Group Accidental Death and Dismemberment Insurance Plan

Terrible accidents can happen. In fact, they are the third leading cause of death in the United States.* That is why we offer AUSA members an Accidental Death and Dismemberment Insurance plan, designed to help provide financial relief that you or your family might need during difficult and trying times.

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*"Leading Causes of Death." Centers for Disease Control and Prevention, United States Government, June 2020.


Plan Highlights

  • Up to $250,000* in accident coverage
  • Cash benefits to use as you and your family see fit—education, medical bills, end-of-life expenses, etc.
  • 24/7 coverage that follows you wherever you go
  • Spouse and dependent education benefit as payment of tuition to an institution of higher learning
  • No required physical exam or health questions for members under age 70

*At age 70 all coverage is reduced by 50% and will be further reduced by 50% at age 75.


Group Accidental Death & Dismemberment Insurance Brochure

Claim Forms

To submit a claim, download and complete the applicable form and mail it to the address shown at the bottom of this page or fax it to 866.817.9009.

Accidental Death Claim Form
Accidental Dismemberment: Loss of Sight, Hearing, or Speech Claim Form

Beneficiary Forms

To update your beneficiary, download the applicable form and mail it to the address shown at the bottom of this page.

Beneficiary Form
Beneficiary Form (VA)

This website explains the general purpose of the insurance described, but in no way changes or affects the Master Policy ADD-13268 as actually issued. In the event of a discrepancy between this website and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.

The Hartford® is The Hartford Financial Services Group, Inc., and its subsidiaries, including issuing company Hartford Life and Accident Insurance Company, Hartford, CT 06155

Accident Form Series includes GBD-1000, GBD-1300, or state equivalent.