Home » Finance » Human Resource Department » Employee Benefits » Accident Select II (Transamerica)



Accident Select II

Transamerica Life Insurance Company
P.O. Box 8063
Little Rock, AR 72203-8063
1-800-400-3042
1-888-763-7474
Claims Fax: 501-227-1651


Accident Select II provides insureds with several benefits to assist with injuries associated with certain accidents. This product is offered through Transamerica.

Schedule of Benefits:

  • Accident Specific Sum Injuries Benefit: Pays for dislocations, burns, ruptured discs and torn knee cartilage, eye injuries, lacerations, internal injuries, fractures, and blood and plasma.

    A. Dislocation (Dislocations which are reduced under general anesthesia)

1. Hip

Open Reduction
Closed Reduction

$4,000
$1,330
2. Knee or Shoulder

Open Reduction
Closed Reduction

$1,330
$530
3. Collar Bone

Open Reduction
Closed Reduction

$2,130
$400
4. Ankle or Foot (excluding toes

Open Reduction
Closed Reduction

$1,330
$400
5. Lower Jaw

Open Reduction
Closed Reduction

1,330
$665
6. Wrist or Elbow

Open Reduction
Closed Reduction

$1,065
$530
7. Toe or Finger

Open Reduction
Closed Reduction

$265
$130

B. Tendons and Ligaments: Must be torn, ruptured, or severed and must be treated by a physician within 72 hours after the Covered Accident and repaired through surgery within six months after the Covered Accident. If a covered person receives a fracture and/or a dislocation and also tears, ruptures, or severs a tendon/ligament in a Covered Accident, the Insurer will pay only one benefit. The Insurer will pay the largest of this benefit, the Fractures Benefit or the Dislocation Benefit.

Repair of one $665
Repair of all if more than one $1,330


1. Second-degree burns of a least 25%, but not more than 35% of body surface $530
2. Second-degree burns of more than 35% of body surface  $1,330
3. Third-degree burns covering 6 through 9 square inches of body surface $1,065
4. Third-degree burns covering 10 through 25 square of inches of body surface $2,665
5. Third-degree burns covering more than 25 square inches of body surface $5,330

D. Ruptured Disc or Torn Knee Cartilage:  Must be treated by a physician within 72 hours after the accident and repaired through surgery within one year after the Covered Accident.

E. Eye Surgery

With Surgical Repair $265

  • Accident Follow-up Treatment Benefit: Pays for additional treatment of injuries sustained in a Covered Accident over and above emergency treatment administered within 72 hours following the accident. This benefit is payable for up to a maximum of three treatments per Covered Person per Covered Accident. Such treatment must begin within 30 days of the Covered Accident or discharged from the hospital or extended care facility, and be within the six-month period following the Covered Accident or discharge. Pays $25 per visit.

  • Accident Emergency Treatment Benefit: Pays for emergency treatment for a Covered Accident, we will pay the amount shown in the Policy Schedule for treatment received. This benefit is payable for treatment by a physician, x-rays, or treatment received in a hospital emergency room. Treatment must be received within 72 hours of such accident. This benefit is payable once per Covered Accident. 

Insured and Spouse $150
Children $105

  • Initial Hospitalization for Injury Benefit:  When a Covered Person is confined for 24 hours or more for a covered accidental bodily injury, the Insurer will pay the benefit amount shown in the Policy Schedule. This benefit is payable only once per Hospital Confinement and only once for each Covered Person per calendar year. Benefit amount is $1,500.

  • Accident Hospital Income Benefit: Pays for hospital confinement for treatment of a Covered Accident, the Insurer will pay the daily amount shown in the Policy Schedule for each day of such confinement. Such confinement must start within 30 days of the accident. The Insurer will pay this benefit for up to 365 days per Covered accident.  Benefit amount is $200 per day.

  • Ambulance Benefit: Pays for ambulance transportation to a hospital or emergency room. Ambulance transportation must be within 72 hours of the accident. Pays four times the Ambulance Benefit for transportation provided by an air ambulance. The hospital or emergency room must be within 100 miles of the site of the accident or residence of the Covered Person. Benefit is limited to one trip per Covered Accident per Covered Person.

    Ground Ambulance $150
    Air Ambulance

    $600

 

 

  • Physical Therapy Benefit: Pays if a physician advises a Covered Person to seek treatment from a physical therapist. Physical therapy must be for injuries sustained in a Covered Accident and must start within 30 days of such accident or discharged from the hospital. Pays for one treatment per day up to six treatments per Covered Accident. The six treatments must take place within six months after the accident. Benefit amount is $75 per day.

  • Transportation Benefit: Pays for transportation to a hospital for special treatment and confinement for injuries sustained in a Covered Accident. This benefit is payable for the trip to the hospital. The local attending physician must prescribe the treatment, and the treatment must not be available locally. This benefit is not payable for transportation to any hospital located within a 100-mile radius of the site of the accident or residence of the Covered Person. This benefit is payable for up to three trips per calendar year per Covered Person. Benefit amount is $300.

  • Family Lodging Benefit: Pays for one motel or hotel room for a member (or members) of the immediate family to accompany the Covered Person for hospital confinement for the treatment of injuries. This benefit is payable only during the same period of time the injured Covered Person is confined to the hospital. Benefit is not payable for the trip to the hospital. The hospital and the motel or hotel must be more than 100 miles from the residence of the Covered Person. The local attending physician must prescribe the treatment. This benefit is payable for up to 30 days per Covered Accident. Benefit amount is $100 per day.

  • Wellness Benefit: After 12 months of paid premium for this benefit, the Insurer will pay for an Insured to undergo routine examinations or other preventive testing. Benefits include and are payable for: annual physical exams, mammograms, pap smears, immunizations, flexible sigmoidoscopy, Prostatic Specific Antigen, and blood screenings. This benefit is payable only once per 12-month period. Benefit amount is $60.

  • Accidental Death Benefit:  Death must occur as a result of a Covered Accident and must occur within 90 days of a Covered Accident. 

Insured

Spouse

Child

Common-Carrier Accidents

$70,000

$35,000

$7,000

Motorized-Vehicle or Pedestrian Accidents

$50,000

$25,000

$5,000

Other Accidents

$30,000

$15,000

$3,000

  • Accidental Dismemberment: Pays a percentage of the Accidental Death Benefit selected.

Both arms and both legs 100%
Two arms or two legs 50%
Two eyes, hands, or feet 50%
One eye, hand, foot, arm, or leg 20%
One or more fingers and/or one or more toes 5%

 


OPTIONAL DISABILITY BENEFITS:

  • Off-the-job Accident Disability Benefit:  This Rider only applies to the Insured employee (not a spouse or child), as shown in the Policy Schedule. A 1,000 monthly benefit is available.
    • 1. Full-time employee through age 69: If an Insured is totally disabled within 90 days of a covered off-the-job accident, pays the benefit selected beginning with the very first day of disability; will pay benefits for up to 12 months.

    • 2. Not Employed Full-time through age 69: If an Insured is unable to perform two or more Activities of Daily Living (ADLs) as certified by a physician, and direct personal assistance is required to perform such ADLs, within 90 days of a covered accident, benefits are payable for up to 12 months.

    • 3. Age 70 or above: If, as a result of a covered off-the-job accident, a covered person is hospital-confined, the Insurer will pay one-thirtieth of the benefit shown in the Policy Schedule times three for each day of confinement. Benefits are payable up to 12 months. 


Accident Select II Monthly Rates:

Employee Only $22.49
Employee and Children $35.09
Employee and Spouse $33.64
Employee and Family $46.24

 

 


This page is maintained by Lisa Giger. Send questions and comments regarding this site to lgiger@deltastate.edu



 

 

Accident during first year of coverage $265
Thereafter $800

C. Burns (Treated by a physician within 72 hours after the accident)
Print Friendly