Accident Medical Insurance
For
Day Cares, Nursery Schools
and Child Care Facilities
Need assistance? You may Direct Dial the following specialists:
Cassie Leonhardt Ext. 126
Jerria Donelson Ext. 119
In the past, accident medical coverage for day cares, nursery schools
and child care facilities was either too costly, too limited, or not
available at all. Individuals were either forced to pay extremely high
insurance premiums or to run facilities without proper insurance protection,
therefore running the risk of personal exposure to lawsuits or a child
or staff member's injury claim.
However, now a comprehensive program has been developed to specifically
cover the inherent risks involved for today's day cares, nursery schools
and child care facilities. This Accident Medical Insurance Program is
designed to help eliminate the financial and emotional burden one can
incur as a result of injury in today's child caring facilities.
The Accident Medical Coverage
Pays the medical bills of an injured child or staff member
Who Is Covered
All participants in the covered activity. Policyholder staff may also
be enrolled under this Plan.
Covered Activity
(A) All activities sponsored and supervised by the Policyholder, including
travel with a group in connection with such activities, and (B) travel
directly and without delay to or from the Insured Person’s home
or residence and the site of such activities.
Medical Expense Benefit
If the Insured Person incurs eligible expense as the result of a covered injury,
directly and independently of all other causes, the Company will pay
the reasonable expenses incurred for such expense within 1 year, beginning
on the date of accident. Payment will be made for eligible expenses in
excess of the applicable Deductible Amount, not to exceed the Maximum
Medical Benefit.The first such expense must be incurred within 60 days
after the date of the accident. “ Reasonable expenses”means charges
for the following necessary treatment and service, not to exceed those
generally charged for similar care 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
If excess coverage is selected, this Plan does not cover treatment or service
for which benefits are payable or service is available under any other
insurance or medical service plan available to the insured person. Primary
coverage pays benefits under the Plan without offset for other insurance
(except Worker ’s Compensation).
Accidental Death & Dismemberment
If a covered injury results in any of the losses specified below within
365 days 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
- Full Principal Sum for loss of sight of both eyes
- 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
“Member”means hand, foot, or eye. Loss of hand or foot means
complete severance above the wrist or
ankle joint. Loss of eye means the total, permanent loss of sight. We
will not pay more than the Principal Sum for this Benefit for all losses
due to the same accident.
Exclusions and Limitations
This Plan does not cover any loss to or resulting from:
- intentionally self-inflicted Injury, suicide while sane or insane
or any attempt thereat (in Missouri
this applies only while sane);• voluntary self-administration
of any drug or chemical substance
not prescribed by, and taken according to the directions of the Insured
Person’s Physician.
- participation in a riot or insurrection;
- an act of declared or undeclared war;
- active duty service in any Armed Forces of any country, and, in such
event, the prorata unearned
premium will be returned upon proof of service.This does not include
Reserve or National Guard
active duty or training unless it extends beyond 31 days;
- parachuting, except for self preservation;
- bungee jumping, flight in an ultralight aircraft, hang gliding;
- sickness, disease, bodily or mental infirmity or medical or surgical treatment
thereof, bacterial infection, regardless of how contracted. This does
not exclude bacterial infection that is the natural and foreseeable
result of an Injury or accidental food poisoning;
- services or treatment rendered by a(n) Physician, Nurse or any other
person who is:
– employed or retained by thePolicyholder; or
– is the Insured Person or anImmediate Family Member;
- flight in an Aircraft, except as a fare-paying passenger;
- dental treatment, except as otherwise provided, and only when Injury
occurs to sound natural teeth:
- any loss for which benefits are paid under state or federal worker’s compensation,
employers liability, or occupational disease law;
- treatment in any Veteran Administration or Federal Hospital, except
if there is a legal obligation to pay;
- 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.
Click
here for Premium Rates
Minimum Premium: $300.00
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