Accidental Death & Specific Loss Schedule: | |
---|---|
Member Principal Sum | $100,000 |
Spouse Principal Sum | $ 50,000 |
Dependant Child Principal Sum | $ 15,000 |
When an insured Member or eligible Spouse receives Injuries resulting in any of the following Losses within 365 days of the accident, benefits will be payable for:
For Loss of: | % of Principal |
---|---|
Life | 100% |
Brain Death | 200% |
Both Hands, or Both Feet, or One Hand and One Foot | 100% |
Entire Sight of Both Eyes | 100% |
One Hand and Entire Sight of One Eye, or One Foot and Entire Sight of One Eye | 100% |
Speech and Hearing in Both Ears | 100% |
Use of Both Arms or Both Hands or Both legs or Both Feet | 100% |
Quadriplegia, Paraplegia, Hemiplegia | 200% |
One Arm, or One Leg, or Use of One Arm, or One Leg | 80% |
One Hand, or One Foot, or Use of One Hand, or One Foot | 75% |
Entire Sight of One Eye | 75% |
Speech or Hearing in Both Ears | 75% |
Thumb and Index Finger of the Same Hand | 33 1/3% |
Loss of Use of Thumb and Index Finger of the Same Hand | 33 1/3% |
Four Fingers of the Same Hand | 33 1/3% |
Hearing in One Ear | 66 2/3% |
Thumb of Either Hand | 25% |
All Toes of the Same Foot | 25% |
One to Three Fingers of Either Hand | 16 2/3% |
When an eligible Child receives Injuries resulting in any of the following Losses within 365 days of the accident, benefits will be payable for:
For Loss of: | % of Principal |
---|---|
Life | 100% |
Brain Death | 1,000% |
Both Hands, or Both Feet, or One Hand and One Foot | 1,000% |
Entire Sight of Both Eyes | 1,000% |
One Hand and Entire Sight of One Eye, or One Foot and Entire Sight of One Eye | 1,000% |
Speech and Hearing in Both Ears | 1,000% |
Use of Both Arms or Both Hands or Both legs or Both Feet | 1,000% |
Quadriplegia, Paraplegia, Hemiplegia | 1,000% |
One Arm, or One Leg, or Use of One Arm, or One Leg | 80% |
One Hand, or One Foot, or Use of One Hand, or One Foot | 75% |
Entire Sight of One Eye | 75% |
Speech or Hearing in Both Ears | 75% |
Thumb and Index Finger of the Same Hand | 33 1/3% |
Loss of Use of Thumb and Index Finger of the Same Hand | 33 1/3% |
Four Fingers of the Same Hand | 33 1/3% |
Hearing in One Ear | 66 2/3% |
Thumb of Either Hand | 25% |
All Toes of the Same Foot | 25% |
One to Three Fingers of Either Hand | 16 2/3% |
If more than one Loss is sustained as the result of any one accident, only one benefit shall be payable, the largest.
The amount specified for losses of
is payable only when such double loss occurs as a result of the same accident.
The maximum payable for all losses sustained by an Insured Person as a result of the same accident shall not exceed the Principal Sum, except as noted for Brain Death, Paraplegia, Hemiplegia, or Quadriplegia.
Waiver of Premium
In the event a Member becomes totally and permanently disabled and his/her waiver of premium claim is accepted and approved under the Trust Fund’s current Group Life policy, then the Accidental Death & Dismemberment premiums payable under this policy are waived as of the same date the claim is accepted and approved by the Group Life Insurer until one of the following occurs, whichever is earlier:
Exclusions
No coverage shall be provided under the Accidental Death and Dismemberment Benefit and no payment shall be made for any Loss or claim resulting from, or contributed to, in whole or in part by, or as a natural and probable consequence of any of the following excluded risks even if the proximate or precipitating cause of the Loss or claim is an accidental Injury: