What Do You Mean It's Not Covered: Adjusting Benefits with Circumstances

Benefits will be adjusted when multiple procedures are performed as a result of the same accident or sickness. For sickness, the policy will pay only for the procedure that provides the largest benefit when two or more surgical or diagnostic procedures are performed. For an accident that causes multiple injuries requiring more than one operation on different areas of the body, the policy will pay the percentage benefit for the most severe operation plus 50% of the percentage benefit for each additional operation or procedure. The insurance company will not pay for more than three operations or diagnostic procedures related to the same accident or sickness. If a particular operation or procedure is not listed in the Schedule of Operations, the insurance company will determine the benefit to be paid based on benefits for other procedures of similar severity.