Who is eligible?
Who is ineligible?
- Recreation Agencies and Commissions or individuals that are NRPA Public Agency members or:
- Recreation Agencies and Organizations that are organizational members of the NRPA with a diversified program of organized sports and non-sports activities are eligible for this program.
Boxing, ice hockey, snow skiing and tackle football programs/activities.
Who is insured?
All registered participants, coaches, trainers and managers to age 70 who engage in supervised recreation activities sponsored by your organization will be covered under the policy.
When they are covered?
The policy provides coverage while:
- managing or participating in scheduled activities sponsored by the member agency; or
- traveling as a member of a group under the supervision of an authorized representative or the member agency.
If a covered injury requires treatment by a licensed physician, the Plan will pay the Medically Necessary and Reasonable Charges actually incurred by an Insured Person which is in excess of any medical expense benefits paid. Plan pays for covered medical expenses starting within 90 days from date of accident causing the injury. We will pay all covered expenses incurred within 3 years from such date, less the deductible (if any), not to exceed the maximum benefit amounts.
Reasonable Charge (R&C): The most common charge for similar professional services, drugs, procedures, devices, supplies or treatment within the area in which the charge is incurred. The most common charge means the lesser of:
- the actual amount charged by the Provider; or
- the negotiated rate, if any; or
- the fee most often charged for in the geographical area where the service was performed.
The Reasonable Charge is determined by comparing charges for similar services to a national database adjusted to the geographical area where the services or procedures are performed, by reference to the 75th percentile of FairHealth schedules. The Insured Person may be responsible for the difference between the Reasonable Charge and the actual charge from the Provider.
Benefits are paid on an excess basis to other insurance coverage on the Insured Person which must be used first. In such cases there is no deductible and this insurance will apply to covered expenses not recoverable from other valid and collectible insurance. If the Insured Person is not covered by other insurance, the Excess Provision shall not apply and full benefits are payable as described less a Deductible of $200 per claim.
Payment for any Accidental Death and Specific Loss Benefit will be subject to all of the following conditions:
- The Loss is caused solely by an Accident; and
- The Loss is not excluded by the terms of the General Exclusions section of this Policy; and
- The Accident must occur while the Insured Person is participating in a Covered Activity; and
- The Loss must occur within 180 days after the date on which the Accident occurred.
Definitions for this Accidental Death and Specific Loss Benefit
Loss of life or a Specific Loss as shown in the Schedule of Losses which is payable under the Policy’s terms and Conditions.
Means, with regard to:
- a natural arm or leg, complete severance at or above the elbow or knee joint;
- a natural hand or foot, complete severance at or above the wrist or ankle joint;
- a natural thumb and fingers, complete severance at or above the metacarpophalangeal joints;
- an eye, the complete and irrecoverable loss of sight;
- speech, the complete and irrecoverable loss of speech;
- hearing, the complete and irrecoverable loss of hearing of an ear.
Accident Medical Expense Limits
Accidental Death and Specific Loss Limits
- Participant Maximum -- $15,000
- Annual Aggregate -- Unlimited
- Deductible Per Claim -- $200
- Benefit Period -- 3 years
- Accidental Death -- $2,500
- Specific Loss -- $2,500
- Max. for Any One Accident -- $500,000
Schedule of Losses
We will pay a percentage of the Principal Sum(s) listed in the Schedule of Benefits for the Benefit as described in the table below, subject to all of the terms and limitations of the Policy:
|Nature of Loss
||Percentage of Principle Sum
|Both arms or both legs
|Both hands and both feet
|One arm and one leg
|One hand and one foot
|Either both hands or both feet
|Speech and hearing in both ears
|The sight of both eyes
|The sight of one eye and either one hand or one foot
|Either one arm or one leg
|Either one hand or one foot
|Speech or hearing in both ears
|Sight of one eye
|Hearing in one ear
|Both the thumb and index finger of one hand
If more than one Loss results from any one Accident, only one amount, the largest, will be paid.
Click here for a list of exclusions.
Terms of Insurance
Coverage will begin on the desired effective date specified in the applications, or the day following the date the application and check are mailed to K&K Insurance (as shown on the postmark), whichever is later. After becoming effective, coverage will continue through the policy expiration date. Participants entering your plan after the effective date will need to be reported and paid for as they join. Their coverage period will end at the expiration of the policy.
The Blanket Accident Insurance policy is provided by Nationwide Life Insurance Company.