Evidence of Insurability |
- Medical evidence
will be required on insurance over $10,500 and to increase LTD
coverage on subsequent re-enrollments.
|
Indexation
(Option 3 only)
|
- On the first
of January each year the monthly income is increased based on
the increases in the Consumer Price Index but shall not exceed
3%. The increase commences on the first of January following the
payment of the initial monthly installment.
|
Maximum Disability Period |
- Benefits
will be payable for either a five year period only or to your
age 65 (depending on the Option selected).
- Benefits
will not be payable beyond age 65, unless you satisfy the Qualifying
Disability Period while age 64, in which case benefits will be
payable for a maximum of 12 months.
|
Pre-existing Conditions |
- No benefits
are payable for any disability beginning within twelve months
of your effective date of insurance if the disability is caused
by, partly attributable to or is a consequence of a sickness or
injury for which you have received medical treatment or services
or took prescription drugs or medicine within ninety days before
your effective date of insurance.
|
Qualifying Disability Period |
- The greater
of 120 days or the end of the benefit period provided under the
Short Term Disability Income benefit.
|
Recurrent Disability |
- If a disability
recurs and it is due to the same or related causes, it will be
considered as one continuous disability and will not be subject
to the Qualifying Disability Period unless you have returned to
active, full-time employment for a period of 6 consecutive months
or longer.
- If new disability
is due to unrelated causes you may be eligible for a new disability
period, subject to the Qualifying Disability Period, if you have
returned to active work for at least one full day.
|
Reductions and Integration of Benefits |
- The monthly
income payable under this benefit will be reduced by any disability
or retirement benefit which is payable or which would have been
payable had you made satisfactory application under:
- |
The Canada/Quebec Pension Plans |
- |
A Workplace Safety Insurance Board (WSIB) act or equivalent provincial act. |
- |
A provincial auto insurance law. |
- |
Any other government plan. |
- The amount
of disability income is reduced so that the sum of all income,
compensation, indemnity and benefits for which you would be eligible
on account of disability, from your employer, a government body,
or under any group insurance or pension plan in which your employer
contributes, may not exceed 85% of your net monthly income determined
at the onset of disability.
|
Rehabilitative Employment |
- If you are
disabled, the Insurer may recommend that you undergo some suitable
rehabilitative training program which would take into account
the nature and limitations of your disability.
|
Subrogation |
- In the event
of any payment under this coverage, the Insurer shall be subrogated
to all of your rights of recovery therefore against any person
or organization and you shall execute and deliver instruments
and papers and do whatever else is necessary to secure such rights.
You shall do nothing to prejudice such rights.
|
Survivor Benefit |
- Upon your
death, the payments will continue for a total of three monthly
payments, without exceeding your sixty-fifth birthday, had you
been living, payable to your spouse, if living or to your children,
if living.
|
Total Disability |
- You are considered
totally disabled, during the first 24 months in which you receive
benefits, if you are unable to perform any and every duty of your
occupation. After this period you are considered totally disabled
if you are unable to perform any and every duty of any occupation
for which you are reasonably qualified by training, education
or experience.
|
Waiver of Premium |
- If receiving
Long Term Disability benefits, Maritime Life will waive the payment
of premiums beginning with the premium for the first full policy
month for which benefits became payable and continuing for each
full policy month for which benefits are payable.
|
Exclusions |
- Injury or
illness resulting from civil unrest, insurrection or war, whether
war be declared or not, or participation in a riot.
- Self-inflicted
injury, while sane or insane.
- Flight or
attempted flight on board a plane or other aircraft if you are
part of the crew or perform any function relating to the flight,
or participate in the flight as a parachutist.
- Injury or
illness resulting from committing, attempting to commit, or provoking
an assault or criminal offense.
|
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). |
|
Termination of Benefit |
- Age 65 or
earlier retirement.
|