Amateur Sports Insurance

The purpose of this kind of policy is to provide insurance for associations, athletic clubs, camps, leagues, sports clinics and teams involved in:

Baseball	Lacrosse
Basketball	Soccer
Bowling	Softball
Boxing	Swimming
Field Hockey	Track and Field
Gymnastics	Tennis
Hockey	Wrestling
Ice Skating	Other Sports and Activities

 

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Disclaimer

This information will serve as a guide to the main points, and is not a plan, policy itself nor a contract or part of one. The information on this page is based on a general concept of amateur sports insurance, and is not meant to constitute advice, or represent any provisions of any policy. The details on this page come from standard self-type plans.

All complete and specific terms are set forth in your policy. The information you read on this site should not be used or relied upon as a substitute for the relevant insurance policy wording or relevant policy documents.

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Coverage

All players, coaches and managers of the sponsoring organization are insured for covered injuries which are received while this policy is in force and occur while:

• a. participating in scheduled practice sessions or games that are sponsored and supervised by the policyholder; or
• b. traveling to, during or after such activities as a member of a group in transportation furnished or arranged by the policyholder.

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Accident Medical Expense

When a covered injury to an insured results in treatment by a legally qualified physician beginning within 60 days after the date of the accident, the company will pay the medical expense incurred in excess of the medical deductible, if any. Benefits will not exceed the usual and customary charges for similar treatment, services and supplies in the geographic area where treatment is performed.

Eligible medical expenses are as follows:

• a. treatment by a legally qualified physician;
• b. care or services from a hospital or ambulatory surgical center;
• c. services from a registered graduate nurse (RN or LPN) not related to the insured by blood or marriage;
• d. professional ambulance service;
• e. orthopedic appliances;
• f. prescription drugs.

Only eligible medical expenses incurred, by the insured within 52 weeks from the date of the accident are covered. Benefits for any one accident shall not exceed, in the aggregate, the medical benefit.

Benefits for injury to sound, natural teeth are included in the overall policy maximum for medical expense.

Primary Excess—Over $100*
The company will pay the first $100 of covered medical expenses incurred. Additional benefits will be paid only when eligible medical expense is not recoverable from any other insurance policy, service contract or Workers’ Compensation. The medical deductible, if any, must be satisfied before benefits are paid. Benefits for any one accident shall not exceed, in the aggregate, the medical benefit.

*Also available in amounts of $200, $300, $400 and $500

Full Excess
The company will pay benefits for medical expense only for such expense which is not recoverable from any other insurance policy, service contract or Workers’ Compensation. The medical deductible, if any, must be satisfied before benefits are paid. Benefits for any one accident shall not exceed, in the aggregate, the medical benefit.

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Accidental Dismemberment

When, because of covered injuries, the insured sustains any one of the following losses within 100 days after the date of the accident, the company will pay benefits for loss of:

Two or more members =	100%
One member =	50%

Member means hand, foot, or sight of eye. The percentage shown is applied to the accidental dismemberment principal sum.

Loss means severance of the limb at or above the joint and total and irrecoverable loss of the entire sight.

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Accidental Death

The company will pay the accidental death principal sum when a covered injury results in the insured’s death. Death must occur within 100 days of the covered accident. (The time limit for Accidental Death does not apply in Pennsylvania.) If accidental dismemberment benefits have been paid for a loss resulting from the same accident, the accidental death benefit will not be payable. To receive benefits loss must be independent of sickness and all other causes.

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Exclusions

This policy does not cover:

1. Treatment, services or supplies which:
• a. are not medically necessary;
• b. are not prescribed by a doctor as necessary to treat an injury;
• c. are determined to be experimental/ investigational in nature;
• d. are received without charge or legal obligation to pay;
• e. are received from persons employed or retained by the school or any family member, unless otherwise specified;
• f. are not specifically listed as covered charges in this policy
2. Intentionally self-inflicted injury, violating or attempting to violate any duly enacted law. Injury by acts of war, whether declared or not.
3. Injury received while traveling or flying by air, except as a fare-paying passenger on a regularly scheduled commercial airline.
4. Injury covered by Worker’s Compensation or the Occupational Disease Law.
• a. treatment of illness, disease or infections, except pyogenic infections or bacterial infections which result from the accidental ingestion of contaminated substances;
• b. heat exhaustion;
• c. treatment of Osgood-Schlatter’s disease, appendicitis, osteomyelitis, pathological (or stress) fractures, congenital weakness, hernia, TMJ, fainting, headaches, boils, blisters, spondylolysis, osteochondritis, dissecans, poison ivy, bee stings, detached retina unless directly caused by injury, or mental or nervous disorders whether or not caused by injury;
• d. injury contributed to by the use of alcohol or drugs not prescribed by a doctor.
5. Suicide or attempted suicide while sane or self-destruction or an attempt to self-destroy while insane.
6. Expense incured for the use of orthotics unless used exclusively to promote healing.
7. Heart and/or circulatory malfunction resulting from partaicipation in the covered activity.
8. Any penalty imposed by other valid and collectible insurance or plan for failure to follow plan procedures.

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Coverage Term

Insurance for a participating organization takes effect on the date of the first regularly scheduled pre-season tryouts or the date its request for policy issue and specifications page are approved and the premium is received by the company, if later, and continues through the playing season. Post season games are included.

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