"As more Americans pursue adventure travel, accidents are likely to happen, so they should be prepared for unplanned expenses from injuries requiring medical attention," says Marc Costantini, Guardian Life's executive vice president, commercial and government markets. "The high cost of medical care, particularly for those with high deductible health plans, can be offset with accident insurance and help people reduce financial stress."

Few survey respondents (28 percent) currently have such a policy–and many aren't even aware of the product. Nearly half (42 percent) are not clear on what an accident policy is designed to do, as 18 percent believe the policy covers their car in an accident and 24 percent aren't sure.

For those who do have accident insurance, the top three reasons for buying the policy are preparation for unexpected injuries (71 percent), relief from needing to use savings to cover the potential costs of medical expenses (50 percent) and to offset high out-of-pocket deductibles (44 percent).

Earlier this year Guardian Life launched a new accident insurance product with "first-to-market" features: money back if the policyholder goes injury-free for five years, and a rainy day fund that provides payment for treatments that might normally exceed primary healthcare policy limits.

Other key findings from the survey include:

• Half (53 percent) of the respondents seek a good mix of relaxation and adventure, with one in 10 (9 percent) focused on adventure only. Top adventure activities include hiking/trekking (56 percent); boating and water sports (42 percent); kayaking/rafting (39 percent); scuba diving/snorkeling (34 percent); cycling/mountain biking (25 percent); and ATV/off-roading (24 percent). One fifth (19 percent) of those traveling have felt like they were going to die on vacation, this increases to nearly a third for adventure-focused travelers (29 percent).
• A majority (68 percent) of adventure travelers have concerns when taking adventure-oriented vacations Specifically, they are worried about not being able to plan for any unexpected outcomes (39 percent); concerned about family members being injured (36 percent); concerned about their own accidents and injuries (30 percent). Parents are significantly more likely to have an accident policy than non-parents (33 percent and 25 percent, respectively)
• A third (34 percent) of all of the survey respondents know someone or have themselves been injured on vacation, which rises to half (49 percent) for adventure-focused travelers and four in 10 for millennials and parents (40 percent and 42 percent, respectively). A significant majority (75 percent) of those injuries resulted in the need for medical attention (73 percent for millennials and 76 percent for parents).
• Nearly half (43 percent) of all of the respondents say they are not confident they could manage out of pocked medical costs as part of an injury on vacation to themselves or their family (50 percent for millennials and 44 percent for parents). Only two in 10 (21 percent) of all of the respondents are completely confident they could handle the medical costs associated with an injury on vacation (16 percent for millennials and 21 percent for parents).

Read more: 

• 5 reasons you should be offering accident insurance
• Almost 40% of Americans would struggle to cover a $400 emergency
• Younger workers plan to enroll in voluntary benefits, though they don't understand them