In today's fast-paced society, accidents can happen anytime,
anywhere.....while traveling with a business group, vacationing,
attending school, participating in athletics or a variety of other
situations. Many families have little or no medical insurance, and those
who do have coverage may be required to meet large deductibles before
their insurance pays any benefits.
However, now a comprehensive program
has been developed to specifically cover the inherent risks involved for
today's adult groups. 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 adult group activities.
The Accident
Medical Coverage
Pays the medical bills of an injured participant or staff member
Who Is Covered
All members of the Policyholder
Covered Activity
All activities sponsored and supervised by the Policyholder during
the Camp or Conference specified in the application, including travel
with a group in connection with such activities and 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 expenses as the result of a covered injury, directly and
independently of all other causes, the Company will pay the charges
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.
"Eligible expense” means charges
for the following necessary treatment and service, not to exceed
the usual and customary charges in the area where provided"
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Medical and surgical care by a
physician |
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Radiology (X-Ray) |
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Prescriptive drugs and medicines |
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Hospital care and service in
semi-private accommodations or as an outpatient |
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Ambulance service from the scene of
the accident to the nearest hospital |
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Orthopedic appliances necessary to
promote healing |
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Dental treatment of sound natural
teeth |
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.
Accidental Death and Dismemberment
Benefit
If a covered injury
results in any of the losses specified below within 1 year (not
applicable in Pennsylvania) after the date of the accident, the Company
will pay the applicable amount:
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Full principal sum for loss of life
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Full principal sum for dismemberment
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Full principal sum for loss of sight
of both eyes
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50% Full principal sum for loss of
one hand, one foot or sight of one eye
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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. If
the Principal Sum is payable, no
indemnity will be paid for dismemberment. In any event, the Double
Dismemberment Indemnity is the
maximum amount payable under this Benefit for all losses resulting from
one accident
Exclusions
and Limitations
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intentionally
self-inflicted Injury, suicide while sane or insane or any
attempt thereat (in Missouri
this applies only while sane); |
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voluntary
self-administration of any drug or chemical substance not
prescribed by, and taken according to the directions of the
Insured Person’s Physician. |
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participation in a
riot or insurrection; |
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an act of declared
or undeclared war; |
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active duty service
in any Armed Forces of any country, and, in such event, the
pro-rata 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;
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parachuting, except
for self preservation; |
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bungee jumping,
flight in an ultra-light aircraft, hang gliding;
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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;
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services or
treatment rendered by a (n) Physician, Nurse or any other person
who is:
– employed or retained by the Policyholder; or
– is the Insured Person or an Immediate Family Member;
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flight in an
Aircraft, except as a fare-paying passenger;
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dental treatment,
except as otherwise provided, and only when Injury occurs to
sound natural teeth: |
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any loss for which
benefits are paid under state or federal worker’s compensation,
employers liability, or occupational disease law;
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treatment in any
Veteran Administration or Federal Hospital, except if there is a
legal obligation to pay; |
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cosmetic surgery,
except for reconstructive surgery due to a covered injury;
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charges which the
Insured Person would not have to pay if He did not have
insurance; |
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eyeglasses, contact
lenses, hearing aids; |
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charges which are in
excess of Usual, Customary and Reasonable charges. |
Allen Financial Insurance Group
A Key
Component of the Allen Financial Difference
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