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PROVIDENT INSURANCE

New Hampshire State Firemen's Association - Effective 01/01/05
Emergency Responder 1
Benefits apply to all classes of membership while
performing an activity of the organization.

Covered injury death benefit - payable for bodily injuries that result in death and are directly related to a covered activity - $10,000

  • Includes Dismemberment, Loss of Sight, Speech or Hearing according to the Table of Losses - up to $10,000.
  • Seat Belt Benefit - Pays an additional 20% of the Principal sum $2,000.
  • Dependent Child Benefit - Pays an additional $10,000 per dependant child.
  • Bereavement Benefit - Pays an additional 10% of the Principal Sum up to $10,000, up to $1,000.

  • Cosmetic Disfigurement from Burns - Payable for third and fourth degree burns, up to $10,000.
  • Covered Illness Death Benefit - Payable for illness that are contracted or suffered during or resulting from a covered activity of the organization. $10,000.
  • Total Weekly Disability Benefits for Volunteers - Covered injury(s) payable up to Lifetime. Covered illness payable up to 5 years. $75/wk
  • Total Weekly Disability Benefits for Career Personnel - Covered injury(s) and illness payable up to 5 years. $75/wk
  • Cost of Living Adjustment - COLA can triple disability payments, up to $225/week
  • Transition Benefit - Payable up to 26 weeks when employer eliminates insured's position. $75/wk
  • Medical Expense Benefit - No time limit for first medical treatment, up to $5,000
This program administered by Provident Agency, Inc., PO Box 11588, Pittsburg, PA 15238-0588.
Toll-Free 1-800-447-0360. This is only an outline.
For actual policy language, see form 209 and 209-AMD, issued by
Provident Life and Accident Insurance Co., Chattanooga, TN.
Benefits for Emergency Service Organizations Since 1928.

 

Download your
Provident Claim Form

Contact Tom Green

Green  Insurance Associates Green Insurance Associates, LLC, our Provident Insurance Carrier

Provident Insurance Provident Life and
Accident Insurance Co



EMAIL NEW HAMPSHIRE STATE FIREMEN'S ASSOCIATION
POST OFFICE BOX 617
CONCORD, NEW HAMPSHIRE 03302

© 2008 ALL RIGHTS RESERVED.
Designed by Earl S. Lincoln