Business Travel and/or
Business and Pleasure Accident Plans
National Safety Council 2003 statistics show that there are more than 90,000 deaths and 18,200,000 disabling injuries each year as a result of accidents. Accidents are the leading cause of death for persons under age 38 and the fourth leading cause of death for all ages.
Most large and medium size employers provide Accidental Death and Dismemberment insurance benefits for their employees while they travel on company business. Today, many small employers are also providing the same kind of benefit plan for their employees. We are able to furnish an accident policy for any size employer. Such benefit plans cover employees while running local errands, traveling overnight, on week long trips, at conventions or any where else the company business takes place, subject to a few sensible exclusions that are listed here.
Many employers go one step further and provide 24-hour business and pleasure coverage on their management employees combined with the business travel coverage on all other employees. (This does not mean that the employer can provide business and pleasure coverage only on their management employees.) The business and pleasure coverage not only covers employees on business trips, but also commutation, vacations and while the insured is home. Coverage is 24 hours a day, 365 days a year.
Disclaimer
The information on this page is based on a general concept of business travel and/or business and pleasure accident plans, and is not meant to constitute advice, or represent any provisions of any policy. These details come from standard self-type plans. This information will serve as a guide to the main points, but is not a plan itself nor a contract or part of one. All complete and specific terms are set forth in your policy.
The information in this site should not be used or relied upon as a substitute for the relevant insurance policy wording or relevant policy documents.
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Eligible persons The policyholder may select any type of classes to be covered. Classes may include, but are not limited to, sales people, officers, members of the board of directors, managers or employees earning within a specific salary range. Eligible persons may also be all employees of the policyholder and/or spouses of the employee who travel with the employee on company business and at the company’s expense. If coverage is for business and pleasure, all employees to be covered must be named.
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Business Travel Coverage The plan will cover injury to the insured while on a trip on business at policyholder’s direction to further the business. Such trip will begin when the insured leaves his or her home or place of regular employment, whichever last occurs. Such trip will end when the insured returns to his or her home or place of regular employment, whichever first occurs. The insured’s travel to and from work and bona fide leaves of absence or vacations are not included in this definition. Aircraft coverage is limited to riding as a passenger and not as a pilot or member of the crew in: (A) any civil aircraft; or (B) any U.S. Military Airlift Command transport type aircraft or aircraft of a similar service of any other country.
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Business and Pleasure Coverage The plan will cover injury to the Insured anywhere in the world, except aircraft coverage is limited to riding as a passenger and not as a pilot or member of the crew in: (A) any civil aircraft; or (B) any U.S. Military Airlift Command transport type aircraft or aircraft of a similar service of any other country. In fact, coverage is provided against any accident, subject to sensible exclusions listed here.
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Benefits The following presents brief descriptions of the benefits that are available. A benefit may be selected up to a maximum amount of $1,000,000 per insured or more.
- Accidental Death and Dismemberment, Loss of Speech or Hearing and/or Plegia
Loss of speech or hearing and/or plegia may not be greater than the amount selected for the accidental death and dismemberment benefit.
- When an injury causes any of the following losses within 365 days after the date of the accident the policy will pay:
- Loss of life—The Principal Sum
- Loss of two limbs, sight of both eyes or any combination thereof—The Principal Sum
- Loss of speech and hearing—The Principal Sum
- Quadriplegia*—The Principal Sum
- Triplegia*—Three-quarters The Principal Sum
- Loss of one limb, the sight of one eye—One-half The Principal Sum
- Loss of speech or hearing—One-half The Principal Sum
- Paraplegia*—One-half The Principal Sum
- Uniplegia*—One-quarter The Principal Sum
- Loss of thumb and index finger of the same hand—One-quarter The Principal Sum
*Must meet certain underwriting requirements to be covered in the policy.
If the insured suffers more than one loss from any one accident, the plan will pay only the larger amount.
- Loss of Income (Optional)
The policy will pay 70% of the insured employee’s basic annual salary up to the maximum amount selected by the policyholder if injuries to the insured employee within 30 days after the accident results in the insured employee being totally and continuously disabled and unable to do each and every duty of his or her job. This benefit starts the first day after the elimination period that was selected and continues for so long as the insured employee is so disabled up to the number of weeks that were selected. If the maximum number of weeks selected is beyond 104 weeks and the insured employee remains totally and continuously disabled the policy will continue to pay the weekly benefit provided the insured employee is unable to do any job for wage or profit for which he or she is qualified based on his or her education, training and experience.
- Medical and Dental Expense (Optional)
The policy will pay this benefit if injuries require the insured to be treated by a physician. Care and treatment must start within 30 days after the accident. The policy will pay for the necessary medical treatment up to the usual and customary charges incurred within 52 weeks from the date of the accident for any of the services listed below:
(a) Medical services in the hospital: (b) Medical or surgical treatment by a physician: (c) Care by a licensed nurse, who is not a family member: (d) X-ray, laboratory test, oxygen, cast, splints and drugs: (e) Ground ambulance within 48 hours of the accident.
Such expenses must be in excess of the deductible amount (if any), but not more that the maximum amount selected. The medical and dental expense benefit may be on a primary or an excess basis (where not prohibited by state law).
- Other Optional Coverages and Benefits
Coverage can also be limited to:
- All conveyance coverage While the Insured is in or getting in or out or being struck by any land or water conveyance or any scheduled airline aircraft.
Coverage is not provided to the insured who is acting as a pilot or driver or member of the crew of any conveyance licensed to carry fare- paying passengers or being tested or being used in a race, speed contest, exhibition or a sporting activity.
- All public conveyance coverage While the insured is in or getting in or out or being struck by any land or water conveyance licensed to carry fare paying passengers of any Scheduled Airline aircraft.
Coverage is not provided to the insured who is acting as a pilot or driver or member of the crew of such vehicles.
All business travel coverages can also be limited to the insured traveling outside any specific territory as requested by the policyholder.
Coverage can also be included for passenger and/or pilot and crew members while on a policyholder-owned or operated aircraft.
- Seat Belt Benefit
If as a result of an automobile accident, the insured employee suffers a loss of life, the principal sum amount applicable to the insured will be increased by 10%, but only if at the time of the accident the insured was wearing his or her seat belt, and provided the official police report of the accident stated that the seat belt was being worn by the insured at the time of the accident.
However, coverage is not provided in an automobile being: tested or used in a race, speed contest, exhibition, sporting event or off a surfaced road.
- Felonious Assault Benefit
The principal sum amount applicable to the insured shall be increased by 15% if injury to such employee is a direct result of criminal battery in the course of or in consequence of the commission or attempted commission of a felony, while the insured is on the policyholder’s premises or on special assignment by the policyholder.
This increase shall not apply if the Insured committed such felonious act.
- Common Carrier Accident
The principal sum amount applicable to the insured shall be increased by 100% to a maximum of $100,000 if injury to such insured results in an accidental loss of life while riding as a passenger (and not as a driver, pilot or a member of the crew) in or on any land or water conveyance licensed for the transportation of passengers for hire or any aircraft operated by a scheduled airline.
- Common Accident Death Benefit
If the policyholder included spouses under the policy and if the insured employee and insured spouse both suffer loss of life within one year as a result of the same accident, the policy will pay on behalf of the spouse the same amount of benefits that are payable for the employee.
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Exclusions This policy does not include coverage for:
- suicide, while sane or insane (in Missouri, while sane) or intentional self-inflicted injury;
- sickness, disease or bacterial infection of any kind, except those which occur as a result of accidental ingestion; or pus forming infections which occur through an accidental cut or wound;
- war or any act of war, whether war is declared or not;
- injury sustained in any of the armed forces of any country or international authority;
- any loss as a result of riding as a passenger or otherwise in any flying device other than as provided in the policy;
- hernia, however caused;
- the insured’s own felonious act or attempt of such an act; or the taking part in any illegal occupation;
- the insured being legally intoxicated as defined by the laws of the state or governing territory in which the loss occurs;
- the Insured being under the influence of any narcotic drug unless taken on the advice of a physician;
Additional Exclusions
The following exclusions may also apply if medical and dental expense benefits have been selected.
- aggravation of any pre-existing conditions;
- services or treatment given by any person employed or retained by the policyholder
- experimental procedures or cosmetic surgery;
- hospital room and board charges in excess of the semi-private room rate unless hospitalized in an intensive care unit;
- medical expenses for which the Insured is entitled to benefits under any Worker’s Compensation act or mandatory no-fault automobile insurance contract.
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Note Not all plans or benefits are available in all states and not all of the exclusions may apply in certain states. Please contact your American Health Administrators, Inc. representative for further details and for information on other available coverages and benefits.
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