Personal Indemnity & Bodily Injury Insurance Questions

Are CCGA members covered by the Group Accident insurance while traveling to their vessel for a search and rescue (SAR) response or other Authorized Activity?

Yes, CCGA members are covered by Group Accident insurance while traveling to their vessel for a SAR response and any other CCGA Authorized Activity.

Are CCGA members covered by Group Accident insurance while conducting boating safety activities?

Yes, CCGA members are covered by the Group Accident insurance while conducting boating safety activities.

Are CCGA members covered by the Group Accident insurance while attending meetings?

Yes, CCGA members are covered by the Group Accident insurance while attending meetings provided these meetings fall within the scope of Authorized Activities.

If a CCGA member is driving a CCGA vehicle during an Authorized Activity, is he/she allowed to let someone else drive the car? To be covered by the CCGA Insurance, does this other person also have to be a CCGA member on Authorized Activity?

To be insured by the accident insurance policy, a person must be a member, volunteer, or volunteer member and participating in an Authorized Activity. However, it is not the intent of the accident policy to insure someone who just happens to be traveling with the member, and the member feels tired and lets the other person drive, and calls this volunteering to participate in an Authorized Activity simply by agreeing to drive the car.

If a member injures himself/herself while on an Authorized Activity, must the members use their own deductible portion from Medicare and/or their own health care insurance first, before claiming against the CCGA insurance?

Yes. Expenses that are insured by Medicare cannot be re-reimbursed by a private medical plan, with a few exceptions. After Medicare, an employees private health care plan, if there is one, becomes second payer and the CCGA plan sits on top as third payer. It should be pointed out that, if a member does not have a group medical plan through an employer, the CCGA plan will respond as a second payer after Medicare. It is illegal in Canada for insurance companies to sell insurance coverage for protection that is already provided by Medicare.

Are guests of the CCGA covered for personal bodily injury while on board CCGA vessels?

Guests, such as media personnel, are covered for personal bodily injury while on board CCGA vessels only if they are invited and the activity is an Authorized Activity. Guests (working or non-working) are not covered while traveling to and from an Authorized Activity. The limit of coverage under the CCGA Group Accident insurance for accidental death or dismemberment for invited guests is $500,000. It is important to note that guests are not to be confused with persons who volunteer to crew for an Authorized Activity if a CCGA vessel is short of crewmembers. Coverage for bodily injury or property damage to guests on board CCGA vessels would be available to the policy limit under the CCGA Protection & Indemnity (marine liability) insurance. Coverage for bodily injury or property damage to guests on land (or at non-marine locations) would be available to the policy limit under the CCGA general liability insurance.

Are CCGA members insured while traveling to and from Authorized Activities or SAR taskings in their own personal vehicles?

Yes, CCGA members are covered under the CCGA Group Accident insurance while traveling to and from Authorized Activities in their personal vehicles. However, the members vehicle is not insured, nor is any injury or damage caused by the members vehicle. Vehicles must be insured under the members personal automobile insurance.

If a member is retired how is compensation under the Group Accident insurance covered if it cant be tied to earnings?

For retired or unemployed members, a flat benefit of $250.00 per week will be paid if a member is disabled because of an accident and is unable to perform all activities of daily living. (Note: Persons receiving employment insurance benefits are considered unemployed).

How many fingers are covered by the group accident insurance policies?

The plan will pay 10% of the principal sum for loss of any one finger other than the index finger. The plan will pay 33% of the principal sum for the loss of the thumb and index finger of the same hand. The plan will pay 25% of the principal sum for the loss of all toes of one foot.

What is the Group Accident coverage if I have a heart attack during an Authorized Activity?

For the Heart or Circulatory Malfunction insurance under the Group Accident policy, coverage applies only if all of the following conditions are met:

     a. the Heart or Circulatory Malfunction of the Insured Person occurs within twenty-four (24) hours of participating in any Authorized Activity of the Policy Holder (CCGA);
     b. the Insured Person is under sixty-five (65) years of age on the date of such Heart or Circulatory Malfunction;
     c. within two (2) years prior to the date of such participation, the Insured Person has not been medically diagnosed with a Heart or Circulatory Malfunction and has not been receiving any medication or treatment for a Heart or Circulatory Malfunction.

This coverage applies only to class I insured persons - all members, volunteers and volunteer-members of the CCGA. It is also important to note that this age exclusion applies only for Heart or Circulatory Malfunction. All members are insured by the CCGA personal indemnity and bodily injury insurance.

What is the Permanent Total Disability lump sum coverage under the CCGA Group Accident insurance?

Permanent Total Disability under the Group Accident policy means that the accidental bodily injuries sustained in a covered Accident during an Authorized Activity solely and directly prevent a person from performing at least two of the six activities of daily living without assistance from another person. This condition must remain for twelve months and then be determined by a physician to be total, permanent, and irreversible for the remainder of his or her life. The six activities are as follows:

     1. Maintaining continance: controlling urination and bowel movements, including the ability to use ostomy supplies or other devices such as catheters.
     2. Transferring: moving between a bed and a chair, or a bed and a wheelchair.
     3. Dressing: putting on and taking off all necessary items of clothing.
     4. Toileting: getting to and from a toilet, getting on and off a toilet, and performing associated personal hygiene.
     5. Eating: performing all the major tasks of getting food
into the body.
     6. Bathing: washing in either a tub or a shower, including the task of getting in and out of the tub and shower. The Company (insurer) will pay the lump sum Benefit Amount less any other Benefit Amount paid or payable due to the same Accident. If the Insured Person has multiple losses as a result of one Accident, the Company (insurer) will pay only the single largest Benefit Amount applicable to the Losses suffered.

This insurance does not apply to persons age seventy (70) years or older. What this means is that CCGA members aged 70 or older are not covered by the Permanent Total Disability benefit if they become totally and permanently disabled during a CCGA Authorized Activity. CCGA members must take this into consideration before responding to any Authorized Activity, including search and rescue (SAR) operations.

It is also important to note that this age exclusion applies only for Permanent Total Disability benefits. All members are insured by the CCGA personal indemnity and bodily injury insurance.

Would a member have to use their sick days first from their employer provided benefits, before the CCGA Group Accident insurance kicks in?

No.

Is there any short-term illness/injury coverage for CCGA members? We note that there is long-term disability coverage, but cannot see any coverage for those who may suffer some financial hardship because of an injury that is not permanent but requires some rehabilitation.

The Group Accident policy provides for a Temporary Total Disability Weekly Benefit for class I and class III. Class I includes all members, volunteers and volunteer-members of the Policyholder (CCGA) who are employed at the time of accident. The insured benefit is equal to 75% of earnings, to a maximum of $1,000 per week, payable for 104 weeks, with no waiting period. For those not employed at the time of the accident, there is a flat weekly benefit of $250.00 payable for 104 weeks with no waiting period.

Class III includes all employees, contract employees and consultants of the Policyholder (CCGA). The insured benefit is equal to 75% of earnings to a maximum of $1,000 payable for 52 weeks with a 7 day waiting period.

Please note that this coverage is in the event of accident only. It does not apply to losses due to illness.

There is also a $10,000 rehabilitation/retraining benefit. This benefit will reimburse reasonable and customary charges within two years of the accident for rehabilitation and/or training that is necessary to either return the insured person to his or her job or qualify the insured person for an occupation in which he or she would not have been engaged except for having suffered the injury.

Is there any additional coverage for coxswains? Given the maritime tradition concerning responsibility of the Master of the vessel, we can envision a situation where an injured member on a CCGA vessel may also make a claim against the coxswain. Not only would the coxswain be faced with a potential liability but he/she could also be faced with significant legal costs.

If the term coxswain is used here as synonymous with the Captain of the vessel, there is liability cover age under the CCGA marine insurance policy. A coxswain is assigned to a boat by the command authority and can only be relieved by the commanding officer or the senior officer present. The coxswains authority is independent of rank and/or seniority in relation to any other person on board the boat. Unlike the commanding officer (captain) of a cutter or ship, a coxswain does not automatically have command authority. If the negligent actions of the CCGA member (Captain) cause bodily injury or property damage to another during a search and rescue (SAR) Authorized Activity, then the CCGA marine insurance policy will respond with respect to a coxswain as it would with respect to the Captain or Master (subject always to the policy terms, conditions, extensions and exclusions).

Are CCGA members covered by the group accident policies as spotters on aircraft?

Yes, CCGA members are covered as spotters on aircraft, but they are NOT covered if they act as pilot(s) or crew.

During special events such as regional SAR Competitions, Training sessions, etc. If a non-auxiliary member volunteers his/her time for the event, is that person covered under the CCGA insurance policy?

Yes, that person would be insured under the accident policy for the duration of the activity, as these are considered Authorized Activities.

Is a Marine Rescue Society member covered by the CCGA National Insurance Program while participating in an Authorized Auxiliary Activity?

Yes, the Marine Rescue Society member is insured under the Auxiliary insurance policies (even if he/she is not a member of the CCGA) as long as the Societys member volunteers his/her time for the event. A Marine Rescue Society volunteer who simply attends the event on their own initiative as a spectator would not be insured.

Are guests of the CCGA covered for personal bodily injury while attending an Authorized CCGA Activity such as a Regional SAR Skills competition or Annual General Meeting?

Yes, Guests of the CCGA are covered for personal bodily injury while participating in an Authorized Activity, at the invitation of the CCGA.

Are guests of the CCGA insured while traveling to and from Authorized Activities in their own personal vehicles?

Guests of the CCGA are not insured while traveling to and from an Authorized Activity.

Does the disability coverage provide for suffering from a traumatic incident if no bodily injury occurs?

The Temporary Total Disability benefit can be extended to cover disability resulting from a traumatic event provided the following conditions are met:

     1. The traumatic event must result in Total Disability (no partial disability).
     2. The diagnosis of a psychological trauma meets the generally accepted standards of medical practice.
     3. The Total Disability is confirmed by a physician.
     4. The Insured Person would have to be actively employed (those individuals in Class 1 who are not employed would not be eligible).

Coverage is limited to 26 weeks for both Class I (employed) and Class 3.

In addition, the psychological therapy benefit can be tied to a traumatic event and not only tied to a specific accidental loss.