HII Newport News Operations Summary Plan ... - Benefits Connect

Exclusions
15. Are there any exclusions to the Plan
Yes. No payment shall be made for any loss which, directly or indirectly, in whole or
in part, is caused by or results from:
• Intentionally self-inflicted Injury, suicide or any attempt thereat while sane or
insane
• Commission or attempt to commit a felony or an assault
• Declared or undeclared war or act of war
• Flight in, boarding or alighting from an aircraft or any craft designed to fly above
the Earth’s surface, except as a passenger in an aircraft piloted by properly
qualified and licensed pilots holding current and valid certificates of competency
of a rating authorizing them to pilot such aircraft
• Sickness, disease, bodily or mental infirmity, bacterial or viral infection or
medical or surgical treatment thereof (except surgical or medical treatment
required by an accident), except for any bacterial infection resulting from an
accidental external cut or wound or accidental ingestion of contaminated food
• Voluntary ingestion of any narcotic, drug, poison, gas or fumes, unless prescribed
or taken under the direction of a Physician and taken in accordance with the
prescribed dosage
• Any accident that occurs while engaged in the activities of active duty service in
the military, navy or air force of any country or international organization.
• Covered accidents that occur while engaged in Reserve or National Guard
training are not excluded until training extends beyond 31 days
The Covered Person’s intoxication as determined according to the laws of the
jurisdiction in which the Covered Accident occurred.
Appeal Procedure
16. What procedure should be followed if benefits applied for are denied
If a claim for benefits is wholly or partially denied, within a reasonable period of time
the applicant will be provided with written notice of the denial containing:
• The reasons for the denial
• Reference to the Plan provisions upon which the denial was based
• A summary of additional material or information, if any, required to complete the
application
• An explanation of the appeal procedure and your right to begin legal action if you
request a review of your claim and it is denied after the review.
The notice of denial will be provided within 90 days after the claim for benefits is
received, unless the insurance company determines that special circumstances require an
Business Travel Accident Insurance Plan
April 2011
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