One of life's big frustrations is figuring out what's covered versus not covered by health insurance. In fact, according to a recent survey on health insurance literacy, nearly half of all Americans say that they've received a surprise charge in the past for something they thought was covered by their insurance. 1
But the opposite also happens. Amid the many pages of policy information, it can be easy to overlook some specific covered benefits, causing insureds to potentially miss out on claim payments that would otherwise be due to them.
In the case of accident insurance, there are several commonly overlooked benefits that might be included in either the base policy or enhancement riders.
Preventive Care
Wait, an accident policy can cover preventive care? That's right. Insureds are often surprised to find that preventive care and wellness benefits can be included as a benefit or rider on an accident policy. After all, maintaining wellness and preventing health problems are sensible measures to include in any health-related insurance policy.
Insureds with this added coverage can receive benefits to help with early disease diagnosis, screenings, assessments to determine predisposition for specific conditions, counseling, health education, immunizations and other necessary intervention to avert potential health issues.*
Some accident policy riders will pay a benefit when the insured or their covered dependents simply visit a physician outside of a hospital for any reason—preventive care, injury, illness or otherwise. This benefit typically pays regardless of any other medical insurance claims the insured submits.
The important thing for insureds to remember is that they have those benefits after the next preventive care visit. After all, whose first thought after a diagnostic test or immunization is, "I really should submit a claim under my accident policy"?
Home and Vehicle Modification
The effects of an accident can be felt for years—or even a lifetime. If injuries are long-lasting or permanent, major changes may be required. This could mean permanent modifications to the home (ramps or shower rails) and/or vehicle (wheelchair lifts or steering knobs). The costs can really add up.
One might think their accident policy only pays for costs directly after the accident, like an ambulance ride, hospital stay or X-rays. But these home and vehicle modifications may also be included in accident coverage, only requiring that a physician sign off to certify that the modifications are necessary due to the injury.
Broken Teeth
After an injury to a tooth, it's easy to assume that insurance claims would be made to a dental insurer. However, accident insurance might actually provide benefits for tooth repair, if the tooth is damaged as a result of an accident—falling off a ladder, getting hit by a softball, etc. Covered procedures are for natural teeth and may include a dental crown, filling or extraction.
Some other overlooked accident benefits include burn treatment, family member lodging and surgical benefits. All benefits are contingent upon the coverage options that employers have chosen and any policy requirements.
No one wants to miss out on benefits they are entitled to. This can be remedied by carefully reading benefit language and even using an online calendar to set claim reminders after doctor appointments.
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