Page 3 - NRLCA RCA Enrollment Kit

Accident Insurance
AccidentAdvance® 24-Hour On & Off-the-Job Insurance
Underwritten by Transamerica Life Insurance Company
You and/or your family are insured 24 hours a day against accidents whether you are working as a rural letter carrier, at home, on vacation, playing sports, etc. Bene ts are paid directly to you. A set dollar amount is paid for broken bones, dislocations, loss of limbs, sight, accidental death, daily hospital expenses, lump sum hospital expenses and much more.
Partial Bene t Schedule
Accident Emergency Treatment
$100
Major Diagnostic Examination
$160
Follow up Visits & Physical Therapy
$75 per visit
Initial Accident Hospitalization Bene t
$2,400
Accident Hospital Income Bene t
$200 per day
See full brochure at www.RC-Bene ts.com
Bene ts are payable only once per insured person, per accident, unless otherwise noted. Bene ts are not payable for services rendered by an immediate family member.
Accident Emergency Treatment
Accident Emergency Treatment Bene t - For treatment
by a physician and X-rays received in a hospital or physician’s of ce received within 96 hours of the accident.
Major Diagnostic Examination Bene t - For one CT Scan, MRI, or EEG completed within 90 days of the accident.
Follow-Up Visits and Physical Therapy
Dislocation Bene t (see policy schedule) Fracture Bene t (see policy schedule)
Accident Follow-Up Treatment Bene t – Maximum of 3 $75 follow-up visits per accident. For follow-up treatment
visits, original treatment must have been received within
96 hours of the accident. Treatment must begin within
30 days of, and completed within the 6 month period following the later of: (1) the accident; (2) discharge from the hospital from a covered con nement; or (3) discharge from an extended care facility. Treatments must be provided by a physician in their of ce or in a hospital on an outpatient basis.
Physical Therapy Bene t – Maximum of 10 treatments $75 per accident. For physical therapy treatments performed
by a licensed Physical Therapist under the advice of a
physician. Treatment must begin within 120 days of the
accident and be completed within 1 year of the accident.
This is a brief summary of AccidentAdvance®, Accident Insurance underwritten by Transamerica Life Insurance Company, Cedar Rapids, Iowa. Policy form series CPACC100 and CCACC100. Forms and form numbers may vary. This insurance may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certi cate and riders for complete details.
$100 $160
Monthly Rates
Member
$13.58
Member plus Children
$19.14
Member plus Spouse
$21.36
Member plus Family
$27.08
Initial Accident Hospitalization
Initial Accident Hospitalization Bene t
Bene t is payable once for the rst hospital admission due to an accident. Bene t is payable once for the rst Intensive Care Unit admission due to an accident. The ICU bene t is paid even if admitted to the hospital initially and then transferred to ICU later during the same hospitalization.
Ambulance Bene t
$2,400
For ambulance transportation by a licensed Ground $480
ambulance service to the nearest hospital for treatment within 96 hours of the accident.
Accident Hospital and ICU Income Rider
Air $2,400 $200
Accident ICU Bene t - For ICU con nement while the $600 person is receiving the hospital income bene t. Bene t
is payable for up to 15 days per accident.
Expanded Bene ts Rider
-Burns
-Lacerations
-Eye Injury
-Emergency Dental Work
-Brain Concussion
-Coma
-Paralysis
-Tendons, Ligaments, and/or Rotator Cuffs -Ruptured Discs and/or Torn Knee Cartilage -Major Surgery
-Appliance
-Prosthetic Devises
-Blood, Plasma and Platelets -Transportation
See policy certi cate for bene t descriptions.
Accident Hospital Income Bene t - For hospital con nement for treatment of injuries beginning within 30 days of the accident. Bene t is payable for up to 365 days per accident.