Who is Eligible? All Active Members of the XYZ Association and their Dependents who are citizens or residents of United States, its territories and protectorates are eligible. XYZ Members and their Family are guaranteed acceptance into this Insurance Plan provided they complete the required Enrollment form and pay the proper premium for their insurance. There are no physical examinations required!
What Limit of Insurance is Available?
Insurance coverage is available starting at $50,000 and goes up to
the amount of $250,000.
What are the
Covered Losses? If You and Your Covered Dependents sustain an
Injury which results in any of the following Losses within 180 days
of the date of accident, We will pay the injured person's amount of
Principal Sum, or a portion of such Principal Sum, as shown opposite
the Loss, after We receive Proof of Loss in accordance with the
Proof of Loss Provision.
This benefit will be paid
according to the General Provisions of the Policy.
We
will not pay more than the Principal Sum to any one person, for all
Losses due to the same accident. Your amount of Principal Sum is
shown in the Schedule of Insurance. The amount of Your Dependents'
Principal Sum is shown as a Percentage of Your Principal Sum in the
Schedule of Insurance.
| For loss of | Benefit Amount |
|---|---|
| Life | Principal Sum |
| Both Hands or Both Feet or Sight of Both Eyes | Principal Sum |
| One Hand and One Foot | Principal Sum |
| Speech and Hearing in Both Ears | Principal Sum |
| Either Hand or Foot and Sight of One Eye | Principal Sum |
| Quadriplegia | Principal Sum |
| Hemiplegia | One-Half of Principal Sum |
| Paraplegia | One-Half of Principal Sum |
| Either Hand or Foot | One-Half of Principal Sum |
| Sight of One Eye | One-Half of Principal Sum |
| Speech or Hearing in Both Ears | One-Half of Principal Sum |
| Thumb and Index Finger of Either Hand | One-Quarter of Principal Sum |
"Quadriplegia" means total Paralysis of both upper and lower limbs.
"Hemiplegia" means total Paralysis of the upper and lower limbs on
one side of the body.
"Paraplegia" means total Paralysis of both upper limbs or
both lower limbs. "Paralysis" means total loss of use. A doctor
must determine the loss of use to be complete and not reversible at
the time the claim is submitted.