DESCRIPTION OF COVERAGES AND BENEFITS This Description of Coverages and Benefits Section describes the Critical Illness Coverages and Benefits provided by this Policy. Benefit amounts, benefit periods and any applicable benefit maximums are shown in the Schedule of Benefits and may be subject to a Benefit Waiting Period and/or an Elimination Waiting Period before benefits can be paid . The Benefit Amounts shown in the Schedule of Benefits will be paid regardless of the actual expenses incurred. Certain words capitalized in the text of these descriptions have special meanings within this Policy and are defined in the General Definitions section. Please read these and the Common Exclusions sections in order to understand all of the terms, conditions and limitations applicable to these coverages and benefits. INITIAL CRITICAL ILLNESS BENEFIT We will pay the Initial Critical Illness Benefit to a Covered Person for the Covered Condition shown in the Schedule of Benefits that are diagnosed while coverage is in force, subject to the conditions and limitations set forth below, and the terms, conditions, limitations and exclusions applicable to all coverage under the Policy. Initial Critical Illness Benefit Amount The amount of the Initial Critical Illness Benefit is the Initial Benefit Amount shown in the Schedule of Benefits . The amount payable per Covered Condition is the Initial Benefit Amount multiplied by the applicable percentage for the diagnosis of the Covered Condition shown in the Schedule of Benefits . Benefit Conditions The Initial Critical Illness Benefit will only be payable if: 1. The Date of Diagnosis occurs after the Benefit Waiting Period, if applicable; 2. The Date of Diagnosis occurs while the Covered Person's coverage under this Policy is in force; 3. The Critical Illness is a different Covered Condition than any of the Covered Conditions for which an Initial Critical Illness Benefit has been paid; 4. The Covered Condition satisfies the Definition in the Policy. 5. For Heart Attack and Stroke, the Covered Person has an Inpatient admission. Benefit Limitations These limitations apply to payments under the Initial Critical Illness Benefit: 1. No more than one Initial Critical Illness Benefit payment will be made regardless of percentage for each Covered Condition shown in the Schedule of Benefits ; 2. No more than one Initial Critical Illness Benefit will be paid per Covered Condition per Covered Person; 3. The Skin Cancer Benefit is not payable as an Initial Critical Illness Benefit. RECURRENCE CRITICAL ILLNESS BENEFIT We will pay the Recurrence Critical Illness Benefit to a Covered Person when diagnosed with the Recurrence of an eligible Covered Condition shown in the Schedule of Benefits while coverage is in force, subject to the conditions and limitations set forth below, and the terms, conditions, limitations and exclusions applicable to all coverage under the Policy. Recurrence Critical Illness Benefit Amount The amount of the Recurrence Critical Illness Benefit payable per Covered Condition is the Initial Benefit Amount shown in the Schedule of Benefits multiplied by the applicable Recurrence percentage for each Recurrence diagnosis also shown on the Schedule of Benefits . Benefit Conditions The Recurrence Critical Illness Benefit will only be payable if: 1. The Date of Diagnosis occurs while the Covered Person's coverage under this Policy is in force; 2. The Covered Condition satisfies the Definition in the Policy; 3. The Covered Condition is the same as a Covered Condition for which an Initial Critical Illness Benefit has been paid; 4. The Covered Person was treatment free for this Covered Condition and a Physician has determined that the Covered Person has No Evidence of Active Disease. 5. For Severe Sepsis that means the Covered Person was discharged from the Inpatient hospital stay for which a(n) Initial Specified Disease Benefit has been paid and is treatment free for Invasive Cancer or Carcinoma in Situ.
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