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How Does Accident Insurance Work?

Accident insurance supplements your major medical insurance to help with expenses your medical insurance may not fully cover. After you or a family member has a covered accidental injury, such as a broken bone or concussion, you submit a claim to your insurance provider for verification. The provider then pays a cash benefit directly to you that can be used in any way you choose, including to offset deductibles or co-pays, ambulance charges, crutches and more, or even to cover household expenses such as your mortgage or groceries. They payout you receive will be based on the type of injury, the severity of the injury and the prescribed treatments. Since the benefit is paid directly to you, you get to decide how to spend it. 

Steps to Using Accident Insurance

  1. Submit your claim, including details of the injury and injury-related treatments, to your insurance provider for verification. 
  2. After your claim is verified, your insurance provider will pay you a cash benefit directly—not to doctors or hospitals—based on the type of injury, the severity of the injury, and the prescribed treatments.
  3. After you receive your cash benefit, you can pay any bills you choose, including deductibles, co-pays, coinsurance, ambulance charges, crutches and wheelchairs, as well as mortgage, groceries or childcare expenses.

Do I Need Accident Insurance If I Have Health Insurance?

Accident insurance compliments but does not replace health insurance. If you or a family member has an accident, chances are you’ll get hit with unexpected expenses. You could be responsible to pay a large deductible should an accident occur. Three in five people don’t have the funds to cover a $3,000 medical bill.1 Accident insurance helps with expenses that your medical insurance doesn’t cover, such as deductibles, co-pays and coinsurance so you don’t have to use savings to cover the expenses of an unexpected accident.
Accident insurance is not meant to replace a customer’s medical insurance plan. Rather, it’s to supplement a plan that may not cover all of the out of the out-of-pocket costs you may have to pay if you or a family member has a covered accidental injury, such as a broken bone, burn or concussion.


2019-87906 (10/21)


1. The Guardian Workplace Benefits Study, Fourth Annual, 2016

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