Merritt Personal Lines Manual: A Sample of Operation Coverages
SCHEDULE OF OPERATIONS
% of Max. Benefit
CARDIOVASCULAR
(Open heart surgery) mitral valve, valvotomy (commissurotomy), closed 100%
Triple valve procedure, replacement and/or repair 100%
Coronary angioplasty (endarterectomy, arterial implantation or anastomosis), with bypass 100%
Aneurysm or occlusive disease, abdominal aorta 100%
Ventricular septal defect, with bypass 100%
Thromboendarterectomy combined aorta-iliac 100%
Thromboendarterectomy, femoral and/or popliteal 100%
Thromboendarterectomy, carotid or vertebral 100%
Arterial embolectomy, direct aorta-iliac 80%
Arterial embolectomy, direct, femoral-popliteal 64%
Varicose veins ligation and division and complete stripping of long or short saphenous veins, unilateral 28%
Ligation and division of long or short saphenous vein, bilateral 48%
This is a sample of a small portion of a Schedule of Operations. We did not reproduce an entire schedule because it is usually three or more pages long and the individual procedures consist of complex medical terms. If you have coverage under a policy that includes a Schedule of Operations, you should examine your own policy.
Procedures are often listed by categories (abdomen, brain, ear, eye, nose and throat, genital system, urinary tract, etc.).
We've used "cardiovascular" procedures to illustrate how the benefits apply. Notice that the benefit percentage depends upon the severity of the operation. For complex operations, such as open heart surgery or triple valve repair, the policy provides 100 percent of the maximum benefit amount. For less serious procedures, such as stripping varicose veins, the policy only provides 28 percent of the maximum benefit amount.
