Per Incident

Per incident refers to the way certain insurance benefits are calculated or limited based on each separate event, illness, or accident rather than by year or lifetime. When a benefit is paid “per incident,” it means you are eligible for reimbursement each time a new, distinct occurrence happens, up to the maximum amount specified for that type of claim.

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This structure is most common in emergency medical, travel, accidental dental, or hospital coverage. It ensures that multiple unrelated events can each qualify for full reimbursement, as long as each is considered a separate incident by the insurer. However, repeated treatments or complications arising from the same original cause are usually treated as one incident.

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Defining incidents clearly allows insurers to balance fairness and cost control while ensuring appropriate coverage for unexpected events.

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Example:

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If your plan provides up to $2,000 for accidental dental treatment per incident and you chip a tooth in January and later break another tooth in July, you may claim up to $2,000 for each accident separately.

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What to Watch For:

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Check your policy’s definition of “incident,” as some insurers group related medical visits or follow-up treatments under a single event. Confirm whether limits are per incident, per year, or per lifetime, since this affects how often you can claim for the same type of expense.