National, Provincial and Regional Sport Organizations
Coverage for practices, games, team travel. One plan covers all participants, managers, coaches, executives, and field officials throughout the entire season.
For each separate accident the Plan pays:
Dental - As Negotiated
For dental treatment resulting from injury to sound natural teeth and completed within 52 weeks of the accident.
Accident Reimbursement - Up To $10,000
For costs not insured by Provincial Medical Plan, including crutches, splints, medical braces, emergency ambulance, excess physiotherapy, prescription drugs for the injury, etc., incurred within 52 weeks of the accident.
Principal Sum Benefits - Up To $20,000
In the event of Loss of Use of Hands, Arms, or Legs: Quadriplegia, Paraplegia, Hemiplegia; Loss of Speech and Hearing or Dismemberment occurring within 52 weeks of the accident (benefit as scheduled).
Accidental Death - $10,000
In the event of accidental death occurring within 52 weeks of the accident:
– Fracture Indemnity Benefit
Up to $500 paid for fracture of bone or bones (including chip and linear fractures).
– Rehabilitation Indemnity Benefit
Up to $3,000 for special occupational training required due to an accident.
– Tuition Fees Reimbursement
Up to $2,000 for tutorial services made necessary by post-accident confinement.
– Emergency Transportation Benefit
Up to $50 for transportation from arena or field to nearest hospital or doctorÕs office.
– Eyeglasses and Contact Lenses Expense
Up to $100 for repair or replacement of eyeglasses or contact lenses when damage results from an accident which required the Insured Person to receive treatment by a physician or dentist.
Limitations and Exclusions
No benefit shall be payable for any loss resulting directly or indirectly, wholly or partially from any of the following causes:
a. purchase, repair, or replacement of eyeglasses, contact lenses or prescriptions thereof (except as otherwise provided);
b. sickness or disease either as a cause or effect;
c. any intentionally self-inflicted injury;
d. any of the hazards of aviation except while riding as a fare paying passenger in a licensed aircraft operating on a regular scheduled service between airports;
e. declared or undeclared war, invasion or civil war, or any act thereof;
f. service in the armed forces of any country;
g. any benefits that are available under any Government Health Insurance Plan, whether enrolled in such a plan or not;
h. dental and/or other expense benefits shall be for the excess of expenses payable under any other benefit plan or policy;
i. an insured person who is not a resident of any Canadian province that has enacted Medical Care Legislation unless stated specifically in this policy.
This insurance is subject to and shall not contravene any Federal or Provincial statutory requirements with respect to hospital or medical plans, nor shall it duplicate any benefits which are provided under any Federal or Provincial Hospital or Medical Plans, or any other policy providing a reimbursement indemnity.
Athletic Accident Claim Procedures
– It is the responsibility of the Insured to obtain an athletic accident claim form from the association or club executive.
– The Insured or parent/guardian shall fully complete the claim form.
– For reimbursement of dental or medical claims, the Insured shall have the attending dentist or physician complete the applicable form.
– The Insured shall submit the completed claim form to the association or club executive for their signed certification.
– Proof of claim, including a report from the attending dentist or doctor, must be submitted within 90 days of the date of the accident.
– Completed claim form and all insured accounts for payment should be forwarded without delay to: