Sickness
Upon death of member or his/her qualified legal dependents the designated beneficiary shall receive the benefits according to the Table of Benefits under sickness category.
Accident
Accidental death is defined as a loss of life resulting directly, independently and exclusively of all other causes, of bodily injury effected solely by external, violent and accidental means of which, except in the case of drowning or if internal injury revealed by an autopsy, there is evidence of a visible contusion or wound on the exterior of the body occurring within one hundred eighty (180) days from date of such injury.
Accidental death benefit shall not be payable if the death results from any one of the following causes:
- Bodily or mental infirmity or disease of any kind.
- Self-destruction or self-inflicted injuries, or any attempted suicide regardless of the person\u2019s state of mind at the time the incident occurs
- Murder (except resulting from self-defense) and those that have been inflicted intentionally by a third party due to provocation
- Driving or riding any vehicle while in influence of alcohol, driving without a driver\u2019s license, the driver is a minor or while racing on wheels
- Any injuries received while on police duty in any armed forces organization or civilian defense or local police forces
- In any brawl, riot, civil commotion, insurrection or war or any related incident
- Flying, other than while travelling as a fare-paying passenger on a licensed aircraft
- While traveling as a passenger or otherwise in any form of underwater transportation, or while engaging in any underwater operation but not limited to scuba diving
- The In commission or attempted commission of felony
- Drug addiction, alcoholism, sexually transmitted diseases and HIV if diagnosed within five years from effective date of coverage