Home
SEARCH
Retiree Health
DB Pension Plan
DB Pension Plan BenefitTabs
DB Pension Plan Links
DC Pension Plan
DC Pension Plan Links
 email this page    printer friendly
IBEW Local 11-LA NECA Active Health Plan
Summary Plan Description (SPD)


Accidental Death & Dismemberment (AD&D)

Insuring Clause for Accidental Death and Dismemberment Insurance

The insured individual will be paid the applicable amount of benefits if he sustains a loss described below. The loss must be due to an accident sustained while insured. Such loss must be incurred within 90 days from the date of such accident.

Payment will be made in accordance with the Payment of Claims provision.

Accidental Death and Dismemberment Benefits

The amount and payment of such benefits shall be as follows:

  1. If injury results in loss of life, the amount of insurance in effect on the date of injury will be payable to the beneficiary. The beneficiary is the same as under the Life Insurance unless the insured individual names a separate beneficiary. Payment will be made in the same manner as under Life Insurance. (Interest will be paid, at the Company's current rate, on proceeds that are not paid by the Company within 30 days from the date of death.) Interest is paid, if state-mandated, from date of death to date of payment.

    A separate beneficiary may be named in the same manner as described under Life Insurance;
  2. If such injury results in dismemberment as listed below, the amount payable will be one-half the maximum amount in effect on the date of injury:
    1. loss of a hand (all of the hand is cut off at or above the wrist);
    2. loss of a foot (all of the foot is cut off at or above the ankle);
    3. loss of eye or sight of an eye (loss of sight of an eye means that the eye is entirely blind and that no sight can be restored in that eye).

    The amount payable for all losses as a result of any one accident may not exceed the individual's maximum amount determined by the schedule of benefits.

Exceptions

Benefits are not payable for losses connected in any way with the following:

  1. Bodily or mental conditions existing at the time of or prior to the accident;
  2. Suicide (or attempt threat) while sane or insane; or intentionally self-inflicted injury;
  3. Ptomaine or bacterial infection other than pyogenic infection of and through a visible accidental cut or wound;
  4. Act or incident of war, declared or undeclared;
  5. Taking part in the commission of an assault or felony;
  6. Travel or flight in (including boarding or alighting therefrom and learning to operate) any type of aircraft or any other aerial device while such aircraft or device is:
    1. being used for a test purpose;
    2. being operated by or for, or under the command of the military authority (other than a transport type aircraft operated by the Military Air Transport Service (MATS) of the United States or a like air service of some other country;
    3. being used while the insured individual is flying, learning to fly or to operate, or acting as a member of the crew;
    4. owned or leased by or on behalf of the Policyholder of a firm under its control.