What is Accident Insurance and How Does it Work? – liveinsure.in

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If you are anything like Daffy Duck (Looney Tunes and Merrie Melodies), you definitely need accident insurance cover. However, most people don’t know the difference between an accident cover and a health insurance plan.

A health plan provides coverage for medical bills and hospital charges. The money is usually paid to the medical provider, in case it is among the network hospitals of the insurer. The plan does not solely cater to accidents, but other diseases and medical conditions as well.On the other hand, an accident insurance plan covers a broad range of accidental injuries and death. The money for recovery is usually given to the insured or the family to take care of needs arising out of the accident, injuryor death.

What is accident insurance?

Accident insurance is a supplemental insurance that helps you pay for out-of-pocket medical and non-medical costs from an accident or injury. With accident insurance you receive payment in the form of a lump-sum cash benefit that is paid directly to you, and not to the doctors and hospitals. This allows you to use the cash where it will impact you and your family the most, including paying for expenses related to your accident as well as non-medical expenses like childcare, transportation to a therapist, and even rent or groceries.

Even if your health plan covers 100% of your accident, your accident insurance benefits are still payable to you. You decide how best to use the funds – for medical expenses like treatment or medication, or to supplement loss of work and other bills. This flexibility is what makes accident insurance unique.

Medical expenses are one of the most common financial hardships for Americans every year¹. Accidents are no exception to these expenses: Americans visit the emergency room more than 30 million times each year to treat many types of injuries². Beyond covering medical expenses, your injury could put you at risk of missing work, which adds to the stress of paying your mortgage, utility bills, and putting food on the table for your family.

Most Americans don’t have a rainy-day fund to cover unexpected medical expenses when accidents strike — nearly 7 in 10 Americans don’t even have $1000 in savings³. This lack of savings can be a big problem if you are injured and need to go to the hospital. That’s where accident insurance comes in.

The average deductible for an individual insurance plan is around $1,600⁴ with out-of-pocket maximums topping out at over $8,000⁵. This is where accident insurance can help you cover medical and non-medical expenses that typically accompany an accident. Using accident insurance to help cover medical costs is a great way to pay for expensive medical bills while also avoiding going into debt to pay them. This coverage can be a huge relief during an already financially stressful time for you and your family.

How does accident insurance work?

Accident insurance provides specific cash benefits for injuries caused by a covered accident. These cash benefits may be used for expenses like copays and deductibles. Like disability insurance, your accident insurance policy should pay you or your beneficiaries a cash benefit whether the injury occurred on or off the job. And you can use the money however you want – pay off bills or take a vacation.

So how does it work?

Let’s say your child, who is already covered on your accident insurance policy, fractures his ankle during a football game and is taken by ambulance to the ER. X-rays determine he has a severe fracture, requiring a hospital stay. Your son is released the next day with a nifty little cast. Because you haven’t met your deductible for the year, you find your health insurance doesn’t cover the entire medical bill. So, you’re left paying hundreds or thousands of dollars out-of-pocket. However, since you have accident insurance, you can simply submit this claim to the insurance company you bought it from. After the claim has been approved, you receive the cash (this only takes about 10 business days with Assurity).

Here are some of the advantages to having an accident insurance policy:

  • Immediate protection within days of receiving your application
  • Helps cover out-of-pocket expenses
  • Benefits are paid directly to you
  • Guaranteed issue or guaranteed renewable (Some insurance policies require no medical exams or tests to qualify, while others do. Once you’ve been accepted, your rates cannot be raised and your policy cannot be cancelled up to a certain age as long as you continue to pay your premiums.)
  • No deductibles, copays or coinsurance
  • Health Savings Account (HSA) friendly

What does accident insurance cover?

As a leader in the accident insurance market, Assurity is always looking at how we can help our customers deal with increasingly high deductibles. As the cost of healthcare continues to rise, even a small accident could turn into a big problem for many families. Accident insurance brings meaningful coverage with real cash benefits, and it’s important to understand your coverage and get help when you need it.

Accident insurance provides a cash payment that can be used to pay for medical expenses resulting from a covered accident. Healing and getting healthy shouldn’t mean a gut-punch to the bank account or regular daily life. That’s why these payments can be used for other expenses too – mortgage or rent, groceries, bills, even childcare. You or your family have the freedom to choose how you want to use your money.

So, what does accident insurance actually cover?

Here is a broad list of what’s covered by an accident insurance policy, along with a few specific types of injuries that may be covered within each category:

  • Emergency care – hospital treatment, ambulance, X-rays, exams or ER visit
  • Specific injury care – burns, concussion, emergency dental work, ear or eye injury or poisoning
  • Supportive care – follow-up treatment, physical therapy, prescription meds, supplies, or even transportation and lodging
  • Hospital care – hospital admission/confinement, intensive care or rehab unit
  • Surgical care – major surgery, ruptured disc, hernia, outpatient surgery or anesthesia
  • Accidental death – benefit is paid directly to your beneficiaries if your death is a result of an accident
  • Preventive care – some policies offer a wellness benefit that pays you cash back for routine blood work, immunizations and more

The types of injuries listed above are not a complete list. In most cases, the more severe the injury, the higher the benefit amount. For conditions that may be less serious, like a cracked tooth or eye injury, your benefit may only be a few hundred dollars. For more serious conditions, such as a coma or paralysis, you can expect a benefit as high as $40,000 or $60,000. Some accident insurance policies also cover the use of medical supplies and devices, such as crutches or even a prosthetic limb. If you die from an accident, as much as $350,000 could be paid to your beneficiaries.

What’s not covered?

If your insurance company doesn’t specifically identify your injury, you won’t receive a benefit. Accident insurance typically does not cover suicide, accidents arising out of illegal activities, self-inflicted injuries, etc. So, if you were drinking while you got injured, it’s very possible your claim would be denied.

Many insurance plans offer riders – options you can add for additional coverage. A common rider available for accident insurance plans is an accidental death and dismemberment rider. This type of rider pays out a benefit to the deceased’s beneficiaries if the insured died or became dismembered (loss of a limb) from an accident. Many individual accident insurance policies offer accidental death insurance as part of the policy, not as an optional rider – oftentimes it’s actually called accidental death insurance.


Each insurance company has different rules about who is eligible to get benefits. For one, you must be 18 years of age. And at a certain age your accident coverage may end, usually between age 60 and 75. Coverage can be available for both individuals and families, including spouses/domestic partners and children.

Is accident insurance worth it?

Accident insurance is not too complicated. In the event of your death or a disability due to an accident, it would pay you or your beneficiaries cash.

Who may need accident insurance?

  • Individuals and families with active lifestyles
  • Individuals and families with small children
  • Anyone with current health insurance
  • Anyone with a limited budget for unexpected medical expenses
  • If you’re looking for an affordable alternative to life insurance or if you want to supplement your life insurance coverage
  • If you’re unable to qualify for life insurance due to medical reasons
  • If a pre-existing condition makes you ineligible for disability insurance, you could receive benefits instead through an accident insurance policy

High health insurance deductibles and unpaid bills can affect your lifestyle, home and family. If your health insurance has higher deductibles or copays, you may benefit from taking out an accident insurance policy. This is because accident insurance offers an easy one-time payment that can help offset your medical expenses. Also, many accident insurance policies are portable, meaning if you leave your job you can take your accident insurance policy with you.

Why do you Need Accident Cover?

Contrary to the popular misconception, a medical insurance plan does not provide complete coverage against the losses arising out of an accident. Although some health insurance policies offer accidental riders, these are not as beneficial as a comprehensive accident insuranceplan. Even if it is, it only covers hospitalization charges, not loss of income.

An accident policy is designed to cover a number of unforeseen eventualities (although not when there is negligence). Accident plans are annual policies that provide coverage in the event of disability, injury or death; caused by accidental or violent events. This includes situations like road accidents, train accidents, or even a fall in the bathroom.

What are the benefits of our accident insurance?

It’s paid directly to you

An accident insurance plan pays you directly in cash without any deductible or extra waiting time after your claim is verified.

You choose how to spend your money

The money you receive from your accident insurance can be used however you want as you recover from your injuries, covering anything from medical costs to non-medical costs like your monthly rent.

Take advantage of our flexible Rainy Day Fund.

Our Rainy Day Fund is standard on all plans. Start each year with up to $500 in the fund that we use to pay claims that would otherwise be denied due to certain limitations.

Use optional features for extra coverage

Employers can tailor their benefits to their employees. With our Injury-Free BenefitTM, you are paid a benefit when your family remains claim-free for five years, and only Guardian offers this benefit. We also offer an automatic increase option that provides an automatic 5% increase in benefits every year for a maximum of five years with no increase in employee premium.

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