A Guide to Accident Insurance

Shawn Plummer

CEO, The Annuity Expert

Thinking about purchasing a personal accident insurance or group accident insurance plan? In the event of a serious accidental injury, paying the medical bills may be the least of your worries. But, if you can’t work, how will you pay the rest of your bills? You still need to put food on the table, pay rent or mortgage, auto loans, and other related expenses. Accident Insurance supplements your paycheck when a disabling accident prevents you from performing the essential functions of your job.

Use our insurance marketplace to compare personal accident insurance coverage.

What is Accident Insurance Coverage?

Accident insurance is a type of temporary supplemental disability insurance coverage a worker(s) can purchase to protect their paycheck if they get injured on the job, including Accidental Death and Dismemberment insurance, loss of sight, speech, and hearing.

Some companies don’t choose to purchase traditional disability insurance at work, and some workers can’t be insured. This is where the personal accident insurance policy comes into play.

The neat thing about this liability insurance product is that everyone is guaranteed (no medical questions or underwriting) to get coverage despite health issues (occupational exclusions below). The process takes about 10 minutes from start to finish.

If you’re constantly traveling internationally, look at a travel accident insurance plan as well.

Disability Insurance vs. Accidental Insurance

Disability insurance provides you benefits every month you’re disabled; voluntary accident insurance only pays you over a fixed period of time. In this case, the Occupational Accident Insurance will pay you as long as you are disabled, up to 52 weeks.

With that said, accident insurance complements Disability Insurance, Workers Compensation, and Social Security Income if you have coverage.

Also Known As

  • Accident Only Disability Insurance
  • Temporary Disability Insurance
  • Supplemental Accident Insurance
  • Group Accident Insurance
  • Guaranteed Issue Disability Insurance
  • Accidental Disability Insurance
  • Accidental Death and Disability Insurance
  • Accidental Death Insurance
  • Accidental and Disability Insurance
  • Injury Insurance
  • Accident Income Replacement Benefit
  • Accidental Temporary Total Disability Insurance
  • Personal Accident Insurance Plan
  • Occupational Accident Insurance
  • Life Accident Insurance
  • Health and Accident Insurance

Underwriting & Background Checks

  • No Health Questions
  • No Occupational Exclusions except Military and Sports Teams
  • No Blood Tests or Urine Samples
  • No Medical Exams
  • No Attending Physician Statements
  • No Income Verification
  • No Credit Verification

Who is Accident Insurance Coverage Perfect For?

  • Anyone Between the Ages of 18 – 70.
  • Blue Collar Workers
  • Firemen
  • Construction Workers
  • Builders
  • Police Officers
  • EMT
  • Government Employees
  • Unions
  • Self Employed Workers
  • Non-Citizens Permanent Residents
  • Sole Proprietors
  • Seniors, Ages 65 – 70
  • Students (Non-Sports Related)
  • Independent Contractors
  • Truckers (Truck Drivers)
  • Volunteers
  • Employees
  • Motorcyclists
  • Horse Riders
  • Pregnancy

How Does Personal Accident Insurance Work?

To receive coverage, purchase a personal or group accident plan for a fixed price, and you pay that premium every month you want to be covered.

If you get injured on the job, you will report an accident insurance report or claim to the insurance company, wait for the elimination period, and then start receiving the supplemental income paychecks (varies by the individual accident policy) until you get well enough to return to work or a maximum number of weeks whichever comes first.

Accidental Death And Dismemberment Insurance

Accidental Death and Dismemberment insurance can be included with a disability insurance plan. Basically, if the insured is dismembered from the accident, the insured will receive Accidental Death Insurance, a small life insurance benefit that is currently $5,000.

Dismemberment includes:

  • Loss of Speech
  • Loss of Hearing
  • Loss of Hand or Foot
  • Loss of Sight

The insured’s beneficiary would receive a lump sum Accidental Death Insurance benefit if the insured’s death were directly caused by the covered accident. This benefit should not be considered as an alternative to true life insurance policies.

How Much Does Accident Insurance Cost?

Guaranteed Issue Disability Insurance policies start around $18 a month on the low end and $40 a month on the high end for a single person.

What is excluded from accident insurance?

Like any insurance plan, there are exclusions to getting the accident coverage needed. Below are scenarios that are not considered covered injuries and where a person(s) can not get accident insurance coverage:

Aircrafts

An insured person is entering or exiting any aircraft owned, leased, or operated by the Policyholder or on the Policyholder’s behalf or operated by an employee of the Policyholder on the Policyholder’s behalf.

An insured person riding as a passenger in, entering, or exiting any aircraft while acting or training as a pilot or crew member.

This exclusion does not apply to passengers who temporarily perform pilot or crew functions in a life-threatening emergency.

An insured person traveling or flying on any aircraft engaged in Specialized Aviation Activities (See Below).

All of these scenarios are not considered a “covered accident.”

Pre-Exisiting Health Conditions

An insured person’s emotional trauma, mental or physical illness, disease, pregnancy, childbirth or miscarriage, bacterial or viral infection, bodily malfunctions, or medical or surgical treatment thereof.

This exclusion does not apply to an insured person’s bacterial infection caused by an Accident or by Accidental consumption of a substance contaminated by bacteria.

Illegal Act

An insured person’s commission or attempted commission of any illegal act, including but not limited to any felony or any crimes injuries where the insured is incarcerated after a conviction

Alcohol and Substance Abuse

An insured person is determined to be intoxicated at the time of an accident.

Intoxication is defined by the laws of the jurisdiction where such an accident occurs.

An insured person being under the influence of any narcotic or other controlled substance at the time of an accident.

This exclusion does not apply if any narcotic or other controlled substance is taken and used as prescribed by a Physician.

Motor Vehicle Racing

An insured person being engaged in or participating in a motorized vehicular race or speed contest.

Military Action

An insured person participating in military action while in active military service with the armed forces of any country or established international authority.

This exclusion does not apply to the first 60 consecutive days of active military service with the armed forces of any country or established international authority.

Suicide

An insured person’s suicide, or attempted suicide, or intentionally self-inflicted injury.

War

An insured person in a declared or undeclared War.

Terms and Definitions

Accident: Accident or Accidental means a sudden, unforeseen, and unexpected event that happens by chance, arises from a source external to an
Insured Person; Is independent of illness, disease, or other bodily malfunction or medical or surgical treatment thereof; occurs while the Insured Person is insured under this policy which is in force, and is the direct cause of Loss.

Accidental Bodily Injury: Accidental Bodily Injury means bodily injury, which is accidental, the direct cause of a loss. This occurs while an Insured Person is insured under this policy, which is in force. Accidental Bodily Injury does not mean a Repetitive Motion Injury.

Benefit Amount: Benefit Amount means the amount stated which applies:

  • At the time of an accident.
  • To an Insured Person.
  • For an applicable Hazard.

Class: Class means the categories of Insured Persons described in the policy. Conveyance means any motorized craft, vehicle, or mode of transportation licensed or registered by a governmental authority with competent jurisdiction.

Domestic Partner: Domestic Partner means a person designated by a Primary Insured Person who is registered as a Domestic Partner under laws of the governing jurisdiction or who:

  • Is at least 18 years of age and competent to enter into a contract.
  • Is not related to the Primary Insured Person by blood.
  • Has exclusively lived with the Primary Insured Person for at least one (1) year prior to the date of enrollment.
  • Is not legally married or separated.

As of the date of enrollment has with the Primary Insured Person at least two (2) of the following financial arrangements:

Neither the Primary Insured Person nor the Domestic Partner can be married to, nor be in a civil union with anyone else.

Elimination Period: Elimination Period means the consecutive amount of time that must elapse before a Benefit Amount becomes payable. The Elimination Period begins on the first day of an Insured Person’s Loss. Benefit Amounts are not payable, nor do they accrue, during an Elimination Period.

Gainful Occupation: Gainful Occupation means an occupation, including self-employment, that is or can be expected to provide an Insured Person with an income equal to at least 60% of the Insured Person’s monthly earnings within twelve (12) months after the Insured Person’s return to work.

Immediate Family Member: Immediate Family Member means an Insured Person’s:

  • Spouse or Domestic Partner;
  • Children including adopted children or stepchildren;
  • Legal guardians or wards;
  • Siblings or siblings-in-law;
  • Parents or parents-in-law;
  • Grandparents or grandchildren;
  • Aunts or uncles;
  • Nieces and nephews.

Immediate Family Member also means a Spouse’s or Domestic Partner’s children, including adopted children or stepchildren; legal guardians or wards; siblings or siblings-in-law; parents or parents-in-law; grandparents or grandchildren; aunts or uncles; nieces or nephews.

Injury: Injury means bodily injury which:

  • Is accidental;
  • Is the direct source of a loss;
  • Is independent of illness, disease, or other cause; and
  • This occurs while an Insured Person is insured under this policy, which is in force.

An injury does not include conditions caused by repetitive motion or cumulative trauma and not a result of an accident, including but not limited to Carpal Tunnel Syndrome, Osgood-Schlatter’s Disease, bursitis, Chondromalacia, shin splints, stress fractures, and tendinitis.

Insured Person: Insured Person means a person qualifying as a Class member:

  • Who elects insurance.
  • For whom insurance is elected.
  • And on whose behalf premium is paid.

Loss: Loss means Accidental:

  • Loss of Foot
  • Loss of Hand
  • Loss of Hearing
  • Loss of Life
  • Loss of Sight
  • Loss of Sight of One Eye
  • Loss of Speech
  • Loss of Thumb and Index Finger

The loss must occur within one (1) year after the Accident.

Loss of Foot: Loss of Foot means the complete severance of a foot through or above the ankle joint. They will consider such severance a Loss of Foot even if the foot is later reattached. However, if the reattachment fails and amputation becomes necessary, the insurer will not pay an additional Benefit Amount for such an amputation.

Loss of Hand: Loss of Hand means complete severance, as determined by a Physician, of at least four (4) fingers at or above the metacarpal phalangeal joint on the same hand or at least three (3) fingers and the thumb on the same hand. The insurer will consider such severance a Loss of Hand even if the hand, fingers, or thumb are later reattached. However, if the reattachment fails and amputation becomes necessary, the insurer will not pay an additional Benefit Amount for such an amputation. 

Loss of Hearing: Loss of Hearing means permanent, irrecoverable, and total deafness, as determined by a Physician, with an auditory threshold of more than 90 decibels in each ear. The deafness cannot be corrected by any aid or device, as determined by a Physician.

Loss of Life: Loss of Life means death, including clinical death, as determined by the local governing medical authority, where such death occurs within 365 days after an Accident.

Loss of Sight: Loss of Sight means permanent loss of vision. The remaining vision from the eye injury must be no better than 20/200 using a corrective aid or device, as determined by a Physician.

Loss of Speech: Loss of Speech means the permanent, irrecoverable, and total loss of speech capability without the aid of mechanical devices, as determined by a Physician.

Loss of Thumb and Index Finger: Loss of Thumb and Index Finger means complete severance, through the metacarpal phalangeal joints, of the thumb and index finger of the same hand, as determined by a Physician. The insurer will consider such severance a Loss of Thumb and Index Finger even if a thumb, an index finger, or both are later reattached. However, if the reattachment fails and amputation becomes necessary, the insurer will not pay an additional Benefit Amount for such an amputation.

Physician: Physician means a licensed practitioner of the healing arts, acting within the scope of their license to the extent provided by the jurisdiction’s laws in which medical care or treatment is provided.

  • A physician does not include:
  • An Insured Person.
  • An Immediate Family Member.

Primary Insured Person: Primary Insured Person means an Insured Person who:

  • Has a direct relationship with the Policyholder.
  • Where applicable, elects insurance under this policy.
  • Pays the required premium, for the insurance elected.

Salary: Salary means a Primary Insured Person’s basic annual earnings from their employer at the time of Accident, as reported by the employer, including overtime and incentive payments.

Specialized Aviation Activity: Specialized Aviation Activity means the use of a properly certified aircraft for the following:

  • Acrobatic or stunt flying.
  • Racing.
  • Any endurance tests.
  • Any flight on a rocket-propelled or rocket launched aircraft.
  • Any test for experimental purposes. Specialized Aviation Activity shall include any flight which requires a special permit or waiver from a governmental authority having jurisdiction over civil aviation, whether or not such permit or waiver is granted.

Spouse: Spouse means an Insured Person’s husband or wife or who is recognized as such by the laws of the jurisdiction in which the Primary Insured Person resides.

Temporary Total Disability or Temporary Totally Disabled

Temporary Total Disability or Temporary Totally Disabled means that Accidental Bodily Injury solely and directly:

  • Prevents a Primary Insured Person from performing all the substantial and material duties of such Primary Insured Person’s regular occupation, or with respect to a Primary Insured Person who is unemployed, prevents such Primary Insured Person from engaging in the normal and customary activities of a person of like age and sex in good health.
  • It causes a condition that is medically determined, by a Physician, to be continuous.
  • Requires the continuous care of a Physician.

Frequently Asked Questions

What is accident insurance?

Accident insurance is basically income protection for you in an accident on the job or personal injury. The injury supplements you an income while you are missing work until you get well.

Do I have to take a medical exam with this accident insurance policy?

For guaranteed issue accident insurance coverage, you do not. Pick your plan online, purchase, and you are covered. There are no drug tests, prescription drugs, or medical history either.

Do I have to be a U.S. resident to purchase personal accident insurance?

You do not have to be a U.S. resident. However, you need to be a Permanent Resident with a Tax ID#.

Shawn Plummer

CEO, The Annuity Expert

I’m a licensed financial professional focusing on annuities and insurance for more than a decade. My former role was training financial advisors, including for a Fortune Global 500 insurance company. I’ve been featured in Time Magazine, Yahoo! Finance, MSN, SmartAsset, Entrepreneur, Bloomberg, The Simple Dollar, U.S. News and World Report, and Women’s Health Magazine.

The Annuity Expert is an online insurance agency servicing consumers across the United States. My goal is to help you take the guesswork out of retirement planning or find the best insurance coverage at the cheapest rates for you. 

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