Insurance Coverage Policy

 

Potomac State College of WVU Athletic Training Insurance Coverage Policy

Accidents do occur and we attempt to provide our athletes with the very best possible care. Medical bills may be incurred when the athlete is treated for bodily injury due to an accident, whether it be locally, during a road trip, or by a medical vendor in his or her own home area.

One Firm Statement:

The NJCAA discourages any College from providing coverage or paying the bills incurred for expenses related to illnesses or conditions which are not sustained as a direct result of an accident in our intercollegiate sports program. (Pre-existing conditions and non-athletic injuries are not covered.)

Insurance Coverage:

The athletic accident insurance at Potomac State College provides coverage for your son/daughter for accidents while participating in the play or official team practice of intercollegiate sports, including sponsored and authorized team travel.

Claim Procedure:

All medical bills for your son/daughter incurred as the result of an accident in the intercollegiate sports program will be sent directly to your son/daughter or to your home address. In some cases the College may receive a copy of the bill, but in no case will Potomac State College be the primary place for the bill incurred to be sent.

 

A

Submit the bills incurred to your family, employer group insurance, or plan administrator 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 twenty-three.

B

If there remains a balance after your personal health insurance has contributed towards the claim, send the explanation of benefits from the insurance company and a copy of the itemized bills incurred to the college's Athletic Training Department.

C

If you receive a letter of denial from your personal health insurance, send the letter of denial and a copy of the itemized bills incurred to the College's Athletic Training Department. If no coverage is available, a letter from your employer with verification will be necessary.

D

If the bills incurred are not paid by your personal health insurance, the claim will be sent from the Athletics Department to our insurance carrier office for processing. If they need any additional information, please cooperate with them and they will process the claim in the least amount of time. It is in your best interest to have the claim settled promptly since all of the bills incurred are in your name.

PLEASE NOTE: If the primary family coverage is through an HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization) you must follow the proper procedures required by your plan in order for the College's insurance to satisfactorily complete its portion of the claim. This is especially important if your plan requires pre-authorization to have your son/daughter treated if out of your plan's service area.   If you have any questions concerning these procedures, please contact the Potomac State College Athletic Training Department at (304) 788-6880.