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DHC
Insurance offers a
comprehensive program
developed to
specifically cover the
inherent risks involved
for today's adult groups.
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 adult group
activities.
The Accident Medical
Coverage
Pays
the medical bills of an
injured participant or
staff member
Who
Is Covered
All members of the
Policyholder
Covered
Activity
All activities sponsored
and supervised by the
Policyholder, including
travel with a group in
connection with such
activities.
Medical
Expense Benefit
If the Insured Person
incurs eligible expenses
as the result of a
covered injury, directly
and independently of all
other causes, the
Company will pay the
charges incurred for
such expense within 1
year, beginning on the
date of accident.
Payment will be made for
eligible expenses in
excess of the applicable
Deductible Amount, not
to exceed the Maximum
Medical Benefit.
The first such expense
must be incurred within
60 days after the date
of the accident.
"Eligible expense' means
charges for the
following necessary
treatment and service,
not to exceed
the usual and customary
charges in the area
where provided.
-
Medical and surgical
care by a physician
-
Radiology (X-rays)
-
Prescription drugs
and medicines
-
Dental treatment of
sound natural teeth
-
Hospital care and
service in
semi-private
accommodations, or
as an outpatient
-
Ambulance service
from the scene of
the accident to the
nearest hospital
-
Orthopedic
appliances necessary
to promote healing
If
Excess coverage is
selected, this Plan does
not cover treatment or
service for which
benefits are payable or
service is available
under any other
insurance or medical
service plan available
to the Insured Person.
Primary coverage pays
benefits under the Plan
without offset for other
insurance (except
Workers Compensation).
Accidental Death And
Dismemberment Benefit
If a covered injury
results in any of the
losses specified below
within 1 year (not
applicable in
Pennsylvania) 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
-
Full Principal Sum
for loss of sight of
both eyes
-
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
"Member" means hand,
foot, or eye. Loss of
hand or foot means
complete severance above
the wrist or
ankle joint. Loss of eye
means the total,
permanent loss of sight.
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.
Exclusions And
Limitations
This Plan does not cover
any loss to or resulting
from:
-
intentionally
self-inflicted
Injury, suicide
while sane or insane
or any attempt
thereat (in Missouri
this applies only
while sane);
-
voluntary
self-administration
of any drug or
chemical substance
not prescribed by,
and taken according
to the directions of
the Insured Person's
Physician.
-
participation in a
riot or
insurrection;
-
an
act of declared or
undeclared war;
-
active duty service
in any Armed Forces
of any country, and,
in such event, the
prorata unearned
premium will be
returned upon proof
of service. This
does not include
Reserve or National
Guard
active duty or
training unless it
extends beyond 31
days;
-
parachuting, except
for self
preservation;
-
bungee jumping,
flight in an
ultralight aircraft,
hang gliding;
-
sickness, disease,
bodily or mental
infirmity or medical
or surgical
treatment thereof,
bacterial infection,
regardless of how
contracted. This
does not exclude
bacterial infection
that is the natural
and foreseeable
result of an Injury
or accidental food
poisoning;
-
services or
treatment rendered
by a(n) Physician,
Nurse or any other
person who is:
-
flight in an
Aircraft, except as
a fare-paying
passenger;
-
dental treatment,
except as otherwise
provided, and only
when Injury occurs
to sound natural
teeth:
-
any
loss for which
benefits are paid
under state or
federal worker�s
compensation,
employers liability,
or occupational
disease law;
-
treatment in any
Veteran
Administration or
Federal Hospital,
except if there is a
legal obligation to
pay;
-
cosmetic surgery,
except for
reconstructive
surgery due to a
covered injury;
-
charges which the
Insured Person would
not have to pay if
He did not have
insurance;
-
eyeglasses, contact
lenses, hearing
aids;
-
charges which are in
excess of Usual,
Customary and
Reasonable charges.
Premium Rates
Minimum Premium: $200.00.
Please call (888)
288-1829 for a quote.
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