifetime Benefit The Lifetime Benefit for Total Disability payable at the end of a particular calendar month
for Total Disability following your 65th birthday while a Period of Disability continues is:
a) the Lifetime Benefit for Total Disability shown for this rider on the Policy Details
page if Total Disability is caused by:
i. Injury before your 65th birthday; or
ii. Sickness first manifested before your 55th birthday; or
b) the Lifetime Benefit for Total Disability shown for this rider on the Policy Details
page multiplied by the applicable percentage shown in the table below if Total
Disability is contributed to or caused by Sickness first manifested after your
55th birthday, or by medical or dental treatment, including surgery, for the
Sickness.
Your Age on the date
you become Disabled Percentage
56 90%
57 80%
58 70%
59 60%
60 50%
61 40%
62 30%
63 20%
64 10%

If the Cost of Living (maximum 3% per year) Rider or Cost of Living (maximum 8% per
year) Rider is included in your policy, the Lifetime Benefit for Total Disability determined
above will be adjusted in the same manner as was the Monthly Disability Benefit under
the Cost of Living Benefit provision of the rider.

The Lifetime Benefit for Total Disability will be payable in accordance with the Payment of
Lifetime Benefit for Total Disability provision below.

(Continued on the back.)

This rider should be kept with the policy.

17230 – 5/07
 LIFETIME BENEFIT – ACCIDENT & GRADED SICKNESS RIDER (continued)

Payment of The Lifetime Benefit for Total Disability will be payable if you:
Lifetime Benefit a) are Totally Disabled on your 65th birthday;
for Total Disability
b) have satisfied the Waiting Period, or the Waiting Period has been waived under
the Presumptive Disability provision, the Catastrophic Disability provision, or
elsewhere under the policy;
c) are receiving medical care from a Doctor that is of an appropriate nature and
frequency for the Disability; and
d) agree to be examined by a Doctor or other person determined by us, if and when
we reasonably require.

Payments will continue during your Disability until the earlier of:
a) the date you are no longer Totally Disabled; and
b) the date of your death.

The Lifetime Benefit for Total Disability will become payable at the end of the calendar
month in which you have satisfied the above conditions. Subsequent payments due will
be made at monthly intervals in arrears. For Lifetime Benefit for Total Disability payments
due for less than a calendar month, the benefit for each day of Disability will be 1/30th of
the applicable Lifetime Benefit for Total Disability.

The Lifetime Benefit for Total Disability during a period of Concurrent Disability will be
payable for only one cause of Disability at any time.

Presumptive If you are considered Totally Disabled under the Presumptive Disability or Catastrophic
Disability and Disability provision:
Catastrophic a) before your 65th birthday, the Lifetime Benefit for Total Disability will be increased
Disability by 25%; or
b) after your 65th birthday, the Lifetime Benefit for Total Disability will not be
increased by 25%.

A lump sum benefit will not be payable under this rider.

Survivorship Despite anything to the contrary, the Survivorship Benefit will not be payable if you die
Benefit Exclusion while the Lifetime Benefit for Total Disability Benefit is payable.

Rider Premium This rider is included in the policy in consideration for the payment of the Yearly Premium
shown for this rider on the Policy Details page. The premium for this rider is payable at the
same time and in the same manner and in addition to the premium for the basic policy.
The premium is payable on the same terms and conditions as the premium for the basic
policy and for the Premium Period for this rider shown on the Policy Details page.

(Continued on the next page.)

This rider should be kept with the policy.

17230 – 5/07
 LIFETIME BENEFIT – ACCIDENT & GRADED SICKNESS RIDER (continued)

Rider Termination Subject to the provisions of the basic policy and any riders and benefits included in the
contract, this rider will terminate on the earliest of the following dates:
a) the monthly anniversary following the date on which we receive the Owner’s
Written Request for termination of this rider;
b) your 65th birthday if you are not Totally Disabled;
c) if you are Totally Disabled on your 65th birthday, the date you are no longer
Totally Disabled;
d) the date of your death; and
e) the date on which the policy terminates for any other reason.

Despite anything to the contrary, if you are Totally Disabled on the Expiry Date, the policy
will not terminate before the date you are no longer Totally Disabled. However, any riders
with the exception of this rider and the Cost of Living (maximum 3% per year) Rider or
Cost of Living (maximum 8% per year) Rider if included in the policy, will terminate on the
Expiry Date.

THE CANADA LIFE ASSURANCE COMPANY

R. L. McFeetors, S. A. Wagar,
President and Chief Executive Officer Secretary

This rider should be kept with the policy.

17230 – 5/07