6. COVERED ACCIDENT BENEFITS What benefits are payable under the Policy? The following are the Covered Accident Benefits covered under the Policy. Eligible benefit payments for a Covered Accident Benefit will be payable in a lump sum as shown in the Benefit Highlights. Each Covered Accident Benefit can be claimed only once for each Covered Accident, unless otherwise specified. We will pay benefits for multiple Injuries sustained in the same Covered Accident up to the benefit amount shown in the Benefit Highlights for such Injuries. Diagnosis and Treatment for Injuries sustained by Covered Accidents must be made within 12 months to qualify for benefits under the Policy unless otherwise specified. Accident Emergency Treatment (non-Emergency Room) Benefit The Accident Emergency Treatment (non-Emergency Room) Benefit is payable for each Insured who receives Treatment from a Physician as the result of Injuries received in a Covered Accident. This benefit is payable only once per Insured for each Covered Accident and not more than once per 24 hour period. If the Insured receives Treatment for the same Injuries in an Emergency Room, we will pay only the Emergency Room Treatment Benefit. Accidental Death Benefit An Accidental Death Benefit is payable if an Insured dies as a result of Injuries received from that Accident. If we pay this benefit for an Insured, we will not pay the Accidental Death Common Carrier Benefit for the same Insured. Accidental Death Common Carrier Benefit An Accidental Death Common Carrier Benefit is payable if an Insured dies as a result of Injuries received from that Covered Accident, while a fare paying passenger on a Common Carrier. If we pay this benefit for an Insured, we will not pay the Accidental Death Benefit for the same Insured. Accidental Dismemberment Benefit An Accidental Dismemberment Benefit is payable if an Insured sustains the following: · Loss of Hand—one hand; · Loss of Foot—one foot; · Loss of Leg—one leg; · Loss of Arm—one arm; · Loss of a Finger or Loss of a Toe—one or more fingers or toes; · Loss of an Eye—one eye; or · irrecoverable Loss of Sight—one eye; due to Injuries received in a Covered Accident. If the Insured loses a finger or a toe and later loses a hand, foot, arm or leg on the same side of the body as the result of the same Covered Accident, we will subtract the amount we paid for the loss of the finger or toe from the benefit we pay for the loss of the hand, foot, arm or leg. For multiple Dismemberments resulting from the same Covered Accident, we will pay 100% of each benefit amount listed in the Benefit Highlights for the applicable dismembered body part. If the Insured loses one arm or one leg and later loses the other arm or leg as the result of the same Covered Accident, we will subtract the amount we paid for that loss of an arm or leg from the benefit we pay for the Catastrophic Accident Benefit. If the Insured loses one arm and one leg or one hand and one foot as the result of the same Covered Accident, we will pay for the Catastrophic Accident Benefit. No Accidental Dismemberment Benefit will be paid in addition to the Catastrophic Accident Benefit. 16-AC-C-01 Page22
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