See Schedule of Benefits to determine if your Plan has an Accident Benefit and the amount of benefit. After this benefit has been exhausted, payments are made under your Major Medical Plan. Covered charges in a non-occupational accident for treatment received within ninety (90) days from Injury are as follows:

1. services of Physicians;
2. services of Hospital;
3. services of a Registered Nurse (R.N.) who is not related to the Covered Person by blood or marriage;
4. services of registered physical therapists;
5. services of dentists in the repair of a fractured jaw or sound natural teeth;
6. diagnostic x-ray and laboratory services; and/or
7. necessary transportation by ground ambulance to the nearest available adequate Hospital.

Once the Maximum Accident Benefit has been paid you will be required to satisfy Deductible and Co-Pay amounts. This provision applies only if your Schedule of Benefits calls for Accident Benefits.

The amount paid will be the lesser of:

1. the Eligible Charges incurred; or
2. the Maximum Accident Benefit shown on your Schedule of Benefits.

The amount of Accident Benefit paid may not be used to satisfy any Deductible or Co-pay maximums.

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