Catastrophic Accident
Medical K-12 Insurance
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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Eligiblity
Any day student who attends kindergarten, elementary, junior or senior high school—public or private, is eligible.
With compulsory coverage all students are covered and the premium is paid by the school.
Students are covered by class, selected by the school or school system.
| Class I |
All enrolled students of the school in grades K-12
Can exclude football |
| Class II |
All interscholastic athletes, including interscholastic football and cheerleading and participants of non-sport extracurricular activities of the school.
Can exclude football |
| Class III |
All interscholastic athletes, including interscholastic football, band members, cheerleaders, football majorettes, participants of intramural sports, gym classes and non-sport extracurricular activities of the school.
Can exclude football |
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Coverage
Compulsory—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.
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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Excess Coverage
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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