Sports Insurance

Accident Medical Insurance For Adult Sports Teams and Leagues

Who Is Covered
All participants of the Policyholder are covered while participating in sponsored activities. A member is also covered while traveling, directly and without interruption, to and from any Policyholder sponsored activity and his or her home or place of residence.

Accidental Death & Dismemberment
If a covered injury results in any of the losses specified below within one year after the date of the accident, the Company will pay the applicable amount.

• Full Principal Sum for loss of life
• Full Principal Sum for double dismemberment
• 50% of the Principal Sum for loss of one hand, one foot or sight of one eye
• 25% of the Principal Sum for loss of index finger and thumb of same hand

If the Principal sum is payable, no indemnity will be paid for dismemberment. In any event, the double dismemberment indemnity is the maximum amount payable under this Benefit for all losses resulting from one accident.

Maximum Medical Expense Benefit
If the Covered Person incurs eligible expenses as the result of a covered injury, the Company will pay the charges incurred for such expense within 52 weeks, beginning on the date of accident. Payment will be made for eligible expenses not to exceed the Maximum Medical Expense Benefit, subject to the applicable deductible amount (if any). The first such expense must be incurred within 60 days after the date of the accident.

Note: Excess Coverage. This plan does not cover treatment or service for which benefits are payable under any other insurance or medical service payment plan available to the insured.

Exclusions and Limitations

This Plan does not cover any loss to or resulting from:

• Sickness or disease in any form, except pyogenic infections due to an accidental cut or wound.
• The use of drugs or narcotics, unless administered under the advice of a physician.
• War or any act of war, whether or not declared.
• Participation in any riot or civil commotion.
• Air travel or the use of any device or equipment for aerial navigation, except as a fare-paying passenger on a regularly scheduled commercial airline.
• Suicide or any attempt thereat or any self-inflicted injury.
• Active duty service in the Armed Forces of any country, not including National Guard or training unless it exceeds 31 days.

Nor does the Plan cover:

• Service provided by any person or facility employed or retained by the Policyholder or member organization.
• Service provided by any member of the Insured Person's family or household.
• Dental treatment, except as the result of a covered injury, repair or replacement of any artificial dental restoration.
• Cosmetic surgery, except for reconstructive surgery due to a covered injury.
• Charges which the insured Person would not have to pay if He did not have insurance.
• Eyeglasses, contact lenses, hearing aids.
• Charges, which are in excess of Usual, customary and Reasonable charges
• Expenses payable under any Workers Compensation Law or similar legislation.
• Injury sustained while riding in or on any two or three wheeled engine driven vehicle, parachuting except for self-preservation, bungee jumping, flight in an ultralight aircraft, handgliding.
  

Premium Rates
Following are the per participant premium rates.