Participant Accident Insurance can be purchased by coaches and activity supervisors for injury coverage through CSURMA Program Directors, Alliant Insurance Services, Inc. This plan provides primary or excess accident medical coverage when participants suffer accidental injury during sponsored and supervised sports programs or other organized youth activities. The plan is sold as blanket coverage, purchased by a group for all its participants. The Participant Accident Insurance program covers a broad range of groups and activities, providing the best possible protection for event participants.
With a quick-quote capability and competitive pricing the University Risk Management Department can help you fill your accident/medical-coverage needs.
Coverage: Participant Accident Insurance (PAI) Program
Coverage Period: Various -On file with company
Policy No.: Various -On file with company
Insurer: Life Insurance Company of North America
A.M. Bests Rating: A:XV
NAMED COVERED ENTITY:
Group or organization while engaged in California State University or CSUSB Auxiliary Organization sponsored activity such as:
- Athletes –including amateur sports, school sports, sports camps
- Volunteers –including community and non-profit organizations
- Child Care Centers – including school and church affiliated centers
- Recreation –including camping, skiing, white water rafting
- Charities, fundraisers, religious retreats and meetings
- One-time special events
COVERAGE FEATURES:
Individual Policy Coverage Limits on File with Company:
- High-limit Accident Medical Expense (AME) benefit maximums –up to $1,000,000
- Accident Medical Expense Limits: Primary, Primary Excess or Full Excess
- Optional Catastrophic Plans - up to $10,000,000
- Accidental Death & Dismemberment benefits
- Medical Evacuation and Repatriation benefits available
- Choice of benefit levels, deductibles and benefit periods
- Coverage can be extended to administrators, organizers, trainers or supervisors
DISCLAIMERS:
Coverage exclusions and limitations may apply. Availability and coverage levels of some plan features subject to state laws and underwriting requirements.
CLAIMS REPORTING:
Written notice must be submitted to Claims Administrators within 30 days after a covered loss occurs or begins to the Claims Administrator:
Health Special Risk, Inc (HSR)
4001 N. Josey Lane
Carrollton, Texas 75007
Phone: (972) 492-6764; Fax: (972) 492-4946
Submit Completed Claim Form #HSR10/99 General Claim Form
Participant’s Accident Insurance Quote Form
In most cases, signed waivers are required from all participants. To request a quotation, contact the Risk Management Department at X73939.
PLEASE NOTE: This summary of the policy terms is provided for information only. It does not convey any rights upon the insurance nor alter its condition for coverage. Please refer to the actual policy for full disclosure of the policy terms.