Short Term Disability Insurance For Your Employees | The Argus Group - Argus Bermuda
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STD Plan Details
Total Disability
Total Disability:
Occurs if an employee becomes disabled while insured under the Short Term Disability Benefit and remains totally disabled beyond the end of the Elimination Period.
A condition due to injury or sickness that requires the regular and ongoing care of a physician appropriate to the injury or sickness, the result of which prevents the insured employee from engaging in their usual occupation.
Argus Pays:
The benefits for which a disabled employee is eligible in accordance with the Schedule of Benefits and all the provisions of the policy.
The net Weekly Benefit as shown in the Schedule of Benefits, reduced by any disability income the insured employee receives under the following: any other group insurance plan, any retirement income, any disability income for which the insured employee is eligible, 50% of the earnings the insured employee earns or receives from any form of employment or Rehabilitation Programme, any sick leave or salary continuation paid by the employer and any amount paid or payable under any automobile insurance policy or similar third party recovery.
Benefit Details
Pre-existing Conditions:
Benefits will not be paid in connection with a disability resulting directly or indirectly from a pre-existing condition until an employee has been insured or reinstated under the policy for at least 12 calendar months. However, if the policy has been in force for fewer than 12 months, and an employee has been insured for similar benefits by a previous insurer for any period of time immediately preceding the effective date of the policy, that period of time will apply in determination of the 12-month insurance period.
Residing outside Bermuda:
Benefits will be paid only if Argus is advised of the need prior to the disabled employee leaving Bermuda.
Pregnancy:
Pregnancy in itself does not constitute disability; however, complications of pregnancy that prevent an employee from working will be considered as a disability. Benefits will not be payable during a leave of absence for pregnancy
Benefit Exclusions
Short Term Disability Benefits will not be paid in the following situations:
- While a disabled employee is imprisoned
- Any disability due to or arising from a self-inflicted sickness or injury, while sane or insane
- War, declared or undeclared, or insurrection of any kind, or active participation in a riot or rebellion
- Commission of, or attempt to commit, an indictable criminal offence or felony
- Injury sustained when the employee is driving while the blood alcohol level exceeds 80 milligrams of alcohol per 100 millilitres of blood, or as otherwise defined by the relevant legislation
- Injury sustained while under the influence of intoxicating liquor or drugs, other than drugs taken in accordance with treatment prescribed by a physician but not for the treatment of drug addiction
- Elective treatment or procedures that are not medically necessary
- Injuries sustained from any sport, stunt, or activity that centres around high speeds and/or heights