Accident Insurance Policy Terms, Conditions and Exclusions:

No policy benefits will be paid to cover any expense or loss not caused exclusively by a covered accidental injury or any expense or any loss resulting from, or for:

 

1) Damage to other than whole, sound, vital and natural teeth or to existing dental bridges, crowns, restorations or braces; orthodontic procedures and services.  Treatment for injury or function of tooth caused either by decay, infection or the breakdown of a dental restoration.

2) Boils, athlete's foot, impetigo or similar skin infection, rashes, poisonous vegetation reactions, warts, blisters, calluses, cramps, muscle spasms, allergies or allergic reactions, ingrown nails, appendicitis, hernia of any kind, however caused; infections occurring other than as a result of such injury; detached retina; or psychiatric care.

3) Any form of illness, sickness or disease including but not limited to the following: Pathological Stress Fractures, Perthes' Disease, Osgood‑Schlatter's Disease, Osteomyelitis, Osteochondritis, Osteogenesis Imperfecta, Slipped Capital Femoral Epiphysis, Thrombophlebitis, Hysterical Reactions, or similar conditions.

4) Any form of fighting or brawling or criminal or felonious assault or the Insured being engaged in an illegal occupation.

5) Services or treatment rendered as a part of the Member school service by a hospital, physician, or person employed or retained by the Member, or by a person related to the Insured by blood or marriage.

6) Riding in or on, being struck by, being towed by, boarding or alighting from, or operating any motorized or engine driven vehicle.  Eligible medical expenses not collectible from other valid coverage will be payable up to $2,000.00 in total.

7) Intentionally self-inflicted injury.

8) War or any act of war; (raids by air, land or sea shall be deemed an act of war), civil disobedience, riots or insurrection.

9) Injuries sustained by the Insured for which benefits are paid or received under any Workmen's Compensation or Employer Liability Laws.

10) Aviation in any form except while the Insured is riding as a passenger in a licensed airplane provided by an incorporated passenger carrier on a regularly scheduled passenger flight and route.

11) The use of or while under the influence of drugs unless administered as prescribed by a physician.

12) The existence or aggravation of physical or mental infirmity, condition or disease, whether infectious, congenital, secondary or acquired in origin.  Conditions or the aggravation of conditions that originated prior to the Insured's policy Effective Date are not covered.

13) Expense resulting from participating in activities for which benefits would be payable, in the absence of this insurance, under any other insurance policy or trust fund is expressly excluded from coverage.

14) Snow skiing of any kind or snow boarding, water skiing, surfboarding, hydro sliding, jet skiing, rodeo, boxing or martial arts training or competition;

15) Participating in organized league sports, semi-professional, amateur or professional sports that are not exclusively supervised, scheduled and funded by Knox College.

16) Any expense for which a benefit is not listed.

 

Policy Definitions

"Covered Accident" means bodily injury of the student which results directly and independently of all other causes from an accident.  Self-inflicted injuries caused by prolonged over-exertion, stress or strain, illness or disease process or aggravation of an existing condition is expressly excluded from coverage under this Policy.

"Pre-existing Condition” means any condition or residual, reoccurrence, complication or aggravation of a prior condition that occurred before the date that the student is covered under the Knox College accident insurance Policy.

 

Excess Coverage Provision:

The Knox College accident insurance policy is ‘EXCESS COVERAGE’.  This means that if an injured student is eligible to receive benefits from any other source of coverage, including parent’s insurance, an HMO or PPO, the student must also file a claim with the student’s other available source of coverage.  The Knox College policy benefits will be limited to the eligible expenses not collectible from other primary coverage sources. If the student elects to or fails to follow the proper procedures to obtain primary coverage from the student’s other available source of coverage, the Knox College accident policy scheduled benefits will be reduced by 50%. 

 

FOR ADDITIONAL INFORMATION AND ANSWERS TO COMMON QUESTIONS CLICK HERE

PLEASE NOTE:

This website is presented as a summary of the insurance policy terms, benefits, provisions, limitations and exclusions.   The master policy contains all of the actual terms, benefits, provisions, limitations and exclusions.  All claims will be processed in accordance with the master policy language.  Students may request a copy of the master policy from the College business office.