For Loss of: |
Life |
The Principal Sum |
Both Hands or Both Feet |
The Principal Sum |
Entire Sight of Both Eyes |
The Principal Sum |
One Hand and One Foot |
The Principal Sum |
One Hand and Entire Sight of One Eye |
The Principal Sum |
One Foot and Entire Sight of One Eye |
The Principal Sum |
Speech and Hearing
|
The Principal Sum |
One Arm or One Leg |
Three-Quarters of the Principal Sum |
One Hand or One Foot |
Two-Thirds of the Principal Sum |
Entire Sight of One Eye |
Two-Thirds of the Principal Sum |
Speech or Hearing |
Two-Thirds of the Principal Sum |
Thumb & Index Finger (of same hand) |
One-Third of the Principal Sum |
Four Fingers of Same Hand |
One-Third of the Principal Sum |
Hearing in One Ear |
One-Quarter of the Principal Sum |
All Toes of Same Foot |
One-Eighth of the Principal Sum |
For Loss of Use of: |
Both Arms or Both Hands |
The Principal Sum |
One Arm or One Leg |
Three-Quarters of the Principal S |
One Hand |
Two-Thirds of the Principal Sum |
Paralysis Benefit: |
Quadriplegia (all four limbs) |
200% of the Principal Sum |
Paraplegia (both lower limbs) |
200% of the Principal Sum |
Hemiplegia (one arm and one leg on the same side of the body) |
200% of the Principal Sum |
Maximum Benefit |
-
Your maximum coverage is $1,500,000.
-
If you have family coverage the maximum amount of coverage for spouse is
$350,000 and each child is $50,000.
|
Loss |
-
With reference to hand or foot, means the actual severance through or above the
wrist or ankle joint; with respect to arm or leg, actual severance through or
above the elbow or knee joint; with respect to eye, the total and irrecoverable
loss of sight; with respect to speech, the total and irrecoverable loss of
speech which does not allow audible communication in any degree; with respect
to hearing, the total and irrecoverable loss of hearing which cannot be
corrected by any hearing aid or device; with respect to thumb and index finger,
actual severance through or above the first phalange; with respect to fingers,
the actual severance through or above the first phalange of all four fingers of
the same hand; with regards to toes, actual severance of both phalanges of all
toes of the same foot.
-
Loss of Use of - must be total, irrecoverable and be continuous for 12 months
after which the benefit is payable, provided the nerve damage is determined to
be permanent.
|
Rehabilitation Benefit |
-
If injury caused by an insured accident requires you to undergo special
training in order to be qualified to engage in a special occupation in which
you would not have engaged except for such injury, ACE INA will pay the
reasonable and necessary expense incurred for such training within two years of
the date of the accident. Maximum benefit of $15,000 as the result of any one
accident.
-
Payment shall not be made for ordinary living, travelling or clothing expenses.
|
Repatriation Benefit |
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When injuries covered by this policy result in loss of life outside 150 km of
your city of principal residence, ACE INA will pay for the preparation and
transportation of your body back to your principal residence.
-
Maximum benefit - $15,000.
|
Spousal Occupational Training Benefit |
-
When payment is made under the Loss of Life benefit, ACE INA will pay in
addition:
- |
the expense actually incurred by your spouse within 365 days from
the date of the accident, for a formal occupational training program for the
purpose of specifically qualifying such spouse to gain active employment in an
occupation for which your spouse would otherwise not have sufficient
qualifications. |
-
Maximum benefit - $15,000
|
Seat Belt Benefit |
-
If, due to a vehicular accident, injury results in a loss payable (as outlined
in the schedule of benefits), the Principal Sum will be increased by 10% if, at
the time of the accident, the Insured Person was driving or riding in a vehicle
and wearing a properly fastened seat belt.
|
Special Education Benefit |
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For those who elect family coverage, if injury results in loss of life, ACE INA
will pay, in addition to all other benefits payable, a "special education
benefit" equal to 5% of your Principal Sum amount, (to a maximum of
$5,000), on behalf of any dependent child who, on the date of the accident, is
enrolled as a full-time student in any institution of higher learning beyond
the 12th or 13th grade level, or was at the 12th or 13th grade level and
subsequently enrolls as a full-time student in an institution of higher
learning within 365 days following the date of the accident.
-
This benefit is payable annually for a maximum of four consecutive annual
payments but only if the dependent child continues his/her education as a
full-time student in an institution of higher learning
|
Family Transportation Benefit |
-
When injuries covered by this policy result in confinement as an in-patient in
a hospital outside 150 km from the city of permanent residence or outside of
Canada and requires personal attendance of a member of the immediate family,
ACE INA will pay for the expense incurred for the transportation by the most
direct route by a licensed common carrier to the confined person.
-
Maximum of $15,000 for any one accident.
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"Member of the Immediate Family" means the spouse, legal or
common-law, parents, grandparents, children over age 18, brother or sister.
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Must be recommended by the attending physician, in writing.
|
Home Alteration and Vehicle Modification |
-
If injury results in a loss as listed in the schedule of benefits (other than
life) and subsequently requires the use of a wheelchair to be ambulatory, ACE
INA will pay the reasonable and necessary expense actually incurred within 365
days from the date of the accident for:
- |
the one-time cost of alterations to your principal residence to
make it wheelchair accessible and habitable; and |
- |
the one-time cost of modifications necessary to a motor vehicle
utilized by the insured person to make it accessible or driveable. |
-
Benefit payments will not be paid unless:
- |
home alterations are made by a person or persons experienced in
such alterations and recommended by a recognized organization, providing
support and assistance to wheelchair users; and |
- |
vehicle modifications are carried out by a person or persons with
experience in such matters and modifications are approved by the Provincial
vehicle licensing authorities. |
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The combined maximum will not exceed $15,000.
|
Day-Care Benefit |
-
If loss of life occurs as a result of an accident ACE INA will pay, in addition
to all other benefits a "Day Care Benefit" equal to the reasonable
and necessary expenses actually incurred, subject to the lesser of 5% of your
Principal Sum amount or a maximum of $5,000 per year, on behalf of any
dependent child who is enrolled in a legally licensed Day Care centre on the
date of the accident or who enrolls in a Day Care centre within 365 days
following the date of the accident. This benefit will be paid each year for
four consecutive years with satisfactory proof of enrollment.
-
Dependent child means either a legitimate or illegitimate child, adopted child,
step-child or any child who is in a parent-child relationship who is unmarried,
twelve years of age and under and dependent upon you for maintenance and
support.
|
Continuation of Coverage |
-
If laid-off on a temporary basis, temporarily absent from work due to
short-term disability, on leave of absence or on maternity leave coverage will
be extended for twelve months with payment of premium.
-
If other occupational duties during the leave or lay-off period are performed,
no benefits will be payable for a loss occurring during the performance of the
occupation
|
Waiver of Premium |
-
If totally disabled and under 65 years of age ACE INA will waive the payment of
premium until the age of 65 with annual proof of total disability.
-
"Total Disability" resulting from accident or sickness means:
- |
a disability which prevents engagement in any business or
occupation and performance in any work for compensation or profit; and |
- |
has existed continuously for a period of at least twelve months or
is in accordance with the waiver of premium requirements under the Group Life
policy. |
|
Conversion Privilege |
-
On the date of termination or during the 31-day period following termination of
employment you may convert your insurance to an individual policy of ACE INA
without evidence of insurability. The individual policy will be effective
either as of the date the application is received or on the date that coverage
under the group policy ceased (whichever is later).
-
The amount converted will not exceed the amount issued during employment.
|
Exclusions |
-
The policy does not cover loss caused by or resulting from any one or more of
the following:
- |
intentionally self-inflicted injuries, suicide or any attempt at
suicide; |
- |
declared or undeclared war or act; |
- |
accident occurring while serving on full-time active duty in the
Armed Forces of any country or international authority (any premium paid to be
returned by ACE INA pro-rata for any such period of full-time active duty); |
- |
travel or flight in any vehicle or device for 1) navigation beyond
the earth's atmosphere, or 2) aerial navigation (including hang-gliding and
parachuting except for self-preservation). |
|
Reduction and Termination of Benefit |
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The benefit terminates at age 65 or earlier retirement.
|
Beneficiary |
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You may change your beneficiary at any time by written notice to your Employer,
subject to any policy or legal limitations
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