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US/Canada: (866) INSU-BUY, International: (972) 985-4400
Pilot's Disability Insurance

Paper Application

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"Temporary Loss of License"

Disability Insurance for People Who Fly For a Living

Cargo Pilots

Corporation Pilots

Helicopter Pilots

Aerial Applicators

Agricultural Pilots

Firefighter Pilots

Air Show Pilots


SPECIAL FEATURES
Recovery, Recurrent and Subsequent Disability:
A recurrent disability is one in which the Insured, received monthly benefits from this insurance, then recovers and subsequently suffers a recurrence of a disability, while this policy is in force, and arises out of or is contributed to by the same cause or causes as the original period of disablement.

The Insured is deemed to have made a recovery when he/she is able to engage in his/her regular occupation and perform the major duties thereof, even if he/she chooses not to.

If the period of recovery continues for 60 days or more, the recurrent disability shall be subject to a new elimination period. If the period of recovery is less than 60 days, no elimination period will be imposed.

If the Insured has made a recovery and suffers a subsequent disability which is covered by this insurance and such subsequent disability is entirely unrelated to the cause of any prior disability, a new elimination period will apply.

With regard to any such recurrent or subsequent disability as insured, the Underwriters will pay the monthly benefit only for the unused portion of the maximum benefit period not previously exhausted by payment of monthly benefit due to any prior disability.

Air travel:
This policy, subject otherwise to its terms, limitations and conditions covers claims arising out of bodily injury sustained by the Insured Person while flying as a pilot, or crew member, in any aircraft for which the Insured Person holds a current valid license or as a passenger in any aircraft including while boarding and alighting therefrom.

Territorial limits:
This policy covers the Insured Person anywhere in the world.

DEFINITIONS
  • Bodily Injury means identifiable physical injury which: a) is caused by an Accident, and b) solely and independently of any other cause, except Sickness directly resulting from, or medical or surgical treatment rendered necessary by such injury, results in a disability which begins within twelve months from the date of the Accident.

  • Accident means a sudden, unexpected, unusual, specific event which occurs at an identifiable time and place. It shall also include exposure resulting form a mishap to a conveyance in which you are traveling.

  • Sickness means a sickness or disease which first manifests itself while this policy is in force. It may result (directly and independently of all other causes), in loss covered by this Policy.

  • Total Disablement means that the you are wholly and continually prevented from performing the major duties pertaining to your occupation as a Pilot.

  • Elimination Period means the number of days at the beginning of a period of total disability, for which no benefit is payable.

  • Maximum Benefit Period means the overall maximum number of months as set forth in the schedule for which monthly benefits are payable by the Underwriters.


SPECIFIED OCCUPATIONS
This is a Specified Occupation Plan. It will terminate automatically if you change from the occupation in which you were engaged at the time the plan was issued, unless an agreement has been obtained in writing from the underwriters and any additional premium required by the underwriters has been paid. The sole liability of the underwriters in the event of an occupation change shall be to return on a pro-rata basis any unearned premiums paid for the balance of the plan term.

TERM OF INSURANCE
The Certificate of Insurance is issued for periods of 1 to 3 years. It is contemplated that the plan will be renewed, however, the underwriters reserve the right to refuse to renew the Certificate or to change the premium rates on renewal of the Certificate. A statement of good health may be required by the underwriters for consideration of renewal. Non-renewal by the Insurer will be without prejudice to any claim in connection with a loss commencing while this plan is in force.

EXCLUSIONS
This policy does not cover losses arising from Bodily Injury, Sickness or Disease directly or indirectly caused or contributed by:
  • War, Invasion, Acts of Foreign Enemies, Hostilities (whether War be declared or not), Civil War, Rebellion, Insurrection or Military or Usurped Power or the Insured Person engaging in or taking part in Naval, Military or Air Force service or operations.

  • Intentional self-injury, attempted suicide (whether felonious or not), assault provoked by the Insured, dueling, fighting (except in bona fide self-defense), venereal or other sexually transmissible diseases.

  • Deliberate exposure of the Insured to exceptional danger (except in an attempt to save human life or to prevent loss of or damage to aircraft, aircraft equipment or other property whatsoever) or any criminal act of the Insured for which the Insured shall have been convicted upon indictment.

  • Psychotic, Psycho-Neurotic or Epileptic causes, personality and/or character change(s) or mental or emotional disease or disorders of any type.

  • Any changes in medical standards imposed by the Licensing Authorities or any other competent authority including Government during the period of this Insurance.

  • Being under the influence of alcohol or having taken drugs or narcotics unless prescribed by a legally qualified physician or surgeon.

  • Injury occasioned or occurring while the Insured Person is committing or attempting to commit a felony or to which a contributing cause was the Insured Person being engaged in an illegal occupation.

  • While riding or driving in any kind of race or endurance test.

  • Pregnancy, Childbirth, Miscarriage or Abortion.

PRIVACY POLICY STATEMENT
Petersen International Underwriters
Petersen International Underwriters want you to understand how they protect the confidentiality of non-public personal information they collected about you.

Information PIU Collects
PIU collects non-public information about you from numerous sources including, but not limited to:
  1. Information PIU receives from you on applications and other forms;
  2. Information about your transactions with the affiliates, others or PIU;
  3. Information PIU receives from consumer-reporting agencies; and
  4. Financial and medical sources.
Information PIU Discloses
PIU does not disclose any non-public information about you to anyone except as is necessary in order to provide the products or services to you or otherwise as required or permitted by law (e.g. subpoena, fraud investigation, regulatory reporting, etc.).

Confidentiality and Security
PIU restricts access to non-public personal information about you to PIU's employees, PIU's affiliates' employees or others who need to know that information to service your account. PIU maintains physical, electronic and procedural safeguards to protect your non-public personal information.

Contacting PIU
If you have any further questions about this privacy statement or would like to learn more about how PIU protects your privacy, please contact us.

ADMINISTRATOR & UNDERWRITER
This plan is administered by

Petersen International Underwriters
23929 Valencia Boulevard, Suite 215
Valencia, CA 91355-2186

It is underwritten by Certain Underwriters at Lloyd's that is rated A "Excellent" by A.M. Best.



This is a brief description of the insurance provided by this plan. The Certificate of Insurance is the complete description of coverage.