Accident Insurance

Offering Vital Protection When Accidents Happen

Unfortunately, accidents are a fact of life. They come in many forms, ranging from falls, burns or unintentional poisoning to motor vehicle or gun-related accidents. They cause a wide range of injuries which, in turn, can create a tremendous financial burden for men and women who are unprepared. Amalgamated Life offers a robust Accident Insurance policy designed to provide vital protection when an accident-related injury occurs.

BENEFIT AMOUNT
Primary Insured
Non-Common Carrier Accident $25,000
Common Carrier Accident $100,000
Catastrophic Accident $20,000*
Loss of Fingers, Toes, Hands, Feet, Arms, Legs or Sight of Eyes
Loss of one hand, or one foot, or one arm, or one leg, or sight of one eye
$10,000
Loss of one finger or toe $2,000
Spouse
Non-Common Carrier Accident $25,000
Common Carrier Accident $100,000
Catastrophic Accident $10,000*
Loss of Fingers, Toes, Hands, Feet, Arms, Legs or Sight of Eyes
Loss of one hand, or one foot, or one arm, or one leg, or sight of one eye
$5,000
Loss of one finger or toe $1,000
Children
Non-Common Carrier Accident $5,000
Common Carrier Accident $10,000
Catastrophic Accident $10,000*
Loss of Fingers, Toes, Hands, Feet, Arms, Legs or Sight of Eyes
Loss of one hand, or one foot, or one arm, or one leg, or sight of one eye
$5,000
Loss of one finger or toe $1,000
Accident Follow-Up $25
Air Ambulance $500
Ambulance $150
Blood, Plasma, Platelets $200
Burns
  Flat amount for:
  2nd degree for 36% or more of body surface $500
  3rd degree 9-34 sq. in. of body surface $1,000
  3rd degree 35 or more sq. in. of body surface $10,000
Coma $7,500
Concussion $50
Dislocation (based on joint involved)
  Open Reduction $100 to $2,000
  Closed Reduction $50 to $1,000
Emergency Dental Work
Broken teeth repaired with crown(s) $300
Broken teeth resulting in extraction(s) $100
Emergency Room Treatment $150
Eye Injury
Surgical Repair $200
Removal of Foreign Object $50
Fracture (based on bone involved)
  Open Reduction   $200 to $1,500
  Closed Reduction   $100 to $1,500
Hospital Admission $1,000
Hospital Confinement Per Day $200
Hospital ICU Admission $1,500
Hospital ICU Confinement Per Day $400
Initial Office Visit $25
Knee Cartilage (Torn)
  With Surgical Repair $500
  Exploratory Surgery or Debridement $150
Laceration
  Treated without stitches, staples, glue $25
  Total not more than 3 inches long
(less than 7.6 centimeters) and repaired by stitches
$50
  Total is greater than 3 and not more than 5 inches long
(7.6 to 12.5 centimeters) and repaired by stitches
$200
  Total is over 5 inches long (12.5 centimeters) and repaired by stitches $400
Lodging Per Day $100
Major Diagnostic Exam $150
Medical Appliances $100
Pain Management/Epidural $75
Paralysis
  Hemiplegia $4,000
  Paraplegia $5,000
  Quadriplegia $10,000
Physical Therapy Per Day $25
Prosthetic Device/Artificial Limb
  One prosthetic device or artificial limb $500
  More than one device or artificial limb $750
Rehabilitation Unit Per Day $100
Ruptured Disc with Surgical Repair $500
Skin Graft 50% of Burn Benefit
Surgery
  Cranial $1,000
  Hernia with Surgical Repair $1,000
  Abdominal/Thoracic With Surgical Repair $1,000
  Abdominal/Thoracic Exploratory Surgery $150
  Miscellaneous Surgery with general anesthesia $250
  Miscellaneous Surgery with conscious sedation $100
Tendon/ Ligament/ Rotator Cuff
  Surgical repair of one or more tendon, ligament or rotator cuff $500
  If exploratory arthroscopic surgery is performed and no repair is done $150
Transportation $350
X-Ray $50

YOU Decide How to Use the Cash Benefits

Our cash benefits provide you with greater coverage options because you get to decide how to use them.

Finances
Can help protect your HSAs, savings, retirement plans and 401ks from being depleted

Travel
You can use your cash benefits to help pay for expenses while
receiving treatment in another city

Home
You can use your cash benefits to help pay the mortgage, rental
payments, or perform needed home repairs for your after care

Expenses
The cash benefit can be used to help pay your family’s living
expenses such as bills, electricity and gas

Accident Plan Features

  • Guaranteed Issue—No medical questions asked
  • Guaranteed Renewable—Coverage remains in force for life as long as premiums are paid
  • Coverage for Family—Insured, spouse and dependent children
  • Portability—Insured can keep benefits even with a change of jobs or retirement
  • Level Premium—Rates do not increase with age

Here’s How it Works

Imagine while cleaning the gutters, you fall from the ladder and break your leg.

These are out-of-pocket expenses you may encounter:
$100 Emergency room copay
$250 Deductible (copays do not count toward deductible)
$35 Specialist visit copay—orthopedic surgeon
$350 Specialist visit copay—occupational/physical therapy for 10 days
$735 Out-of-pocket expenses
And here is a sample of benefits you may be eligible for with Amalgamated Life’s Accident Insurance:
$150 Accident Emergency Treatment
$50 X-Ray (for diagnosis of broken leg)
$150 MRI
$675 Fracture (broken leg)
$100 Appliance (crutches)
$25 Accident Follow-up Doctor ($25 per visit, up to 1 per accident)
$150 Physical Therapy ($25/day for 6 days)
$1,150 of benefits paid to you in additional to other coverage you may have with other insurance companies

Accident Claims Checklist

Have this information handy to identify your policy:
  • Policy number
  • Policyholder’s name 
  • Policyholder’s date of birth   
  • Policyholder’s address
Here’s a list of common items you will need to file a claim:
  • Patient’s name and date of birth
  • Patient’s relationship to policyholder
  • Date and description of injury
  • Location of accident
  • Copy of police report (motor vehicle accidents)
  • Authorization to obtain information: To allow Amalgamated Life to contact your provider on your behalf, please include the provider’s name, address and fax number (if available)
  • For hospital confinement: Ask your hospital to provide a completed UB04 document or ask your physician to provide a completed HCFA 1500 document
  • For surgery: Include the operative report, and both the surgeon’s and anesthesia’s bills
  • Include all ambulance, mobility aids, lodging and transportation invoices

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