Supplemental — DUO^® Accident Insurance

THIS PRODUCT PROVIDES LIMITED BENEFITS. DUO ACCIDENT INSURANCE IS GROUP ACCIDENT-ONLY COVERAGE. THIS COVERAGE IS SUPPLEMENTAL AND IS NOT A SUBSTITUTE OR REPLACEMENT FOR COMPREHENSIVE HEALTH INSURANCE COVERAGE. IT IS NOT INTENDED TO COVER ALL MEDICAL EXPENSES. THIS PRODUCT DOES NOT PROVIDE COVERAGE FOR ILLNESS OR DISEASE.

This document provides a brief description of USAble Life’s DUO Accident insurance. This is not an insurance policy. Limitations and exclusions apply, and coverage may be reduced or terminated due to lack of eligibility. Please read the insurance policy carefully.

Please consult your policy, certificate, and any attached riders, if applicable, for specific information about the benefits available, the benefit amounts payable, and the requirements that describe qualifying for payment of the benefits.

Renewability
The policy is renewable at the option of the policyholder, subject to the terms and conditions of the policy. The acceptance of a renewal premium is optional with the company. An employee’s coverage is contingent upon continued employment or membership in the group.

Change of Premium
Premiums are subject to change. Rates are guaranteed for two years from the policy effective date. The company reserves the right to change the premium rate at the end of any rate guarantee period.

Cancelability and Modification
The policy may be canceled at any time by the policyholder. We may cancel or modify the policy with at least 31 days’ notice, subject to the policy provisions.

Termination
Coverage will end when an employee is no longer actively at work, no longer eligible for insurance, when due premium is not paid, or when the policy is terminated by us or the policyholder, subject to the policy provisions.

We will not pay benefits for a loss that is caused by, contributed to by, or occurs as a result of any of the following:

1. Receiving treatment for illness, disease, bodily or mental infirmity, bacterial or viral infection, or medical or surgical treatment.
2. Intentionally self-inflicting bodily injury or attempting suicide, while sane or insane.
3. Being exposed to any act of war, declared or undeclared, or serving in any of the armed forces.
4. Being exposed to a nuclear, chemical, biological, or radiological event.
5. Participating in, or attempting to participate in commission of a felony; actively participating in a riot or insurrection; or that occurs while incarcerated in any type of penal institution.
6. Being under the influence of alcohol or any narcotic, unless taken as prescribed by a physician.
7. Participating in any form of flight aviation other than as a fare-paying passenger in a fully licensed/passenger-carrying aircraft.
8. Engaging in bungee jumping, sail gliding, parachuting, parasailing, parakiting, hang gliding, mountain climbing, or jumping from any aircraft.
9. Participating in any organized sport in a professional or semi-professional capacity.
10. Riding in or driving any motor-driven vehicle in a race, stunt show or speed test.

We will not pay benefits for medical care or receiving healthcare treatment, services, transportation, or for a hospital stay in any medical facility outside the United States of America or Canada.

Accidental death or dismemberment must occur within 180 days of a covered accidental injury.

Based on the plan selected, hospital admission benefits are limited to a maximum of one admission per accident, and hospital confinement benefits are limited to a maximum of 30 days per accident/365 days per calendar year.

Plan-specific benefit amounts and maximums are included in your certificate and any attached riders, if applicable.

Benefits
At the group policyholder’s option, your certificate may also include benefits for any of the following: burns, brain injury, coma, dislocation (nonsurgical), eye injury (nonsurgical), fracture (nonsurgical), lacerations, ambulance, blood products, chiropractic therapy, diagnostic examination, emergency dental procedure, emergency treatment, follow-up physician treatment, medical equipment, pain management injections, physical therapy, physician office and urgent care treatment, prosthetics, surgery, X-ray, hospital admission, hospital confinement, intensive care unit admission, intensive care unit confinement, rehabilitation, lodging, transportation, accidental death, functional loss, paralysis, and/or preventative care.

For complete details of coverage, please refer to the group policy forms: GACC-POL (9-20), GACC-CRT (9-20), GRP-SUPP-PC-RDR (9-20)

We will not pay benefits for a loss that is caused by, contributed to by, or occurs as a result of any of the following:

1. Receiving treatment for illness, disease, bodily or mental infirmity, bacterial or viral infection, or medical or surgical treatment.
2. Intentionally self-inflicting bodily injury or attempting suicide, while sane or insane.
3. Being exposed to any act of war, declared or undeclared, or serving in any of the armed forces.
4. Being exposed to a nuclear, chemical, biological, or radiological event.
5. Participating in, or attempting to participate in commission of a felony; actively participating in a riot or insurrection; or that occurs while incarcerated in any type of penal institution.
6. Being intoxicated as defined by the laws of the jurisdiction in which the loss occurred, unless taking narcotics as prescribed by a physician.
7. Participating in any form of flight aviation other than as a fare-paying passenger in a fully licensed/passenger-carrying aircraft.
8. Engaging in bungee jumping, sail gliding, parachuting, parasailing, parakiting, hang gliding, mountain climbing, or jumping from any aircraft.
9. Participating in any organized sport in a professional or semi-professional capacity.
10. Riding in or driving any motor-driven vehicle in a race, stunt show or speed test.

We will not pay benefits for medical care or receiving healthcare treatment, services, transportation, or for a hospital stay in any medical facility outside the United States of America or Canada.

Accidental death or dismemberment must occur within 180 days of a covered accidental injury.

Based on the plan selected, hospital admission benefits are limited to a maximum of one admission per accident, and hospital confinement benefits are limited to a maximum of 30 days per accident/365 days per calendar year.

Plan-specific benefit amounts and maximums are included in your certificate and any attached riders, if applicable.

Benefits
At the group policyholder’s option, your certificate may also include benefits for any of the following: burns, brain injury, coma, dislocation (nonsurgical), eye injury (nonsurgical), fracture (nonsurgical), lacerations, ambulance, blood products, chiropractic therapy, diagnostic examination, emergency dental procedure, emergency treatment, follow-up physician treatment, medical equipment, pain management injections, physical therapy, physician office and urgent care treatment, prosthetics, surgery, X-ray, hospital admission, hospital confinement, intensive care unit admission, intensive care unit confinement, rehabilitation, lodging, transportation, accidental death, functional loss, paralysis, and/or preventative care.

For complete details of coverage, please refer to the group policy forms: GACC-POL (9-20), GACC-CRT (9-20), GRP-SUPP-PC-RDR (9-20)

We will not pay benefits for a loss that is caused by, contributed to by, or occurs as a result of any of the following:

1. Receiving treatment for illness, disease, bodily or mental infirmity, bacterial or viral infection, or medical or surgical treatment.
2. Intentionally self-inflicting bodily injury or attempting suicide, while sane or insane.
3. Being exposed to any act of war, declared or undeclared, or serving in any of the armed forces.
4. Being exposed to a nuclear, chemical, biological, or radiological event.
5. Participating in, or attempting to participate in commission of a felony; actively participating in a riot or insurrection; or that occurs while incarcerated in any type of penal institution.
6. Being under the influence of alcohol or any narcotic, unless taken as prescribed by a physician.
7. Participating in any form of flight aviation other than as a fare-paying passenger in a fully licensed/passenger-carrying aircraft.
8. Engaging in bungee jumping, sail gliding, parachuting, parasailing, parakiting, hang gliding, mountain climbing, or jumping from any aircraft.
9. Participating in any organized sport in a professional or semi-professional capacity.
10. Riding in or driving any motor-driven vehicle in a race, stunt show or speed test.

We will not pay benefits for medical care or receiving healthcare treatment, services, transportation, or for a hospital stay in any medical facility outside the United States of America or Canada.

Accidental death or dismemberment must occur within 180 days of a covered accidental injury.

Based on the plan selected, hospital admission benefits are limited to a maximum of one admission per accident, and hospital confinement benefits are limited to a maximum of 30 days per accident/365 days per calendar year.

Plan-specific benefit amounts and maximums are included in your certificate and any attached riders, if applicable.

Benefits

At the group policyholder’s option, your certificate may also include benefits for any of the following: burns, brain injury, coma, dislocation (nonsurgical), eye injury (nonsurgical), fracture (nonsurgical), lacerations, ambulance, blood products, chiropractic therapy, diagnostic examination, emergency dental procedure, emergency treatment, follow-up physician treatment, medical equipment, pain management injections, physical therapy, physician office and urgent care treatment, prosthetics, surgery, X-ray, hospital admission, hospital confinement, intensive care unit admission, intensive care unit confinement, rehabilitation, lodging, transportation, accidental death, functional loss, paralysis, and/or preventative care.

For complete details of coverage, please refer to the group policy forms: GACC-POL (9-20), GACC-POL-51 (9-20), GACC-CRT (9-20), GACC-CRT-51 (9-20), GRP-SUPP-PC-RDR (9-20)

We will not pay benefits for a loss that is caused by, contributed to by, or occurs as a result of any of the following:

1. Receiving treatment for illness, disease, bodily or mental infirmity, bacterial or viral infection, or medical or surgical treatment.
2. Intentionally self-inflicting bodily injury or attempting suicide, while sane or insane.
3. Being exposed to any act of war, declared or undeclared, or serving in any of the armed forces.
4. Being exposed to a nuclear, chemical, biological, or radiological event.
5. Participating in, or attempting to participate in commission of a felony; actively participating in a riot or insurrection; or that occurs while incarcerated in any type of penal institution.
6. Being under the influence of alcohol or any narcotic, unless taken as prescribed by a physician.
7. Participating in any form of flight aviation other than as a fare-paying passenger in a fully licensed/passenger-carrying aircraft.
8. Engaging in bungee jumping, sail gliding, parachuting, parasailing, parakiting, hang gliding, mountain climbing, or jumping from any aircraft.
9. Participating in any organized sport in a professional or semi-professional capacity.
10. Riding in or driving any motor-driven vehicle in a race, stunt show or speed test.

We will not pay benefits for medical care or receiving healthcare treatment, services, transportation, or for a hospital stay in any medical facility outside the United States of America or Canada.

Accidental death or dismemberment must occur within 180 days of a covered accidental injury.

Based on the plan selected, hospital admission benefits are limited to a maximum of one admission per accident, and hospital confinement benefits are limited to a maximum of 30 days per accident/365 days per calendar year.

Plan-specific benefit amounts and maximums are included in your certificate and any attached riders, if applicable.

Benefits
At the group policyholder’s option, your certificate may also include benefits for any of the following: burns, brain injury, coma, dislocation (nonsurgical), eye injury (nonsurgical), fracture (nonsurgical), lacerations, ambulance, blood products, chiropractic therapy, diagnostic examination, emergency dental procedure, emergency treatment, follow-up physician treatment, medical equipment, pain management injections, physical therapy, physician office and urgent care treatment, prosthetics, surgery, X-ray, hospital admission, hospital confinement, intensive care unit admission, intensive care unit confinement, rehabilitation, lodging, transportation, accidental death, functional loss, paralysis, and/or preventative care.

For complete details of coverage, please refer to the group policy forms: GACC-POL (9-20), GACC-CRT (9-20), GRP-SUPP-PC-RDR (9-20)

We will not pay benefits for a loss that is caused by, contributed to by, or occurs as a result of any of the following:

1. Receiving treatment for illness, disease, bodily or mental infirmity, bacterial or viral infection, or medical or surgical treatment.
2. Intentionally self-inflicting bodily injury or attempting suicide, whether sane or insane.
3. Being exposed to any act of war, declared or undeclared, including a nuclear, chemical, biological, or radiological event, or serving in any of the armed forces.
4. Participating in a felony, riot, or insurrection, including any loss that occurs while incarcerated in any type of penal institution.
5. Alcoholism or drug addiction or mental disorder.
6. Participating in any form of flight aviation in a professional capacity.
7. Participating as a professional in any of the following: bungee jumping, sail gliding, parachuting, parasailing, parakiting, hang gliding, mountain climbing, or jumping from any aircraft.
8. Participating in any organized sport in a professional or semi-professional capacity.
9. Riding in or driving any motor-driven vehicle in a race, stunt show or speed test in a professional capacity.
10. Being injured during occupation or employment for compensation, wage or profit or for which benefits may be payable under a workers’ compensation law, occupational disease law or similar law.*

*Does not apply to 24-hour coverage.

For purposes of the Exclusions, professional means for wage or profit.

We will not pay benefits for medical care or receiving healthcare treatment, services, transportation, or for a hospital stay in any medical facility outside the United States of America or Canada.

Accidental death or dismemberment must occur within 180 days of a covered accidental injury.

Based on the plan selected, hospital admission benefits are limited to a maximum of one admission per accident, and hospital confinement benefits are limited to a maximum of 30 days per accident/365 days per calendar year.

Plan-specific benefit amounts and maximums are included in your certificate and any attached riders, if applicable.

Benefits
At the group policyholder’s option, your certificate or riders may also include benefits for any of the following: burns, brain injury, coma, dislocation (nonsurgical), eye injury (nonsurgical), fracture (nonsurgical), lacerations, ambulance, blood products, chiropractic therapy, diagnostic examination, emergency dental procedure, emergency treatment, follow-up physician treatment, medical equipment, pain management injections, physical therapy, physician office and urgent care treatment, prosthetics, surgery, X-ray, hospital admission, hospital confinement, intensive care unit admission, intensive care unit confinement, rehabilitation, lodging, transportation, accidental death, functional loss, and/or paralysis.

For complete details of coverage, please refer to the group policy forms: GACC-POL (9-20), GACC-CRT (7-22)

We will not pay benefits for a loss that is caused by, contributed to by, or occurs as a result of any of the following:

1. Receiving treatment for illness, disease, bodily or mental infirmity, bacterial or viral infection, or medical or surgical treatment.
2. Intentionally self-inflicting bodily injury or attempting suicide, whether sane or insane.
3. Being exposed to any act of war, declared or undeclared, including a nuclear, chemical, biological, or radiological event, or serving in any of the armed forces.
4. Participating in a felony, riot, or insurrection, including any loss that occurs while incarcerated in any type of penal institution.
5. Alcoholism or drug addiction or mental disorder.
6. Participating in any form of flight aviation in a professional capacity.
7. Participating as a professional in any of the following: bungee jumping, sail gliding, parachuting, parasailing, parakiting, hang gliding, mountain climbing, or jumping from any aircraft.
8. Participating in any organized sport in a professional or semi-professional capacity.
9. Riding in or driving any motor-driven vehicle in a race, stunt show or speed test in a professional capacity.
10. Being injured during occupation or employment for compensation, wage or profit or for which benefits may be payable under a workers’ compensation law, occupational disease law or similar law.*

*Does not apply to 24-hour coverage.

For purposes of the Exclusions, professional means for wage or profit.

We will not pay benefits for medical care or receiving healthcare treatment, services, transportation, or for a hospital stay in any medical facility outside the United States of America or Canada.

Accidental death or dismemberment must occur within 180 days of a covered accidental injury.

Based on the plan selected, hospital admission benefits are limited to a maximum of one admission per accident, and hospital confinement benefits are limited to a maximum of 30 days per accident/365 days per calendar year.

Plan-specific benefit amounts and maximums are included in your certificate and any attached riders, if applicable.

Benefits
At the group policyholder’s option, your certificate or riders may also include benefits for any of the following: burns, brain injury, coma, dislocation (nonsurgical), eye injury (nonsurgical), fracture (nonsurgical), lacerations, ambulance, blood products, chiropractic therapy, diagnostic examination, emergency dental procedure, emergency treatment, follow-up physician treatment, medical equipment, pain management injections, physical therapy, physician office and urgent care treatment, prosthetics, surgery, X-ray, hospital admission, hospital confinement, intensive care unit admission, intensive care unit confinement, rehabilitation, lodging, transportation, accidental death, functional loss, and/or paralysis.

For complete details of coverage, please refer to the group policy forms: GACC-POL (9-20), GACC-CRT (7-22)

We will not pay benefits for a loss that is caused by, contributed to by, or occurs as a result of any of the following:

1. Receiving treatment for illness, disease, bodily or mental infirmity, bacterial or viral infection, or medical or surgical treatment.
2. Intentionally self-inflicting bodily injury or attempting suicide, whether sane or insane.
3. Being exposed to any act of war, declared or undeclared, including a nuclear, chemical, biological, or radiological event, or serving in any of the armed forces.
4. Participating in a felony, riot, or insurrection, including any loss that occurs while incarcerated in any type of penal institution.
5. Alcoholism or drug addiction or mental disorder.
6. Participating in any form of flight aviation in a professional capacity.
7. Participating as a professional in any of the following: bungee jumping, sail gliding, parachuting, parasailing, parakiting, hang gliding, mountain climbing, or jumping from any aircraft.
8. Participating in any organized sport in a professional or semi-professional capacity.
9. Riding in or driving any motor-driven vehicle in a race, stunt show or speed test in a professional capacity.
10. Being injured during occupation or employment for compensation, wage or profit or for which benefits may be payable under a workers’ compensation law, occupational disease law or similar law.*

*Does not apply to 24-hour coverage.

For purposes of the Exclusions, professional means for wage or profit.

We will not pay benefits for medical care or receiving healthcare treatment, services, transportation, or for a hospital stay in any medical facility outside the United States of America or Canada.

Accidental death or dismemberment must occur within 180 days of a covered accidental injury.

Based on the plan selected, hospital admission benefits are limited to a maximum of one admission per accident, and hospital confinement benefits are limited to a maximum of 30 days per accident/365 days per calendar year.

Plan-specific benefit amounts and maximums are included in your certificate and any attached riders, if applicable.

Benefits
At the group policyholder’s option, your certificate or riders may also include benefits for any of the following: burns, brain injury, coma, dislocation (nonsurgical), eye injury (nonsurgical), fracture (nonsurgical), lacerations, ambulance, blood products, chiropractic therapy, diagnostic examination, emergency dental procedure, emergency treatment, follow-up physician treatment, medical equipment, pain management injections, physical therapy, physician office and urgent care treatment, prosthetics, surgery, X-ray, hospital admission, hospital confinement, intensive care unit admission, intensive care unit confinement, rehabilitation, lodging, transportation, accidental death, functional loss, and/or paralysis.

For complete details of coverage, please refer to the group policy forms: GACC-POL (9-20), GACC-CRT (7-22)

We will not pay benefits for a loss that is caused by, contributed to by, or occurs as a result of any of the following:

1. Receiving treatment for illness, disease, bodily or mental infirmity, bacterial or viral infection, or medical or surgical treatment.
2. Intentionally self-inflicting bodily injury or attempting suicide, whether sane or insane.
3. Being exposed to any act of war, declared or undeclared, or serving in any of the armed forces.
4. Being exposed to a nuclear, chemical, biological, or radiological event.
5. Participating in, or attempting to participate in commission of a felony; actively participating in a riot or insurrection; or that occurs while incarcerated in any type of penal institution.
6. The covered person being intoxicated as defined by the laws of the jurisdiction in which the loss occurred, unless taking narcotics as prescribed by a physician.
7. Participating in any form of flight aviation other than as a fare-paying passenger in a fully licensed/passenger-carrying aircraft.
8. Engaging in bungee jumping, sail gliding, parachuting, parasailing, parakiting, hang gliding, mountain climbing, or jumping from any aircraft.
9. Participating in any organized sport in a professional or semi-professional capacity.
10. Riding in or driving any motor-driven vehicle in a race, stunt show or speed test.
11. Being injured during occupation or employment for compensation, wage or profit or for which benefits may be payable under a workers’ compensation law, occupational disease law or similar law.*

*Does not apply to 24-hour coverage.

We will not pay benefits for medical care or receiving healthcare treatment, services, transportation, or for a hospital stay in any medical facility outside the United States of America or Canada.

Accidental death or dismemberment must occur within 180 days of a covered accidental injury.

Based on the plan selected, hospital admission benefits are limited to a maximum of one admission per accident, and hospital confinement benefits are limited to a maximum of 30 days per accident/365 days per calendar year.

Policy-specific benefit amounts and maximums are included in your certificate and any attached riders, if applicable.

Benefits
At the group policyholder’s option, your certificate or riders may also include benefits for any of the following: burns, brain injury, coma, dislocation (nonsurgical), eye injury (nonsurgical), fracture (nonsurgical), lacerations, ambulance, blood products, chiropractic therapy, diagnostic examination, emergency dental procedure, emergency treatment, follow-up physician treatment, medical equipment, pain management injections, physical therapy, physician office and urgent care treatment, prosthetics, surgery, X-ray, hospital admission, hospital confinement, intensive care unit admission, intensive care unit confinement, rehabilitation, lodging, transportation, accidental death, functional loss, paralysis, and/or preventative care.

For complete details of coverage, please refer to the group policy forms: GACC-POL (9-20), GACC-CRT (7-22), GACC-AC-RDR (7-22), GRP-SUPP-PC-RDR (9-20)

We will not pay benefits for a loss that is caused by, contributed to by, or occurs as a result of any of the following:

1. Receiving treatment for illness, disease, bodily or mental infirmity, bacterial or viral infection, or medical or surgical treatment.
2. Intentionally self-inflicting bodily injury or attempting suicide, whether sane or insane.
3. Being exposed to any act of war, declared or undeclared, including a nuclear, chemical, biological, or radiological event, or serving in any of the armed forces.
4. Participating in a felony, riot, or insurrection, including any loss that occurs while incarcerated in any type of penal institution.
5. Alcoholism or drug addiction or mental disorder.
6. Participating in any form of flight aviation in a professional capacity.
7. Participating as a professional in any of the following: bungee jumping, sail gliding, parachuting, parasailing, parakiting, hang gliding, mountain climbing, or jumping from any aircraft.
8. Participating in any organized sport in a professional or semi-professional capacity.
9. Riding in or driving any motor-driven vehicle in a race, stunt show or speed test in a professional capacity.
10. Being injured during occupation or employment for compensation, wage or profit or for which benefits may be payable under a workers’ compensation law, occupational disease law or similar law.*

*Does not apply to 24-hour coverage.

For purposes of the Exclusions, professional means for wage or profit.

We will not pay benefits for medical care or receiving healthcare treatment, services, transportation, or for a hospital stay in any medical facility outside the United States of America or Canada.

Accidental death or dismemberment must occur within 180 days of a covered accidental injury.

Based on the plan selected, hospital admission benefits are limited to a maximum of one admission per accident, and hospital confinement benefits are limited to a maximum of 30 days per accident/365 days per calendar year.

Plan-specific benefit amounts and maximums are included in your certificate and any attached riders, if applicable.

Benefits
At the group policyholder’s option, your certificate or riders may also include benefits for any of the following: burns, brain injury, coma, dislocation (nonsurgical), eye injury (nonsurgical), fracture (nonsurgical), lacerations, ambulance, blood products, chiropractic therapy, diagnostic examination, emergency dental procedure, emergency treatment, follow-up physician treatment, medical equipment, pain management injections, physical therapy, physician office and urgent care treatment, prosthetics, surgery, X-ray, hospital admission, hospital confinement, intensive care unit admission, intensive care unit confinement, rehabilitation, lodging, transportation, accidental death, functional loss, and/or paralysis.

For complete details of coverage, please refer to the group policy forms: GACC-POL (9-20), GACC-CRT (7-22)

We will not pay benefits for a loss that is caused by, contributed to by, or occurs as a result of any of the following:

1. Receiving treatment for illness, disease, bodily or mental infirmity, bacterial or viral infection, or medical or surgical treatment.
2. Intentionally self-inflicting bodily injury or attempting suicide, whether sane or insane.
3. Being exposed to any act of war, declared or undeclared, or serving in any of the armed forces.
4. Being exposed to a nuclear, chemical, biological, or radiological event.
5. Voluntarily participating in, or attempting to participate in commission of a felony; voluntarily participating in a riot or insurrection; or that occurs while incarcerated in any type of penal institution.
6. Voluntarily participating in an illegal activity while being under the influence of alcohol or any narcotic, unless taken as prescribed by a physician.
7. Participating in any form of flight aviation other than as a fare-paying passenger in a fully licensed/passenger-carrying aircraft.
8. Engaging in bungee jumping, sail gliding, parachuting, parasailing, parakiting, hang gliding, mountain climbing, or jumping from any aircraft.
9. Participating in any organized sport in a professional or semi-professional capacity.
10. Riding in or driving any motor-driven vehicle in a race, stunt show or speed test.
11. Being injured during occupation or employment for compensation, wage or profit or for which benefits may be payable under a workers’ compensation law, occupational disease law or similar law.*

*Does not apply to 24-hour coverage.

We will not pay benefits for medical care or receiving healthcare treatment, services, transportation, or for a hospital stay in any medical facility outside the United States of America or Canada.

Accidental death or dismemberment must occur within 180 days of a covered accidental injury.

Based on the plan selected, hospital admission benefits are limited to a maximum of one admission per accident, and hospital confinement benefits are limited to a maximum of 30 days per accident/365 days per calendar year.

Plan-specific benefit amounts and maximums are included in your certificate and any attached riders, if applicable.

Benefits
At the group policyholder’s option, your certificate or riders may also include benefits for any of the following: burns, brain injury, coma, dislocation (nonsurgical), eye injury (nonsurgical), fracture (nonsurgical), lacerations, ambulance, blood products, chiropractic therapy, diagnostic examination, emergency dental procedure, emergency treatment, follow-up physician treatment, medical equipment, pain management injections, physical therapy, physician office and urgent care treatment, prosthetics, surgery, X-ray, hospital admission, hospital confinement, intensive care unit admission, intensive care unit confinement, rehabilitation, lodging, transportation, accidental death, functional loss, paralysis, and/or preventative care.

For complete details of coverage, please refer to the group policy forms: GACC-POL (9-20), GACC-CRT (7-22), GRP-SUPP-PC-RDR (9-20)

We will not pay benefits for a loss that is caused by, contributed to by, or occurs as a result of any of the following:

1. Receiving treatment for illness, disease, bodily or mental infirmity, bacterial or viral infection, or medical or surgical treatment.
2. Intentionally self-inflicting bodily injury or attempting suicide, while sane or insane.
3. Being exposed to any act of war, declared or undeclared, or serving in any of the armed forces.
4. Being exposed to a nuclear, chemical, biological, or radiological event.
5. Participating in, or attempting to participate in commission of a felony; actively participating in a riot or insurrection; or that occurs while incarcerated in any type of penal institution.
6. Participating in any form of flight aviation other than as a fare-paying passenger in a fully licensed/passenger-carrying aircraft.
7. Engaging in bungee jumping, sail gliding, parachuting, parasailing, parakiting, hang gliding, mountain climbing, or jumping from any aircraft.
8. Participating in any organized sport in a professional or semi-professional capacity.
9. Riding in or driving any motor-driven vehicle in a race, stunt show or speed test.
10. Being injured during occupation or employment for compensation, wage or profit or for which benefits may be payable under a workers’ compensation law, occupational disease law or similar law.*

*Does not apply to 24-hour coverage.

We will not pay benefits for medical care or receiving healthcare treatment, services, transportation, or for a hospital stay in any medical facility outside the United States of America or Canada.

Accidental death or dismemberment must occur within 365 days of a covered accidental injury.   

Based on the plan selected, hospital admission benefits are limited to a maximum of one admission per accident, and hospital confinement benefits are limited to a maximum of 30 days per accident/365 days per calendar year.

Plan-specific benefit amounts and maximums are included in your certificate and any attached riders, if applicable. 

Benefits
At the group policyholder’s option, your certificate or riders may also include benefits for any of the following: burns, brain injury, coma, dislocation (nonsurgical), eye injury (nonsurgical), fracture (nonsurgical), lacerations, ambulance, blood products, chiropractic therapy, diagnostic examination, emergency dental procedure, emergency treatment, follow-up physician treatment, medical equipment, pain management injections, physical therapy, physician office and urgent care treatment, prosthetics, surgery, X-ray, hospital admission, hospital confinement, intensive care unit admission, intensive care unit confinement, rehabilitation, lodging, transportation, accidental death, functional loss, paralysis, and/or health screening benefit.

For complete details of coverage, please refer to the group policy forms: GACC-POL (9-20), GACC-CRT (7-22), GRP-SUPP-HSB-RDR-WA (9-20)

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