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Voluntary Accidental Death _ Dismemberment Insurance - Mutual of Omaha


									Mutual of Omaha Insurance Company

Voluntary Accidental Death
& Dismemberment Insurance

Unintentional injuries are the leading cause of death for people under age 34, and the fifth leading
cause of death for people of all ages.
                                                                              Injury Facts, National Safety Council, 2003

Comprehensive Benefits                                Mutual of Omaha’s AD&D Insurance
At No Cost to the Employer                            This stand-alone voluntary benefit is available at
Provide additional value to an employee benefits      affordable rates. It provides employees with peace of
package with Mutual of Omaha’s voluntary accidental   mind against the risk of covered injuries or death.
death & dismemberment (AD&D) insurance. We            Mutual of Omaha will tailor the AD&D plan to best fit
provide superior customer service, product experts    the needs of each employer. The benefits listed below
and disability management solutions with:             are available in most states:

• 24-hour coverage for spouses and/or eligible
  family members                                        Accidental Death & Dismemberment Loss Table
• Both living and death benefits
                                                          Life                              Principal Sum
• Outstanding support from experienced customer
                                                          Both Hands or Both
  service professionals                                                                     Principal Sum
                                                          Feet or Both Eyes
• Many unique benefits, which allows employers
                                                          One Hand and
  to design a benefit plan for their specific needs                                         Principal Sum
                                                          One Foot
                                                          One Hand and One Eye
For more than 95 years, we’ve offered the best            or One Foot and                   Principal Sum
products and services from an experienced team            One Eye
of professionals.                                         One Hand or One Foot              One-half
                                                          or One Eye                        Principal Sum
                                                          Speech and Hearing                Principal Sum
                                                          Speech or Hearing
    Eligibility Requirements                                                                Principal Sum

    • Employers with 100 or more                          Thumb and Index
      eligible employees                                  Finger of the
                                                                                            Principal Sum
    • All active, full-time employees working             Same Hand
      30 or more hours per week who are U.S.
      citizens domiciled in the United States
    • Minimum enrollment of 35 enrolled
      employees or 25 percent of eligible
      employees, whichever is greater
    • Certain industries are ineligible

   Additional Benefits
   In addition to AD&D coverage, we offer the following                  Felonious assault – Benefit amount payable for a
   optional benefits:                                                    covered loss is increased when an insured person
                                                                         receives injuries due to a felonious assault.
   Air bag benefit – A loss of life benefit is payable if
   an air bag was in place and engaged during a                          Premium waiver – When an insured person suffers
   covered accident.                                                     loss of life, coverage for insured dependents will
                                                                         continue without premium payment until whichever
   Coma benefit – Benefit payable if due to covered                        of the following occurs first: (a) the date your spouse
   injuries an insured person becomes comatose.                          remarries; (b) the date the insurance terminates;
   Air travel – Coverage is provided 24 hours a day                      (c) the date an unmarried dependent child ceases to
   including traveling as a passenger and getting on                     be eligible due to age or marriage; or (d) the date the
   or off: (a) any licensed U.S. civil aircraft or its foreign           12-month benefit period ends.
   equivalent; (b) any transport-type, multiengined                      Paralysis coverage – Benefits are payable when
   fixed-wing aircraft; or (c) any aircraft of the United                 an insured person suffers injuries which result in
   States Department of Defense, other than a single-                    paralysis (hemiplegia, paraplegia or quadriplegia)
   engine jet.                                                           commencing within 60 days after the accident and
   Children’s dismemberment benefit – Increases the                       continuing for one year.
   percent of principal sum payable when a dependent                     Increased common carrier benefit – Benefit amount
   child suffers a specific loss, other than a loss of life,              payable for a covered loss is increased when an
   covered under the policy.                                             insured person incurs injuries while riding as a
   Common accident benefit – Increases the principal                      passenger in any public air, land or water conveyance
   sum amount payable for a dependent spouse if the                      provided by a common carrier primarily for passenger
   covered insured and spouse both die due to injuries                   service.
   resulting from the same accident.                                     Seat belt usage benefit – Additional benefit amount
   Day care benefit – Benefit payable for each covered                     payable for loss of life if at the time of a covered
   dependent child enrolled in an accredited day-care                    accident an insured person was: (a) the operator of or
   facility if the insured’s injuries result in payment of               a passenger in a private passenger automobile; and
   the principal sum.                                                    (b) utilizing a seat belt.
   Child education benefit – Benefit payable for each                      Surviving spouse education/training benefit
   covered dependent child enrolled and attending                        – Additional benefit payable, in the event of an
   either the 12th grade or an accredited college/                       insured’s loss of life, for any licensed professional or
   university if the insured’s injuries result in loss of life.          trade school training program for which the covered
   Exposure & disappearance – Benefits are payable for                    spouse: (a) enrolls for the purpose of obtaining an
   a covered loss due to exposure to the elements or loss                independent source of support and maintenance;
   of life due to disappearance of the body of an insured                (b) successfully completes; and (c) receives a
   person resulting from the disappearance, sinking                      certificate or degree upon completion.
   or damaging of a conveyance on which the insured                      Note: Availability may vary by state.
   person was riding.

Underwritten by:
Mutual of Omaha Insurance Company
Mutual of Omaha Plaza
Omaha, NE 68175

This insurance plan overview is not intended to provide a complete description of the
voluntary benefit coverage. Benefits may not be available in all states. Some exclusions,
limitations and reductions may apply. Please contact your Mutual of Omaha representative
for specific product details and policy provisions. Mutual of Omaha Insurance Company is
licensed in all states.
Policy Form T66BA Series 13569 or state equivalent

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