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Subject: Camps and Clinics Blanket Accident Insurance

1. Purpose:

The purpose of this paper is to explain the Camps and Clinics Blanket Accident Insurance Program and the procedures which campus coordinators should follow when using this program.

2. Background:

Camps and clinics insurance is purchased by System Risk Management to reduce the potential for liability claims arising out of injuries which occur at the various campus sponsored camps and clinics. This is not a substitute for liability insurance but rather provides "goodwill coverage" for small medical bills incurred by camp participants. These medical expenses must be the result of a covered accident, this is not an illness policy. The policy gives us the ability to pay the medical expenses of camp participants covered under the policy without being negligent, thus reducing the number of claims and suits from participants and their parents. Coverage is primary to State liability insurance and the camper's personal insurance on the first $1,000 of covered medical expenses and excess up to $5,000 per student, but is intended to target injuries incurred related to camp activities. It is not meant to cover a student with allergies or a student who is playing with a pocket knife. Coverage can be provided for camps and clinics based on the following criteria:

1. Camps and clinics must be sponsored by a UW campus and open to the public.
2. Premium must be included as part of the registration fee or paid as a gift or grant authorized for this purpose.
3. Only camps and clinics oriented toward people who are high school age and younger will be covered.
4. Students involved in summer research projects, projects in which the student receives a stipend, adult continuing education classes, leagues which include adult participants, and extremely hazardous activities such as mountain climbing are excluded from coverage.

These are only guidelines to help determine eligibility for the program. If you have a camp or clinic that you feel should be covered and does not fall directly under these guidelines please contact System Risk Management and we can determine if the activity can be covered under this policy.

** Also keep in mind, the coverage is not required but encouraged by System Risk Management to avoid the potential of a lawsuit.

3. Policy Coverage Details:

Insurer:	Chubb Insurance Group
Medical Benefits:	$1,000 primary and excess up to $5,000 per participant for medical expenses including;
	$100 per tooth, $300 per dental injury
	$15 per physical therapy visit, maximum five visits

There are some limitations for medical benefits in the policy and they are:

1. For hospital room and board, benefits shall not exceed the hospital's usual charge for its semi-private room accommodations; and
2. For dental treatment, benefits shall not exceed $100 for repair or replacement of each injured tooth (including dental x-rays) and all treatment thereto which was sound and natural at the time of injury and a maximum of $300 for any one injury; and
3. For plastic or cosmetic procedures, benefits shall not exceed $250; and
4. For diathermy, ultrasonic, whirlpool or heat treatments, adjustment, manipulation, massage or any form of physical therapy and or office visit connected therewith, benefits shall be limited to $15.00 for each treatment not to exceed five treatments.

The maximum total medical payments that can be made to a camp participant is $5,000. This $5,000 includes all of the limitations that are discussed above regarding dental, physical therapy, plastic or cosmetic procedures, and the hospital room limitations. The insurance company will pay the reasonable cost for these services actually rendered within one year from the date of the accident up to the $5,000 limit.

Coverage does not apply while any participants are in or on any aircraft.

The other benefits that are covered in addition to the medical expenses are:

(a)		Accidental Loss of Life		$5,000.
(b)		Accidental Loss of Hand or Foot		$2,500.
(c)		Accidental Loss of both Hands or Both Feet		$5,000.
(d)		Accidental Loss of Sight of one Eye		$2,500.
(e)		Accidental Loss of Sight of Both Eyes		$5,000.
(f)		Accidental Loss of Speech or Hearing		$2,500.
(g)		Accidental Loss of Speech and Hearing		$5,000.
(h)		Accidental Loss of One Hand and One Foot		$5,000.
(i)		Accidental Loss of Thumb and Index Finger		$1,250.
(j)		Accidental Loss of One Hand or One Foot and Sight of one Eye		$5,000.

Deductible:	None
Rates:	$2.20 per participant per camp per week regardless of exposure. Daily rate .39/day for 1 to 2 day camps with no overnight stay.
	*See section C under procedures*
Renewal Date:	Annually on January 1
Coverage Provisions:	Coverage is in effect while the participant is attending the camp and is taking part in camp-related activities

4. Procedures:

1. Each campus risk manager should meet with the camps and clinics coordinator annually to discuss the coverage and procedural changes which have occurred. This information should be provided to all potential camps and clinics coverage users such as the program directors.
2. The camps and clinics coordinator or the campus risk manager should receive a copy of the camp or clinic brochure at least two weeks before the camp begins. This allows time to evaluate the eligibility of the camp or clinic. If there is a question regarding eligibility, consult System Risk Management.
3. Seven days of activity constitutes a week. If an event is held only one day per week for several weeks, seven, one day events equals one week of coverage. If an event is held for eight days, two weeks of premium must be paid. If there are camps that are held for only one day the charge is $.39. Camps that are held for two days with no overnight stay involved, the charge will be $.39 per day for a total of $.78. Any camps held for three days or more require a charge of $2.20. If a camp is two days with an overnight stay, the charge is $2.20.

There have been questions from some institutions about using other carriers. This is the only acceptable insurance. Our reasons are: 1. Our policy offers 24 hour coverage. 2. Our policy is primary medical coverage which is the sole reason for having the policy. If the policy is not primary it may then become a liability issue and would fall under our liability coverage under the state of Wisconsin. 3. It allows for an understanding of what is covered by our policy rather than attempting to understand other parties' contracts.

4. The camp and clinic coordinator must send to System Risk Management one list of camp and clinic participants along with the applicable premium by April 10, July 10, October 10, and January 10. Internal record-keeping and accounting of the accumulated premiums will be the responsibility of the camp coordinator during the quarter. A single check for the total premium during the quarter is acceptable.
5. Complete both parts of the Reporting Form and forward to the System Risk Management office with the applicable premium by the four above listed dates.
6. Claims reporting procedure:
1. In the event of an injury, common sense should be used in assuring adequate care is given to the camper. If personal health insurance is available, that may be used in lieu of this policy.
2. Upon injury, the injured camper or his/her parent (and physician if possible) should complete a copy of the attached claim form.
3. The camp director must inform the parent that the claims form must be filed within 90 days of the injury to the following parties with medical bills and the original report sent to:

Karla Buss
AON Risk Services Inc. of Wisconsin
330 East Kilbourn Avenue, Suite 450
Milwaukee, WI 53202-3179

4. If the injury is severe and potentially may result in expenses greater than $5,000, immediately inform System Risk Management in case the injury results in a liability claim.
5. All claims must include the name of the campus where the camp was held. This information must be completed on the claim form by the campus before it is given to the claimant. This is especially important as the frequency and severity of claims increases, since this information helps us determine which institutions and camps are having the problems. The Institution's location code follows.

Institution	Letter	Year	Number
Madison	A	06	001
Milwaukee	B	06	001
Eau Claire	C	06	001
Green Bay	D	06	001
La Crosse	E	06	001
Oshkosh	F	06	001
Parkside	G	06	001
Platteville	H	06	001
River Falls	J	06	001
Stevens Point	K	06	001
Stout	L	06	001
Superior	M	06	001
Whitewater	N	06	001
Colleges	R	06	001
Extension	T	06	001

7. We would recommend the following verbage be used as a photo and or video release on the application that is signed by the participant and/or parent:

I understand that the University may take photographs and or videos of camp participants and activities. I agree that the University of Wisconsin-____________ shall be the owner of and may use such photographs and or videos relating to the promotion of future camps. I relinquish all rights that I may claim in relation to the use of said photographs.

8. If the campuses are going to list that there is accident insurance in their informational materials they need to note that it is limited accident insurance and is primary on the first $1,000 and excess up to $5,000.
9. The Department of Health and Family Services has developed legislative language to govern Health and Educational Camps under Chapter HFS 175. UW System Risk Management has negotiated variances to parts of these requirements that are outlined in Appendix A. The variances were granted based on a collective process between UW System campuses and the Department of Health and Family Services. Changes to these variances or the recommendation of other variances must be cleared with the System RM due to liability concerns. The campus, by written protocol, shall keep available the required list under subsection (2) for each campus and be centrally maintained by the campus to meet the requirements of HFS175. These protocols are to be made available to the licensing authority upon request.

Protocols to include:

• Means of contacting medical authorities in an emergency.
• Medical histories maintained centrally, by each camp director, or the camp health supervisor.
• Medicine protocol for university designated camp staff.
• Emergency procedures.
• Lost camper policy/security.
• Severe weather policy.

 

FORMS

Consent for Medication Administration/Health History Questionnaire
Camps and Clinics Reporting Form (view only)
Premium Calculation Form
Accident Claim Form (view only)
Appendix A

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Updated 01/04/07