6. COVERED ACCIDENT BENEFITS Rehabilitation Unit Benefit A Rehabilitation Unit Benefit provides a daily benefit if the Insured is Confined in a Rehabilitation Unit for physical, occupational or speech therapy Treatment of Injuries incurred from a Covered Accident. The rehabilitation unit confinement must be preceded by Confinement in a Hospital. This benefit is limited to the maximum number of days per Insured per Covered Accident as shown in the Benefit Highlights. The Rehabilitation Unit benefit will not be paid if the Hospital Confinement Benefit is paid for the same day; only the highest eligible benefit will be paid. Skin Graft Benefit A Skin Graft Benefit is payable for each Insured who receives a skin graft for a burn for which a benefit was received under the Burn benefit. This benefit is payable once per Insured per Covered Accident. Surgery Benefit A Surgery Benefit is payable for each Insured who undergoes a surgical procedure listed in the Benefit Highlights for repair of internal Injuries received as the result of a Covered Accident. Treatment must be first provided by a Physician and the Injury repaired through surgery. The surgery may be provided in a Hospital on an Inpatient or Outpatient basis or in a licensed ambulatory surgical facility. Benefits will be payable for Exploratory Surgery or other specified surgery without repair as shown in the Benefit Highlights. Debridement Benefit A Debridement Benefit is payable for each Insured who undergoes debridement as the result of an Injury received in a Covered Accident. Treatment must be first provided by a Physician and the Injury must be repaired through surgery by a Physician. Exploratory Surgery Benefit An Exploratory Surgery Benefit is payable for each Insured who undergoes an operation performed for diagnostic purposes only as the result of an Injury received in a Covered Accident. Treatment must be first provided by a Physician and the surgery must be performed by a Physician. Miscellaneous Surgery Benefit A Miscellaneous Surgery Benefit is payable for each Insured who undergoes a surgery requiring Anesthesia received as the result of a Covered Accident that is not covered by any other Injury benefit in the Benefit Highlights. Treatment must be first provided by a Physician and the Injury must be repaired through surgery by a Physician. Only one Miscellaneous Surgery Benefit is payable per 24 hour period even though multiple surgical procedures may be performed. Open Surgery Benefit An Open Surgery Benefit is payable for each Insured who undergoes open abdominal, cranial or thoracic surgery to repair internal Injuries received as the result of a Covered Accident. However, an Open Surgery Benefit also includes exploratory laparotomy. Treatment must be first provided by a Physician and the Injury must be repaired through surgery by a Physician. Benefits will be payable for Exploratory Surgery or other specified surgery without repair as shown in the Benefit Highlights. We will pay this benefit once per Covered Accident. Ruptured/Herniated Disc Benefit A Ruptured/Herniated Disc Benefit is payable for each Insured who sustains a ruptured or herniated disc in the spine as the result of Injuries received in a Covered Accident. Treatment must be first provided by a Physician and the Injury repaired through surgery by a Physician. Tendon/Ligament/Rotator Cuff Benefit A Tendon/Ligament/Rotator Cuff Benefit is payable for each Insured who injures a tendon, ligament, or rotator cuff as the result of Injuries received in a Covered Accident. The tendon, ligament, or rotator cuff must be torn, ruptured or severed. Treatment must be first provided by a Physician and the Injury repaired through surgery by a Physician. If exploratory arthroscopic surgery is performed and no repair is done, the applicable amount payable is shown in the Benefit Highlights. 16-AC-C-01 Page28
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