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Accidental Death & Dismemberment |
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You are insured against the perils described in the Loss
Schedule. Your protection is world-wide, 24 hours a day, on or
off the job. Benefits are payable regardless of any other
benefits that you may receive from any insurance company other
than the Company, or any other organization. “The Company”
means RBC Life Insurance Company.
Who is eligible?
You are eligible if you are a Member of the Policyholder in
good standing and you are under age 80.
Principal Sum
Your amount of Principal Sum is equal to the amount of your
Basic Life Insurance under the Plan.
Termination clause
All benefits terminate on the earlier of the day you reach
age 80 or the day you retire, or the day you cease to be covered
under the Hour Bank rules explained in the General Information
Section of this booklet.
When is this plan effective?
Your insurance is effective as per the eligibility
provisions established by the Plan Administrator, as explained
in the General Information Section of this booklet.
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Loss Schedule
If an accident causes a loss payable under this schedule within
one year from the date of the accident, the Company pays the sum
set opposite such loss, and not more than the aggregate of the
Principal Sum is paid for injuries resulting from the same
accident.
| For Loss of: |
Percentage
of Principle Sum: |
| Life |
100% |
| For Loss of or Loss of
Use of: |
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| Both Hands or Both Feet |
100% |
| Sight of Both
Eyes |
100% |
| One Hand and One Foot |
100% |
| One Hand or Foot and Sight of One Eye |
100% |
| Speech and Hearing in Both Ears |
100% |
| One Leg or One Arm |
75% |
| Hearing in One Ear |
50% |
| Either Hand or
Foot |
66 2/3% |
| Speech or Hearing in Both Ears |
66 2/3% |
| Sight of One Eye |
66 2/3% |
| Thumb and Index Finger of the Same
Hand |
33 1/3% |
| Four Fingers of the Same
Hand |
33 1/3% |
| All Toes of One
Foot |
12 1/2% |
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For Total and Irreversible Paralysis of:
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| All four limbs (Quadriplegia) |
200% |
| Both lower limbs
(Paraplegia) |
200% |
| One arm and one leg on the same side of the body
(Hemiplegia) |
200% |
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“Loss” means, with regard to:
Hands and Feet: Actual severance through or above the
wrist or ankle joint;
Eyes: Entire and irrecoverable loss of sight;
Leg or Arm: Actual severance through or above the
knee or elbow joint;
Thumb and Fingers: Actual severance through or above the
metacarpophalangeal joints;
Speech and Hearing: Entire and irrecoverable loss;
Toes: Actual severance through or above the
metatarsophalangeal joints;
“Loss of Use of” means, with regard to:
Any Limb(s): 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.
Indemnity provided under this section for all losses you
sustain as
a result of any one accident does not exceed the following:
- With the exception of Quadriplegia, Paraplegia and
Hemiplegia,
the Principal Sum.
- With respect to Quadriplegia, Paraplegia and Hemiplegia,
two
times the Principal Sum.
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Exposure and Disappearance
If loss results from unavoidable exposure to the elements and
indemnity is otherwise payable hereunder, such loss is payable
under the terms of the policy.
If your body is not found within one year after the date of the
disappearance, sinking or wrecking of the vehicle in which you
are an occupant at the time of the accident and under such
circumstances as would otherwise be covered hereunder, it is
presumed that you suffered loss of life resulting from bodily
injury caused by an accident at the time of such disappearance,
sinking or wrecking.
Waiver of Premium
If you become totally disabled from an accident or sickness
and waiver of premium is approved under your applicable Group
Life Insurance Plan, premiums under this plan are waived while
total disability continues, until the earlier of your attainment
of age 65, your eligibility terminates or the policy is
terminated.
Repatriation
If you lose your life as a result of a covered accident
occurring at least 100 kilometres from your principal residence,
the Company pays up to $10,000 for the preparation and
transportation of your body back to your principal
residence.
If you receive benefits for a loss described in the Loss
Schedule, the Company pays for the expenses actually incurred by
your spouse within three years from the date of the accident,
for an approved and mutually agreed upon formal occupational
training program, specifically qualifying him to gain active
employment in an occupation for which he would otherwise not
have had sufficient qualifications. The maximum payable
hereunder is $10,000.
Spousal Retraining
“Spouse” means a person who is living with you and who is
legally married to you; or if you are not married, is a person
whom you have publicly represented as your Spouse and with whom
you have resided continuously for at least 12 months in a
conjugal-like relationship, civil union, adult interdependent
relationship and who is:
• at least 18 years of age;
• competent to contract; and
• not related by blood closer than would legally bar marriage.
If more than one person meets this definition, the Insurance
Company will only pay one benefit, which will be paid in equal
shares to the persons meeting the definition.
Rehabilitation
If you receive benefits for a loss described in the Loss
Schedule and you require special training to allow you to work
in an occupation that you would not have engaged in except for
the injuries you sustained, the Company pays for that training,
considering the expenses are reasonable and necessary (other
than travelling, clothing and ordinary living expenses), up to $10,000,
occurring within two years from the date of the accident.
Family Transportation
If while on a trip, you sustain an injury and as a result,
are confined as an in-patient in a Hospital, are under the
Regular Care and Attendance of a Physician and require the
personal attendance of a Member of the Immediate Family as
recommended by the attending Physician, the Company pays for the
expense incurred by the family member for transportation to your
bedside by the most direct route by a licensed common carrier,
but not to exceed an amount of $3,500 as the result of
any one accident.
“Hospital” means an institution licensed as a
hospital, which is open at all times for the care and treatment
of injured persons, with organized facilities for diagnosis,
major surgery and with twenty-four (24) hour nursing service.
Hospital will not include a facility or part of a facility
primarily used for the aged, the treatment of drug addiction or
alcoholism, rehabilitative care, custodial or educational care,
or a rest home, nursing home or convalescent hospital.
“Member of the Immediate Family” means your Spouse or
common-law Spouse, parents, grandparents, children over age 18,
brother or sister.
“Regular Care and Attendance” means observation and
treatment to the extent necessary under existing standards of
medical practice for the condition causing the confinement.
Education
The Company pays for tuition fees in the event of your
accidental death. To qualify, eligible dependent children must
be enrolled as full-time students in a post-secondary “institution
of education” at the time of your death or must enroll within
one year following your death.
The amount paid for tuition fees and textbook expenses is equal
to the lesser of 3% of your Principal Sum or $5,000,
per year per child, for a maximum of four consecutive years. The
Company must receive proof of enrollment and attendance for each
year that a payment is to be made for each child. If there are
no dependent children eligible for this benefit, your Principal
Sum is increased by $2,500.
For the purpose of this benefit, “Dependent child” means
your unmarried natural born child, legally adopted child,
step-child or any common-law child (if you have his legal
custody and control), who is under 25 years of age and is
dependent upon you for support and maintenance. In addition, a
child incapable of self-support by reason of mental or physical
infirmity is covered beyond the maximum age.
“Institution of education” includes any University,
CEGEP, Trade School or College, as defined where you live.
Home Alteration and Vehicle Modification
If you receive benefits for a loss described in the Loss
Schedule and are subsequently required (due to the cause for
which payment under the Loss Schedule is made) to use a
wheelchair to be ambulatory, the Company pays, upon presentation
of proof of payment, the one-time cost of (a) alterations to
your residence to make it wheelchair accessible and habitable
and (b) modifications necessary to your motor vehicle to make
the vehicle accessible or driveable for you.
Benefits herein are not paid unless: (a) 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 (b) 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 this benefit is $10,000.
To whom are benefits paid?
Your accidental death benefit is paid to the beneficiary
designated under your applicable Group Life Insurance Plan, or
to your estate if no such designation is made. Any other
benefits are paid to you (those described in the Loss Schedule
are paid as a percentage of the Principal Sum).
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EXCLUSIONS
The insurance does not cover losses caused in any way from
suicide or any suicide attempt; self-inflicted injuries; war,
declared or undeclared; full-time active service in the armed
forces of any country; travelling as a pilot or crew member of
any aircraft or travel in the Policyholder’s owned or leased
aircraft.
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Claim Procedures
To make a claim under this plan, written notice of the accident
must be given to the Company within 30 days of the date of the
accident and written proof must be submitted within 90 days of
the date of the accident. The Company provides the necessary
claim forms as well as instructions covering other requirements
that may aid in a prompt handling of the claim.
If the Company does not receive the required notice and proof of
loss, the claim may not be considered after the 90 day period
has expired, unless there is good reason for the delay. In no
event is a claim considered after one year from the date of the
accident if the Company was not notified and the necessary forms
not completed and submitted to the Company.
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