Program Management Program Trip/Event Insurance Policy Number: C.E.S.P. 6-2 Date Revised: 4-23-2001 Supersedes: 8-19-1999

Summary: Provides a trip/event insurance policy for Extension program participants.

I. Responsibility for Insurance

4-H clubs are not required to have insurance for every one of their club meetings, but it is highly recommended for club activities where there is a high risk for injury. All county events should be insured. The state office will insure the district, state, and national events. The Quick Reference Guide contains a column which gives insurance information whether the coverage is the responsibility of the club or county or the state.

A. Club Events

When it is deemed necessary, it is the responsibility of the 4-H Club to arrange for and purchase insurance from 4-H club funds for a club activity to cover medical expenses, within limits, for accidental bodily injuries that may occur en route to, from, or during a club activity. Special activity coverage is extended to enrolled 4-H members, guests, adult volunteers and parents. The club may want to consider an annual "blanket coverage" policy for each enrolled 4-H club member, but this policy does not cover youth under age 5.

B. County Events

It is the responsibility of the county Extension faculty to arrange for and purchase insurance from county 4-H funds for county wide 4-H events to cover medical expenses, within limits, for accidental bodily injuries that may occur en route to, from, or during the county 4-H event. Special activity coverage is extended to enrolled 4-H members, guests, adult volunteers and parents. The county may want to consider an annual "blanket coverage" policy for each enrolled 4-H club member, but this policy does not cover youth under age 5.

Extension faculty and staff should not be included in this policy since they are covered under a separate employee policy.

C. District and State Events

The 4-H Events Coordinator will prepare a list of district, state, and national 4-H events to be covered by insurance purchased through the Arkansas 4-H Foundation from the specific event fees. See the Quick Reference Guide.

Some statewide "special events" which are not conducted by state specialists should have county coverage for participation. (For example, the Arkansas Flower & Garden Show.)

II. Insurance Company

American Income Life is the preferred company for insurance of District and State events because of past favorable experience with prompt claim processing, and their familiarity with Extension activities. Their "option 3", which is selected overage, is $0.23/day/person (all non-Extension employees) for the maximum coverage available. Claims for regular 4-H events are limited to $3,000 per injury. Special limits apply for horse events and winter sports events. See the policy for these limits.

Annual "blanket coverage" for club or county events is available but is limited to enrolled 4-H members, age 5-19, only. It is the parent's responsibility to provide health/medical insurance for their child; this is a supplemental policy only.

III. Process for Coverage

A. Activities Coverage for Accident or Illness

Before you leave: To guarantee coverage an application must bear a postmark date at least one day prior to the effective date. If this is not possible, confirm your application for coverage prior to departure by telephone to the Special Risk Division at 317-849-5545, 8:30 a.m.-5:00 p.m., Monday-Friday. FAX: 317-849-2793. (24 Hours). The application form is in the brochure, "Special Activities Coverage For Accident or Illness," available from the F Y 4-H office.

After you return: A remittance form must be mailed within 10 days after completion of camp or activity. This is available in the brochure, "Special Activities Coverage For Accident or Illness," available from the F Y 4-H office.

B. Blanket Coverage for One Year

Application available in brochure, "Accident Insurance, 4-H Club Members, One Full Year," available from the FY4-H office. This does not cover children under 5 years of age. Cost is $1.00 per person per year.

IV. Filing a Claim

A. Claim forms may be obtained from American Income Life Insurance Company, Special Risk Division, P.O. Box 50158, Indianapolis, I N 46250, or from the F Y 4 H Office. The claim must be filed to the company within twenty days of commencement of any loss covered by this policy, or as soon as is reasonably possible.

B. In case of injury or illness to any insured person, see that they are given proper medical attention. Report the following to the Company as soon as possible.

1. Name of the disabled.
2. Date of the disability.
3. How the disability was sustained.
4. Complete medical diagnosis by the attending physician.
5. Serial number of application under which person was covered.

C. Statements for services rendered by doctor, hospital or nurse are necessary in all instances.

D. Claim reports must be signed by group leader or camp director.

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