Medical Insurance Requirements

Primary Insurance Coverage

Student-athletes must be covered by a primary medical insurance plan to participate in intercollegiate athletics at DePauw.

If you do not have primary medical insurance coverage, you will need to purchase coverage prior to starting your intercollegiate sport participation at DePauw. Many insurance companies exclude injuries from athletic participation. The policy you purchase must not exclude injuries from participation in intercollegiate athletics. Currently, we are aware of a Cigna medical plan through Collegiate Insurance Associates (www.collegiateinsurance.com) that will cover intercollegiate athletic injuries as well as general medical injuries and illnesses. As we become aware of other insurance companies who offer this type of coverage, we will add their contact information to this page. No student-athlete will be allowed to participate in any organized team activity until they are covered for athletic participation by a primary medical insurance plan.

Secondary Insurance Coverage

The secondary athletic accident insurance at DePauw University provides coverage for student-athletes who are injured in an accident while a participant during in-season play or in-season practice of intercollegiate sports, including sponsored and authorized team travel. Injuries during official and coach supervised non-traditional season practices are also covered. Injuries from conditioning and strength training activities which are not both a supervised and official team activity are not covered even during the traditional or non-traditional seasons. This coverage is secondary to the student-athlete’s primary group insurance or plan, which must contribute its maximum benefit, before the DePauw secondary policy has any liability. If the claim is otherwise payable and the deductible of the student’s primary insurance has not been met, this coverage will apply. For the 2006-2007 school year, the secondary coverage has a deductible of $1000 and a medical maximum of $75,000 per claim. Coverage is underwritten by the Guarantee Trust Life Insurance Co. of Glenview, IL. This policy also contains a $1000 Accidental Death Benefit and a $5000 Dismemberment Schedule.

Secondary Insurance Claim Procedure for Parent or Guardian

All medical bills for your son/daughter resulting from an accident in the intercollegiate sports program should be sent directly to your son/daughter or to your home address, unless DePauw University has instructed the medical vendors otherwise. In some cases the athletic office may get a copy of the bill, but in no case will the athletic office be the primary place for the bill incurred to be sent. Please follow the following steps:

Submit the bills incurred to your family, employer group coverage or plan first. They will do one of two things:
1. Honor the claim and pay all or a portion of the bills incurred.
2. Not honor the claim and send you a letter of denial. An example might be that your son/daughter is no longer part of your group policy after attaining the age of 23.
If there remains a balance after your family, employer group insurance or plan has contributed towards the claim:
1. You must complete and submit a Student-Athlete Claim Information Form. This form can be accessed from the link above or your son or daughter may request it from their DePauw staff athletic trainer.
2. Send all claim sheets (EOB - Explanation of Benefits) from your insurance company and a copy of the itemized bills incurred to the DePauw University Athletic Office, attention to: the staff athletic trainer working with your son or daughter. If you receive a letter of denial from your family, employer group insurance or plan administrator, send the letter of denial and a copy of the bills incurred to the DePauw University Athletic Department;
If the bills incurred are not paid by your family, employer group insurance or plan, the claim will be sent from our athletic office to Student Athletic Protection, Inc. which is in Kalamazoo, Michigan, for processing. If they need any additional information, they will contact you. Please cooperate with them and they will process the claim in the least possible amount of time. It is in your best interest to have the claim settled promptly since all of the medical bills incurred are in your son’s/daughter’s name.
Payment of claims by Student Athletic Protection, Inc. is made at the 90th percentile. This means that the maximum benefit payable is the amount that 90% of the physicians in the geographic area accept as payment in full for the services rendered. This may result in some unpaid balances.
HMO or PPO. For parents to have payable coverage on their son/daughter, when a member of these organizations, proper procedures outlined by that plan must be followed and authorized medical vendors from the list provided to you by your HMO/PPO must be used. The DePauw University coverage through Student Athletic Protection, Inc. is EXCESS coverage and does contain an exclusion for those bills incurred that were "payable" by the family insurance or plan. If you choose not to use the authorized medical vendors of your plan or you do not follow your plans procedures, you should be aware that Student Athletic Protection, Inc. will not be able to pay the bills incurred that would have been honored had you used the proper vendors or procedures.
Accidents which occur during participation in an intercollegiate sport at DePauw are covered by the secondary insurance. An Accident is defined as an unexpected, sudden and definable event, which is the direct cause of a bodily injury, independent of any illness, prior injury or congenital predisposition. Conditions which result from participation in sports do not necessarily constitute an accident but are considered under the policy.
Treatment by a licensed practitioner of medicine must begin within 180 days of the accident.
Only expenses incurred within 52 weeks of the original date of the accident are considered for the first $15,000.00 of any claim. When claims exceed $15,000.00, to a maximum of $75,000.00 ($60,000.00 of coverage), coverage is provided for 208 weeks from the original date of the accident.
The following are policy exclusions:
1. Suicide or a suicide attempt while sane; or self-destruction or an attempt to self-destroy while insane.
2. Riding in a vehicle or device for aerial navigation, except as a passenger in a scheduled aircraft used for the transportation of passengers.
3. Service provided by the policy Holder’s infirmary employees or salaried physician.
4. Declared or undeclared war
5. Expense covered by worker's compensation or an occupational disease law.
6. Loss covered by other valid and collectable insurance or plan.
7. Hernia, in any form.
8. Sickness or disease, in any form.
9. Fighting, unless an innocent victim.
10. Expense incurred for the use of orthotics unless used exclusively to promote healing.
11. Use of electric, biomechanical devices (bone growth simulation).
12. Non-prescription drugs.

Privacy Policy

This notice applies to insurance products underwritten, or administered by, the Guarantee Trust Life Insurance Company of Glenview, Illinois. Information is the key to our ability to provide you with world class service. We want to keep your trust so we are committed to protecting and maintaining the privacy of your information in our possession, regardless of whether you are a customer, applicant, insured, or former insured.

Collection and Use of Information. We may collect information about your health including mental, dental and general health, substance abuse treatment and sexually transmitted diseases, including HIV and AIDS. We may also collect financial information relevant to your insurance, such as your income, other sources of benefits, or other types of work or job information. This information will be used for business purposes such as assisting you in your decision to purchase insurance, underwriting your application for insurance, and investigating your claim for benefits. We will only collect information from sources other than you as permitted by law or with your written authorization. This information will be used by authorized company personnel solely for these purposes, and it may be integrated into our databases for statistical and audit purposes.

Disclosure of Information. With some exceptions, we will not disclose your protected information without your written authorization. There are circumstances when we will disclose protected information related to medical underwriting or a claims investigation without your authorization to third parties or affiliates assisting us with medical underwriting or claim management, as permitted by law. We will also disclose protected information to third parties without your authorization as required by law such as in the case of subpoenas and mandated governmental disclosures. Protected information means any personally identifiable information including financial information, employment related information, genetic information, and diagnosis, treatment, and evaluation of any past and current medical or other conditions, including laboratory tests or examinations performed.

Access to and Correction of Information. You have a right to see and obtain copies of protected information in your file by submitting a written request to us. Within 30 business days of our receipt of your request you may have access to information about you which is reasonably locatable and retrievable. This right does not extend to information with relates to and is collected in reasonable anticipation of a civil or criminal proceeding, suspected fraud, or which we are otherwise permitted to withhold.

If the information is incorrect you have a right to have it corrected or amended. You may request correction or amendment b sending us a written request explaining why you believe the information is incorrect. Within 30 business days of our receipt of your request we will tell you if, in fact, we complied with your request. If we do not agree with you, we will notify you of our refusal, give you our reasons, and give you the opportunity to file a concise statement of dispute with us. Your statement will be sent with any future disclosure of the information that we make to others.

You may also submit a written request for the identity of persons or companies to whom we have disclosed protected information. To the extent we are required to maintain a record of disclosures, we will provide you with the names and addresses within 30 business days of the receipt of your request.

To request any of the information mentioned in this Privacy Notice, or if you have questions about our privacy policies, please contact:

Compliance Office
Guarantee Trust Life Insurance Company
1217 Milwaukee Avenue
Glenview, Illinois 60025

NCAA Catastrophic Insurance Coverage

The NCAA provides catastrophic athletics injury insurance coverage for all active member institutions. This policy has a $75,000 deductible. It covers student-athletes who are catastrophically injured while participating in a covered intercollegiate athletic activity (subject to all policy terms and conditions). This coverage does not qualify as the basic coverage required for participation in athletics at DePauw University. It is supplemental coverage in the event of a catastrophic injury. A complete policy brochure appears on the NCAA online website, www.ncaa.org. Look for the "insurance" category on the homepage.