Cheerleaders, Dance Teams and Mascots Catastrophic Accident Policy
| Insurer: |
National Union Fire Insurance Company of Pittsburgh, PA |
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| Policy Number: |
SRG 0009117187 |
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| Benefit: |
Accidental Death and Dismemberment |
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Accidental Medical/Dental Expense |
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| Description of Class: |
Class 1: All Student Athletes, Trainers, Managers and Coaches of the Policyholder. |
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| Covered Sports: |
Cheerleaders, Mascots & Dance participants |
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| Description of Activity: |
Coverage is provided for all cheerleaders, dance team members, and mascots, for all campuses of the University of Wisconsin State College System while participating as a member of a Policyholder team during spirit competitions, practice, alumni events, charity events, or any activity not related to a specific sport event. |
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Definition of Covered Injury: |
Injury: Means bodily injury caused by an accident that : (1) occurs while this Policy is in force as to the person whose injury is the basis of claim; (2) occurs while such person is participating in a Covered Activity; and (3) results directly and independently of all other causes in a covered loss. |
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| How to File a Claim: |
Written notice of claim must be given to the Company within 20 days after an Insured’s loss, or as soon thereafter as reasonably possible. Notice given by or on behalf of the claimant to the Company at American International Companies, Accident and Health Claims Division, P. O. Box 15701, Wilmington, DE 19850-5701, with information sufficient to identify the Insured, is deemed notice to the Company.
The Company will send claim forms to the claimant upon receipt of a written notice of a claim. The notice should include the Insured’s name, the Policyholder’s name, the Policy number, written proof covering the occurrence, and the character and extent of the loss for which claim is made. |
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| Benefit: |
$10,000 Class 1 |
| Accidental Loss of: |
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Percent of Loss of Life Benefit Amount |
| Life |
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100% |
| Both Hands, or Both Feet |
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100% |
| Sight of Both Eyes |
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100% |
| One Hand and One Foot |
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100% |
| One Hand and the Sight of One Eye |
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100% |
| One Foot and Sight of One Eye |
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100% |
| One Hand, or One Foot |
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50% |
| The Sight of One Eye |
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50% |
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| Excess Accidental Medical Expense: |
Class 1-Covered Activities |
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| $5,000,000: Maximum Amount (10 year Benefit Period) |
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$75,000: Deductible per Accident- must be met within 2 years of the Accident |
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Included: Dental Maximum |
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| Catastrophe Cash: |
$500,000: $100,000 Lump Sum, $20,000 for 20 years |
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| Aggregate Limit of Insurance: |
$500,000 |
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| Major Exclusions: |
Aircraft Owned, Leased or Operated |
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Suicide or Intentional Injury |
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Aircraft Pilot or Crew |
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Disease or Illness |
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War |
Back to RM Manual Table of Contents
Revised 6/8/10
