ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS
Accidental Death and Dismemberment Benefits are payable on behalf of all covered Participants under an insurance policy with American International Life Insurance Company of New York (the “Company”).
Principal Sum. As applicable to each insured Participant, Principal Sum means the amount of $100,000.
Reduction Schedule. The amount payable for a loss will be reduced if an Insured Person is age 70 or older on the date of the accident causing the loss with respect to any Benefit provided by this Policy where the amount payable for the loss is determined as a percentage of his or her Principal Sum. The amount payable for the Insured Participant’s loss under this Benefit is a percentage of the amount that would otherwise be payable, according to the following schedule:
|AGE ON DATE OF ACCIDENT||PERCENTAGE OF AMOUNT OTHERWISE PAYABLE|
|85 and older||15%|
“Age” as used above refers to the age of the Insured Person on the Insured Person’s most recent birthday, regardless of the actual time of birth.
Limitation on Multiple Benefits. If an Insured Participant suffers one or more losses from the same accident for which amounts are payable under more than one of the following Benefits provided by this Policy, the maximum amount payable under all of the Benefits combined will not exceed the amount payable for one of those losses, the larger of the Accidental Death Benefit or the Accidental Dismemberment Benefit.
Accidental Death Benefit. If Injury to the Insured Participant results in death within 365 days of the date of the accident that caused the Injury, the Company will pay 100% of the Principal Sum.
Accidental Dismemberment Benefit. If Injury to the Insured Participant results, within 365 days of the date of the accident that caused the Injury, in any one of the Types of Losses specified below the Company will pay the percentage of the Principal Sum shown below for that Loss:
|Schedule For Insured|
|Type of Loss||Percentage of Principal Sum|
|Both Hands or Both Feet||100%|
|Sight of Both Eyes||100%|
|One Hand and One Foot||100%|
|One Hand and Sight of One Eye||100%|
|One Foot and Sight of One Eye||100%|
|Speech and Hearing in Both Ears||100%|
|One hand or One Foot||50%|
|Sight of One Eye||50%|
|Speech or Hearing in Both Ears||50%|
|Hearing in One Ear||25%|
|Thumb and index Finger of Same Hand||25%|
If more than one Loss is sustained by an Insured Participant as a result of the same accident, only one amount, the largest, will be paid.
Exposure and Disappearance. If by reason of an accident occurring while an Insured Participant’s coverage is in force under the Policy, the Insured Participant is unavoidably exposed to the elements and as a result of such exposure suffers a loss for which a benefit is otherwise payable under the Policy, the loss will be covered under the terms of the Policy.
If the body of an Insured Participant has not been found within one year of the disappearance, forced landing, stranding, sinking or wrecking of a conveyance in which the Participant was an occupant while covered under the Policy, then it will be deemed, subject to all other terms and provisions of the Policy, that the Insured Participant has suffered accidental death within the meaning of the Policy.
“Loss” of a hand or foot means complete severance through or above the writs or ankle joint.”Loss of sight of an eye” means total and irrecoverable loss of the entire sight in that eye.”Loss of hearing” in an ear means total and irrecoverable loss of the entire ability to hear in that ear.”Loss of speech” means total and irrecoverable loss of the entire ability to speak.”Loss of the thumb and index finger” means complete severance through or above the metacarpophalangeal loss of both digits.
No coverage shall be provided under this Policy and no payment shall be made for any loss resulting in whole or part from, or contributed to by, or as a natural and probable consequence of any of the following excluded risks even if the proximate or precipitating cause of the loss is an accidental bodily injury.
- suicide or any attempt at suicide or intentionally self-inflicted Injury or any attempt at intentionally self- inflicted Injury.
- sickness, or disease, mental incapacity or bodily infirmity whether the loss results directly or indirectly from any of these, unless specifically provided by this Policy.
- travel or flight in or on (including getting in or out, on or off of) any vehicle used for aerial navigation, other than as a fare-paying passenger on a scheduled or charter flight operated by a scheduled airline whether as a passenger, pilot, operator or crew member, unless specifically provided by this Policy.
- declared or undeclared war, or any act of declared or undeclared war.
- infections of any kind regardless of how contracted, except bacterial infections that are directly caused by botulism, ptomaine poisoning or an accidental cut or wound independent and in the absence of any underlying sickness, disease or condition including but not limited to diabetes.
- service in the Armed Forces or units auxiliary thereto of any country or international authority. (Unearned premium for any period for which the Insured Person is not covered due to his or her active duty status will be refunded) (Loss caused while on short-term National Guard or reserve duty for regularly scheduled training purposes is not excluded).
- the Insured Person being under the influence of drugs unless taken under the advice of and as specified by a Physician.
- the Insured’s Person’s participation in a felony, riot, or insurrection.
- the medical or surgical treatment of sickness, disease, mental incapacity or bodily infirmity whether the loss results directly or indirectly from the treatment.