Personal Accident Coverage Can Be Key Slice Of The Benefits Pie

September 02, 2007 at 04:00 PM
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Let's face it: Most people don't even like saying the words "accidental death and dismemberment."

It brings to mind some pretty terrible thoughts about our own mortality. But just as scary are the challenges–financial, physical and emotional–that can follow an accidental injury. That's why it is crucial to understand exactly what benefits are available through personal accident insurance and how it fits into the overall benefits picture.

It helps to think of AD&D benefits as benefits that bridge an existing gap in insurance. What does that mean exactly? When you think about your health insurance, it provides coverage for medical treatment and services. Your disability insurance provides income replacement should you experience a disabling injury or illness. Life insurance, of course, is available to provide financial support to designated beneficiaries in the event of your death. But personal accident insurance fills in the holes that we might not even realize are there, until it is too late, and it can be paid regardless of any other benefits received.

Here is a hypothetical example, to clarify this point. A 42-year-old male survives an automobile accident, but becomes paralyzed. His health care coverage covers some of his medical costs, and his disability insurance covers a certain percentage of his salary. Accident coverage can fill in the gap left behind after health and disability insurance kicks in. It pays him a lump-sum amount (typically ranging from 50% to 100% of the policy's face value) to cover other expenses associated with his injury. Perhaps his spouse used to stay at home with their children but now needs to work outside of the home, or the claimant used to stay at home with their children. Regardless, this could create a need for child care services, and according to the Child Care Resource & Referral average, annual fees paid for full-time care can range from $3,900-$14,225, and the total can be much higher in some large cities.

Further, in order to provide long-term financial support, the claimant's spouse may need retraining or education. The substantial cost of such training would not be easily absorbed by a budget already stretched thin. Because in addition to expenses already mentioned, it is likely that home and automobile modifications would need to be made to accommodate a paralyzed person.

Accident coverage could potentially pay for all of these expenses in addition to the face value of the policy. For example, in this case, the claimant would receive an additional payout to cover the cost of home modifications. These paid benefits are designed to pay additional benefits to assist families in meeting their other financial obligations, such as a mortgage, credit card debt, medical bills not covered by health insurance, to name a few.

Completing the benefits package

Although accident insurance fills that gap left by other insurance coverage, sometimes it integrates with other benefits to provide a stronger support system when needed most. For example, some accident plans also provide substantial assistance when beneficiaries are faced with the accidental death of a loved one. These services are important to point out because they don't often come to mind when thinking of personal accident coverage. They can include:

Bereavement counseling: Access to free, confidential bereavement services by phone. It also can provide coverage for telephonic appointments with grief counselors and/or face to face counseling sessions. Finally, it connects beneficiaries with local resources in their specific community, like self-help groups, educational programs, non-profit organizations and public resources. In fact, bereavement counselors provide a proactive outreach call to let the employee or beneficiary know exactly what services are available to them.

Legal assistance: Free access to telephonic legal consultation from licensed, practicing attorneys. Such services might also provide referrals to discounted, professional legal services for help with settling an estate, preparing a will, or receiving general legal advice.

Legal and financial guidebooks: In-depth information on probating an estate, investigating additional benefit sources, and financial assessment and planning. This can include sample letters for beneficiaries to use when searching for additional benefit sources.

Expert financial guidance: Free telephonic consultation with financial professionals (including Certified Public Accountants, Certified Financial Planners, Chartered Financial Consultants, Registered Investment Advisors, Chartered Life Underwriters, stockbrokers and personal financial specialists.)

Bank account access to benefits: Arrangements to deposit benefits directly into interest-bearing bank accounts. Such access spares beneficiaries the time they need to deal with more pressing issues while offering the peace of mind that their money is where it should be.

Business travel accident coverage

Another area where accident coverage can complement other benefits available to employees is through protection while traveling on business. Business travel accident coverage is often overlooked as a means to provide protection and peace of mind to an employer's workforce. Further, some benefits professionals may not be aware of the types of resources now available through their employers' BTA plans. Today's policies go beyond simply providing financial protection to those who suffer a loss while traveling, by also providing a dedicated staff of professionals that employees can call for help from any country, at any time of day or night.

Once again, these travel assistance services available through BTA coverage can help fill a gap normally not covered by employees' healthcare benefits, but they also work best when bundled with health and disability benefits.

For example, medical coverage might fund any medical treatment necessary while traveling and disability benefits will cover income replacement should a traveling employee experience a disabling injury or illness. But travel assistance services through BTA coverage can provide funding for the costs associated with getting such care, such as transportation to a medical facility where the employees can receive a high standard of care and communication assistance. Why is this so important? Because helping employees get timely and effective medical treatment can prevent long-term or disabling medical issues, which can negatively affect both an employee's financial well-being and an employer's bottom line.

The following are services offered through high-quality business travel accident insurance that can work together with medical and disability benefits to provide the full protection employees need while traveling for their employer.

Worldwide travel assistance services: When problems occur overseas, they are often compounded by unfamiliar languages, customs and health care systems. Worldwide travel assistance services can provide global travel assistance, as well as assistance for those traveling domestically for business. In the event of a medical emergency, some accident insurers offer programs that will arrange for and cover the cost of transportation to the nearest hospital or medical facility where an insured can receive appropriate care; provide up-front payment for medical services that are often required when abroad; and transport travelers facing a medical emergency anywhere and bring them home safely.

As an example, one claimant with BTA coverage experienced severe cardiac symptoms while on a business assignment in Indonesia. The company was able to medically evacuate him by air ambulance to Singapore, where there was a higher standard of care. He underwent heart bypass surgery and due to the anticipated length of hospitalization, the insurance company covered the cost of transporting his wife to be by his side. The travel costs for both the employee and his wife would not be covered as part of his health plan. Without these services, this employee could have faced the possibility of sub-standard care or encountered costly out-of-pocket travel expenses.

"Above and beyond" protection for business travel: In addition to these features that work together with other benefits, BTA coverage can also provide additional services that truly make business travel as easy and safe as possible. For example, worldwide travel assistance services can provide referrals to local legal and financial assistance, as needed. It can help employees recover or replace lost luggage, passports or other important documents and possessions while traveling.

Pre-trip planning: Traveling abroad requires an extra level of preparation as employees could face different needs in different countries. Coverage that offers pre-trip support for employees traveling abroad can provide information on: immunization requirements, visa and passport requirements, foreign exchange rates, embassy/consular referrals, travel/tourist advisories, temperature and weather conditions, and cultural information. This support is a priceless resource for anyone traveling abroad and a necessity for employers asking their employees to travel overseas.

Emergency travel services: Emergency travel services provide much needed support when the unexpected arises, including: emergency cash advances with confirmation of reimbursement; emergency changes to travel plans; emergency message relay to friends, relatives and business associates; legal referrals; translation and interpretation assistance as well as assistance with lost or stolen items. Such support can be a great tool to attract and retain valuable talent that might be hesitant to travel.

In short, accident plans can inexpensively complement existing benefits like medical and disability coverage to provide the best support and protection to those covered. These services can make all the difference and potentially prevent accidents from turning into long-term disabling injuries. In addition, they provide extra services and support for employees and beneficiaries when they are at their most vulnerable.

Dan Berenbaum is senior director of accident and specialty for CIGNA Group Insurance-Life, Accident and Disability at CIGNA Corp., Philadelphia.

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