Group accident insurance contract of a minimum company

[Company Name] [Address] [City, State, Zip Code] [Phone Number] [Email]

GROUP ACCIDENT INSURANCE CONTRACT

This Group Accident Insurance Contract (“Contract”) is made and entered into on [Effective Date], by and between [Company Name] (“Company”), and [Insurance Provider] (“Insurance Provider”).

WHEREAS, the Company desires to provide its employees with accident insurance coverage, and Insurance Provider is willing to provide such coverage in accordance with the terms and conditions set forth in this Contract.

NOW, THEREFORE, in consideration of the mutual promises contained herein, the parties agree as follows:

SECTION 1. COVERAGE

1.1 Eligibility All full-time employees of the Company who are actively at work are eligible for coverage under this Contract.

1.2 Coverage Insurance Provider agrees to provide accident insurance coverage to eligible employees of the Company. Such coverage shall include payment for injuries sustained as a result of an accident, including but not limited to:

• Loss of life
• Loss of limb
• Loss of sight
• Loss of hearing
• Permanent disability
• Hospitalization
• Medical expenses

The amount of coverage and the applicable benefits shall be set forth in the Schedule of Benefits attached hereto as Exhibit A.

1.3 Exclusions This Contract shall not cover any injuries sustained as a result of:

• Intentional self-injury
• Suicide or attempted suicide
• War or any act of war, declared or undeclared
• Engaging in any criminal activity
• Participating in any professional sports or hazardous activities

SECTION 2. PREMIUMS AND PAYMENTS

2.1 Premiums The Company shall pay the premiums for coverage under this Contract. Premiums shall be determined based on the number of eligible employees and the applicable benefits selected by the Company.

2.2 Payment Premium payments shall be due and payable in accordance with the payment schedule set forth in the Schedule of Benefits attached hereto as Exhibit A.

SECTION 3. CLAIMS

3.1 Filing a Claim In the event an eligible employee suffers an injury covered by this Contract, the employee or his/her beneficiary must notify Insurance Provider of the injury within 30 days of the date of the accident.

3.2 Proof of Loss The employee or his/her beneficiary must provide proof of loss to Insurance Provider within 90 days of the date of the accident.

3.3 Payment of Benefits Insurance Provider shall pay the applicable benefits under this Contract upon receipt of satisfactory proof of loss.

SECTION 4. TERMINATION

4.1 Termination by Company The Company may terminate this Contract at any time upon written notice to Insurance Provider.

4.2 Termination by Insurance Provider Insurance Provider may terminate this Contract at any time upon written notice to the Company.

4.3 Effect of Termination Upon termination of this Contract, Insurance Provider shall refund any unearned premium to the Company.

SECTION 5. MISCELLANEOUS

5.1 Entire Agreement This Contract contains the entire agreement between the parties and supersedes all prior negotiations, representations, and agreements, whether oral or written.

5.2 Amendment This Contract may be amended only by written agreement signed by both parties.

5.3 Governing Law This Contract shall be governed by and construed in accordance with the laws of the state in which the Company is located.

5.4 Assignment This Contract may not be assigned by either party without the prior written consent of the other party.

IN WITNESS WHEREOF, the parties have executed this Contract as of the date first above written.

[Company Name] By: ________________________________ Title: _______________________________

[Insurance Provider] By: ________________________________ Title: _______________________________

Exhibit A – Schedule of Benefits