How does Accident Medical Expense Insurance differ from other types of scheduled indemnity insurance? Read this claims scenario to find out.

The following claim scenario follows Sylvia, a single 49-year-old professional living in New Jersey. Sylvia purchased a high deductible health plan from her employer and a $5,000 Accident Medical Reimbursement plan from Arch Insurance. Sylvia has a major medical in-network deductible of $1,600 and at the time of the accident had not yet made any payments for medical expenses in the current plan year that counted toward that deductible.

On an unusually warm sunny afternoon in January, Sylvia decided to enjoy the weather with a stroll through the local park, her favorite strawberry ice cream in hand. As she roamed, Sylvia noticed her friend, Amy, and Amy’s golden retriever playing fetch in the distance. The dog, Max, had a weakness for anything sweet, and recognized Sylvia as she came closer. The enticing smell of strawberry ice cream proved too much for the playful dog. In a moment of unrestrained enthusiasm, Max leapt towards Sylvia, aiming for a lick of the delicious treat. Unfortunately, in his eagerness, Max accidentally bit Sylvia’s arm. Amy was mortified. Max, realizing his mistake, whimpered apologetically. Despite the surprising incident, and a bite injury to her arm, Sylvia couldn’t help but laugh at the comical guilt written all over Max’s face. While she, Amy and Max continue to be great friends and see each other often, but on the day of the incident Sylvia was slightly injured and required medical care. Luckily the incident was right around the corner from an in-network hospital.