Occupational Accident Insurance Coverage

Occupational Accident Insurance Coverage Highlights

Eligible Employee Classes:

Class 1: Permanent Full Time employees under the age of 75 and regularly working 20 hours or more per week.

Class 2: Permanent Part Time employees under the age of 75 and regularly working 10 hours or more per week.

Class 3: Contract staff under the age of 75 and regularly working 20 hours or more per week.

Class 4: Casual employees under the age of 75

Class 5: Volunteers

Class 1 Coverage

  • First day coverage for occupational accidents.
  • Taxable benefit paying 80% of weekly income to a maximum of $1,500 per week for up to 260 weeks for total temporary disability (up to 52 weeks if disability occurs on or after the attainment of age 70) or $750 per week for 52 weeks for partial temporary disability.
  • Accidental Death & Dismemberment Occupational Accident non-taxable lump sum benefit paying $500,000 after 12 months of permanent and total disability. Claimants qualifying for this benefit must be totally and continuously disabled for 12 months and unable to engage in any occupation or employment for which he/she is suited by reason of education, training, or experience for the remainder of his/her life.

Class 2 Coverage

  • First day coverage for occupational accidents.
  • Taxable benefit paying 80% of weekly income to a maximum of $750 per week for up to 260 weeks for total temporary disability (up to 52 weeks if disability occurs on or after the attainment of age 70) or $375 per week for 52 weeks for partial temporary disability.
  • Accidental Death & Dismemberment Occupational Accident non-taxable lump sum benefit paying $300,000 after 12 months of permanent and total disability. Claimants qualifying for this benefit must be totally and continuously disabled for 12 months and unable to engage in any occupation or employment for which he/she is suited by reason of education, training, or experience for the remainder of his/her life.

Class 3 Coverage

  • First day coverage for occupational accidents.
  • Taxable benefit paying 80% of weekly income to a maximum of $750 per week for up to 78 weeks for total temporary disability (up to 8 weeks if disability occurs on or after the attainment of age 70) or $150 per week for 13 weeks for partial temporary disability.
  • Accidental Death & Dismemberment Occupational Accident non-taxable lump sum benefit paying $100,000 after 12 months of permanent and total disability. Claimants qualifying for this benefit must be totally and continuously disabled for 12 months and unable to engage in any occupation or employment for which he/she is suited by reason of education, training, or experience for the remainder of his/her life.

Class 4 Coverage

  • First day coverage for occupational accidents.
  • Taxable benefit paying 80% of weekly income to a maximum of $150 per week for up to 52 weeks for total temporary disability (up to 4 weeks if disability occurs on or after the attainment of age 70) or $150 per week for 13 weeks for partial temporary disability.
  • Accidental Death & Dismemberment Occupational Accident non-taxable lump sum benefit paying $100,000 after 12 months of permanent and total disability. Claimants qualifying for this benefit must be totally and continuously disabled for 12 months and unable to engage in any occupation or employment for which he/she is suited by reason of education, training, or experience for the remainder of his/her life.

Class 5 Coverage

  • First day coverage for occupational accidents.
  • Accidental Death & Dismemberment Occupational Accident non-taxable lump sum benefit paying $50,000 after 12 months of permanent and total disability. Claimants qualifying for this benefit must be totally and continuously disabled for 12 months and unable to engage in any volunteer duties for which he/she is suited by reason of education, training, or experience for the remainder of his/her life.

Additional Coverage for All Benefit Classes:

  • Accidental medical benefit to a maximum of $25,000
  • Accidental dental benefit to a maximum of $3,500
  • In-Hospital confinement monthly income benefit up to $4,000.
  • Rehabilitation benefit to a maximum of $10,000
  • Loss of and Loss of use provisions
  • Repatriation benefit to a maximum of $10,000
  • Education benefit payable for actual incurred costs for tuition fees, room and board to a maximum of $5,000 annually for four years to surviving dependents
  • Child care benefit payable for actual costs payable for actual incurred costs to a maximum of $5,000 annually for each child, to a maximum of $25,000 for all children in all years.
  • Home Alteration benefit to a maximum of $15,000
  • Family Transportation benefit to a maximum of $10,000
  • Includes burn, HIV, and contagious disease riders
  • Funeral expense subsidy to a maximum of $6,500
  • Bereavement benefit up to $1,000
  • Spousal retraining to a maximum of $10,000
  • Psychological therapy benefit to a maximum of $5,000
  • CHUBB provides the following:
    • 24 hour care
    • Health promotion
    • Early Intervention
      • Day 1
      • Evaluation of treatment and duration
    • Medical case management
      • Disease specific
      • Medical peer review
      • Preferred providers
      • Transitional work
      • Custom software
      • Benchmarking and Reporting

Scope of Coverage / Business Travel

CHUBB will pay the benefits described in the policy for any accident which happens while an Insured Person is:

  1. On the premises of the Policyholder, in the course of his job; or
  2. Making a business trip authorized by the Policyholder (Business Travel).

Business Travel coverage is subject to the following terms:

CHUBB will pay the benefits described in the policy for any accident which happens during travel and sojourn by an Insured Person on business for the Policyholder, provided such travel is to a point or points located away from the premises of the Policyholder in the city of permanent assignment.

Coverage begins at the actual start of an anticipated trip whether it be from an Insured Person’s place of employment, his home, or other location.  Coverage terminates upon his return to his home or place of employment, whichever shall first occur.

Coverage for business travel is not provided during:

  1. Commuting between the Insured Person’s home and place of employment;
  2. Travel to another location where the Insured Person is expected to be assigned for more than 60 days by the Policyholder;
  • Sojourn in excess of 3 days.

“Sojourn” means an activity that meets all of the following conditions:

  1. Is not reasonably related to the business trip;
  2. Is not incidental to the Policyholder’s business;
  3. Occurs prior to the end of the trip

CHUBB Insurance program features:

  • Financial arrangements with 65% of the total premium allocated to the Weekly Accident Indemnity experience rated benefit.
  • Part of a block program that renews annually on January 1st
  • Customized self administered billing to submit monthly premium payment
  • Employee communication package including explanation of the program and processes, benefit booklet and claim forms
  • Claims management in order to return employees back to work in a safe and timely manner

 

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