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Long Term Care - Insurance Benefit

If, at the time of signing the Membership Application, the Owner is in good health, is at least eighteen (18) but not more than sixty-five (65) years old and performing the normal activities of daily life, he shall be insured by Kaiser under a Group Master Insurance Contract underwritten by a reputable and duly authorized insurance company, as described below:

  • Term Life Insurance - If the owner dies before attaining the age of sixty-five (65) years and prior to entitlement to the Long-Term Care Benefit as indicated in the Schedule of Benefits, his beneficiaries shall be entitled to an amount equal to the Long-Term Care Benefit upon approval of the claim by the insurance company.
  • Accidental Death And Disbursement Insurance - Should the Owner suffer, directly and independently of all other causes, any bodily injury effected solely through external, violent and accidental means, occurring prior to the Owner's 65th Birthday and prior to entitlement to the Long-Term Care Benefit, which result in any of the specified losses within 180 days after the accident causing the injury, the insurance company will pay the following:
  • Description Benefit
    Loss of life 100%
    Loss of both hands 100%
    Loss of both feet 100%
    Loss of sight of both eyes 100%
    Loss of one hand and one foot 100%
    Loss of one hand and sight of one eye 100%
    Loss of one foot and sight of one eye 100%
    Loss of one hand or one foot 50%
    Loss of sight of one eye 50%

    Loss shall mean the dismemberment of hands and feet by severance at or above the wrist bone or ankle joints respectively. Loss of eyesight must be total and irrecoverable.

    Any partial benefit already paid for any loss(es) shall not be carried over in the subsequent contract year, i.e., the amount of benefits to be paid in the succeeding contract year shall not be reduced by any amount paid in the preceding contract year.

    The loss of the first joint of the thumb or any other finger or of any toe shall be considered as equal to the loss of one half of the thumb or finger or toe. The loss of more than one phalanx of the thumb or of any other finger or of any toe shall be treated as loss of the entire thumb or finger or toe. Where there is loss of two or more parts of the hand, the percentage payable shall not be more than the loss of one whole hand.

    The aggregate of all percentages payable with respect to any more accident shall not exceed 100%.

  • Credit Life Insurance - If the Owner dies during the Accumulation Period and before exceeding the age of sixty-five, the proceeds of the credit life insurance shall be applied to the balance of this Contract Price upon approval of the claim by the insurance company, if any.
  • Waiver Of Installment Due To Total And Permanent Disability - If the Owner becomes totally disabled during the Accumulation Period and before his 60th birthday thereby preventing him from engaging in any occupation for compensation or profit, is so disabled for life, and such disability continues for at least six (6) months, Kaiser shall waive the payment of each installment becoming due during the period of disability. However, pending approval of the claim, installments should be paid as they fall due, subject to refund upon approval.

All claims under the above insurance coverage shall be subject to contestability as provided for by law, but for a reduced period of one (1) year from the date of issue or reinstatement of this Contract.

If the member dies during the Accumulation Period, the Principal Beneficiary named herein shall be substituted as the new Member, but no longer with insurance benefits and subject to the provisions on Pre-existing Illness or Injury (Art. VII). If the Member dies during the Extended Period, this Contract shall be considered terminated and his Beneficiary shall be entitled to the corresponding Cash Value.

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