Group Accidental Death & Dismemberment Insurance
(AD&D)
Did you realize that accidents are one of the major killers of men and women in their prime?
- Up to the age of 34, accidents lead all other causes in the death of Canadians.
- Every few seconds, someone is hurt in an accident - over 25 people die of these injuries everyday of the year.
- Auto accidents account for almost 50% of the accidental deaths in Canada, and increase by a few percent each year.
It is important to include Accidental Death and Dismemberment Benefits to your Life Insurance Portfolio!
- ELIGIBILITY
- BENEFIT AMOUNTS AND PREMIUM RATES
- PRODUCT FEATURES
- ADDITIONAL BENEFITS
- GENERAL INFORMATION
Eligibility
Accredited Businesses of the Better Business Bureau serving Mainland BC who are applying for insurance coverage, who are under age 70, and reside in Canada are eligible to apply for Accidental Death & Dismemberment (AD&D) Insurance. Coverage is available on an accredited business only basis.
Accredited businesses, as defined under the plan, includes employees of an Employer Company who is an associated business of the Better Business Bureau serving Mainland BC.
Employee means a person who is employed by an Employer Company that is in good standing as an associated business of the Better Business Bureau serving Mainland BC.
Benefit Amounts and Premium Rates
You can apply for coverage indicated below. The maximum under this plan is a principal sum of $200,000 per person.
- Coverage is available on an accredited businesses only basis.
- Coverage will expire at age 70.
| Benefit Amounts and Premium Rates | |
| $50,000 | $50.00 per person annually |
| $100,000 | $75.00 per person annually |
| $200,00 | $125.00 per person annually |
Product Features
Payment of Benefit
If Injury results in the permanent and total Loss of Use of a "Specified Loss Item" within 365 days of the date of an accident, Axa Assurances Inc. will pay the benefit amount indicated in the Schedule of Losses. Only the largest amount shown on the Schedule of Losses is payable for all losses resulting from any one accident.
Specific Loss Accident Indemnity
When Injury results in any of the following losses within three hundred and sixty-five (365) days after the date of the Accident, the Insurer will pay:
| For Loss Of: | Percentage of Benefit |
| Life | 100% |
| Entire sight of both eyes | 100% |
| Speech and hearing in both ears | 100% |
| One hand and the entire sight of one eye | 100% |
| One foot and the entire sight of one eye | 100% |
| Entire sight of one eye | 75% |
| Speech or hearing in both ears | 75% |
| Hearing in one ear | 40% |
| All toes of one foot | 331/3% |
| For Loss Of Use Of: | |
| Both hands | 100% |
| Both feet | 100% |
| One hand and one foot | 100% |
| One arm or one leg | 80% |
| One hand or one foot | 75% |
| Thumb and index finger or at least four fingers of one hand | 40% |
| For Paralysis Of: | |
| Both Upper and Lower Limbs (Quadriplegia) |
200% |
| Both Lower Limbs (Paraplegia) |
200% |
| Upper and Lower Limbs of one side of body (Hemiplegia) | 200% |
Additional Benefits
The Better Business Bureau's Accidental Death and Dismemberment Insurance coverage also includes the following additional benefits:
1. Repatriation
In the event a Loss of Life resulting from Injury is sustained by an Insured Person more than fifty (50) kilometres from the Insured Person's normal place of residence and indemnity for such Loss becomes payable in accordance with the terms of this policy, the Insurer will pay the reasonable and customary expenses actually incurred for the transportation of the body of the deceased Insured Person to the first (1st) resting place (including but not limited to a funeral home or the place of interment) in proximity to the normal place of residence of the deceased, including charges for the preparation of the body for such transportation, not to exceed in the aggregate the amount of fifteen thousand dollars ($ 15,000) for all such expenses.
2. Education
When the Accidental Death benefit becomes payable for an insured employee, the education benefit refunds expenses incurred for each qualifying dependent child up to $5,000 for each year (up to four years) that the child continues to remain in school beyond the secondary level.
3. Day-Care Benefit
When the Accidental Death benefit becomes payable for an insured employee, the day-care benefit refunds expenses incurred for each qualifying dependent child up to $5,000 for each year (up to four consecutive years) the child continues to be enrolled in a legally licensed day-care centre.
4. Rehabilitation
When a specific loss benefit becomes payable for an insured employee, the rehabilitation benefit refunds expenses up to $15,000 incurred by the Insured Person participate in a rehabilitation program in order to be qualified to engage in an occupation in which he would not have engaged except for such Injury, the Insurer will pay the reasonable and necessary expenses actually incurred, within three (3) years from the date of Loss, by the Insured Person for such program.
5. Workplace Modification and Accommodation
In the event an Insured Person sustains an Injury which results in a Loss payable under the section entitled "Specific Loss Accident Indemnity" of this policy and such Insured Person requires special adaptive equipment and/or workplace modification in order to reasonably accommodate his return to active full-time work with the Policyholder, the Insurer will pay the reasonable and necessary expenses actually incurred by the Employer.
The benefit will be paid to the Policyholder upon the Insured Person's return to active full-time work with the Policyholder and the Insurer has been provided with written proof of the expenses incurred. Payment by the Insurer for the total of all expenses incurred by the Policyholder will not exceed five thousand dollars ($ 5,000) as a result of any one (1) Accident subject to certain conditions.
6. Occupational Training
In the event a Loss of Life resulting from Injury is sustained by an Insured Person and indemnity for such Loss becomes payable in accordance with the terms of this policy, the Insurer will pay the reasonable and necessary expenses actually incurred, within three (3) years from the date of such Loss, by the Spouse of the Insured Person who engages in a formal occupational training program in order to become specifically qualified for active employment in an occupation for which he would not otherwise have sufficient qualifications, not to exceed in the aggregate the amount of fifteen thousand dollars ($ 15,000) for all such expenses. Payment will not be made for room, board or other ordinary living, travelling or clothing expenses.
7. Family Transportation Benefit
When, following an Injury which results in a Loss payable under the section entitled "Specific Loss Accident Indemnity" of this policy, an Insured Person is confined as an inpatient in a Hospital located more than one hundred and fifty (150) kilometres from his normal place of residence and such Insured Person is under the Regular Care and Attendance of a Physician, the Insurer will pay the reasonable expenses actually incurred by any Immediate Family Member(s) or a family representative for Accommodation and transportation by the most direct route from the normal place of residence of the Immediate Family Member(s) or family representative to the confined Insured Person and return to the normal place of residence of such Immediate Family Member(s) or family representative, not to exceed in the aggregate the amount of fifteen thousand dollars ($ 15,000) for all such expenses as the result of any one (1) Accident. Payment will not be made for board or other ordinary living, travelling or clothing expenses. If transportation occurs in a vehicle or device other than one operated under a license for the conveyance of passengers for hire, then reimbursement of transportation expenses will be limited to a maximum of twenty-five cents ($ 0.35) per kilometre travelled.
8. Identification
In the event a Loss of Life resulting from Injury is sustained by an Insured Person and the police or similar governmental authority requires identification of the Insured Person's body, the Insurer will reimburse one (1) Immediate Family Member's or a family representative's expenses incurred for transportation to the location of the Insured Person's body and return to his normal place of residence by the most direct route and for lodging and board, up to a maximum of ten thousand dollars ($10,000). If transportation is by any motor vehicle not for hire then the reimbursement of transportation expenses will be limited to a maximum of twenty-five cents ($0.35) per kilometre travelled. The Insured Person's body must be located more than one hundred fifty (150) kilometre from the Immediate Family Member's residence.
9. Seatbelt
In the event an Insured Person sustains an Injury which results in a Loss payable under the section entitled "Specific Loss Accident Indemnity" of this policy, the Insurer will pay an additional sum equal to ten percent (10%) of the applicable amount payable under the section entitled "Specific Loss Accident Indemnity", subject to a maximum of twenty thousand dollars ($20,000), which maximum is in combination with the Seat Belt Benefit maximum provided under any other policy issued to the Policyholder by the Insurer, if at the time of the Accident, the Insured Person was driving or riding in a Motorized Vehicle and wearing a properly fastened Seat Belt.
The driver of the Motorized Vehicle must hold a current and valid driver's license of a rating authorizing him to operate such Motorized Vehicle and neither be intoxicated nor under the influence of drugs, unless such drugs are taken as prescribed by a Physician, at the time of the Accident. "Intoxicated" and "under the influence of drugs" are as defined by the local jurisdiction where the Accident occurs.
10. Home Alteration and Vehicle Modification
In the event an Insured Person sustains the Loss of or Loss of Use of Both Feet or Legs or becomes Quadriplegic, Paraplegic or Hemiplegic, for which indemnity is payable in accordance with the terms of this policy, and he subsequently requires the use of a wheelchair to be ambulatory, the Insurer will pay the reasonable and necessary expenses actually incurred within three (3) years of the date of Loss for:
- the cost of alterations to the Insured Person's principal residence for the purpose of making it accessible, and/or
- the cost of modifications to one (1) motor vehicle utilized by the Insured Person, when such modifications are approved by licensing authorities where required for the purpose of adapting it to the needs of the Insured Person.
Payment by the Insurer for the total of all expenses incurred by or for any Insured Person will not exceed a maximum of fifteen thousand dollars ($ 15,000) as the result of any one Accident. The amount payable under this section will be coordinated with any amount paid or payable under any other insurance plan providing the same or similar benefit.
11. Aircraft Coverage
Insurance provided under this policy includes Injury sustained while and in consequence of:
- riding as a passenger, and not as a pilot, operator or member of the crew in or on any aircraft having a current and valid certificate of airworthiness and piloted by a person who then holds a current and valid pilot's license of a rating authorizing him to pilot such aircraft.
- riding as a passenger, and not as a pilot, operator or member of the crew in or on any aircraft operated by the Canadian Armed Forces or by a similar military service of any duly constituted governmental authority of any other recognized country.
- boarding or alighting from or being struck by any aircraft.
Notwithstanding (1) and (2) above, this policy excludes Injury sustained while and in consequence of riding in or on any aircraft owned, operated or leased by or on behalf of the Employer.
12. Exposure and Disappearance
If, by reason of an Accident covered by this policy, an Insured Person is unavoidably exposed to the elements and as the result of such exposure, suffers a Loss for which indemnity is otherwise payable hereunder, such Loss will be covered under the terms of this policy.
If the Insured Person is not found within one (1) year after the date of the disappearance or sinking or wrecking of the conveyance in which the Insured Person was riding at the time of the Accident and under such circumstances as would otherwise be covered hereunder, it will be presumed the Insured Person suffered a Loss of Life resulting from Injury at the time of such disappearance, sinking or wrecking.
13. Aggregate Limit of Indemnity
The Insurer's aggregate limit of indemnity for all losses arising out of any one (1) Accident, for which coverage is provided hereunder, is $2,500,000. In the event said limit of indemnity for any one (1) Accident is insufficient to pay the full amount of indemnity for each Insured Person, then the amount payable for each Insured Person will be in the proportion that the limit of indemnity for any one (1) Accident bears to the total amount of insurance that would have been payable, except for such limit of indemnity.
This section only applies to losses payable under the following sections: Specific Loss Accident Indemnity.
14. Beneficiary Designation
Indemnity payable in the event of the Loss of Life of an Insured Person will be payable to the beneficiary or beneficiaries designated in writing by the Insured Person on his Basic Group Life Insurance application on file with the Policyholder or on file with an Employer, as the case may be, or if there is no such beneficiary designation with respect to the Insured Person, such indemnity will be payable to the estate of the Insured Person. All other indemnities payable will be payable to the Insured Person, with the exception of indemnities payable under the following sections:
- Repatriation Benefit
- Education Benefit
- Day-Care Benefit
- Workplace Modification and Accommodation Benefit
- Occupational Training Benefit
- Family Transportation Benefit
- Identification Benefit
15. Individual Terminations
The insurance of an Insured Person will immediately terminate on the earliest of the following dates:
- on the date this policy is terminated;
- on the premium due date if the accredited business Employer fails to pay the required premium for the Insured Person;
- on the date the Insured Person reaches seventy (70) years of age;
- on the date the Insured Person ceases to be an active employee of the Policyholder on account of leave of absence, lay-off, maternity leave, disability, resignation, dismissal, pension or retirement, except as provided under the following sections:
- Waiver of Premium
- Continuation of Coverage
- During Approved Leaves
- Extension of Coverage
16. Waiver of Premium
If, under the accredited businesses Employer's insurance policy, an Insured Person's life insurance is extended under a waiver of premium provision as the result of total disability, coverage under this policy will also be extended and waiver of premium granted.
Premiums will continue to be waived until the earliest of the following dates:
- on the date this policy is terminated;
- on the date the Insured Person reaches sixty five (65) years of age; or
- on the date the Insured Person ceases to be totally disabled.
The Insurer reserves the right to request proof of total disability or any continuance thereof from time to time as the Insurer may reasonably require. Failure to provide proof satisfactory to the Insurer may result in termination of this Waiver of Premium clause.
The coverage which is continued under this clause will be subject to the terms and provisions of this policy in effect as of the date of commencement of disability, including any provision providing for reductions in amounts of insurance.
Notwithstanding anything contained to the contrary in this policy, in no event will benefits payable for any Loss which occurs while coverage is being continued under this clause exceed the amount of insurance that would have been payable to the Insured Person at the date of commencement of disability.
17. Continuation of Coverage During Approved Leaves
If, under the Policyholder's Basic Group Life Insurance policy, an Insured Person's life insurance is continued during any approved leave of absence, temporary lay-off, maternity leave or disability leave, coverage under this policy will also be continued, provided payment of premium is continued.
The coverage which is continued under this clause will be subject to the terms and provisions of this policy in effect as of the date of commencement of the leave, including any provision providing for reductions in amounts of insurance.
Notwithstanding anything contained to the contrary in this policy, in no event will benefits payable for any Loss which occurs while coverage is being continued under this clause exceed the amount of insurance that would have been payable to the Insured Person at the date of commencement of the leave.
18. Extension of Coverage
This extension of coverage will terminate at 12:01 a.m., Standard Time, on the first (1st) day of the month following either the completion of the twelve (12) month period or the date the Insured Person returns to work in any capacity, whichever is earlier.
The coverage which is continued under this clause will be subject to the terms and provisions of this policy in effect as of the date of termination of employment, including any provision providing for reductions in amounts of insurance.
Notwithstanding anything contained to the contrary in this policy, in no event will benefits payable for any Loss which occurs while coverage is being continued under this clause exceed the amount of insurance that would have been payable to the Insured Person at the date of termination of employment.
19. Exclusions
This policy does not cover any Loss, fatal or non-fatal, caused or contributed to by:
- suicide or intentionally self-inflicted Injury;
- war, whether declared or not;
- participation in a riot, insurrection, civil commotion or disturbance;
- active full-time, part-time or temporary service in the armed forces of any country;
- riding as a passenger or otherwise in any vehicle or device for aerial navigation, other than as provided in the section entitled "Aircraft Coverage";
- medical treatment or surgery, except if the medical treatment or surgery was needed because of an Accident.
General Information
Fully Portable Coverage
If you are an accredited businesses, coverage goes with you regardless of a change in your profession, job status, place of employment or residence - 24 hours a day, anywhere in the world - as long as you continue to pay your premiums.
Money Back Guarantee
Once your application is received and approved, you will be sent a Certificate of Insurance. You will have 60 days to review it to ensure that it meets your needs. Should you choose not to accept the insurance you can cancel your coverage and return the Certificate within 60 days of the effective date. You will receive a full refund of any premiums already paid.
Beneficiary
You may name any beneficiary you choose for the Accidental Death benefit.
The Contract
This policy includes the endorsements and attached papers, if any, and contains the entire contract of insurance. No statement made by the applicant for insurance will void the insurance or reduce benefits hereunder unless contained in a written application signed by the applicant. No agent has authority to change this policy or to waive any of its provisions. No change in this policy will be valid unless approved by an officer of the Insurer and such approval be endorsed hereon or attached hereto.
All statements contained in any such application for insurance will be deemed representations and not warranties.
Certificate of Insurance
The Policyholder shall not deliver to any Insured Person any written description of the benefits available under this policy without first allowing the Insurer to review the description. The Insurer may at its discretion require the Policyholder to make changes to the description if the description contains a discrepancy with the wordings of the policy. Where the Insurer has not been allowed to review the description, or where the Policyholder does not make a change to the description as required by the Insurer, then the Policyholder will indemnify and hold harmless the Insurer against all claims that may be paid by or made against the Insurer and which arise out of a discrepancy between the description and the wording of the policy. In addition, the Policyholder will indemnify and hold harmless the Insurer from all losses, costs, charges and expenses, including but not limited to legal fees, that the Insurer may incur as a result of any such claims.
Termination
The Policyholder may cancel this policy by mailing to the Insurer written notice stating when thereafter such cancellation will be effective. The Insurer may cancel this policy by mailing to the Policyholder at the address shown in this policy written notice stating when, not less than thirty (30) days prior to the Anniversary Date of this policy, such cancellation will be effective. The mailing of such notice as aforesaid will be sufficient proof of notice and the effective date of cancellation stated in the notice will become the end of the policy period. Delivery of such written notice either by the Policyholder or by the Insurer will be equivalent to mailing.
Unless otherwise provided in this policy, if the Policyholder cancels, earned premiums will be computed in accordance with the customary short rate table and procedures. If the Insurer cancels, earned premiums will be computed pro rata. Premium adjustment may be made at the time cancellation is effected, and if not then made, will be made as soon as practicable after cancellation becomes effective. The Insurer's cheque or the cheque of its representative mailed or delivered as aforesaid will be sufficient tender of any refund of premium due the Policyholder.
Inspection of Records
The Insurer will be permitted to examine the Policyholder's records relating to this policy at any reasonable time, and from time to time until two (2) years after expiration of this policy or until final adjustment and settlement of all claims hereunder, whichever is the later.
DISCLAIMER:
This information summarizes the terms and conditions of the program. All rights and obligations are determined in accordance with the group policy. For detailed information, please contact your employer or Pat Anderson Agency Ltd..