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If you suffer any of the losses described below as a result of Sickness or bodily Injury, the Fund will pay the amount specified in the applicable Schedule of Benefits for Non-Medicare Eligible Retirees and Schedule of Benefits for Medicare Eligible Retirees. You must submit a letter from your Physician for accidental dismemberment benefits. If the claim is for your accidental death, your Beneficiary need only submit a certified copy of your death certificate. 

Covered losses include:

  • Accidental Death;
     
  • Two Accidental Dismemberments, which include the loss of:
     
    • Both hands,
       
    • Both feet,
       
    • The sight of both eyes,
       
    • One hand and one foot,
       
    • One hand and the sight of one eye,
       
    • One foot and the sight of one eye; and
  • One Accidental Dismemberment, which includes the loss of:
     
    • One hand,
       
    • One foot, or
       
    • The sight of one eye.

With respect to the loss of sight in one or both eyes, you are eligible for Accidental Dismemberment Benefits for loss of sight if you are deemed to be “legally blind” in one or both eyes under the laws of the United States.

Accidental Death Benefits will be paid if you die as a direct result of bodily Injury caused solely by an accident and you die within ninety days from the date of the accident. No more than the amount listed in the Schedule of Benefits for Non-Medicare Eligible Retirees and Schedule of Benefits for Medicare Eligible Retirees will be paid for losses resulting from any one event. Benefits for Accidental Death will be paid to the Beneficiary you have named to receive your Death Benefits, in the order provided.

Accidental Dismemberment Benefits will be paid if the dismemberment is a direct result of bodily Injury caused solely by an accident and the dismemberment occurs within ninety days from the date of the accident.  Accidental Dismemberment Benefits will be paid to you, or to the person caring for you, if you are unable to care for yourself. No more than $15,000 will be paid for losses resulting from any one event.

Once you retire, your eligibility for the Accidental Death and Dismemberment  Benefit terminates six months after the effective date of your retirement. If you are no longer eligible under the Plan for any other reason, you are no longer eligible for the Accidental Death and Dismemberment Benefit.