Accident Medical Expense (AME) coverage
Up to $2500, $5000, $7500 or $10,000 in AME Coverage:
Many health policies have a high deductible due to the constant increases in health care costs. The average trip to an emergency room could require you to pay hundreds of dollars out-of-pocket! Can you afford this sudden expense?
You never know when an accident will happen, but when it does you should be prepared. For those without coverage this plan is affordable and one you shouldn't be without. The potential savings it offers for services and health-related products more than justifies the cost.
Take a look at the benefits you'll receive and just imagine the peace-of-mind this plan provides.
WHEN COVERAGE APPLIES:
Accident Insurance provides coverage 24 hours a day - worldwide - while on business or pleasure.
AME BENEFIT DESCRIPTION:
Accident Medical Expense Benefit Amounts for Members and their spouses/domestic partners and dependent children:
$2,500 or $5,000 benefit subject to a deductible of $195
WBA will pay $95 of your deductible as a member benefit
$7,500 or $10,000 benefit subject to a deductible of $275
WBA will pay $175 of your deductible as a member benefit
This benefit will reimburse medical expenses up to the maximum elected if accidental bodily injury causes an insured person to first incur medical expenses for care and treatment of the accidental bodily Injury within 90 days after an accident. The benefit amount for Accident Medical Expense is payable only for medical expenses incurred within 52 weeks after the date of the accident causing the accidental bodily Injury. The benefit amount is subject to a deductible. The deductible will be deducted from any benefit amount for Accident Medical Expense that the insurance company pays. This deductible applies separately to each insured person and each accident.
Limitation on Accident Medical Expense:
The benefit amount for Accident Medical Expense does not apply to charges and services: a) for which an insured person has no obligation to pay; b) for any injury where worker's compensation benefits or occupational injury benefits are payable; c) for any injury occurring while fighting, except in self-defense; or d) for treatment that is educational, experimental or investigational in nature or that does not constitute accepted medical practice; e) for treatment by a person employed or retained by the policyholder; or f) for treatment involving conditions caused by repetitive motion injuries, or cumulative trauma and not as the result of an accidental bodily Injury.
This insurance applies only to medically necessary charges and services.
This policy does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from providing the insurance. In addition no benefits will be paid for any accident caused by or resulting from any of the following: 1) an Insured Person being in, entering, or exiting any aircraft: a) owned, leased or operated by the Policyholder or on the Policyholder's behalf; or b) operated by an employee of the Policyholder on the Policyholder's behalf; 2) an Insured Person riding as a passenger in, entering, or exiting any aircraft while acting or training as a pilot or crew member. (This exclusion does not apply to passengers who temporarily perform pilot or crew functions in a life threatening emergency.); 3) an Insured Person's emotional trauma, mental or physical illness, disease, pregnancy, childbirth or miscarriage, bacterial or viral infection, bodily malfunctions or medical or surgical treatment thereof. (This exclusion does not apply to an Insured Person's bacterial infection caused by an accident or by accidental consumption of a substance contaminated by bacteria.); 4) an Insured Person?s commission or attempted commission of any illegal act, including but not limited to any felony; 5) any occurrence while an Insured Person is incarcerated after conviction; 6) an Insured Person being intoxicated, at the time of an accident. Intoxication is defined by the laws of the jurisdiction where such accident occurs; 7) an Insured Person being under the influence of any narcotic or other controlled substance at the time of an accident. (This exclusion does not apply if any narcotic or other controlled substance is taken and used as prescribed by a Physician.); 8) an Insured Person being engaged in or participating in a motorized vehicular race or speed contest; 9) an Insured Person participating in military action while in active military service with the armed forces of any country or established international authority. (This exclusion does not apply to the first 60 consecutive days of active military service with the armed forces of any country or established international authority.); 10) an Insured Person traveling or flying on any aircraft engaged in Specialized Aviation Activities; 11) an Insured Person's suicide, or attempted suicide while sane or intentionally self-inflicted injury; 12) a declared or undeclared War.
Sample AME Certificate