VFIS VOLUNTEER FIREFIGHTER ACCIDENT AND SICKNESS INSURANCE ELIGIBLE
VFIS VOLUNTEER FIREFIGHTER ACCIDENT AND SICKNESS INSURANCE
ELIGIBLE PARTICPANTS v v Any volunteer member of the Fire Department A paid on call volunteer (includes members that receive a monthly or annual stipend) v v v Junior member or Auxiliary member A commissioner, director, trustee, or person acting in a similar position A non-member deputized at the scene of an emergency by one of your officers, but only for the duration of the emergency
ON DUTY BENEFITS ARE PAID DEPENDING ON THE TYPE OF ACTIVITY ( FOR TRAVEL TO, DURING, & FROM) Emergency Duties Other Covered Activities v v
EMERGENCY DUTIES v v v Firefighting Rescue Operations Good Samaritan acts Training Exercises which simulates an emergency Firematic Events or Contests (battle of the barrel, ladder climbs, tug of war) Classroom training
GOOD SAMARITAN ACTS If a volunteer firefighter responds to an emergency not on behalf of the Policyholder or any other organization, and applies his/her knowledge to help out and gets injured, they are covered under the policy.
COVERED ACTIVITIES v v v Emergency Duties Firematic Events & Contests Fundraising Monthly meetings, conventions Any other authorized activities (dinners and banquets) Non – members also have coverage while helping in these covered activities.
ON DUTY LOSS OF LIFE BENEFITS Accidental Death Seat Belt Illness Loss of Life Dependant Child Spousal Support Memorial Repatriation
ACCIDENTAL DEATH BENEFIT Is paid, when Loss of Life is a result of participating in a Covered Activity Note: No Time Limitations PRINCIPAL SUM BENEFIT LIMIT OF $100, 000
SEAT BELT BENEFIT When a properly fastened Seatbelt is worn and Loss of Life occurs, 25% of the Principal Sum is paid in addition to the death benefit. AN ADDITIONAL BENEFIT LIMIT OF $25, 000
ILLNESS LOSS OF LIFE BENEFIT Payable when a death occurs due to an illness while participating in a Covered Activity. Death or Medical treatment must be received within 48 hours. Note: If Loss of Life occurs during the Covered Activity, automatic coverage is applied regardless of current/past health situation. BENEFIT LIMIT OF $100, 000
ILLNESS LOSS OF LIFE EXAMPLE SMOKE INHILATION FIREFIGHTER GOES TO HOSPITAL FOR TREATMENT WITHIN 48 HOURS AND IS RELEASED. 1 WEEK LATER DEVELOPS COMPLICATIONS FROM THE EXPOSURE AND PASSES AWAY
DEPENDANT CHILD BENEFIT Benefit is paid to the legal guardian for each dependant child. Accidental Death Indemnity or Illness Loss of Life Benefit must be payable. AN ADDITIONAL BENEFIT LIMIT OF $15, 000
SPOUSAL SUPPORT BENEFIT Benefit is automatically paid to the surviving spouse of an Insured Person. Accidental Death Indemnity or Illness Loss of Life Benefit must be payable. AN ADDITIONAL BENEFIT LIMIT OF $10, 000
MEMORIAL BENEFIT Benefit is automatically payable to the Policyholder to cover final expenses incurred for an insured person or as they see fit. Accidental Death Indemnity or Illness Loss of Life Benefit must be payable. AN ADDITIONAL BENEFIT LIMIT OF $3, 000
REPATRIATION BENEFIT Benefit responds to cover reasonable expenses incurred, (outside of 50 kms) to return an insured persons body to their current place of residence. Accidental Death Indemnity or Illness Loss of Life Benefit must be payable. AN ADDITIONAL BENEFIT LIMIT OF $15, 000
LUMP SUM BENEFITS Accidental Dismemberment Quadriplegia, Paraplegia, or Hemiplegic(paralysis) Vision Impairment Home Alteration & Vehicle Modification Illness Permanent Impairment Heart Impairment Cosmetic Disfigurement ( Burns) HIV Positive Felonious Assault Cancer
ACCIDENTAL DISMEMBERMENT BENEFIT IF AN INJURY CAUSES ANY OF THE LISTED LOSSES TO BE SUFFERED, THE INDICATED PERCENTAGE OF THE ACCIDENTAL DISMEMBERMENT INDEMNITY PRINCIPAL SUM WILL BE PAID. (NO TIME LIMITATIONS) IF MORE THAN ONE LOSS IS SUFFERED IN ANY ONE ACCIDENT ONLY ONE AMOUNT, THE LARGEST, WILL BE PAID. v v v v Both Hands or Feet One Hand or Foot Entire Sight of Both Eyes 100% One hand Entire Sight of One Eye One Foot and Entire Sight of One Eye Speech & Hearing One Arm or One Leg Speech or Hearing One Hand or One Foot Entire Sight of One Eye Both Thumbs One Thumb Each Joint of a Finger or Toe 100% 100% 75% 50% 50% 10% 5% 1%
QUADRAPELGIA, PARAPALEGIA OR HEMIPLEGIA (PARALYSIS) IF AN INJURY CAUSES ANY OF THE LISTED LOSSES TO BE SUFFERED, THE INDICATED PERCENTAGE OF THE ACCIDENTAL DISMEMBERMENT INDEMNITY PRINCIPAL SUM WILL BE PAID. (NO TIME LIMITATIONS) v v v Quadriplegia Parapalegia Hemipeligia 200%
VISION IMPAIRMENT BENEFIT Benefit will respond when an insured person suffers irreparable injury which results in permanent impaired vision, but not a total and irrecoverable loss of sight. This benefit will not respond to losses to the same eye that are payable under the Accidental Dismemberment Benefit. Each eye is worth 50%of the Principal Sum ( NOT TO EXCEED 50% OF THE PRINCIPAL SUM)) Benefit amounts vary based on eye sight abilities before the accident and the amount of impairment sustained. (No Time Limitations)
HOME ALTERATION & VEHICLE MODIFICATION BENEFIT Benefit will respond when an Insured Person suffers a an Injury or Illness for which the Accidental Dismemberment or Permanent Physical Impairment Benefit is paid and as a direct result of the loss requires a wheelchair to be ambulatory. COVERAGE PROVIDED FOR: v Alterations to the Insured Persons residence that are necessary to make the residence accessible and habitable for a wheel chair confined person. v Modifications to a motor vehicle owned, leased or newly purchased by the Insured Person that are necessary to make the vehicle accessible to and/or drivable by the Insured Person.
INJURY PERMANENT IMPAIRMENT BENEFIT Benefit is payable when an Insured Person suffers a permanent impairment due to an injury and the Insured Person participates in an approved physical rehabilitation program, if their physical condition so warrants. Benefit will not respond if coverage is provided under the Heart Permanent Impairment or Illness Permanent Impairment Benefits. % of the Principal Sum Based on the Impairment Value assigned by an examining physician. Benefit is paid in addition to any Accidental Dismemberment or Vision Impairment Benefit but not to exceed 200% of the largest Principal Sum.
Injury Permanent Impairment Example A wall collapses on a firefighter causing tendons to sever in their shoulder. After the tendons are fused back together and after physiotherapy, the firefighter lost a % of the use of their shoulder. If it is 50%use of their shoulder, then applied to the body as a whole, the percentage could be 15%, which is applied to the principal sum and paid. The firefighter could be back to work and this benefit is still paid.
ILLNESS PERMANENT IMPAIRMENT BENEFIT v Benefit will respond if an illness results in an Insured Person being on Total Disability Benefits for 5 years (260 weeks). v If the Insured Person is unable to return to their occupation 50% of the Benefit is payable. If the Insured Person is unable to return to any gainful occupation 100% of the Benefit is payable.
HEART PERMANENT IMPAIRMENT BENEFIT Benefit is payable if an Insured Person has a Heart Permanent Impairment due to a heart condition that results in at least 26 weeks of Total Disability. The % payable varies based on the Functional Classification and % of Impairment and further modified by the Insured Persons age at the date of impairment.
COSMETIC DISFIGUREMENT RESULTING FROM BURNS BENEFIT When an Insured Person suffers from cosmetic disfigurement due to a burn that is classified as a full thickness or third degree burn this Benefit will be paid. Benefit is paid based on the Cosmetic Burn Schedule on a % basis. Benefits may not exceed 100% of the Cosmetic Disfigurement from Burns Principal Sum as a result of any one accident.
HIV POSITIVE BENEFIT As a direct result of a Covered Activity an Insured Person tests HIV Positive this Benefit is payable and 100% of the Principal Sum is paid upfront. Benefit is not Payable if there is coverage under the Illness Loss of Life or Illness Permanent Impairment Benefits.
FELONIOUS ASSAULT BENEFIT If an Insured Person suffers as a result of a “Felonious Assault” that is directed at the Insured Person while participating in a Covered Activity this Benefit will pay an Additional 50% of the total amount payable under: v v v v Accidental Death Indemnity Accidental Dismemberment Cosmetic Disfigurement Resulting from Burns Injury Permanent Impairment Heart Permanent Impairment Illness Permanent Impairment Vision Impairment
CANCER BENEFIT Benefit is provided when an Insured Person, as a result of occupational hazards of a firefighter, suffers Life threatening Leukemia, Non. Hodgkin’s, Lymphoma, Kidney Cancer, Brain Cancer, or Bladder Cancer for which chemotherapy or radiation treatments are recommended. Insured Person will receive $5, 000 so long as such treatment is received within one year from the onset of diagnosis and must survive at least 30 days after such diagnosis.
WEEKLY INCOME BENEFITS Total Disability Weekly Income Partial Disability General Disability Transition
TOTAL DISABILITY WEEKLY INCOME BENEFIT v v v Income Benefits are selected or chosen by FD. If Injury or Illness from a Covered Activity results in Total Disability the benefit payable is $300/wk for the 1 st 28 days. If Total Disability continues beyond 28 days the benefit payable is up to $300/wk to a maximum of 260 weeks unless option has been taken to increase the payout period to 520 weeks.
TOTAL DISABILITY WEEKLY INCOME BENEFIT The amount payable is determined based on the Insured Persons Gross Average Weekly Wage minus any other disability income benefits received by the Insured Person from Workers Compensation or other Valid Collectable Insurance. v Payment may not exceed the Total Disability Maximum Weekly Amount shown on the schedule. v The Total Disability Minimum Weekly Amount is payable regardless of the Insured Persons monetary loss. This is guaranteed to pay up to 260 or 520 weeks, whichever option is chosen.
TOTAL DISABILITY WEEKLY INCOME BENEFIT Example � All T 4’s for employer related jobs. Line 101 on T 1 General for Self Employed. � Firefighter Gross Average Weekly Wage= Workers Compensation Pays= Out of pocket Loss= � � $1, 000. 00/wk $750. 00/wk $250. 00/wk For the 1 st 4 weeks (28 days) Guaranteed payment of selected benefit After the 1 st 4 weeks (28 days) payment is made up to the maximum or Out of pocket Loss, whichever is less. Never less than the Guaranteed minimum amount.
PARTIAL DISABILITY BENEFIT v If injury or illness from a Covered Activity results in Partial Disability the benefit payable is $150/wk for the 1 st 28 days. v If Partial Disability continues beyond 28 days the benefit payable is up to $150/wk to a maximum of 52 weeks. Partial Disability is paid 50% of the Total Disability Benefit v
PARTIAL DISABILITY BENEFIT v v The amount payable is determined based on the Insured Persons Gross Average Weekly Wage minus any other disability income benefits received by the Insured Person from Workers Compensation or other Valid Collectable Insurance, but calculated at 50% of the value Payment may not exceed the Partial Disability Maximum Weekly Amount shown on the schedule. The Partial Disability Minimum Weekly Amount is payable regardless of the Insured Persons monetary loss for 52 weeks.
GENERAL DISABILITY BENEFIT If an Insured Person is Totally or Partially Disabled for less than a week, this Benefit will pay 1/7 of the Benefit otherwise payable for each full day the Insured Person is so disabled. Periods of Total and Partial Disability separated by less than 5 years will be considered one period of disability unless due to separate and unrelated causes.
TRANSITION BENEFIT When an Insured Person is receiving Total Weekly Disability Benefits and they are terminated from their employment and remain unemployed after the Total Disability Benefits end under the policy the Transition Benefit will pay as long as the person remains unemployed for up to a maximum of 26 weeks. Payment ends when person is employed or 26 weeks period is reached, whichever comes first.
OCCUPATIONAL RETRAINING BENEFIT This Benefit is payable if an Insured Person is rendered Permanently Totally Disabled and chooses to enroll in an institution of higher learning or professional trade program. v The objective of this Benefit must be to return the Insured Person to work in an occupation to which they are suited. Expenses covered include but are not limited to: Tuition, books, and other training materials required by the educational institute. v
MEDICAL EXPENSE BENEFIT MEDICAL EXPENSE COSMETIC/PLASTIC SURGERY POST TRAUMATIC STRESS DISORDER CRITICAL INCIDENT STRESS MANAGEMENT FAMILY EXPENSE
MEDICAL EXPENSE BENEFIT This Benefit covers expenses in excess of benefits provided by any provincial or federal hospital and/or medical plan or other policy providing medical reimbursement expenses. Coverage for Reasonable and Customary Expenses as a result of injury or Illness for necessary: v v v Medical, Hospital, or Surgical treatment Home Health care Nursing services prescribed and monitored by a physician Post exposure Prophylaxis protocol (PEP) treatment, when treatment is advise by attending physician Infectious Disease screening tests Post exposure preventative inoculations as a result of participation in a Covered Activity
COSMETIC PLASTIC SURGERY BENEFIT Coverage for Reasonable and Customary expenses incurred, if an Insured Person requires skin grafting or plastic surgery due to an Injury for which Medical Expense Benefits are paid or payable.
POST TRAUMATIC STRESS DISORDER BENEFIT Benefits payable for the Reasonable and Customary expenses incurred, if, as the result of participation in a specific Covered Activity in which a Traumatic Incident occurred, an Insured Person requires Hospital or Medical treatment of a Post Traumatic Stress Disorder. This Benefit covers expenses in excess of benefits provided by any provincial or federal hospital and/or medical plan or other policy providing medical reimbursement expenses.
CRITICAL INCIDENT STRESS MANAGEMENT BENEFIT Benefit is payable for expenses incurred by a Critical Incident Stress Management Team when services are requested by the Policyholder and as a result of an Insured Persons participation in a Covered Activity in which a Traumatic Incident occurred. Covered expenses are those for necessary transportation, meals, and lodging.
FAMILY EXPENSE BENEFIT If an Insured Person requires Hospital confinement for 3 or more consecutive days for an Injury or Illness this Benefit will respond retroactively to the first day, paying $100/day. If after such Hospital Confinement an Insured Person participates in Out Patient Physical Therapy as a result of such Injury or Illness this Benefit will pay 50% or $50/day of the Family Expense Benefit is payable for up to a combined 26 weeks regardless of whether it is paid 100% or 50%.
OPTIONAL BENEFITS WEEKLY PERMANENT PHYSICAL IMPAIRMENT v v Payable if Injury to an insured person results in a Permanent Physical Impairment Permanent physical Impairment is valued at 50% or greater Begins on the 261 st week from the date of participation in the Covered Activity which caused the injury Paid weekly for the remainder of the Insured Persons Lifetime COLA BENEFIT v v Increases Weekly Disability Benefits after they have been paid for 52 consecutive weeks Percentage of increase will equal the increase in the Consumer Price Index
OPTIONAL BENEFITS WEEKLY HOSPITAL INDEMNITY EXTENDED TOTAL DISABILITY v Increases the maximum benefit period from 260 to 520 weeks v v If Weekly Income Benefits are payable under this policy, this Benefit will also pay the Weekly Hospital Indemnity Benefit if the Insured Person requires Hospital Confinement or Out Patient Physical Therapy for the same Injury or Illness. $300/wk paid. Payable for a maximum of 52 weeks.
OFF DUTY OR 24 HOUR COVERAGE Provides World Wide coverage when not performing On Duty activities for the Fire Department. This coverage may be purchased for the Volunteer Fire Fighter only or extended to include their family members. Premium is based on a person basis whose names are listed on the roster to which premiums were paid.
OFF DUTY OR 24 HOUR COVERAGE MEMBER ONLY PROVIDES COVERAGE FOR: Accidental Death & Dismemberment and Paralysis (Loss must occur within 365 days) Vision Impairment Seat Belt Benefit is 15% of Principal Sum
MEMBER ONLY Additional Benefits included ACCIDENTAL WEEKLY DISABILITY v v v Up to $300/wk 7 day waiting period payable on day 8 Payable up to 104 weeks Coordination with other disability benefits Non income earners receive a flat $100/wk for 13 weeks Example of Non Income Earners are Students, Retirees, Unemployed and Home Makers
MEMBER ONLY Additional Benefits included v v Repatriation Benefit Daycare Benefit (per child up to max 4 years) v Dependant Child Education Benefit v v (per child up to max 4 years) v v Spousal Education Benefit Identification Benefit Funeral Expense v v v Bereavement Benefit Felonious Assault Parental Care Benefit Coma Benefit Home Alteration & Vehicle Modification Rehabilitation Benefit Family Transportation Psychological Therapy
DAY CARE BENEFIT When an Accidental Death Indemnity Benefit is paid this Benefit will respond on behalf of any child who was an Insured Persons dependant at the time of loss. v v v Who is under age 13 Currently enrolled in an accredited day care centre or subsequently enrolled in an accredited day care center within 365 days following such loss Benefit paid is the lesser of actual cost charged by daycare, 5% of the Insured Person Principal Sum, or $5, 000/yr Payable annually for 4 consecutive payments
DEPENDANT CHILD EDUCATIONAL BENEFIT When an Insured Person suffers an Injury resulting in Loss of Life and a Benefit is Paid out in the Table of Losses this Benefit will respond to cover the costs of a Dependant Childs Tuition at an Institution of Higher Learning. v v v The lesser of $5, 000 per school year or 5% of the Insured Persons Principal Sum Payable up to 4 consecutive years If Dependant child is currently enrolled in as a full time student in an Institution of Higher Learning.
SPOUSAL EDUCATIONAL BENEFIT When an Insured Person suffers a Loss of Life for which a Benefit is paid, this Benefit will pay the actual cost incurred for a Professional or Trades training program in which the spouse enrolls for the purpose of obtaining an independent source of support and maintenance. v v Must be incurred within 30 months of Insured Persons Loss of Life Maximum amount payable is $15, 000
IDENTIFICATION BENEFIT When identification of the Insured Persons body is requested by the Police or similar law enforcement agency having authority over such matters is requested. This Benefit will respond to: v v v Lodging and Board up to 3 consecutive days Transportation expenses Up to a maximum of $10, 000
FUNERAL EXPENSE If an Insured Person suffers Injury resulting in Loss of Life this Benefit will reimburse the person who has incurred the actual expense pertaining to the cremation, burial or funeral expenses of the Insured Person v Payable to a maximum of $5, 000
BEREAVMENT BENEFIT Benefit responds to reasonable and necessary expenses incurred for grief counseling provided that: v v v Counseling is for a spouse and/or dependant child of Insured Person Expenses are incurred within 365 days of the Loss of Life Counseling is provided by a therapist or counselor who is licensed, registered, or certified to provide such treatment and is not a member of the Immediate family of the Insured Person
PARENTAL CARE BENEFIT If an Insured Person suffers an Injury causing a Loss of Life this Benefit will pay 10% of the Insured Persons Principal Sum to a maximum of $10, 000 to or on behalf of any Dependant Parents of the Insured Person
COMA BENEFIT If an Insured Person suffers an Injury, other than Loss of Life, and within 90 days of the date of the accident is disabled by coma, which coma is continuous and persistent for a period of 6 consecutive months at which point a physician determines to be permanent. v v v 1% of the Principal Sum Less any other amount paid or payable under this contract in connection with the same accident, Injury or Loss Payable monthly up to a maximum of 100 payments
REHABILITATION BENEFIT Benefit will pay the reasonable and necessary expenses actually incurred for the occupational training of the Insured Person who suffers an Injury. v v Training is required because of Injury and in order for the Insured Person to be qualified to engage in an occupation in which they would not have been engaged except for having suffered such injury Training expenses are incurred within 2 years from the date of the accident which caused the injury No payment for ordinary living, travelling, or clothing expenses Maxi mum amount payable is $15, 000 per Insured Person for any 1 accident
FAMILY TRANSPORTATION If an Insured person suffers an Injury that confines them to a hospital located more than 50 km from their permanent place of residence this Benefit will respond to reasonable and necessary expenses actually incurred v v v Confinement must be within 365 days of the accident causing injury Reimbursement costs are limited to the cost of economy class return airfare via direct route or the equivalent amount toward another type of common carrier transportation Maximum amount payable $15, 000 per Insured Person for any 1 accident
PSYCHOLOGICAL THERAPY If an Insured Person sustains an Injury which results in a Loss payable, and as a result of such Injury and Loss, the Insured Person requires, within 2 years from the date of such Injury, Psychological Therapy as prescribed by a Physician, this Benefit will pay the reasonable and customary expenses for Psychological Therapy.
ACCIDENT WEEKLY TOTAL DISABILITY If an Insured Person becomes Totally Disabled as a result of an Injury this Benefit will respond. v v v If the Total Disability commences and has been medically treated within 60 days after the accident causing such Injury. Benefit commences after a 7 day waiting period Benefit shall not exceed 104 weeks Benefits are coordinated with Workers Compensation and any other Valid and Collectable Insurance to pay up to 100% of the Insured Persons Gross Average Weekly wage or the Weekly Benefit selected, whichever is less. If the insured Person has no income or does not suffer any out of pocket loss, the minimum Benefit payable is $100/wk for a maximum of 13 weeks
FAMILY COVERAGE v Benefit payout is based on the Family Status at the time of Loss. The following percentages are applied to the Insured Person’s Principal Sum to determine his/her Eligible Dependents Principal Sum: Spouse Only= 60% of Insured Persons Principal Sum Child/ren Only= 20% of Insured Persons Principal Sum Spouse=%50 and Child/ren=15% of Insured Persons Principal Sum v v v v v Benefits Available Accidental Death & Dismemberment Paralysis Seat Belt Benefit Funeral Expense Benefit Psychological Therapy Benefit Identification Benefit Repatriation Benefit Home Alteration & Vehicle Modification Daycare Benefit Accidental Weekly Disability – Spouse Only -Payable after the 7 days wait -Benefit payable is a flat $100/wk for a maximum of 13 weeks
EXCLUSIONS v v v Suicide or any attempt at, while sane or insane Intentional self –inflicted injuries while sane Injuries that happen while flying except: a. As a passenger on a commercial aircraft; or b. As a passenger on any aircraft while taking part in a Covered Activity
EXCLUSIONS CON’T v v v Injuries that happen while flying as a crew member, or during parachute jumps from the aircraft Service as a member of the armed forces of any nation, or loss resulting from enemy action or any act of war, whether declared or undeclared Mental or emotional disorders except as specifically provided under the Post Traumatic Stress Disorder coverage
EXCLUSIONS CON’T v v v Treatment of Alcoholism or drug addiction and any complications arising there from, except loss sustained during and resulting from a Covered Activity. Illness except as provided by the policy Military service of any state, province, or country
VFIS Educational Department � � � As a client of VFIS, you have access to all of their programs and materials, the majority offered FREE of charge Simply visit the web www. vfis. com Have your policy # handy Call Toll Free 1 -800 -461 -8347 and place your order. All items shipped to you Free of Charge.
THANK YOU FOR ALLOWING US THE OPPORTUNITY TO PROVIDE INSURANCE COVERAGES TO YOUR DEPARTMENT THIS PRESENTATION IS MEANT AS A SUMMARY OF COVERAGE ONLY. PLEASE REFER TO POLICY WORDINGS FOR COMPLETE COVERAGES, LIMITS AND EXCLUSIONS Underwritten by: AIG Insurance Company of Canada 145 Wellington Street West Toronto, ON M 5 J 1 H 8 P: 800 -461 -8347 F: 855 -558 -0014 E: Canada@vfis. com
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