Group Personal Accident 

DEFINITIONS

Accident

Accident means bodily injury affected solely through external, violent, and accidental means.

Accidental Dismemberment

Accidental Dismemberment means any of the following conditions resulting directly, and independently of all other causes, from Accident.

"Loss of use of limb" means total, continuous and permanent functional disablement of a limb, which has lasted for at least 180

days. This includes the physical loss of a limb; for arm, at the upper part of the wrist or for leg, at the upper part of the ankle.

"Loss of sight" means vision that even when tested with the use of visual aids, is measured at 3/60 or worse in an eye using a Snellen eye chart or equivalent test.

“Loss of hearing” is defined as a definite diagnosis of the total and irreversible loss of hearing in both ears, with an auditory threshold of 90 decibels or greater within the speech threshold of 500 to 3,000 hertz.

“Loss of speech” is defined as a definite diagnosis of the total and irreversible loss of the ability to speak as the result of physical injury or disease, for a period of at least 180 days.

"Loss of thumb" means the amputation of all phalanges of the thumb.

"Loss of toe" means the amputation of all phalanges of the toe.

Confirmation of Accidental Dismemberment must be made by our appointed registered medical practitioner/ physician/ doctor. The opinion of this registered medical practitioner/ physician/ doctor will be binding on the Member and Manulife. For physical loss of limbs/thumbs/toes, this confirmation can be made at any time.

BENEFITS

Subject to this Policy’s provisions, Manulife shall pay the Accidental Dismemberment Benefit in the event of the Member’s accidental dismemberment upon receipt of acceptable proof and approval by Manulife that the Member’s accidental dismemberment meets the definition of Accidental Dismemberment described above. The Accidental Dismemberment Benefit proceed will be paid to the Member.

The proceeds from the Accidental Dismemberment Benefit shall be a percentage of the amount specified on the Policy Summary following the Table of Benefits below, or as subsequently endorsed on the Policy.

Table of Benefits:

In case of multiple injuries from one accident, only the loss carrying the highest indemnity will be payable. Manulife’s liability on all death, total disability and dismemberment claims in this Policy will be limited to 100% of the Death Benefit specified in the Policy Summary. The Accidental Dismemberment Benefit in the succeeding policy year shall not be reduced by any benefit paid in the preceding policy year.

EXCLUSIONS:

No Accidental Dismemberment Benefit will be payable under this Provision, if the occurrence of the insured event results directly or indirectly, in whole or in part, from any of the following:

a)   Committed suicide or attempted suicide, whether the Member is sane or insane; or

b)   A committed criminal offense, or an attempted commitment of a criminal offense by the Policyowner, Member or Beneficiary. Beneficiaries not involved in the aforementioned criminal activity will remain eligible to receive their benefits; or

c)   Any unprescribed drug, alcoholic substance, poison, gas or fumes, voluntarily taken, administered, absorbed or inhaled; or

d)   Any loss sustained by the Member while resisting arrest by a law enforcement officer or violation of alcohol intake and/or speed limits as prescribed by the applicable traffic law at the time of accident; or

e)   Bodily or mental illness or disease of any kind or any infection, other than infections occurring simultaneously with and in consequence of an accidental wound; or

f)   Travelling or flight in any vehicle or device for aerial navigation, except as a passenger on an aircraft operated by a regular airline; or

g)   Engaging in or taking part in driving or riding in any kind of race, underwater activities or other hazardous pursuit such as mountaineering or potholing or parachuting or bungee jumping; or

h)   War or any act of war, whether declared or not, riot, insurrection, civil commotion, strikes, terrorist activities, whether or not the Member was participating therein; or

i)   Pre-existing Conditions which originated before the later of: (a) the Policy Year Date; or (b) Member’s effective date of insurance. A “Pre-existing Condition” is an illness which the Life Insured has reasonable knowledge of, unless the conditions are declared to the Company and accepted by the Company.

A Member may be considered to have reasonable knowledge of pre-existing     conditions where the condition is one for which:

i.   The Member had received or is receiving treatment;

ii.   Medical advice, diagnosis, care, or treatment has been recommended;

iii.   Clear and distinct symptoms are or were evident;

iv.   Its existence would have been apparent to a reasonable person in the circumstances.

A Member’s insurance cover provided under the Policy shall terminate on the occurrence of the first of any of the following:

a.   The Member having attained the age of sixty-one (61);

b.   The Member’s death or total disability caused by accident claim has been paid;

c.   Upon group policy termination;

d.   Member enters the army, navy, air force, coast guard or any police organization;

e.   Written notice from the Policyowner directing that the insurance be cancelled.