Obtain Coverage

To apply for coverage, please complete the application and fax to 866.925.6192. 
 
OCCUPATIONAL ACCIDENT BENEFITS
If you are in a covered work-related accident that results in bodily injury within 72 hours of the event, or as soon as reasonably possible, the benefits below are payable. Coverage must be in effect and you must be performing the regular activities of your job as an independent contractor.
 

  • Accidental death and dismemberment benefits - up to $250,000
  • Accident medical/dental expenses - up to $1 million for up to 104 weeks     
         - Dental expenses are limited to $1,000 per covered accident
         - Lifetime maximum for covered expenses resulting from treatment, services or supplies for a hernia is $10,000
  • Temporary total disability - After seven days of continuous total disability, weekly benefits are paid equal to 70% of your average weekly earnings (AWE), up to $600 per week, for up to 104 weeks.
  • Permanent total disability - After 104 weeks of continuous total disability, benefits are paid equal to 70% of your AWE multiplied by 52 weeks and divided by 12 months, up to $2,600 per month, until such time as you are no longer eligible for social security disability benefits.
  • Benefits are also payable for cumulative trauma and occupational diseases.

NON-OCCUPATIONAL ACCIDENT BENEFITS
If you are in a covered accident that is not work-related that results in bodily injury, the following benefits are payable.
 

  • Accidental death and dismemberment benefits, up to $10,000
  • Accident medical/dental expenses, up to $15,000 for up to a maximum of 52 weeks (dental expenses are limited to $250 per covered accident)
  • No disability benefits are payable for a non-occupational accident

COMBINED SINGLE BENEFIT LIMIT
Up to $1 million per occupational accident ($50,000 per condition for occupational disease and cumulative trauma) will be paid under all benefits combined for any one person due to any one occupational accident.
 
APPLY FOR COVERAGE
To apply for coverage, please complete the application and fax to 866.925.6192.
 
For questions, please contact Univantage at 385.351.8328.
 
CLASS 1:  $138 per person, per month
CLASS 2:  $159 per person, per month
CLASS 3:  $175 per person, per month

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