2005/05/11 Council Agenda Packet

Participant accident medical coverage is provided only for eligible participants as defined in the policy and not for ' any other persons or additional insureds who are not also eligible participants.This policy only provides coverage , for accidental bodily injury suffered during APBA Sanctioned Events. &SPA WEIMIER ;ASIC s c1 t 1TS 1 BILA BION-MDt IM =A5tC €NEFtT% PERSONAL WATERCRAFT PERSONAL WATERCRAFT *Accidental Death and * Accidental Death and - Dismemberment $1,000 Dismemberment Not Available *Participant Accident * Participant Accident Medical Expense $20,000- Medical Expense Not Available ALL OTHER CATEGORIES ALL OTHER CATEGORIES *Accidental Death and * Accidental Death and Dismemberment $10,000 Dismemberment Not Available *Participant Accident * Participant Accident Medical Expense $20,000** Medical Expense $1,000' '`$2,000 deductible regardless of other valid and collectible insurance. ":$250 deductible for those having no other valid and collectible insurance (and no separate deductible for those having other collectible insurance). ACCIlHEt TAI ®EATIR Aq® ®tS".Emma,;I - K s`l S: The full benefit is paid for accidental loss of life,two limbs,both eyes.One half the benefit amount is paid for loss of one limb or one eye.Benefits are payable up to one year from the date of the accident. DAMTICI®AIfl ACCI®tlfl CxC $S vEDICAI E)1®I13SE - !`iBORIS AMP NON-WiI;MSEISS:If,as a result of accidental bodily injury,the participant requires: 1) treatment or services of a legally qualified physician or surgeon or a licensed or graduate nurse;2)x-ray examination;3) confinement in a hospital;or 4) the use of an ambulance for transportation from the location of the covered event to the location where first treatment by a qualified physician or surgeon is administered,the policy will pay the reasonable costs of such services actually rendered within one year from the date of accident that are in excess of the applicable deduct- ible amount but not more than the applicable amount of benefit shown above. PENEFlT LIMITATIONS AND CONDITIONS: Hospital room and board payment will not exceed the semi-private room and board charge. MEttiCAI CxCrc$SlOfs: r: Coverage does not apply for medical expenses incurred due to a pre-existing condition,which means any injury that the participant received medical treatment for during the 12-month period immediately preceding the date of covered accident. GOMM I)bCWSIOt S ltCl 1 1. RUT An LOT El N ITI I TO: Loss resulting from: (1) driving while intoxicated; (2) assault and battery; (3j committing a felony; (4) illness, disease,and bacterial infection except bacterial infection of an accidental bodily injury; (5) the operation or €. use (including demonstration,practicing,acceleration,testing,or racing of any description) of any jet pro- pelled,rocket propelled,or nuclear powered vehicle or by means of jet or rocket propulsion or nuclear power for locomotion,unless specifically endorsed onto the policy; (6) participating in special events,thrill shows, entertainment, (7) serving as a member of the crew or learning to operate an aircraft. 32