The Marion County School Board strives to provide a safe learning environment for all students. Sports accidents that happen during practice or play are not usually the fault of the school. Schools are not required by law to purchase coverage for accidental injuries. As a service, the School District purchases a basic sports accident insurance policy to assist families with some of the medical expenses that may result from a school sports related injury. This coverage will not pay for 100% of all charges incurred as a result of an accidental injury. It is the Parent responsibility to pay for any expenses not covered by the school insurance plan or any other insurance plan.
For a listing of the policy benefits,terms,provisions and exclusions Click Here for a Summary of Insurance.
HOW TO FILE A CLAIM FOR INTERSCHOLASTIC SCHOOL SPORTS RELATED ACCIDENTS
If your student has suffered a sports related accident please follow these steps:
1) File your claim with your primary insurance first and stay within your primary insurance network.
2) Obtain a claim form from the Coach or Athletic Director's Office. Instructions appear on the claim form. The Coach must completely fill in the school area, PART B, sign and date the form. It is the parent’s responsibility to make sure that the completed claim form is submitted to School Insurance of Florida’s office within 90 days after the date of the accident. Claims will not be paid if received after 90 days from the accident date.
3) Please refer to our list of preferred providers when seeking treatment for sports related injuries.
PLEASE REMEMBER: If a student has any primary insurance (HMO, PPO, private insurance, group coverage through parents employment, Blue Cross, Tri-care, Champva, etc...) they should stay in that primary insurance network even if they have a deductible. They must file a claim with any primary insurance coverage first in order to be eligible for the student accident insurance even if they have a deductible. If they do not stay within their primary network, School Insurance of Florida may reduce benefits payable as if they did stay inside the primary network.
If there is no primary insurance coverage, students may seek medical treatment from any licensed hospital or licensed physician and be eligible to receive the stated school policy benefits that are outlined in the enrollment application or summary of insurance. School Insurance of Florida has set up a Preferred Provider Network. These providers of service have agreed, in most cases, not all cases, to accept the stated policy benefits as outlined on the summary of insurance. It is the parent or student's responsibility to ask the Doctor or provider of service if they are participating in the network and what out of pocket expense they may be held accountable for paying. Please refer to the top part of Summary of Insurance for a summary listing of policy benefits, limitations and exclusions. The Insurance Company cannot regulate how much doctors or other providers of service charge. Doctors and Hospitals are allowed to establish and charge their own fee levels. Doctors and Hospitals may charge more than what the School Insurance of Florida accident insurance policy pays. The insurance benefits will be paid based upon the stated policy provisions. Please retain a Summary of Insurance for your records. If you have any questions please contact School Insurance of Florida. 1-800-432-6915. Please do not contact the school. Schools do not keep claim records or process claims. Contact the insurance agency, School Insurance of Florida.
FREQUENTLY ASKED QUESTIONS:
♦ Who is eligible for Marion County School District Athletic and Special Activities school insurance policy benefits?
Marion County Public high school and middle school students that are members of school sponsored interscholastic sports teams and Marion County School Board approved special activities. Covered group activities must be scheduled, sponsored, funded and directly supervised by a Marion County School Official. The cost of the athletic and special activity protection plan is paid for by the Marion County School Board. Regular school classes and classroom activities are not covered under this policy. However, additional insurance can be purchased by parents to cover other school activities. Click on the "Excess Student Accident Insurance Overview" link to view these optional insurance plans; Or, click here to purchase On-line now
♦ Does this mean that the school will pay for all medical expenses due to a school related sports injury?
NO! The insurance policy was purchased by the school as a public service to help families of injured students pay for some of the medical bills related to school injuries resulting from an approved interscholastic sport or special extra- curricular activity. Florida schools are not required by law to purchase medical insurance for students. Accidents that happen at school are generally not the fault of the school. The insurance plan purchased by the school pays limited benefits based on the policy schedule. Doctors and hospitals are free to set and charge their own fees. Medical service charges may be more than the insurance benefits available from the school policy. The school cannot accept responsibility for paying medical bills for students.
♦ What does the Athletic and Special Activities school insurance plan cover?
A detailed description of the school policy benefits, limitations, and exclusions can be downloaded from this website or a brochure can be obtained from the school Athletic Office. Click on the "Excess Student Accident Insurance Overview" link above to view details concerning specific policy benefits, terms and limitations. This summary also pertains to special activities approved by Marion County Schools. IMPORTANT NOTE: Regular class time, summer school, general class room activities, club sports, summer camp sports, sports leagues and sports that are not exclusively sponsored and funded by the Marion County School District are not covered.
♦ Can I receive an insurance identification card for my child?
Individual Insurance Identification Cards are not available for Interscholastic Sports. If you choose to purchase the School Time or 24 Hour insurance by mail, you would need to send a self-address, stamped envelope, so we may send the insurance card. If you purchase the insurance online, you may download and print your insurance card from your online account.
♦ Can I enroll my child in Extended Coverage plans to cover other school accidents and accidents at home, on the weekends, vacations and the summer months when school is not in session?
Yes! Obtain an enrollment brochure from the school or download the enrollment brochure from this website and mail the enrollment brochure to School Insurance of Florida, along with your premium payment for the Extended Coverage Option of your choice. Click under Important Links above the "Excess Student Accident Insurance Overview" link for more information; or, you may enroll online. Click Here to Purchase Now.
♦ Are accidental injuries occurring during school football practice and games covered?
Football injuries that occur while a student is practicing for or competing in Marion County Public School sports that are scheduled, fully funded, sponsored and supervised by the Marion County School Board are eligible for policy benefits. Injuries while participating in Club sports, summer camp sports, sports leagues and sports that are not exclusively sponsored and funded by the Marion County School District are not covered.
♦ If a student is injured during a school sports practice or game or covered special activity, will the school insurance plan cover all medical expenses, including visits to the doctor and hospital?
The school insurance policy will not pay for 100% of all medical expenses due to the limits of the policy as described in the benefit insurance summary. The insurance company does not have control over the amounts charged by doctors, hospitals and other medical service providers. The payment of benefits that you will receive from the school insurance policy will be based on the policy limits that are stated in the school insurance policy. Specific benefits, policy limits, terms and provisions are explained in the school insurance brochure. For a more complete description of coverage, please click on “Excess Student Accident Insurance Overview”.
♦ If my son or daughter is injured in a Marion County school sport, do I have to take them to a specific hospital or doctor to receive benefits under the school insurance policy?
Marion County Schools has developed a “Participating Interscholastic Sports Provider Network”. Participating doctors, clinics and other medical providers have agreed to accept the school insurance policy benefits as full settlement for their fees for some services, not all, services. However, if you choose to use a doctor, clinic or hospital outside the “Participating Provider Network” of area hospitals and doctors, you could be billed for expenses not covered by the Marion School’s insurance policy. Please be sure to ask your doctor, clinic or hospital if they are Marion County School District Participating Providers and what, if any, charges you will be responsible for paying.
♦ How do I file a claim?
Please follow the instructions on “How to file a Claim” above. Please be sure to forward the completed claim form to School Insurance of Florida no later than 90 days after the date of accident to be eligible for policy benefits. If the student had an injury not related to interscholastic sports and you purchased the optional coverage, please complete Part A of the claim form and mail to School Insurance of Florida.
♦ Who do we contact for answers regarding claims or coverage?
DO NOT CALL THE SCHOOL OFFICE ABOUT THE STATUS OF A CLAIM PAYMENT OR TO ASK QUESTIONS ABOUT COVERAGE! The school does not process claims or keep records regarding claims. All claims are processed by School Insurance of Florida's claim office. Therefore, contact SCHOOL INSURANCE OF FLORIDA to obtain prompt answers to claim or coverage questions. School Insurance of Florida P. O. Box 784268, Winter Garden, Florida 34778-4268. Phone: 1-800-432-6915 Fax: 407-798-0296. Email: email@example.com
The questions and answers stated above are intended to provide a general, brief explanation of the school student accident insurance policy. The policy summary in this website contains a more detailed summary of provisions and terms. The Marion County School District will receive a master policy that contains all terms and provisions from which all claims benefits will be determined. The insurance policy contains specific definitions and terms that may not be included in this website and are not fully explained by the school. For answers to more specific questions, please contact School Insurance of Florida, P.O. Box 784268, Winter Garden, Florida 34778-4268. Phone 800-432-6915.
FLORIDA LAW requires us to inform you that: "Any person who knowingly and with intent to injure, defraud or deceive any insurance company, files a statement of claim containing any false, incomplete or misleading information is guilty of a felony of the third degree."When filing a claim for school policy benefits, parents must disclose all other possible sources of primary insurance on the claim form. Failure to provide true and accurate information may jeopardize your rights to receive benefits from the school policy.