Accident Policy
THE ACCIDENT COVERAGE
$100,000.00 Benefit (Pays the medical bills of an injured student of staff member)
Medical Expense Benefit
If any youth or adult student or staff member incurs eligible expenses as the result of a covered injury, directly and independently of all other causes, 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 in excess of other applicable insurance, not to exceed the Maximum Medical Expense Benefit of $100,000.00, subject to a deductible of $250.00. The first such expense must be incurred within 60 days after the date of the accident.
“Eligible expenses” means charges for the following necessary treatment and service, not to exceed the usual and customary charges in the area where provided.
Medical and surgical care by a physician
Radiology (X-rays)
Prescription drugs and medicines
Dental treatment of sound natural teeth
Hospital care and service in semi-private accommodations or as an outpatient
Ambulance service from the scene of the accident to the nearest hospital
Orthopedic appliances necessary to promote healing
Physiotherapy
Accidental Death and Dismemberment Benefit ($50,000.00 Benefit)
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 ($50,000.00)
Full Principal Sum for double dismemberment ($50,000.00)
50% of the Principal Sum for loss of one hand, one foot or sight of one eye ($25,000.00)
Exclusions
This Plan does not cover any loss contributed 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 on the advice of a physician, war or any act of war, whether or not declared, or 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 an intentionally self-inflicted injury. Nor does this Plan cover: service provided by (a) any person of facility employed or retained by the Policyholder or member organization, or (b) any member of the Insured Person’s family or household; examination for, prescription for, or the purchase of eyeglasses or contact lenses or hearing aids; the repair or replacement of any orthopedic appliance or artificial dental restoration; expenses payable under any Workers’ Compensation Law or similar legislation; injury sustained while riding in or on any two or three-wheeled engine-driven motorized vehicle.