Covered Incidents

Covered Incidents

Aggravated Assault
Coverage is 24 hours a day, 365 days a year for insureds when they sustain a bodily injury from an Aggravated Assault while in the United States. Benefits will be paid in accordance with the sums shown in the schedule and subject to any maximum limits.

An Aggravated Assault for purposes of coverage is defined as an attack without a weapon when serious injury results or an attack with a weapon involving any injury. Serious injury includes broken bones, lost teeth, internal injuries, loss of consciousness, and any unspecified injury requiring two or more days of hospitalization.

Sexual Assault
Coverage is 24 hours a day, 365 days a year for insureds when they experience a Sexual Assault while in the United States. Benefits will be paid in accordance with the sums shown in the schedule and subject to any maximum limits.

A Sexual Assault for purposes of coverage is any willful or unlawful use of force by the perpetrator upon an insured that occurs without the explicit consent of the recipient of the unwanted sexual activity. Falling under this definition are: forced sexual intercourse, sodomy, oral penetration or penetration using an object, and rape. This does not include cases involving minor sexual assaults or indecent exposure, exhibitionism, or employee sexual verbal harassment.

Mass shooting
Coverage is 24 hours a day, 365 days a year for insureds when they sustain a bodily injury from a Mass Shooting while in the United States. Benefits will be paid in accordance with the sums shown in the schedule and subject to any maximum limits.

A Mass Shooting for purposes of coverage is a shooting with 3 or more shooting victims, not including the shooter.

Terrorism
Coverage is 24 hours a day, 365 days a year for insureds when they sustain a bodily injury from a Terrorist Act while in the United States. Benefits will be paid in accordance with the sums shown in the schedule and subject to any maximum limits.

A Terrorist Act for purposes of coverage is an act, or acts, of any person, or group(s) of persons, committed for political, religious, ideological or similar purposes with the intention to influence any government and/or to put the public, or any section of the public, in fear. Terrorist activity can include, but not be limited to, the actual use of force or violence and/or the threat of such use. Furthermore, the perpetrators of terrorist activity can either be acting alone, or on behalf of, or in connection with any organization(s) or governments(s).

Bodily injury may be either directly or indirectly caused by, resulting from, or in connection with any of the following; 1) Murder or Assault subsequently proved beyond reasonable doubt to have been the act of agents of a state foreign to the nationality of the insured person whether war be declared with that state or not, 2) Terrorist activity, always provided that the insured person(s) are not actively participating in any, or all, of (1) to (2) above, and further provided that neither (1) nor (2) above are the result of the utilization of Nuclear, Chemical or Biological weapons of mass destruction howsoever these may be distributed or combined.

Accidental Death
Coverage is for insureds when they suffer an accidental death while in the United States. Benefits will be paid in accordance with the sums shown in the schedule and subject to any maximum limits.

Contract an Infectious Disease at Work or School
Coverage is for insureds when they contract an infectious disease after suffering an accident while on business for/or on the premises of their employer in the course of their educational curriculum (dependent children) which resulted in either ruptured skin or unintentional contact with blood or certain bodily fluids of a third party such as blood, urine, vomit, rectal fluids, vaginal fluids, semen (cum), pre-seminal fluid (pre-cum), or breast milk. The disease must be listed, on the date of the accident, by the Centers for Disease Control and Prevention on the National Notifiable Diseases Surveillance System. Current National Notifiable Diseases are listed here. 2) while at work while in the United States. Please review your policy for complete details.

In order to receive benefits, you must within sixty (60) days test disease positive for an infectious disease and be unable to either carry out the material duties of your regular occupation or attend your educational curriculum due to the infectious disease. You must within a period of five (5) days following the accident concerned undergo an initial made by a registered medical practitioner in accordance with laboratory and clinical criteria - you must advise us of the facility conducting the initial test within five (5) days following the accident, or as soon as possible thereafter if the accident occurs over a weekend or a public holiday. In order to verify the accidental exposure to the infectious disease, we'll need a copy of the workplace incident report. A physician’s statement that this is the first time you’ve tested positive for the infectious disease is also required before benefits will be paid. We understand you may not have one at this time, so we will include instructions in our follow-up email to your submission of a claim for benefits which must be submitted in full within fourteen (14) days following the diagnosis or discharge from the hospital, whichever the latter.

Traumatized by Witnessing Violence at Work or School
Coverage is for insureds when they 1) witness a aggravated assault or threat of an aggravated assault directed toward persons at work or on duty by 1) persons who enter the workplace to commit a robbery or other crime; or 2) by customers, clients, patients, students, inmates or any others to whom the employer provides a service 3) while at work while in the United States. Benefits will be paid in accordance with the sums shown in the schedule and subject to any maximum limits.

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