Fracture Benefit

A fracture benefit is a lump-sum payment provided under certain accident or supplemental health insurance plans when you sustain a broken bone as a result of an accidental injury. This benefit is designed to help cover unexpected costs associated with recovery, such as lost income, medical equipment, transportation, or rehabilitation expenses.

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Each insurer maintains a detailed schedule of payments that outlines how much is paid based on the type and severity of the fracture. For example, a small bone in a finger or toe may qualify for a lower payment, while a major fracture of the leg, hip, or skull typically results in a higher benefit. The payout is made directly to you and does not depend on actual medical costs or whether those costs are covered elsewhere.

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Example:

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If your accident policy includes a fracture benefit of up to $2,000, the plan might pay $150 for a finger fracture, $500 for a forearm fracture, and $1,000 for a leg fracture, depending on the insurer’s schedule.

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What to Watch For:

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Confirm the definitions and exclusions in your policy, since stress fractures, hairline fractures, or fractures from certain activities like professional sports may not qualify. Some plans combine fracture and dislocation benefits, so review your insurer’s payment table carefully to understand how claims are calculated.