In the event of your death or dismemberment due to an accident, a lump sum payment may be made in addition to any other benefit you or your family might already receive, making Accidental Death & Dismemberment (AD&D) the perfect complement to your Life coverage.
Members of the following associations: (a) the Ontario Medical Association, (b) the New Brunswick Medical Society, (c) the Medical Society of Prince Edward Island, (d) the Newfoundland and Labrador Medical Association and (e) Doctors Nova Scotia are eligible for AD&D Insurance.
In addition, you must be under age 65, reside in Canada* and be (1) actively engaged in
medical practice (including research, teaching and administration) in Canada, or (2) retired from medical practice. You are also eligible if you are a medical student or resident.
AD&D coverage is also available for your lawful married spouse or person (under age 65) who, although not legally married to, cohabits with and is publically represented as your spouse in the community in which you reside provided you do not have a spouse or former spouse insured under plans G-3900, G-29500 or G-29700. You must be insured under plans G-3900, G-29500 or G-29700 or be uninsurable in order to insure your spouse.
You and/or your spouse are not eligible if either is on active full-time duty in the Armed
*Residents of Quebec are eligible if (i) they practice or study outside of Quebec but still
reside in Canada; (ii) the application is signed in a province other than Quebec, and (iii) the certificate and all other communications are delivered in a province or territory other than Quebec
A minimum of $50,000 to a maximum of $500,000 in increments of $50,000. This amount cannot exceed the amount of your life insurance.
Spouse AD&D coverage cannot be greater than the Member AD&D amount.
When injuries caused by a covered accident result in death or dismemberment within 365 days of an accident which occurs while you are covered under the plan, the OMA Accidental Death and Dismemberment Plan will pay these benefits:
No more than one benefit, the largest, will be paid for all losses to the same limb due to
or related to any one accident. The amount of benefits payable for all losses due to the
same or related accident cannot exceed the Principal Sum.
If you suffer a loss listed above as a result of exposure to the elements, such loss will be
considered a covered loss resulting from an accidental injury.
If you are riding in a conveyance and such conveyance either disappears or sinks as the
result of an accident and your body is not found within one year after the accident, New York Life will presume you suffered a loss of life due to an accidental injury within
365 days of such accident.
If you die as a result of injuries sustained in an accident, provided the death occurs within 365 days of the accident, while travelling in a private passenger car*, properly wearing a seat belt and the driver of the car was a licensed driver and not under the influence of alcohol or drugs, the benefit amount is the lesser of 10% of the insured’s Principal Sum Amount or $50,000.
*“Private Passenger Car” means a validly registered four-wheeled privately owned or Employer-owned car, jeep, pickup truck or van, including a sport utility vehicle (SUV),
that is not licensed commercially or being used for racing, or acrobatic or stunt driving.
If you were positioned in a seat belt protected by a properly functioning, original factory installed air bag system that inflated upon impact when the accident occurred; the benefit amount is the lesser of 10% of the insured’s Principal Sum or $10,000.
If you die in an accident, your insured spouse can take advantage of a formal occupational training program within five years of your death, to become qualified for active employment where your spouse would not otherwise be qualified. This benefit equals the reasonable and necessary expenses actually incurred, but not to exceed the aggregate maximum amount of $15,000. Payment will not be made for room, board, or other normal living, traveling or clothing expenses.
If your death is due to a Covered Loss and you have an insured spouse who at the time
of your death is a student attending an accredited post-secondary educational institution,
including but not limited to a college or a vocational or technical school on a full-time basis
as determined by such institution or is within 365 days of attending such institution and
provides proof of enrolment in such institution, an additional benefit equal to the lesser of
a) $5,000 or b) the actual amount of the tuition is payable.
If both you and your spouse die in an accident that occurs within the same 24-hour period, the percentage for the spouse will be increased up to the Member’s Principal Sum if the combined benefits do not exceed $500,000.
If you incur a Covered Loss, an additional benefit may be payable for participation in a
rehabilitation program. The benefit is equal to the lesser of the expense incurred for the
rehabilitation program or $10,000.
If your death is due to a Covered Loss outside your permanent residence, a benefit will
be paid for the cost of preparation of the body for cremation or burial and the transportation of the body to the burial or cremation site or $15,000, whichever is less.
Your AD&D coverage may become effective as follows:
If you do not have life insurance coverage:
Your coverage continues as long as you maintain membership in an eligible association.
If you have selected the Waiver of Premium (WOP) benefit under your life insurance plan, it will automatically apply under your AD&D coverage (WOP does not apply to your insured spouse).
Coverage terminates for you and/or your spouse:
A loss resulting from any of the following events is not covered: