Accidental Death & Dismemberment                          

BENEFIT SCHEDULE

Accidental Death & Dismemberment   $10,000 Member; $5,000 Spouse; $2,500 Child
Accident Medical Expense*   $2,000 Per Injury (Maximum benefit)
Deductible   $100 Per Occurrence
Aggregate Limit of Liability   $50,000

COVERAGE – 24 HOURS

Accidental Death and Dismemberment Indemnity

The Company shall pay an indemnity determined from the Table of Losses provided that:

1.   such loss occurs within 90 days after the date of accident causing such loss; and
2.   the indemnity payable for any such loss shall be the amount stated opposite such loss in said Table, and the Principal Sum stated therein shall be the amount stated as Principal Sum applicable to such person and this Coverage; and
3.   if more than one loss is sustained as the result of one accident, only one of the amounts, the largest, shall be payable.

TABLE OF LOSSES

Description of Loss Indemnity

Life........................................................................................100% of the Principal Sum

Both Hands or Both Feet or Sight of Both Eyes....................100% of the Principal Sum

One Hand and One Foot........................................................100% of the Principal Sum

One Hand and the Sight of One Eye......................................100% of the Principal Sum

One Foot and the Sight of One Eye.......................................100% of the Principal Sum

One Hand, One Foot or the Sight of One Eye......................... 50% of the Principal Sum

Thumb & Index Finger of the Same Hand................................ 25% of the Principal Sum

 
 
 


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