Citi Benefits Handbook
The Accident Plan complements your medical coverage by helping to ease the financial impact of an accident for you or a covered family member. If you are injured by
1 All daily benefits for hospital stays begin on day one.
2 Open reduction pays two times the closed reduction benefit.
The following additional benefit apply:
- Waiver of Premium: If you miss 30 continuous days of work as a result of an accidental injury, your Accident Insurance coverage premium will be waived beginning on the first pay period that occurs after the 30th day of your absence, through the next six months of coverage. You must remain employed to qualify for a waiver of premium. This waiver of premium benefit does not apply to your covered dependents.
- Organized Sports Benefit: If you sustain an accidental injury while playing as a registered member of an organized sports activity, your benefit will be increased by 25%. Benefits for burns, burn skin graft and service dog are not included in the organized sports benefit.
Exclusions and Limitations
Benefits for covered accidental injuries will be paid upon a diagnosis that satisfies the requirements of the policy and when all other policy requirements are met. Accident Plan benefits are not payable for any care, service or supply for an accidental injury related to:
- Certain competitive or recreational activities, including but not limited to: ballooning, bungee jumping, parachuting, and skydiving;
- Any semi-professional or professional competitive athletic contest, including officiating or coaching, for which you receive payment;
- Act of war, riot or war;
- Operating, learning to operate or serving as a pilot or crew member of any aircraft, whether motorized or not;
- Assault, felony, illegal occupation, or other criminal act;
- Bacterial infections that are not caused by a cut or wound from an accidental injury;
- Care provided by immediate family members or any household member;
- Elective or cosmetic surgery;
- Nutritional supplements;
- Suicide or attempt at suicide, intentionally self-inflicted injury, or any attempt at self-inflicted injury, or any form of intentional asphyxiation, except when resulting from a diagnosed disorder;
- Violating any cellular device use laws of the state in which the accident occurred, while operating a motor vehicle; or
- Accidental injury sustained while intoxicated or under the influence of any drug intoxicant, including those prescribed by a physician that are misused.
Benefits will not be paid for a service or supply rendered or received that are not specifically covered or not related to an accidental injury.
Any service, stay or visit must be on or after the effective date of coverage, while coverage is in force and take place in the United States or its territories.