$600
$1,200
Upper Jaw
Will not pay for lower jaw, teeth, or bones of face fractures
$600
$1,200
Lower Jaw
Will not pay for Upper Jaw, Teeth, or Bones of face fractures
$600
$1,200
Bones of Face or Nose
Will not pay for Upper Jaw, Lower Jaw, or Teeth fractures
$600
$1,200
Vertebral Processes
$200
$400
Rib
More than 1 rib fracture pays 2 times the Benefit Amount
$200
$400
Coccyx
We will not pay for Vertebrae or Pelvis fractures
$100
$200
Finger
More than 1 finger pays 2 times the Benefit Amount. We will not pay for fractures to Hand or Wrist.
$100
$200
Toe
More than 1 toe fracture pays 2 times the Benefit Amount shown on schedule. We will not pay for Foot, Heel or Ankle fractures.
$100
$200
Sternum
$100
$200
Heel
We will not pay for Foot, Toe, or Ankle fractures
25% of Closed fracture benefit
Not Applicable
Chip Fracture
We will not pay in addition to Closed fracture benefit
200% of the single fracture benefit for multiple fractures to the same bone
Not Applicable
Multiple Fractures
We will not pay multiple fracture benefit in addition to single fracture benefits
DISLOCATIONS BENEFITS
Benefit Type DISLOCATIONS: Must be diagnosed and treated by a doctor within 90 days of a Covered Accident
Non-Surgical/Closed
Surgical/Open
Benefit Amount
Benefit Amount
$3,000
$6,000
Hip Joint
4
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