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SUNNYISLES <br />1703779 City of Sunny Isles Beach <br />• GROUP ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE <br />BENEFITS: <br />If an Insured Person sustains an accidental bodily injury which directly causes one of the following losses <br />within 365 days following the injury, Jefferson Pilot Financial will pay the benefit listed below: <br />LOSS <br />Loss of one hand by severance <br />at or above the wrist <br />Loss of one foot by severance <br />at or above the ankle <br />Irrecoverable loss of the <br />sight in one eye <br />Any combination of two or <br />more of the losses listed above <br />Loss of life <br />BENEFIT <br />One -half the Principal Sum <br />One -half the Principal Sum <br />One -half the Principal Sum <br />Principal Sum <br />Principal Sum <br />The total benefit for all losses resulting from the same accident may not exceed the Principal Sum. The <br />•Principal Sum for the Insured Person's class is shown in the Schedule of Insurance. <br />Benefits for loss of life will be paid in accord with the Beneficiary Section. All other benefits will be paid to the <br />Insured Person. <br />LIMITATIONS: <br />Benefits are not payable for any loss to which a contributing cause is: <br />- intentional self - inflicted injury or self- destruction; <br />- disease, bodily or mental infirmity, or medical or surgical treatment of these; <br />- the Insured Person's participation in riot; <br />- duty as a member of any military, naval or air force; <br />- war or any act of war, declared or undeclared; <br />- the Insured Person's participation in the commission of a felony; <br />- use of drugs except where prescribed by a physician; <br />- voluntary inhalation of gas; including carbon monoxide; <br />- travel or flight in any aircraft, including balloons and gliders, except as a fare paying passenger on a <br />regularly scheduled flight; or <br />- the Insured Person driving a vehicle while having an alcohol concentration of .10 grams of alcohol or more <br />per 100 milliliters of blood. <br />r� <br />24 Hour Jefferson Pilot Financial Insurance Company <br />8 11/16/2001 <br />