Accidental Death, Dismemberment and Loss of Sight Insurance
For Active Employees Only
This benefit is payable for losses that are caused by injuries you sustain in an accident that occurs while you are insured and are the direct result of the injuries independent of all other causes. Benefits are payable for injuries sustained in accidents occurring on or off the job.
For loss of life, benefits will be paid to the beneficiary you name. You may change your beneficiary at any time by submitting a new beneficiary card to the Trust Fund Office, as described under the Life Insurance section.
The Full Amount of your insurance is the benefit amount shown in the Schedule of Benefits.
Loss of hand or foot means severance of the hand or foot at or above the wrist or ankle joint. Loss of sight means total and permanent blindness.
The payment for all losses resulting from any one accident will not be more than the full amount of your Insurance, but the benefits paid on account of one loss will not prevent further payment for losses resulting from subsequent accidents. This benefit may not be assigned or converted to an individual policy.

No Accidental Death, Dismemberment and Loss of Sight Insurance benefits will be paid for any loss caused or contributed to by:
• bodily or mental infirmity (including the medical or surgical treatment of such a condition);
• disease or Illness of any kind (including the medical or surgical treatment of such a condition);
• ptomaine or bacterial infection unless through a visible cut or wound;
• the taking of drugs or poison or asphyxiation from the inhaling of gas, when done on a voluntary basis. (This will not apply to drugs that are taken on the advice of a Physician.);
• suicide, attempted suicide, or intentionally self-inflicted Injury, while sane or insane;
• any act due to war, if declared or not;
• participation in an insurrection or riot;
• committing or attempting to commit an assault or felony;
• travel or flight in or descent from any kind of aircraft, except as a fare paying passenger on a regularly scheduled commercial route or chartered flight; or travel in a military aircraft, other than as a passenger; or travel in any aircraft not holding a current and valid air-worthiness certificate.
- In the event of death of any Employee covered by the Plan, obtain a "Proof of Death” claim form from the Trust Fund Office. Upon completion, return it to the Trust Fund Office with a certified copy of the death certificate. Upon verification of eligibility, the claim will be forwarded to the Insurance Company for processing and payment.
- In cases of accidental dismemberment or loss of sight,-the Trust Fund Office should be notified immediately and the necessary forms will be sent for filing a claim.