Insurance – Certificates

If you are trying to access a claim form for either a team or umpire, please go back to the home page and click on the tab that pops out on the “Insurance” link that states “Request a Claim Form”. From this point on, choose the appropriate form for either team or umpire, fill out the form and hit “Submit” and your request will be reviewed and a signed claim form will be issued.

Wilson Sports Insurance Services: Schedule of Payments

Liability Coverage:

Our plan offers $1,000,000 in liability coverage with a $3,000,000 aggregate. The coverage is provided for third party lawsuits of negligence brought against your team during practice and play for Bodily Injury and Property Damage. The plan will pay sums for which the insured becomes legally obligated to pay as damages because of:

  • Bodily Injury and Property Damage
  • Participant Legal Liability
  • Premises and Operations
  • Personal and Advertising Injury

Defense and Legal Fees are covered in addition to the policy limits provided. Property owners can be provided certificates of insurance naming them as additionally insured, upon request, at no additional charge.

General Liability is provided by:
AIG Insurance Company

Excess Accident Coverage:

This policy covers purchased team insurance, via Wilson Sports Insurance Services, rostered players, and coaches, against specific losses resulting directly and independently of all other causes, from accidental bodily injury sustained while participating as a member in a scheduled game, official tournament, or practice session, or while traveling directly to or from such game or practice session.

Accidental Medical Expenses – FULL EXCESS

  • $100,000.00 Maximum Benefit Amount
  • $250.00 Per injury / Deductible – Corridor*
  • Benefit Period – From September 1st until August 31st of each calendar year.

Eligible Medical Expenses are:

  • Treatment by a Legally Qualified Physician;
  • Care or service from a Hospital or Ambulatory Surgical Center;
  • Services from a registered graduate nurse (RN or LPN) not related to the Insured by blood or marriage;
  • Professional ambulance service; $500.00 Max
  • Orthopedic appliances:  $500.00 Max
  • Emergency Room / Ambulatory Medical Center:  $1,500.00 Max

Dental Expense Benefit (covers injuries to sound, natural teeth)

  • Maximum Benefit Amount:  $500.00 per injury

Diagnostic (X-Ray/Radiology)

  • Maximum Benefit Amount – $200 per injury

Diagnostic Imaging (Cat Scan/MRI)

  • Maximum Benefit Amount – $500 per injury

Surgical Benefit

  • Surgeon Maximum Benefit Amount – $1,000
  • Surgical Center (facility charge) Maximum Benefit Amount – $1,500

Physical Therapy Expense Benefit (includes Chiropractic and Spinal Treatment)

  • Maximum Benefit Per Visit – $75
  • Maximum Benefit Amount – $1,000 per Injury **

Prescription Drug Expense Benefit

  • Maximum Benefit Amount – U&C per Injury ** (Max $200)

Rental Charges for Wheelchair, Hospital bed and Iron Lung

  • Maximum Benefit Amount – $1,000 per Injury **
  • Other Durable Medical Equipment – Not Covered

* Corridor Deductible – regardless of the benefit amounts paid by other Insurance Providers, the stated deductible amount must be paid by the Insured before benefits under this program are payable.

** Subject to Accident Medical Expense Deductible and Maximum Benefit
Excess coverage is provided over and above other group blanket or franchise health insurance coverage; other group hospital or medical services plans & pre-payment coverage; any coverage under labor management trustee or employee benefit organization plans; coverage under an governmental program; coverage required or provided by any statute & automobile reparations insurance (no fault) coverage. Please note any amounts paid by another plan as defined above (or applicable state variation) cannot be used to satisfy any deductible under our policy.

Accidental Death benefit pays $5,000; Dismemberment benefit pays $10,000 for an injury resulting from a covered accident resulting in loss of life; both hands or both feet; or sight of both eyes; one hand and one foot; or hand or foot and sight of one eye. Plan pays $5,000 for the loss of one hand; one foot; or the sight of one eye. Loss must occur within 180 days of the accident. If more than one loss is sustained, only one of the amounts, (the largest), will be payable. Loss of hand or foot means severance through, or above wrist and ankle joint. Loss of eye means entire and irrecoverable loss of sight.

The provisions of the policies constitute the only agreement between the insured and the Insurance Companies.

The excess accident coverage is provided by:
ARCH Insurance Company