$1,000 ACCIDENT INSURANCE FOR ALL MEMBERS
As an eligible member of the Credit Union you are entitled to receive $1,000.00 of 24-hour Accidental Death and Dismemberment Insurance simply by completing and mailing the attached application. There is NO COST to you! The credit union pays the premiums. It's just one of the many benefits of credit union membership.IMPORTANT! Your completed form must be on file in order for a Certificate of Insurance to be issued in your name. (See Summary of Insurance Provisions inside for details.) We urge you to complete your form and mail it today!
SUMMARY OF INSURANCE PROVISIONS-Insurance Company of North America
As a member of the Credit Union age 18 or over, you are eligible for $1,000 of Accidental Death and
Dismemberment Insurance. Premiums for this Basic Coverage will be paid by your Credit Union. THERE
IS NO COST TO YOU. In order to receive your Certificate of Insurance, COMPLETE THE ENCLOSED
APPLICATION FORM AND MAIL. (In New York and North Carolina coverage is reduced 50% at age
70.)
This summary explains in general terms the insurance described, but in no way changes or affects the insurance afforded under such Policy as actually issued. All coverages are subject to actual Policy conditions and exclusions. Each member participating in the plan will receive a Certificate of Insurance describing the exact coverage and benefits provided.
Coverage Provided
When covered injury results in any of the following losses within one year from the date of the accident,
the Company will provide, in one sum, the following amounts:
| Loss of life | $1,000 |
| Loss of two members (hand, foot, or eye) | $1,000 |
| Loss of speech and hearing | $1,000 |
| Loss of entire sight in both eyes | $1,000 |
| Loss of entire sight in one eye | $500 |
| Loss of one hand or foot | |
| Loss of speech or hearing | |
| Loss of thumb and index finger on same hand |
The loss of a hand or foot means complete severance through or above the wrist or ankle joint; for thumb or index finger, it means complete severance through or above the metacarpophalangeal joints. The loss of sight of eye means irrecoverable loss of entire sight. The loss of speech means complete and irrecoverable loss thereof; for hearing it means complete and irrecoverable loss of hearing in both ears.
Who is Eligible
All members of the Credit Union age 18 or over when applying, are eligible for coverage. Every member of
the Credit Union age 18 or over who completes and returns an application will be accepted.
Individual Terminations
As long as you remain a member of the Credit Union and the Master Policy remains in force, your
coverage will be renewed. (In New York, Group Master Policy is renewable annually.)
General Exclusions
The Policy does not cover any loss caused by or resulting from; suicide or self-destruction or any attempt
thereat; declared war or any act of war; committing or attempting a felony or illegal act; riding in any
aircraft or device for aerial navigation except as a passenger for transportation only (not as a pilot or crew
member) in an aircraft certified as airworthy by the appropriate authority of the country of its registry.