Transamerica Supplemental Insurance: Understanding Auto Accident Injury Coverage

Transamerica's Accident Insurance is a flexible policy that helps cover unexpected medical costs resulting from a covered accident. It complements major medical insurance by providing benefits that can be used to cover co-pays, deductibles, or other expenses. The policy offers a range of benefits, including coverage for organised sports injuries, acupuncture and chiropractic treatments, and mental health visits. It also provides observation benefits for hospital stays and a health screening benefit to encourage early detection and treatment.

However, it is important to note that Transamerica's Accident Insurance has certain exclusions and limitations. The policy will not cover accidents caused by or occurring during specific activities, such as driving for wage or profit, participating in certain extreme sports, or engaging in illegal activities. It is essential to refer to the policy, certificate, and riders for complete details on exclusions and limitations.

What is covered by Transamerica Accident Insurance?

Transamerica Accident Insurance is a highly flexible policy that helps cover unexpected medical costs that can add up quickly due to a covered accident. The policy offers benefits such as:

• An organized sports benefit rider that pays an additional percentage of total benefits, making this policy ideal for active families.
• Acupuncture or chiropractic benefits that allow up to ten annual visits at up to $150 per visit, with one treatment per visit.
• Mental health benefits that allow up to five annual mental health visits with a psychiatrist or psychologist at up to $150 per visit.
• Observation benefits that pay for treatment in a hospital emergency room if the insured person is being held for observation and is not admitted as an inpatient due to a covered accident.

Transamerica Accident Insurance complements major medical insurance by providing a benefit that employees can use however they need, whether that's covering co-pays and deductibles or household bills and expenses. It is designed to give employees relief from rising healthcare costs.

What is not covered by Transamerica Accident Insurance?

Transamerica Accident Insurance is a flexible policy that helps cover unexpected medical costs that can add up fast due to a covered accident. The policy offers employers the ability to fully customise plan designs to best meet the needs of a diverse workforce.

However, there are certain exclusions and limitations to the policy. Transamerica will not pay benefits for an insured person's accident that is caused by or occurs as a result of the following:

• Driving a taxi for wage, compensation, or profit, including ride-share programs such as Uber and Lyft.
• Mountaineering, parachuting, or hang gliding.
• Voluntarily taking, administering, absorbing, or inhaling poison, gas, or fumes.
• Alcoholism or drug addiction.
• Participating in any sport or sporting activity for wage, compensation, profit, or racing any type of vehicle in an organised event.
• Travelling in or descending from any vehicle or device for aerial navigation, except as a fare-paying passenger in an aircraft operated by a commercial airline (other than a charter airline) on a regularly scheduled passenger trip.
• War, or any act of war, whether declared or undeclared.
• Participating in any activity or event, including the operation of a vehicle, while intoxicated or under the influence according to the laws of the jurisdiction in which the accident occurred.
• Actively participating in a riot, civil commotion, civil disobedience, or unlawful assembly.
• Committing, attempting to commit, or taking part in a felony or assault, or engaging in an illegal occupation.
• Intentionally self-inflicting a bodily injury or attempting suicide, while sane or insane.
• Any loss incurred while on active-duty status in the armed forces.
• Injuries that occur in the workplace or during the course of any employment for pay, benefit, or profit.

In addition, Transamerica Accident Insurance may not be available in all jurisdictions, and there may be other limitations and exclusions that apply. It is important to refer to the policy, certificate, and riders for complete details.

What is the process for claiming auto accident injury expenses?

Transamerica Accident Insurance is a flexible policy that can help cover unexpected medical costs resulting from a covered accident. It is an employee benefit offered by employers to their workforce. The policy can be customized to meet the diverse needs of employees and can be matched or improved by employers to meet existing accident insurance plans.

Step 1: Understand Your Insurance Policy

Before an accident occurs, it is important to familiarize yourself with your insurance policy. Understand what is covered and what is excluded. Review the application and policy thoroughly to ensure that the coverages, policy limits, and deductibles meet your needs.

Step 2: Take Necessary Actions at the Scene of the Accident

If you are involved in an auto accident, the first priority is to ensure the safety of yourself and others. Stop immediately and move only if it is safe. Call 911 if there are any injuries, and notify the police. Exchange information with the other driver(s), including names, addresses, telephone numbers, driver's license numbers, license plate numbers, and vehicle identification numbers. Obtain insurance information from the other driver(s) and provide them with your insurance details. Take photographs of the accident scene, including vehicle damage, road conditions, traffic controls, and visual obstacles. If there are witnesses or passengers, get their names, addresses, and telephone numbers as well.

Step 3: Notify Relevant Parties

Notify your insurance agent and/or company immediately after the accident. If the vehicle damage exceeds a certain amount or there are injuries, you may also need to report the accident to the Department of Motor Vehicles within a specified timeframe.

Step 4: Provide Information and Documentation

Your insurance company will contact you for detailed information about the accident and may request a written or recorded statement. They may also require documentation of your injuries and expenses, including medical records, invoices, and statements for medical expenses, repair costs, lost wages, etc.

Step 5: Vehicle Damage Assessment

A qualified adjuster or appraiser will typically inspect the vehicle damage and provide an estimate for repairs. If additional damage is found during the repair process, the repair shop will need to contact the insurer for approval of the additional costs.

Step 6: Settlement and Payment

Once your claim has been accepted, the insurance company will determine the settlement amount based on the policy terms and the extent of the damage. They will then issue a check or draft to the insured and any lienholders, such as a bank or finance company.

It is important to note that the above process serves as a general guide, and specific steps may vary depending on your insurance provider and the circumstances of the accident. It is always advisable to review your insurance policy and understand your rights and responsibilities in the event of an auto accident.

What are the exclusions and limitations of the policy?

Transamerica Accident Insurance is a highly flexible policy that helps cover unexpected medical costs resulting from a covered accident. It is worth noting that Transamerica Accident Insurance is not available in all jurisdictions and limitations and exclusions apply.

• Transamerica will not pay benefits for an insured person's accident that is caused by or occurs as a result of driving any taxi for wage, compensation, or profit, including ride-sharing programs such as Uber and Lyft.
• Injuries sustained while mountaineering, parachuting, or hang gliding are not covered.
• Transamerica will not cover losses if the insured person voluntarily takes, administers, absorbs, or inhales poison, gas, or fumes.
• Alcoholism and drug addiction are not covered by the policy.
• Racing any type of vehicle in an organized event or participating in any sport or sporting activity for wage, compensation, or profit is excluded from the policy.
• The policy does not cover losses incurred while travelling in or descending from any vehicle or device for aerial navigation, except as a fare-paying passenger in a commercial or charter airline.
• War or any act of war, whether declared or undeclared, is excluded from the policy.
• Transamerica will not cover losses if the insured person participates in any activity, including operating a vehicle, while intoxicated or under the influence according to the laws of the jurisdiction in which the accident occurred.
• The policy does not cover losses incurred while actively participating in a riot, civil commotion, civil disobedience, or unlawful assembly.
• Committing, attempting to commit, or taking part in a felony, assault, or engaging in an illegal occupation is excluded from the policy.
• Transamerica will not cover any losses resulting from an insured person intentionally self-inflicting bodily injury or attempting suicide, whether sane or insane.
• Any loss incurred while on active-duty status in the armed forces will not be covered. However, Transamerica will refund any premiums paid for any period where no coverage is provided due to this exception.
• Injuries that occur in the workplace or during the course of any employment for pay, benefit, or profit are not covered by the policy.

It is important to refer to the policy, certificate, and riders for complete details on exclusions and limitations, as this is only a brief summary.

What are the benefits of Transamerica Accident Insurance?

Transamerica Accident Insurance is a highly flexible policy that pays the insured a benefit to help cover unexpected medical costs that can add up fast due to a covered accident. This policy is customisable to meet the needs of a diverse workforce. It can be used to complement major medical insurance by providing a benefit that employees can use however they need, whether that’s covering co-pays and deductibles or household bills and expenses.

Transamerica Accident Insurance includes a variety of benefits to help cover medical or other costs that can arise after an accident. These benefits include:

• An organised sports benefit rider that pays an additional percentage of total benefits, making this policy ideal for active families.
• Acupuncture or chiropractic benefits that allow up to ten annual visits at up to $150 per visit, with one treatment per visit.
• Mental health benefits that allow up to five annual mental health visits with a psychiatrist or psychologist at up to $150 per visit.
• Observation benefits that pay for treatment in a hospital emergency room if the insured person is being held for observation due to a covered accident and is not admitted as an inpatient.

Frequently asked questions