Elizabeth City Pasquotank County Schools 2018-2019 Athletic Accident Insurance
Summary Of Benefits:
|Accidental Death Benefit||$10,000|
|Accidental Paralysis Benefit||$10,000|
|Crisis Death Benefit||$10,000 up to $100,000 aggregate|
|Coverage||Secondary to other insurance, primary if none|
|Benefit Period||One year from the date of injury|
|Initial Treatment||Within 60 days of injury|
|Room & Board||100% to $150 per day|
|Impatient Hospital Miscellaneous||100% to $500|
|Outpatient Hospital Miscellaneous||100% to $750|
|Physician's Visits||$30 first visit then $25 thereafter|
|Physiotherapy||$30 first visit then $20 thereafter 5 visits maximum|
|Medical Emergency||100% to $150|
|X-Rays||100% to $200|
|CAT Scan or MRI||100% to $200|
|Laboratory||100% to $50|
|Prescription Drugs||100% to $50|
|Orthopedic Braces & Appliances||100% to %75|
|Surgeon's Fees||100% to $750|
|Anesthetist/Assistant Surgeon||20% of surgical benefit|
|Ambulance||100% to $200|
|Dental||100% to $100 per tooth|
- This Accident insurance is on all students participating in school sponsored and supervised interscholastic sports.
- This Accident Insurance policy is SECONDARY and pays on accident claims after other insurance has paid. If there is no other available insurance this accident insurance policy becomes primary.
- This Accident Insurance provides LIMITED BENEFITS. Parents should consider purchasing the voluntary School Time, 24 hour or Football Accident Insurance for additional Accident Insurance coverage.
- Voluntary student Accident Insurance can be reviewed and purchased online at www.k12studentinsurance.com.
- If an insured student has an accident a school administrator should complete and sign the designated area on the accident claim form and send it to the parent to complete the parent’s portion. It is the parent’s responsibility to send the claim form along with all itemized bills, to the claims office by email, fax or mail (addresses on the claim form).
- For questions pertaining to a claim contact the claims office at 1-866-409-5734 or at K12claims@hsri.com.
- This is a summary of the district purchased student Accident Insurance. For complete details consult the master policy on file in your district office. Any conflicts between this summary and the master policy the master policy will prevail.