An Accident/Disability/Sickness Plan offered by TransAmerica Life*
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Trans Accident provides
Insureds with several benefits to assist with injuries
associated with certain accidents. More importantly, it
gives Insureds peace of mind in the event of a Covered Accident. |
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*** This plan includes options
that pay $1000/month disability/sickness benefit in
addition to amounts listed below *** |
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Schedule of Benefits
Accident
Specific Sum of Injuries Benefit
| Pays for
dislocations, burns, ruptured discs and torn knee
cartilage, eye injuries, lacerations, internal injuries,
fractures, and blood and plasma. See Rider for specific
amounts payable, definitions, and limitations for each
specific accident. (Benefits will not be paid for
services rendered by a member of the immediate family of
a Covered Person)
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$30 -
$2,000 |
The following is an example
of the Policy Schedule benefits:
Dislocation (Dislocations
which are reduced under anesthesia)
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From Hip |
Open reduction |
$2,000 |
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Closed reduction |
665 |
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To Toe or Finger |
Open reduction |
130 |
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Closed reduction |
65 |
Tendons and Ligaments
Tendons and ligaments must be
torn, ruptured, or severed and must be treated by a
physician within 72 hours after the Covered Accident and
repaired through surgery within six months after the Covered
Accident.
If the Covered Person received a fracture and/or a
dislocation and also tears, ruptures, or severs a
tendon/ligament in a Covered Accident, the Insurer will pay
only one benefit. The Insurer will pay the largest of this
benefit, the Fractures Benefit or the Dislocation Benefit.
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Repair of one |
$330 |
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Repair of all if more
than one |
665 |
Burns (Treated by a
physician within 72 hours after the accident)
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From Second degree burns
of at least 25%, but not more than 35% of body
surface |
$265 |
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To Third degree burns
covering more than 25 square inches of body surface |
2,665 |
Ruptured Disc or Torn Knee
Cartilage
Must be
treated by a physician within 72 hours after the accident
and repaired through surgery within one year after the
Covered Accident.
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Accident within the
first year of coverage |
$130 |
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Thereafter |
400 |
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Eye Injury |
With
surgical repair |
$130 |
Accident Follow-Up Treatment
Benefit
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Pays for additional
treatment of injuries sustained in a Covered Accident
over and above emergency treatment administered within
72 hours following the accident. This benefit is payable
for up to a maximum of three treatments per Covered
Person per Covered Accident. Such treatment must begin
within 30 days of the Covered Accident or discharge from
the hospital or extended care facility, and be within
the six-month period following the Covered Accident or
discharge. Treatments must be furnished by a physician
in a physician's office or in a hospital on an
outpatient basis. (Benefits will not be paid for
services rendered by a member of the immediate family of
a Covered Person)
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$25/visit |
Accident Emergency Treatment
Benefit
Pays for emergency treatment for a
Covered Accident; we will pay the amount shown in the Policy
Schedule for treatment received. This benefit is payable for
treatment by a physician, x-rays, or treatment received in a
hospital emergency room. Treatment must be received within 72
hours of such accident for benefits to be payable. This benefit
is payable once per Covered Accident. (Benefits will not be paid
for services rendered by a member of the immediate family of a
Covered Person.)
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Insured & Spouse |
$100 |
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Children |
70 |
Initial Hospitalization For
Injury Benefit
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When a Covered Person is
hospital confined for 24 hours or more for a covered
accidental bodily injury, the Insurer will pay the
benefit amount shown in the Policy Schedule. This
benefit is payable only once per Hospital Confinement
and only once for each Covered Person per calendar year
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$500
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Accident Hospital Income
Benefit
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Pays for hospital
confinement for treatment of a Covered Accident, the
Insurer will pay the daily amount shown in the Policy
Schedule for each day of such confinement. Such
confinement must start within 30 days of the accident.
The Insurer will pay this benefit for up to 365 days per
Covered
Accident..................................................................................................................
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$100/day
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Additional Intensive Care
Benefit
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Pays an additional benefit
equal to three times the Accident Hospital Income
Benefit for each day the Covered Person is confined in
an Intensive Care Unit (ICU). This benefit is payable
for up to 15 days per Covered Accident
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$300/day
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Accidental Death Benefit
Death must occur as a result of a
Covered Accident and must occur within 90 days of a Covered
Accident
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Insured |
Spouse |
Child |
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Common-Carrier Accidents |
$35,000 |
$17,500 |
$3,500 |
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Motorized-Vehicle or
Pedestrian Accidents |
25,000 |
12,500 |
2,500 |
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Other Accidents |
15,000 |
7,500 |
1,500 |
Accidental Dismemberment
Pays a percentage of the Accidental
Death Benefit selected.
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Both arms
and both legs |
100% |
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Two arms or
two legs |
50% |
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Two eyes,
hands, or feet |
50% |
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One eye,
hand, foot, or leg |
20% |
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One or more
fingers and/or one or more toes |
5% |
Ambulance Benefit
Pays for ambulance transportation to
a hospital or emergency center (within 100 miles) for injuries
sustained in a Covered Accident. Ambulance transportation must
be within 72 hours of the accident. Pays four times the
Ambulance Benefit for transportation provided by an air
ambulance.
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Ground Ambulance |
$150 |
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Air Ambulance |
600 |
Appliances Benefit
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Pays if the physician
advises a Covered Person to use a medical appliance as
an aid in personal mobility as a result of injuries
sustained in a Covered Accident. Benefits include and
are payable for: crutches, leg braces, wheelchairs, and
walkers
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$100
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Physical Therapy Benefit
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Pays if the physician
advises a Covered Person to seek treatment from a
physical therapist. Physical therapy must be for
injuries sustained in a Covered Accident and must start
within 30 days of such accident or discharge from the
hospital. Pays for one treatment per day up to six
treatments per Covered Accident. The six treatments must
take place within six months after the
accident...................................................................................................................
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$50/day
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Prosthesis Benefit
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Pays if a Covered Person
requires use of a prosthetic device as a result of a
Covered
Accident
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$500 |
Transportation Benefit
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The local attending
physician must prescribe the treatment, and the
treatment must not be available locally. This benefit is
not payable for transportation to any hospital located
within a 100-mile radius of the site of the accident or
residence of the Covered Person
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$300 |
Family Lodging Benefit
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Pays for one motel or hotel
for a member (or members) of the immediate family to
accompany the Covered Person for hospital confinement
for the treatment of injuries sustained in a Covered
Accident. The hospital and the motel or hotel must be
more than 100 miles from the residence of the Covered
Person. The local attending physician must prescribe the
treatment. This benefit is payable for up to 30 days per
Covered Accident
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$100/day |
Wellness Benefit
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After 12 months of paid
premium for this benefit, the Insurer will pay for an
Insured to undergo routine examinations or other
preventive testing. Benefits include and are payable
for: annual physician exams; mammograms, pap smears,
immunizations, flexible sigmoidoscopy, Prostatic
Specific Antigen, and blood screenings. This benefit
will become available following each anniversary of this
Rider's Effective Date, and is payable only once each
12-month period. Family members include an insured
employee's spouse and dependent children. Services must
be under the supervision of, or recommended by a
physican and a charge must be
incurred...................................................................... |
$60 |
Additional
Limitations and Exclusions
The Insurer will not pay benefits
for a Covered Accident that is caused by, or occurs as a result
of:
- Mountaineering, parachuting,
or hang gliding. (Does not apply in Iowa).
- Poison, gas, or fumes
voluntarily taken, administered, absorbed, or inhaled.
- Alcoholism or drug
addiction.
- Participating in any sport
or activity for wage, compensation, or profit; or racing any
type vehicle in an organized event.
- Travel in, or descent from
any vehicle or device for aerial navigation, except as a
fare-paying passenger in an aircraft operated by a
commercial airline (other than a chartered airline) on a
regularly scheduled passenger trip.
- War, or any act of war,
whether declared or undeclared.
- Participating in any
activity or event, including the operation of a vehicle,
while under the influence of a controlled substance (unless
administered by a physician or taken according to the
physician's instructions), or committing an illegal act
while intoxicated (intoxicated means that condition as
defined by the law of the jurisdiction in which the accident
occurred).
- Participating in, or an
attempt to participate in, an illegal activity that is
defined as a felony, whether charged or not. (A felony is
defined by the law of jurisdiction in which the activity
takes place.)
- Intentionally self-inflicted
bodily injury or attempted suicide, while sane or insane
(while sane in Missouri).
- Any loss incurred while on
active duty status in the armed forces. (If the Insurer is
notified of such active duty, a refund will be provided for
any premiums paid for any period for which no coverage is
provided as a result of exception.)
*Benefits and rates subject to change. Please call us at
877-472-5541 for current information.
Presented By
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