Trade Risk
Rooftop Falls, Burns & Cuts: Reading the Accident Rider
March 22, 20266 min readBy CoolCover Health
Every HVAC tech with five years on the job knows somebody who's come off a roof. Most walk away with a fracture and a six-week recovery. The medical plan covers the bills; the accident rider is supposed to cover the lost income, the deductible, and the unexpected costs. Here's how to make sure yours actually does.
What a fall actually costs
ER visit + imaging (X-ray + CT)$1,800–$4,500
ORIF surgery (fractured wrist)$12,000–$22,000
PT, 6–8 weeks$1,200–$2,400
Lost income (8 weeks, residential tech)$12,000–$18,000
What a good accident rider pays
- Fracture benefit: $1,000–$5,000 depending on bone and displacement.
- Surgery rider: $500–$2,000 inpatient surgical procedure.
- ER + ambulance: $200–$600 combined.
- Follow-up visits: $50–$100 per visit, capped at 6–10 visits.
Exclusions that matter for the trade
- Some policies exclude 'occupational' injuries — fine if you're W-2 with comp, dangerous if you're 1099.
- Some cap the per-injury payout at the per-event limit even when multiple injuries occur (a fall that fractures a wrist AND causes a concussion).
- Some require a 24-hour ER visit window — meaning if you delay the ER trip until next morning, the rider doesn't pay.
Related coverage
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