Can you file two accident claims for the same incident?

August 18, 2023 12:17 PM

In the United States. My Spouse and I both have Accident Insurance through our employers and our children and included as dependents on each policy. This is not medical insurance that pays direct bills, but pays out specific benefits based on trigger events such as a laceration, fracture, burn, etc... I know it is insurance fraud to submit a medical insurance claim based on actual medical costs to separate companies (unless coordinated), but this seems different. Is there a law against this and if so, what is it?
posted by Lil Kitty to Health & Fitness (2 answers total)

If this is something like AFLAC insurance, they say specifically that their payout is a payment to you. They're not paying doctors or hospitals. The point of their insurance is to support you in the time of an event.

From their FAQ: Major medical insurance pays for doctors and hospitals. Our coverage is designed to provide you with cash benefits, unless otherwise assigned, that you can use to help with daily expenses when you're sick or hurt—cash to be used as you wish to help you and your family with unexpected expenses.

You might see if your Accident Insurance has similar wording.
posted by hydra77 at 12:30 PM on August 18, 2023

I suspect the answer if that you can claim on both policies, as these provide specific, defined benefits and not coverage for costs, but of course I don't know about your specific policies.

This is not likely a question about specific laws, but more about the policies themselves. Easiest would be to simply ask the appropriate people at your respective employers. If you don't want to do that (though I think it would be a very reasonable question to ask and not out out of the ordinary at all), get a copy of both policies and read through them.
posted by ssg at 4:19 PM on August 18, 2023