Eligibility and Effective Dates:
All completed membership applications received and processed on or before the 25th of any month will be effective on the first day of the following month. Membership applications received and processed after the 25th of any month will be effective 30 days from the 1st of the following month. Coverage for eligible dependents you acquire after your coverage will be effective on that date that your application for the additional dependent is approved except that coverage for adopted children, newborn children, foster children and children in your custody by a court order is effective for 31 days from the date of birth, date of adoption or placement. To continue coverage beyond 31 days for these children, you must provide notice of such children. For purposes of this benefit: an otherwise eligible dependent child must also reside in your home for more than 6 months a year and chiefly rely on you for support and maintenance to be covered; and eligible dependent includes a child past the age of 19 (25 if a full time student) who has a handicapped condition which renders the child incapable of self-sustaining employment and who is chiefly dependent on you or other care providers for lifetime care and supervision because of a handicapped condition that occurred before such age.
Aircraft Restrictions:
If the accident happens while a Covered person is riding in, or getting on or off an Aircraft, the carrier will pay benefits, but only if:
1) Riding as a passenger in a commercial airline, and not as a pilot or member of the crew; and
2) The aircraft is not being used for:
a) Crop dusting, spraying, or seeding; fire firefighting; sky writing; sky diving or hang gliding; pipeline or power line inspection, aerial photography or exploration, racing, endurance tests, stunt or acrobatic flying; or
b) Any operation which requires a special permit from the FAA, even if it is granted (this does not apply if the permit is required only because of the territory flown over or landed on).
Aircraft Not Covered:
No benefits will be paid if the Aircraft is any of the following:
1) Leased aircraft
2) Operated or Controlled Aircraft, or
3) Owned aircraft
Unless otherwise stated, benefits will be paid for a covered loss, only once, even if coverage was provided under more than one Description of Hazards.
Exclusions:
Benefits will not be paid for a covered person's loss which:
1) Is caused by or results from the Covered Person’s own:
a) Intentional self-inflicted injury, suicide or any attempt thereat;
b) Voluntary self-administration of any drug or chemical substance not prescribed by, and taken according to the directions of a doctor (accidental ingestion of a poisonous substance is not excluded);
c) Commission or attempt to commit a felony;
d) Participation in a riot or insurrection;
e) Driving under the influence of a controlled substance unless administered on the advice of a doctor; or
f) Driving while intoxicated. “Intoxicated” will have the meaning determined by the laws in the jurisdiction of the geographical area where the loss occurs;
2) Is caused by or results from:
a) The Covered Person being Intoxicated. “Intoxicated” will have the meaning determined by the laws in the jurisdiction of the geographical area where the loss occurs; or
b) Any narcotic, drug, poison, gas or fumes voluntarily taken, administered, absorbed or inhaled, unless prescribed by a doctor;
c) Declared or undeclared war or act of war;
d) Injury sustained while in the service of the armed forces of any country. When the Covered Person enters the armed forces of any country, we will refund the unearned pro rata premium upon request;
e) Aviation, except as specifically provided in this Policy;
f) Sickness, disease, bodily or mental infirmity or medical or surgical treatment thereof, bacterial or viral infection, regardless of how contracted. This does not include bacterial infection that is the natural and foreseeable result of an accidental external bodily injury or accidental food poisoning;
Additional Exclusions:
Benefits will not be paid for:
1. Dental care or treatment other than care of sound, natural teeth and gums required on account of Injury resulting from an Accident while the Covered Person is covered under this Certificate, and rendered within 6 months of the Accident;
2. Services or treatment rendered by a doctor, nurse or any other person who is:
a) Employed or retained by the Certificateholder; or
b) Who is the Covered Person or a member of his immediate family;
3. Charges which:
a) The Covered Person would not have to pay if he did not have insurance; or
b) Are in excess of Usual, Reasonable and Customary charges.
4. An Injury that is caused by flight in:
a) An aircraft, except as a fare-paying passenger;
b) A space craft or any craft designed for navigation above or beyond the earth’s atmosphere; or
c) An ultra light, hang-gliding, parachuting or bungi-cord jumping;
5. Travel in or upon;
a) A snowmobile;
b) Any two or three wheeled motor vehicle;
c) Any off-road motorized vehicle not requiring licensing as a motor vehicle;
6. Any Accident where the Covered Person is the operator of a motor vehicle and does not possess a current and valid motor vehicle operator’s license;
a) That part of medical expense payable by any automobile insurance policy without regard to fault. (Does not apply in any state where prohibited);
7. Any Sickness, except infection which occurs directly from an Accidental cut or wound or diagnostic tests or treatment, or ingestion of contaminated food;
8. Practice or play in any sports activity, including travel to and from the activity and practice, unless specifically provided for in this Certificate;
9. Expenses to the extent that they are paid or payable under other valid and collectible group insurance or medical prepayment plan;
10. Blood or Blood plasma, except for charges by a Hospital for the processing or administration of blood;
11. Elective treatment or surgery, health treatment, or examination where no Injury is involved;
12. Eyeglasses, contact lenses, hearing aids, braces, appliances, or examinations or prescriptions therefore;
13. Treatment in any Veterans Administration or Federal Hospital, except if there is a legal obligation to pay;
14. Treatment of temporomandibular joint (TMJ) disorders involving the installation of crowns, pontics, bridges or abutments, or the installation, maintenance or removal or orthodontic or occlusal appliances or equilibration therapy;
15. Cosmetic surgery, except for reconstructive surgery on a diseased or injured part of the body;
16. Any loss which is covered by state or federal worker’s compensation, employers liability, occupational disease law, or similar laws;
17. The repair or replacement of existing artificial limbs, orthopedic braces or othotic devices;
18. Rest cures or custodial care;
19. The repair or replacement of existing dentures, partial dentures, braces or fixed or removable bridges;
20. Expenses incurred for an Accident after the Benefit Period shown in the Schedule of Benefits;
21. Hernia of any kind; or any bacterial infection that was not caused by an Accidental cut or wound;
22. Prescription medicines unless specifically provided for under this Certificate.
“Note from US Fire Insurance Company: As a member of IAB, you acknowledge that at any one time you and each covered person may have access to only one (1) certificate providing limited medical indemnity insurance coverage by United States Fire Insurance Company ("USF"). If it is determined that an insured has duplicate or multiple USF coverage, coverage will only be provided under the USF plan that has been in force for the longer period of time. USF will refund premiums paid for all other USF plans in effect during the same period of time.”
Some exclusions may not be applicable or wording may differ in your state of residence. Full details are available upon request in the master policy/certificate that is on file at the association’s administrative office.