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| In the past, accident
medical coverage for riding clubs, sports teams, leagues and athletic
association was either too costly or not available at all. Individuals were
either forced to pay extremely high insurance premiums or to run teams and
clubs without proper insurance protection; running the risk of
personal exposure to lawsuits or a participant or staff member's injury
claim. |
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| We have developed a
comprehensive program to specifically cover the inherent risks involved for
today's riding club and athletic associations. 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 athletic arena. |
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Who Is
Covered
All participants of the Policyholder are covered while participating in
sponsored activities. A member is also covered while traveling, directly and
without interruption, to and from any Policyholder sponsored activity and
his or her home or place of residence.
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EXAMPLE
OF BENEFITS
• $100,000 Medical Maximum, excess only
• $2,500.00 Deductible
• Reasonable covered expenses are payable in full subject to the following
limitations:
A. Hospital Room and Board – Semi-private room rate.
B. Dental – Reasonable Expenses per sound and natural tooth. $1,000
maximum.
C. Outpatient Physical Therapy – Reasonable Expenses. $500 maximum
D. Outpatient Orthopedic Appliances and Braces – Reasonable
Expenses. $500
• Treatment must commence within 30 days from the date of injury.
• Coverage up to one year from the date of injury.
• Coverage is excess to other insurance.
ACCIDENTAL DEATH & DISMEMBERMENT
Benefits are paid for losses which are incurred within 180 days from date of
injury. The following benefits (the largest
applicable amount) are paid in addition to the medical benefit:
• Loss of Life $30,000
• Double Dismemberment $30,000
• Single Dismemberment $15,000
“Loss means with regard to hands and feet, actual severance above the wrist
or ankle joint; with regards to sight, the
entire and irrevocable loss thereof.
PARALYSIS
Paralysis schedule is as follows: $25,000
• Both Upper & Lower Limbs 100%
• Both Lower Limbs 100%
• One Lower & One Upper Limb 100%
• One Lower Limb & One Upper Limb 100%
The Paralysis must occur within 180 days after the date of the Accident,
continue for 6 consecutive months and be diagnosed by a doctor as being
complete and not reversible.
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Accidental Death &
Dismemberment
If a covered injury results in any of the losses specified below within one
year 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
- 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
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.
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Maximum
Medical Expense Benefit
If the Covered Person incurs eligible expenses as the result of a covered
injury, the Company will pay the charges incurred for such expense within 52
weeks, beginning on the date of accident. Payment will be made for eligible
expenses not to exceed the Maximum Medical Expense Benefit, subject to the
applicable deductible amount (if any). The first such expense must be
incurred within 60 days after the date of the accident.
| Note: |
Excess Coverage. This plan does
not cover treatment or service for which benefits are payable under any
other insurance or medical service payment plan available to the
insured. |
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Exclusions and Limitations
This Plan does not cover any loss to or resulting from:
- Sickness or disease in any form,
except pyogenic infections due to an accidental cut or wound.
- The use of drugs or narcotics,
unless administered under the advice of a physician.
- War or any act of war, whether or
not declared.
- Participation in any riot or civil
commotion.
- Air travel or the use of any device
or equipment for aerial navigation, except as a fare-paying passenger on a
regularly scheduled commercial airline.
- Suicide or any attempt thereat or
any self-inflicted injury.
Nor does the Plan cover:
- Service provided by any person or
facility employed or retained by the Policyholder or member organization.
- Service provided by any member of
the Insured Person's family or household.
- Dental treatment, except as the
result of a covered injury.
- The repair or replacement of any
artificial dental restoration.
- Expenses payable under any Workers
Compensation Law or similar legislation.
- Injury sustained while riding in or
on any two or three wheeled engine driven vehicle.
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Call us at 800-874-9191 or email
ballen@eqgroup.com
for a fee no obligation quotation. Policy Minimum Premium -
$150.00 |
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