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| APSIT Group Personal Accident Insurance Plan |
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If you've already taken the opportunity to enroll, now's your chance to increase coverage or add dependents' coverage. This plan was designed exclusively for members of participating member associations of the American Physical Society Insurance Trust. Accidents can happen anytime, anywhere. But just because the unexpected can happen, doesn't mean you have to be unprepared. That's why a lot of people today buy personal accident insurance that protects them at home, at work, or at play. Let's face it, the death or injury of a breadwinner can create serious financial problems for any family. But with personal accident insurance, you can soften the blow with a ready source of cash, just when your family needs it most. They can use the benefits for final expenses in the event of your death, or if you're injured and can't work, use it to pay medical bills, living expenses or rehabilitation costs. This plan can provide you with financial protection against the accidental loss of life or limb. It's available to you now, through the American Physical Society Insurance Trust and, it's underwritten by New York Life. This Personal Accident Insurance Program is flexible; you may select the coverage amount that best meets your needs from $20,000 to $300,000, and you may also obtain coverage for your family, all at affordable group rates! This coverage can be used as a supplement to any other insurance which you may have. Its benefits are payable regardless of any other coverage which you may have. Review the following pages for details of all the fine features of this plan. Who's Eligible? As an active member of a participating association, you're eligible to apply for coverage for yourself and your spouse, as long as you're both under age 70. You may also cover your unmarried dependent children under age 19 (under age 23 if a full-time student). If both you and your spouse are eligible members, each may apply as a member, but you may not duplicate coverage by applying as dependents of each other. Only one member may request coverage for your eligible children. Amounts Available You may select any Principal Sum amount from $20,000 up to $300,000 in increments of $20,000. Family Plan Option In addition to your own coverage, dependent coverage provides the following insurance for your eligible dependents:
What's Covered Under this plan you and your eligible dependents, if you elect dependent coverage, are covered 24 hours a day anywhere in the world - at home or at work, while traveling for business or pleasure (subject to the Exclusions provisions). If while insured you, or an insured dependent, suffer a covered accident that results in any of the following losses, these benefits are payable...
Losses must occur within 365 days of the accident to be covered under this plan. If more than one loss occurs as a result of the same accident, only the largest amount applicable will be paid. Loss means, with respect to hand and feet, actual severance through or above the wrist or ankle joint; with respect to thumb and index finger, actual severance through or above the metacarpophalangeal joints; with respect to loss of sight, speech and hearing, total and permanent loss. You Also Receive These Added Benefits Permanent Total Disability (Members Only) This benefit will pay the Principal Sum you've selected (less any amount paid or payable under the Accidental Death & Dismemberment Benefit) if: you provide written proof that you were permanently and totally disabled due to a covered accident that occurred before age 70; the disability began within 180 days of the accident; the disability continued without interruption for 12 months; and is expected to continue uninterrupted throughout your lifetime. Permanent Total Disability means your continuous inability to perform the material and substantial duties of any occupation for which you are suited either by education, training, or experience. Education Benefit If your dependents are covered under the family plan and you die and the Principal Sum is payable, the plan will pay an Education Benefit to each student who qualifies. The Education Benefit will be the lesser of 5% of your Principal Sum or the maximum amount of $5,000. To receive this benefit, a student must show proof that on the date of your death he or she was a covered dependent and: a post-high school student in a school for higher learning, or a student in 12th grade that became a full-time post high school student in a school for higher learning within 365 days. This benefit is payable every year in which the student meets the above definition for up to four years, provided the dependent child submits proof of his or her student status each year. If an Education Benefit would be payable, but no person qualifies as a student, the plan will pay the minimum amount of $1,000 according to the terms of the beneficiary section. Common Carrier Benefit If you or your covered dependent are injured while riding as a passenger on a Common Carrier, the amount of the Principal Sum payable under the Accidental Death & Dismemberment benefit will be doubled. However, the Principal Sum will never be increased by more than the Common Carrier limit of $50,000. Common Carrier is a vehicle operated by a business organized and licensed to transport passengers for hire, and operated by an employee of that business. Common Disaster Benefit If you and your spouse die as a result of injuries received in the same accident and a Principal Sum is payable under the Accidental Death & Dismemberment benefit for each death, the benefit for your spouse will be increased to equal your Principal Sum to a maximum combined benefit of $500,000. Repatriation Benefit If you or your covered dependents die outside the state or country of permanent residence, and the Principal Sum is payable, the plan will pay a Repatriation benefit. This benefit will be the lesser of:
Rehabilitation Benefits (Members Only) If you suffer a loss other than loss of life, and a Principal Sum is payable under the Accidental & Dismemberment benefit, the plan will pay the lessor of:
Expense incurred means that the actual cost of training and materials needed for training. Expenses must be incurred within two years of the date of accident. Rehabilitative training means any education required because of your injury, which prepares you for work you would have not done otherwise. Private And Commercial Flying Benefits are payable for losses sustained while traveling as a fare-paying passenger in a regularly scheduled flight, or while flying in a private aircraft as long as the aircraft and pilot have current and proper certification and ratings. Beneficiary Selection Benefits for loss of your life will be paid to the beneficiary you have designated. If you have not designated a beneficiary, the life benefit will be paid to your estate. Benefits for loss other than life will be paid to you. All dependents benefits are paid to you.
To calculate your semi-annual premium, divide your selected Principal Sum by 20,000 then multiply the result by the appropriate rate above and add a $.50 administrative billing fee. Rates shown are current and may be changed by New York Life on any premium due date and on any date on which benefits are changed. However, your rates may change only if they are changed for all others in the same class of insureds under the same Group Policy. For example, a class of insureds is a group of people with the same age and gender. Future benefits are subject to change by agreement between New York Life and APSIT.
Term Of Coverage Your insurance will go into effect on the earliest of the 1st or the 15th of the month following the date your application is approved, providing you are actively at work on that day and your premium is paid in a timely manner. Dependent coverage will begin on the date you become covered or, the earlier of the 1st or the 15th of the month following approval of your application to add your dependents. Your coverage under this plan will remain in force as long as:
Your dependents' insurance remains in force as long as your coverage is in effect, premiums are paid when due, and they remain eligible dependents. Exclusions This policy does not cover losses caused by: declared or undeclared war or war-related activities; intentionally self-inflicted injuries, suicide or its attempts while sane or insane; committing a felony or other illegal activity; use of drugs unless prescribed by a physician; disease or treatment of disease except any resulting from treatment of injury caused by a covered accident; riding in or descending from any aircraft except as stated in the Private And Commercial Flying Section. Missouri Residents: This plan will not provide benefits for death, dismemberment or any other loss, resulting from suicide or self inflicted injury within the first 2 years if New York Life can show that suicide was intended at the time of application. Repatriation Benefit: Not available to residents of Pennsylvania or Texas. Here's How To Apply
Your application is subject to underwriting approval by New York Life. Each member participating in the plan will receive a certificate of insurance describing the exact coverage and benefits purchased. If you have any questions regarding the plan, application or claims, contact the Plan Administrator. APSIT offers a full complement of insurance products from New York Life. Ask your Plan Administrator for information on the Group Term Life (standard plan), 10 Year Level Term, Personal Accident, Disability Income, and Hospital Indemnity Benefit Plans. Coverage under this plan is generally available to residents of the United States and Canada (except Quebec). Coverage may not be available in some states-call the Plan Administrator for details. Notice to Florida Residents: Ken Friedman (an employee of Herbert V. Friedman, Inc.) is a licensed Agent for service to residents of Florida. This website provides a general description of the insurance plan offered and is not a contract. Complete terms, conditions, definitions, limitations, exclusions and renewability are detailed in Group Policy G-29068-2 -Policy Form GMR (Note: in Texas Policy Form GMR-FACE/G-29068-2) issued to APSIT. Insured Members are provided a Certificate of Insurance which details their coverage.
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