KNOX COLLEGE STUDENT ACCIDENT INSURANCE POLICY SUMMARY
All Knox College full time degree seeking students are eligible for accident insurance policy benefits as described in the following information.
Eligibility
To be eligible for policy benefits, medical treatment by a licensed physician must be rendered within 90 days from the date of the original accident date.
Benefits
The policy will pay the specified policy benefits necessary to treat the covered injury that is incurred and rendered within up to one (1) year from the original date of the covered accident up to the specified medical benefits outlined below.
Deductible
This policy has no deductible.
Policy Dates
The policy effective date is August 11, 2021.
The policy termination date for covering Knox College students is August 11, 2022.
Basic Accident Insurance Policy Benefits
Maximum Medical Benefit (per covered accident):
Up to
Intercollegiate Sports Accident Maximum Policy Benefit: Up to $1,000.00
Motor Vehicle Related Accident Maximum Policy Benefit: Up to $2,000.00
Accidental Death Benefit: $2,500.00
INPATIENT HOSPITAL CHARGES
Daily Semi- Private Room & Board
including all miscellaneous charges including supplies, services, operating room, implantable devices, etc.: $1,000.00 / day
While in Intensive Care
including all miscellaneous charges, supplies, services, operating room, implantable devices, etc.: $1,250.00 / day
OUTPATIENT HOSPITAL, ER or Surgi-Center Charges
(Including all charges, supplies, and services)
When major surgery is performed requiring general anesthesia: $2,500.00
When major surgery is not performed: $500.00
PHYSICIAN’S FEES
Non-surgical office or hospital visits, consultations;
(8 visit maximum per accident): $60 initial visit / $40 follow-ups
Physician’s Surgery Fees: UCR* (See note below)
Anesthesiology and Assistant Surgeons Fees: 20% of Surgery Fee Benefit
OUTPATIENT RADIOLOGY, SCANS, LAB FEES
(Includes interpretation and reading fees)
X-Rays, CAT and other Scans: Up to $300.00
MRI Benefit (includes interpretation fees): Up to $500.00
Laboratory Tests: Up to $150.00
OTHER
OUTPATIENT PHYSICAL THERAPY
Treatment Visits (Limited to 10 visits per covered injury): $40.00 per visit
Emergency Ambulance Service (Air or Ground): Up to $500.00
Drug Store Prescriptions Prescribed by Physician: Up to $150.00
Dental Services: (includes x-rays and supplies)
(amount payable per injured tooth): $300.00 per tooth
Replacement Eyeglasses or Hearing Aids:
(If broken during a covered accident requiring medical treatment): Up to $125.00
Orthopedic Appliances/Braces/Implantable Devices or Equip Rentals;
(Payable when physician prescribed for rehab purposes only): Up to $250.00
*NOTE: ‘UCR’ refers to ‘usual, customary and reasonable’ fees as referenced in the Fair Health, Inc. fees survey.