health
benefits

Accidental Death & Dismemberment

• Coverage
• Schedule of Losses
• Exposure and Disappearance
• Repatriation Benefit
• Educational Benefit
• Rehabilitation Benefit
• Family Transportation
• Seat Belt Rider
• Home Alteration and Vehicle Modification
• Day Care Benefits
• In-Hospital Indemnity Benefit
• Permanent Total Disability Indemnity
• Conversion Privilege
• Continuance of Coverage
• Waiver of Premium
• Beneficiary Designation
• Exclusions
   

Coverage
The Member and his/her registered dependents are insured against the perils described in the “Schedule of Losses”. The Basic Accidental Death & Dismemberment plan provides coverage 24-hours a day, anywhere in the world, for specified accidental losses occurring on or off the job. If any of the losses listed below in the Schedule of Losses are suffered as the result of an accidental injury which results directly and independently of all other causes and the loss occurs within 365 days of the date of the accident, the benefits indicated below will be paid.

Who is Covered?
Class I: All Members who are eligible as outlined in Part I of this Booklet.
Class II: All spouses under age 70.
Class III: All eligible Dependent Children

Amount of Coverage
Class I: $12,500.00.
Class II: $20,000,00.
Class III: $5,000.00.

1. Pay the lesser of the following amounts to or on behalf of any Dependent Child who, at the date of accident, was enrolled as a full time student in any higher learning beyond the 12th grade level:
   1. The actual annual tuition, exclusive of room and board, charged by such institution per school year.
   2. $10,000.00 per school year.
   3. 5% of the Insured Person’s Principal Sum.
   Such amount will be payable annually for a maximum of four consecutive annual payments, only if the Dependent Child continues his education.
   “Dependent Child” as used herein means any unmarried child under 26 years of age who was dependent upon the Insured Person for at least 50% of his maintenance and support.
   “Institution of Higher Learning” as used herein includes, but is not limited to, any University, Private College, or Trade School.
2. Pay to or on behalf of the surviving spouse the actual cost incurred within 30 months from the date of death of the Insured Person as payment for any professional or trades training program in which such spouse has enrolled for the purpose of obtaining an independent source of support and maintenance, but not to exceed a maximum total payment of $10,000.00.

1. such training is required because of such injuries and in order for the Insured Person to be qualified to engage in an occupation in which he would not have been engaged except for such injuries,
2. expenses be incurred within three years from the date of the accident,
3. no payment shall be made for ordinary living, traveling or clothing expenses.

1. The one-time cost of alterations to the injured person’s residence to make it wheelchair accessible and habitable; and
2. The one-time cost of modifications, necessary to a motor vehicle owned by the injured person, to make the vehicle accessible or driveable for the Insured Person. Benefit payments herein will not be paid unless:
   1. Home alterations are made on behalf of the Insured Person and carried out by an experienced individual in such alterations and recommended by a recognized organization providing support and assistance to wheel-chair users; and
   2. Vehicle modifications are made on behalf of the Insured Person and carried out by an experienced individual in such matters and modifications are approved by the Provincial vehicle licensing authorities. The maximum payable under both Items A and B combined will not exceed $15,000.00.

1. The actual cost charged by such day care centre per year, or
2. 3% of the Insured Principal Sum, or
3. $5,000.00 per year,

1. a monthly benefit of one (1) percent of the Insured’s applicable Principal Sum; or
2. for periods of less than one (1) month, one thirtieth (1/30) of the above monthly benefit per day.

1. a monthly amount not to exceed $1,000.00; and
2. a total of twelve (12) months for any covered accident.

1. holds a license as a hospital (if licensing is required in the Province);
2. operates primarily for the reception, care and treatment of sick, ailing or injured persons as in-patients;
3. provides 24-hour a day nursing service by registered or graduate nurses;
4. has a staff of one or more licensed Physicians available at all times;
5. provides organized facilities for diagnosis, and major medical surgical facilities; and
6. is not primarily a clinic, nursing, rest or convalescent home or similar establishment nor is not, other than incidentally, a place for alcoholics or those addicted to drugs.

1. The date the Insured Person attains age 65.
2. The date of the death or recovery of the Insured Person.
3. The date the Master Policy is terminated.

• Suicide or self-inflicted injuries;
• Full-time service in the Armed Forces;
• Declared or undeclared war or any act thereof;
• Injuries received during aircraft travel except for the purposes of transportation where the Member is traveling as a passenger.