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Guardian Accident Protection Plus Silver

Coverage Summary
(see your policy for further details)
How it Works

Accident Protection Plus Insurance is a benefit that supplements your existing medical coverage.  It can help with expenses related to an accidental injury, such as a broken bone or a concussion, that medical insurance may not fully cover.  The benefit is paid directly to you and can be used to offset your out-of-pocket costs related to the accidental injury in any way you choose, including to offset medical insurance deductibles, ambulance charges, crutches or braces, or other related costs.  Upon verification of a covered accident type, you will be eligible to receive a payout according to the schedule below, by treatment and/or injury type.

Your Plan Benefits
Guardian Pays
(see policy for full list of coverage)
Injury Outpatient Treatment
Urgent Care Doctor Visit $10
Diagnostic X-Ray $30
Diagnostic CT, CAT, MRI, EEG  $120
Emergency Room $150
Follow-Up Visit $25
Physical Therapy up to 10x at $25
Injury Ambulance Services
Ambulance $150
Air Ambulance $1,000
Injury Hospital Treatment
Hospital Admission $1,250
Hospital ICU Admission $2,500
Hospital Confinement $250/day
Hospital ICU Confinement  $500/day
Rehabilitation Confinement $100/day
Injury Restorative Treatment
Prescribed Appliance $125
Dental Crown or Extraction up to $250
Eye Surgery or Object Removal  $250
Prescribed Prosthetic $1,250
Lump Sum Injury Benefits
Concussion $75
Laceration up to $500
Fracture – Non-Surgical  up to $2,250
Fracture – Surgical  up to $4,500
Dislocation – Non-Surgical   up to $2,250
Dislocation – Surgical  up to $4,500
Other Surgery  up to $1,250
Burn (2nd, 3rd Degree) up to $10,000
Coma $7,500
Lump Sum Accidental Dismemberment or Death Benefits
Accidental Dismemberment or Death:  
   
   Member up to $25,000
   Spouse up to $12,500
   Child up to $5,000

(If an Accidental Death and Accidental Dismemberment result from the same accident, the plan benefit will only pay the Accidental Death Benefit.)

Children’s Organized Sports Benefit

If a dependent child (18 and younger) was participating in an organized sport when the covered accident occurred, the benefit paid will increase by 20%

Deductibles
What you pay out-of-pocket before your plan pays benefits
You Pay
There is no deductible
$0
Maximum Payouts
The maximum amount Guardian will pay for accident occurrences
Maximum Guardian Pays
Annual Benefit Maximum

Guardian pays according to the treatment or injury schedule.  There is no annual maximum

Ongoing Eligibility Requirements
Renewability

Coverage is renewable annually.

Premiums may occasionally change for all members of a class.  If premiums change, you will receive at least 60 days advance notice

Age-Related Termination

Coverage will be terminated at age 90

Exclusions
(see your policy for further details)

This Policy will not pay benefits for any Injury caused by, or related to, directly or indirectly, any of the following: 

  • Sickness, disease, mental infirmity or medical or surgical treatment.  
  • Voluntary use of any poison, chemical, prescription or non-prescription drug or controlled substance unless: (1) it was prescribed for You by a Doctor, and (2) it was used as prescribed.  In the case of a non-prescription drug, this Policy does not pay for any Accident resulting from or contributed to by use in a manner inconsistent with package instructions.  "Controlled substance" means anything called a controlled substance in Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, as amended from time to time. 
  • You being legally intoxicated. “Intoxicated” means that condition as defined by the law of the jurisdiction in which the Accident occurred. 
  • Declared or undeclared war, declared or undeclared act of war, or armed aggression. 
  • Active Duty Service in the armed forces, National Guard, or military reserves of any state or country. Upon receipt of proof of service, We will refund any Premium paid during Your time of active duty. 
  • Taking part in a riot or civil disorder. 
  • Commission of, or attempt to commit, a felony. 
  • Treatment rendered or Hospital Confinement outside the United States or Canada.  
  • Intentionally self-inflicted Injury, while sane or insane. 
  • Suicide or attempted suicide, while sane or insane. 
  • Travel or flight in any kind of aircraft, including any aircraft owned by or for You, except as a fare-paying passenger on a Common Carrier. 
  • Participation in any kind of sporting activity for compensation or profit, including coaching or officiating. 
  • Riding in or driving any motor-driven vehicle in a race, stunt show or speed test. 
  • Participation in hang gliding, bungee jumping, sail gliding, parasailing, parakiting, ballooning, parachuting, skydiving or a similar activity. 
  • Job related or on the job Injuries. 
  • An Accident that occurred before You are covered by this Policy. 
  • Injuries to a dependent child received during the birth. 

 

For North Carolina residents, any reference on this site to “child” includes “foster child.”

Accident Insurance is underwritten by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Those shown above are illustrative only. The actual limitations and exclusions that apply to your Accident Plan are governed by the policy forms approved for use in your state. Please refer to your plan documents for a complete list of limitations and exclusions. Plan documents are the final arbiter of coverage.

Policy Form # IP-ACC-16