 
  
| Broken leg while playing softball | $5,000 | |
| Ambulance transportation | $100 | |
| Emergency room visit | $150 | |
| Follow-up visit with orthopedist | $50 | |
| Physical therapy (six visits) | $50 | |
| Knee roller/scooter (appliance) | $100 | |
| TOTAL | $5,500 | |
| Sample payment only. Sample is for Accident Plan 3; coverage and amounts may differ. Your policy will contain complete details. | ||
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