Who Is Covered
All participants in the covered activity. Policyholder staff may also be enrolled under this plan. Covered Activity (A) All activities sponsored and supervised by the Policyholder, including travel with a group in connection with such activities, and (B) travel directly and without delay to or from the Insured Person's home or residence and the site of such activities.
Medical Expense Benefit
If the Covered Person incurs eligible expenses as the direct result of a covered injury and independent of all other causes, the Company will pay the charges incurred for such expense within 365 days, beginning on the date of accident. Payment will be made for eligible expenses in excess of the applicable Deductible Amount, not to exceed the Maximum Medical Benefit. The first such expense must be incurred within 90 days after the date of the accident. "Reasonable expenses" means charges for the following necessary treatment and service, not to exceed those generally charged for similar care in the area where provided.
Medical and surgical care by a physician
Radiology (X-rays)
Prescription drugs and medicines
Dental treatment of sound natural teeth
Hospital care and service in semi-private accommodations, or as an outpatient
Ambulance service from the scene of the accident to the nearest hospital
Orthopedic appliances necessary to promote healing
If excess coverage is selected, this plan does not cover treatment or service for which benefits are payable or service is available under any other insurance or medical service plan available to the Covered Person. Primary coverage pays benefits under the plan without offset for other insurance (except Worker's Compensation).
Accidental Death and Dismemberment Benefit
If a covered injury results in any of the losses specified below within 365 days after the date of the accident, the Company will pay the applicable amount:
Full Principal Sum for loss of life
Full Principal Sum for double dismemberment
Full Principal Sum for loss of sight of both eyes
50% of the Principal Sum for loss of one hand, one foot, or sight of one eye
25% of the Principal Sum for loss of index finger and thumb of same hand
"Member" means hand, foot, or eye.
Loss of hand or foot means complete severance above the wrist or ankle joint. Loss of eye means the total, permanent loss of sight. We will not pay more than the Principal Sum for this Benefit for all losses due to the same accident.
Exclusions and Limitations
This plan does not cover any loss to or resulting from:
Voluntarily taking any drug or narcotic unless the drug or narcotic is prescribed by a Physician.
Suicide, self-destruction, attempted self-destruction or intentional self-inflicted injury while sane or insane.
War or any act of war, declared or undeclared.
Sickness, disease or any bacterial infection, except one that results from an accidental cut or wound or pyogenic infections that result from accidental ingestion of contaminated substances.
Injury caused by, contributed to or resulting from the Covered Person's use of alcohol, illegal drugs or medicines that are not taken in the dosage or for the purpose as prescribed by the Covered Person's Physician.
Service for Active Duty in the armed forces, National Guard, military, naval or air service or organized reserve corps of any country or international organization.
Services or treatment rendered by a Physician, Nurse or any other person who is employed or retained by the policyholder; or an Immediate Family member of the Covered Person.
Treatment of a hernia, Osgood-Schlatter's disease, osteo-chondritis, appendicitis, osteomyelitis, cardiac disease or conditions, pathological fractures, congenital weakness, whether or not caused by a Covered Accident.
Damage to or loss of dentures or bridges or damage to existing orthodontic equipment, except as specifically provided in this Policy.
Eyeglasses, contact lenses, hearing aids.
Travel or flight in or on any vehicle for aerial navigation, including boarding or alighting from: While riding as a passenger in any aircraft not intended or licensed for the transportation of passengers.
