Totally Disabled or Totally Disabled or Total Disability means either: Total Disability 1. inability of the Covered Person who is currently employed to do any type of work for which he is or may become qualified by reason of education, training or experience; or 2. inability of the Covered Person who is not currently employed to perform the normal activities of a person of like age and sex and who is under the regular care of a Physician who certifies that such person is Totally Disabled. 3. In the Eligibility and Effective Date Provisions, the Eligibility section is replaced with the following: Eligibility An Employee becomes eligible for insurance under this Policy on the date he meets all of the requirements of one of the Covered Classes and completes any Eligibility Waiting Period, as shown in the Schedule of Benefits. No person may be eligible for insurance under this Policy as both an Employee and a Spouse or Dependent Child at the same time. However, this limitation will not apply when the Employee and the Spouse are employed by the same Employer and by reason to their employment are both participating in a group insurance plan. 4. In the General Provisions section, the following provision is replaced: Incontestability 1. Of This Policy or Participation Under This Policy All statements made by the Subscriber to participate under this Policy are considered representations and not warranties. No statement will be used to deny or reduce benefits or be used as a defense to a claim, or to deny the validity of this Policy or of participation under this Policy unless a copy of the instrument containing the statement is, or has been, furnished to the Subscriber. After two years from the Policy Effective Date, no such statement will cause this Policy to be contested. 2. Of A Covered Person's Insurance All statements made by a Covered Person are considered representations and not warranties. No statement will be used to deny or reduce benefits or be used as a defense to a claim, unless a copy of the instrument containing the statement is, or has been, furnished to the claimant. After two years from the Covered Person’s effective date of insurance, or from the effective date of increased benefits, no such statement will cause insurance or the increased benefits to be contested except for lack of eligibility for insurance. In the event of death or incapacity, the beneficiary or representative shall be given a copy. 5. The following benefit is added to the Description of Benefits section: AMBULANCE BENEFIT We will pay the benefit shown in the Schedule of Benefits, subject to the following conditions and exclusions, if the Covered Person requires ambulance services due to a Covered Injury resulting directly and independently of all other causes from a Covered Accident. The Covered Person must be transported by ambulance to a Hospital and admitted as an inpatient Any payment will be paid directly to the ambulance provider rendering such service if such provider has not received payment for such service from any other source and includes the following statement on the face of each bill: ''NOTICE: This bill subject to mandatory assignment pursuant to Connecticut general statutes.'' In the event any Covered Person is covered under more than one policy, the Hospital Policy will be primary and pay benefits. Exclusions The exclusions that apply to this benefit are in the Common Exclusions Section. GA-00-2212.07 18
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