Intercollegiate Athletic Student Accident Insurance

Summary of Coverage

This is a fully insured program. The Intercollegiate Athletic Student Accident Insurance program provides coverage for student-athletes, student managers, student trainers, student coaches and student cheerleaders for bodily injuries sustained while participating in athletic competitions that are authorized, sanctioned or scheduled by the college for approved sporting programs. This includes College-supervised practices, game related activities, off-season conditioning and related, covered travel.

Coverage also extends to prospective athletes (same benefits and limits as regular student-athletes) and their named chaperon(s) (up to $10,000) while they are visiting the College or any facility to which they are invited by a College official.

Claims are paid in excess of any other available insurance. If the student-athlete does not have his or her own medical insurance, the policy pays on a primary basis.

Coverage Types

Basic Policy

Student-athletes must incur medical expenses within 90 days of injury for the Basic Policy to respond.

The Basic Policy provides the following limits:

• Accidental medical expenses per incident: $25,000
• Accidental death and dismemberment (AD&D): $10,000
• Aggregate limit of liability (all colleges): $5 million (AD&D only)
• Benefit period: 104 Weeks

Catastrophic Policy

Student-athletes must incur medical expenses of $25,000 or more within 24 months from the date of injury for the Catastrophic Policy to respond.

The Catastrophic Policy provides the following limits:

• $5 million Benefit Limit
• Lifetime Benefit Period

Reporting Claims

Claims must be reported within 30 days of injury to meet policy provisions.

ALL INCIDENTS, whether seeking medical attention or not need to be reported

1. File an accident/incident report by calling the Office of Safety and Security at 407.708.2178.
2. Colleges are to file their claims through the On Line Risk Manager portal, http://collegesportsinsurance.com If for some reason you are unable to utilize your internet the college can file a paper form. Paper forms are to be emailed to tanya.brown@mutualofomaha.com or mailed to: Mutual of Omaha, Claims, Special Risk, P.O. Box 31156, Omaha NE 68131. FCSRMC is to be copied on all paper claims, email to bgillian@fcsrmc.com or mail to FCSRMC, 4500 NW 27th Avenue, Suite B2, Gainesville, FL 32606.
3. Claims must be reported to Mutual of Omaha within 30 days (or as soon as possible) of injury to meet policy provisions.
4. College should forward completed Accident-Incident Report to the Consortium indicating "this claim has been submitted to Mutual of Omaha".
5. Advise your student-athletes if they have other available insurance they must file with other insurance first then send Explanation of Benefits to Mutual of Omaha to handle claim.
6. The insurance adjuster will email the student confirmation of receipt of claim and directly correspond with the student regarding the claim.
7. The student is responsible for submitting all related medical bills, as well as, any other supporting documentation directly to the insurance adjuster.

Please note: Student-athletes who have other available insurance must file with their primary insurance company first. Their Explanation of Benefits (EOB) should then be sent to our insurance carrier to handle the claim. Please advise your student-athletes accordingly.

Example of Claim

• Student-athlete tears her rotator cuff while playing in a softball game for the College.