For total and permanent disablement which occurs while a member is employed in a gainful occupation, business or profession or within 6 months of the date an insured member becomes unemployed, the following definition shall apply:
Total and permanent disability occurs when:
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(i)
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the Member suffers the loss of use of 2 limbs or the sight of both eyes or the loss of use of one limb and the sight of one eye (where limb is defined as the whole hand or the whole foot), or;
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(ii)
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the Member having been absent from their Occupation with the Employer through Injury or Illness for 6 consecutive months and having provided proof to the satisfaction of us that the Member has become incapacitated to such an extent as to render the Member unlikely ever to engage in or work for reward in any occupation or work for which he or she is reasonably qualified by reason of education, training or experience.
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(iii)
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the Member through Illness or Injury and having provided proof to the satisfaction of us is permanently unable to perform 2 of the following 6 basic activities of everyday living.
- Bathing – to shower or bathe
- Dressing – to dress or undress;
- Toileting – to use the toilet including getting on and off;
- Feeding – to eat and drink;
- Mobility – to get out of bed or chair or wheelchair; or
- Continence – to control bladder and bowel function; or
If the Member can perform the activity by using special equipment, they will be considered able to undertake that activity.
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(iv)
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the Member through Illness or Injury and having provided proof to the satisfaction of us is suffering from the permanent deterioration or loss of intellectual capacity that has required the Member to be under continuous care and supervision by another adult person for 6 consecutive months and this care is likely to be on a permanent daily basis and on-going.
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