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| Truckers
Occupational Accident Insurance - Summary of Benefits TRK 000910 4961 |
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| Benefit | PLAN 1 | PLAN 2 | PLAN 2B | PLAN 3 | PLAN 3B | |||
| Occupational
Accident Benefits Accidental Death Benefit Principal
Sum
Incurral Period Deductible Amount |
$50,000 365 Days $0 |
$10,000 365 Days $0 |
$10,000 365 Days $0 |
$50,000 365 Days $0 |
$50,000 365 Days $0 |
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Survivor's Benefit Principal
Sum Monthly Benefit Percentage Monthly Benefit Amount (for 100 months) |
$250,000 1% $2,500 |
$240,000 1% $2,400 |
$240,000 1% $2,400 |
$250,000 1% $2,500 |
$250,000 1% $2,500 |
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Accidental Dismemberment & Paralysis Benefits Principal
Sum Incurral Period Deductible Amount |
$250,000 365 Days $0 |
$250,000 365 Days $0 |
$250,000 365 Days $0 |
$250,000 365 Days $0 |
$250,000 365 Days $0 |
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Temporary Total Disability Commencement
Period (Initial Disability) Waiting Period Participating Percentage Maximum Weekly Benefit Amount Maximum Benefit Period |
30 Days 7 Days 66 2/3% $300 52 Weeks |
30 Days 7 Days 66 2/3% $300 52 Weeks |
30 Days 7 Days 66 2/3% $300 52 Weeks |
30 Days 7 Days 66 2/3% $300 104 Weeks |
30 Days 7 Days 66 2/3% $300 104 Weeks |
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Continuous Total Disability Participation
Percentage Maximum Weekly Benefit Amount Maximum Benefit Period |
66 2/3% $300 To Age 70 |
66 2/3% $300 To Age 70 |
66 2/3% $300 To Age 70 |
66 2/3% $300 To Age 70 |
66 2/3% $300 To Age 70 |
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Accident Medical Expense (Primary) Commencement
Period Deductible Amount Maximum Benefit Period Maximum Benefit Amount Dental Maximum: Per Tooth / Per Accident |
N/A | 30 Days $100 52 Weeks $300,000 $100 / $500 |
30 Days $100 52 Weeks $300,000 $100 / $500 |
30 Days $100 52 Weeks $500,000 $100 / $500 |
30 Days $100 52 Weeks $500,000 $100 / $500 |
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| Non-Occupational
Accident Benefits Accidental Death Benefit Principal
Sum Incurral Period Deductible Amount |
$15,000 365 Days $0 |
$15,000 365 Days $0 |
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| Accidental Dismemberment Benefit Principal
Sum Incurral Period Deductible Amount |
$15,000 365 Days $0 |
$15,000 365 Days $0 |
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Accident Medical Expense (Primary) Commencement
Period Deductible Amount Maximum Benefit Period Maximum Benefit Amount Dental Maximum: Per Tooth / Per Accident |
30 Days $0 52 Weeks $10,000 $100 / $500 |
30 Days $0 52 Weeks $10,000 $100 / $500 |
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| Limits of Liability | PLAN 1 | PLAN 2 | PLAN 2B | PLAN 3 | PLAN 3B | |||
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Occupational Coverage Combined
Single Limit
Non-Occupational
CoverageAggregate Limit of Liability Combined
Single Limit Aggregate Limit of Liability |
$250,000 $500,000 |
$300,000 $600,000 |
$300,000 $600,000 $15,000 $30,000 |
$500,000 $1,000,000 |
$500,000 $1,000,000 $15,000 $30,000 |
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| Premium Rates | PLAN 1 | PLAN 2 | PLAN 2B | PLAN 3 | PLAN 3B | |||
| Monthly Premium (per person) | $53.00 | $114.00 | $119.00 | $135.00 | $140.00 | |||
All plans provide the following services:
Travel Assistance Services (Fuel Station/Best Fuel Price Locator, Traffic Information, Truck Towing Referrals, ATM Locator, Restaurant Referrals, Hotel/Motel Finder, Local Entertainment Information) Identify Theft Services (assist eligible persons who may be identity theft victims by ordering and reviewing credit bureau records and assist, in the Company's sole discretion, in restoring their identity) |
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Disclaimer
This
Policy is not Offered as a Substitute for Legally Required Workers'
Compensation Insurance. Pallay Insurance Agency and Chartis Recommend Consulting Your Attorney for
Interpretation and Application of Local Workers' Compensation Laws. |
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GAS/DIESEL HAULERS: Click here for special plan/rates.
This plan will NOT cover the hauling of hazardous materials. |
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| Click Here to Read Exclusions | ||||||||
| Click Here to Enroll Online | ||||||||
| Click Here to Print Our Brochure and Enrollment Form | ||||||||
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Contact
Us
Pallay Insurance Agency
P.O. Box 727
Mokena, IL 60448
Phone:
888.549.8533
815.744.6505
708.478.7499
Fax:
800.428.9163
708.478.8430
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PALLAY INSURANCE AGENCY |
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"e-Commerce with the personal touch" |
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