| What Parents Should Know About Little League
Insurance |
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WARNING: Protective equipment cannot
prevent all injuries a player might receive while participating in Baseball /
Softball.
The Little League Insurance Program is designed to afford
protection to all participants at the most economical cost to the local league.
The Little League Player Accident Policy is an excess coverage, accident only
plan, to be used as a supplement to other insurance carried under a family
policy or insurance provided by parent’s employer. If there is no primary
coverage, Little League insurance will provide benefits for eligible charges,
up to Usual and Customary allowances for your area, after a $50.00 deductible
per claim, up to the maximum stated benefits.
This plan makes it
possible to offer exceptional, affordable protection with assurance to parents
that adequate coverage is in force for all chartered and insured Little League
approved programs and events.
If your child sustains a covered injury
while taking part in a scheduled Little League Baseball or Softball game or
practice, here is how the insurance works:
- The Little League Baseball and Softball accident
notification form must be completed by parents (if the claimant is under 19
years of age) and a league official and forwarded directly to Little League
Headquarters within 20 days after the accident. A photocopy of the form should
be made and kept by the parent/claimant. Initial medical/dental treatment must
be rendered within 30 days of the Little League accident.
- Itemized bills, including description of service,
date of service, procedure and diagnosis codes for medical services/ supplies
and/or other documentation related to a claim for benefits are to be provided
within 90 days after the accident. In no event shall such proof be furnished
later than 12 months from the date the initial medical expense was
incurred
- When other insurance is present, parents or
claimant must forward copies of the Explanation of Benefits or Notice/ Letter
of Denial for each charge directly to Little League Headquarters, even if the
charges do not exceed the deductible of the primary insurance program
- Policy provides benefits for eligible medical
expenses incurred within 52 weeks of the accident, subject to Excess Coverage
and Exclusion provisions of the plan
- Limited deferred medical/dental benefits may be
available for necessary treatment after the 52-week time limit when:
- Deferred medical benefits apply when necessary
treatment requiring the removal of a pin /plate, applied to transfix a bone in
the year of injury, or scar tissue removal, after the 52-week time limit is
required. The Company will pay the Reasonable Expense incurred, subject to the
Policy’s maximum limit of $100,000 for any one injury to any one Insured.
However, in no event will any benefit be paid under this provision for any
expenses incurred more than 24 months from the date the injury was sustained.
- If the Insured incurs Injury, to sound, natural
teeth and Necessary Treatment requires treatment for that Injury be postponed
to a date more than 52 weeks after the injury due to, but not limited to, the
physiological changes of a growing child, the Company will pay the lesser of:
1. A maximum of $1,500 or 2. Reasonable Expenses incurred for the deferred
dental treatment.
Reasonable Expenses incurred for deferred dental
treatment are only covered if they are incurred on or before the Insured’s
23rd birthday. Reasonable Expenses incurred for deferred root canal therapy are
only covered if they are incurred within 104 weeks after the date the Injury
occurs.
No payment will be made for deferred treatment unless the
Physician submits written certification, within 52 weeks after the accident,
that the treatment must be postponed for the above stated reasons.
Benefits are payable subject to the Excess Coverage and the Exclusions
provisions of the Policy
We hope this brief summary has been helpful
in a better understanding of an important aspect of the operation of the Little
League endorsed insurance program. |
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