Benefit Conditions Medical supplies must be purchased within 90 days from the date of the Covered Accident.
Benefit Limitations 1.
We will not pay for Durable Medical Equipment. 2. This benefit is only payable 1 time per Covered Accident.
Abdominal or Thoracic Surgery Benefit We will pay the benefit shown in the Schedule of Benefits, if a Covered Person requires abdominal or thoracic surgery due to a Covered Injury resulting directly and independently of all other causes from a Covered Accident.
Benefit Conditions The surgery must be performed by a Physician within 120 days from the date of the Covered Accident.
Benefit Limitations 1.
This benefit is only payable 1 time per covered accident. 2. If We pay this benefit, We will not pay for any other surgical benefit.
Tendon, Ligament, Rotator Cuff, or Knee Cartilage Surgery - Repair Benefit We will pay the benefit shown in the Schedule of Benefits, if a Covered Person requires surgical repair to a tendon, ligament, rotator cuff or knee cartilage due to a Covered Injury resulting directly and independently of all other causes from a Covered Accident. Benefit Conditions 1. The injured area must be torn, ruptured, or severed and the surgical procedure must be performed by a Physician. 2. Surgical repair must occur within 120 days from the date of the Covered Accident.
Benefit Limitations 1.
This benefit is only payable 1 time per Covered Accident. 2. If exploratory surgery is performed with no repair, we will not pay this benefit.
Tendon, Ligament, Rotator Cuff, or Knee Cartilage Surgery - Exploratory Benefit We will pay the benefit shown in the Schedule of Benefits, if a Covered Person requires exploratory surgery to a tendon, ligament, rotator cuff or knee cartilage due to a Covered Injury resulting directly and independently of all other causes from a Covered Accident. We will pay this benefit in addition to the Tendon, Ligament, Rotator Cuff, or Knee Cartilage Surgery – Repair Benefit.
Benefit Conditions 1.
This surgery must be performed by a Physician. 2. This surgery must occur within 90 days from the date of the Covered Accident.
Benefit Limitations 1.
This benefit is only payable 1 time per Covered Accident.
Ruptured Disc Surgery - Repair Benefit We will pay the benefit shown in the Schedule of Benefits, if a Covered Person requires surgical repair to a ruptured disc in the spine due to a Covered Injury resulting directly and independently of all other causes from a Covered Accident.
Benefit Conditions 1.
This surgery must be performed by a Physician. 2. This surgery must occur within 90 days from the date of the Covered Accident.
Benefit Limitations This benefit is only payable 1 time per Covered Accident.
Eye Injury Surgery Benefit We will pay the benefit shown in the Schedule of Benefits, if a Covered Person requires surgical repair to one eye or both
30
Made with FlippingBook flipbook maker