Volunteer Workers Accident Insurance
Disclaimer
The information on this page is based on a general concept of volunteer worker accident 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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Coverage All eligible members of the participating organization will be covered for accidental bodily injury or death. Injury or death must be caused solely by a covered accident which occurs while insured under the policy and under adult supervision and while:
- participating in a scheduled, sponsored and supervised activity; or
- traveling to or from such activity.
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Benefits
- Accident Medical Expense
When a covered injury to an insured requires treatment by a legally qualified physician; care given by a graduate nurse; confinement in a hospital; ambulance service to and from the hospital; and services and supplies ordered by a physician; the company will pay the usual and reasonable expenses incurred on a primary excess or full excess basis (see below), less the deductible selected, up to the policy maximum.
The first expense must be incurred within 90 days of a covered accident. To be covered, any further expense must be incurred within 365 days of the date of injury.
Benefits for injury to sound natural teeth are subject to the $2,000 maximum dental limit, which is included in the overall policy maximum for medical expense.
- Primary Excess—Over $100*
The company will pay the first $100.00 of covered expenses incurred. Additional benefits will be paid only when eligible expenses are in excess of amounts paid or payable by another plan providing medical expense benefits to the maximum selected. Deductibles (if any) must be satisfied before benefits are paid.
*Also available in amounts over $200, $300, $400 and $500.
- Full Excess
The company will pay the covered expenses incurred which are in excess of those paid or payable by another plan providing medical expense benefits to the maximum selected. Deductibles (if any) must be satisfied before benefits are paid.
Note that ‘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.
- Accidental Dismemberment
If covered injury results in loss of limb(s) or sight, the company will pay the benefit shown below. The percentage shown is applied to the accidental dismemberment:
| Benefit |
For Loss Of |
| Two Members |
100% |
| One Member |
50% |
In this context, ‘Member’ means hand, foot or sight of eye.
Loss of hand or foot means complete severance through or above the wrist or ankle joint; with regard to sight, the entire and irrecoverable loss of sight. Only one benefit, the largest to which the insured is entitled, will be paid, for all losses that result from any one accident. Injury must result in loss within 365 days of the accident.
- Accidental Death
The company will pay the accidental death benefit when a covered injury results in the insured’s death. Death must occur within 365 days after the accident occurs. If dismemberment benefits have been paid for a loss resulting from the same accident, the accidental death benefit will not be payable.
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Exclusions
This policy does not cover any loss incurred as the result of:
- (a) dental treatment, except as a result of injury to sound, natural teeth;
- (b) services or treatment rendered by a Doctor, nurse or any other person employed or retained by the Applicant; services or treatment rendered by a Doctor, or nurse who is the Insured or a member of his or her immediate family;
- (c) war or any act of war;
- (d) replacement of eye glasses or eye examinations for the correction of vision or fitting of glasses;
- (e) any intentionally self-inflicted injury;
- (f) injury for which the insured is covered under Worker’s Compensation or similar law;
- (g) the insured’s part in committing or attempt to commit a felony, or as the result of the insured’s involvement in an illegal occupation;
- (h) that part of medical expenses for which mandatory automobile no-fault benefits are due;
- (i) charges which are not usual and reasonable for services in the geographical area where performed, or
- (j) sickness or disease.
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Renewability This is single-term, non-renewable insurance. For coverage during a subsequent outing, activity, or season, it is necessary to complete a new applications and specifications page.
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Underwriting Name lists are not required, but all group members must be insured under the same plan. This insurance is available to all organized, sponsored and supervised groups that are primarily of a social, rather than athletic, nature.
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