CATASTROPHIC ACCIDENT INSURANCE PLAN DESCRIPTION
Who is Covered?

The Catastrophic Accident policy covers: all currently registered member players, coaches and officials for injuries in excess of a $100,000 Basic Accident Policy Limit.

Covered Activities

Covered activities are defined as the following for Players, Coaches and Officials:

  1. Scheduled games, team practice sessions, camps, clinics, tournaments or sponsored activities, provided they are under the direct supervision of a team official.
  2. Group Travel as a Team or as a group of officials, directly to or from such scheduled practices, games or sponsored activities.
  3. Other sponsored and supervised activities, such as team or league meetings, banquets and usual, non-hazardous fundraisers are also covered by both the accident and liability policies. Examples of non-hazardous fundraisers are bake sales, car washes and other similar events. No coverage is provided for any event that includes fireworks.
  4. In addition to the above, US Lacrosse Member Officials are also covered while officiating in any and all amateur lacrosse activities, and when acting as an Assignor for Lacrosse activities.

Coverage Description

Catastrophic Accident Policy Limits:

Accident Medical Expense Limit $1,000,000
Benefit period 10 Year Benefit Period
Catastrophic Cash Benefit $250,000
Deductible $100,000  
Deductible Incurral period 2 years
   

Catastrophic Medical Expense Benefit: Once the injured person’s claim exceeds the deductible of $100,000 (within the 2 year incurral period), the claim will be eligible for coverage under this Catastrophic Accident policy. The Catastrophic Medical Expense Benefit provides up to $1,000,000 to cover medical expenses resulting from a covered injury. Claims will be paid on a reasonable and customary basis relative to the geographic area where treatment was rendered. Any subsequent medical expenses resulting from that injury, such as additional surgeries or rehabilitation, would be covered for up to a 10 year period from the date of Injury. In the event of a serious injury, this is meaningful since in a catastrophic situation, there may be medical expenses that spread out over a period of many years.

Catastrophic Cash Benefit: If a covered injury to a member of US Lacrosse results in Paralysis or Coma within 180 days from the date of injury, the policy will pay a lump sum cash benefit to the injured participant, subject to the following conditions.

  1. The paralysis or coma must last 12 consecutive months (the waiting period).
  2. After the waiting period, a physician must determine that the condition is irreversible and has resulted in permanent disability.
  3. The benefit is payable according to the schedule below

    For Coma --- $250,000 (100%)
    For Paralysis of 2 or more limbs (upper and/or lower) --- $250,000 (100%)
    For Paralysis of one limb (upper or lower) --- $125,000 (50%)
    For Paralysis of one or more other parts of the body --- See Note

NOTE: If the insured’s paralysis is a part of the body other than a limb, the percentage of the cash benefit used to determine the amount of the benefit will be adjusted in proportion to the extent of the paralysis. The final determination of comparable extent of the disability will be made through the use of the most current edition of the “Guide to the Evaluation of Permanent Impairment,” published by the American Medical Association.

Policy Exclusions

"Important note: This policy covers only those medical/dental expenses arising out of accidental injuries that occur during covered activities. It does not provide coverage for claims arising out of sickness, illness or bodily conditions, such as stroke, asthma attack or cardiac arrest."

 

This policy does not cover any loss, fatal or non-fatal, incurred or resulting from the following:

  1. Suicide, or intentionally self-inflicted injury;
  2. Infections except pyogenic or bacterial infections caused wholly by a covered injury or sickness;
  3. Injury or sickness resulting from any declared or undeclared war;
  4. Loss resulting from air travel, except as a fare-paying passenger on a commercial airline;
  5. Expenses for treatment on or to the teeth, except for treatment resulting from injury to natural teeth;
  6. Eyeglasses, hearing aids, and examination for the prescription or fitting therof;
  7. Injury or sickness covered by any workers' compensation or occupational disease law;
  8. Hernia, unless it results from a covered injury;
  9. The insured being intoxicated or under the influence of any narcotic unless administered on the advice of a physician;

 

Underwriting Company

The Accident Insurance Program is underwritten by by Markel Insurance Company, Glen Allen, VA.  Markel is rated "A" by A.M. Best's rating service.


How to File an Accident Claim

If you are injured during a covered Lacrosse activity, you may obtain a claim form and instructions on filing the claim by clicking here: How to File a Claim  No new claim needs to be filed in the event of a catastrophic accident claim.  The catastrophic accident claim will be coordinated with the claim filed under the Base Accident policy.

All claims are handled and paid by Bollinger, insurance administrator for US Lacrosse.

This summary is a brief description only of the coverages, conditions and exclusions of the policy, and in no way affects or alters the scope of coverage provided. For the full details of terms and limitations, please refer to the actual policy.

 


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