What is Group Accident Insurance? (Coverage & Benefits)

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Group accident insurance is available as corporate insurance for employees or the company’s owner. Even if you have major medical insurance, group accident insurance can help cover the costs until the medical insurance kicks in.

Schmidt & Clark lawyers have seen different types of group accident insurance. We’ve provided counsel and advised countless employers on which accident insurance to get.

We’ve dealt with almost all insurance companies that offer group accident insurance, so today, we’ll explain everything you should know about an accident insurance program and its benefits.

Summary of the Key Findings

Group insurance provides employee benefits. All expenses will be covered in case of an accident.
Group insurance has core and optional additional benefits.
Group insurance is paid directly to the employee.
You’ll have to submit documents covering complete details of the accident to claim group insurance.

What’s Group Accident Insurance?

Group accident insurance is a type of insurance that complements existing medical coverage.

Its purpose is to serve as additional protection for employees and help pay for actual expenses such as emergency room treatment [1].

The employer can offer this insurance to the employees to protect them from medical expenses that a workplace injury incurs.

This can be especially significant if employees work in a manufacturing unit where they are exposed to risks. The employer can cover the employees under a group insurance design plan. This way, the employees are protected, and the employer usually gets a discount based on the company size.

“If the insured is injured in a covered accident, they can get a payout to use any way they wish to help cover deductibles, out-of-pocket medical costs or everyday living expenses.” Policy Bazaar

Here are some key features of this insurance:

Group accident insurance policy covers compensation for employees who suffer injuries due to a workplace accident.
This insurance has 24/7 coverage.
Benefit payout doesn’t depend on an employee’s income or other employer insurance offerings.
Group accident insurance covers all expenses connected with the accident, even ambulance transport.
This insurance helps the claim get settled quicker, which is especially significant if an employee dies or suffers a permanent disability.
If there's an accidental death, 100% of the claim is paid to the deceased's nominee. This way, the employer avoids the liability burden.
If the insured employee loses vital limbs, they get 100% of the insured sum.
In case of partial disablement, the employee gets 50% of the insured sum.
Some group accident insurance offerings include coverage for heart attack and stroke.
Companies offering group accident insurance to their employees have a better reputation and image. It shows they care about their workers.

Employees pay the premium cost through payroll deduction in the usual group accident plan. The employee can choose who to cover.

Most group insurances pay an upfront lump-sum cash benefit based on injuries received. The cash is given directly to the employee. It can be used any way the employee chooses, for example, physical therapy, health questions, trauma counseling, speech therapy, child care, and other expenses.

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Benefits of Group Accident Insurance

The biggest benefit of this insurance is that it protects the employee in case of death or disability due to a work accident. This is a chance for you to provide for your family even in cases of lost income.

This insurance can be customized to include different benefits. Here are the core benefits group insurance covers:

Ambulance, including air, water, or ground
Dislocation
Emergency room
Bone fracture
Eye injuries
Hospital stay
Paralysis
Death (payable to the nominee)
Transport of remains from the accident site to the residence
Funeral expenses
Medical evacuation
In case of a permanent disability, disability insurance pays for the child’s education
Dental injuries

Apart from including health insurance and disability insurance, some providers offer extra optional benefits, such as [2]:

Pet boarding — The insurance covers pet boarding expenses for each day you receive treatment or spend in a rehabilitative facility.
Partner lodging — When your partner incurs lodging.
Dependent parent — If an employee or spouse gives financial support to a dependent parent.
Wellness benefit — Once a year for the insured and their partner.
Organized sports benefits — Some insurances increase the benefits if a covered dependent child is injured while playing an organized sport.
Disability rider — Additional payment is made when the employee or their spouse becomes disabled.
Mental health benefits:
1. PTSD
2. Trauma counseling
3. Rehab therapy

What Group Insurance Doesn’t Cover?

Group insurance doesn’t cover:

Natural death
Injury caused while under the influence
War
Pregnancy and childbirth
Radioactivity
Criminal acts
Self-inflicted injury

How to Claim Group Insurance?

Follow these steps to claim group insurance:

Inform the life insurance company about the accident by phone or email.
The life insurance company has to register the claim. Once the claim is registered, the insurance provider sends the claim form to the injured person with a checklist of all required documents.
If the injured person’s documents are incomplete, the insurance company will let them know.
Once all documents are received, the claim is processed.
A check is sent to the insured person when the claim is processed.
If the claim is rejected, a rejection letter is sent to the insured person.

FAQ

What is the point of accident insurance?

The point of accident insurance is to help you pay for medical bills after an injury. This is a good safety net and can include medical exams, stay at the hospital, transportation, and lodging.

What is an example of an accidental injury?

An example of an accidental injury is cut, burn, fall, drowning, dismemberment, and more.

How does group accident insurance work?

Group accident insurance works when the employer offers it to employees, who then choose who to cover and pay the premiums. The insured can use the benefit payment to cover medical deductibles and everyday living expenses.

Hire a Financial Professional to Help You with Group Insurance

Work accidents result in unintentional injuries. However, they can be very serious, so you should get medical help and notify your employer and the insurance company.

You should also hire an experienced attorney. Insurance companies will try to pay only limited benefits or not pay at all.

Schmidt & Clark, LLP attorneys can help you deal with the insurance provider and gather and file all the necessary documents.

References:

1.https://www.accgov.com/7818/Group-Accident-Insurance#

2.https://www.allstatevoluntary.com/sava/pdf/ABJ16564_1_Sava%20GVAP1_BI_Accident.pdf

What Is Group Accident Insurance? Everything You Need to Know