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Group Accidental Death and Dismemberment Insurance*
Member benefit up to $500,000
Spouse benefit 50% of Member benefit
Child benefit $10,000 for each child
- Covers Death, Dismemberment, loss of sight, speech, or hearing
- Additional features:**
- Seat Belt Benefit
- Common Carrier Benefit
- Surviving spouse Benefit for insured spouse,
- Education Benefit for insured children,
- Permanent Disability Benefit
*Underwritten by New York Life Insurance Company, 51 Madison Avenue, New York, NY 10010 Policy Form GMR-FACE-G29190
**Certain restrictions apply.
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Listed
below is all the additional information for Accidental Death
and Dismemberment Insurance. This policy can only be applied for by members. A 30 day free look provides an opportunity for return of the Certificate of Insurance and a full refund. Please note state specific applications
and other forms if applicable. To view a file you must have
Adobe Acrobat Reader installed.
AD&D Brochure
AD&D Application
If you wish to apply for this coverage, simply download
and complete the appropriate application and send it to Pediatrics
Insurance Consultants, Inc.
Puerto Rico residents should send application to:
Global Insurance Agency Inc.
P.O. Box 9023918
San Juan, Puerto Rico 00902-3918.
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