How It Works
Motor vehicle and other unexpected accidents cause 45 million trips to the emergency room each year—costing on average $1,350 per visit.* Your major medical insurance will help with many of your expenses, but wouldn’t you feel better knowing you’ll have extra help paying some of your bill?
Accident insurance pays you a lump sum cash benefit to help cover your out-of-pocket expenses so you can focus more on getting well and less on the extra expenses an accident can bring. Benefits include:
*National Hospital Ambulatory Medical Care Survey: 2009 Emergency Department Summary Tables (based on 136 million total annual ER visits).
American Hospital Association Resource Center, April 2012.
**Coverage is guaranteed provided (1) the employee is actively at work and (2) dependents to be covered are not subject to medical restrictions as set forth on the enrollment form and in the Certificate. Some states require the insured to have medical coverage. Additional restrictions apply to dependents serving in the armed forces or living overseas.
***Eligibility for portability through the Continuation of Insurance with Premium Payment provision may be subject to certain eligibility requirements and limitations. For more information, contact your MetLife representative.
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Who is the provider?
How can this help me?
Most families don’t budget for the costs associated with accidents. When an accident does occur, the last thing that should be on your mind is the charges accumulating while at the emergency room:
These costs can add up fast. Most families have medical insurance that will cover a majority of the expenses. But, what about the out-of-pocket medical expenses, such as required copay, or the lost wages an employee or spouse/domestic partner loses when out of work or staying home to care for an injured family member? You hope that an accident never happens, but at some point you very well may take a trip to your local emergency room. If that time comes, wouldn’t it be nice to have an insurance plan that pays you a benefit regardless of any other insurance you have? Group Accident insurance does just that, providing a cash benefit to cover the costs associated with unexpected trips to the emergency room.
Who is eligible?
When can I enroll?
What if my employment status changes?
Will my rates increase as I get older or if I file a claim?
What types of accidents and injuries am I covered for?
Once you’re enrolled in this coverage, you’ll collect benefits for more than 150 different covered events3, including:
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You’ll also receive a lump-sum payment when you have these covered medical services/treatments3:
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Will I have to take a medical exam to get this coverage?
1Centers for Disease Control and Prevention: Emergency Department Visits. CDC/National Center for Health Statistics. https://www.cdc.gov/nchs/fastats/emergency-department.html. Accessed January 2022.
2The Cost of Unwarranted ER Visits: $32 Billion a Year. Kaiser Health News, July 25, 2019. https://khn.org/morning-breakout/the-cost-of-unwarranted-er-visits-32-billion-a-year/ Accessed January 2022.
3Children may be covered to age 26. There are benefit reductions that may begin at age 65.
4Coverage is guaranteed provided: (1) the employee is actively at work; and (2) dependents to be covered are not subject to medical restrictions as set forth on the enrollment form and in the Certificate. Some states require the insured to have medical coverage. Additional restrictions apply to dependents serving in the armed forces or living overseas.
5Eligibility for portability through the Continuation of Insurance with Premium Payment provision may be subject to certain eligibility requirements and limitations. For more information, contact your MetLife representative.
6Eligible Family Members mean all persons eligible for coverage as defined in the Certificate.
7Covered services/treatments must be the result of a covered accident as defined in the group policy/certificate. See your Disclosure Statement or Outline of Coverage/Disclosure Document for more details.
8Chip fractures are paid at 25% of Fracture Benefit and partial dislocations are paid at 25% of Dislocation Benefit.
METLIFE’S ACCIDENT INSURANCE IS A LIMITED BENEFIT GROUP INSURANCE POLICY. The policy is not intended to be a substitute for medical coverage and certain states may require the insured to have medical coverage to enroll for the coverage. The policy or its provisions may vary or be unavailable in some states. There are benefit reductions that begin at age 65, if applicable. Like most group accident and health insurance policies, policies offered by MetLife may include waiting periods and contain certain exclusions, limitations and terms for keeping them in force. For complete details of coverage and availability, please refer to the group policy form GPNP12-AX or contact MetLife.
Benefits are underwritten by Metropolitan Life Insurance Company, New York, NY. Hospital does not include certain facilities such as nursing homes, convalescent care or extended care facilities. See MetLife’s Disclosure Statement or Outline of Coverage/Disclosure Document for full details.