Common use of Accidental Dental Injury Services Clause in Contracts

Accidental Dental Injury Services. We cover restorative Services necessary to promptly repair, but not replace, sound natural teeth that have been injured as the result of an external force. Coverage is provided when all of the following conditions have been satisfied: 1. The accident has been reported to your primary care Plan Physician within seventy-two (72) hours of the accident; 2. A Plan Provider provides the restorative dental Services; 3. The injury occurred as the result of an external force that is defined as violent contact with an external object, not force incurred while chewing; 4. The injury was sustained to sound natural teeth; 5. The covered Services must begin within sixty (60) days of the injury; and 6. The covered Services are provided during the twelve (12) consecutive month period commencing from the date that treatment for the injury occurred. Coverage under this benefit is provided for the most cost-effective procedure available that, in the opinion of the Plan Provider, would produce the most satisfactory result. For the purposes of this benefit, sound natural teeth are defined as a tooth or teeth that (a) have not been weakened by existing dental pathology such as decay or periodontal disease or (b) have not been previously restored by a crown, inlay, onlay, porcelain restoration or treatment by endodontics.

Accidental Dental Injury Services. We cover restorative Services necessary to promptly repair, but not replace, sound natural teeth Sound Natural Teeth that have been injured as the result of an external force. Coverage is provided when all of the following conditions have been satisfied: 1. met: • The accident has been reported to your primary care Plan Physician within seventy-two (72) 72 hours of the accident; 2. • A Plan Provider provides the restorative dental Services; 3. • The injury occurred as the result of an external force that force. “External force” is defined as violent contact with an external object, ; not force incurred while chewing; 4. • The injury was sustained to sound natural teeth; 5Sound Natural Teeth. • The covered Services must begin be requested within sixty (60) 60 days of the injury; and 6. • The covered Services are provided during the twelve (12) 12 consecutive month period commencing from the date that treatment for the injury occurred. Coverage under this benefit is provided for the most cost-effective procedure available that, in the opinion of the Plan Provider, would produce the most satisfactory result. For the purposes of this benefit, sound natural teeth Sound Natural Teeth are defined as a tooth or teeth that (a) have not been weakened by existing dental pathology such as decay or periodontal disease disease, or (b) have not been previously restored by a crown, inlay, onlay, porcelain restoration restoration, or treatment by endodontics. Accidental Dental Injury Services Exclusions: • Services provided by non-Plan Providers. • Services provided after 12 months from the date the injury occurred. • Services for teeth that have been avulsed (knocked out) or that have been so severely damaged that in the opinion of the Plan Provider, restoration is impossible.

Accidental Dental Injury Services. We cover restorative Services necessary to promptly repair, but not replace, sound natural teeth that have been injured as the result of an external force. Coverage is provided when all of the following conditions have been satisfied: 1. The accident has been reported to your primary care Plan Physician within seventy-two (72) hours of the accident; 2. A Plan Provider provides the restorative dental Services; 3. The injury occurred as the result of an external force that is defined as violent contact with an external object, not force incurred while chewing; 4. The injury was sustained to sound natural teeth; 5. The covered Services must begin within sixty (60) days of the injury; and 6. The covered Services are provided during the twelve (12) consecutive month period commencing from the date that treatment for the injury occurred. Coverage under this benefit is provided for the most cost-effective procedure available that, in the opinion of the Plan Provider, would produce the most satisfactory result. For the purposes of this benefit, sound natural teeth are defined as a tooth or teeth that (a) have not been weakened by existing dental pathology such as decay or periodontal disease or (b) have not been previously restored by a crown, inlay, onlay, porcelain restoration or treatment by endodontics. Accidental Dental Injury Services Exclusions: • Services provided by non-Plan Providers. • Services provided after twelve (12) months from the date treatment for the injury commenced. • Services for teeth that have been avulsed (knocked out) or that have been so severely damaged that in the opinion of the Plan Provider, restoration is impossible.

Accidental Dental Injury Services. We cover restorative Services necessary to promptly repair, but not replace, sound natural teeth that have been injured as the result of an external force. Coverage is provided when all of the following conditions have been satisfiedmet: 1. The accident has been reported to your primary care Plan Physician within seventy-two (72) hours of the accident;. 2. A Plan Provider provides the restorative dental Services; 3. The injury occurred as the result of an external force that is defined as violent contact with an external object, ; not force incurred while chewing; 4. The injury was sustained to sound natural teeth; 5. The covered Services must begin be requested within sixty (60) days of the injury; and 6. The covered Services are provided during the twelve (12) consecutive month period commencing from the date that treatment for the injury occurredstarted. Coverage under this benefit is provided for the most cost-effective procedure available that, in the opinion of the Plan Provider, would produce the most satisfactory result. For the purposes of this benefit, sound natural teeth are defined as a tooth or teeth that (a) have not been weakened by existing dental pathology such as decay or periodontal disease disease, or (b) have not been previously restored by a crown, inlay, onlay, porcelain restoration restoration, or treatment by endodontics. Accidental Dental Injury Services Exclusions: • Services provided by non-Plan Providers. • Services provided after twelve (12) months from the date the injury occurred. • Services for teeth that have been avulsed (knocked out) or that have been so severely damaged that in the opinion of the Plan Provider, restoration is impossible.