Legal Definitions - accident policy

An accident policy is a type of insurance that provides financial benefits specifically for injuries, disability, or death resulting directly from an unexpected, external, and violent event, often referred to as an "accident." Unlike general health insurance, which covers medical treatment for illnesses and injuries, an accident policy typically pays out a predetermined sum or specific benefits for certain types of injuries (e.g., broken bones, burns, dismemberment) or for accidental death, regardless of other insurance coverage. It is designed to help cover out-of-pocket expenses, lost income, or other costs associated with an unforeseen incident.

Here are some examples illustrating how an accident policy works:

• Example 1: Sports Injury
  Sarah has an accident policy in addition to her standard health insurance. While playing recreational soccer, she collides with another player and suffers a fractured tibia. Her health insurance covers the medical treatment for the break, but her accident policy pays her a lump sum benefit specifically for the broken bone, as outlined in her policy. This payment helps her cover the deductible on her health insurance, lost wages from time off work, and other unexpected expenses like physical therapy co-pays or specialized equipment.

• Example 2: Household Mishap
  David is performing routine maintenance on his roof when he slips and falls, resulting in a severe concussion and several stitches for a head laceration. His accident policy includes benefits for concussions and lacerations requiring medical attention. Upon submitting a claim with documentation from his doctor, his accident policy pays him a set amount for these injuries. This payment is separate from any claims made to his health insurance for the emergency room visit and follow-up care, providing him with additional financial support during his recovery.

• Example 3: Travel Incident
  Maria is on vacation and, while exploring a new city, she trips on an uneven sidewalk, spraining her ankle badly enough to require crutches and a visit to an urgent care clinic. Her accident policy covers specific benefits for sprains that require medical intervention. After she files a claim, her policy provides a payout for the ankle injury. This helps offset the unexpected medical costs incurred while traveling and the cost of renting crutches, without affecting her primary health insurance claims.