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In today's fast-paced society, accidents can happen anytime, anywhere.....while
traveling with a business group, vacationing, attending school, participating
in athletics or a variety of other situations. Many families have little
or no medical insurance, and those who do have coverage may be required
to meet large deductibles before their insurance pays any benefits.
However, now a comprehensive program has been developed to specifically
cover the inherent risks involved for today's unique events. This Accident
Medical Insurance Program is designed to help eliminate the financial
and emotional burden one can incur as a result of injury in today's activities.
The Accident Medical Coverage
Pays the medical bills of an injured participant or staff member
Who Is Covered
All participants of the Policyholder are covered while participating in
sponsored activities. A member is also covered while traveling, directly
and without interruption, to and from any Policyholder sponsored activity
and his or her home or place of residence.
Accidental Death & Dismemberment
If a covered injury results in any of the losses specified below within
one year after the date of the accident, the Company will pay the applicable
amount.
- Full Principal Sum for loss of life
- Full Principal Sum for double dismemberment
- 50% of the Principal Sum for loss of one hand, one foot or sight of
one eye
- 25% of the Principal Sum for loss of index finger and thumb of same
hand
If the Principal sum is payable, no indemnity will be paid for dismemberment.
In any event, the double dismemberment indemnity is the maximum amount
payable under this Benefit for all losses resulting from one accident.
Maximum Medical Expense Benefit
If the Covered Person incurs eligible expenses as the result of a covered
injury, the Company will pay the charges incurred for such expense within
52 weeks, beginning on the date of accident. Payment will be made for
eligible expenses not to exceed the Maximum Medical Expense Benefit, subject
to the applicable deductible amount (if any). The first such expense must
be incurred within 60 days after the date of the accident.
| Note: |
Primary Coverage pays benefits under the plan without offset
for other insurance. Excess Coverage does not cover treatment
or service for which benefits are payable under any other insurance
or medical service plan available to the insured. |
Exclusions and Limitations
This Plan does not cover any loss to or resulting from:
- Sickness or disease in any form, except pyogenic infections due to
an accidental cut or wound.
- The use of drugs or narcotics, unless administered under the advice
of a physician.
- War or any act of war, whether or not declared.
- Participation in any riot or civil commotion.
- Air travel or the use of any device or equipment for aerial navigation,
except as a fare-paying passenger on a regularly scheduled commercial
airline.
- Suicide or any attempt thereat or any self-inflicted injury.
Nor does the Plan cover:
- Service provided by any person or facility employed or retained by
the Policyholder or member organization.
- Service provided by any member of the Insured Person's family or household.
- Dental treatment, except as the result of a covered injury.
- The repair or replacement of any artificial dental restoration.
- Expenses payable under any Workers Compensation Law or similar legislation.
- Injury sustained while riding in or on any two or three wheeled engine
driven vehicle.
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