Disability Insurance

This is a brief summary of the disability coverage provided under policy form SG DI 001 0619. See Policy for complete details.

WHAT’S COVERED?

The Policy covers Disability, which means:

• Inability due to Injury or Sickness to perform the material and substantial duties of the Insured’s occupation at the time when the Disability starts, and;

• Receiving continuous care by a licensed Physician, and;

• Not working for wages or profit.

• Disability includes Complications of Pregnancy but not pregnancy or childbirth absent such complications.

As shown on the Schedule Page of the Policy:

• The Monthly Insurance Benefit Amount (chosen by the Insured at the time of application) cannot exceed the lesser of the Maximum Benefit Amount or 60% of an employee’s Monthly Salary or an Independent Contractor’s or Self-Employed individual’s Average Monthly Income at the time of application (NOTE: if the Lump Sum Insurance Benefit Amount is selected, it cannot exceed the lesser of the Maximum Benefit Amount of 60% of an employee’s total Monthly Salary or an Independent Contractor’s or Self-Employed individual’s total Average Monthly Income at the time of application.);

• Benefits may be payable monthly for up to the Maximum Benefit Period, or in one lump sum if so indicated;

• A Waiting Period (retroactive or non-retroactive to the date disability begins) may apply before benefits begin;

• A Lifetime Aggregate Maximum Benefit applies.

WHAT’S NOT COVERED?

The Policy excludes benefits for any Disability that is:

• a result of a pre-existing medical condition which means that the Insured has been treated by, diagnosed by or consulted with a licensed Physician or licensed chiropractor for the medical condition in the Pre-Existing Conditions Months, as shown on the Schedule Page, before the Policy Effective Date and such condition becomes the cause of Disability within the Pre-Existing Conditions Months, as shownon the Schedule Page, after the Policy Effective Date;

• due to hospitalization that occurs during the first ninety (90) days after the Policy Effective Date due to illness;

• a result of normal pregnancy that does not include Complications of Pregnancy;

• a result of war or any act of war (declared or undeclared);

• a result of a self-inflicted injury;

• a result of voluntary ingestion of illegal drugs;

• a result of intoxication;

• a result of injuries during commission of a felony;

• a result of participation in a riot or insurrection; or

• a result of an illegal occupation or activity.

Medical Care Requirement: Benefits are not payable for any period of Disability during which the Insured is not under the care of a licensed Physician. Such care must be appropriate, according to generally accepted medial standards for the condition which is causing the Disability and must be provided by a licensed Physician whose area of expertise is appropriate for the Sickness or Injury.

If the Insured incurs a qualifying Disability event and a qualifying Involuntary Unemployment event or Salary Gap event, only one benefit will be paid, and it will be the larger of the two benefits amounts.

Involuntary Unemployment

This is a brief summary of the involuntary unemployment coverage provided under policy form SG DI 001 0619. See Policy for complete details.

WHAT’S COVERED?

When the Insured becomes Involuntarily Unemployed, benefits as shown on the Schedule Page will be payable as follows:

• The Insured must:

  (1) be Involuntarily Unemployed, and

  (2) remain Involuntary Unemployed for the duration of the Waiting Period, as shown on the Schedule Page.  Benefits begin 1 day following the end of the Waiting Period.  Benefits may or may not be retroactive to the incurred date of the qualifying event as shown on the Schedule Page; and

  (3) be approved for and receiving state unemployment benefits.

• Benefits for Involuntary Unemployment will stop when the Monthly or Lump Sum Insurance Benefit Amount has been paid for the entire Maximum Benefit Period shown in the Schedule Page or, if earlier, on the date the Insured is no longer Involuntarily Unemployed,

• Involuntary Unemployment benefits will be reduced as necessary so that Involuntary Unemployment benefits plus all government and/or private unemployment benefits do not exceed the salary, wages or employment income from employment held immediately prior to the incurred date of a qualifying event from the occupation shown in the application.

If the Insured incurs a qualifying Disability event and a qualifying Involuntary Unemployment event, only one benefit will be paid, and it will be the larger of the two benefits amounts.

WHAT’S NOT COVERED?

Involuntary Unemployment benefits are not payable in these circumstances:

• For a seasonal worker, meaning a person whose occupation can be carried on only during certain seasons or defined portions of the year and where the customary period of employment is less than one thousand (1,000) hours during the calendar year;

• Occurring in the Involuntary Unemployment Insurance Vesting Period as shown on the Schedule Page. During the Involuntary Unemployment Insurance Vesting Period, at the Insured’s option following the denial of a claim, the Involuntary Unemployment coverage can be cancelled for a full refund of premium;

• Due to termination as a result of cause or willful misconduct (a transgression of some established and definite rule of action, a forbidden act or omission, or an act or omission involving dishonesty, or a dereliction of duty, active or passive, which is willful in character and beyond simple negligence), excessive absenteeism or tardiness, or criminal misconduct (unlawful behavior as determined by Local, State or Federal law); resulting directly or indirectly from any dishonest, fraudulent or criminal act; due to a circumstance known by the Insured prior to the Policy Effective Date; 

• Due to war or any act of war (declared or undeclared);

• For an Employee: due to a voluntary forfeiture of salary, wages or employment income;

• For an Employee or Independent Contractor: due to a voluntary resignation or retirement;

• For a Self-Employed individual: voluntary resignation or divestiture of business interest;

• For an Independent Contractor or Self-Employed individual:  due to a voluntary forfeiture of salary, wages, employment income or independent contracting income;

• For an Independent Contractor or Self-Employed individual:  due to the contractual expiration of an employment or engagement contract.

SALARYGAP Re-employment Insurance

This is a brief summary of the SALARYGAP re-employment coverage provided under policy form SG DI 001 0619. See Policy for complete details.

WHAT’S COVERED?

When the Insured experiences a qualifying Salary Gap, benefits as shown on the Schedule Page will be payable as follows:

• The Insured must:

  (1) be Involuntarily Unemployed, and

  (2) find Replacement Employment within the SALARYGAP Eligibility Months, and

  (3) experience a Salary Gap while this Rider is in force.

• Commencement of SALARYGAP benefits starts once the definition of Salary Gap has been satisfied.  Benefits may or may not be retroactive to the starting date of the Replacement Employment as shown on the Schedule Page.

• Monthly or Lump Sum insurance benefits for a Salary Gap will stop when the Monthly or Lump Sum insurance benefits have been paid for the entire Maximum Benefit Period or Lifetime Aggregate Maximum Benefit as shown on the Schedule Page or, if earlier, on the date the Insured no longer experiences a Salary Gap.

• For an Employee:  SALARYGAP benefits will be reduced as necessary so that SALARYGAP benefits plus all salary, wages or employment income from Replacement Employment, plus any residual government sponsored unemployment benefits do not exceed the salary, wages or employment income from employment held before Involuntary Unemployment started

• For an Independent Contractor or Self-Employed individual:  SALARYGAP benefits will be reduced as necessary so that SALARYGAP benefits plus all salary, wages or contracting income from Replacement Employment, plus any residual government sponsored unemployment benefits do not exceed the Average Monthly Income immediately before Involuntary Unemployment started.

If the Insured incurs a qualifying Disability event and a qualifying Salary Gap event, only one benefit will be paid, and it will be the larger of the two benefits amounts.

WHAT’S NOT COVERED?

SALARYGAP benefits are not payable in these circumstances:

• For a seasonal worker, meaning a person whose occupation can be carried on only during certain seasons or defined portions of the year and where the customary period of employment is less than one thousand (1,000) hours during the calendar year;

• Occurring in the SALARYGAP Insurance Vesting Period as shown on the Schedule Page.  During the Vesting Period, at the option of the Insured following the denial of a claim, SALARYGAP coverage can be cancelled for a full refund of premium;

• Due to termination as a result of cause or willful misconduct (a transgression of some established and definite rule of action, a forbidden act or omission, or an act or omission involving dishonesty, or a dereliction of duty, active or passive, which is willful in character and beyond simple negligence), excessive absenteeism or tardiness, or criminal misconduct (unlawful behavior as determined by Local, State or Federal law); resulting directly or indirectly from any dishonest, fraudulent or criminal act; due to a circumstance known by the Insured prior to the Policy Effective Date;

• Due to war or any act of war (declared or undeclared);

• For an Employee:  due to a voluntary forfeiture of salary, wages or employment income;

• For an Employee: voluntary resignation or retirement;

• For an Employee:  as an Independent Contractor or a Self-Employed individual;

• For a Self-Employed individual: voluntary resignation or divestiture of business interest;

• For an Independent Contractor or Self-Employed individual:  due to a voluntary forfeiture of salary, wages or employment income or independent contracting income;

• For an Independent Contractor or Self-Employed individual:  due to the contractual expiration of an employment or engagement contract;

• For an Independent Contractor: voluntary resignation or retirement.

Average Monthly Income – Independent Contractor and Self-Employed

The monthly average of total earned income for the Look Back Period as shown on the Schedule Page including all forms of compensation.

Insured

The person named as the insured on the application for the Policy.

Lump Sum Insurance Benefit Amount

The Lump Sum Insurance Benefit Amount is the amount payable for each occurrence of a qualifying event (Disability, Involuntary Unemployment or Salary Gap).  The Lump Sum Insurance Benefit Amount for Disability is shown on the Schedule Page; for Involuntary Unemployment or SALARYGAP, it is equal to the Lump Sum Insurance Benefit Amount for Disability times the Involuntary Unemployment or SALARYGAP Benefit Ratio as shown on the Schedule Page.

The total aggregate Lump Sum Insurance Benefit Amount cannot exceed the lesser of the Maximum Benefit Amount or 60% of the Insured’s, for an Employee: total Monthly Salary or for an Independent Contractor or Self-Employed individual: total Average Monthly Income immediately prior to the incurred date of a qualifying event for the Look Back Period from the occupation shown in the application.  If the total Aggregate Monthly Insurance Benefit Amount issued under any 1 or more policies exceeds the Maximum Benefit Amount, coverage will be reduced to the Maximum Benefit Amount and a proportionate share of any premium charge for the excess coverage will be refunded or coverage will be cancelled and the full amount of premium charged will be refunded less any claims paid.

Monthly Insurance Benefit Amount

The Monthly Insurance Benefit Amount is the amount payable for each occurrence of a qualifying event (Disability, Involuntary Unemployment or Salary Gap).  The Monthly Insurance Benefit Amount for Disability is shown on the Schedule Page; for Involuntary Unemployment or SALARYGAP, it is equal to the Monthly Insurance Benefit Amount for Disability times the Involuntary Unemployment or SALARYGAP Benefit Ratio as shown on the Schedule Page.

The total aggregate Monthly Insurance Benefit Amount cannot exceed the lesser of the Maximum Benefit Amount or 60% of the Insured’s, for an Employee:  Monthly Salary or for an Independent Contractor or Self-Employed individual: Average Monthly Income for the Look Back Period immediately prior to the incurred date of a qualifying event from the occupation shown in the application.  If the total Aggregate Monthly Insurance Benefit Amount issued under any 1 or more policies exceeds the Maximum Benefit Amount, coverage will be reduced to the Maximum Benefit Amount and a proportionate share of any premium charge for the excess coverage will be refunded or coverage will be cancelled and the full amount of premium charged will be refunded less any claims paid.

Self-Employed

A person working for income coming directly from his or her own business, trade, profession, or partnership. A company or entity in which the individual has a ten percent (10%) or greater equity or ownership interest will be regarded as his or her own business.

Waiting Period – SALARYGAP

The number of consecutive days following a qualifying Involuntary Unemployment event before the SALARYGAP Eligibility Period begins as shown on the Schedule Page. 

Complications of Pregnancy

A condition which requires medical treatment and whose diagnosis is distinct from pregnancy but is adversely affected by or are caused by pregnancy, such as:

When pregnancy is NOT terminated:

• acute nephritis;

• nephrosis;

• cardiac decompensation;

• missed abortion;

• eclampsia;

• puerperal infection;

• R.H. Factor problems;

• severe loss of blood requiring transfusion; and 

• other similar medical and surgical conditions of comparable severity related to pregnancy.

When pregnancy IS terminated:

• non-elective cesarean section;

• ectopic pregnancy that is terminated; and

• spontaneous termination of pregnancy during a period of gestation in which a viable birth is not possible.

Complications of Pregnancy will NOT include:

• false labor;

• occasional spotting;

• Physician prescribed rest during the period of pregnancy;

• morning sickness;

• preeclampsia;

• similar conditions associated with the management of a difficult pregnancy but which are not a separate Complication of Pregnancy; and

• elective cesarean section.

Family Member

The Insured’s parents (includes a step-parent), grandparent, spouse, child(ren), includes legal adopted or step or foster child(ren), brother or sister, grandchild(ren), or in-laws.  A Family Member includes an individual who normally lives in the Insured’s household.

Physician

A legally qualified licensed Physician or surgeon other than the Insured or a Family Member who is acting within the scope of his or her license.

Involuntary Unemployment / Involuntarily Unemployed - Employee

Total loss of salary or wages that occurs after the Involuntary Unemployment Insurance Vesting Period as shown on the Schedule Page, and lasts as long as the Waiting Period as shown on the Schedule Page from one of the following causes:

• layoff – a suspension of employment, which continues more than the Waiting Period as shown on the Schedule Page;

• termination by the Insured’s employer – a complete and permanent severance of employment at the order of the Insured’s employer;

• strike – an authorized, unionized labor dispute and organized labor stoppage, that continues more than the Waiting Period as shown on the Schedule Page by a chartered or previously organized trade or labor union, through the coalition of its members (including the Insured), to obtain higher wages, shorter hours of employment, better working conditions or some other concession from the Insured’s employer, by the employees stopping work at a pre-concerted time, which involves a combination of persons and not a single individual.  Non-union collective bargaining is not included in this definition;

• lockout – the Insured’s employer’s discharge of employees (including the Insured) or temporary closing of a place of employment by the Insured’s employer, in response to organized employee activity, which continues more than the Waiting Period as shown on the Schedule Page; or

• natural disaster – interruption of work lasting longer than the Waiting Period as shown on the Schedule Page which causes a termination or suspension of the Insured’s employment.

Involuntary Unemployment / Involuntarily Unemployed - Independent Contractor or Self-Employed

Loss of at least the total Average Monthly Income Loss Ratio as shown on the Schedule Page of the Insured’s income that occurs after the Involuntary Unemployment Insurance Vesting Period as shown on the Schedule Page and lasts as long as the Waiting Period as shown on the Schedule Page from one of the following causes:

• layoff – a suspension of employment contract(s) which continues more than the Waiting Period as shown on the Schedule Page;

• strike – an authorized, unionized labor dispute and organized labor stoppage, that continues more than the Waiting Period as shown on the Schedule Page by a chartered or previously organized trade or labor union, through the coalition of its members (which may include the Insured), to obtain higher wages, shorter hours of employment, better working conditions or some other concession from the Insured’s employer, by the employees stopping work at a pre-concerted time, which involves a combination of persons and not a single individual. Non-union collective bargaining is not included in this definition;

• lockout – the Insured’s contracting employer’s discharge of employees and Independent Contractors or Self-Employed (including the Insured) or temporary closing of a place of employment by the Insured’s contracting employer(s), in response to organized employee activity which continues more than the Waiting Period as shown on the Schedule Page;

• natural disaster – interruption of work lasting more than the Waiting Period as shown on the Schedule Page which causes a termination or suspension of employment contract(s) or otherwise prevents the Insured from honoring the terms of employment contract(s);

• total involuntary loss of the Insured’s business interest; or

• involuntary bankruptcy, Chapter 7, Title 11 of the United States Bankruptcy Code.

Salary Gap - Employee

Salary Gap occurs if:

• Involuntarily Unemployed while SALARYGAP coverage is in force; and

• Replacement Employment is secured during the SALARYGAP Eligibility Period; and

• the difference between the Monthly Salary immediately before Involuntary Unemployment and the new Monthly Salary from the Replacement Employment is at least the Salary Gap Reduction Ratio as shown on the Schedule Page times the Monthly Salary immediately before Involuntary Unemployment.

Salary Gap - Independent Contractor or Self-Employed

Salary Gap occurs if:

• Involuntarily Unemployed while SALARYGAP coverage is in force; and

• qualifying Replacement Employment is secured during the SALARYGAP Eligibility Period; and

• the difference between the Average Monthly Income immediately before Involuntary Unemployment and the new Average Monthly Income for the Replacement Employment is at least the Salary Gap Reduction Ratio as shown on the Schedule Page times the Average Monthly Income immediately before Involuntary Unemployment.

SALARYGAP Benefit Ratio

A percentage of the Disability Benefits as shown on the Schedule Page.

SALARYGAP Eligibility Period

The period beginning on the day after satisfying the Waiting Period as shown on the Schedule Page for a qualifying Involuntary Unemployment event and ending after the number of months have elapsed equal to the SALARYGAP Eligibility Months as shown on the Schedule Page.

Privacy Policy

Last Revision: October 20, 2022.

We endeavor to secure and protect all information provided by our customers, clients, vendors, web visitors, and others who use our websites. Your privacy and security are important to us, and we honor that by managing your information with the utmost respect.

Below is our Website Privacy Statement, which includes the home page and all other pages.

We want you, our visitors, to know we take your information's security seriously. We use our best efforts to protect all personal data we process by maintaining physical, electronic, and procedural safeguards.

However, due to the open, communicative nature of the Internet, no systems are foolproof. We employ leading cybersecurity practices and security measures, including training, encryption, and least privileged access, to ensure unauthorized third parties will not access all personal data. We limit our personal data processing and data storage to the U.S.

The following sets forth the principles and key elements of our commitment to privacy and data security practices.

Information We Collect

INFORMATION YOU PROVIDE DIRECTLY TO US

We and our service providers may collect the information you directly provide us, such as information included in claim submissions, including injuries and treatment, names of witnesses, and whether a violation was issued; fraud reports, including names of those persons involved; applications for insurance policies; or online contact forms for comments, questions, or requests.

The information you provide may include:

• (a) Contact information: your name, postal address, email address, telephone number, and fax number.

• (b) Other identifying numbers include your social security number, federal employer identification number, date of birth, and driver's license number.

• (c) Claim and account information, including account number, policy number, client ID, or access credentials.

• (d) Relevant information to an insurance policy or claims, such as information about employment, income, and net worth, information about property or collateral insurance coverage, and medical information.

INFORMATION WE COLLECT BY AUTOMATED MEANS

When you use our website, we and our service providers may collect or retain information by automated means, using technologies such as web server logs.

Our web servers may log information including, but not limited to: your operating system type; domain; system settings; the language your system uses; the country and time zone in which your device is located; the address of the web page that referred you to the website; the IP address and actual location of the device you use to connect to the Internet; and information about your interactions with the website such as the pages you visit.

We may use third-party web analytics services on our website, such as those of Google Analytics. These service providers use cookies to analyze how visitors use the website. The information the cookies collect (including your IP address) will be disclosed to these services providers who use the information to evaluate your use of the website. For information about how Google uses information, see Terms of Service and the Google Privacy Policy. To learn about opting out of Google Analytics, you may visit http://tools.google.com/dlpage/gaoptout.

We may combine information you provide and information we automatically collect with information from public or third-party sources to provide you with relevant information regarding our products and services.

INFORMATION WE COLLECT FROM OTHER ENTITIES

In the process of providing services to you, we may collect information about you from other entities, including insurance support organizations, government agencies; insurance information-sharing bureaus; and consumer reporting organizations. The information we collect primarily relates to your creditworthiness and the veracity of claims you submit to us. In addition, we may occasionally consult with an independent expert, such as a medical professional, when determining the value of the claim you have submitted to us.

INFORMATION WE RETAIN

We will only keep your personal information for as long as it is necessary for the purposes set out in this Privacy Statement unless a longer retention period is required or permitted by law. We will not keep your personal information any longer than necessary.

INFORMATION WE DISCLOSE

We only share your personal information as necessary to provide you with requested services and as required by our legal obligations. Specific instances of when your personal information may be shared with third parties include:

• To service a claim – your information may be provided to insurance companies and their agents, including our subsidiaries and/or affiliates. Your name, address, telephone number, policy number, and coverage may be shared with service providers to resolve claims.

• To an insurance institution, agent, insurance-support organization, or self-insurer to detect or prevent criminal activity, fraud, material misrepresentation, or material nondisclosure in connection with insurance transactions.

• To a medical-care institution or professional for the purpose of verifying insurance coverage or benefits, conducting operations or services audits (provided such information is only disclosed as is reasonably necessary to accomplish the foregoing purposes).

• To an insurance regulatory authority.

• To comply with Legal Obligations - your information may be provided to an attorney or law firm for the purpose of facilitating a claim.

• To law enforcement or other governmental authority, pursuant to law.

• To groups for the purpose of conducting actuarial analysis.

• To an affiliate or services provider in connection with an audit of the insurance institution or agent, or the marketing of an insurance product or service.

• To a group policyholder for the purpose of reporting claims experience or conducting an audit of the insurance institution's or agent's operations or services (provided the information disclosed is reasonably necessary for the group policyholder to conduct the review or audit)

• Information obtained via a report from an insurance-support organization (an organization regularly engaging, in whole or in part, in the business of assembling or collecting information about natural persons to provide information to an insurance institution or agent for insurance transactions) may be retained by the insurance-support organization and disclosed to other persons.

WE DO NOT SELL CONSUMER INFORMATION TO ANY THIRD PARTIES.

California Privacy Rights

This PRIVACY NOTICE FOR CALIFORNIA RESIDENTS supplements the information contained in our Website Privacy Statement. It applies solely to visitors, users, and others who reside in the State of California ("consumers" or "you") when visiting the website or subscribing to receive the services (collectively, our "Services"). We adopt this notice to comply with the California Consumer Privacy Act of 2018 ("CCPA") and other California privacy laws.

As a resident of California, you have the right to request and receive information on any third parties to whom we have disclosed personal information for marketing purposes within the previous calendar year, along with the type of personal information disclosed. We will not discriminate against you for exercising your rights under California law. If you would like to make such a request, please do so using the contact information below.

AS A RESIDENT OF CALIFORNIA, YOU HAVE THE LEGAL RIGHT TO:

Inquire and verify:

• If your personal information is in our possession and the type/categories of information we have about you.

• With whom your information has been shared.

• The business purpose for sharing your information.

• The type/categories of information shared with third parties.

• Copies of the specific personal information we have collected or stored.

Request:

• A deletion of your personal information.

• A restriction or to "opt-out" of having your personal information shared with a third party.

IF YOU ARE A CALIFORNIA RESIDENT AND WANT TO EXERCISE ANY OF THESE RIGHTS, YOU MAY DO SO VIA:

• Emailing at customerservice@agu.net;

• Contacting us at 804.273.9797; or

• Writing us at the address below.

Nevada Privacy Rights

If you are a resident of Nevada, you have the right to restrict us from selling certain personal information about you to third parties. Specifically, you have the right to restrict us from selling information we have collected about you through our online services and is tied to or includes a personal identifier. Personal identifiers include your name, social security number, date of birth, driver's license number, email or physical address, telephone number, or other information that could be used to verify your identity or contact you.

You may exercise this right to opt-out via:

• Emailing at customerservice@agu.net;

• Contacting us at 804.273.9797; or

• Writing us at the address below.

Privacy Rights Under State Insurance Regulations

If you are or were one of our policyholders, applicants, or claimants and a resident of Arizona, Connecticut, Georgia, Illinois, Maine, Massachusetts, Minnesota, Montana, New Jersey, North Carolina, Ohio, Oregon, Virginia, or other states pursuant to applicable law, you have rights over your private information under state-level insurance laws and regulations. This includes the right to access a copy of your information, request the correction/amendment of your information, or delete your information.

You may exercise any of these rights via:

• Emailing at customerservice@agu.net;

• Contacting us at 804.273.9797; or

• Writing us at the address below.

Links to Other Sites

We are not responsible for the availability of a link to this site on any other site. We do not take responsibility for the contents, advertising, products, privacy policies or other material made available through any other site, nor do we endorse other sites. Please direct any concerns with another site to the other site's appropriate contacts.

Privacy Statement Changes

This Privacy Statement is reviewed annually. We may also update this Privacy Statement as needed. The updated version will be indicated by an updated "Revised" date and the updated version will be effective as soon as it is accessible. If we make material changes to this Privacy Statement, we may notify you either by prominently posting a notice of such changes, or by directly sending you a notification. We encourage you to review this Privacy Statement frequently to be informed of how we are protecting your information.

Your Acceptance of this Policy

By using this website, you signify your acceptance of our Privacy Statement. If you do not agree with this Privacy Statement, please do not use our site.

Questions About Our Privacy and Information Security Practices?

Please feel free to contact us and your inquiry will be addressed promptly:

Wage Protector

4510 Cox Road Suite 111 - Glen Allen, VA 23060

customerservice@agu.net

(804) 273-9797

Hours of Operation: 8:30 AM to 5:00 PM Eastern