Along with basic life insurance protection, the plan automatically provides you with basic AD&D insurance - an extra measure of protection against a number of losses. If you wish to increase your coverage, or obtain coverage for your spouse or child, you can purchase optional AD&D insurance as well.
For a summary of your AD&D insurance coverage, refer to the Benefits At-a-Glance section.
Basic and Optional AD&D Insurance for You
In the event of a covered loss (other than loss of life), the benefit will be paid to you. In the event of your death, the benefit amount is payable to your designated beneficiary, or to your estate if your beneficiary has died before you or you haven't designated a beneficiary.
Designating a beneficiary - and keeping your beneficiary designation up to date - ensures that your intended beneficiaries are well-protected. To designate or update your beneficiary, completed the Beneficiary Designation form and return it to Johnson Inc.
Optional AD&D Insurance for Your Dependents
You, your spouse and child can only be covered once under the plan. For example, if your spouse is also covered under the plan, they cannot choose family coverage if you have also chosen family coverage.
In the event of a covered loss, including loss of life, the benefit will be paid to you.
What’s Covered
If an injury results in a loss or loss of use of a limb as specified in the table below, within one year from the date of the accident, you will receive a percentage of the benefit amount you have in place for both basic and optional coverage. However, not more than one (the largest) of such benefits will be paid with respect to injuries resulting from one accident.
| Covered Loss |
Percentage Payable |
|
100% |
- Hemiplegia (paralysis of one arm and one leg on the same side of the body)
- Paraplegia (paralysis of both lower limbs)
- Quadriplegia (paralysis of all four limbs)
- Use of both hands, both feet, or both arms
|
200% |
- Entire sight in both eyes
- One hand and one foot
- One hand or foot and entire sight in one eye
- Speech and hearing in both ears
- Brain death
|
100% |
- Use of one leg or one arm
|
75% |
- Use of one hand or one foot
- Entire sight in one eye
- Speech or hearing in both ears
|
66 ⅔% |
|
50% |
- Thumb and index finger of the same hand
- Four fingers of the same hand
|
33 ⅓% |
|
25% |
For
benefits to be payable, the loss of use must:
- be total and irrecoverable,
- continue for 12 consecutive months, and
- be determined by the insurer to be permanent.
Example: How Coverage Works
Let’s assume that you have basic AD&D coverage of $90,000 and optional AD&D coverage of $100,000. If you were to lose an arm, you would receive 75% of your coverage, as follows:
| Basic coverage |
75% x $90,000 = $67,500 |
| Optional coverage |
75% x $100,000 = $75,000 |
| Total benefits |
= $142,500 |
Now let’s assume that your optional AD&D coverage of $100,000 is family level. If your spouse were to lose an arm, you would receive 75% of your optional coverage, as follows:
| Had you lost your arm |
75% x $100,000 = $75,000 |
| If your spouse were to lose an arm |
If you have dependent children:
50% x $75,000 = $37,500
If you do not have dependent children:
60% x $75,000 = $45,000
|
Additional Benefits
| Basic Coverage |
|
Bereavement
|
If injuries covered under this plan result in your death within 365 days from the date of the accident, the plan will pay the reasonable and necessary expenses actually incurred by your spouse and dependent children for up to six sessions of grief counselling by a professional counsellor. The maximum reimbursement is $1,000 for all sessions combined. |
|
Cosmetic disfigurement
|
This coverage does not apply to business travel policies. If you suffer a third-degree burn in a non-occupational accident, the plan will pay a percentage of your basic accidental death coverage, depending on the area of the body that was burned, as follows:
Body part |
(A)
Area classification
|
(B)
Maximum allowable % for burned area
|
(C)
Maximum % of your basic accidental death coverage payable
|
| Face, neck, head |
11 |
9% |
99% |
| Hand and forearm |
5 |
4.5% |
22.5% |
| Either upper arm |
3 |
4.5% |
13.5% |
| Torso (front or back) |
2 |
18% |
36% |
| Either thigh |
1 |
9% |
9% |
| Either lower leg (below knee) |
3 |
9% |
27% |
The maximum benefit payable (C) is determined by multiplying the area classification (A) by the maximum allowable percentage for the burned area (B). In the event of a 50% surface burn, the maximum allowable percentage for the burned area (B) is reduced by 50%.
Note:Â This table only represents the maximum percentage of your basic accidental death coverage payable for any one accident. If you suffer burns in more than one area as a result of any one accident, benefits will not exceed a maximum of $25,000. |
|
Day care
|
In the event of your accidental death, the plan pays for reasonable and necessary day care expenses incurred for each dependent child under age 12 who is:
- enrolled in a licensed day care facility at the time of your accident, or
- enrolled in a licensed day care facility within 365 days of the date of your accident.
Benefits are payable for up to four consecutive years, to an annual maximum of 5% of your coverage or $5,000, whichever is lower.
In this case, the dependent child must:
- be your legitimate or illegitimate child, adopted child, stepchild, or any child who is in a parent-child relationship with you,
- be 12 years old or under, and
- depend on you for maintenance and support.
If you do not have eligible dependent children at the time of your death, your beneficiary will receive an additional benefit of $1,500 under this benefit or the special education benefit, but not both.
The insurer will require satisfactory proof that the child is enrolled in a licensed day care facility. |
|
Disappearance
|
If your body has not been found within one year of the disappearance, stranding, sinking or wrecking of the vehicle in which you were an occupant at the time of the accident, it will be assumed that you have died. The plan will then pay benefits. |
|
Family transportation
|
If you suffer an accidental injury and are hospitalized outside Canada or at least 150 km from your principal place of residence, the plan will pay up to $15,000 for transportation costs to have a member of your immediate family visit you.
Your attending physician, however, must require your family member’s presence in writing.
Transportation must be by the most direct route by a licensed common carrier. |
|
Home and vehicle alteration
|
If you receive benefits for a covered loss and must use a wheelchair, the plan will pay up to the greater of $15,000 and 10% of your basic accidental death coverage to a maximum of $50,000, for both of the following combined:
- the one-time cost of alterations to your home so it is wheelchair accessible and habitable, and
- the one-time cost of alterations to your vehicle so it is accessible and you can drive it.
For benefits to be paid:
- expenses must be incurred within 365 days of the accident that resulted in the covered loss,
- home alterations must be made by someone experienced in such matters who is recommended by a recognized organization providing support and assistance to wheelchair users, and
- vehicle alterations must be made by someone experienced in such matters and approved by provincial licensing authorities.
|
|
Identification
|
If you pass away accidentally at least 150 km away from your normal place of residence and the police or a similar government requests that a member of the immediate family identify the body, the plan will reimburse the reasonable expenses actually incurred by such member for:
- transportation by the most direct route or town where the body is located, and
- hotel accommodation in that city or town, subject to a maximum duration of three days.
The maximum amount payable for all of these expenses combined is $15,000. Reimbursement is subject to the subsequent payment of the basic accidental death benefit following the identification of the body as the insured person.
The plan does not cover board or other ordinary living, travelling or clothing expenses. Also, transportation must occur in a vehicle or device operated under a license for the conveyance of passengers for hire.
These benefits are limited to only one policy should this benefit be contained in two or more policies issued to the policyholder by the insurer. |
|
In-hospital confinement monthly income
|
If an accident leads to your hospitalization for at least seven consecutive days and you are under the care of a legally qualified and registered physician or surgeon (other than yourself), the plan will pay a monthly benefit of 1% of your coverage, up to $2,500 per month.
For hospitalization of less than one month, the plan will pay 1/30 of the monthly benefit per day.
Benefits cannot exceed 365 days for any covered accident. |
|
Permanent and total disability
|
If you suffer an injury that results in permanently and totally disability (after 365 days from the date of an accident) the plan pays a benefit equal to your coverage amount, less any benefit payment already made under the plan as a result of the same accident.
|
|
Rehabilitation
|
If you are entitled to benefits for eligible losses, the plan will pay up to $15,000 of reasonable and necessary expenses for special training to be qualified for an occupation in which you would have not engaged in had the accident not occurred. Expenses must be incurred within two years of the accident.
No benefits are payable for ordinary living, travelling or clothing expenses. |
|
Repatriation
|
In the event of your accidental death outside Canada or over 50 km from your principal place of residence, the plan will pay up to $15,000 for the preparation and transportation of your body to such place.
Your death must occur within 365 days of the accident. |
|
Seat-belt benefit
|
If you suffer a covered loss while wearing a properly fastened seat belt in a private passenger car, station wagon, van, or jeep-type automobile at the time of the accident, the plan will pay 10% of the amount that would otherwise be payable for the covered loss.
The official accident report must certify that you or your covered dependents were wearing seat belts at the time of the accident. |
|
Special education benefit
|
In the event of your accidental death, the plan will pay a benefit to any dependent child who, on the date of the accident that led to your death:
- is enrolled full-time in any post-secondary institution beyond the 12th or 13th grade level, or
- was at the 12th or 13th grade level and subsequently enrols as a full-time student in any post-secondary institution within 365 days of the accident that led to your death.
The benefit is equal to 5% of your coverage amount, to a maximum of $5,000 per year. This benefit is payable for a maximum of four consecutive annual payments, provided your dependent child remains full-time in a post-secondary institute.
If no dependent child qualifies at the time of the accident, the plan will pay an additional benefit of $1,500 to your designated beneficiary under this benefit or the day care benefit, but not both. |
|
Spousal occupational training
|
In the event of your accidental death, the plan will pay up to $15,000 for any occupational training expenses incurred by your spouse to gain active employment in a field for which they were not previously qualified.
The expenses must be incurred within three years of the date of the accident. |
|
Waiver of premium
|
If you become totally disabled before age 65 and provide annual satisfactory evidence of your total disability, you will not have to pay your premium for coverage. This waiver will last until your return to active employment with your employer, your 65th birthday, or coverage is terminated. |
| Optional Coverage |
Bereavement |
If injuries covered under this plan result in your death within 365 days from the date of the accident, the plan will pay the reasonable and necessary expenses actually incurred by your spouse and dependent children for up to six sessions of grief counselling by a professional counsellor. The maximum reimbursement is $1,000 for all sessions combined. |
Comatose benefit |
If you become comatose as a result of an accident, the plan will pay a monthly benefit equal to 1% of your optional coverage for accidental death, until the earliest of:
- 100-month period,
- your death, and
- the date you are deemed to be out of the coma.
This benefit will be reduced by any optional benefit already paid by the plan for your accidental loss if you become comatose within 365 days of the accident and remain comatose for 31 consecutive days. |
Common disaster |
If you and your covered spouse die within one year from injuries resulting from the same accident, or separate accidents occurring within the same 24-hour period, your spouse’s coverage will be increased to equal your optional coverage, up to $200,000.
Benefits will be payable to and divided equally among your surviving dependent children. |
Cosmetic disfigurement |
This coverage does not apply to business travel policies. If you suffer a third-degree burn in a non-occupational accident, the plan will pay a percentage of your basic accidental death coverage, depending on the area of the body that was burned, as follows:
Body part |
(A)
Area classification
|
(B)
Maximum allowable % for burned area
|
(C)
Maximum % of your basic accidental death coverage payable
|
| Face, neck, head |
11 |
9% |
99% |
| Hand and forearm |
5 |
4.5% |
22.5% |
| Either upper arm |
3 |
4.5% |
13.5% |
| Torso (front or back) |
2 |
18% |
36% |
| Either thigh |
1 |
9% |
9% |
| Either lower leg (below knee) |
3 |
9% |
27% |
The maximum benefit payable (C) is determined by multiplying the area classification (A) by the maximum allowable percentage for the burned area (B). In the event of a 50% surface burn, the maximum allowable percentage for the burned area (B) is reduced by 50%.
Please note that this table only represents the maximum percentage of your basic accidental death coverage payable for any one accident. If you suffer burns in more than one area as a result of any one accident, benefits will not exceed a maximum of $25,000. |
Escalation benefit |
After you have been covered under the plan for 12 months, your coverage is increased each year by 1% for a maximum of five years. |
Extended family benefit |
If your family is covered when you suffer an accidental death, coverage may continue for your spouse and dependent children for a maximum of six months, provided premiums are paid. |
Special benefit for dependent children |
| Injury |
Benefit |
- Loss of two hands
- Loss of two arms
- Loss of two legs
- Loss of two feet
- Loss of one hand and one foot
- Loss of entire sight in both eyes
- Loss of speech and hearing
- Quadriplegia
|
4 x what the plan would have paid for your child’s accidental death |
- Loss of one arm or one leg
- Loss of speech or hearing
- Paraplegia
- Hemiplegia
|
2 x what the plan would have paid for your child’s accidental death |
- Loss of life
- Loss of one hand or foot
|
1 x what the plan would have paid for your child’s accidental death |
| The maximum benefit payable is $100,000. |
|
Homemaker weekly indemnity |
If your spouse suffers a covered loss and becomes disabled and is prevented from performing any and all of the regular household and/or childcare duties, the plan will pay $150 per week (from the second day of the disability) for the duration of the disability, to a maximum of 26 weeks.
Your spouse must:
- become disabled within 30 days of the accident,
- be unemployed and not in receipt of employment insurance benefits at the time of the covered loss, and
- be under the regular care and attendance of a physician during the disability.
|
Identification |
If you pass away accidentally at least 150 km away from your normal place of residence and the police or a similar government requests that a member of the immediate family identify the body, the plan will reimburse the reasonable expenses actually incurred by such member for:
- transportation by the most direct route or town where the body is located, and
- hotel accommodation in that city or town, subject to a maximum duration of three days.
The maximum amount payable for all of these expenses combined is $15,000. Reimbursement is subject to the subsequent payment of the basic accidental death benefit following the identification of the body as the insured person.
The plan does not cover board or other ordinary living, travelling or clothing expenses. Also, transportation must occur in a vehicle or device operated under a license for the conveyance of passengers for hire.
These benefits are limited to only one policy should this benefit be contained in two or more policies issued to the policyholder by the insurer. |
