|
Accidental Death |
| - Primary Insured |
$250,000 |
| - Spouse |
$50,000 |
| - Children |
$10,000 |
|
Dismemberment |
| - Primary Insured |
Up to $60,000 |
| - Spouse |
Up to $30,000 |
| - Children |
Up to $4,000 |
| Emergency Treatment |
$200 |
|
Accident Follow up |
| Per Follow up |
$60 |
| # of Treatments / Acc |
12 |
| Ambulance (ground) |
$300 |
| Ambulance (air) |
$2,000 |
| Burns (30% + of Body) |
$15,000 |
| Dislocation (Open Reduction) |
$6,800 |
| Dislocation (Closed Reduction) |
$1,800 |
| Family Lodging (30 days max) |
$300 |
| Fracture (Open/Compound) |
Up to $8,000 |
| Fracture (Closed Compound) |
Up to $4,000 |
| Lacerations |
$200 |
| Diagnostic Exams |
$300 |
| Paralysis Quadriplegia |
$10,000 |
| Hemiplegia |
$6,000 |
| Paraplegia |
$4,000 |
| Physical Therapy (max 10) |
$40 |
| Prosthesis |
$1,000 |
| Surgery |
Up to $1,600 |
| Transportation (Round trip) |
$600 |
Hospital Admission Benefit
(per admission) |
$1,750 |
Hospital Confinement
(per day) |
$350 |
Intensive Care Benefit
(per day) |
$350 |
Rehabilitation Benefit
(per day) |
$100 |
|
Hospital Cash Rider — Benefits Descriptions
|
| The optional Hospital Cash Rider pays benefits for the primary
insured for hospital admission, hospital confinement, intensive care and
rehabilitation resulting from a covered accident. The maximum number of units
is five (5). Each benefit has limits on the number of days of payment per year
and lifetime. This is an indemnity benefit. If the rider is selected, all
dependents covered by the base plan will be covered by the Hospital Cash Rider. |
|
1. Hospital Admission Benefit
|
| The company will pay the applicable principal sum upon the
insured's admission to a hospital as the result of injures sustained in a
covered accident. This benefit is payable as a lump sum and is in addition to
the Hospital Confinement Benefit. The confinement must begin within 72 hours
after the accident. This benefit is payable only once per year. |
|
2. Hospital Confinement Benefit
|
| The company will pay the applicable principal sum if the insured is
confined to a hospital for at least 24 hours as the result of injuries
sustained in a covered accident. The confinement in the hospital must begin
within 72 hours after the accident. This benefit is limited to 30 consecutive
days of hospital confinement per injury for each insured person.The lifetime
limit for this benefit is 365 days for each insured person.
|
|
3. Intensive Care Unit Benefit
|
|
The company will pay the applicable principal sum if the insured is confined to
an intensive care unit of a hospital as the result of injures sustained in a
covered accident and is only payable on the same days as the Hospital
Confinement Benefit is payable. This benefit is limited to 15 days of intensive
care unite confinement per injury for each insured person.If any covered
insured is confined to a hospital unit that does not meet the definition of
intensive care unit in this policy, the company will pa the Hospital
Confinement Benefit.
|
|