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My FamilyProtect
Program Guide
Accident, Critical Illness, Cancer,
Accidental Death & Dismemberment,
Hospital Indemnity, Funeral Expense
and Bereavement Counseling
SMARTSM Accident Plus products are underwritten by one of the following, depending on the state:
Life of the South Insurance Company, Southern Financial Life Insurance Company, Bankers Life of Louisiana, and Response Indemnity of California.
Protect What
You Love.
Accident Insurance
More than 62% of all personal bankruptcies are caused
by the cost of overwhelming medical expenses.1
Missing work due to an accident can put your family
at serious financial risk. A new study done by Harvard
University suggests that more than 62% of all personal
bankruptcies are caused by the cost of overwhelming
medical expenses.1
SMARTSM
Accident Plus allows you to select the coverage
you need, with benefit amounts in increments of $5,000
up to $15,000. You choose! We recognize that you
and your family have unique needs working within
your budget. That is why we offer this affordable
coverage in such a flexible manner.
Due to changes in medical insurance legislation, many
employers and individuals are choosing medical insurance
plans with higher deductibles and co-payments. With this
type of plan, there are major trade offs. The price you pay
for a lower premium is shouldering more of your out-of-
pocket health care costs.
With SMARTSM
Accident Plus, you can lower your out-
of-pocket medical expenses in the event of a covered
accident or critical illness.
Peace of mind is invaluable, and SMART Accident
Plus is an affordable way to protect your family.
Flexible, affordable coverage.
You choose from 3 benefit
amounts.	
The unexpected happens.
Timely coverage when you need it the most.
l Benefits paid regardless of other coverage you may have. *
l Help reduce the burden of out-of-pocket expenses associated with co-pays and other expenses not covered by your
primary medical plan.
l Reimbursement for a wide variety of costs associated with unexpected, covered accidents.
l Reduce the out-of-pocket expense of emergency room visits, ambulance costs, and major diagnostic exams.
l Additional coverage can include Critical Illness, Cancer Only Critical Illness, Accidental Death & Dismemberment, 		
Hospitalization, and Funeral & Bereavement Insurance.
Recommended Additional
Protection
* Current or future Medicaid Eligibility may affect benefits provided by the policy.
Accident	
  Benefits	
  
Benefit	
  Amounts	
  
(Each	
  Calendar	
  Year)	
  
Three	
  Op8ons:	
  $5,000,	
  $10,000	
  or	
  $15,000	
  
Covered	
  Expenses	
   Ambulance	
  benefits,	
  emergency	
  care,	
  in-­‐pa8ent	
  hospital	
  and	
  follow-­‐up	
  care.	
  
Also	
  covers	
  drug	
  benefit	
  costs	
  while	
  in	
  a	
  facility,	
  fracture	
  benefits,	
  major	
  
diagnos8c	
  exams,	
  x-­‐ray	
  benefits,	
  physical	
  therapy	
  and	
  prosthe8c	
  devices.	
  	
  
Family	
  Coverage	
  Op:ons	
   Spouse	
  and/or	
  children	
  may	
  be	
  included	
  in	
  the	
  policy.	
  
How	
  to	
  Qualify	
  for	
  Policy	
   Age	
  64	
  and	
  under.	
  Driving	
  record	
  may	
  be	
  reviewed.	
  
Brief	
  Medical	
  Ques8onnaire.	
  	
  
Coordina:on	
  of	
  Benefits	
   This	
  plan	
  does	
  not	
  coordinate	
  with	
  other	
  health	
  insurance	
  coverage.	
  Benefits	
  
are	
  paid	
  in	
  addi8on	
  to	
  those	
  received	
  from	
  other	
  insurance	
  policies.*	
  
Deduc:ble	
  
(Amount	
  of	
  covered	
  medical	
  costs	
  
you	
  are	
  responsible	
  for	
  paying)	
  
Five	
  op8ons:	
  $0,	
  $250,	
  $500,	
  $750	
  or	
  $1,000	
  Calendar	
  Year	
  Deduc8ble	
  
*Current or future Medicaid Eligibility may affect benefits provided by the policy.
Accident	
  Benefits	
  
Benefit	
  Amounts	
  
(Each	
  Calendar	
  Year)	
  
Three	
  Op8ons:	
  $5,000,	
  $10,000	
  or	
  $15,000
Covered	
  Expenses	
   Ambulance	
  benefits,	
  emergency	
  care,	
  in-­‐pa8ent	
  hospital	
  and	
  follow-­‐up	
  care.	
  
Also	
  covers	
  drug	
  benefit	
  costs	
  while	
  in	
  a	
  facility,	
  fracture	
  benefits,	
  major	
  
diagnos8c	
  exams,	
  x-­‐ray	
  benefits,	
  physical	
  therapy	
  and	
  prosthe8c	
  devices.	
  	
  
Family	
  Coverage Op:ons	
   Spouse	
  and/or	
  children	
  may	
  be	
  included	
  in	
  the	
  policy.	
  
How	
  to	
  Qualify	
  for	
  Policy	
   Age	
  64	
  and	
  under.	
  Driving	
  record	
  may	
  be	
  reviewed.	
  
Brief	
  Medical	
  Ques8onnaire.	
  	
  
Coordina:on	
  of	
  Benefits	
   This	
  plan	
  does	
  not	
  coordinate	
  with	
  other	
  health	
  insurance	
  coverage.	
  Benefits	
  
are	
  paid	
  in	
  addi8on	
  to	
  those	
  received	
  from	
  other	
  insurance	
  policies.*	
  
Deduc:ble	
  
(Amount	
  of	
  covered	
  medical	
  costs	
  
you	
  are	
  responsible	
  for	
  paying)	
  
Five	
  op8ons:	
  $0, $250,	
  $500,	
  $750	
  or	
  $1,000	
  Calendar	
  Year	
  Deduc8ble	
  
Critical Illness & Cancer
l Every year, about 785,000 Americans have a first coronary attack. Another 470,000 who have already had one or 		
more coronary attacks have another attack. 2
l Stroke is a leading cause of death in the United States. Over 800,000 people die in the U.S each year from 			
cardiovascular disease and strokes. 2
l Compared to the general population, bankruptcy rates are nearly twice as high among cancer patients one year 		
after diagnosis. 4
If you were to suffer from a heart attack, stroke,
or be diagnosed with cancer, would your family be
able to handle the financial burden?
Optional Coverage
**Invasive cancer, or cancer that requires an invasive surgery.
**
Cri$cal	
  Illness	
  
Covered	
  Cri)cal	
  Illness	
  	
   Heart	
  A0ack,	
  Stroke,	
  Invasive	
  Cancer	
  
Benefit	
  Amounts	
  
(Benefits	
  are	
  Payable	
  per	
  Life$me	
  
per	
  Insured)	
  
Five	
  Op$ons:	
  $5,000,	
  $10,000,	
  $15,000,	
  $20,000	
  or	
  $25,000	
  
Family	
  Coverage	
  Op)ons	
   Spouse	
  and/or	
  children	
  may	
  be	
  included	
  in	
  the	
  policy.	
  
How	
  to	
  Qualify	
  for	
  Policy	
   Brief	
  Medical	
  Ques$onnaire.	
  
Coordina)on	
  of	
  Benefits	
   This	
  plan	
  does	
  not	
  coordinate	
  with	
  other	
  health	
  insurance	
  coverage.	
  Benefits	
  
are	
  paid	
  in	
  addi$on	
  to	
  those	
  received	
  from	
  other	
  insurance	
  policies.*	
  
Deduc)ble	
   No	
  deduc$ble.	
  Receive	
  a	
  lump	
  sum	
  if	
  you	
  are	
  diagnosed	
  with	
  a	
  covered	
  cri$cal	
  
illness.	
  
* Current or future Medicaid Eligibility may affect benefits provided by the policy.
Recovery after a critical illness can be a long road.
Coverage gives you peace of mind, reducing your
burden so you can focus on what’s important.
Cancer is one of the most financially devastating diseases.
The American Cancer Society estimates that the 2010
total cost of cancer in the U.S. rose to $263.8 billion.3
A new study by the Fred Hutchinson Cancer Research
Center shows a close link between cancer diagnosis and
personal bankruptcy.4 Compared to the general
population, bankruptcy rates are nearly twice as high
among cancer patients one year after diagnosis.4
Of the bankruptcies caused by a cancer, a surprising 78%
reported having some form of health insurance. This
disproves the myth that medical bills only really affect
the uninsured.4
According to Duke University Medical Center, the average
out-of-pocket cost for cancer patients is currently $1,266
per month. Medical bills for these patients can quickly
wipe out retirement accounts, college savings funds,
and home equity.5
Cancer Only Critical Illness is an affordable addition
to your policy that can give you the financial help you
need to reduce your burden and focus on what’s
important - getting healthy for your family.
Recommended Additional
Protection
Cri$cal	
  Illness	
  –	
  Cancer	
  Only	
  
Covered	
  Cri)cal	
  Illness	
  	
   Invasive	
  Cancer	
  
Benefit	
  Amounts	
   Five	
  Op$ons:	
  $5000,	
  $10,000,	
  $15,000,	
  $20,000	
  or	
  $25,000	
  
Family	
  Coverage	
  Op)ons	
   Spouse	
  and/or	
  children	
  may	
  be	
  included	
  in	
  the	
  policy.	
  
How	
  to	
  Qualify	
  for	
  Policy	
   Brief	
  Medical	
  Ques$onnaire.	
  
Coordina)on	
  of	
  Benefits	
   This	
  plan	
  does	
  not	
  coordinate	
  with	
  other	
  health	
  insurance	
  coverage.	
  Benefits	
  
are	
  paid	
  in	
  addi$on	
  to	
  those	
  received	
  from	
  other	
  insurance	
  policies.	
  *	
  
Deduc)ble	
   No	
  deduc$ble.	
  Receive	
  a	
  lump	
  sum	
  if	
  you	
  are	
  diagnosed	
  with	
  a	
  covered	
  
invasive	
  cancer.	
  	
  
* Current or future Medicaid Eligibility may affect benefits provided by the policy.
Accidental Death
& Dismemberment
Comprehensive Accidental Death and Dismemberment (AD&D) Coverage.
No one likes to think about the worst, but this affordable coverage is an intelligent way for you and your family to be ready
for the unexpected. This coverage makes an excellent supplement to traditional life insurance and can help bridge the gap
between expenses and lost income. If you were involved in an accident that left you unable to provide for your
family, AD&D provides a lump sum benefit due to various types of bodily injuries or loss of life.
Accidental	
  Death	
  &	
  Dismemberment	
  Coverage	
  
Accidental	
  Death
&	
  Dismemberment	
  Benefit	
  Amount	
  
Minimum	
  $25,000	
  to	
  maximum	
  $100,000.	
  Available	
  in	
  increments	
  of	
  $25,000.	
  
Accidental	
  Death	
  Benefit	
  	
  
for	
  Loss	
  of	
  Life	
  
Pays	
  100%	
  of	
  the	
  Accidental	
  Death	
  &	
  Dismemberment	
  Benefit	
  Amount	
  for	
  accidental	
  
death	
  occurring	
  in	
  Policy	
  Month	
  7	
  or	
  later.	
  No	
  benefit	
  for	
  Accidental	
  Death	
  occurring	
  
in	
  Policy	
  Month	
  1	
  through	
  6.	
  	
  
Accidental	
  Dismemberment	
  Benefit	
  
due	
  to	
  dismemberment.	
  	
  
• Pays	
  100%	
  of	
  the	
  Accidental	
  Death	
  &	
  Dismemberment	
  Amount	
  for	
  accidental
dismemberment	
  occurring	
  in	
  Policy	
  Month	
  7	
  or	
  later.	
  No	
  benefit	
  for	
  accidental
dismemberment	
  occurring	
  in	
  Policy	
  Month	
  1	
  through	
  6.
• Both	
  Hands	
  or	
  Both	
  Feet
• Sight	
  in	
  Both	
  Eyes
• One	
  Hand	
  and	
  One	
  Foot
• One	
  Hand	
  and	
  the	
  Sight	
  in	
  One	
  Eye
• One	
  Foot	
  and	
  the	
  Sight	
  of	
  One	
  Eye
Pays	
  50%	
  of	
  the	
  Accidental	
  Death	
  Benefit	
  for	
  the	
  loss	
  of:	
  	
  
• One	
  Hand	
  or	
  One	
  Foot
• The	
  Sight	
  of	
  One	
  Eye
Primary	
  and	
  Spouse,	
  18-­‐64	
  |	
  Children,	
  0-­‐17	
  
Premium	
  Rate	
  Bands	
   Ages:	
  18-­‐24	
  |	
  25-­‐39	
  |	
  40-­‐54	
  |	
  55-­‐64	
  
Renewability	
  	
   Guaranteed	
  Renewable	
  to	
  age	
  65	
  
Benefit	
  Payment	
  Condi@ons	
  	
   Will	
  pay	
  the	
  applicable	
  benefit	
  amount	
  if	
  the	
  insured’s	
  loss	
  occurs	
  within	
  90	
  days	
  of	
  
the	
  date	
  of	
  the	
  accidental	
  injury	
  that	
  causes	
  the	
  loss.	
  
If	
  more	
  than	
  one	
  loss	
  is	
  sustained	
  by	
  an	
  insured	
  person	
  as	
  a	
  result	
  of	
  the	
  same	
  
accident,	
  only	
  one	
  amount,	
  the	
  largest,	
  will	
  be	
  paid.	
  	
  
Common	
  Carrier	
  Benefit	
  	
   If	
  riding	
  as	
  a	
  fare-­‐paying	
  passenger	
  in	
  or	
  on	
  a	
  licensed	
  public	
  conveyance	
  operated	
  by	
  
a	
  common	
  carrier	
  for	
  the	
  regular	
  transport	
  of	
  passengers,	
  the	
  benefit	
  amount	
  will	
  be	
  
doubled.	
  	
  
Funeral Expense and
Bereavement Counseling
Funeral Expense and Bereavement Coverage
The loss of a loved one because of an accident can be the hardest thing anyone ever has to endure. Along with the emotional
burden,funeralexpensescanadduptothousandsof dollars. Paymentforfinal expensestendstobedueimmediately-
adding more stress to your loved ones in an already difficult situation. Funeral Expense and Bereavement Counseling
provides up to $2,000 to cover funeral expenses and compassionate counseling for your grieving family.
Additional Accident Insurance
Information
Hospital Indemnity
Hospital Indemnity
Hospital expenses add up. If you suffer an accidental injury that requires you to be confined to a hospital as an inpatient,
the Hospital Indemnity Benefit will provide you and your family with needed coverage to ease the financial burden.
Hospital	
  Indemnity	
  
Benefit	
  Amounts	
   Two	
  Op3ons:	
  $100	
  or	
  $250	
  per	
  day	
  
Maximum	
  Benefits	
   Coverage	
  up	
  to	
  90	
  days	
  
Family	
  Coverage	
  Op9ons	
   Spouse	
  and/or	
  children	
  may	
  be	
  included	
  in	
  the	
  policy.	
  
How	
  to	
  Qualify	
  for	
  Policy	
   Brief	
  Medical	
  Ques3onnaire.	
  	
  	
  
Coordina9on	
  of	
  Benefits	
   This	
  plan	
  does	
  not	
  coordinate	
  with	
  other	
  health	
  insurance	
  coverage.	
  Benefits	
  
are	
  paid	
  in	
  addi3on	
  to	
  those	
  received	
  from	
  other	
  insurance	
  policies.*	
  
* Current or future Medicaid Eligibility may affect benefits provided by the policy.
Funeral	
  Expense	
  and	
  Bereavement	
  Counseling	
  
Benefit	
  Amounts	
   $2,000	
  
Maximum	
  Benefits	
   Up	
  to	
  $250	
  for	
  family	
  members	
  listed	
  on	
  the	
  policy.	
  	
  
Hospital	
  Indemnity	
  
Benefit	
  Amounts	
   Two	
  Op3ons:	
  $100	
  or	
  $250	
  per	
  day
Maximum	
  Benefits Coverage	
  up	
  to	
  90	
  days	
  
Family	
  Coverage Op9ons	
   Spouse	
  and/or	
  children	
  may	
  be	
  included	
  in	
  the	
  policy.	
  
How	
  to	
  Qualify	
  for	
  Policy	
   Brief	
  Medical	
  Ques3onnaire.	
  	
  	
  
Coordina9on	
  of	
  Benefits	
   This	
  plan	
  does	
  not	
  coordinate	
  with	
  other	
  health	
  insurance	
  coverage.	
  Benefits	
  
are	
  paid	
  in	
  addi3on	
  to	
  those	
  received	
  from	
  other	
  insurance	
  policies.*	
  
1. “Medical Bankruptcy in the United States, 2007: Results of a National Study by Elizabeth Warren of Harvard Law School,” The American Journal of Medicine, August 2009
2. Center for Disease Control and Prevention
3. The American Cancer Society
4. Fred Hutchinson Cancer Research Center
5. Duke University Medical Center
SMARTSM
Accident Plus.
Affordable peace of mind you and your family deserve.
We hope you found this Program Guide useful. We
understand that the benefits offered in this program are
ones you or your loved ones hope you will never need.
With this accident insurance you can have the peace of
mind that we can be there in your time of need to use. No
one likes to think about the worst, but it is important to
plan for the unexpected.
We have thoughtfully put together this package in order to
provide you with options for affordable, flexible
coverage that fits the unique needs of your family. We
understand that not every family is the same and
coverage of this nature is not one-size-fits-all. That’s why
the accident plan can be purchased alone, or with
additional, optional coverages as outlined in this guide. If
in the process of reviewing this Program Guide you need
clarity on any of the information you can reach our
licensed agents, not telemarketers, for a respectful
consultation.
Our brand promise is to ensure you and your family have
peace of mind - there is help when they need it most. Our
claims process is easy and hassle-free, and we are there to
help you receive your benefits when you need them. We
recognize that our promise does not end with your
enrollment into SMARTSM
Accident Plus. Our promise
is that you have affordable peace of mind and coverage
when you need it the most.
SMARTSM
Accident Plus
References
Renewability
Coverage can be continued for each insured person until the policy anniversary on or following the insured person’s 65th birthday, subject
to the policy’s termination and insured child provisions, by paying all premiums when they are due. We will not add any restrictive riders or
endorsements while this policy is in force. We reserve the right to change the premium charged for this policy. Any change in premium will be
made on a class basis only, as we determine, and will be based on the insured person’s age on the effective date. No change in premium will
become effective until 45 days after we deliver to you, or mail to your last known address, a written notice of premium change. Premiums may
not be changed more often than once every 12 months.
Exclusions
Accident Coverage and Accidental Death & Dismemberment Coverage No benefits will be paid under this policy if covered services provided
are not related to a covered accident or any loss caused in whole or in part by, or resulting in whole or in part from the following:
l Any illness, loss or condition specifically excluded from the definition of any Accident.
l The Insured Person’s suicide or attempt at suicide, or intentional self-inflicted injury, or any attempt at intentional self-inflicted injury while 		
sane or insane;
l The Insured Person being under the influence of a stimulant (such as – amphetamines or nitrates), depressant, hallucinogen, narcotics; or 		
any other drug intoxicant including those prescribed by a Physician that are misused by the Insured Person;
l The Insured Person’s Commission of or attempt to commit an assault or felony;
l The Insured Person Engaging in an illegal activity or occupation;
l The Insured Person’s Voluntary participation in any riot or civil insurrection;
l The Insured Person’s participation in declared or undeclared war, or any act of declared or undeclared war;
l The Insured Person Operating, learning to operate, serving as a crew member of, or jumping, parachuting, or falling from an aircraft or hot 		
air balloon, including those which are not motor driven;
l The Insured Person Engaging in hang gliding, bungee jumping, parachuting, sail gliding, parasailing, or para kiting or any similar activity;
l The Insured Person Riding in or driving any motor vehicle in a race, stunt show or speed test;
l The Insured Person Practicing for or participating in any semi-professional or professional competitive athletic contest for which such 		
Insured Person receives any compensation or remuneration;
l The Insured Person Operating any type of land, water, or air vehicle while having a blood alcohol content at or above the level made illegal 		
for operation of such vehicle by the jurisdiction where the Accidental Injury occurred.
Critical Illness
PREEXISTING CONDITION LIMITATION We will pay NO benefits for critical Illness that are caused by a Preexisting Condition unless the critical
illness commences after this Rider has been in force for 12 months from the Effective Date or most recent reinstatement date. We will not
use the existence of a Preexisting Condition to deny benefits after this Rider has been in force for a period of 12 months following the date of
application for this Rider.
For any Insured Person:
(a) We will pay NO benefits for any critical illness that is Incurred or Manifests, whichever is applicable, and/or Diagnosed before the first 30 days
after the date coverage on the Insured Person becomes effective under this Policy. However, an Insured Child born after the Effective Date of this
Policy or any subsequent reinstatement will be covered from birth for the Critical Illnesses stated in the Policy Schedule.
(b) We will pay NO benefits for any Critical Illness or any loss caused in whole or in part by, or resulting in whole or in part from:
(i) any illness, loss, or condition specifically excluded from the definition of any Critical Illness; or
(ii) balloon angioplasty, laser relief of an obstruction, and/or other intra-arterial procedure
Critical Illness - Cancer Only
PREEXISTING CONDITION LIMITATION We will pay NO benefits for critical Illness that are caused by a Preexisting Condition unless the critical
illness commences after this Rider has been in force for 12 months from the Effective Date or most recent reinstatement date. We will not
use the existence of a Preexisting Condition to deny benefits after this Rider has been in force for a period of 12 months following the date of
application for this Rider.
For any Insured Person:
(a) We will pay NO benefits for any Critical Illness that is Incurred or Manifests, whichever is applicable, and/or diagnosed before the first 30
days after the date coverage on the Insured Person becomes effective under this Policy. However, an Insured Child born after the Effective Date
of this Policy or any subsequent reinstatement will be covered from birth for the Critical Illnesses stated in the Policy Schedule.
(b) We will pay NO benefits for any Critical Illness or any loss caused in whole or in part by, or resulting in whole or in part from any illness, loss,
or condition specifically excluded from the definition of any Critical Illness.
This Program Guide is intended to be used as a guide only and the content, or any written or oral statement contradicting, modifying, explaining
or clarifying any provision of the information contained herein, is not intended to create, or shall create, any express or implied contractual
obligations that are binding upon any party. This guide is intended to provide information about available policies and benefits that may or may not
be available in all states. The information contained herein is subject to change without notice. Information contained herein is not meant as, nor
should it take the place of, legal advice. This brochure is a summary only. Other terms, conditions, limitations or exclusions may apply.
Administrative Offices: InsuranceTPA.com, 462 Midland Road, Suite 100, Janesville, Wisconsin 53546.
© 2015 Life of the South and the Life of the South logo are trademarks of Life of the South Insurance Company. SMART Accident Plus and its logo are
service marks of SASid, Inc. All rights reserved worldwide.

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SMART-Accident-Program

  • 1. My FamilyProtect Program Guide Accident, Critical Illness, Cancer, Accidental Death & Dismemberment, Hospital Indemnity, Funeral Expense and Bereavement Counseling SMARTSM Accident Plus products are underwritten by one of the following, depending on the state: Life of the South Insurance Company, Southern Financial Life Insurance Company, Bankers Life of Louisiana, and Response Indemnity of California.
  • 2. Protect What You Love. Accident Insurance More than 62% of all personal bankruptcies are caused by the cost of overwhelming medical expenses.1 Missing work due to an accident can put your family at serious financial risk. A new study done by Harvard University suggests that more than 62% of all personal bankruptcies are caused by the cost of overwhelming medical expenses.1 SMARTSM Accident Plus allows you to select the coverage you need, with benefit amounts in increments of $5,000 up to $15,000. You choose! We recognize that you and your family have unique needs working within your budget. That is why we offer this affordable coverage in such a flexible manner. Due to changes in medical insurance legislation, many employers and individuals are choosing medical insurance plans with higher deductibles and co-payments. With this type of plan, there are major trade offs. The price you pay for a lower premium is shouldering more of your out-of- pocket health care costs. With SMARTSM Accident Plus, you can lower your out- of-pocket medical expenses in the event of a covered accident or critical illness. Peace of mind is invaluable, and SMART Accident Plus is an affordable way to protect your family.
  • 3. Flexible, affordable coverage. You choose from 3 benefit amounts. The unexpected happens. Timely coverage when you need it the most. l Benefits paid regardless of other coverage you may have. * l Help reduce the burden of out-of-pocket expenses associated with co-pays and other expenses not covered by your primary medical plan. l Reimbursement for a wide variety of costs associated with unexpected, covered accidents. l Reduce the out-of-pocket expense of emergency room visits, ambulance costs, and major diagnostic exams. l Additional coverage can include Critical Illness, Cancer Only Critical Illness, Accidental Death & Dismemberment, Hospitalization, and Funeral & Bereavement Insurance. Recommended Additional Protection * Current or future Medicaid Eligibility may affect benefits provided by the policy. Accident  Benefits   Benefit  Amounts   (Each  Calendar  Year)   Three  Op8ons:  $5,000,  $10,000  or  $15,000   Covered  Expenses   Ambulance  benefits,  emergency  care,  in-­‐pa8ent  hospital  and  follow-­‐up  care.   Also  covers  drug  benefit  costs  while  in  a  facility,  fracture  benefits,  major   diagnos8c  exams,  x-­‐ray  benefits,  physical  therapy  and  prosthe8c  devices.     Family  Coverage  Op:ons   Spouse  and/or  children  may  be  included  in  the  policy.   How  to  Qualify  for  Policy   Age  64  and  under.  Driving  record  may  be  reviewed.   Brief  Medical  Ques8onnaire.     Coordina:on  of  Benefits   This  plan  does  not  coordinate  with  other  health  insurance  coverage.  Benefits   are  paid  in  addi8on  to  those  received  from  other  insurance  policies.*   Deduc:ble   (Amount  of  covered  medical  costs   you  are  responsible  for  paying)   Five  op8ons:  $0,  $250,  $500,  $750  or  $1,000  Calendar  Year  Deduc8ble   *Current or future Medicaid Eligibility may affect benefits provided by the policy. Accident  Benefits   Benefit  Amounts   (Each  Calendar  Year)   Three  Op8ons:  $5,000,  $10,000  or  $15,000 Covered  Expenses   Ambulance  benefits,  emergency  care,  in-­‐pa8ent  hospital  and  follow-­‐up  care.   Also  covers  drug  benefit  costs  while  in  a  facility,  fracture  benefits,  major   diagnos8c  exams,  x-­‐ray  benefits,  physical  therapy  and  prosthe8c  devices.     Family  Coverage Op:ons   Spouse  and/or  children  may  be  included  in  the  policy.   How  to  Qualify  for  Policy   Age  64  and  under.  Driving  record  may  be  reviewed.   Brief  Medical  Ques8onnaire.     Coordina:on  of  Benefits   This  plan  does  not  coordinate  with  other  health  insurance  coverage.  Benefits   are  paid  in  addi8on  to  those  received  from  other  insurance  policies.*   Deduc:ble   (Amount  of  covered  medical  costs   you  are  responsible  for  paying)   Five  op8ons:  $0, $250,  $500,  $750  or  $1,000  Calendar  Year  Deduc8ble  
  • 4. Critical Illness & Cancer l Every year, about 785,000 Americans have a first coronary attack. Another 470,000 who have already had one or more coronary attacks have another attack. 2 l Stroke is a leading cause of death in the United States. Over 800,000 people die in the U.S each year from cardiovascular disease and strokes. 2 l Compared to the general population, bankruptcy rates are nearly twice as high among cancer patients one year after diagnosis. 4 If you were to suffer from a heart attack, stroke, or be diagnosed with cancer, would your family be able to handle the financial burden? Optional Coverage **Invasive cancer, or cancer that requires an invasive surgery. ** Cri$cal  Illness   Covered  Cri)cal  Illness     Heart  A0ack,  Stroke,  Invasive  Cancer   Benefit  Amounts   (Benefits  are  Payable  per  Life$me   per  Insured)   Five  Op$ons:  $5,000,  $10,000,  $15,000,  $20,000  or  $25,000   Family  Coverage  Op)ons   Spouse  and/or  children  may  be  included  in  the  policy.   How  to  Qualify  for  Policy   Brief  Medical  Ques$onnaire.   Coordina)on  of  Benefits   This  plan  does  not  coordinate  with  other  health  insurance  coverage.  Benefits   are  paid  in  addi$on  to  those  received  from  other  insurance  policies.*   Deduc)ble   No  deduc$ble.  Receive  a  lump  sum  if  you  are  diagnosed  with  a  covered  cri$cal   illness.   * Current or future Medicaid Eligibility may affect benefits provided by the policy.
  • 5. Recovery after a critical illness can be a long road. Coverage gives you peace of mind, reducing your burden so you can focus on what’s important. Cancer is one of the most financially devastating diseases. The American Cancer Society estimates that the 2010 total cost of cancer in the U.S. rose to $263.8 billion.3 A new study by the Fred Hutchinson Cancer Research Center shows a close link between cancer diagnosis and personal bankruptcy.4 Compared to the general population, bankruptcy rates are nearly twice as high among cancer patients one year after diagnosis.4 Of the bankruptcies caused by a cancer, a surprising 78% reported having some form of health insurance. This disproves the myth that medical bills only really affect the uninsured.4 According to Duke University Medical Center, the average out-of-pocket cost for cancer patients is currently $1,266 per month. Medical bills for these patients can quickly wipe out retirement accounts, college savings funds, and home equity.5 Cancer Only Critical Illness is an affordable addition to your policy that can give you the financial help you need to reduce your burden and focus on what’s important - getting healthy for your family. Recommended Additional Protection Cri$cal  Illness  –  Cancer  Only   Covered  Cri)cal  Illness     Invasive  Cancer   Benefit  Amounts   Five  Op$ons:  $5000,  $10,000,  $15,000,  $20,000  or  $25,000   Family  Coverage  Op)ons   Spouse  and/or  children  may  be  included  in  the  policy.   How  to  Qualify  for  Policy   Brief  Medical  Ques$onnaire.   Coordina)on  of  Benefits   This  plan  does  not  coordinate  with  other  health  insurance  coverage.  Benefits   are  paid  in  addi$on  to  those  received  from  other  insurance  policies.  *   Deduc)ble   No  deduc$ble.  Receive  a  lump  sum  if  you  are  diagnosed  with  a  covered   invasive  cancer.     * Current or future Medicaid Eligibility may affect benefits provided by the policy.
  • 6. Accidental Death & Dismemberment Comprehensive Accidental Death and Dismemberment (AD&D) Coverage. No one likes to think about the worst, but this affordable coverage is an intelligent way for you and your family to be ready for the unexpected. This coverage makes an excellent supplement to traditional life insurance and can help bridge the gap between expenses and lost income. If you were involved in an accident that left you unable to provide for your family, AD&D provides a lump sum benefit due to various types of bodily injuries or loss of life. Accidental  Death  &  Dismemberment  Coverage   Accidental  Death &  Dismemberment  Benefit  Amount   Minimum  $25,000  to  maximum  $100,000.  Available  in  increments  of  $25,000.   Accidental  Death  Benefit     for  Loss  of  Life   Pays  100%  of  the  Accidental  Death  &  Dismemberment  Benefit  Amount  for  accidental   death  occurring  in  Policy  Month  7  or  later.  No  benefit  for  Accidental  Death  occurring   in  Policy  Month  1  through  6.     Accidental  Dismemberment  Benefit   due  to  dismemberment.     • Pays  100%  of  the  Accidental  Death  &  Dismemberment  Amount  for  accidental dismemberment  occurring  in  Policy  Month  7  or  later.  No  benefit  for  accidental dismemberment  occurring  in  Policy  Month  1  through  6. • Both  Hands  or  Both  Feet • Sight  in  Both  Eyes • One  Hand  and  One  Foot • One  Hand  and  the  Sight  in  One  Eye • One  Foot  and  the  Sight  of  One  Eye Pays  50%  of  the  Accidental  Death  Benefit  for  the  loss  of:     • One  Hand  or  One  Foot • The  Sight  of  One  Eye Primary  and  Spouse,  18-­‐64  |  Children,  0-­‐17   Premium  Rate  Bands   Ages:  18-­‐24  |  25-­‐39  |  40-­‐54  |  55-­‐64   Renewability     Guaranteed  Renewable  to  age  65   Benefit  Payment  Condi@ons     Will  pay  the  applicable  benefit  amount  if  the  insured’s  loss  occurs  within  90  days  of   the  date  of  the  accidental  injury  that  causes  the  loss.   If  more  than  one  loss  is  sustained  by  an  insured  person  as  a  result  of  the  same   accident,  only  one  amount,  the  largest,  will  be  paid.     Common  Carrier  Benefit     If  riding  as  a  fare-­‐paying  passenger  in  or  on  a  licensed  public  conveyance  operated  by   a  common  carrier  for  the  regular  transport  of  passengers,  the  benefit  amount  will  be   doubled.    
  • 7. Funeral Expense and Bereavement Counseling Funeral Expense and Bereavement Coverage The loss of a loved one because of an accident can be the hardest thing anyone ever has to endure. Along with the emotional burden,funeralexpensescanadduptothousandsof dollars. Paymentforfinal expensestendstobedueimmediately- adding more stress to your loved ones in an already difficult situation. Funeral Expense and Bereavement Counseling provides up to $2,000 to cover funeral expenses and compassionate counseling for your grieving family. Additional Accident Insurance Information Hospital Indemnity Hospital Indemnity Hospital expenses add up. If you suffer an accidental injury that requires you to be confined to a hospital as an inpatient, the Hospital Indemnity Benefit will provide you and your family with needed coverage to ease the financial burden. Hospital  Indemnity   Benefit  Amounts   Two  Op3ons:  $100  or  $250  per  day   Maximum  Benefits   Coverage  up  to  90  days   Family  Coverage  Op9ons   Spouse  and/or  children  may  be  included  in  the  policy.   How  to  Qualify  for  Policy   Brief  Medical  Ques3onnaire.       Coordina9on  of  Benefits   This  plan  does  not  coordinate  with  other  health  insurance  coverage.  Benefits   are  paid  in  addi3on  to  those  received  from  other  insurance  policies.*   * Current or future Medicaid Eligibility may affect benefits provided by the policy. Funeral  Expense  and  Bereavement  Counseling   Benefit  Amounts   $2,000   Maximum  Benefits   Up  to  $250  for  family  members  listed  on  the  policy.     Hospital  Indemnity   Benefit  Amounts   Two  Op3ons:  $100  or  $250  per  day Maximum  Benefits Coverage  up  to  90  days   Family  Coverage Op9ons   Spouse  and/or  children  may  be  included  in  the  policy.   How  to  Qualify  for  Policy   Brief  Medical  Ques3onnaire.       Coordina9on  of  Benefits   This  plan  does  not  coordinate  with  other  health  insurance  coverage.  Benefits   are  paid  in  addi3on  to  those  received  from  other  insurance  policies.*  
  • 8. 1. “Medical Bankruptcy in the United States, 2007: Results of a National Study by Elizabeth Warren of Harvard Law School,” The American Journal of Medicine, August 2009 2. Center for Disease Control and Prevention 3. The American Cancer Society 4. Fred Hutchinson Cancer Research Center 5. Duke University Medical Center SMARTSM Accident Plus. Affordable peace of mind you and your family deserve. We hope you found this Program Guide useful. We understand that the benefits offered in this program are ones you or your loved ones hope you will never need. With this accident insurance you can have the peace of mind that we can be there in your time of need to use. No one likes to think about the worst, but it is important to plan for the unexpected. We have thoughtfully put together this package in order to provide you with options for affordable, flexible coverage that fits the unique needs of your family. We understand that not every family is the same and coverage of this nature is not one-size-fits-all. That’s why the accident plan can be purchased alone, or with additional, optional coverages as outlined in this guide. If in the process of reviewing this Program Guide you need clarity on any of the information you can reach our licensed agents, not telemarketers, for a respectful consultation. Our brand promise is to ensure you and your family have peace of mind - there is help when they need it most. Our claims process is easy and hassle-free, and we are there to help you receive your benefits when you need them. We recognize that our promise does not end with your enrollment into SMARTSM Accident Plus. Our promise is that you have affordable peace of mind and coverage when you need it the most. SMARTSM Accident Plus References
  • 9. Renewability Coverage can be continued for each insured person until the policy anniversary on or following the insured person’s 65th birthday, subject to the policy’s termination and insured child provisions, by paying all premiums when they are due. We will not add any restrictive riders or endorsements while this policy is in force. We reserve the right to change the premium charged for this policy. Any change in premium will be made on a class basis only, as we determine, and will be based on the insured person’s age on the effective date. No change in premium will become effective until 45 days after we deliver to you, or mail to your last known address, a written notice of premium change. Premiums may not be changed more often than once every 12 months. Exclusions Accident Coverage and Accidental Death & Dismemberment Coverage No benefits will be paid under this policy if covered services provided are not related to a covered accident or any loss caused in whole or in part by, or resulting in whole or in part from the following: l Any illness, loss or condition specifically excluded from the definition of any Accident. l The Insured Person’s suicide or attempt at suicide, or intentional self-inflicted injury, or any attempt at intentional self-inflicted injury while sane or insane; l The Insured Person being under the influence of a stimulant (such as – amphetamines or nitrates), depressant, hallucinogen, narcotics; or any other drug intoxicant including those prescribed by a Physician that are misused by the Insured Person; l The Insured Person’s Commission of or attempt to commit an assault or felony; l The Insured Person Engaging in an illegal activity or occupation; l The Insured Person’s Voluntary participation in any riot or civil insurrection; l The Insured Person’s participation in declared or undeclared war, or any act of declared or undeclared war; l The Insured Person Operating, learning to operate, serving as a crew member of, or jumping, parachuting, or falling from an aircraft or hot air balloon, including those which are not motor driven; l The Insured Person Engaging in hang gliding, bungee jumping, parachuting, sail gliding, parasailing, or para kiting or any similar activity; l The Insured Person Riding in or driving any motor vehicle in a race, stunt show or speed test; l The Insured Person Practicing for or participating in any semi-professional or professional competitive athletic contest for which such Insured Person receives any compensation or remuneration; l The Insured Person Operating any type of land, water, or air vehicle while having a blood alcohol content at or above the level made illegal for operation of such vehicle by the jurisdiction where the Accidental Injury occurred. Critical Illness PREEXISTING CONDITION LIMITATION We will pay NO benefits for critical Illness that are caused by a Preexisting Condition unless the critical illness commences after this Rider has been in force for 12 months from the Effective Date or most recent reinstatement date. We will not use the existence of a Preexisting Condition to deny benefits after this Rider has been in force for a period of 12 months following the date of application for this Rider. For any Insured Person: (a) We will pay NO benefits for any critical illness that is Incurred or Manifests, whichever is applicable, and/or Diagnosed before the first 30 days after the date coverage on the Insured Person becomes effective under this Policy. However, an Insured Child born after the Effective Date of this Policy or any subsequent reinstatement will be covered from birth for the Critical Illnesses stated in the Policy Schedule. (b) We will pay NO benefits for any Critical Illness or any loss caused in whole or in part by, or resulting in whole or in part from: (i) any illness, loss, or condition specifically excluded from the definition of any Critical Illness; or (ii) balloon angioplasty, laser relief of an obstruction, and/or other intra-arterial procedure Critical Illness - Cancer Only PREEXISTING CONDITION LIMITATION We will pay NO benefits for critical Illness that are caused by a Preexisting Condition unless the critical illness commences after this Rider has been in force for 12 months from the Effective Date or most recent reinstatement date. We will not use the existence of a Preexisting Condition to deny benefits after this Rider has been in force for a period of 12 months following the date of application for this Rider. For any Insured Person: (a) We will pay NO benefits for any Critical Illness that is Incurred or Manifests, whichever is applicable, and/or diagnosed before the first 30 days after the date coverage on the Insured Person becomes effective under this Policy. However, an Insured Child born after the Effective Date of this Policy or any subsequent reinstatement will be covered from birth for the Critical Illnesses stated in the Policy Schedule. (b) We will pay NO benefits for any Critical Illness or any loss caused in whole or in part by, or resulting in whole or in part from any illness, loss, or condition specifically excluded from the definition of any Critical Illness.
  • 10. This Program Guide is intended to be used as a guide only and the content, or any written or oral statement contradicting, modifying, explaining or clarifying any provision of the information contained herein, is not intended to create, or shall create, any express or implied contractual obligations that are binding upon any party. This guide is intended to provide information about available policies and benefits that may or may not be available in all states. The information contained herein is subject to change without notice. Information contained herein is not meant as, nor should it take the place of, legal advice. This brochure is a summary only. Other terms, conditions, limitations or exclusions may apply. Administrative Offices: InsuranceTPA.com, 462 Midland Road, Suite 100, Janesville, Wisconsin 53546. © 2015 Life of the South and the Life of the South logo are trademarks of Life of the South Insurance Company. SMART Accident Plus and its logo are service marks of SASid, Inc. All rights reserved worldwide.