DISMEMBERMENT SCALE

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DISMEMBERMENT SCALE

• For loss ofSpeech 100 Index finger - three
  phalanges 10Both feet 100 -two
  phalanges 8 Both hands 100 -one
  phalanx 4Total light perception of one or
  both eyes 100 Middle finger-three phalanges
  6Arm at shoulder 100 -two phalanges
  4Arm between shoulder
  and elbow 100 -one phalanx
  2Arm at elbow 100 Ring finger-three phalanges
  5Arm between
  elbow and wrist 100 -two phalanges
  4Hand at wrist 100 -one phalanx
  2Leg at hip 100 Little finger-three
  phalanges 4Leg between knee and hip 100
  -two phalanges 3 Leg below knee
  100 -one phalanx 2Hearing -
  both ears 100 Metacarpals-first or second
  (additional)
  3 - one ear 15 -third,
  fourth, or fifth (additional)
  2Sight of one eye except for lightperception
  50 Toes-all 15Lens of one eye
  50 -great, both phalanges 10Four
  fingers and thumb of one hand 50 -great,
  one phalanx 5Four fingers 40 Each
  toe-other than great toe, if more than one
  toe 1Thumb - both phalanges 25
  - one phalanx 10When injury does not
  result in loss of life of the Insured Person, but
  does result within 365 days in any one of the
  specific losses shown in the schedule below, the
  Company will pay the scheduled percentage of the
  Principal Sum applicable to such Insured Person
  in accordance with the Classification of Insured
  Persons and Schedule of Benefits.However, under
  no circumstances will payment be made for more
  than one such loss, the greatest sustained by any
  one Insured Person as a result of any one
  accident.The complete and irrecoverable loss of
  use of any part of the body specified above shall
  be deemed to be the loss of such part. In the
  event of partial loss of any member of the body
  specified above, a proportionately lower
  percentage of the Principal Sum shall be payable,
  such percentage to be determined by the Company,
  in conjunction with the recommendation/s of the
  relevant medical practitioner.

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CONTENTS EXECUTIVE SUMMARY GROUP PERSONAL
ACCIDENT PROPOSAL TERMS AND CONDITIONS BENEFIT
DESCRIPTION DISMEMBERMENT SCALE CLAIMS
REQUIREMENTS ADDENDUM (Draft of American Home
Assurance Companys Contract and Sample Claim
Forms)
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