Doctors of BC Accidental Death and Dismemberment Insurance

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1 Doctors of BC Accidental Death and Dismemberment Insurance

2 AD&D Accidental Death and Dismemberment (AD&D)Insurance Accidents Happen... The Doctors of BC Accidental Death & Dismemberment Plan has been designed to help protect you and your family against the financial burden of an unforeseen accidental injury or death. Tax-free, lump-sum benefits are paid for covered losses occurring within 365 days of an accidental injury. Only the largest loss resulting from any one accident will be paid. Who is eligible? You are eligible to apply for AD&D Insurance if you are: 1 under age 69; and, 2 an active member of Doctors of BC or YMA. You can enroll for coverage on a Member only or Family basis. All eligible members are guaranteed acceptance in the plan. Proof of good health is not required. Eligible Dependents If you choose the Family option, your spouse and all of your dependent children will be insured for a percentage of your benefit as follows: Spouse Only (No Dependent Children) 50% Spouse and Dependent Children: Spouse 40% Each Dependent Child 10% Dependent Children Only (No Spouse) 15% Spouse means the legal spouse of a Member, provided there is no separation in effect, or an individual who has been residing with the Member for a period of at least 12 consecutive months. Spousal coverage terminates on the spouse s 75 th birthday. Dependent Child means any child of the Member who is under 21 years of age; or age 21 through age 25, unmarried, and is in full-time attendance at a School for Higher Learning; mentally or physically handicapped.

3 How much coverage can I apply for? AD&D insurance is available to you in units of $100,000 up to a maximum of $1,000,000. What are some benefits? The Accidental Death & Dismemberment Insurance provides payment for losses resulting from accidental bodily injury occurring anywhere in the world, 24 hours a day. In the event of your death, benefits will be paid to your named beneficiary. In the event of the death of one of your dependents, benefits will be paid to you. Benefits for all other losses will be paid to you. For covered injuries resulting from and occurring within 365 days of an accident, the plan will pay: % of Principal Sum Loss of Life Two Hands, Two Feet or Entire Sight of Both Eyes Speech and Hearing in Both Ears One Foot or One Hand and Entire Sight of One Eye One Hand and One Foot One Arm or One Leg One Foot, One Hand, or the Entire Sight of One Eye Speech or Hearing in Both Ears 75% 66 2/3% 50% Thumb and Index Finger of Same Hand 33 1/3% Four Fingers of Either Hand 33 1/3% Hearing in One Ear 33 1/3% All Toes of One Foot 25% Quadriplegia (total paralysis of all four limbs) 200% Paraplegia (total paralysis of both legs) 200% Hemiplegia (total paralysis of one arm and leg on one side of body) 200% Only the largest amount (shown on the schedule of losses) is payable for all losses resulting from any one accident. Benefits for loss of use shall be paid if the loss is permanent, total and irrecoverable and continuous for 12 months. Loss of a hand or foot means severance at or above the wrist or ankle joint. Loss of an arm or leg means severance at or above the elbow or knee joint. Loss of a thumb or index finger means severance at joint nearest the hand. Loss of sight, speech or hearing means complete and irrecoverable loss. With regard to quadriplegia, paraplegia and hemiplegia, total paralysis means permanent and irrecoverable paralysis of such limbs.

4 Bereavement Benefit If you die as a result of an injury and a benefit is payable under the terms of this policy, the Company will pay reasonable and necessary expenses incurred by your Spouse and Dependent Children for up to six sessions of grief counselling to a maximum of $1,000. Common Disaster Benefit In the event of the accidental death of both you and your Spouse as a result of a common accident and where both deaths occur within 90 days of the accident, the Principal Sum for your Spouse will be increased to the amount of your Principal Sum to an aggregate maximum of $1,000,000. This benefit is only available under the Family option. Critical Disease Benefit If an Insured Person is diagnosed by a Specialist with a Covered Disease prior to age 65 and is Totally Disabled from the Covered Disease for at least nine months, the Company will pay 5% of the Principal Sum to a maximum of $25,000. (Covered Disease means Acute Poliomyelitis, Acute Rheumatic Fever, ALS, Encephalitis, Huntington s Disease, Meningitis, Necrotizing Fasciitis, Parkinson s Disease, Tuberculosis, Typhoid Fever and Yersinia Pestis.) Day Care Benefit If you die due to an accident and your children, under the age of 13, require daycare, the Company will reimburse daycare expenses up to 5% of your principal sum to a maximum of $5,000 for up to 4 consecutive years for each child. Education Benefit If you die due to an accident and your children pursue full-time post-secondary education, the Company will reimburse post-secondary education expenses up to 5% of your principal sum to a maximum of $5,000 for up to 4 consecutive years for each child. Your children must begin a full time post-secondary program within a year of your death. Family Transportation Benefit When, as a result of loss covered by this policy, you are confined as an inpatient in a hospital located not less than one hundred and fifty kilometers from your normal place of residence, the Company will pay the reasonable expenses actually incurred by all members of the immediate family for hotel accommodation and transportation by the most direct route to you, up to a maximum of $15,000. Funeral Expense Benefit If you die as a result of an injury and a claim is paid within the terms of this policy, an additional amount is payable for reasonable and necessary funeral expenses to a maximum of $5,000. Home Alteration Benefit If you or your insured dependents are injured in an accident and permanently require a wheelchair, the Company will reimburse the costs of home and/or vehicle modifications incurred within three years of the accident for wheelchair accessibility, up to a maximum of $15,000. Identification Benefit In the event accidental loss of life is sustained by an Insured Person not less than one hundred and fifty kilometres (150 kms) from the Insured Person s normal place of residence and identification of the body by a member of the immediate family has been requested by the police or a similar governmental authority, the Company will reimburse the reasonable and customary expenses for transportation and hotel accommodation to a maximum of $5,000. Extended Family Benefit In the event of your death from any cause, under the Family option, coverage is continued for your Spouse and your Child(ren) for a period of up to six months or until the next premium due date, whichever is earlier. Eyeglasses, Contact Lenses and Hearing Aids Benefit If, as a result of an injury, you require and receive treatment by a physician, which results in the purchase of eyeglasses, contact lenses or hearing aids within 12 months of the date of the accident, when none of which were previously worn, the Company will pay the reasonable and necessary expenses to a maximum of $1,000.

5 Spousal Retraining Benefit If injury results in the Loss of your life and at the time of such loss your Spouse is insured under the Policy, the Company will reimburse your Spouse for the actual educational expense incurred for retraining to pursue gainful occupation if they are not gainfully employed on a full-time basis outside the home. The Company will reimburse expense incurred to a maximum of $15,000 within three years from the date of loss. Rehabilitation Benefit If you are injured in an accident and are required to undergo special training to engage in a new occupation, the Company will reimburse you for retraining expenses up to a maximum of $15,000. Repatriation Benefit If you or your insured dependents die outside of your city of residence due to an accident, the Company will pay the actual expense incurred for preparing the deceased for burial or cremation and for the shipment of the body back to the city of residence, up to a maximum of $15,000. Seat Belt Benefit If injury results, due to a vehicular accident, in a loss payable under this policy, the amount of Principal Sum will be increased by 10% to a maximum of $25,000 if, at the time of the accident, you were wearing a properly fastened seat belt. The driver of the vehicle must hold a current and valid driver s license and neither be intoxicated nor under the influence of drugs. Exposure and Disappearance If due to an accident you are unavoidably exposed to the elements and if, within one year of the accident you suffer a loss that would have otherwise been payable, such loss will be deemed to be the result of injury. If you disappear due to the accidental wrecking, sinking or disappearance of the transportation in which you were traveling and your body is not found within one year of the disappearance, it will be assumed that you died and loss of life benefits will be paid. Aircraft Coverage The Accident Plan covers injury which occurs while riding as a passenger (but not as a pilot or crew member), boarding or alighting from, being struck by, or making a forced landing with or from any aircraft having a current and valid airworthiness certificate. This aircraft must be piloted by a person who holds a current and valid pilot s license for such aircraft or any transport-type aircraft operated by the Canadian Armed Forces or by a similar transport service of a duly constituted government authority anywhere in the world provided the aircraft is not being used for experimental purposes. Waiver of Premium In the event you become totally disabled and your waiver of premium claim is accepted and approved under the Policyholder s current Group Life policy, then premiums payable under this policy are waived as of the same date the claim is accepted and approved by the Group Life Policy Underwriter.

6 Exclusions Benefits will not be paid for losses due to: suicide or attempted suicide while sane or insane; intentionally self-inflicted injury; declared or undeclared war; active full-time service in the armed forces of any country, or; aircraft accidents except as described under Aircraft Coverage Termination of Coverage Your coverage terminates on the earliest of: the premium due date coinciding with or immediately following your 75 th birthday; the date you terminate your Doctors of BC or YMA membership, or; the date you fail to make a required premium payment. Claims If you or your insured dependent(s) die or suffer a covered injury as a result of an accident, you or your beneficiary should contact the Doctors of BC Insurance Department to make arrangements for claiming benefits How much does it cost? Choose the benefit amount and plan that best suits your needs: BENEFIT ANNUAL PREMIUM Amount Member Family $100,000 $24 $36 $200,000 $48 $72 $300,000 $72 $108 $400,000 $96 $144 $500,000 $120 $180 $600,000 $144 $216 $700,000 $168 $252 $800,000 $192 $288 $900,000 $216 $324 $1,000,000 $240 $360 To enroll in the Plan, simply complete and mail or fax the application to the Doctors of BC Insurance Department. Do not send any money with your application. You will receive an invoice when your coverage is approved. Coverage will remain in force until age 75, provided premiums are paid and you are a Doctors of BC or YMA member.

7 To help protect your financial future and your assets, Doctors of BC offers and administers a comprehensive array of insurance products that includes: Disability Income Insurance Physicians Disability Insurance (PDI) Plan Professional Expense Insurance Life Insurance Accidental Death and Dismemberment Insurance Critical Illness Insurance Health Benefits Trust Fund, providing health/dental benefits for physicians and office staff Information and application forms for all Doctors of BC insurance plans may be found at or contact a Doctors of BC Insurance Administrator: Tel: or Toll Free: x2882 or x The BCMA, operating as Doctors of BC administers the Accidental Death and Dismemberment plan, and is available to answer questions regarding coverage and provide necessary forms. The insurer of this plan is Industrial Alliance Insurance and Financial Services. This brochure provides the highlights but not all the details of the Doctors of BC Accidental Death and Dismemberment plan. The complete terms, conditions, exclusions and limitations governing the insurance coverage are found in the group insurance policy number issued to the British Columbia Medical Association by Industrial Alliance Insurance company. AA E (AD & D)

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