If within one year from the date of the accident, injury results in any of the following specific losses, the Plan pays a sum for injury resulting from an accident. Each sum is calculated based on the amount of principle sum.
| Percentage of Principle Sum | ||
|---|---|---|
| For Loss of: | Member/ Spouse | Dependent Children |
| Life | 100% | 100% |
| Both hands | 100% | 400%*** |
| Both feet | 100% | 400%*** |
| Entire sight of both eyes | 100% | 400%*** |
| One hand and one foot | 100% | 400%*** |
| One hand and entire sight of one eye | 100% | 100% |
| One foot and entire sight of one eye | 100% | 100% |
| Speech and hearing in both ears | 100% | 400%*** |
| One arm or one leg | 100% | 200%**** |
| One hand or one foot | 100% | 100% |
| Entire sight of one eye | 100% | 100% |
| Speech | 100% | 200%**** |
| Hearing in both ears | 100% | 200%**** |
| Thumb and index finger of the same hand | 100%** | 200% |
| Hearing in one ear | 100%*** | 25% |
| Use of both arms or both hands | 100% | 100% |
| Use of both legs or both feet | 100% | 100% |
| Use of one arm or one hand | 100% | 75% |
| Use of one leg or one foot | 100% | 75% |
| Paralysis benefits: | ||
| Quadriplegia (all four limbs) | 100% | 400%*** |
| Paraplegia (both lower limbs) | 100% | 200%**** |
| Hemiplegia (upper and lower limbs of one side of body) | 100% | 200%**** |
| ** The maximum benefit amount payable will not exceed a total of $250,000. | ||
| *** The maximum benefit amount payable will not exceed a total of $200,000. | ||
| **** The maximum benefit amount payable will not exceed a total of $100,000. | ||
“Loss” means, with regard to:
| Hands and feet: | Actual severance through or above the wrist or ankle joint; |
| Arms and legs: | Actual severance through or above the elbow or knee joint; |
| Thumbs and fingers: | Actual severance through or above the metacarpophalangeal joints; |
| Eyes: | Entire and irrecoverable loss of sight; |
| Speech and hearing: | Entire and irrecoverable loss of speech and/or hearing; |
| Paralysis: | Permanent and irrecoverable paralysis; |
| Loss of use: | Permanent, total and irrecoverable loss of use. The loss of use must be continuous for 12 months from the date of accident. |
The total benefit paid for all losses sustained by one person as a result of any one accident will not exceed the principle sum.
Only one benefit, the largest, is payable to each insured for all losses resulting from one accident.
