Account #: 1234567890
John Smith is Logged In 
Reinstate Policy
Product Name: Spouse Life
Certificate #: 987654321
Policy Mode: Semi-Annual
Previous Balance: $0.00
| Coverage Option | Coverage Amount | Modal Premium | Balance Due |
|---|---|---|---|
| $500,000 | $600.00 | $200.00 | |
| $400,000 | $550.00 | $150.00 | |
| $350,000 | $500.00 | $100.00 | |
| $300,000 | $425.00 | $25.00 |
| Please reinstate my coverage amount as indicated above through April 30, 2010. I understand, once reinstated, I will be billed shortly for my second semi-annual payment for coverage from April 30, 2010 through September 30, 2010. If a claim has occured following cancellation of coverage, acceptance of an online processed payment does not constitute reinstatement of coverage, and no coverage is in effect. |
