Accident Insurance

Accident Insurance  

Overview

Accidents can happen when you least expect them. And while you can’t always prevent them, you can get help to make your recovery less expensive and stressful.

In the U.S. there are approximately 35 million trips to the emergency room (ER) annually due to injuries.1 These visits can be expensive — in fact, ER bills average around $2,032 per visit,2 and even seemingly small injuries can come with unexpectedly high hospital bills.

You may be thinking — that’s why I have health insurance. But even the best medical plans may leave you with unexpected expenses like deductibles, co-pays, extra costs for out-of-network care, and non-covered services.

 

Enrollment

Add accident insurance coverage to help offset costs that may not be covered under your employer's existing medical plan.

 

 

Learn More

These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing.

 

FAQ
Outline of Coverage
Plan Summary

How It Works

FAQs

Answers about the plan, including eligibility, options, enrollment and customer service.
  • Who is the provider?

    With over 150 years of experience, MetLife is a recognized leader in protection planning as well as retirement and savings solutions.
  • How can this help me?

    When an accident occurs, the last thing that should be on your mind is the charges accumulating while at the emergency room:

    • Ambulance ride
    • Casts
    • Use of the emergency room
    • Wheelchairs
    • Surgery and anesthesia
    • Crutches
    • Stitches


    These costs can add up fast. Most families have medical insurance that will cover a majority of the expenses. But, what about the out-of-pocket medical expenses, such as the required copay, or the lost wages you or your spouse/domestic partner loses when out of work or staying home to care for an injured family member? You hope that an accident never happens, but at some point, you very well may take a trip to your local emergency room. If that time comes, wouldn’t it be nice to have an insurance plan that pays you a benefit regardless of any other insurance you have? Group Accident insurance does just that, providing a cash benefit to cover the costs associated with unexpected covered accidents.

  • Who is eligible?

    You and your eligible family members6 just need to enroll during your enrollment period and be actively at work for your coverage to be effective. Dependents to be enrolled may not be subject to a medical restriction as set forth on the enrollment form and in the Certificate. Some states require the insured to have medical coverage.4
  • When can I enroll?

    As a new hire, you can enroll during your new hire enrollment period. Outside of your new hire enrollment period, enrollment is limited to the annual enrollment period.
  • What if my employment status changes?

    When you leave or retire from your current employer, you can continue your coverage without interruption, subject to applicable law and the policies' terms and conditions. Although payroll deduction will no longer be available, you can opt for other payment methods such as direct bank account deduction, or home billing.

    Your coverage will only end if you stop paying your premium or if your employer offers you similar coverage with a different insurance carrier.4
  • Will my rates increase as I get older or if I file a claim?

    No, your rates will not increase due to age, health or individual claims.
  • What types of accidents and injuries am I covered for?

     Our accident insurance pays a benefit for a wide array of events, medical services, and treatments.7
     

    This plan provides a lump-sum payment for over 150 different covered events, such as:

    • Fractures8
    • Dislocations8
    • Second and third degree burns
    • Skin grafts
    • Torn knee cartilage
    • Ruptured disc
    • Concussions
    • Cuts or lacerations
    • Eye injuries
    • Coma
    • Broken teeth

     

    You’ll also receive a lump-sum payment when you have these covered medical services/treatments:

    • Ambulance
    • Emergency care
    • Inpatient surgery
    • Outpatient surgery
    • Medical Testing Benefits (including X-rays, MRIs, CT scans)
    • Physician follow-up visits
    • Transportation
    • Home modifications
    • Therapy services (including physical and occupational therapy)


    This plan provides protection for covered events experienced while off the job only. See your Disclosure Statement or Outline of Coverage/Disclosure Document for full details on your coverage.

  • Will I have to take a medical exam to get this coverage?

    No! Your Accident insurance is guaranteed issue,  which means your acceptance is guaranteed, provided you enroll during the Enrollment Period, are actively at work and dependents to be covered are not under a medical restriction as set forth in the Certificate. There are no medical exams to take and no health questions to answer. Some states require the insured to have medical coverage.3

 

1Centers for Disease Control and Prevention: Emergency Department Visits. CDC/National Center for Health Statistics. https://www.cdc.gov/nchs/fastats/emergency-department.html. Accessed January 2022.
2The Cost of Unwarranted ER Visits: $32 Billion a Year. Kaiser Health News, July 25, 2019. https://khn.org/morning-breakout/the-cost-of-unwarranted-er-visits-32-billion-a-year/ Accessed January 2022.
3Children may be covered to age 26. There are benefit reductions that may begin at age 65.
4Coverage is guaranteed provided: (1) the employee is actively at work; and (2) dependents to be covered are not subject to medical restrictions as set forth on the enrollment form and in the Certificate. Some states require the insured to have medical coverage. Additional restrictions apply to dependents serving in the armed forces or living overseas.
5Eligibility for portability through the Continuation of Insurance with Premium Payment provision may be subject to certain eligibility requirements and limitations. For more information, contact your MetLife representative.
6Eligible Family Members mean all persons eligible for coverage as defined in the Certificate.
7Covered services/treatments must be the result of a covered accident as defined in the group policy/certificate. See your Disclosure Statement or Outline of Coverage/Disclosure Document for more details.
8Chip fractures are paid at 25% of Fracture Benefit and partial dislocations are paid at 25% of Dislocation Benefit.

 

METLIFE’S ACCIDENT INSURANCE IS A LIMITED BENEFIT GROUP INSURANCE POLICY. The policy is not intended to be a substitute for medical coverage and certain states may require the insured to have medical coverage to enroll for the coverage. The policy or its provisions may vary or be unavailable in some states. There are benefit reductions that begin at age 65, if applicable. Like most group accident and health insurance policies, policies offered by MetLife may include waiting periods and contain certain exclusions, limitations and terms for keeping them in force. For complete details of coverage and availability, please refer to the group policy form GPNP12-AX or contact MetLife.

 

Benefits are underwritten by Metropolitan Life Insurance Company, New York, NY. Hospital does not include certain facilities such as nursing homes, convalescent care or extended care facilities. See MetLife’s Disclosure Statement or Outline of Coverage/Disclosure Document for full details.

 

 

 

 

Mercer's Role & Compensation

Details of Mercer disclosure of the compensation.