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VBA Truckers Occupational Accident Insurance Program


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VBA Truckers Occupational Accident
Insurance Program

Motor carriers and the independent owner-operators who contract with them face specialized financial risks. An accident can have a serious economic impact on an owner-operator and his/her family and can leave a motor carrier liable for the losses. Truckers Occupational Accident Insurance covers injuries that result from eligible on-the-job accidents that owner-operators or contract drivers sustain.

Value Benefits of America, Inc. along with the Great American Insurance Company is providing members with Truckers Occupational Accident Insurance.

Benefit Coverage Highlights:

  • Truckers Occupational Accident Insurance pays benefits for injuries sustained in a covered accident

  • Up to $1,000,000 Accident Medical Expense, there is no deductible

  • Up to either $150,000 or $200,000 Accident Dismemberment or Paralysis

  • $125,000 or $225,000 Survivors Benefit paid in monthly installments

  • $700 per week Temporary Total Disability for 104 weeks
    (7 day waiting period up to 70% of income up to $700 weekly)

  • $700 per week Continuous Total Disability to age 70
    (up to 70% of income up to $700 weekly)

Plan B

DESCRIPTION OF BENEFITS OCCUPATIONAL NON-OCCUPATIONAL

ACCIDENTAL DEATH AND DISMEMBERMENT

MAXIMUM BENEFIT AMOUNT $200,000 PRINCIPAL SUM $10,000 PRINCIPAL SUM
SURVIVOR'S BENEFIT (LUMP SUM) (($50,000 DEATH LUMP SUM) + $1,500 PER MONTH UP TO 100 MONTHS) LUMP SUM
INCURRAL PERIOD 52 WEEKS 52 WEEKS
ACCIDENTAL DISMEMBERMENT - INCLUDING PARALYSIS AND SEVERE BURN BENEFIT INCLUDED IN PRINCIPAL SUM INCLUDED IN PRINCIPAL SUM
ACCIDENTAL MEDICAL EXPENSE $1,000,000 MAXIMUM BENEFIT AMOUNT $10,000 MAXIMUM BENEFIT AMOUNT
COMMENCEMENT PERIOD 90 DAYS 90 DAYS
DEDUCTIBLE $ 0 $ 0
INCURRAL PERIOD 104 WEEKS 52 WEEKS
ACCIDENTAL DENTAL MAXIMUM BENEFIT AMOUNT $ 1,000 PER INJURY/ $ 10,000 LIFETIME $ 500 PER INJURY/ $ 5,000 LIFETIME
CHIROPRACTIC CARE, OCCUPATIONAL THERAPY, PHYSICAL THERAPY NO SUB-LIMIT APPLIES NO SUB-LIMIT APPLIES
TEMPORARY TOTAL DISABILITY *$700 MAX/ $150 MIN PER WEEK NOT COVERED
WAITING PERIOD 7 DAYS RETROACTIVE
COMMENCEMENT PERIOD 90 DAYS
DURATION-MAXIMUM BENEFIT PERIOD 104 WEEKS
*Subject to the lesser of: 70% of Average Weekly Earnings or the Maximum Weekly Benefit Amount shown
CONTINUOUS TOTAL DISABILITY *$700MAX/ $150 MIN PER WEEK NOT COVERED
BENEFIT PERIOD 104 WEEKS
DURATION-MAXIMUM BENEFIT PERIOD UP TO SOCIAL SECURITY RETIREMENT AGE**
*Subject to the lesser of: 70% of Average Weekly Earnings or the Maximum Weekly Benefit Amount shown
CERTIFICATE COMBINED SINGLE LIMIT ANY ONE ACCIDENT AND AGGREGATE $1,000,000
OCCUPATIONAL ACCIDENT PREMIUM RATE: $151.00 (INCLUDES $10.00 VBA ADMIN FEE) PER PERSON PER MONTH
This coverage is not Workers' Compensation Insurance or for any other purpose except occupational accidents (unless non-occupational benefits apply). This policy does not cover disease unless otherwise endorsed. The list of benefits is only a brief description of the actual coverages. Certain exclusions and limitations do apply. For complete details please refer to your policy. In the event of any conflict between the information listed here and the actual policy, the insurance policy will govern in all cases.
**Social Security Retirement Age (SSRA) will vary depending upon your date of birth. If you are to reach your SSRA before satisfying the waiting period, you may not qualify for Continuous Total Disability Benefits.

VALUE BENEFITS OF AMERICA MEMBERSHIP
ALSO INCLUDES DISCOUNTS AND DIVIDENDS *

  • The Dividend Club:
    • Members will earn Dividends (paid quarterly to you) on Merchandise, Services, Travel & Entertainment when you shop from our On-line Mall and make a purchase. Choose from retailers like these, just to name a few, and get the dividends: Walmart.com, Target.com, BestBuy.com, CircuitCity.com, CompUSA.com, DisneyStore.com, OfficeMax.com, BrooksBrothers.com, Brookstone.com, Buy.com, EddieBauer.com, LizClairborne.com, FOA.com, FOSSIL. com, HotelDiscounts.com, Jcrew.com, etc.

  • Refund Sweepers:
    • Free Merchandise, Bargains, On-line Coupons, Rebates, Sweepstakes & more

  • Car Rental Services:
    • Provides discounts at Alamo, National, Hertz and Avis

  • Rewards Network:
    • America's Premier Dining Rewards Program and Hotel Discounts. Save up to 20% off every meal plus up to 15% off your hotel room rate

  • Included at no charge:
    • discounts at over 55,000 pharmacies for your prescription drugs as well as lab tests and x-ray imaging services

Discounts and Dividends are not insurance

BENEFITS DETAILS

BENEFITS DETAILS

  • Truckers Occupational Accident Insurance
    • For active full-time independent Truck Owner-Operators or Co-Owners who are contracted with a motor carrier and have not reached the maximum eligible age as stated in the Schedule of Benefits listed with the Policy and on the Enrollment form. In spite of your best efforts to prevent them, accidents can and do happen every day. If a serious accident occurs, your primary concern should be recovering from the injury and not the financial loss such an accident can cause you. That's why Value Benefits of America, Inc. designed an Occupational Accident Insurance Program that can help provide you and your loved ones with insurance in the event of a covered accident.

  • Eligibility
    • All active, full-time independent Truck Owner-Operators and Co-Owners contracted with a motor carrier to haul commodities under an executed lease agreement and for whom the required premium has been paid and a completed enrollment form has been signed.

  • Covered Activity
    • 24 hours a day while under Dispatch from a motor carrier you have contracted with
      • Accidental Death and Dismemberment
      • Survivors Benefit
      • Paralysis Benefit
      • Severe Burn Benefit
      • Accidental Medical Expense Coverage, including Accident Dental Expense coverage
      • Temporary Total Disability Coverage
      • Continuous Total Disability

  • Effective Date
    • If enrolling within 31 days after becoming eligible, the later of: 1. Policy effective date; or 2. Date completed enrollment form and proper premium has been received by Plan's Administrator. If enrolling after 31 days after becoming eligible, the first of the month following the date the completed enrollment form and proper premium has been received by the Plan's Administrator

  • Termination Date
    • The earliest of the following dates: 1. the date through which premium has been paid subject to the grace period; or 2. the date the Master Policy is terminated. 3. The date the driver's contract with the participating organization

  • Core Benefits

    Accidental Death Benefits

    • When covered injuries result in loss within within the incurral period shown in the Schedule and beginning on the date of the covered accident, this coverage will pay the Principal Sum as shown in the Benefit Schedule.

    Survivor's Benefit

    • If covered injury results in death within within the incurral period shown in the Schedule and beginning on the date of the covered accident, the Company will pay a monthly Survivors Benefit (thereafter referred to as "Monthly Benefit")to the surviving Spouse each month, subject to the Maximum Survivor's Benefit shown above. If there is no surviving Spouse, or if the Spouse dies or remarries, the Company will pay or continue to pay the monthly benefit to your surviving Dependent Children, if any. If there is more than one surviving Dependent Child, the monthly benefit will be distributed equally among the surviving Dependent Children.
    • The payment of the monthly benefit will end on the First to occur of the following dates:
      • the date your spouse dies or remarries, if there are no Dependent Children; or
      • the date the last Dependent Child dies or is no longer eligible as defined below; or
      • the date the Maximum Survivor's Benefit has been paid. If you are not survived by a Spouse or any Dependent Children the Company will pay the Accidental Death Benefit to the Insured Person's designated beneficiary.

    Accidental Dismemberment, Severe Burn & Paralysis Benefits

    • If Injury to the Insured results in any one of the Losses, Severe Burn or Paralysis specified below, within the incurral period shown in the Schedule and beginning on the date of the covered accident, this coverage will pay the Percentage of the Principal Sum shown below for that Loss:

    Dismemberment

    For Loss of: Percentage of the Principal Sum:
    Both Hands or Both Feet 100%
    Sight of Both Eyes 100%
    One Hand and One Foot 100%
    One Hand and the Sight of One Eye 100%
    One Foot and the Sight of One Eye 100%
    Speech and Hearing in Both Ears 100%
    One Arm or One Leg 75%
    One Hand or One Foot 50%
    Sight of One Eye 50%
    Speech or Hearing in Both Ears 50%
    Four Fingers of Same Hand 25%
    Hearing in One Ea 25%
    Thumb and Index Finger of Same Hand. 25%
    All Toes of Same Foot 13%
    One Thumb 10%
    One Finger 2%
    One Toe 1%
    • "Loss" of a hand or foot means complete severance through or above the wrist or ankle joint. "Loss" of sight of an eye means total and irrecoverable loss of the entire sight in that eye. "Loss" of hearing in an ear means total and irrecoverable loss of the entire ability to hear in that ear. "Loss" of speech means total and irrecoverable loss of the entire ability to speak. "Loss" of an arm or leg means complete severance through or above the shoulder or hip joint. "Loss" of four fingers means complete severance through or above the metacarpophalangeal joint of all four digits. "Loss" of thumb and index finger means complete severance through or above the metacarpophalangeal joint of both digits. "Loss" of all toes means complete severance through or above the metatarsophalangeal joint of all five digits. "Loss" of one thumb means complete severance through or above the metacarpophalangeal joint of the digit. "Loss" of one finger means complete severance through or above the metacarpophalangeal joint of the digit. "Loss" of one toe means complete severance through or above the metatarsophalangeal joint of one digit.
    • If an Insured Person as a result of the same Accident sustains more than one Loss, only one amount, the largest, will be paid

    Severe Burn:

    • Severe Burn/Severely Burned - means cosmetic disfigurement of the surface of a body area due to an Injury that is a full- thickness or third-degree burn as determined by a Physician. (A full-thickness or third-degree burn is the destruction of the skin through the entire thickness or depth of the dermis and possibly into underlying tissues, with loss of fluid and sometimes shock, by means of exposure to fire, heat, caustics, electricity or radiation).
    Specified Body Area Maximum Percentage of Principal Sum
    Face and Neck and Head 99%
    Hand and Forearm Below Elbow Joint (Right) 22.5%
    Hand and Forearm Below Elbow Joint (Left) 22.5%
    Upper Arm Below Shoulder Joint to Elbow Joint (Right) 13.5%
    Upper Arm Below Shoulder Joint to Elbow Joint (Left) 13.5%
    Torso Below Neck to Shoulder Joints and Hip Joints (Front) 36%
    Torso Below Neck to Shoulder Joints and Hip Joints (Back) 36%
    Thigh Below Hip Joint to Knee Joint (Right) 9%
    Thigh Below Hip Joint to Knee Joint (Left) 9%
    Foot and Lower Leg Below Knee Joint (Right) 27%
    Foot and Lower Leg Below Knee Joint (Left) 27%
    • If more than one of the Insured Person's Specified Body Areas is Severely Burned as a result of the same accident, the benefit payable is the lesser of: (1) the sum of the benefit amounts calculated separately, according to the above rules, with respect to each such Specified Body Area; or (2) 100% of the Principal Sum.

    Paralysis:

    Type of Paralysis: Percentage of the Principal Sum
    Quadriplegia 100%
    Paraplegia 50%
    Hemiplegia 50%
    Uniplegia 25%
    • "Quadriplegia" means the complete and irreversible paralysis of both upper and both lower limbs. "Paraplegia" means the complete and irreversible paralysis of both lower limbs. "Hemiplegia" means the complete and irreversible paralysis of the upper and lower limbs of the same side of the body. "Uniplegia" means the complete and irreversible paralysis of one limb. "Limb" means entire arm or entire leg. As used in this policy, neither quadriplegia, paraplegia, hemiplegia, uniplegia, nor paralysis includes paresis.
    • Paralysis benefits for more than one type of paralysis may not be combined. If an Insured Person sustains more than one type of paralysis as a result of the same Accident, the only paralysis benefit payable under this policy will be the largest single paralysis benefit that applies.

    Accidental Medical Exclusions

    • For treatment by a legally qualified physician or surgeon within 30 days of a covered accident, we will pay up to the maximum amount selected for the following services:
      • Hospital semi-private room and board(or room and board in an intensive care unit); Hospital ancillary services including, but not limited to, use of the operating room or emergency room); or use of an Ambulatory Medical Center;
      • services of a Physician or a registered nurse (RN);
      • ambulance service to or from a Hospital;
      • laboratory tests;
      • radiological procedures;
      • anesthetics and the administration of anesthetics;
      • blood, blood products and artificial blood products, and the transfusion thereof;
      • physical therapy, Occupational therapy, and chiropractic care, up to the Physical Therapy, Occupational Therapy and Chiropractic Care Maximum, if any, shown in the Schedule;
      • rental of Durable Medical Equipment, up to the actual purchase price of such equipment;
      • artificial limbs, artificial eyes or other prosthetic appliances;
      • medicines or drugs administered by a Physician or that can be obtained only with a Physician's written prescription; or
      • repair or replacement of Sound Natural Teeth damaged or lost as a result of Injury, up to the Dental Maximum, if any, shown in the Benefit Schedule.

    Accident Dental

    • Coverage is for sound natural teeth as a result of an accident.

    Accidental Medical Expense Exclusions

    • In addition to the Exclusions in Section VI of this policy, Usual and Customary Charges for Covered Accident Medical Services do not include, and benefits are not payable with respect to, any expense for or resulting from:
      • repair or replacement of existing artificial limbs, artificial eyes or other prosthetic appliances or repair of existing Durable Medical Equipment, unless for the purpose of modifying the item because Injury has caused further impairment in the underlying bodily condition;
      • new or repair or replacement of, dentures, bridges, dental implants, dental bands or braces or other dental appliances, crowns, caps, inlays or onlays, fillings or any other treatment of the teeth or gums;
      • new eyeglasses or contact lenses or eye examinations related to the correction of vision or related to the fitting of glasses or contact lenses, unless Occupational Injury has caused impairment of sight; or repair or replacement of existing eyeglasses or contact lenses unless for the purpose of modifying the item because Injury has caused further impairment of sight;
      • new hearing aids or hearing examinations, unless Injury has caused impairment of hearing-, or repair or replacement of existing hearing aids, unless for the purpose of modifying the item because Occupational Injury has caused further impairment of hearing;
      • rental of Durable Medical Equipment where the total rental expense exceeds the usual purchase expense for similar equipment in the locality where the expense is incurred (but if, in the Company's sole judgment, Accident Medical Expense Benefits for rental of Durable Medical Equipment are expected to exceed the usual purchase expense for similar equipment in the locality where the expense is incurred, the Company may, but is not required to, choose to consider such purchase expense as a Usual and Customary Covered Accident Medical Expense Benefit in lieu of such rental expense);
      • Custodial Services; or
      • Personal Comfort or Convenience Items.

    We will not pay for such items

    Temporary Total Disability

    • If Injury to the Insured Person results in Temporary Total Disability within the period between the date of Injury and the policy Anniversary/Termination date, the Company will pay the Temporary Total Disability Benefit as described, subject to satisfaction of any applicable Waiting Period as shown in the Schedule of Benefits. The Waiting Period starts on the date of the Accident that caused such Injury. After the Waiting Period has been satisfied, the Temporary Total Disability Benefit shall be payable, retroactively from the date the disability began, provided the Insured Person remains Temporarily Totally Disabled.

    Continuous Total Disability

    • benefits payable for a Temporary Total Disability Covered Loss ceased solely because the Maximum Benefit Period shown in the Schedule for Temporary Total Disability has been reached, but the Insured Person remains disabled; and
    • the Insured Person has not reached their Normal Social Security Retirement Age on the day after the Maximum Benefit Period shown in the Schedule for Temporary Total Disability has been reached; and
    • the Insured Person has been granted a Social Security Disability Award for his or her disability; and
    • the Insured Person's disability is reasonably expected to continue without interruption until the Insured Person dies.

    The Continuous Total Disability Benefit shall cease on the earliest of the following dates:

    • the date the Insured Person is no longer Continuously Totally Disabled,
    • the date the Insured Person dies,
    • the date the Insured Person's Social Security Disability Award ceases,
    • the date the Insured Person attains age 70,
    • the date the Maximum Benefit Period shown in the Schedule for Continuous Total Disability has been reached.

    The weekly benefit payable under Continuous Total Disability benefits is equal to the calculated weekly Temporary Total Disability benefit less any Social Security Disability award. Note: Social Security Retirement Age (SSRA) will vary depending upon your date of birth. If you are to reach your SSRA before satisfying the waiting period, you may not qualify for Continuous Total Disability Benefits.

    Non-Occupational Coverage

    • Non-Occupational Coverage. References in this Policy to an Injury or Accident, where applicable, are hereby deemed to include Non-Occupational Injury and Non-Occupational Accident, respectively. Benefits shall be payable for only those Covered Losses listed in the Schedule under Non-Occupational Accident Benefits, and shall be subject to the Non-Occupational Accident Benefit limitations shown therein.
    • Non-Occupational means, with respect to an activity, Accident, incident, circumstance or condition involving an Insured Person, that it is not proximately caused by the Insured Person's performing Occupational Services.
    • Non-Occupational Injury means physical Injury caused by a Non-Occupational Accident occurring while this policy is in force as to the person whose injury is the basis of claim and resulting directly and independently of all other causes in a Covered Loss.


Exclusions and Limitations

  • General Exclusions
    • This Policy does not cover any Injury, Accident, expense, or loss caused in whole or in part by, or resulting in whole or in part from, any of the following:
      • an Insured Person's suicide or any attempt at suicide; intentionally self-inflicted injury or any attempt at intentionally self-inflicted injury;
      • sickness, disease or infection of any kind, except bacterial infection due to a cut or wound, or botulism or ptomaine poisoning, caused directly by an Occupational Accident;
      • any Pre-Existing Condition, unless the Insured Person has been continuously covered under this Policy (or a substantially identical policy issued by the Company or another insurer, of which this policy is a renewal) for twelve consecutive months;
      • Occupational Cumulative Trauma, unless (and then only to the extent that) such coverage has been specifically added to this Policy by endorsement;
      • Occupational Disease, unless (and then only to the extent that) such coverage has been specifically added to this Policy by endorsement;
      • hernia of any kind, unless (and then only to the extent that) such coverage has been specifically added to this Policy by endorsement;
      • hemorrhoids of any kind, unless (and then only to the extent that) such coverage has been specifically added to this Policy by endorsement;
      • performing, learning to perform or instructing others to perform as a master or crew member of any vessel while covered under the Jones Act or the United States Longshoremen's and Harbor Workers' Compensation Act or any amendment of that Act, or any similar state or federal law;
      • declared or undeclared war, or any act of declared or undeclared war;
      • full-time active duty in the armed forces of any country or international authority, except the National Guard or organized reserve corps duty;
      • any Injury for which the Insured Person is entitled to benefits pursuant to any workers' compensation law or other similar legislation;
      • employers' liability
      • the Insured Person's being under the influence of any drug or intoxicant, unless taken at the direction of his or her Physician; or
      • the Insured Person's commission of, or attempt to commit, a felony; or
      • travel or flight in or on (including getting in or out of, or on or off of) any type of aircraft, if the Insured Person is:
        • riding as a passenger in an aircraft not designed and licensed for the transportation of passengers; or
        • performing, learning to perform or instructing others to perform as a pilot or crew member of any aircraft; or
        • riding as a passenger in an aircraft owned, leased or operated by the Policyholder; or
      • any strike, boycott or stop-work action, whether or not the Insured Person participated in such strike, boycott, or stop-work action

  • Limits

    Combined Single Limit

    • The Combined Single Limit stated in the Schedule will be the total limit of the Company's liability for any and all benefits payable under this Policy with respect to any one Insured Person arising out of any and all Injury sustained by such individual as the result of any one Accident.

    Aggregate Limit of Liability

    • The Aggregate Limit of Liability stated in the Schedule will be the total limit of the Company's liability for all benefits payable under this Policy with respect to all Insured Persons arising out of Injury sustained by one or more Insured Person(s) as the result of any one Accident. If the total of such benefits exceeds the Aggregate Limit of Liability, the Company shall not be liable to any Insured Person for a greater proportion of such Insured Person's benefits than said Aggregate Limit of Liability bears to the total benefits afforded all such Insured Persons under this Policy.


DEFINITIONS

DEFINITIONS

  • Ambulatory Medical Center means a licensed public establishment with an organized staff of Physicians and permanent facilities that are equipped and operated primarily for the purpose of providing medical services or performing surgical procedures. Such establishment must provide continuous Physician and registered nursing (RN) services whenever a patient is in the facility. An Ambulatory Medical Center does not include a Hospital, a Physician's office, or a clinic.

  • Continuous Total Disability and Continuously Totally Disabled refer to disability that:
    • prevents an Insured Person from performing the duties of all occupations for which he or she is otherwise qualified by reason of education, training or experience; and
    • requires and results in the Insured Person's receiving Continuous Care.

  • Custodial Services means any of the following kinds of services which are provided to care for an Insured Person's physical well-being, but are not intended primarily as medical treatment for a specific Injury. Custodial Services include, but shall not be limited to, services:
    • related to watching or protecting the Insured Person;
    • related to performing or assisting the Insured Person in performing any activities of daily living, such as: (a) walking; (b) grooming; (c) bathing; (d) dressing; (e) getting in or out of bed; (f) toileting; (g) eating; (h) preparing foods; or (i) taking medications that can usually be self administered; and
    • that are not required to be performed by trained or skilled medical or paramedical personnel.

  • Dependent Child(ren)
    • means the Insured Person's unmarried children (including natural children from the moment of birth, step- or foster-children, or adopted children, from the moment of placement in the home of the Insured Person) who are under age 19 (24 if attending an accredited institution of higher learning on a full-time] [basis) and primarily dependent on the Insured Person for support and maintenance at the time of the Insured Person's death caused by an Occupational Injury. It also includes any unmarried Dependent Child(ren) of the Insured Person who are incapable of self-sustaining employment by reason of mental or physical incapacity, and who are primarily dependent on the Insured Person for support and maintenance at the time of the Insured Person's death caused by an Occupational Injury.
    • The Company may require proof of the Dependent Child(ren)'s incapacity and dependency within 60 days before the Dependent Child(ren) reach(es) the age limit specified above. The Company may request that satisfactory proof of the Dependent Child(ren)'s continued incapacity and dependency be submitted to the Company on an annual basis. If the requested proof is not furnished within 31 days of the request, such child(ren) shall no longer be considered Dependent Child(ren) as of the end of that 31 day period.

  • Dispatch means the time the Insured actually operates a truck, including all of the following:
    • In route to pick up a load;
    • Picking up a load;
    • In route to deliver a load;
    • Unloading a load;
    • The waiting time for a load if the Insured is not at home.

  • Dispatch does not include time spent (a) during overnight stops, (b) on personal errands or personal side-trips, (c) for rest, entertainment or relaxation, or (d) in travel between the Insured's residence and a place at which the Insured performs Occupational services.

  • Durable Medical Equipment refers to equipment of a type that is designed primarily for use, and used primarily, by people who are injured (for example, a wheelchair or a hospital bed). It does not include items commonly used by people who are not injured, even if the items can also be used in the treatment of injury or for rehabilitation or improvement of health (for example, a stationary bicycle or a spa).

  • Hernia means a protrusion of an organ or part through connective tissue or through a wall of the cavity in which it is normally enclosed. Hernia does not include diaphragmatic (hiatal) hernia.

  • Hemorrhoids means a mass of dilated veins in swollen tissue at the margin of the anus or nearby within the rectum.

  • Injury means physical Injury to an Insured Person caused by an Occupational Accident while coverage is in force under this Policy, which results directly and independently of all other causes in a Covered Loss. All Injuries sustained by an Insured Person in any one Accident shall be considered a single Injury.

  • Insured means a person who: (1) is a member of an eligible class as described in the Eligible Persons section of the Schedule of Benefits, and (2) has enrolled for coverage, and (3) has paid the required premium. However, an Insured does not include any person covered under this Policy solely as an Authorized Passenger.

  • Insured Person means an Insured or, if Authorized Passenger coverage is scheduled on the Schedule of

  • Medically Necessary means that a Covered Accident Medical Service: (1) is essential for diagnosis, treatment or care of the Occupational Injury for which it is prescribed or performed, (2) meets generally accepted standards of medical practice, and (3) is ordered by a Physician and performed either by a Physician or under his or her care, supervision or order.

  • Physician means a practitioner of the healing arts, acting within the scope of his or her license, who is neither: (1) the Insured Person nor (2) an Immediate Family Member of the Insured Person nor (3) retained by the Motor Carrier.

  • Sound Natural Teeth means natural teeth that either are unaltered or are fully restored to their normal function and are disease-free, have no decay, and are not more susceptible to injury than unaltered natural teeth.

  • Temporary Total Disability and Temporarily Totally Disabled refer to disability that:
    • prevents an Insured Person from performing the duties of his or her regular, primary occupation;
    • requires and results in the Insured Person's receiving Continuous Care.

  • Usual and Customary Charge(s) means a charge that: (1) is made for a Covered Accident Medical Service; (2) does not exceed the usual level of charges for similar treatment, services or supplies in the locality where the expense is incurred (or, for a Hospital room and board charge, other than for a Medically Necessary stay in an intensive care unit, one that does not exceed the Hospital's most common charge for semi- private room and board); and (3) does not include charges that would not have been made if no insurance existed.


VBA TERMS

VBA TERMS AND CONDITIONS

  • Member understands that VBA is not an insurance company or program. Insurance coverage is provided by Great American Insurance Company.

  • VBA provides savings to its members through a number of sources. The current list of benefits may be modified through additions or deletions. A quarterly newsletter, posted on our website or sent via e-mail, will keep members up-to-date on benefits and other pertinent information.

  • Payments for VBA Programs are due in advance. Payments will be drafted on or about 15 days before the due date. If you choose to cancel your program, it is your responsibility to make sure that your membership card and a written request for cancellation are sent to VBA at least 15 days prior to the anniversary of your effective date in order for your account not to be charged for additional fees.

  • Member hereby appoints, Value Benefits of America Association (VBA) President, or failing this person, a VBA Director, as proxy holder for and on behalf of the member with the power of substitution to attend, act and vote for and on behalf of the member in respect of all matters that may properly come before the meeting of the members of VBA and at every adjournment thereof, to the same extent and with the same powers as if the undersigned member were present at the said meetings or any adjournment thereof. Annual meetings are to be held in Arizona the second Tuesday of August.

  • VBA reserves the right to terminate any enrollment or deny eligibility in the program for lack of payment to VBA, Returned checks or insufficient notices on bank drafts for payment of the membership fee is deemed to be evidence of non-payment by a member. There will be a $10.00 charge to be reinstated in the program after such denial. If reinstatement for non-payment happens more than once, a $20.00 reinstatement will apply.

  • In the event of any dispute, member agrees to resolve said dispute solely by binding arbitration that shall be governed by the laws of the state of Arizona and enforceable at Scottsdale, Maricopa County,

  • Membership cancelled within the first 30 days of the enrollment date may be eligible for refund if the membership card and written cancellation request are sent to VBA, The administrative fee is nonrefundable. Approved refunds will be processed approximately 30 days after cancellation.

  • Membership is effective on the 1st of the month following enrollment acceptance by VBA

Discounts and Dividends are not insurance coverage and are not provided by Great American Insurance Company.

SECURITY & PRIVACY STATEMENT

SECURITY & PRIVACY STATEMENT

When you become a GACquote.com customer, you entrust us with your personal data. We consider your data to be private and confidential, and we hold ourselves to the highest standards of trust and fiduciary duty in their safekeeping and use.

General Agent Center (GAC) and our partners will not release information about you or your application, policy or claims information, unless one or more of the following conditions are met:

1. We receive your prior written consent.
2. We believe the prospective recipient to be you or your authorized representative.
3. We are required by law to release information to the recipient.

Questions about your medical history and physical condition are required by our insurance carrier partners and will be released to the insurer so that they may underwrite your insurance application. GAC will not give or sell information about you to any other company, individual, or group without your prior authorization.

GAC will only use information about you to help us better serve your insurance needs or to suggest GAC services or insurance materials that may be of interest to you.

To further protect your privacy, our web site uses the highest levels of Internet security, including data encryption, user names and passwords, and other security tools.

Occasionally, GAC may conduct marketing surveys or research to help us evaluate products, services, and the changing needs of our customers. It is GAC's policy to keep this information confidential.

We will not share individual marketing data gathered from our web site with individuals or business entities not affiliated with GAC.

We know that the privacy of your personal information is important to you. In order to provide you with insurance products of the highest quality and with the service you deserve, it may be necessary for us from time to time to collect nonpublic personal and financial information about you (the "Information") and, in certain situations, to share that Information with others. The following notice describes our policies and practices with regard to your Information.

  • HOW WE PROTECT YOUR INFORMATION
    • We maintain physical, electronic and procedural safeguards to protect the Information against unauthorized access and use. We restrict access to the Information to those employees who need access to provide products and services to you and your dependents. The personnel who have access are trained in the proper handling of the Information. Employees who violate this strict level of confidentiality are subject to our disciplinary process.

  • CATEGORIES OF INFORMATION THAT WE COLLECT
    • In the normal course of business we may collect the following types of Information:
      • Information you provide on applications and other forms (including name and address)
      • Data about your transactions with us (such as types of products you have purchased and your account status)
      • Information gathered on our Web sites through online forms, site visit data and online information-collecting devices known as "cookies"

  • HOW WE USE YOUR INFORMATION
    • We may share your information among the Insurance Companies as permitted by law, including for routine business administration.
    • We may share information with non-affiliated companies as allowed by law, such as firms that perform services on our behalf, including the administration and marketing of our products. We require these companies to meet strict privacy standards.
    • We may disclose information to non-affiliated entities when required by law, such as to respond to a subpoena, to prevent fraud or to comply with an inquiry by a government agency.

  • ACCURACY OF YOUR INFORMATION
    • We strive to maintain the accuracy of Information that is in our possession about you. In order to help us maintain accuracy, you have the right to reasonably access your information. If you believe any information in our possession is inaccurate, a request can be made to amend or delete the information that you believe to be erroneous. If we concur with the request, we will amend or delete the information in question. You may write our Privacy Office at the address below to receive our complete policy on accessing and amending the Information.

  • CHANGES TO THIS NOTICE
    • We reserve the right to change this Notice. We reserve the right to make the revised Notice effective for the Information we already have about you as well as any Information we receive in the future. If we make any material changes to our policies or practices, we will provide you with a copy of a revised Notice. We will post a copy of the current Notice on our websites. The Notice will contain in the top right-hand corner, the effective date.
      You may contact our Privacy Office at:
      General Agent Center
      8700 E. Vista Bonita Dr., Suite 174 Scottsdale, AZ 85255

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