ICC18 LR14GP-ADD-2 3 ADD-12995 (11/25) The Supplemental Children’s AD&D insurance amount will not exceed the Supplemental Employee AD&D insurance amount in force. You may not elect a higher amount of Supplemental Children’s AD&D insurance than Supplemental Employee AD&D insurance. ACCIDENTAL DEATH BENEFIT For: Benefit Amount: Loss of life Full Amount of AD&D insurance ACCIDENTAL DISMEMBERMENT BENEFITS For: Benefit Amount: Loss of an Arm 50% of the Full Amount of AD&D insurance Loss of a Leg 50% of the Full Amount of AD&D insurance Loss of a Hand 50% of the Full Amount of AD&D insurance Loss of a Foot 50% of the Full Amount of AD&D insurance OTHER ACCIDENTAL LOSS BENEFITS For: Benefit Amount: Loss of Sight in both eyes 100% of the Full Amount of AD&D insurance Loss of Sight in one eye 50% of the Full Amount of AD&D insurance Loss of Speech 50% of the Full Amount of AD&D insurance Loss of Hearing 50% of the Full Amount of AD&D insurance Paralysis of all four limbs 100% of the Full Amount of AD&D insurance Paralysis of three limbs 75% of the Full Amount of AD&D insurance Paralysis of two limbs 50% of the Full Amount of AD&D insurance Paralysis of one limb 25% of the Full Amount of AD&D insurance Coma 2% of the Full Amount of AD&D insurance to a maximum of $24,000 Only one Full Amount is payable for any combination of the losses listed above per Covered Person. For example: if the Covered Person has a loss for which the Benefit Amount paid was 50% of the Full Amount of that Covered Person’s AD&D insurance, then the Benefit Amount for that Covered Person’s next loss will be no more than 50% of the Full Amount.