In accident and health insurance, dismemberment means the loss of a limb, sight, hearing, or another specified body function as defined by the policy. In plain language, it is a policy term for certain serious accidental losses that trigger a stated benefit.
Why the definition matters
Insurance does not use the term loosely. Dismemberment usually refers to losses specifically described in the contract, such as:
- loss of a hand or foot
- loss of sight in one or both eyes
- loss of hearing or speech where the policy includes those losses
- functional loss treated as equivalent to severance when the wording says so
This is important because a claim can involve severe injury without meeting the policy’s exact definition of dismemberment.
Where the term appears
Dismemberment is most commonly associated with accidental death and dismemberment coverage, group accident benefits, and certain accident-health riders. The benefit is usually scheduled, meaning the policy states how much is paid for loss of one member, two members, sight, or another listed loss.
Practical example
If an accident causes permanent loss of sight in one eye and the policy lists that loss as a covered dismemberment event, the insured may receive the scheduled benefit amount. If the injury is serious but does not meet the policy’s exact listed-loss definition, the claim may be handled differently or not qualify for that benefit at all.
Related Terms
- Disability
- Disability Benefit
- Medical Payments Insurance
- Long-Term Care (LTC)
- Mandated Benefits
- Occupational Disease