Volunteer Firefighters Program (New York)

• Who the Policy Covers
• When Coverage is Provided
• Description of Coverages
• Accident Medical Expense Benefit
• Accident Total Disability Benefit
• Cost of Living Adjustment Benefit
• Accident Partial Disability Benefit
• Permanent Total Disability
• Managed Disability
• Additional Benefit for Loss of Life - $2,000
• Benefit for Additional Covered Conditions
• Cosmetic Disfigurement From Burn
• Family Expense Reimbursement Benefit
• Education Benefit
• Hospital Indemnity Benefit
• Junior Firefighters
• Firefighters Auxiliary
• Rating
• Available Discounts and Deductibles
• Important Limitations, Exclusions and Definitions
  
  • Accident Coverages
  • Other Coverages
  • Policy Exclusions
  • Definitions
• Underwriting
• General Remarks
• Print this Page

Who the Policy Covers

Class 1: All volunteer members of the fire company, including members of the Organization who may receive a nominal fee as a retainer. All paid drivers or employees of an ambulance, first aid or rescue squad not affiliated with a fire company; paid drivers or employees of the Organization regularly employed as full-time firefighters; All deputized bystanders who are not members of the Organization or any other voluntary firefighter organization, but have been deputized by the Fire Chief or other official of the Organization for an emergency. All members of another volunteer firefighter organization whose services have been accepted by the Organization for a particular emergency.

Class 2: Registered Junior Firefighters of the Organization.

Class 3: Members of the Firefighters Auxiliary of the Organization.

When Coverage is Provided

For Class 1: The Policy covers each Class 1 Insured Person who is on duty while:

1. at a fire, traveling to or returning from a fire, at a fire drill, at a parade, funeral, or at a test or trial of any fire-fighting Apparatus; or
2. assisting, with other members of the Organization, another fire department, company or unit thereof;
3. performing duties directly related to the prevention or investigation of fires or other disasters;
4. instructing or being instructed in fire duties, attending or participating in a competitive or noncompetitive training school or program;
5. attending or working at meetings;
6. working in connection with the construction, testing, inspection, repair or maintenance of:
   • the firehouse, fixtures, furnishing and equipment thereof;
   • the fire fighting vehicles, apparatus and equipment used by the fire department, fire company or other unit thereof;
7. working in connection with the construction, testing, inspection, repair or maintenance of fire alarm and water supply systems, fire wells, fire cisterns or fire suction pools;
8. practicing for, or participating as a contestant or an official in any competitive tournament, contest or public exhibition conducted for firefighters which is intended to promote the efficiency of the fire department, fire company or any unit thereof;
9. engaged in the inspection of fire fighting vehicles and apparatus prior to delivery under a contract of purchase, or performing duties in relation to the delivery thereof;
10. participating in a competitive fund raising event in which the Volunteer Firefighter or Volunteer Ambulance Worker is a competitor. In no event will this include participation in league athletics;
11. working in connection with a call for general ambulance service by a member of an emergency rescue and first aid squad;
12. attending a convention or conference of firefighters or officers;
13. performing work or services, leading or directing an authorized youth program;
14. participating in, or attending as a volunteer member of the Organization, (but not as a paid driver or employee) any other regularly approved, supervised activity of the Organization; or
15. riding on Organization Apparatus (including a private passenger automobile furnished by the Organization for the transportation of the Fire Chief or other official of the Organization) while traveling to or returning from a fire drill, a parade, or a test or trial of any fire-fighting Apparatus.

Necessary travel including travel directly to and return directly from a Covered Activity is covered for all items except items, 5, 6, 8, and 12.

However, any necessary travel connection with the covered activity under items 5, 6, 8, 12 will be considered part of the covered activity.

For Class 2: (Junior Firefighters) The Policy covers each Class 2 Insured Person who is on duty under direct supervision of the Fire Chief or other authorized official of the Organization.

For Class 3: (Firefighters Auxiliary) This Policy covers each Class 3 Insured Person who is on duty and is:

1. at a fire, traveling to or returning from a fire at a fire drill, at a parade, funeral, or at a test or trial of any fire-fighting Apparatus;
2. at a drill, parade or test or trial of any emergency Apparatus;
3. participating in, or attending as a volunteer member of the Organization, (but not as a paid driver or employee) any other regularly approved, supervised activity of the Organization; or
4. riding On Organization Apparatus (including a private passenger automobile furnished by the Organization for the transportation of the Fire Chief or other official of the Organization) while traveling to or returning from a fire drill, a parade or a test or trial of any fire-fighting Apparatus.

Description of Coverages

Accidental Death and Dismemberment Catastrophic Loss Benefit - Maximum benefit available is $200,000. Higher benefits may be available upon request.

Pays for Loss Of

Life	The Principal Sum
Both Hands or Both Feet or Sight of Both Eyes	The Principal Sum
One Hand and One Foot	The Principal Sum
Either Hand or Foot and Sight of One Eye	The Principal Sum
Hearing in Both Ears and Speech	The Principal Sum
Movement of Both Upper and Lower Limbs (Quadriplegia)	The Principal Sum
Movement of Both Lower Limbs (Paraplegia)	The Principal Sum
Movement of Both Upper and Lower Limbs of One Side of the Body (Hemiplegia)	The Principal Sum
Hearing in One Ear and Speech	Three-Quarters of The Principal Sum
One Arm or One Leg	Three-Quarters of The Principal Sum
Movement of One Upper Limb or One Lower Limb	One-Half of The Principal Sum
Speech or Hearing in Both Ears	One-Half of The Principal Sum
Either Hand or Foot	One-Half of The Principal Sum
Sight of One Eye	One-Half of The Principal Sum
Hearing in One Ear	One-Quarter of The Principal Sum
Thumb and Index Finger of Either Hand	One-Quarter of The Principal Sum
One Thumb	One-Twentieth of The Principal Sum
Each Joint of Finger or Toe	One One-Hundredth of The Principal Sum

The term "loss" will mean with regard to hand or foot, complete severance through or above wrist or ankle joint; with regard to sight, speech or hearing, total and irrecoverable loss of sight, speech or hearing; with regard to thumb or index finger, complete severance through or above metacarpophalangeal joint; with regard to arm or leg, complete severance through or above the elbow or knee joint; with regard to each joint of finger or toe, complete severance through or above the joint of the finger or toe; with regard to movement, complete and irreversible paralysis involving the entire arm with respect to upper limb, or entire leg with respect to the lower limb.

If the insured person disappears while he or she is engaged in an activity within the scope of coverage of the policy and his or her body has not been found within one year following such disappearance, then, for the purposes of this benefit, it will be deemed that he or she suffered "loss of life."

Seat Belt Coverage - A death benefit will be paid if loss of life occurs due to a covered seat belt accident. A "covered seat belt accident" means the unintentional collision of an Automobile or Fire Engine during which the insured person is participating in a Covered Activity and is wearing a seat belt. A police report must indicate the insured person was wearing an unaltered seat belt at the time of the accident. The Benefit Amount is $20,000.

Accident Medical Expense Benefit

The Maximum Benefit available is $100,000. Higher benefits may be available upon request. Individual deductibles of $100, $250, $500 and $1,000 are available.

Pays the Reasonable Expenses incurred (not to exceed the maximum benefit amount selected and in excess of any deductible amount) for Medical Care prescribed by the doctor for treatment of injuries sustained as a result of an accident. This benefit includes medical expenses for skin grafting or plastic surgery due to injury up to the full amount of the Accident Medical Benefit.

It also includes a Post Traumatic Stress Disorder benefit up to a maximum of $5,000 per person for all expenses incurred as the result of one or more Traumatic Events. Benefits are further limited to expenses incurred within 12 months of Participation in the Covered Activity during which the Traumatic Event occurred. Post-Traumatic Stress Disorder means:

• recurrent and intrusive distressing recollections of the Traumatic Event;
• recurrent distressing dreams of the Traumatic Event;
• suddenly acting or feeling the Traumatic Event is recurring; or
• intense psychological distress at exposure to events that symbolize or resemble an aspect of the Traumatic Event.

Traumatic Event means an event that is outside the range of usual human experiences and would be markedly distressing to almost anyone, such as:

• actual or threatened serious physical harm to the Insured's Person's life or body;
• witnessing actual or threatened serious physical harm to the life or body of another person who has recently been or is being seriously injured or killed as a result of an accident or physical violence.

Accident Total Disability Benefit

Maximum benefit available is $1,000 per week. The Fire Company may select a weekly benefit amount from $100 to $1,000 in $50 increments.

In the event of Total Disability due to injury, this benefit will pay a Weekly Benefit Amount for each week of disability for 2 years, 5 years or to Age 65, depending on the Benefit Period selected by the Fire Company.

The weekly benefit, payable on the first day of disability, will be the weekly benefit amount selected by the Fire Company or 70% of the insured person's average weekly wage, whichever is less. Benefits will be reduced by: any Other Income Benefits which the insured person is entitled, such as Worker's Compensation or Social Security, 50% of income from rehabilitative employment; and all income from any employer or from any work.

However, in no event will benefit payments be less than $100 per week. Furthermore, if the insured person's Social Security disability benefits increase due to a Cost of Living adjustment, benefit payments will not be offset by the increase.

Total Disability means the complete and continuous inability of the insured person to:

• perform the essential duties of his or her regular occupation until the weekly Benefit has been paid for 104 weeks; and thereafter,
• engage in any gainful occupation for which the insured person can be reasonably fitted through training, experience or education.

Existing policyholders have the option of "grandfathering" the disability benefit. Existing policyholders may elect the "old" version of the Accident Total Disability Benefit when opting for the grand-fathered disability benefit, (COLA) is not available. In addition, the Partial Disability Benefit will be the Grandfathered version.

New policyholders will not be allowed to purchase the "grandfathered" option and will be offered the "new" versions of the Accident Total Disability Benefit.

Cost of Living Adjustment Benefit

The Cost of Living Adjustment (COLA) option can help claimants stay ahead of inflation. If an insured person has been totally disabled for 12 consecutive months, COLA allows benefit payments to increase each year that he or she remains disabled following the first full year of a covered disability. The increase will be the lesser of 3% or one-half the percentage change in the Consumer Price Index. An insured person can receive up to ten annual increases.

Accident Partial Disability Benefit

This benefit is automatically included with the Accident Total Disability Benefit. The benefit period matches the benefit period selected by the Fire Company under the Accident Total Disability Benefit.

Benefits for partial disability are paid if an insured person receives total disability benefits, but is then able to perform at least one of the substantial and material duties of his or her occupation, either part-time or full-time. The Partial Disability benefit lets an insured person rebuild his or her income to its pre-disability level as he or she returns to full-time employment. This benefit is payable for the maximum payment period selected by the Fire Company for the Accident Total Disability Benefit; 2 years, 5 years or to age 65; and is payable up to 80% of the benefit under Accident Total Disability.

Permanent Total Disability

Maximum benefit available is $200,000.

Pays the benefit selected, less any amount paid or payable under the Accidental Death and Dismemberment Catastrophic Loss Benefit, if the insured person suffers a permanent total disability after a period of continuous total disability equal to the payment period selected under the Accident Total Disability Benefit.

This benefit is available only if the Accidental Death and Dismemberment Catastrophic Loss Benefit and the Accident Total Disability Benefit are purchased, and only if the 104- or 260-week Accident Total Disability payment period option is selected. The maximum benefit available for Permanent Total Disability is equal to the benefit selected under the Accidental Death and Dismemberment Catastrophic Loss Benefit.

Managed Disability

As one of the nation's largest writers of disability coverages and as a leader in the managed disability marketplace, it's our business to help maximize abilities. At The Hartford, Managed Disability is more than just a single product or program. It's a comprehensive approach that brings together all aspects of disability products, programs and services to focus on helping to successfully control disability costs while getting covered persons back on the job quickly in a positive and humanistic way. We accomplish this through Partnership and Cost Containment.

Partnership: The Hartford, fire companies, covered persons, rehabilitation specialists, physicians and others work together toward the common goals of returning covered persons to work and containing costs. We work with covered persons to establish counseling, retraining or continuing education programs, worksite modifications and job placement opportunities.

Cost Containment: Through cost-containment techniques we focus on providing the most for the disability benefits dollar. Our techniques include early intervention, careful review of appropriate treatment, duration/review guidelines, disability case management, rehabilitation programs, Social Security Assistance, and return-to-work programs.

Our goal is to educate and motivate individuals with disabilities to lead productive and fulfilling lives, and to reach their highest level of ability. For instance, our rehabilitation programs include; vocational counseling, work site modifications, coordination of vocational testing, transferable skills training, job seeking skills training, job placement services, education and retraining.

By emphasizing abilities rather than disabilities, The Hartford gets covered persons rehabilitated and motivated to return to work as quickly as possible. We strive to reduce disability costs and to allow claimants to maintain productive lifestyles.

Additional Benefit for Loss of Life - $2,000

We will pay an Additional Benefit amount for Loss of Life if an insured person injury results in loss of Life which:

• is a direct result of participation in Emergency Duty;
• occurs within 26 weeks of the date of Emergency Duty;
• is paid or payable as a death benefit by the Volunteer Ambulance Worker's Benefit Law, Chapter 64-B of the Consolidated Laws of New York, the Volunteer Firefighters' Benefit Law, Chapter 64- A of the Consolidated Laws of New York or Workers' Compensation; and
• is not payable under the Accidental Death and Dismemberment Benefit.

This benefit is automatically included at no additional charge.

Benefit for Additional Covered Conditions

When an insured person suffers from an Additional Covered Condition as a result of participation in a covered activity, we will pay a Death Benefit, Medical Expense Benefit and/or a Total Disability Benefit.

Covered Condition means a disease, illness, or infection that would so naturally and unavoidably result from injury as to be recognized as injury under New York Volunteer Firefighters Benefit or Volunteer Ambulance Workers Laws. Although these laws do not cover certain competitive fund raising activities, this definition will encompass like conditions arising from such Covered Activities. However, this does not extend coverage to league athletics.

Additional means conditions exclusive of those that would ordinarily meet this policy's definition of Injury so as not to duplicate any benefits for injury.

Death Benefit (Maximum benefit available is $200,000)

Pays the selected Death Benefit is the insured person dies within 26 weeks of the participation in a covered activity.

Medical Expense Benefit (Maximum benefit available is $100,000)

Pays the Reasonable Expenses for necessary Medical Care (not to exceed the maximum benefit amount selected and in excess of any deductible amount) incurred within 52 weeks after the date of the covered activity.

Total Disability Benefit (Maximum benefit available is $1,000 per week. The Fire Company may select a weekly benefit amount from $100 to $1,000 in $50 increments.)

In the event of Total Disability due to a covered activity, this benefit will pay a Weekly Benefit Amount for each week of disability for 26 weeks, 52 weeks or 104 weeks, depending on the Benefit Period selected.

The weekly benefit amount is calculated as described under the Accident Total Disability Benefit. In no event will benefit payments be less than $100 per week. No payment will be made under this benefit during any time for which a benefit is payable under the Accident Total Disability Benefit.

Cosmetic Disfigurement From Burn

Maximum benefit available is $200,000.

Provides coverage when an insured person suffers third or fourth degree burns from participating in a covered activity. Pays up to the maximum benefit amount selected for cosmetic disfigurement. The benefit payable for any one loss is based on a percentage proportional to the total amount of the body actually burned and on the severity of the burn. If benefits are payable under the Cosmetic Disfigurement from Burns Benefit, and at a later date, benefits are payable for the same area of the body under the Accidental Death and Dismemberment Catastrophic Loss Benefit, we will pay any amount due which is equal to the difference between the two benefits.

Family Expense Reimbursement Benefit

$5,000 reimbursement benefit.

When benefits are payable under the Cosmetic Disfigurement from Burns benefit, then benefits are also payable to the insured's immediate family for necessary transportation, meals and lodging if the severity of the burn requires hospitalization at least 50 miles from the insured's permanent residence. Expenses incurred are payable for a maximum of 52 weeks from the date of the injury.

Education Benefit

Up to $5,000 reimbursed per year for 4 consecutive years.

If any benefits are payable for loss of life under the Accidental Death and Dismemberment Catastrophic Loss Benefit due to the insured person's death, we will pay an Education Benefit to the insured person's eligible spouse and dependent children. To qualify, the insured person's spouse must enroll at an institution of higher learning within 52 weeks of the death of the insured, or be enrolled in an institution of higher learning at the time of the insured person's death for the purpose of obtaining an independent source of income and maintenance.

Eligible dependent children must be enrolled as a full-time student at an institution of higher learning beyond the twelfth grade level, or be under the age of 21, and within 52 weeks of the insured person's death, enroll as a full-time student in an institution of higher learning.

The Education Benefit payable is the cost for tuition at an institution of higher learning, exclusive of room and board, up to a maximum annual amount of $5,000 per eligible person for 4 consecutive years. An institution of higher learning includes, but is not limited to, any state university, private college, professional or trade school.

Hospital Indemnity Benefit

Maximum benefit available is $100 per day up to 365 days for Accident only, $100/day for up to 2 years for Accident and Sickness.

Two benefits are available. One provides coverage only for confinement due to a covered accident while the other provides coverage for confinement due to a covered accident or covered sickness.

If a covered accident (or covered sickness) requires an insured person to be hospital confined as an inpatient, and such confinement commences within 30 days after a covered accident (or sickness), the benefit will pay the Daily Hospital Benefit selected for each day of actual confinement subject to a maximum of 365 days (Accident only), or 2 years (Accident and Sickness benefit) for any one period of confinement due to any one injury (or sickness). Benefits are payable only for those days for which the hospital charges a full day inpatient confinement.

Junior Firefighters

Provides an Accidental Death and Dismemberment Benefit up to a maximum of $10,000 and an Accident Medical Expense Benefit of $10,000 at no charge for all Junior Firefighters of the fire company. For an additional fee, an Accident Medical Expense Benefit of $25,000 is available.

To be covered, the Junior Firefighters must be on duty and under the direct supervision of the Fire Chief or other authorized official of the fire company. The Junior Firefighters benefit is not available for affiliated or non-affiliated ambulance, first-aid, and rescue squads.

Firefighters Auxiliary

Members of the Firefighters Auxiliary are covered under the policy while actually on duty at a fire, including going to or returning from a fire, and riding in or on fire company apparatus, going to or returning from a fire drill, parade, or a test or trial of any fire-fighting apparatus, for the following benefits:

Accidental Death and Dismemberment Catastrophic Loss Benefit - Maximum benefit available is $50,000.

Accident Medical Expense Benefit - Maximum benefit available is $50,000.

Accident Hospital Indemnity Benefit - Maximum benefit available is $100 per day up to 180 days for any one period of confinement due to any one injury.

Rating

The rates for our Volunteer Firefighter Program are determined by the total pieces of apparatus used by the Fire Company. Apparatus includes any piece of apparatus normally used by a fire company or ambulance, first-aid or rescue squad, except a private passenger car provided for the transportation of the Chief or other officer. Please contact your reporting office for detailed information and/or a proposal of benefits that will include rates and any applicable discounts.

Available Discounts and Deductibles

A County or Association Discount is available when all fire departments (or ambulance, first aid or rescue squads) of a county or association are covered under one policy.

Individual deductibles of $100, $250, $500 and $1,000 are available on Medical Expense Benefits.

Important Limitations, Exclusions, and Definitions

Accident Coverages

Accidental Death and Dismemberment Catastrophic Loss - We will not pay more than the Principal Sum for all losses due to the same accident.

Seat Belt Coverage - This benefit does not cover loss of life if the insured person is operating the automobile or fire engine while under the influence of any intoxicant, excitant, or any narcotic (unless administered under the advice of a physician) as verified in the police accident report.

Accident Medical Expense - To be covered, the first expense must be incurred within 26 weeks of the accident, and the last expense within 7 years. The Hartford will pay all reasonable expenses, subject to maximum benefit amounts selected by the policyholder. However, no payment will be made for any medical expenses for which benefits are payable under any Workers' Compensation or The New York Volunteer Fireman's Benefit Law.

Accident Total Disability - To be covered, the insured person must be actively at work at the time disability commences and total disability must result from injury, begin within 30 days of the accident, be continuous, and require the care of a legally qualified physician. If the maximum payment period is "to age 65" and the Total Disability begins: before age 63, the weekly benefit amount will be payable to age 65; or on or after age 63, the weekly benefit amount will be payable for two years.

The sum of the disability benefit amount and the total income received from a program of rehabilitative employment can equal 100% of the insured person's pre-disability average weekly wage without benefits being reduced. (Applies to all disability benefits listed for Volunteer Firefighters New York.)

Periods of disability: (a) due to the same or related medical causes, and (b) separated by less than 90 days during which an insured person is actively-at-work, will be considered one period of disability. (Applies to all disability benefits listed for Volunteer Firefighters New York.)

Accident Partial Disability - To be covered, partial disability must result from injury and begin within 30 days of the accident, or immediately follow a period of total disability for which benefits are payable. The partial disability must be continuous, cause a loss of income between 20 and 80 percent and require the regular care of a legally qualified physician. No payment will be made for any day for which a benefit is payable for Total Disability.

Permanent Total Disability - To be covered, injury resulting in permanent total disability must be sustained prior to age 60.

Benefits for Additional Covered Conditions:

Total Disability Benefit - Such period of continuous total disability must:

• commence within 30 days after participation in a Covered Activity;
• result from an Additional Covered Condition; and
• require the care of a legally qualified physician other than the insured person.

Accident Medical Expense - We will not pay expenses for which benefits are payable under:

• the Accident Medical Expense Benefit;
• Workers' Compensation or similar law;
• any condition for which the insured person has been medically diagnosed or received any Medical Care within 12 months prior to the date of the Covered Activity.

The Additional Covered Condition must be diagnosed and the first expense incurred within 30 days of the Covered Activity.

Other Coverages

Hospital Indemnity Benefit - Hospital Indemnity Benefit - Successive periods of confinement due to the same or related causes, not separated by a period of 90 days or longer, will be considered as one period of hospital confinement. Sickness means: Any disease, illness, or infection, caused by and directly resulting from participating in an Emergency Duty, if the first symptoms of the sickness are medically diagnosed:
a) while the insured person is covered under the Policy; and
b) within 30 days of the insured person's exposure while performing the Emergency Duty; provided the Sickness Benefit is included in this Policy.

Firefighters Auxiliary - Benefits are payable under the Hospital Indemnity Benefit if the insured person is confined due to injury and the first day of confinement for the first benefit period occurs within 30 days after the accident. Successive periods of confinement due to the same or related injury and separated by a period of less than 90 days, shall be considered one period of confinement.

Policy Exclusions

The Volunteer Firefighter Accident Policy does not cover loss, disability or expense incurred as a result of:

• Intentionally self-inflicted injury, suicide or attempted suicide.
• War or act of war, whether the war is declared or not.
• Accidents occurring while in or on any aircraft, except while a passenger in or on an aircraft operated by a passenger airline on a regularly scheduled passenger trip over its established route.

Definitions

Apparatus means, but is not limited to, a fire truck, engine or pumper, hose wagon, ladder truck, patrol ambulance, tournament truck and any other fire-fighting vehicle.

Average Weekly Wage is the greatest of the insured person's total wages, salaries, tips, and commissions for the:

1) calendar year immediately preceding the year in which the loss occurred divided by 52 weeks;
2) twelve months immediately preceding the loss (determined by the sum of the twelve months of income divided by 52); or
3) 3 months immediately preceding the loss multiplied by 4 and then divided by 52 weeks.

Average Weekly Wage will be verified by the insured person's employer and/or tax records.

Emergency Duty means the fighting of a fire or responding to any other emergency call for the Policyholder.

Injury means:

• bodily injury of an insured person which results directly and independently of all other causes from an accident which occurs while participating in a Covered Activity; and
• Post Traumatic Stress Disorder which results directly and independently of all other causes from a Traumatic Event which occurs while participating in a Covered Activity.

Loss resulting from sickness or disease or medical or surgical treatment thereof, except pus-forming infection which occurs through an accidental wound, is not considered as resulting from injury.

Medical Care means necessary:

• medical or surgical treatment, services and supplies;
• hospital, nursing and ambulance services.

Each item of Medical Care must be:

• prescribed by a legally qualified physician other than the insured person
• for the sole purpose of treating the injury.

Other Income Benefits means the amount of any benefit for loss of income provided, to the insured person or the insured person's family, as a result of the period of disability for which the insured person is claiming benefits under this plan. This includes any benefits for which the insured person or the insured person's family are eligible or that are paid to the insured person, to the insured person's family or to a third party on the insured person's behalf, pursuant to any:

(a) temporary or permanent disability benefits under a Workers' Compensation Law, occupational disease law, or from any similar law for firefighters and rescue personnel;
(b) governmental law or program that provides disability or unemployment benefits as a result of the insured person's job with any employer;
(c) plan or arrangement of coverage, whether insured or not, as a result of employment by or association with an employer or as a result of membership in or association with any group, association, union or other organization;
(d) individual insurance policy where the premium is wholly or partially paid by an employer;
(e) "no fault" automobile insurance plan;
(f) disability benefits under the United States Social Security Act, the Canada Pension Plan, the Quebec Pension Plan, or similar plan or act that the insured person, the insured person's spouse and children are eligible to receive because of the insured person's disability or because of the insured person's retirement, unless the insured person was receiving them prior to becoming disabled;
(g) disability benefits under any employer's retirement plan that is wholly or partially funded by the employer, unless:
   (a) the insured person was receiving it prior to becoming disabled; or
   (b) the insured person immediately transfers the payment to another plan qualified by the United States Internal Revenue Service for the funding of a future retirement.

Other Income Benefits will not include the portion, if any, of such retirement benefit that was funded by the insured person's after-tax contributions;
(h) any portion of a settlement or judgment, minus associated costs, of a lawsuit that represents or compensates for the insured person's loss of earnings.

Reasonable Expenses means fees and prices which do not exceed those generally charged for similar Medical Care in the local area where received by the insured person. For purposes of this insurance, we reserve the right to determine reasonable expenses. An expense is considered to be incurred on the date the Medical Care is rendered.

Total Disability means the complete and continuous inability of the insured person to:
(a) perform the essential duties of his or her regular occupation until the Weekly Benefit has been paid for 104 weeks; and thereafter,
(b) engage in any gainful occupation for which he or she is or can be reasonably fitted through training, experience, or education.

Rehabilitative Employment means employment or service which prepares a totally or partially disabled person to resume gainful work and is approved by The Hartford.

Workers' Compensation Offset: This policy has been issued at a discounted premium on the basis that the Policyholder has purchased Workers' Compensation type coverage for both paid and voluntary firefighters and rescue personnel. Therefore, this Policy will not act as a substitute for Workers' Compensation or any other similar statutory plan of compensation for paid or voluntary firefighters and rescue personnel.

If, in the state of the Policyholders' domicile:
(a) participation in the Workers' Compensation system is voluntary under the law; and
(b) the Policyholder, after electing this rider for a discounted premium, does not purchase or continue to maintain a plan of Workers' Compensation insurance, this policy will act as though the underlying Workers' Compensation insurance policy was in force. We will reduce the benefits of this policy by the statutory defined benefits as though the Policyholder had elected to subscribe to and had purchased the Workers' Compensation coverage or similar statutory plan prescribed for firefighters and rescue personnel.

Underwriting

The minimum premium for each policy written is $375. Complete the request form on this site, taking into consideration the following:

If coverage has been provided by another carrier, premium and incurred loss information for the past 3 years must accompany the Request for Insurance.

General Remarks

The policy provides ACCIDENT insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York State Insurance Department.

IMPORTANT NOTICE: THE POLICY DOES NOT PROVIDE COVERAGE FOR SICKNESS.