Frequently Asked Questions
What is the purpose of this coverage?
How much coverage can I have?
Who is eligible to enroll in this plan?
What types of accidental injuries are covered?
A. The coverage pays benefits for accidental loss that results from an accident. “Loss” means the person’s:
- loss of life;
- total and permanent loss of sight;
- total and permanent loss of speech;
- total and permanent loss of hearing;
- loss of hand or foot by severance at or above the wrist or ankle;
- loss of thumb and index finger of the same hand by severance at or above the point at which they are attached to the hand;
- loss due to quadriplegia, paraplegia, or hemiplegia;
- loss due to coma;
- total and permanent disability (members only). You can find a complete description in the Personal Accident Insurance Summary Plan Description.
What types of accidental injuries are not covered?
A. A “loss” is not covered if it results from any of these:
- suicide or attempted suicide, while sane or insane;
- intentionally self-inflicted injuries, or any attempt to inflict such injuries;
- sickness, whether the loss results directly or indirectly from the sickness;
- medical or surgical treatment of sickness, whether the loss results directly or indirectly from the treatment;
- most bacterial or viral infections (see Summary Plan Description for exceptions);
- taking part in any insurrection;
- war, or any act of war. War means declared or undeclared war, and includes resistance to armed aggression;
- an accident that occurs while the person is serving on full-time active duty for more than 30 days in any armed forces (does not include Reserve or National Guard active duty for training);
- commission of or attempt to commit a felony, assault, or illegal action;
- travel or flight in any vehicle used for aerial navigation (see Summary Plan Description for details);
- being legally intoxicated or under the influence of any narcotic unless administered or consumed on the advice of a doctor.
How do I report an accidental injury?
How are benefits paid out?
A. The amount payable depends on the type of loss, as shown here:
- 100% of covered amount paid for loss of: life, sight of both eyes, speech and hearing in both ears, both hands, both feet, one hand and one foot, one hand and sight of one eye, and quadriplegia.
- 75% of covered amount paid for: paraplegia.
- 50% of covered amount paid for loss of: sight of one eye, speech, hearing in both ears, one hand, one foot, and hemiplegia.
- 25% of covered amount paid for loss of: thumb and index finger of the same hand, and hearing in one ear.
- 1% of covered amount paid per month, up to 100 months for: total and permanent disability, and coma.
Unless otherwise stated, benefits are paid as lump-sum.
Do I lose the coverage if I retire?
How do I enroll?
You can select from $10,000 to $500,000.
Cover your spouse and unmarried children up to age 26.
Safe Driver, Education, Child Care, and other benefits included at no additional cost.
You can continue this plan, even if you change agencies, retire, or leave your federal employment.