| If you suffer
certain dismemberment’s or die as the result of an accident, Accidental Death
and Dismemberment Insurance pays a benefit if you are insured at the time of the
injury and at the time of the loss. |
Benefit amount
If you are
insured for Accidental Death and Dismemberment Insurance, you are covered for
two types of benefits:
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Death benefits. If you die
while insured as the result of an accidental bodily injury within two years after
the injury occurred, your beneficiary will receive an accidental death benefit.
The benefit equals one half of the Life Insurance amount in force. This amount
is paid in addition to your Life Insurance benefit. |
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Dismemberment benefits.
Accidental Death and Dismemberment Insurance also pays a benefit if you suffer a
covered dismemberment or loss of sight as a result of an accidental bodily
injury within two years of the injury. The benefit you receive will be a
percentage of your Life Insurance benefit - depending on the nature of your
loss: |
Loss
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Accidental Death and
Dismemberment Benefit
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Accidental death or accidental loss of more than
one of the following: hand, foot or sight of an eye |
Equal to ½ Life Insurance in force |
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Accidental loss of one of the following: hand, foot
or sight of an eye |
Equal to ¼ Life Insurance in force |
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Loss of a hand or foot means loss by severance at or above
the wrist or ankle joint; and
loss of sight of an eye means total and irrecoverable loss of
sight |
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If you file a
dismemberment claim, the carrier reserves the right to examine you while a claim
is pending - at its expense - as often as it may reasonably require. (In the
case of an accidental death, the carrier also reserves the right to conduct an
autopsy, if permitted by law.) |
Maximum
benefits
Total payment for
losses from a single accident cannot be more than one-half of your Life
Insurance benefit unless you die as a result of a job-related accident. In that
instance, the benefit paid will be three times the scheduled amount of the
Accidental Death and Dismemberment Benefit. Your beneficiary will receive this
benefit if your death results:
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From accidental bodily injuries caused solely by your employment
with the Company |
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Solely from an accident in which the cause and results are
unexpected and definite as to time and place |
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Some losses aren't covered
Accidental Death
and Dismemberment Insurance does not pay benefits for any loss caused by:
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An act of war |
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Self-destruction or intentionally self-inflicted
injury |
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Disease, or bodily or mental infirmity - or medical
or surgical treatment of that condition |
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Any infection (except infection caused by an
external visible wound sustained in an accident) |
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Your act of aggression, participation in a felonious
enterprise or illegal use of drugs |
How your benefits are paid
As soon as
satisfactory proof is submitted to the carrier, your accidental death benefit
will be paid to your beneficiary(ies). If $10,000 or more is payable to a
beneficiary, an interest paying money market account will be established for the
beneficiary under the provisions of UNICARE's Guaranteed Access Account. A
beneficiary may withdraw the account balance at any time. Additional information
will be provided to your beneficiary in the event of your death.
Accidental
dismemberment benefits will be paid in a lump sum only - as soon as satisfactory
proof of your loss is received by the carrier.
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Beneficiary
Accidental death
benefits are paid to the beneficiary of your Life Insurance.
Accidental
dismemberment benefits are paid to you.
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When
coverage ends
Generally, your
Accidental Death and Dismemberment Insurance coverage's will continue as long as
you continue working for the Company. When you terminate your employment, your
coverage will end (subject to the conditions described in the "What happens if I
stop working for any reason?" section).
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