Optional AD&D Insurance

Have you considered Optional Accidental Death and Dismemberment Insurance?

Optional Accidental Death and Dismemberment Insurance is offered as part of your group benefits plan. It offers an affordable way to protect you and your family from the financial impact of an accident that causes death or serious injury. Coverage is available for you and your family members.
 
This insurance pays you a benefit if you suffer certain severe injuries (such as loss of a limb or loss of sight) caused by an accidental injury. It also pays your beneficiary if you die due to an accident covered by your plan. Optional AD&D is payable in addition to any other insurance you may have, such as Basic Life.
 
Enhancements made to our Optional AD&D insurance, provided by SSQ Financial Group and contact information for Group Benefits Solutions are outlined in the Group Benefits Solutions Bulletin focusing on this insurance.
 
If you are considering this insurance, or wish to increase your current benefit level, please contact your Benefits Administrator or Human Resources Department for a Brochure/Enrollment form. 


Introduction

"It couldn't happen to me."

No one expects to be involved in a serious accident; yet, chances are that you know at least one person who has.

Accidents are the number one killer of Canadians under age 45 and the third leading cause of death overall. Auto accidents account for almost 50% of these deaths.

If you survive a serious accident, you could be faced with great and immediate financial problems. Loss of limbs, eyesight, speech or hearing can occur, as well as loss of use of limbs.

Any form of paralysis could also cause major financial setbacks in a person's life.

"I don't want to think about it."

A common response when faced with the possibility. Unfortunately, no one has control over the fact that an accident may happen. You do, however, have a measure of control over the financial outcome of such an event.

By taking a few minutes to consider this program, you will allow yourself the freedom of knowing that you and your family will be prepared financially should a major accident occur.

Why should I participate in this program? 5 good reasons!

  • This coverage is an opportunity for you and your family to obtain extensive coverage at a very low monthly cost.
  • This group Accident Insurance Program offers far more extensive coverage at a fraction of the cost of an individual plan.
  • Few programs will pay lump sum benefits if you survive an accident.
  • This is a great, low cost way to supplement your Life Insurance Program.
  • Most people don't foresee losing their health during their prime years, but will agree that an accident is beyond their control.
     

Who is eligible?

  • The following employees who are under age 70, their Spouse and Dependent Children:
    • All permanent employees who work on a full-time basis for at least 37.5 hours per week.
    • All permanent employees who work on a part-time basis for at least 40% of the minimum hour requirement for full-time employees.
  • Employees who are compensated by the employer for services rendered in the normal course of the employer's business, and
  • Employees who are residents of Canada.


Note: This coverage is not available for temporary and casual employees.

If you are absent from active full-time work for any reason other than bona fide vacation on the date you become eligible, you will only become eligible when you return to active full-time work.

"Spouse" means an individual under the age of 70;

  • to whom you are legally married,
  • with whom you have continuously cohabited in a conjugal relationship for a minimum of one year immediately before a Loss is incurred under the Program.

Only one individual will qualify as spouse.

If you are legally married but are also cohabiting with an individual as described above, the spouse will be the individual to whom you are legally married.

"Dependent Children" means persons who are either your legitimate or illegitimate children, adopted children, step-children or children who are in a parent-child relationship with you. The children are dependent upon you for maintenance and support and:

  • under 21 years of age and unmarried, or
  • under 26 years of age and unmarried and in attendance at an "institution of higher learning" on a full-time basis, or
  • by reason of mental or physical infirmity, are incapable of self-sustaining employment and are totally dependent upon the employee for support within the terms of the Income Tax Act.

The Dependent Child will be covered from birth provided such child is born alive.

Institution of higher learning" includes any university, private college, CEGEP or trade school.

 

What am I covered for?

You are covered for any accident resulting in Death, Dismemberment, Pa ralysis, Loss of use of limbs, Loss of sight, speech or hearing - anywhere in the world - 24 hours a day - on or off the job.

 

What amounts of insurance coverage are available?

You may elect to insure yourself only or yourself and your family for one of the plans outlined below:

A. Employee Only Plan
You may select an amount of insurance from a minimum of $10,000 to a maximum of $300,000 in units of $10,000.

B. Employee & Family Plan
You may select an amount of insurance from a minimum of $10,000 to a maximum of $300,000 in units of $10,000, and your family will automatically be insured for the following:

(i) Spouse
Your Spouse will be insured for 60% of the benefit you select for yourself if you do not have any Dependent Children, or 50% of your benefit if you do have Dependent Children.

(ii) Children
Each Dependent Child will be insured for 15% of your benefit if you have a Spouse, or 20% if you do not have a Spouse.

 

How can I enrol?

If you are not presently insured, you may enrol in the program by completing a Application Form - Group Insurance Benefits and returning it to your Benefits Administrator.

If you are presently insured under the program, you may increase your insurance and/ or add the Family Option by completing and returning it to your Benefits Administrator.

 

When is my coverage effective?

Coverage will commence on the date your signed application is received by your Benefits Administrator. However, if you are absent from active work for any reason other than vacation, coverage will only begin when you return to active work.

 

How do I increase, decrease, change my plan or cancel my insurance?

You may increase or decrease your coverage or change your plan by making application to your Benefits Administrator. You may cancel your coverage by advising your Benefits Administrator in writing. Coverage will change or cease on the date you notify your Benefits Administrator.

 

Are there any circumstances where premiums are waived?

Provided you have been approved for Waiver of Premium and remain eligible for such under the terms and conditions of your Employer's Basic Group Life Insurance policy, you need not pay any further premiums under the Policy for yourself, your Insured Spouse and/or Insured Dependent Children, while you remain disabled, until the earliest of the following dates:

  1. the Policy terminates;
  2. you reach age 65;
  3. you cease to be totally disabled.

All terms and provisions of the Policy apply during the period premiums are waived.

Notwithstanding anything contained to the contrary in the Policy, benefits payable for any Loss which occurs while this clause is in effect cannot exceed the amount of insurance payable on the commencement date of your disability.

 

Can my coverage be continued during a leave of absence?

Coverage may be continued for up to twelve months for you and your Insured Dependent(s) during any approved leave of absence, maternity leave or disability leave, provided payment of premium is continued and you do not return to work in any capacity with any other Employer.

With respect to approved disability leave, coverage as provided under this clause will terminate upon attainment of age 65, return to work in any capacity or qualification for Waiver of Premium whichever first occurs. The amount of insurance cannot be increased during a continuation period.


To whom are benefits paid?

Your accidental death benefit will be paid to the beneficiary designated on your application. If there is no such beneficiary designation, such benefit will be paid to your Estate.

With the exception of the " Occupational Training," "Education," "Day-Care," "Common Disaster," "Identification" and "Extension of Family Coverage " Benefits any other benefits payable (which include those payable for Dependents) will be paid to you.


How do I appoint a beneficiary for this insurance?

Having a designated beneficiary (or more than one if you like) ensures that when you die, your wishes will be carried out instead of having your benefits paid to your estate. It is very important to ensure you always have a current beneficiary.

For Optional Accidental Death and Dismemberment insurance, you must name a beneficiary. To do so, you'll need to give the full name of the beneficiary and the person's relationship to you (mother, father, brother, etc.).

There are several types of beneficiaries:

  • Revocable: You can change the name of the revocable beneficiary at any time and without his or her consent.
  • Contingent: Having a contingent beneficiary means you can name more than one beneficiary to receive benefits if the primary beneficiary dies.

For example:

When naming a beneficiary, remember:

  • Initial and date any changes or modifications you make on the form.
  • Always use a pen (not pencil).
  • Spell out all full names, and do not use abbreviations.
  • Conflicting or unclear beneficiary designations are not acceptable.
  • Review your beneficiary designations periodically, to make sure your choices still reflect your situation.
  • If you appoint a minor child as a beneficiary, be sure to fill in the "trustee designation" section on your enrolment form.

Remember to let your Benefits Administrator know right away if you have new dependents to be covered under the plan.

 

What happens in the event of a claim?

You or your beneficiary must notify your Employer.

In the case of claim, written notice of Injury must be given to SSQ Financial Group within 30 days after the date of the accident and written proof of loss must be furnished to them within 90 days after the date of such Loss. Failure to furnish such notice or proof within such time shall not invalidate nor reduce any claim if it shall be shown not to have been reasonably possible to furnish such notice or proof and that such notice or proof was furnished as soon as was reasonably possible, but in no event later than one year after the date of the accident.

 

When does my insurance coverage stop?

Your insurance coverage will stop on the earliest of the following dates:

  • on the date the Policy is terminated.
  • on the premium due date if Health Association Nova Scotia fails to pay your premiums to SSQ Financial Group except as the result of an inadvertent error.
  • on the date you give notice of cancellation to your Benefits Administrator.
  • on the date you reach age 70.
  • on the date you cease to be an eligible employee.
  • on the date you cease to be an active employee on account of leave of absence, lay-off, maternity leave, resignation, dismissal, pension or retirement, except as provided under: Waiver of Premium or Continuation of Coverage during Approved Leaves.

The insurance coverage for your Insured Spouse and/or Insured Dependent Children stops on the earlier of:

  • the date such person ceases to be an eligible dependent;
  • the date your insurance coverage stops, except as provided under the "Extension of Family Coverage” section.

If your insurance and/ or the insurance of your Spouse or Dependent Children should stop, you can still file a claim under the Policy for Losses arising from an accident, which occurred prior to the termination date, subject to the terms and provisions of the Policy.

 

Definitions

Under the Optional Accidental Death & Dismemberment Insurance plan:

"Policy" means the Optional Accidental Death & Dismemberment Group Policy # 9225112 which is on file with Health Association Nova Scotia.

"Injury" means bodily Injury caused by an accident occurring while your coverage is in force under the Policy, and resulting directly and independently of all other causes in Loss covered by the Policy, 24 hours a day, anywhere in the world.

"Principal Sum", when referring to you, means the amount indicated on your application which you have completed.

"Principal Sum", when referring to your Insured Dependents, means the percentages outlined on this web site.

"Policyholder" means Nova Scotia Association of Health Organizations (Health Association Nova Scotia is a registered business name of NSAHO).

"Insured Person" means an Employee, Spouse and his/her Dependent(s) insured under the Policy.

"Insurer" means SSQ Financial Group

"Member of the Immediate Family" means a person at least 18 years of age, who is your spouse, son, daughter, father, mother, brother, sister, son-in-law, daughter-in-law, father-in-law, mother-in-law, brother-in-law, sister-in-law, (all of the above include natural, adopted or step relationship), grandson, granddaughter, grandfather or grandmother.