Accident
Benefit
Receive pre-determined benefits in the event of your child’s death, injury, fracture, dismemberment or total loss of use as the result of an accident.
We got you covered. And it is easier than you think.
Accidental Death
- from 30 days to 75 years: $50,000
- Dismemberment or total loss of use resulting from an accident
- of both feet or of both hands: $200,000
- of one hand and one foot: $200,000
- of one foot and loss of sight of one eye: $200,000
- of one hand and loss of sight of one eye: $200,000
- of one foot or of one hand: $100,000
- of sight of one eye: $25,000
- of hearing of one ear: $25,000
- of two phalanges or more of the same finger or toe: $5,000
Note: Benefits for dismemberment or total loss of use are not cumulative
Fracture resulting from an accident
- of the skull, spine, pelvis or thigh bone: $1,000
- of a rib,the sternum, larynx, windpipe, shoulder blade, humerus, kneecap, shin bone, fibula: $200
- of any bone not included in the above list: $150
Benefits paid for hospitalization resulting from an accident
- Private or semi-private room per day of hospitalization: $55 maximum
- Hospitalization from the first to the 365th day: $25 per day
Total disability resulting from an accident (students only)
- Overall coverage after 12 months of disability: $1,500
- Weekly benefits for June, July and August for ages 16 and up: $150
Reimbursement of expenses resulting from an accident
- Fees for a nurse or nursing assistant, with referral lifetime: maximum of $5,000
- Prescribed drugs and orthopedic devices lifetime: maximum of $10,000
- Chiropractor, speech therapist, logotherapist, osteopath,
podiatrist or psychologist: $15/visit – $240 per year - Physiotherapist, with referral: $15/visit – $240 per year
- Dentures, per natural, healthy tooth: up to $300
- Dental prosthesis: up to $250
- Initial prosthesis, including hearing aids: lifetime maximum of $3,000
- Medical, surgical and hospital services rendered outside Canada lifetime: maximum of $10,000
- Fees of only one x-ray: up to $25
- Fees of repairing or replacing eye glasses: up to $75
- Transportation by ambulance or taxi from the scene of an accident
to the nearest hospital and from the hospital to home: reasonable expenses
Reimbursement (students only)
- Transportation and accommodation expenses for a person accompanying the injured person: up to $500
- Private make-up classes: up to $1,000 Rehabilitation education fees
Exclusions
- No benefits are payable under this Accident Benefit coverage:
- 1.1. if injuries, resulting, directly or indirectly in death, dismemberment, total loss of use or a need for medical care are:
- a) self inflicted injuries, whether or not the child is sane or insane;
- b) sustained by the child while aboard an aircraft, except as a passenger on a regularly scheduled flight;
- c) incurred while participating in a sport for which the child receives monetary reward or compensation;
- d) sustained by the child during a riot, a demonstration, an insurrection, a war or any related act;
- e) sustained by the child when participating or attempting to participate in an illegal or a criminal act or while driving a motor vehicle or a boat while being under the influence of drugs or when the blood alcohol level exceeds 80 milligrams per 100 millilitres of blood;
- f) sustained by the child while under the influence of any drug, hallucinogen or narcotic. 1.2. when death or injuries are a direct or indirect result of gas inhalation, poisoning or drug absorption.
- 1.3. as soon as the child ceases to be a permanent resident of Canada
- 1.1. if injuries, resulting, directly or indirectly in death, dismemberment, total loss of use or a need for medical care are:
- 2. Unless the child was hospitalized, fees of chiropractors and physiotherapists are excluded if the injuries sustained result from the child training for or participating, in any organized league sport.
- 3. No benefits, under article 4 of the Accident Benefit, are payable:
- 3.1. for prosthesis and orthotic devices used exclusively to participate in sports or sporting activities or that are not medically necessary for rehabilitation or recovery;
- 3.2. if the child is covered under a similar insurance plan or under a public plan administered by a governmental agency;
- 3.3. for costs incured for cosmetic or esthetic purposes.
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