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Comprehensive Major Medical Benefit Your BenefitsBenefits are payable, as shown in the Schedule of Benefits, for Covered Charges that you, or one of your Dependents, incur within a calendar year, which are in excess of the Deductible. The DeductibleThe Deductible is an "out-of-pocket" expense which you and your Dependents are required to pay before you are entitled to the Comprehensive Major Medical Benefit. The Deductible Amount per individual is shown in the Schedule of Benefits. The Deductible applies only once in the calendar year. Any expenses incurred in the last three (3) months of a calendar year which are used to satisfy the Deductible, in part of in full, will also be applied to reduce the Deductible for the following calendar year. Common AccidentIf two (2) or more covered members in a family are injured in the same accident, only one Deductible has to be met during that calendar year and the following calendar year for Covered Charges which are incurred as a result of the common accident. Separate Deductibles will still apply to charges not related to the common accident. Automatic ReinstatementMajor Medical benefit payments made on you or your dependent's behalf reduce the lifetime Maximum Benefit amount. Each January 1st, the Plan will automatically reinstate the amount of Comprehensive Major Medical Benefits which have been paid during the preceding calendar year, up to a maximum of one thousand dollars ($1,000). The reinstatement is made without any action required on your part. However, in no event will the total benefit, including any amount reinstated, exceed the original lifetime maximum at any one time. Maximum BenefitThe annual maximum amount payable with respect to all illnesses or injuries is shown below:
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