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How much does the Plan pay if I accidentally die?
You can buy from $25,000 to $350,000 in accident insurance for yourself, in units of $25,000.
If you are in an accident and die within 365 days as a result, the Plan will pay your beneficiary a lump sum equal to your full coverage amount.
In the event of accidental death, the plan may pay other benefits as well.
How much does the Plan pay if a family member accidentally dies?
The Plan will pay you a lump-sum benefit, provided:
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you chose family coverage; and |
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your spouse or a dependent child is in an accident and, within 365 days, dies as a result. |
The benefit will be equal to a percentage of the accident insurance you purchased for yourself ($25,000 to $350,000). The actual percentage payable will depend on your family composition, as follows:
| If you have … |
The benefit is equal to the following percentage of your accident insurance …
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| A spouse and dependent children |
50% if your spouse dies
10% (up to $50,000) if a dependent child dies
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| A spouse only (no dependent children) |
60% if your spouse dies
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| Dependent children only (no spouse) |
20% (up to $50,000) if a dependent child dies |
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Example
If your accident insurance is equal to $100,000 and your spouse accidentally dies, the Plan will pay you the following benefits:
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If you have a spouse and dependent children:
50% x $100,000 = $50,000 |
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If you have a spouse only (no dependent children):
60% x $100,000 = $60,000 |
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In the event of accidental death, the plan may pay other benefits as well.
How much does the Plan pay if I suffer an accidental injury?
If you are in an accident and, within 365 days, suffer an injury as a result, the Plan will pay a lump sum equal to a percentage of your full coverage amount ($25,000 to $350,000), depending on the covered loss.
Covered loss
(must be permanent and total) |
Percentage of full coverage amount payable
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Hemiplegia |
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Paraplegia |
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Quadriplegia |
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200%
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Use of both hands or both feet |
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Entire sight in both eyes |
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Use of one hand and one foot |
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Use of one hand (or one foot) and entire sight in one eye |
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Speech and hearing in both ears |
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100%
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Use of one leg or one arm |
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75%
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Use of one hand or one foot |
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Entire sight in one eye |
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Speech or hearing in both ears |
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66 2/3 %
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Hearing in one ear |
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Use of thumb and index finger of either hand |
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Use of all toes of one foot |
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33 1/3%
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Use of four fingers of either hand |
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25%
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Example
If your full coverage amount is equal to $100,000 and you lose the use of one arm, the Plan will pay:
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75% x $100,000 = $75,000 |
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In the event of accidental injury, the plan may pay other benefits as well.
How much does the Plan pay if a family member suffers an accidental injury?
The Plan will pay you a lump-sum benefit, provided:
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you chose family coverage; and |
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your spouse or a dependent child is in an accident and, within 365 days, suffers an injury as a result. |
The benefit will be equal to a percentage of the amount you would have received had the injury happened to you instead. The actual percentage payable will depend on your family composition, as follows:
| If you have … |
The benefit is equal to the following percentage of your benefit …
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| A spouse and dependent children |
50% if your spouse becomes injured
20% (up to $75,000) if a dependent child becomes injured
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| A spouse only (no dependent children) |
60% if your spouse becomes injured
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| Dependent children only (no spouse) |
40% (up to $75,000) if a dependent child becomes injured |
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Example
If your full coverage amount is equal to $100,000 and you lose the use of one arm, the Plan will pay:
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75% x $100,000 = $75,000 |
If your child loses the use of one arm instead, the Plan will pay:
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If you have a spouse and dependent children:
20% x $75,000 = $15,000 |
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If you have dependent children only (no spouse):
40% x $75,000 = $30,000 |
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In the event of accidental injury, the plan may pay
other benefits as well.
What happens in the event of multiple injuries?
The Plan can only pay for one injury per person for any one accident. As a result, the benefit will be equal to the injury that pays the highest benefit.
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Example
If you have one injury payable at 50% of your accident coverage, and another injury payable at 100%, the Plan will pay 100% of your accident coverage, not 150%.
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What happens if more than one covered person is injured in the same accident?
The Plan will pay applicable benefits, subject to the Plan provisions and a maximum of $2.5 million for all losses resulting from any accident.
Also, if you and your covered spouse die within one year from injuries resulting from the same accident, the benefit payable for your spouse's death will be increased to the benefit payable for your death. The benefit payable for both deaths cannot exceed $700,000.
Does the Plan pay other benefits, such as rehabilitation?
Yes, the Plan pays the following benefits:
Day-care benefit
Family transportation benefit
Home and vehicle modification benefit
Hospital indemnity expense
Rehabilitation benefit
Repatriation benefit
Seat-belt benefit
Special education benefit
Spousal retraining benefit
| Day-care benefit |
If you die accidentally, the Plan will pay for reasonable and necessary day-care expenses actually incurred for each dependent child who is covered at the time of your death and:
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is enrolled in a legally licensed day-care centre on the date of the accident; or |
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enrolls in a legally licensed day-care centre within 365 days after the date of your death. |
This benefit is payable for up to four consecutive years, to an annual maximum of 5% of your coverage or $5,000, whichever is lower.
The Plan will pay benefits each year immediately upon receipt of satisfactory proof that the child is enrolled in a legally licensed day-care centre.
No benefits will be paid for the following expenses:
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expenses incurred prior to your death; |
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room and board; or |
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expenses incurred prior to your death; |
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room and board; or
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ordinary living, travelling, or clothing expenses. |
Benefits are payable to your surviving spouse, or, if the child does not reside with your surviving spouse, the child's legally appointed guardian.
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| Family transportation benefit |
The Plan will reimburse up to $10,000 for actual transportation costs to have a member of your immediate family visit you if:
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you are incapacitated as the result of an accident that occurred more than 200 km from your home;
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you are hospitalized for at least five days as a result, upon the written recommendation of your attending physician; and
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a member of your immediate family must be with you. |
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| Home and vehicle modification benefit |
If you accidentally lose the use of both of your feet or become quadriplegic, paraplegic or hemiplegic, and you subsequently require a wheelchair to be ambulatory, the Plan will cover the reasonable and necessary expenses actually incurred within three years of the accident to:
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modify your principal residence to make it wheelchair accessible; and
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modify your vehicle, when approved by licensing authorities, to make it wheelchair accessible.
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Benefits are payable up to $10,000.
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| Hospital indemnity expense |
If an accidental injury leads to your hospitalization as a resident in-patient for more than seven days, the Plan will pay:
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a monthly benefit of 1% of your accident coverage; or |
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1/30 of the monthly benefit per day, if hospitalization lasts less than one month.
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Benefits cannot exceed $1,000 per month and 12 months for any one injury.
Your hospitalization must be recommended by a legally qualified physician or surgeon and begin while your coverage is in force.
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| Rehabilitation benefit |
If an accidental injury requires you to undergo special training to qualify for an occupation that you would not have engaged in had the injury not occurred, the Plan will pay the reasonable and necessary expense incurred for such training, up to $10,000 per accident.
These expenses must be incurred within two years of the accident.
The Plan will not cover:
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rehabilitation benefits for your spouse or dependent children;
travelling or clothing expenses; or
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room, board or other ordinary living expenses.
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| Repatriation benefit |
In the event of your accidental death, the Plan will pay the reasonable and necessary expenses actually incurred for the preparation and return of your body to your city of residence. Benefits are payable up to $10,000.
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| Seat-belt benefit |
If you accidentally die or suffer a covered injury and you were wearing a properly fastened seat belt at the time of the accident, the Plan will increase the benefit by 10%.
The driver of the vehicle must hold a valid driver's license authorizing him or her to operate the vehicle. Also, at the time of the accident, the driver must be neither intoxicated nor under the influence of drugs, unless such drugs are taken as prescribed by a physician. "Intoxicated" and "under the influence of drugs" are defined by the local jurisdiction where the accident occurs.
The official accident report must certify that you were wearing a seat belt at the time of the accident.
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| Special education benefit |
If you accidentally die, the Plan will pay a special education benefit to any dependent child covered under the Plan at the time of your death who, on the date of your accident:
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was a full-time student in any post-secondary institution, or
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was a full-time student in any secondary school but enrolls as a full-time student in any post-secondary institution within 365 days of your death.
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The benefit is equal to the reasonable and necessary expenses actually incurred, up to $5,000 per year, for such schooling.
This benefit is payable for a maximum of four consecutive years, provided your dependent child continues to be enrolled full-time in a post-secondary institute. Satisfactory proof is required each year.
The Plan will not cover:
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expenses incurred before your death;
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travelling or clothing expenses; or
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room, board or other ordinary living expenses. |
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| Spousal retraining benefit |
If you chose to cover your spouse and the Plan pays benefits for your accidental death, the Plan will also pay any reasonable and necessary occupational training expenses actually incurred by your spouse, up to $10,000, to gain active employment in a field for which he or she was not previously qualified.
The expenses must be incurred within three years of the date of the accident.
The Plan will not cover:
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travelling or clothing expenses; and
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room, board or other ordinary living expenses.
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Can I change coverage or stop participating?
Yes. You can change the amount of your coverage or stop participating altogether at any time.
To make a change:
- Complete the application form.
- Return the completed form to your school board.
Are benefits taxable?
No.
When are benefits NOT payable?
Benefits are not payable when accidental death or injury results from:
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suicide or attempted suicide while sane or insane; |
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intentionally self-inflicted injury; |
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flying as a pilot or crew member in any aircraft, or flying in an aircraft owned, operated or leased by or on behalf of QPAT; |
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declared or undeclared war or act of war; or |
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full-time active service in the armed forces of any country. |
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