Index of Page

Accidental Death & Specific Loss Schedule

Air Travel Coverage

Common Carrier Accident Coverage

Repatriation Benefit

Rehabilitation Benefit

Occupational Training Benefit

Permanent Total Disability Benefits

Monthly Accident Indemnity

Special Education Benefit

Hospital Indemnity Benefit

Emergency Hospital/Medical Expense for Accident or Sickness Occurring Outside of Canada

Fractures, Dislocation and Miscellaneous Indemnity

International Travel Assistance Program Who is Eligible:

All members of The Asbestos Workers' Local 95 Benefit Fund. (See General Provisions)

What Are You Covered For:

This Plan covers you and your dependents 24 hours a day, each day of the year, against loses resulting from injuries which are received anywhere in the world.

Amounts You Are Covered For:

All Eligible Members are covered for a Principal Sum of $100,000.

Spouses and/or Dependent Children are covered and family benefits are a percentage of the Members' benefits as set out on the following sections outlining the covered benefits.

Benefits You Are Covered For:

Accidental Death & Specific Loss Schedule

When an insured Member receives Injuries resulting in any of the following Losses within 365 days of the accident, benefits will be payable for:

Loss of Life	Principal Sum
Loss of Both Hands, Both Feet or Both Eyes	Principal Sum
Loss of One Hand and One Foot	Principal Sum
Loss of One Hand and One Eye or One Foot an One Eye	Principal Sum
Loss of Speech and Hearing in Both Ears	Principal Sum
Loss of One Arm or One Leg	Three-Quarters of Principal Sum
Loss of One Hand, One Foot or One Eye	Two-Thirds of Principal Sum
Loss of Speech or Hearing in Both Ears	One-Half of Principal Sum
Loss of Thumb and Index Finger or at Least Four Fingers of One Hand	One-Third of Principal Sum
Loss of Hearing in One Ear	One-Sixth of Principal Sum
Loss of All Toes of One Foot	One-Eighth of Principal Sum
Loss of Use of Both Legs or Both Feet	Principal Sum
Loss of Use of Both Arms or Both Hands	Principal Sum
Loss of Use of One Arm or One Leg	Three-Quarters of Principal Sum
Loss of Use of One Hand or One Foot	Two-Thirds of Principal Sum
Quadriplegia (total paralysis of both upper and lower limbs)	Principal Sum
Paraplegia (total paralysis of both lower limbs)	Principal Sum
Hemiplegia (total paralysis of upper and lower limbs of one side of the body)	Principal Sum

Only one of the amounts shown above (the largest applicable) will be paid for injuries to the same limb resulting from any one accident.

The maximum payable for all losses sustained by a Member as a result of the same accident shall not exceed the Principal Sum.

The eligible Spouse is insured for 50% of the Member's Principal Sum, under the same benefit schedule.

Each eligible Dependent Child is insured for 15% of the Member's Principal Sum in the event of Accidental Death and ten (10) times the Dependent's Principal Sum in the event of:

• Loss of Both Hands, Both Feet or Both Eyes
• Loss of One Hand and One Foot
• Loss of One Hand and One Eye or One Foot and One Eye
• Loss of Speech and Hearing in Both Ears
• Loss of Both Legs or Both Feet
• Loss of Use of Both Arms or Both Hands
• Quadriplegia (total paralysis of both upper and lower limbs)
• Paraplegia (total paralysis of both lower limbs
• Hemiplegia (total paralysis of upper and lower limbs of one side of the body)

Loss of a hand or foot means severance at or above the wrist joint or ankle joint, respectively. Loss of an arm or leg means severance at or above the elbow joint or knee joint, respectively. Loss of an eye means the total and irrecoverable loss of the entire sight thereof. Loss of a thumb and index finger or at least four fingers of one hand means complete severance at or above the metacarpophalangeal joint. Loss of all toes means complete severance at or above the foot joint. Loss of speech or hearing must be total and irrecoverable and must be continuous for 12 months, after which the above benefit is payable, provided such a disability is determined to be permanent.

Loss of use of an arm, hand, foot or leg must be total and irrecoverable and must be continuous for twelve (12) months, after which the above benefit is payable, provided such disability is determined to be permanent.

"Quadriplegia" means the complete and irreversible paralysis of the upper and lower limbs, and must be continuous for twelve months from the date of the accident causing loss after which the above benefit is payable.

"Hemiplegia" means the complete and irreversible paralysis of the upper and lower limbs one one side of the body, and must be continuous for twelve months from the date of accident causing the loss after which the above benefit is payable.

"Paraplegia" means the complete and irreversible paralysis of both lower limbs, and must be continuous for twelve (12) months from the date of the accident causing the loss after which the above benefit is payable.

"Paralysis" means the complete and irreversible paralysis of both lower limbs, and must be continuous for twelve months from the date of accident causing the loss after which the above benefit is payable.

Only one of the amounts shown above (the largest applicable) will be paid for injuries to the same limb resulting from any one accident.

The maximum payable for all losses sustained by an insured person as a result of the same accident shall not exceed the Principle Sum.

The amount specified above for losses of

• both hands, both feet or both eyes
• one hand and one foot
• one hand and one eye
• one foot and one eye
• use of both arms, both hands, both legs or both feet
• speech and hearing
• thumb and index finger or at least four fingers of one hand
• all toes of one foot

is payable only when such double loss occurs as a result of the same accident.

Air Travel Coverage

An insured person is covered for losses resulting from injuries which are received while travelling as a passenger, but not as a pilot or member of the crew, in:

• any civil aircraft other than a limited, restricted or experimental classification and which is operated by a person holding a current and valid pilot's licence (other than a student licence) of a rating authorizing him to operate it;
  
• any military aircraft other than a single engine jet aircraft, which is being operated by a pilot who has proper authorization to operate it;
  

provided that such aircraft is at the time making a flight which is for the principal purpose of transporting passengers or passengers and cargo, or for observation or data gathering with respect to the engineering, scientific or economic business of the Policyholder and not for or in connection with any other operational purpose or any tactical or test purpose, and provided such injuries are otherwise covered by the policy.

The eligible Spouse is insured for 50% of the Member's Principal Sum, under the same benefit schedule.

Each eligible Dependent Child is insured for 15% of the Member's Principal Sum in the event of Accidental Death and ten (10) times the Dependent's Principal Sum in the event of:

• Loss of Both Hands, Both Feet or Both Eyes
• Loss of One Hand and One Foot
• Loss of One Hand and One Eye or One Foot and One Eye
• Loss of Speech and Hearing in Both Ears
• Loss of Both Legs or Both Feet
• Loss of Use of Both Arms or Both Hands
• Quadriplegia (total paralysis of both upper and lower limbs)
• Paraplegia (total paralysis of both lower limbs)
• Hemiplegia (total paralysis of upper and lower limbs of one side of the body)

Common Carrier Accident Coverage

In addition to the above-mentioned Twenty-Four Hour Accident Coverage, a Member is covered for losses resulting from injuries which are received provided such injuries are received while the Member, as a passenger,but not as a Member of the operating crew is riding in, boarding or alighting from any public air, land or water conveyance provided by a common carrier primarily for passenger service.

The eligible Spouse is insured for 50% of the Member's Principal Sum. the eligible Dependent Child is insured for 15% of the Member's Principal Sum in the event of Accidental Death and ten (10) times the Dependent's Principal Sum in the event of any of the disabilities listed above.

Repatriation Benefit

When injuries covered result in Loss of Life of a Member at a distance greater than 200 kilometers from th normal place of residence of the Member, and withing 365 days after the date of the accident, the Company will pay the actual expense incurred for preparing the deceased for burial or cremation and shipment of the body to the place of burial subject to a maximum amount not to exceed $5,000.00.

Rehabilitation Benefit   

When injuries result in a payment being made under this coverage, the Company will pay in addition the reasonable and necessary expenses actually incurred up to a limit of $5,000.00 for special training of the Insured Person provided:

• such training is required because of such injuries and in order for the Insured Person to be qualified to engage in an occupation in which he would not have been engaged except for such injuries, and
• expenses be incurred within two years from the date of the accident. No payment will be made for ordinary living, travelling or clothing expenses.

Occupational Training Benefit

When injuries to the Member result in a payment being made under Loss of Life Benefit, additional payment will be made for the expenses actually incurred by the Spouse of the Member for a formal training program for the purpose of specifically qualifying such Spouse to gain active employment in an occupation for which the Spouse would otherwise not have sufficient qualifications. The maximum payable hereunder is $10,000.00.

Permanent Total Disability Benefits

When a Member or Spouse receives injuries resulting in Permanent Total Disability within 365 days of an accident, the Principal Sum will be paid less any amount paid or payable under the Accidental Death and Specific Loss Benefits for the same accident. Disability must be total and irrecoverable and must be continuous for 12 months, during which time the Member or Spouse receives medical treatment and after which the benefit is payable, provided such disability is determined to be permanent.

Monthly Accident Idemnity

If, within thirty days (30) of the date of an accident, a Member sustains an injury resulting in total and continuous disability and preventing him from engaging in any and every occupation or employment for compensation or profit for which he is qualified by reason of his education, training or experience, the monthly dues of the Asbestos Workers' Local 95 will be paid for the period the Member is so disabled. The Member must be under the regular care of a legally qualified physician commencing with the first day of disability. A maximum of twenty-four (24) consecutive months will be paid as the result of any one accident.

Special Education Benefit

If injury sustained by a Member results in Loss of Life, within 365 days of the date of accident, an Education Benefit equal to the lesser of five percent of the Principal Sum or $2,000.00 will be paid to any covered dependent who is eligible for the Education Benefit.

A covered dependent shall be eligible for the Education Benefit if such dependent was enrolled as a full-time student in any institution of higher learning beyond the 12th grade level, or was at the 12th grade level and subsequently enrols as a full-time student in an institution of higher learning within 365 days following the date of Loss.

The Education Benefit is payable annually for a maximum of four consecutive annual payments, provided that the covered dependent eligible for the Education Benefit continues education as a full-time student in an institution of higher learning.

If, at the time of Loss, the Member has no covered dependent(s) eligible for the Education Benefit, an additional amount of $1,000.00 will be paid to the designated beneficiary.

Hospital Indemnity Benefit

The Member will be paid a daily benefit of Fifty Dollars ($50.00) to a maximum monthly Hospital Indemnity Benefit of $6,000.00 while such person is confined in a hospital and under the care of a licensed physician. Such period of hospitalization must:

(a) be necessary because of injury or illness; and

(b) begin while insurance under the Policy is in force with respect to such Member.

The daily benefit will be paid from the first day of such period of hospitalization to a maximum of 120 days per injury or illness.

If any injury or illness requires more than one period of hospitalization then the maximum benefit period of 120 days in a hospital will be reinstated provided that at least 61 days has elapsed between such periods of hospitalization.

In addition, for an illness or accident that begins while the insurance is in force, a benefit of 50% of the specified daily benefit will be paid, with respect to such Insured Person, equal to the number of days at home that the Insured Person was hospitalized for a covered illness or accident, to a maximum of twenty (20) days of recovery at home, to a maximum of $500.00.

The eligible Spouse is insured for an amount equal to that of the Member.

Each eligible Dependent Child is insured for a daily benefit of $15.00 subject to a maximum of 120 days and $1,800.00.

Emergency Hospital/Medical Expense for Accident or Sickness Occurring Outside of Canada

Coverage under this provision is available on an "Emergency" basis only and is limited to a 45 day maximum with a 10 day automatic extension subject to a maximum of $1,000,000.00.

Benefits:

Emergency Hospital, Medical and Therapeutic Services Occurring Outside Canada

When injuries or sickness result in hospital, medical or therapeutic services, benefits will be paid to a maximum of $1,000,000.00, for the actual expenses incurred outside Canada that exceed the amount which is payable with respect to such expenses under any government hospitalization or medical care plan in Canada, or if an Insured Person is not covered under any such plan, to the extent they exceed any amount which would be payable with respect to such expenses under the government hospitalization or medical care plan if he or she were covered under any such plan.

If an Insured Person's expenses for services, that began while this coverage was in force, continue after the expiration of the 45 day period of coverage, benefits will be paid for such continued services incurred outside Canada for up to 10 additional days.

Hospital Confinement:

If you are confined as a resident inpatient in a hospital, reimbursement will include those charges made by the hospital for services and supplies rendered and provided for use during such confinement.

Medical and Therapeutic Services:

Benefits are payable for:

(a) the services of a legally qualified physician or surgeon (other than an Insured Person),

(b) the services of a legally qualified anaesthetist,

(c) the services of a registered graduate nurse (other than a relative by blood or marriage),

(d) X-ray examination by a legally qualified doctor of medicine for the purpose of diagnosis,

(e) the use of a licensed ambulance,

(f) rental of crutches or hospital type bed or the cost of splints, trusses, braces or other approved prosthetic appliance,

(g) out-patient services provided by a hospital, or

(h) drugs or medicine requiring a legally qualified physician's written prescription but not to exceed $500.00 with respect to each Insured Person.

If there is no other government sponsored hospital, medical or therapeutic coverage in force, amounts payable are limited to the pro rata share of the amount that would have been payable had such coverage been in force.

EXCLUSIONS:

Benefits are not payable for:

(a) injuries received while an Insured Person is participating in any manoeuvres or training exercises of the armed forces,

(b) pregnancy or childbirth,

(c) sickness or injury where the trip is undertaken for the purpose of securing medical treatment or advice for such sickness or injury,

(d) dental surgery or cosmetic surgery unless such surgery is a result of a covered injury

(e) any loss or injury if at the time of the loss or injury, the Member is affected by drugs, alcohol or other intoxicants (unless administered on the advice of a legally qualified physician) to such an extent that it causes or contributes to the loss or injury,

(f) treatment or services that contravene any government hospital or medical care plan in Canada, or

(g) expenses incurred on an elective (non-emergency) basis.

The eligible Spouse is insured for an amount equal to that of the Member.

Each eligible Dependent Child is insured for an amount equal to that of the Member.

Fracture, Dislocation and Miscellaneous Indemnity

If injury requires medical or surgical treatment within 30 days of the date of accident, the amount specified in the following Schedule will be paid provided that not more than one such indemnity, (the largest), shall be payable as the result of any one accident.

FRACTURES:

Spine (two or more Vertebrae	$5,000.00
Spine (one Vertebra)	2,000.00
Spine (compression Fracture)	1,000.00
Cranium (depressed Fracture)	5,000.00
Cranium (other compound)	2,000.00
Facial Bones	300.00
Pelvis	3,000.00
Femur	1,500.00
Lower Leg	1,000.00
Knee Cap	1000.00
Forearm (compound or comminuted	700.00
Forearm (not compound)	350.00
Upper Jaw	1,500.00
Lower Jaw	400.00
Arm, between Elbow and Shoulder	800.00
Shoulder Blade	1,000.00
Ankle (Pott's Fracture)	1,000.00
Wrist (Colle's Fracture	1,000.00
Two or More Ribs	500.00
One Rib	200.00
Sacrum or Coccyx	500.00
Sternum	500.00
Collar Bone	500.00
Heel Bone	250.00
One Hand (one or more Metacarpal (s))	200.00
One Foot (Calcaneum and/or Metatarsal(s))	200.00
Nose	100.00
Chip or Hairline Fracture	50.00
Any Bone not specified above	50.00

DISLOCATIONS:

Hip	$1,500.00
Knee (with open primary repair)*	1,500.00
Shoulder (with open reduction)	1,000.00
Elbow	350.00
Wrist	300.00
Bone of Foot, other than Toes	250.00
Ankle	50.00

Recurrent dislocations are not provided for under the Policy.

*Payments will only be made if the injury requires surgical treatment from a qualified and fully licensed physician and such treatment commences within thirty days of the date of injury.

BURNS, LACERATIONS AND SURGICAL PROCEDURES

When injury requires medical or surgical treatment, the amount specified opposite such loss will be paid as follows:

For burns requiring one or more skin grafts	$1,000.00
For Second and Third degree burns (more than two square inches)	$200.00

For lacerations requiring suturing:

Over five inches in length	$300.00
Between two to five inches in length	$200.00
Less than two inches in length	$50.00

For surgical procedures requiring general anaesthesia:

External an Internal Injuries requiring

a general anaesthesia	$500.00
Arthoscopy	$100.00

The eligible Spouse is insured for an amount equal to 50% of the Member.

Each eligible Dependent Child is insured for an amount equal to 15% of the Member's, subject to a minimum of $10.00.

EXPOSURE AND DISAPPEARANCE

If, while insured, an Insured Person is unavoidably exposed to the elements because of a covered accident and if, as a result of such exposure and within 365 days of the accident, an Insured Person sustains a loss for which benefits are otherwise payable, such loss will be covered.

If, while covered, an Insured Person disappears because of a covered accident resulting in the sinking or disappearance of a conveyance for which an Insured Person is covered by the Policy and in which an Insured Person was riding and if the body of an Insured Person has not been found within 365 days of the accident, it will be presumed that an Insured Person has sustained Loss of Life as a result of injuries covered by the Policy, unless there is evidence to the contrary.

INTERNATIONAL TRAVEL ASSISTANCE PROGRAM

An Insured Person will be provided with assistance and benefits should a medical emergency occur while travelling outside the province of residence, provided services are (a) made upon the recommendation of a licensed physician and (b) have been made with the prior consent of the company.

Coverage under this program is effective for up to 45 days per trip. However, if an Insured Person is confined to a hospital on the 45th day, coverage will be extended until the date of discharge.

The Wallet Certificate (ID Card) should be kept with the Member at all times for immediate reference should an emergency arise.

The primary benefits include:

1. payment of charges incurred for transporting an Insured Person to the nearest hospital with adequate facilities or to Canada;

2. payment of reasonable and necessary charges made by a hospital for Room and Board;

3. payment of reasonable and necessary charges made by a Physician for treatment and services

4. payment of accommodation charges up to $75 per day for a maximum of 5 days if, following hospitalization outside an Insured Person's province of residence, the attending physician and our medical staff determine that an Insured Person should convalesce in a hotel before returning home;

5. payment of transportation and accommodation for a family member to attend to the Insured Person if while travelling alone, the Insured Person becomes hospitalized due to a medical emergency. Accommodation charges are limited to a maximum of $150 a day for a maximum of 5 days;

6. payment of charges incurred for transporting the Insured Person's unattended dependent children back to Canada including transportation costs for an escort to accompany the children, should an escort be necessary;

7. payment of up to $500 of the unused portion of an uninsured airline ticket if forfeited due to a medical emergency while travelling; and

8. payment for the cost of having a private automobile returned to the Insured Person's province of Residence by a commercial agency in the event of death or if unable to drive the vehicle due to a medical emergency, subject to a maximum of $500.

The maximum amount payable under items #5 and #6 combined shall be $5,000 for any one medical emergency.

If the emergency services performed cost $200 or less, the Member must pay the amount due and then submit a claim for reimbursement by the Provincial Health Plan and this Plan.

Payment is conditional upon the Member:

1. providing proof to the Insurance Company of all expenses incurred for which a claim is made; and,

2. verifying the originally planned date of the uninsured return trip when applicable.

This program does not pay for any charges incurred that directly or indirectly result from travel outside the Member's province of residence when it is for the express purpose of securing or with the specific intention of receiving medical attention or hospital services. In addition, no amount is payable for any treatment or surgery which could be reasonably delayed until the Insured Person returns to Canada.

The Travel Assistance program also provides non-medical services. These services include:

1. the use of the message centre. In case of emergency, the Insured Person can leave messages for family, friends or business associates. Messages are held for up to 15 days;

2. telephone interruption services in most major languages; and

3. assistance in obtaining passports, visas and tickets should the originals become lost or stolen.

The Insurance Company will not be responsible for the availability, quality or results of any medical treatment nor for failure by the Member or the Insured Person to obtain medical treatment.

EXCLUSIONS AND LIMITATIONS

This Policy does not cover Losses caused by or resulting from:

(a) suicide or attempted suicide while sane or insane,

(b) any act of declared or undeclared war,

(c) intentionally self-inflicted injury,

(d) pregnancy or childbirth,

(e) full-time active service in the armed forces of any country,

(f) injuries received while travelling in any aircraft which is owned or leased by the Policyholder, a subsidiary, affiliate or associate company of the Policyholder.

DEFINITIONS

"Member" means a Member in benefit under Asbestos Workers' Local 95 Benefit Fund. "Insured Person" means a Member, Spouse and/or Dependent Child insured under the Policy. "Spouse" means a person who is either:

(a) legally married to the Member, or

(b) a person of the opposite sex who, although not legally married to the Member, cohabits with and is publicly represented as the Member's Spouse in the community in which they reside, but does not include any person who is insured under the Policy as a Member. The spouse must be a resident of Canada or the United States of America.

"Dependent Child" means any natural, step, foster or legally adopted child of the Member, residing in the Member's household, who is under the age of 21 years, unmarried and dependent upon the Member for support and maintenance. In the event that a Dependent Child has passed his 21st birthday and is a full-time student in an accredited school, college or university, such child will continue to be eligible up to his 25th birthday or the date he ceases to be such a student, whichever date occurs first.

A Dependent Child who is mentally retarded or physically handicapped will continue to be eligible beyond the maximum age specified above provided the child is incapable of self-sustaining employment and is fully dependent upon the Member for support and maintenance.

A Dependent Child must be a resident of Canada or the United States of America.

"Hospital"means an incorporated or licensed hospital having accommodation for resident bed patients, a laboratory, a registered graduate nurse always on duty and an operating room where surgical operations are performed by a legally qualified physician or surgeon, but in no event shall this include a convalescent or nursing home or home for the aged or health spa.