Accidents can happen anytime, anywhere. Major medical insurance pays many of the doctor and hospital bills - but there are likely to be many other medical and non-medical expenses that you must pay yourself. Even if you have an emergency cash fund, chances are it may not be enough.
With Accident Insurance from Combined Insurance, you can count on:
- Cash benefits paid directly to you for payable claims (in addition to all other private insurance)†††
- Immediate coverage - no waiting period
- 24/7 coverage on or off the job, 365 days a year
- No reduction in benefits if you file multiple claims
- Protection that you keep even if you change jobs
††† Unless you assign payable claims to a third party
Use your cash benefits to help cover all kinds of expenses:
- Deductibles and copayments on your medical insurance
- Other out-of-pocket medical costs
- Monthly expenses such as mortgage or rent, car payments, utility bills and more
- Everyday needs like childcare, home maintenance, groceries and transportation
Real-Life Facts
- Over 4 out of 10 people are treated in hospital emergency rooms every year!1
- The average hospital stay is 6 days.2
- The average hospital stay is over $10,000.3
- 43% of Americans report having a difficult time covering medical expenses - even with medical insurance.4
1National Safety Council, Injury Facts, 2016 edition.
2National Center for Health Statistics, Health, United States, 2015.
3Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, 2012.
4The Commonwealth Fund, Tracking Trends in Health Performance, 2014.
Exclusions and Limitations
This is an Accident Only policy. Benefits will not be payable if an injury is directly caused by, or results from, any sickness or infection* not as a result of the covered accident, or occurs as a result of a covered person's:
- Being intoxicated or under the influence of alcohol, an illegal substance or other prescription drug (unless taken as prescribed);**
- Participating in illegal activity or a felony;***
- Committing or attempting to commit suicide†, or self-inflicted intentional injuries;
- Having dental treatment, except for treatment due to injury of sound natural teeth;††
- War or any act of war, declared or undeclared, or serving in the armed forces or units auxiliary thereto.
The policy is guaranteed renewable for life, but the company reserves the right to increase premium rates on a class basis.
* "Infection" is not applicable in IL
** Not applicable in OR, NV, VT, MI, SD; "Alcoholism or drug addiction" in ID, OK, and WA
*** Not applicable in NJ; In ID, participating in a felony, riot, or insurrection
† In MO, while sane
†† In TN, "except for Emergency Dental, as defined in this policy, within 60 days of the Covered Accident"
Note: Hospital is an institution in the U.S. or Canada and does not include a nursing home or convalescent facility.
All benefits are payable once per a covered person, per a covered accident, unless otherwise indicated.
| Benefits | Standard | Choice | Preferred | Benefits Limits |
|---|---|---|---|---|
| Hospital Admission | $1,000 | $1,000 | $1,250 | |
| Hospital Confinement | $200 | $275 | $375 | Per day/Maximum 365 days |
| ICU Admission | $2,000 | $2,000 | $2,500 | |
| ICU Confinement | $400 | $550 | $750 | Per day/Maximum 30 days* |
| Rehabilitation Admission | $1,000 | $1,000 | $1,250 | |
| Rehabilitation Confinement | $120 | $165 | $225 | Per day/Maximum 30 days |
| Outpatient Surgical Facility | $200 | $200 | $300 | |
| Recovery Benefit | $35 | $50 | $100 | Per day/Maximum 7 days |
| Emergency Room | $75 | $100 | $150 | |
| Initial Doctor's Office Visit | $50 | $75 | $125 | |
| Follow-up, Physical & Occupational Therapy | $20 | $25 | $50 | Per day/Maximum 3 days |
| Urgent Care | $50 | $75 | $125 | |
| X-Ray | $15 | $20 | $40 | |
| Diagnostic exams (CT, MRI, etc.) | $75 | $100 | $200 | |
| Air Ambulance | $750 | $1,000 | $2,000 | |
| Ground Ambulance | $100 | $120 | $200 | |
| Appliances | $50 | $75 | $100 | |
| Blood, Plasma, Platelets | $150 | $200 | $300 | |
| Burns*** | $600 - $6,000 | $750 - $7,500 | $1,000 - $10,000 | |
| Coma Injury | $6,000 | $7,500 | $12,500 | |
| Concussion | $50 | $60 | $100 | |
| Emergency Dental Work*** | $40 - $160 | $50 - $200 | $100 - $400 | |
| Eye Injury | $150 | $200 | $300 | |
| Herniated Disc | $300 | $400 | $750 | |
| Internal Organ Loss | $2,000 | $2,500 | $2,500 | |
| Knee Cartilage Torn (repair) | $300 | $400 | $750 | |
| Lacerations*** | $15 - $250 | $20 - $300 | $30 - $500 | |
| Lodging (per night) | $75 | $100 | $150 | Maximum 30 nights |
| Loss of Finger, Toe, Hand, Foot or Sight*** | $450 - $7,500 | $600 - $10,000 | $1,000 - $20,000 | |
| Prosthetic Device or Artificial Limb | $250 | $500 | $1,500 | One prosthetic device or artificial limb |
| Prosthetic Device or Artificial Limb | $500 | $1,000 | $3,000 | More than one prosthetic device or artificial limb |
| Skin Graft | 25%† | 25%† | 25%† | |
| Surgery (abdomen/thoracic only) | $550 | $750 | $1,500 | |
| Tendon, Ligament, Rotator Cuff | $250 | $400 | $750 | One repair |
| Tendon, Ligament, Rotator Cuff | $450 | $600 | $1,125 | Multiple repairs |
| Transportation | $200 | $300 | $600 | |
| Fractures & Dislocations*** | $30 - $750 | $50 - $1,000 | $200 - $2,000 | |
| Sports Package | 25%** | 25%** | 25%** | Up to $1,000 per year |
| AD&D (Primary, spouse, child) | $20,000 | $30,000 | $50,000 | Per person |
*Maximum 31 days in UT
**Additional benefit of 25% of benefit amount paid for the Covered Accident if injury is sustained while participating in Organized Sports Activity.
***Benefit payable varies depending on the nature and severity of injury and/or treatment received.
†25% of applicable Burn Benefit Amount
IMPORTANT NOTICE This is a supplement to health insurance and is not a substitute for Major Medical Coverage. Lack of Major Medical Coverage (or other minimum essential coverage) may result in an additional payment with your taxes.
THIS IS VERY IMPORTANT: If a covered individual is a Medicaid recipient, policy benefits may be assigned and payable to your state Medicaid agency. Also, benefit payments you receive may count as income for Medicaid eligibility purposes.
This is a brief description of policy benefits for accident ONLY policy Form No.series 14150R. See the actual policy for complete details of the policy plans, features, benefits, options, rates, definitions, limitations, and exclusions. Products vary by state and are subject to availability and qualifications. The amount of benefits provided depend on the plan selected and the premium will vary with the benefit amount selected.
© 2016 Combined Insurance
A-ACC-LVB-GEN-R (8/16)