Accident Insurance (PAID Enhanced)

Every benefit below is transcribed from ManhattanLife PAID Enhanced brochure PAIDEH-BR 0524, and from the Nevada application AK7026NV. Benefits, amounts and riders vary by state; the policy issued to you governs.

• Choose 24-hour cover or off-the-job only Included

  Two plan options. The 24-hour plan pays wherever the accident happens. The off-the-job plan pays only away from work and costs less.

  Off-the-job only is the right choice where an employer carries workers' compensation and the wrong one for anybody self-employed. This policy is not workers' compensation and will not stand in for it.

• Choose one unit or two Included

  Every benefit below is shown at both levels. Two units roughly doubles most of the schedule and costs about a fifth more.

• Accidental death and dismemberment Included

  Accidental death pays $25,000 for the employee, $10,000 for a spouse and $5,000 for a child on one unit; $50,000, $20,000 and $10,000 on two. Death as a fare-paying passenger on a plane, bus or train doubles it. Dismemberment pays a lump sum from $625 to $40,000 at either level.

  Death must occur within 90 days of the accident — 180 days in Utah, 365 in Washington. Dismemberment is paid once per covered person per accident.

• Hospital admission, confinement and intensive care Included

  Admission pays $1,000 on one unit or $2,000 on two, with $500 or $1,000 added if you go straight to intensive care. Confinement pays $150 or $300 a day to a maximum of 365 days. Intensive care confinement pays $300 or $600 a day for up to 15 days, on top of the confinement benefit.

  Admission requires confinement within 180 days and a stay of at least 20 hours; intensive care must begin within 30 days.

• Getting there and getting treated Included

  Air ambulance $1,000 or $2,000 within 48 hours. Ground ambulance $100 or $200 within 90 days. Emergency room treatment $200 at either level within 72 hours. Urgent care $225 at either level within 60 days. An ambulatory surgical centre or outpatient hospital facility pays $100 or $200.

• The doctors afterwards Included

  A physician's office visit pays $75 or $150 within 60 days, and follow-up visits $25 each to a maximum of six, or $50 each to a maximum of eight on two units. A chiropractor pays $35 or $70 a day for up to five visits. Physical therapy pays $35 or $70 a treatment for up to ten treatments per accident.

  Physical therapy must start within 30 days of the accident or of hospital discharge and finish within six months of it.

• Fractures, dislocations, lacerations and torn tissue Included

  Fractures pay $25 to $2,500 on one unit and $50 to $5,000 on two, on a schedule in the policy. Dislocations pay $50 to $2,000, or $100 to $4,000. Lacerations pay $50 to $400 or $100 to $800 by length. A torn knee cartilage pays $500 or $1,000, a ruptured disc $500 or $1,000, and a torn tendon, ligament or rotator cuff $500 or $1,000.

  Exploratory surgery on a knee, tendon or ligament pays $100 or $200 instead, and a knee cartilage benefit is reduced by any arthroscopic surgery already paid.

• The serious end of the schedule Included

  Quadriplegia pays $5,000 or $10,000 and paraplegia $2,500 or $5,000. A coma of at least seven days pays $5,000 or $10,000. A concussion pays $100 or $200. Burns pay up to $10,000 or $20,000 by size and degree if treated within 72 hours. Internal surgery within 72 hours pays $1,000 or $2,000 for thoracic or open abdominal work, $100 or $200 for exploratory.

  Hernia repair is not covered, except in Virginia. A gunshot wound needing confinement within 24 hours and surgery within 72 pays $500 for the primary insured only, and that benefit is not approved in Pennsylvania.

• Rehabilitation Included

  Admission to a rehabilitation unit pays $500 or $1,000 on the first day of transfer, and the rehabilitation unit itself pays $150 a day at either level, limited to 30 days per hospital confinement and 60 days a calendar year.

  The admission benefit is not paid for a day on which the hospital confinement benefit is also paid.

• The costs around the accident Included

  Companion lodging pays $100 a night for up to 30 days when you are confined more than 100 miles from home, and transportation pays $300 a round trip for up to three trips. Emergency dental pays $150 or $300 for repairs with a crown and $50 or $100 for an extraction. Blood, plasma and platelets pay $300 for the primary insured and $200 for a spouse or child. An appliance — a wheelchair, leg or back brace, walker or crutches — pays $125 at either level. A prosthesis pays $750 or $1,500.

• Tests and scans Included

  An eye injury needing surgery or removal of a foreign object pays $200. Major diagnostic exams — angiogram, CT, CTA, MRI, MRA or EEG — pay $100 or $200 a calendar year. An X-ray pays $50 or $100, once a calendar year. Epidural pain management pays $100, no more than twice per accident per person.

• Annual wellness benefit rider Optional rider

  A one-off $60 a year for each covered person for any one of an annual physical, a dental exam, a mammogram, a pap smear, an eye examination, an immunisation, a flexible sigmoidoscopy, a PSA test, an ultrasound or a blood screening test.

  Not offered by Manhattan Life in California, Washington. Waiting period: 30 days. The brochure states where this rider is not approved twice and the two lists differ by Idaho. We record the wider of them, because a rider we wrongly believe is unavailable costs you nothing but a question, and one we wrongly believe is available costs you a complaint. Ask us to confirm it for your state.

PAID Enhanced (Personal Accident Indemnity Delivery) on its own page, with its own enrollment link.

Issue ages

18 to 84, as individual, individual and spouse, single parent or family. In California and Nevada a spouse means a spouse or domestic partner, and in Hawaii a spouse or reciprocal beneficiary.

Underwriting

The application asks about occupation and exact duties, occupational class and monthly income, and four questions: whether anybody to be insured takes part in hazardous sports or activities — racing, parachuting, rodeo riding, motorcycling, mountain climbing, scuba diving or semi-professional and professional sport — or intends to; whether a driving licence has been suspended or revoked in the past three years; whether anybody has had a DUI or been treated for drug or alcohol abuse in that period; and what similar insurance is already in force. A telephone interview may form part of underwriting.

Renewability

Guaranteed renewable for life, subject to the company's right to change premium rates.

Policy form

AK7025, AK7024. Rider forms AK7027. Form numbers and benefits vary by state.