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Loss of Entire Sight of One Eye <br />Loss of Speech <br />Loss of Hearing (both ears) <br />Loss of Thumb and Index Finger of the Same Hand <br />50% <br />50% <br />50% <br />25% <br />Loss of a hand or foot means complete Severance through or above the wrist or ankle joint. <br />Loss of sight means the total, permanent loss of sight of the eye. The loss of sight must be irrecoverable by <br />natural, surgical or artificial means. <br />Loss of speech means total, permanent and irrecoverable loss of audible communication. <br />Loss of hearing means total and permanent loss of hearing in both ears which cannot be corrected by any <br />means, <br />Loss of a thumb and Index finger means complete Severance through or above the metacarpophalangeal <br />joints (the joints between the fingers and the hand), <br />In California, loss of a thumb and index finger means loss by complete Severance of at least one whole phalanx <br />of -each <br />In South Carolina, the complete severance of four whole fingers from one hand equals the loss of one hand. <br />"Severance" means the complete separation and dismemberment of the part from the body, <br />BENEFIT - MEDICAL EXPENSE <br />We will pay, Eligible Expenses for a Covered Person's Injury, subject to the Deductible Amount and Coinsurance <br />Percentage, if any, shown in the Schedule of Benefits. Eligible Expenses are those incurred for: <br />(1) Hospital Room and Board — charges for the most common semi -private daily room rate for each day of the <br />Hospital Stay, up to the Maximum Daily Benefit Amount shown in the Schedule of Benefits for Hospital Room <br />and Board. <br />(2) Intensive Care Room and Board - charges for each day of Intensive Care Unit confinement, up to the Daily <br />Maximum Benefit Amount shown in the Schedule of Benefits for the Intensive Care Room and Board benefit. <br />This payment is in lieu of payment for the Hospital Room and Board charges for those days. <br />(3) Hospital Miscellaneous - charges during a Hospital Stay, up to the Maximum Daily Benefit Amount shown in <br />the Schedule of Benefits for the Hospital Miscellaneous benefit. Miscellaneous charges do not include <br />charges for telephone, radio or television, extra beds or cots, meals for guests, take home items, or other <br />convenience items. <br />(4) Outpatient Hospital Expenses - charges by a Hospital for: <br />(a) Pre -admission testing (confinement must occur within 7 days of the testing); or <br />(b) Emergency room treatment, up to the Maximum Benefit Amount per emergency shown in the <br />Schedule of Benefits for the Outpatient Emergency Room Treatment benefit. <br />(5) Surgical Benefits - charges for: <br />(a) A Doctor, for primary performance of a surgical procedure, up to the Maximum Benefit Amount shown in <br />the Schedule of Benefits per procedure. Two or more surgical procedures through the same incision will <br />be considered as one procedure. However, we will pay up to 50% of the surgical procedure charge when <br />more than one surgical procedure through different operating fields are performed during the same <br />surgical session. <br />(b) A Doctor, for: (1) assistant surgeon duties; (ii) a second surgical opinion; or (iii) consultation, up to the <br />Maximum Benefit shown in the Schedule of Benefits for an Assistant Surgeon, Second Surgical Opinion, <br />and Consultation. <br />GAC26932 <br />