Sports Accident Insurance
DO NOT WAIT FOR MEDICAL BILLS TO ARRIVE! NO MEDICAL BILLS SHOULD BE SENT TO THE USA TAEKWONDO OFFICE. ALL MEDICAL BILLS SHOULD BE SENT TO THE INSURANCE COMPANY UPON SUBMITTING A CLAIM FORM.
An Athlete, Referee, Coach or Life Member of USA Taekwondo is eligible for secondary medical coverage. Insurance covering the member obtained through work, parents or individual medical plans are held as the primary payer. The coverage provided by USA Taekwondo is secondary insurance protection. If there is no primary insurance, this policy becomes the primary payer after verification.
The following claim criteria apply:
- You must be a USA Taekwondo registered Athlete, Referee, Coach or Life Member BEFORE the injury.
- Place of covered injury:
- Injury has taken place at a regularly scheduled supervised sanctioned practice. The club must be a registered member of USA Taekwondo.
- Injury has taken place at a USA Taekwondo sanctioned event.
- Medical benefits payable are limited to one year from the date of injury.
BENEFITS: Death and dismemberment: $5,000.00.
Medical Expenses: $5,000.00 excess to other insurance; 80/20 on balance due.
Dental expenses: $250.00 per tooth. $500.00 limit per incident
DEDUCTIBLE: $1,000.00 per claim.
TO FILE A CLAIM CALL THE USAT OFFICE (719-866-4632) TO HAVE THE INSURANCE PAPERS SENT TO YOU. THEN SEND THE COMPLETED PAPERWORK TO:
BOLLINGER SPORTS CLAIMS
c/o Health Special Risk, Inc.
HSR Plaza II
4100 Medical Parkway
Carrollton, TX 75007
- Call within 30 days of the injury.
- Please have the exact date of injury and place of injury (sanctioned tournament or practice) available.