Contents Close

AD&D provides you or your beneficiary with financial support if you die as a result of an accident or suffer an insured accidental injury. My Choice offers the following coverage options:

	Coverage
Option 1	2 x Annual Salary
Option 2	3 x Annual Salary
Option 3	5 x Annual Salary
Option 4	7 x Annual Salary

Each of the above AD&D options is available as "Associate Only" or "Family" coverage. With "Family" coverage, the Spouse and Child insured amounts will be as follows:

■ Spouse (no Children): 60% of Associate insured amount

■ Spouse (with Children): 50% of Associate insured amount

■ Each Child (no Spouse): 20% of Associate insured amount

■ Each Child (with Spouse): 15% of Associate insured amount

ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) DETAILS

Schedule of Losses:

If injury results in any of the following losses, within 365 days of the date of the accident, ACE INA Insurance will pay the benefit specified.

For Loss of:
Life	The Principal Sum
Brain Death	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, Both Hands, Both Legs or Both Feet	Two Times the Principal Sum
One Arm or One Leg	Three-Quarters of the Principal Sum
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

g 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.

g 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” as used with reference to quadriplegia (paralysis of both upper and lower limbs), paraplegia (paralysis of both lower limbs), and hemiplegia (total paralysis of upper and lower limbs of one side of the body), means the complete and irrecoverable paralysis of such limbs.

■ 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.

g Brain Death

■ Means the irreversible unconsciousness with total loss of brain function; and complete absence of electrical activity of the brain, even though the heart is still beating.

g Surgical Reattachment Provision

■ If an insured Person suffers complete severance of a hand, foot, arm or leg as described under the Schedule of Losses, then the Company will pay the amount specified under the Accidental Death and Dismemberment Loss Schedule, even if the affected (severed) limb is surgically reattached whether successful or not.

g Rehabilitation Benefit

■ If injury caused by an insured accident requires you to undergo special training in order to be qualified to engage in an 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.

g Repatriation Benefit

■ When injuries covered by this policy result in loss of life outside 150 km of your city of principal residence or outside of Canada, ACE INA will pay for the preparation and transportation of your body back to your principal residence.

■ Maximum benefit - $15,000.

g 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

g Seat Belt Benefit

■ If, due to a vehicular accident, injury results in a loss payable (as outlined in the schedule of losses), 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.

g Special Education Benefit

■ 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 12^th or 13^th grade level, or was at the 12^th or 13^th 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.

g Family Transportation Benefit

■ When injuries covered by the 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.

■ "Member of the Immediate Family" means the spouse, legal or common-law, parents, grandparents, children over age 18, brother or sister.

■ Must be recommended by the attending physician, in writing.

g Home Alteration and Vehicle Modification

■ If injury results in a loss as listed in the schedule of losses (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.

■ The maximum payable under both items 1 and 2 shall be the expense actually incurred up to the greater of $15,000 or 10% of the Insured Persons Principal Sum amount to a maximum of $50,000.

g 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 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.

g Identification Benefit

■ In the event accidental Loss of Life is sustained by the Insured Person not less than one hundred and fifty (150) kilometres from the Insured Person’s normal place of residence and identification of the body by a member of the immediate family has been requested by the police or similar governmental authority, ACE INA will reimburse the reasonable expenses actually incurred by such member for:

a) Transportation by the most direct route to the city or town where the body is located; and

b) Hotel accommodation in such city or town, subject to a maximum duration of three (3) days.

■ The reimbursement of such expenses incurred is subject to the accidental loss of life indemnity being subsequently payable in accordance with the terms of this policy following the identification of the body as the Insured Person. The maximum amount payable will not exceed $15,000 for all such expenses.

■ Payment will not be made for board or other ordinary living, travelling or clothing expenses, and transportation must occur in a vehicle or device operated under a license for the conveyance of passengers for hire.

g Bereavement Benefit

■ When injuries covered by the policy result in loss of life of an Insured Person with 365 days from the accident, ACE INA will pay the reasonable and necessary expenses actually incurred by the spouse and dependent children of the Insured Person for up to six (6) sessions of grief counselling, by a Professional Counsellor, subject to a maximum of $1,000. “Professional Counsellor” means the treatment or counselling by a therapist or counsellor who is licensed, registered or certified to provide such treatment.

g In-Hospital Indemnity

■ In the event an Insured Person sustains an injury which results in a payment being made under the Schedule of Losses, excluding Loss of Life Benefit and the Insured Person is hospital confined as an in-patient and is under the care of a legally qualified and registered physician or surgeon other than himself, ACE INA will pay for each full month, one percent (1%) of the Insured Person’s Principal Sum, subject to a maximum benefit of $2,500, or one-thirtieth of such monthly benefit for each day of partial month, retroactive to the 1^st full day such confinement but not to exceed 365 days in the aggregate for each period of hospital confinement.

■ “Hospital” as used herein means a legally constituted establishment which meets all of the following requirements: (1) operates primarily for the reception, care and treatment of sick, ailing or injured persons as in-patients; (2) provides 24 hour a day nursing service by registered or graduate nurses; (3) has a staff of one or more licensed physicians available at all times; (4) provides organized facilities for diagnosis and surgical facilities; and (5) is not primarily a clinic, nursing home or convalescent home or similar establishment nor, other than incidentally, a place for alcoholics or drug addicts.

■ “In Patient” means a person admitted to a hospital as a resident or bed-patient and who is provided at least one day’s room and board by the hospital

g Cosmetic Disfigurement

■ If, an Insured Person suffers a third degree burn in a non-occupational accident, ACE INA will pay a percentage of the Principal Sum depending on the area of the body which was burned according to the following table:

Body Part	(A) Area Classification	(B) Maximum allowable % for Area Burned	(C) Maximum % of Principal Sum Payable
Face, Neck, Hand	11	9%	99%
Hand & Forearm	5	4.5%	22.5%
Either Upper Arm	3	4.5%	13.5%
Torso (Front or Back)	2	18%	36%
Either Thigh	1	9%	9%
Either Lower Leg (below knee)	3	9%	27%

■ The maximum percent of Principal Sum Payable (C) is determined by multiplying the Area Classification (A) by the Maximum Allowable percent for Area Burned (B). In the event of a 50% surface burn, the Maximum Allowable percent for Area Burned (B) is reduced by 50%. This table only represents the maximum percent of the Principal Sum payable for any one accident. If the Insured suffers burns in more than one area as a result of any one accident, benefits will not exceed a maximum of $25,000.

g 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.

g 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.

■ Benefits payable under this section will be limited to only one (1) policy in the event the benefits are contained in two (2) or more policies issued to the Policyholder by ACE INA (not applicable to the Schedule of Losses and Conversion).

g 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.

g 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 aerial navigation, while being used for any test or experimental purposes; while the Insured Person is operating, learning to operate or serving as a member of the crew thereof; any such aircraft or device which is owned or leased by or on behalf of the Policyholder.

g Reduction and Termination of Benefit

■ The benefit terminates at age 65 or earlier retirement.

g Beneficiary

■ You may change your beneficiary at any time by written notice to your Employer, subject to any policy or legal limitations.

Contents Close