What’s covered Once your coverage goes into effect, you can file a claim for covered accidents that occur after your insurance plan’s effective date. Unless otherwise specified, benefits are payable only once for each covered accident, as applicable. The full list of benefits is listed here. Choose the plan that best meets your needs and your budget. LOW PLAN HIGH PLAN DISLOCATIONS OPEN CLOSED OPEN CLOSED (SURGERY) (NO SURGERY) (SURGERY) (NO SURGERY) Hip $2,000 $1,000 $4,000 $2,000 Knee, ankle, or bones of the foot $1,000 $500 $2,000 $1,000 Elbow, wrist or Lower jaw $400 $200 $800 $400 Shoulder $500 $250 $1,000 $500 Collarbone or bones of the hand $800 $400 $1,600 $800 Finger(s) or toe(s) $100 $50 $200 $100 FRACTURES OPEN CLOSED OPEN CLOSED (SURGERY) (NO SURGERY) (SURGERY) (NO SURGERY) Hip or thigh $2,000 $1,000 $4,000 $2,000 Skull-depressed $3,000 $1,500 $6,000 $3,000 Skull-simple $1,500 $750 $3,000 $1,500 Vertebral processes, Bones of the face or Nose $350 $175 $700 $350 Leg $1,000 $500 $2,000 $1,000 Vertebrae, Sternum or Pelvis $800 $400 $1,600 $800 Upper jaw or upper arm $375 $190 $750 $375 Lower jaw, Collarbone, Shoulder, Forearm, Hand, Wrist, Foot, Ankle, $325 $170 $650 $325 Kneecap, Elbow or Heel Rib, Finger, Toe or Coccyx $175 $90 $350 $175 Multiple ribs $500 $250 $1,000 $500 ADDITIONAL INJURIES Eye Injury - surgical repair $125 $250 Eye Injury - object remove $125 $250 Gunshot wound $250 $500 Paralysis—paraplegia $12,500 $25,000 Paralysis—quadriplegia $25,000 $50,000 Coma $5,000 $10,000 Concussion $50 $100 BURNS 2ND DEGREE 3RD DEGREE 2ND DEGREE 3RD DEGREE 21-40 square centimeters $200 $500 $400 $1,000 41-65 square centimeters $400 $1,000 $800 $2,000 66-160 square centimeters $600 $3,000 $1,200 $6,000 161-225 square centimeters $800 $7,000 $1,600 $14,000 More than 225 square centimeters $1,000 $10,000 $2,000 $20,000 Skin graft 50% of the applicable Burn 50% of the applicable Burn Benefit Benefit LACERATIONS No sutures and treated by doctor $20 $35 Single laceration under 5 cm with sutures $35 $65 5-15 cm with sutures (total of all lacerations) $125 $250 Greater than 15 cm with sutures (total of all lacerations) $250 $500 800-247-6875 • sunlife.com/us Accident Insurance