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Supplemental Insurance Protection

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Presentation on theme: "Supplemental Insurance Protection"— Presentation transcript:

1 Supplemental Insurance Protection
Connecticut Approval date: 09/04/2012 Code: ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

2 Fit Plus Supplemental Series ProtectFit Plus
Accidental Injury Only Insurance Policy Form CH IP (06/09) CT ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

3 Introduction This is a brief description of the SureBridge® ProtectFit Plus plan. SureBridge® is a brand name used for insurance products underwritten and administered by The Chesapeake Life Insurance Company®. For more plan details, refer to the product materials. Premium drafted on submission of the application. The benefits described in this presentation are subject to all provisions, terms, definitions, and limitations and exclusions of the applicable policy. Supplemental plans serve a specific purpose in the insurance market. These plans are not intended as substitutes for accident and sickness health insurance and should not be construed as such. ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

4 Accidental Injury Only Insurance Policy
Form CH IP (06/09) CT ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

5 ProtectFit Plus Inpatient Hospital Confinement
Outpatient Emergency / Diagnostic Lump-Sum Accidental Injury Follow-Up & Restorative Injury Accidental Death & Dismemberment Ambulance Transport Disability Income Protection (High only) ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

6 ProtectFit Plus Benefit Overview
Provides benefits for accidental injuries that First Occur after the insured’s coverage becomes effective and while in force First Occur means an accidental injury for which diagnosis, treatment, surgery or advice by a physician, or manifested symptoms, initially occurred while the Policy is in force for the insured and for the first time in the insured’s lifetime. Does not provide benefits for losses resulting from a sickness Provides a blend of Lump Sum and Daily Benefits ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

7 Benefits Inpatient Hospital Confinement High Low
(Confinement must begin within 30 days of Accidental Injury) One-time Lump Sum Hospital (Per person, per policy year) $1,000 $500 Daily Hospital Up to 365 days per insured person per day, per covered accident resulting in a room charge $300 $150 One-time Lump Sum Intensive Care Hospital $2,000 Daily Intensive Care Hospital Up to 15 daysper insured person per day, per covered accident $250 ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

8 Benefits Outpatient, Emergency and Diagnostic
High Low Outpatient, Emergency and Diagnostic Accidental Injury Emergency Treatment Primary/Spouse Covered Dependent child(ren) One time per insured person, per covered accident $150 $100 $50 Major Diagnostic Examinations CT Scan, MRI, EEG One payment per Policy Year, per insured person $200 Lump Sum Accidental Injury Covered Injury Dislocation, burn, skin grafts, eye injury, laceration, fracture, brain concussion, emergency dental repairs, coma, paralysis See policy for complete list $35-$12,500 $25-$6,250 ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

9 Benefits Follow-Up/Restorative High Low
Accidental Injury Follow-Up Treatment Must follow ER or Urgent Care treatmentand must begin within 30 days of the covered injury Benefits are per visit, per policy year $35 10 visits $25 5 visits Accidental Injury Follow-Up Physical Therapy Must follow ER or Urgent Care treatment and must begin within 30 days of the covered injury Hospital Rehabilitation Unit Per day of rehabilitation Maximum for each insured person per hospital confinement Maximum per policy year Paid in lieu of daily hospital confinement benefit $150 30 days 60 days $75 Appliances Prosthesis Blood Plasma and Platelets Per insured person, per accidental injury $750 $200 $100 $375 ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

10 Benefits Accidental Death and Dismemberment Ambulance Transport High
Low Accidental Death and Dismemberment Death Primary and covered spouse Covered dependent child(ren) $50,000 $15,000 $25,000 $7,500 Common Carrier Death $150,000 $75,000 $12,500 Dismemberment $3,000-$50,000 $1,000-$15,000 $1,500-$25,000 $500-$7,500 Ambulance Transport Emergency Ambulance Actual charge up to the maximum allowable rate established by the Department of Public Health, per insured person per accidental injury 100% ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

11 $500 per Insured Person, per Policy Year
Benefits High Low Supplemental Disability Income Protection Total Disability must occur within 60 days of the accident Subject to a 21-day elimination period Primary and covered spouse Covered dependent child(ren) Per month, payable up to 12 continuous months Must be employed at time of purchase for high plan only $500 - Accidental Injury Emergency Treatment for Accidental Ingestion/Consumption of a Controlled Drug $500 per Insured Person, per Policy Year ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

12 ProtectFit Plus Claim Example
Ralph purchased Chesapeake's ProtectFit Plus Low Plan and then later that same year was involved in a serious motorcycle accident. He was knocked unconscious and had to be rushed by ambulance to the hospital where he was admitted with a broken leg, a 3.2 cm laceration on his right arm, a suspected concussion, and internal bleeding of unknown origin. Ralph was given a transfusion as exploratory abdominal surgery was immediately performed to stop the bleeding. Orthopedics set his leg with a cast. Ralph was admitted to the ICU for 2 days and then moved to a semi-private room for an additional 3 days. While admitted, he underwent a CT scan of his brain that confirmed a concussion. After a 5 day stay, Ralph was discharged from the hospital but was unable to work for 75 days as he recovered from his injuries. Let's take a look at the benefits his ProtectFit Plus Low Plan provided: ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

13 ProtectFit Plus Claim Example
Ralph purchased Chesapeake's ProtectFit Plus Low Plan and then later that same year was involved in a serious motorcycle accident. He was knocked unconscious and had to be rushed by ambulance to the hospital where he was admitted with a broken leg, a 3.2 cm laceration on his right arm, a suspected concussion, and internal bleeding of unknown origin. Ralph was given a transfusion as exploratory abdominal surgery was immediately performed to stop the bleeding. Orthopedics set his leg with a cast. Ralph was admitted to the ICU for 2 days and then moved to a semi-private room for an additional 3 days. While admitted, he underwent a CT scan of his brain that confirmed a concussion. After a 5 day stay, Ralph was discharged from the hospital but was unable to work for 75 days as he recovered from his injuries. Let's take a look at the benefits his ProtectFit Plus Low Plan provided: ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

14 ProtectFit Plus Claim Example (Low Plan)
Plan Benefits Low Plan Pays Ground Ambulance Benefit $ Inpatient Hospital - One-Time Lump Sum ICU $ 1,000 Inpatient Hospital - One-Time Lump Sum Hospital Confinement $ Daily ICU Confinement (2 $250 per day) $ Daily Hospital Confinement (3 $150 per day) $ Open Abdominal Surgery $ Blood Plasma / Platelets Benefit $ Leg Fracture Benefit Laceration <7.5 cm, Sutured by Physician $ Major Diagnostic Exam - CT Scan Brain Concussion Benefit $ Disability Income Protection (Available on High Plan, not Low Plan) Total Paid to Ralph $ 3,410 ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

15 ProtectFit Plus Claim Example
INPATIENT HOSPITAL CONFINEMENT BENEFIT ADDITIONAL LUMP SUM PAYMENT INFORMATION Under the Inpatient Hospital Confinement benefit, there are two lump sum benefits, the One-Time Lump Sum Hospital Confinement Benefit and the One-Time Lump Sum ICU Confinement Benefit. Only one benefit is payable per confinement, per policy year. When both hospital and ICU rooms are used during the same confinement, the highest amount (Lump Sum ICU) will be paid if it has not been used during that policy year. In our example, Ralph was paid the One-Time Lump Sum for ICU but not the One-Time Lump Sum for Hospital Confinement. If he has another accident during this same policy year, he will not be eligible for another ICU lump sum but will still be eligible for the hospital confinement lump sum for a regular hospital room. Ralph is also eligible for the daily hospital and ICU confinement benefits under the Inpatient Hospital Confinement Benefit, according to plan provisions. ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

16 ProtectFit Plus Exclusions & Limitations
We will not provide any benefits for loss caused by, resulting from or in connection with: Sickness, including but not limited to pregnancy and childbirth; Any disease, or other medical condition not the direct result of an Accidental Injury occurring while the Insured Person's coverage is in force or benefits which are not specifically provided for in this Policy; Hospital Confinement for childbirth, including routine or normal newborn child care; Accidental Injuries that do not First Occur while the policy is in force for the insured person; Any act of war, declared or undeclared; Active military duty in the service of any country; Participation in a riot, civil commotion or insurrection; Suicide, attempted suicide, or any intentionally self-inflicted injury, except when related to Mental or Nervous disorders; Mental or Nervous disorders; Having cosmetic surgery or other elective procedures; ©2012 SureBridge® Product Training Materials | Proprietary and Confidential. 16

17 ProtectFit Plus Exclusions & Limitations, continued
Operating any motorized passenger vehicle for wage, compensation or profit; No indemnity will be paid for loss caused by the voluntary use of any controlled substance as defined in Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, as now or hereafter amended, unless as prescribed by his physician for the insured; Being intoxicated or under the influence of incarcerated; intoxicant; defined as having a blood alcohol content which results in the Insured person being deemed legally intoxicated under the laws of the jurisdiction in which the loss is sustained or contracted; Committing or trying to commit a felony; Mountaineering using ropes and/or other equipment, parachuting, hang gliding, officiating or coaching, racing any type of vehicle in an organized or unorganized event, sky diving, scuba diving below 50 feet, motorized racing, para-sailing, experimental aviation, ultra-light flying, base jumping, bungee jumping, heli-skiing or heli-snowboarding; Travel in or descent 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) certified by the U.S. Federal Aviation Administration (FAA), on a regularly scheduled passenger trip. ©2012 SureBridge® Product Training Materials | Proprietary and Confidential. 17

18 ProtectFit Plus Renewability
The policy is guaranteed renewable to age 65, subject to the Company’s right to discontinue or terminate the coverage as provided in the TERMINATION OF COVERAGE section of the Policy. Under our business rules, Eligible Dependents covered under the Policy may continue coverage until age 26, subject to the termination provisions of the Policy. ©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

19 Additional State Variations
This presentation is not inclusive of all policy provisions. See product materials for complete details and any additional state variations regarding Termination of Coverage, Renewability, Premium Changes, Eligible Dependents, and Policy Definitions. SureBridge® products are individual supplemental products, and are not available as group coverage.  There is no list bill and premiums may not be paid by employers for employees.  The claim examples used in this presentation are for training purposes only and are not approved for any other use. This material cannot be copied or used in any way for advertising or presentation purposes. ©2012 SureBridge® Product Training Materials | Proprietary and Confidential. 19


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