conseiller

Catherine Beaulieu

Independent representative
Financial security advisor  
514 282-5360 866 665-0500, 25360

Details of coverage offered under the Best Buds program


Eligibility
Any child over age 14 days (who has left the hospital) to 5 years, inclusive, whose father or mother is a Mutual member.

Brief description of coverage
Accident insurance takes effect as of the date of receipt of the duly completed application form. The term of the contract is 24 months for each insured. Insured children are covered 24 hours a day.

This brief product description does not constitute a contract and is intended solely to give a brief overview of the coverage available. The insurance policy you receive when you take out the coverage governs the specific provisions of your coverage. Only the accident insurance policy may be used to settle any legal issues..


TABLE OF BENEFITS
Accidental death, death resulting from natural causes, accidental dismemberment or loss of use
Benefit paid
Accidental death
As a paying passenger with a public carrier $15,000
Other circumstances $6,000
Death from natural causes $3,500
Accidental dismemberment or loss of use
Loss of more than two of the following parts of the body:
hand, foot, arm, leg or sight in one eye
$70,000
Loss of hearing in both ears and loss of speech $70,000
Loss of hearing in both ears or loss of speech $35,000
Loss of a hand, a foot, an arm, a leg or sight in one eye or hearing in one ear $9,000
A finger or toe (per finger or toe) $1,300

Limitations
If, on the date of an accident, an insured has incurred more than one of the losses set out in the TABLE OF BENEFITS, the insurer shall only pay benefits for one loss. The benefit paid shall correspond to the highest amount set out in the Table of Benefits for said loss.

Reimbursement of miscellaneous expenses
Hospital and paramedical expenses following an accident Per accident
Expenses for the purchase of drugs obtained on prescription by the attending physician Included
Expenses for the purchase of a first hearing aid or an artificial eye (Max. $600/prosthesis) Max. $1,200 1
Expenses for occupying a room in a hospital centre in Canada Max. $75/day
Professional fees of a registered nurse if care is prescribed by a physician Max. $6,000 1
Cost of rental or purchase of a cane, crutches, a walker or a wheelchair Included
Expenses for purchase or rental of an orthosis Max. $350
Cost of treatment by a physiotherapist, occupational therapist, osteopath, podiatrist, speech therapist, audiology specialist or chiropractor $15/visit, Max. $180 1
Expenses for emergency transportation immediately following an accident Included
Expenses for medical care not indicated above AND received outside the province Max.$6,000 1
Transportation and accommodation expenses
For the insured and the person accompanying the insured for treatments that cannot be obtained less than 50 km from the insured's home Max. $1,000
Financial support in the event of hospitalization
Hospitalized insured $25 /night, Max. $1,000 1
Transportation and accommodation expenses
Children under age 8 (injured insured child) $10 /hour, Max. $100 1
1 Maximum amount for the duration of the contract

Definitions
An accident is an unforeseeable chance event of a violent nature that causes the insured, directly and independently of any other reason, bodily injury due exclusively to external causes and is corroborated by a physician. Furthermore, the accident must occur after the effective date of the contract, and the loss resulting from said injury must occur within 365 days of the date of the accident.

Restrictions and exclusions
The insurer shall not pay any benefits in the following cases:
a) The accident is a direct or indirect result of voluntarily self-inflicted injuries, suicide or attempted suicide, whether or not the insured is of sound mind.
b) The accident is a result of the insured's participation in a criminal act, including driving a motor vehicle while under the influence of drugs or alcohol in excess of the legal limit. A vehicle, whether moving or stationary, is defined as any means of transportation by land, air or water moved by any force, including physical force.
c) The accident is a result of a physical or mental illness, a medical or surgical treatment, anaesthesia or an infection other than an infection caused by an injury sustained during the accident.
d) The accident is a result of a military operation, an act of terrorism, war, whether declared or undeclared, a riot or an insurrection.
e) The accident is a result of injuries that produced no visible wounds or contusions on the surface of the body, except in the case of accidental drowning.
f) The accident is a direct or indirect result of the abusive consumption of medication, drugs or narcotics, or gas inhalation, whether voluntary or not.
g) The accident is the result of the insured's participation in a flight, other than as a regular passenger on a regularly-scheduled flight operated by a public carrier, or the participation of the insured in a dangerous sport such as scuba diving, hang-gliding, skydiving, free falling, mountaineering or climbing.
h) The accident is the result of the insured's participation in a sporting activity for which he or she is compensated, his or her participation in a motor vehicle competition, or in training for such a competition.
i) The expenses were incurred more than 104 weeks following the accident.
j) The care or services were administered by a relative of the insured or policyholder.
k) The loss resulting from said injury occurs more than 365 days following the date of the accident. However, this exclusion does not apply if the insured is in a comatose state at the end of this period. In such a case, the insurer determines the benefits payable, if applicable, at the end of the coma.
Telephone assistance service
As soon as the contract takes effect, the insurer will provide the policyholder, the insured and the insured's family members living under the same roof with telephone assistance service, which will provide referral services and information to help them deal with day-to-day problems and situations. The telephone assistance number will be provided to the client along with documentation containing the Best Buds accident insurance policy.

The telephone assistance service is offered by the insurer in cooperation with various service providers. In the event of the failure of one of the service providers, the insurer undertakes to take reasonable and necessary measures to replace them. The insurer reserves the right to discontinue this service at any time.

Coordination of benefits
If an insured is covered by several insurance policies (private or public), the total amount of benefits receivable cannot exceed expenses actually incurred.

If an insured is covered by one or more plans that does not include coordination of benefits with other plans, the insured must be reimbursed by these other plans first. The insurer's responsibility is limited to the portion of the expenses that are not reimbursed by the other plans.

If the other plans include coordination of benefits, benefits are paid proportionally between these plans and those of the insurer, in accordance with the amounts that should have been paid by each insurance plan.

Multiple insurance
If the insured is covered under more than one Best Buds accident insurance contract, the insurer will only pay one benefit per covered loss, i.e., the highest benefit from among all such contracts.