This policy is an excess or secondary coverage policy.
“Secondary” means that if the injured member has other insurance, that insurance
is automatically “primary” and must pay the incurred costs first. In order
to be eligible for any secondary sports accident insurance benefits, you must
have followed all requirements and conditions under your primary carrier including
any “in-network” requirements. USA Wrestling sports accident insurance will
pay benefits up to the policy limits after the deductible has been paid and the
80-20 co-insurance condition has been met (see below). If the injured member
has no other insurance, the USA Wrestling secondary sports accident insurance
applies, with the same coverage amount and deductible described below. All valid
claims must first be filed with the injured’s primary insurance company regardless
of the type of claim. All claims, and subsequent benefits, if any, are subject
to verification by USA Wrestling’s National Headquarters of each membership
benefits. No benefits will be extended under the secondary coverage, if you
do not follow any and all requirements of your primary including any and all "in-network"
requirements. Call if you have questions. Deductible: This policy includes a $500 deductible per membership year. Each membership period, in terms of the deductible, begins September 1 until September 1 of the next year. Co-Insurance Limits: This policy has the following co-insurance conditions: Plan pays 80% and injured party pays 20% per valid claims, after the $500 deductible. Once the member has met the $500 deductible, and has paid an additional $2,000 out of his/her own pocket (which does not include the $500 deductible) in a Benefit period, which runs from September 1 to September 1 of the next year, plan pays 100%. Medical Necessity and Medical Appropriateness: The benefits in this program will be covered only when and so long as they are determined to be medically appropriate for the proper treatment of the patient’s condition. Determination of whether the services provided were appropriate, reasonable and customary for the proper treatment of the client’s condition and Guarantee Trust Life Insurance Company will decide proper level of care. Who is covered? The following USA Wrestling members are provided benefits under this policy: Wrestlers holding USAW Competitor’s membership Coaches holding USAW Coach’s membership Officials holding USAW Officials membership Foreign competitors wrestling in the United States, including those involved with international and cultural exchanges sanctioned through USA Wrestling, are required to purchase or be provided a specially discounted membership specifically for secondary sports accident insurance. Foreign wrestlers holding USAW Competitor’s membership are covered under the policy when participating at a USA Wrestling sanctioned event, but treatment must be in the United States. No other membership benefits, services, or liability insurance coverage benefits are extended to foreign participants holding USA Wrestling membership. Foreign officials performing mat or pairing duties at a USA Wrestling sanctioned event, who have been invited to this country through the protocol procedures coordinated by the National Headquarters, are also covered under this policy. Treatment must be performed in the United States. When are USA Wrestling members covered? Members are provided benefits under the policy if as a result of an accidental bodily injury: at USA Wrestling chartered club practices, when practices are organized and supervised by a member coach(es), and when all participating club members are individual members of USA Wrestling; going to or from sanctioned USA Wrestling events, also to or from USA Wrestling club practices; while participating in sanctioned USA Wrestling events and activities. Coverage includes participation abroad in international events or exchanges that are sanctioned and approved by the National Headquarters of USA Wrestling. Sports Accident Insurance benefits are only afforded to valid current members of USA Wrestling. Membership in USA Wrestling – and secondary sports accident benefits – begin when the state association, or its directors, receive both the membership information and the appropriate fees. Accordingly, a wrestler applying for membership and paying the appropriate fees at the beginning of a sanctioned event for example, is immediately provided with sports accident insurance benefits. However, for any claims to be processed, the National Headquarters of USA Wrestling must have a record of membership. It is essential that when an individual signs up to be a member of USA Wrestling, the membership forms and fees be processed at once. Failure to process membership applications in a timely manner can delay the benefits each member is eligible to receive. Official’s membership in USA Wrestling is the one individual membership category that is not administered at the state level. The United States Wrestling Officials Association (USWOA) registers members through a separate and independent office. The USWOA office provides member’s information and registration forms for individual officials to register. Consequently, secondary sports accident insurance coverage of an official begins when the official applies for membership, pays to appropriate dues, and is recorded into the official membership roll of the USWOA. Policy Limits and Types of Coverage: The Secondary Sports Accident insurance policy provides secondary or excess coverage on covered claims, if as a result of a bodily injury occurring at a USA Wrestling sanctioned event, activity or chartered club practice, and after the deductible ($500) has been met. This insurance is in excess of other valid and primary collectible insurance and includes an 80/20 co-insurance condition. In order to be eligible for any secondary sports accident insurance benefits, you must have followed all requirements and conditions under your primary carrier including any “in-network” requirements. Benefits under the secondary sports accident insurance include: 1. $100,000 per Benefit period after deductible. (Benefit Period is enforce form September 1 until September 1 of the next year.) 2. $1,000,000 Lifetime secondary sports accident maximum. 3. Miscellaneous Expense Benefit. A catastrophically injured Insured Person, who is totally disabled, will receive $200 per month until age 18. 4. Chiropractic and physical therapy services are limited to 20 visits in a benefit period. 5. Dental sports accident insurance includes secondary coverage benefits of $250 per occurrence, after the deductible ($500) has been met. The plan includes an 80/20 co-insurance condition. Coverage Exclusions: 1. An injury arising out of war, or any act of war, declared or undeclared; 2. Dental treatment, dental x-rays, other than for injuries to sound natural teeth, expenses incurred for the repair or replacement of existing dentures, partial dentures, braces, fixed or removable bridges, or other artificial restoration; 3. Air travel, parachuting, hang-gliding; 4. Cost of care given by any person employed by the Policy Holder; 5. Suicide or its attempt; 6. Intentional self-inflicted injury; 7. Eye examinations or expenses incurred for repair or replacement of existing eye glasses, artificial limbs or orthopedic braces; 8. Injury or sickness which is covered by any Workers’ Compensation Act or similar Law; 9. Aggravation of a pre-existing or chronic condition; 10. Care given by the Federal Government. 11. Not adhering to any and all requirements under a primary policy which would have covered the expenses or a portion thereof. How long do you have to file a valid claim? Claims should be filed immediately, but must be filed within one year of the accident. How do you file a valid claim? Once you have filed the claim with your primary insurance carrier and they have fulfilled their obligations relating to the injury, follow the instructions described below. 1. To begin the process, obtain and complete a Notice of Injury form to start your file with the insurance company. This form may be obtained from your state association membership director or from USA Wrestling by calling 1-719-598-8181 and ask for Membership Processing. Note: Any individual familiar with the injury – a coach, parent, or official, for example – may fill out the Notice of Injury form. Important: You must fill out the form entirely. Be sure to include your USAW membership card number on the Notice of Injury form. (Your membership number appears on the front of your USAW membership card.) Forms without membership numbers or forms not completely filled out will not be processed! 2. Send the Notice of Injury form to USA Wrestling for verification of membership and incident site. The address is already printed on the form. Once membership status and site of injury are verified, USA Wrestling will forward the Notice of Injury form to the sports accident insurance administrator. You will then receive an insurance claim form in the mail, along with a cover letter that explains step-by-step how to fill out the form and submit the valid claim. 3. Once you have submitted the claim form and allowed time for processing, you can call or write the sports accident insurance administrator directly with any questions you might have. See the address and telephone number below. 4. Remember that you must complete information regarding your primary insurance company and all information regarding the claim. Failure to do so may delay or invalidate your pending claim. Insurance Administrator The insurance administrator for the USA Wrestling member secondary sports accident insurance benefit is Maksin Management Corporation. The address is: ATTN: Nancy Zieminski-Foltz Maksin Management Corporation Kevon Office Center Suite 160 2500 McClellan Avenue Pennsauken, NJ 08109 The toll free telephone number is 1-800-257-6250. USA Wrestling Liability Insurance Information Type of Coverage Occurrence Form-Commercial General Liability insurance is provided under the USA Wrestling policy, and includes participant legal liability insurance (explained below). This insurance provides coverage for liability imposed by law. The policy provides Commercial General Liability insurance for Bodily Injury, Property Damage, Personal Injury, Advertising Injury and Incidental Products per the conditions of the policy. The policy excludes medical payment coverage for athletic participation. Limits of the Policy The limit of liability under the Occurrence Form-Commercial General Liability Insurance Policy for USAW is $1,000,000 per occurrence; with an additional Excess Liability coverage of $1,000,000, no event or annual aggregate limit applies. A fire legal limit of $50,000 is included in those limits of lliability. The Participant Legal Liability Policy is included in the limits of liability described above. Participants Legal Liability USA Wrestling is provided coverage for claims brought by Athletic Participants for Bodily Injury and Property Damage arising out of occurrences for which the named insured is found legally liable. This does not cover claims brought by one athlete against another athlete. To whom does this policy apply? The following are covered under USA Wrestling’s liability policy, for covered claims and related litigation, after the appropriate fees and/or registration materials have been received and approved: Wrestlers holding Competitor Membership Coaches holding Coach’s Membership Officials holding Official’s Membership Members hold General Membership USA Wrestling chartered clubs USA Wrestling chartered club leaders and volunteers Event directors and volunteers of sanctioned events Administrators Trainers (but not as medical malpractice) Additional Insureds, such as owners of facilities, who are specifically listed on appropriate forms prior to the event Member associations When does this coverage apply? (See When are these members covered? In the preceding section on secondary sports accident insurance for an explanation of when the insurance protection starts.) 1. USAW Competitors, Coaches, Officials and other qualified members are covered under the policy, for covered claims and related litigation, when they join USA Wrestling. Joining USA Wrestling requires submitting membership information and the payment of fees to the appropriate party. 2. Clubs, club leaders and club volunteers are covered under the policy, for covered claims and related litigation, when the club is registered as a Chartered Club of USA Wrestling. A club joins USA Wrestling by submitting an Application for Club Charter, being approved, and payment of fees to the appropriate party. Note: Being a USA Wrestling chartered club carries with it responsibilities: Participation in national sponsorship programs, reviewing the Club Organizing Guide, and complying with membership rules, insurance requirements and USA Wrestling’s By-laws, operating rules and policies. USA Wrestling benefits and services are provided to chartered clubs in which all wrestlers and designated coaches are individual members of USA Wrestling. Practices must be organized and supervised by USAWrestling member coaches. 3. Event directors and event volunteers are covered under the policy, for covered claims and related litigation, when the event is sanctioned by USA Wrestling, but coverage applies only on the date(s) of the event and those days immediately preceding or following which are approximately related to the event. The sanctioning process requires timely receipt by the National Headquarters of an application for Sanction of an Event form, payment of a sanction fee, and approval of the state association and the National Headquarters of USA Wrestling. Note: USA Wrestling benefits and services are provided to sanctioned events in which all wrestlers are individual members of USA Wrestling and event directors comply with membership rules, insurance requirements, USA Wrestling’s By-laws, operating rules and policies. Sanctioned events may include formal competitions, meets, wrestling state games, exhibitions, clinics and state association sponsored camps, i.e. Cadet and Junior National Training Camps. A separate Application for Sanction of Event must be submitted and approved for each event, and one application cannot be submitted for sanction of multiple sites or disparate dates. Certificates of Insurance Certificates of Insurance will be issued prior to the event. A Certificate of Insurance is written proof that the named insured has coverage under the liability policy. Certificates of Insurance will be issued to clubs. Any special requests should be made in writing and addressed to Acordia Sports, A Division of Acordia of Colorado, PO Box 39117, Colorado Springs, CO 80919. The owner/operator of the facility used for chartered club practices may be added as a Certificate Holder and/or Additional Insured. Contact the National Headquarters for details. Certificates will be mailed to the Club Leader listed on the appropriate form, and that person is responsible to distribute the Certificate, if applicable. Sanctioned events will be issued a Certificate of Insurance. The owner/operator of the facility used for a sanctioned event may be added as a Certificate Holder and/or Additional Insured. Contact the National Headquarters for details. Certificates will be mailed to the Event Director listed on the appropriate form, and that person is responsible to distribute the Certificate, if applicable. Special coverage or conditions cannot be accommodated on the Certificate of Insurance, but special language conforming to the needs of state institutions may be requested. Contact Acordia Sports, A Division of Acordia of Colorado, PO Box 39117, Colorado Springs, CO 80919, for such requests, and allow 30 days for processing. Additional coverage and understandings The property damage in the liability policy includes coverage for loss or damage to items customarily associated with a wrestling event, such as mats, score clocks, gymnasium and locker room facilities. Personal effects of individuals, including cash are not covered. Certain spectator property may be covered. Property damage insurance applies only when a legal condition of liability exists, caused by negligence of the insured. Coverage is subject to a $500.00 deductible. Policy does not include full replacement. Cost and depreciation are considered in all claims. Policy does not cover collision or damage to vehicles used by members in association with USAW sanctioned activities. Personal property owned by a chartered club or members should be covered by separate policy purchased independently. NOTE: State Associations have coverage for non-owned and hired automobile liability. There is no coverage in place for individual clubs. Please contact Trish Beyer at Acordia, 1-800-332-9256 for any special requirements. USA Wrestling’s liability policy is applicable worldwide, provided claims are brought in the coverage territory as defined in the policy. The policy period for USA Wrestling insurance is coordinated to expire with the membership year, 12:01 p.m. September 1, 2001. Policies and provisions may change from year to year. State Associations operating Regional Training Centers should apply for liability coverage by submitting an Application for Club Charter, naming the State Association as the name of the club, and Regional Training Center sites as an additional practice facility. Claims and Potential Claims Report the facts and circumstances immediately to USA Wrestling Insurance Broker Fax to: Trish Beyer Acordia Sports Fax: 1-719-592-0799 Insurance Carrier: American Specialty Insurance Services 1-800-245-2744 In the event of such an occurrence, DO NOT MAKE ANY STATEMENTS CONCERNING FAULT, since this is a matter which may require legal determination at a later date. Please also avoid providing any details concerning the coverage or limits of the policy. It is also important to report POTENTIAL LIABILITY CLAIMS so that the insurance company can take appropriate steps. If you are aware of a situation that could potentially lead to a liability claim, locate and forward to Acordia Sports any “Waiver or Release” from liability that accompanied any entry forms, if used. Standard Waiver and Release from Liability language is found on the back of every Application for Sanction of Event form. Any legal papers of any nature should be sent immediately to Acordia Sports. It is helpful, in the event of a lawsuit, if USA Wrestling has on file a signed “Waiver and lease from Liability” form for members of USA Wrestling involved in a suit. This signed form can be instrumental in USA Wrestling’s defense in the event of a lawsuit brought against USA Wrestling or its members. Certificate & Information In the event a certificate is needed or special wording on a certificate is required contact: Acordia Sports Attn: Trish Beyer, or Tammy Pimentel PO Box 39117 Colorado Springs, CO 80919 Toll-free: 1-800-332-9256 Fax: 1-719-592-0799 Insurance Company The insurance company for USA Wrestling liability insurance is Fidelity and Guaranty Insurance Company. Insurance Agent For specific answers to questions on coverages, conditions and limitations please contact: Trish Beyer, Acordia Sports at 1-800-332-9256. |
Secondary Sports Accident Insurance |