Dental Services - Accident Only. Dental services when all of the following are true: • Treatment is needed because of accidental damage. • You receive dental services from a Doctor of Dental Surgery or Doctor of Medical Dentistry. • The dental damage is severe enough that first contact with a Physician or dentist happened within 72 hours of the accident. (You may request this time period be longer if you do so within 60 days of the Injury and if extenuating circumstances exist due to the severity of the Injury.) Please note that dental damage that happens as a result of normal activities of daily living or extraordinary use of the teeth is not considered an accidental Injury. Benefits are not available for repairs to teeth that are damaged as a result of such activities. Dental services to repair damage caused by accidental Injury must follow these time-frames: • Treatment is started within six months of the accident, or if not a Covered Person at the time of the accident, within the first six months of coverage under the Policy, unless extenuating circumstances exist (such as prolonged hospitalization or the presence of fixation wires from fracture care). If, due to the nature of the injury, treatment could not begin within six months of the accident, treatment is started within six months of the earliest date that it would be medically appropriate to begin such treatment. • Treatment must be completed within 12 months of the accident, or if not a Covered Person at the time of the accident, within the first 12 months of coverage under the Policy. Benefits for treatment of accidental Injury are limited to the following: • Emergency exam. • Diagnostic X-rays. • Endodontic (root canal) treatment. • Temporary splinting of teeth. • Prefabricated post and core. • Simple minimal restorative procedures (fillings). • Extractions. • Post-traumatic crowns if such are the only clinically acceptable treatment. • Replacement of lost teeth due to Injury with implant, dentures or bridges.
Dental Services - Accident Only. Dental services when all of the following are true: • Treatment is needed because of accidental damage to sound natural teeth where the continuous course of treatment is started within six (6) months of the accident. • You receive dental services from a Doctor of Dental Surgery or Doctor of Medical Dentistry. Dental services are covered for the treatment of a fractured jaw or an Injury to sound natural teeth. For the purpose of this Benefit, "sound natural teeth" are defined as natural teeth that are free of active clinical decay, have at least 50% bony support, and are functional in the arch. Please note that dental damage that happens as a result of normal activities of daily living or extraordinary use of the teeth is not considered an accidental Injury. Benefits are not available for repairs to teeth that are damaged as a result of such activities. Benefits for treatment of accidental Injury are limited to the following: • Emergency exam. • Diagnostic X-rays. • Endodontic (root canal) treatment. • Temporary splinting of teeth. • Prefabricated post and core. • Simple minimal restorative procedures (fillings). • Extractions. • Post-traumatic crowns if such are the only clinically acceptable treatment. • Replacement of lost teeth due to Injury with implant, dentures or bridges.
