Focus on getting well
Here is an example of a hypothetical claim that qualified for assumed benefits:
Alan’s cycling accident
Example Claim
Alan submits a claim ...
| Benefit | Benefit Amount |
|---|---|
| Ambulance ride to the hospital | $400 |
| Hospital2 Admission | $1,500 |
| X-rays | $100 |
| CT scan | $500 |
| Broken arm fracture treatment | $500 |
| Concussion treatment | $200 |
| Broken ribs | $500 |
| Thoracic surgery repair | $1,500 |
| Hospital confinement (2 nights) | $900 ($450 per night) |
... and he received additional benefits
| Benefit | Benefit Amount |
|---|---|
| Physical therapy (3x per week/4 weeks) | $1,200 ($100 per visit) |
| A wheelchair | $400 |
| Follow-up doctor's visit | $100 |
| Pain management | $200 |
| Over the counter medication (Up to 3) | $30 ($10 per medication) |
This is a hypothetical example for illustrative purposes only. This example is based on a High Plan with a Closed Reduction (no surgery required) benefit for the rib and arm fracture.
Actual experience and benefits may vary.
Benefits mentioned may vary by state and plan design.
1 A Group Accident claim must be filed and required proof of loss must be provided. Certain covered benefits may be paid based on the nature of the reported injury and/or proof of loss, without requiring additional documentation for those specific benefits. Payment of assumed benefits does not constitute acceptance of liability for other benefits or claims that may arise from the same covered accident or for any future claims.
2 The term “hospital” does not include any institution or part thereof used as: a) a rehabilitation unit; b) a hospice unit, including any bed designated as a hospice or a swing bed; c) a convalescent home; d) a rest or nursing facility; e) an extended-care facility; f) a skilled nursing facility; or g) a facility primarily affording custodial or educational care, care or treatment for persons suffering from mental disease or disorders, care for the aged, or care for persons addicted to drugs or alcohol.
FOR FINANCIAL PROFESSIONALS. NOT FOR USE WITH THE PUBLIC.
NOT FOR USE IN NM.
MASSMUTUAL GROUP ACCIDENT INSURANCE PROVIDES LIMITED BENEFITS and DOES NOT PROVIDE COVERAGE FOR SICKNESS. This Accident insurance is NOT hospital or medical expense insurance or minimum essential coverage. In NY: This policy provides ACCIDENT insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York State Department of Financial Services.
This insurance, its name, or its provisions may vary or be unavailable in some states. This coverage has exclusions, limitations, reductions of benefits that may affect any benefits payable, and terms under which the policy may be continued in force or discontinued. Some benefits or options have limited availability based on age. For availability, cost, and coverage details contact your benefits advisor or MassMutual.
Group Accident Insurance (GPAC), (MM-GPAC-2021, MM-GCAC-2021 and MM-GPAC-2021 (NC) and MM-GCAC-2021 (NC) in North Carolina) is limited benefit non-participating life insurance. The GPAC policy and GCAC certificates are issued by Massachusetts Mutual Life Insurance Company, Springfield, MA 01111-0001.