Student Accident Medical Expense Insurance, Including Sports
Disclaimer
The information on this page is based on a general concept of student accident medical expense insurance plans, and is not meant to constitute advice, or represent any provisions of any policy. These details come from standard shelf-type plans. This information will serve as a guide to the main points, but is not a plan itself nor a contract or part of one. All complete and specific terms are set forth in your policy.
The information in 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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Eligibility
Any day student who attends kindergarten, elementary, junior or senior high school—public or private, is eligible. Boarding school students may purchase the 24-hour plan.
With compulsory coverage all students are covered and the premium is paid by the school.
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Coverage
Compulsory—Primary Excess, Full Excess
School time accident coverage for all students Insurance coverage for injury during the hours and days when school is in session and while attending or participating in school-sponsored and supervised activities on or off the school premises. Includes participation in interscholastic sports including interscholastic football, during the school year. Includes summer recreation activities, travel to and from school, and includes religious services and necessary travel.
Interscholastic football or any interscholastic sports Premiums paid by school. Coverage includes try-out, pre-season and post-season play, and supervised travel.
Full-time, 24-hour accident coverage Insurance coverage for injuries is in force on an around-the-clock, 24-hours-per-day basis. Covers weekends and vacation periods including the entire summer. Students are protected at home or while away, any place, any time, anywhere.
School time accident coverage Insurance covers injury during the hours and days when school is in session and while attending or participating in school-sponsored and supervised activities on or off the school premises. Coverage includes during the school year, summer recreation activities, travel to and from school, and includes religious services and necessary travel.
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Definitions
Injury means a bodily injury caused by an accident, which occurs directly and independently of all other causes while the insured is covered under the policy.
Plan providing medical expense benefits means any group-type policy, contract, or other arrangement for benefits or services for medical or dental care or treatment.
Senior high school means 10th, 11th and 12th grades, or 9th 10th, 11th and 12th grades(includes any grade when participating in senior high school interscholastic sports or football).
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Basis of Benefits
Benefits will be paid on a primary, primary excess or full excess basis, to cover the usual and reasonable expenses for covered medical expenses which are incurred within the maximum incurral period stated in the application. The first treatment must be received within 90 days after the date of injury.
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Primary Coverage
Benefits are payable for covered medical expenses from the first dollar—no deductible, no co-insurance—paying in addition and without regard to payments by other insurance up to the policy maximum (see table).
Primary excess over $100 Benefits are payable for the first $100.00 of covered expenses, without regard to other insurance. Thereafter, benefits are payable for covered expenses above $100.00 that are not recoverable from another ‘plan providing medical expense benefits’ to the applicable maximum. If the insured is not covered by another ‘plan providing medical expense benefits’, the excess provision shall not apply, and benefits are payable to the limits described in the brochure. (Primary excess is available in amounts over $100, $200, $300, $400, and $500.)
Full excess Benefits are payable for covered expenses that are not recoverable from another ‘plan providing medical expense benefits’ to the applicable maximum. If the insured is not covered by another ‘plan providing medical expense benefits’, the excess provision shall not apply, and benefits are payable to the limits described in your policy.
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