Accident Insurance – Frequently Asked Questions
1. What is an accident?
An accident is defined as a sudden event which results in an injury.
2. What is an injury?
Bodily injury, due to an accident which:
- Results directly and independently of disease, bodily infirmity or other causes.
- Solely, directly and independently of all other causes results in medical expense.
- Occurs after the effective date of the Covered Person’s coverage under this Certificate, and
- Occurs while this Certificate is in force.
3. Who is the insurance company offering this plan?
Guarantee Trust Life Insurance Company, a 72 year old insurance company.
4. What’s the catch? Why is this plan so cheap?
There is no catch, but keep in mind that this is not a major medical health insurance plan. This plan helps cover medical costs associated with the treatment of injuries that result from accidents.
5. What types of medical expenses are eligible under this plan?
- Hospital room and board, and general nursing care, up to the semi-private room rate.
- Doctor’s fees for surgery.
- Hospital Emergency care.
- X-ray and lab services
- Rx drug expense
- Dental treatment for Injury to Sound Natural Teeth.
- Registered nurse expense.
- Hospital miscellaneous expense during Hospital confinement or for outpatient surgery under general anesthetic, such as the cost of operating room, lab tests, x-ray exams, anesthesia, drugs (excluding take home drugs) or medicines, therapeutic services and supplies.
6. If I have an accident, am I required to go to a particular doctor?
No, you can visit any doctor you want and there is no network. This plan will pay you directly for medical expenses resulting from an accident.
7. Does this plan work only if I visit the hospital?
No. The treatment must be performed or given under direction of a doctor in order to be an eligible medical expense, but the doctor may be in many different kinds of facilities.
8. How soon do I need to seek treatment for my injury?
You must seek treatment within 12 weeks from the date of your injury
9. Does this plan also help cover expenses for follow up surgery, recuperation or physical therapy?
Yes, as long as treatment is for injuries sustained in your accident.
10. How long do I have to be treated?
The initial treatment period is 12 weeks and the total benefit period is 52 weeks.
11. Are medications an eligible medical expense?
Yes, this plan will help you pay for prescription medications required to treat your injuries resulting from an accident.
12. Are ambulance rides eligible medical expenses?
Yes.
13. Can I buy greater coverage?
Not for our Accident Medical Plan. If you’d like to discuss an individual major medical plan, please call 214-872-7526.
14. What is the deductible?
$100 per injury.
15. Do I get an ID card after I enroll?
You won’t get a card, but you will get a certificate of coverage which includes your policy number and a full outline of coverage.
16. When are you going to bill me?
You will be billed within the next 48 hours.
17. If I pay annually, will it automatically renew at the end of the year?
Yes it will. You will need to notify us if you wish to cancel prior to your anniversary date.
18. After my accident, what is the process to seek reimbursement for my medical expenses? How do I file a claim?
To submit a claim for injuries resulting from an accident, you will need to call Consumer Benefits of America at the number found in their member guide and welcome letter.
