Accidental
Death and Dismemberment
(Participant Only)
If
you are eligible under this plan and you die on or after September 1, 1999 and
your death is a result of an accident (on or off the job), your beneficiary
receives an additional $30,000. This benefit is payable for death resulting
within 365 days from the date of the accident. An additional benefit of $10,000
is available if the participant dies in an automobile accident and we have proof
the participant was wearing a seat belt device.
If you
are involved in an accident which does not result in death but causes the loss of
hands, feet or eyes, you receive one of the following lump sum benefits. This
benefit is payable for loss resulting within 365 days from the date of the
accident. If more than one specific loss results from the same accident, your
benefit is for the loss for which the largest amount is payable.
For
the purpose of this benefit, “loss” is defined as total severance at
or above the wrist or ankle joint, irreversible paralysis, or entire and
irrecoverable loss of sight. Not more than one payment per limb per lifetime is
allowable.
Schedule of Indemnities
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In
The Event of Loss of:
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The Plan
Pays:
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Both hands, or both feet, or
sight of both eyes
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$60,000
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One hand and one
foot
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$60,000
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One hand and sight of one
eye
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$60,000
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One foot and sight of one
eye
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Quadriplegia (paralysis of
all four limbs)
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$60,000
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One hand or one
foot
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$15,000
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Sight of one eye
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$15,000
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Paraplegia
(paralysis of the legs or lower part of the body)
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$15,000
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Hemiplegia
(paralysis of one side of the body)
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$15,000
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Exclusions
– Accidental Death and Dismemberment
Benefits
are not provided for death or dismemberment caused
by or as a result of:
- Disease
of the body, mental infirmity, illness, pregnancy, heart attack, stroke, or
diagnostic test; or medical or surgical treatment, except a loss resulting from
a surgical operation necessary because of an injury not excluded, provided
surgery is performed within 365 days of the injury.
- Ptomaines,
disease or bacterial infections not the result of an injury, except pyogenic
infections which should occur through or with an accidental cut or wound.
- Intentionally
self-inflicted injuries; or illnesses or injuries self-inflicted or sustained in
the following
circumstances:
- Suicide
or attempted suicide while sane or insane.
- While
engaged in any activity that results in committing an assault, battery or
felony.
- While
performing any acts of violence or physical force that would not be performed by
a reasonably prudent person in similar circumstances.
- While
participating in a riot.
- Recreational
use of, abuse of or overdose of legal, illegal or over-the-counter drugs or
other substances, whether or not the person was then capable of intending to
inflict self-injury
Being
under the influence of a chemical substance will not be considered to affect the
person’s ability to form intent.
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