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Per-Accident Maximum Benefits, per Person: |
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Benefit Amounts:
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Plan 1
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Plan 2
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Plan 3
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Plan 4
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Plan 5
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Plan 6
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Plan 7
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Medical Expenses
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$1,000
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$1,500
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$2,000
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$2,500
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$3,000
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$3,500
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$4,000
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Air & Ground Ambulance
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$2,500
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$2,500
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$5,000
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$5,000
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$7,500
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$7,500
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$10,000
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Accidental Death
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$5,000
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$5,000
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$10,000
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$10,000
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$10,000
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$10,000
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$10,000
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Maximum Dismemberment
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$5,000
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$5,000
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$10,000
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$10,000
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$15,000
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$15,000
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$20,000
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Benefits
are payable subject to policy provisions, limitations and exclusions.
There is
a $50 deductible for an accidental injury which requires an Emergency Room
visit.
Medical
Expense Benefit: Outpatient covered expenses include physician charges,
surgery, x-rays, reduction of fractures or other emergency first-aid expenses
incurred in a physician’s office, clinic, outpatient hospital facility or
ambulatory surgical center which are incurred within 28 days of the accident.
Inpatient covered expenses include physician charges, hospital room and hospital
billed services and supplies that are incurred within 28 calendar days of the
accident.
Air & Ground Ambulance Benefit: Pays benefits for covered
expense for ground or air ambulance transportation (within 28 days of accident)
due to an accidental injury. Accidental Death Benefit: For loss of life
due to accidental injury (within 90 days of the accident).
Accidental
Dismemberment Benefit: Paysbenefits if the Primary Insured suffers a
specified dismemberment due to accidental injury within 90 days of the accident.
This benefit applies only to the Primary Insured. The total amount payable for
all losses resulting from the same accident will not exceed the Maximum
Dismemberment Benefit Per Accident. Dismemberment benefits are paid in
lieu of other benefits if they exceed other benefits payable under the policy.
If both an Accidental Death Benefit and an Accidental Dismemberment Benefit
would otherwise be payable, benefits will be paid under the provision that would
pay the most.
• Choose your
own doctor or hospital
• Covers
individuals or families
• Guaranteed
Renewable for Life
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