Coverage (page 2 of 2)
Participant Accident Medical Protection Program
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. Loss of a hand or foot means
complete severance through or above the wrist or ankle joint. Loss of sight means the total, permanent loss
of sight of the eye. The loss of sight
must be irrecoverable buy natural, surgical or artificial means. Loss of
speech means total, permanent and irrecoverable loss of audible communication.
Loss of hearing means total and permanent loss of hearing in both ears
which cannot be corrected by any means.
Loss of a thumb and index finger means complete severance through or
above the metacarpophalangeal joints.
Maximum Medical Expense Benefit
If
the Covered Person incurs eligible expenses as a 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 stated in the policy.
The first such expense must be incurred within 90 days after the date of
the accident.
Excess Coverage
This Plan does not cover treatment or service for which benefits are
payable or service is available under any other insurance or medical service
plan available to the Insured Person.
Exclusions and Limitations*
This
Plan does not cover any loss to or resulting from:
- Sickness or disease in any
form, except phylogenic 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:
- Medical service provided by any person or facility
employed or retained by the Policyholder or member organization.
- Medical 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.