University of New Hampshire Athletics
Insurance Information
Insurance
University of New Hampshire Athletic Department Insurance Policy –
The goal of the UNH Athletic Department is to provide the best health care delivery system for student-athletes at University of New Hampshire. The information below will help explain, medical referrals and procedures for filing insurance claims.
Athletic Department Insurance (UNH AD) is provided by UNH for the benefit of our student-athletes. This coverage is offered on an excess basis only. Under the terms of the policy, this coverage is considered to be excess to all other valid and collectible medical insurance policies. Most notable would be parental insurance.
NOTE: UNH ATHELTIC DEPARTMENT INSURANCE IS AN EXCESS POLICY.
This excess policy covers varsity athletes for bodily injury sustained while participating in supervised intercollegiate sports (including participation in scheduled games, supervised practice sessions, weight training at UNH, and authorized team travel to and from such events.) In order for an injury to be eligible for this policy:
1) The injury must be a qualifying injury (see above);
2) The services provided must be to aid in the recovery of a qualifying injury (services to prevent or protect from future injury are not covered);
3) And the primary insurance must be billed and the claim either partially paid or denied.
This policy will cover medically necessary bills for which the student-athlete would otherwise be liable in the absence of this policy.
The parent(s)/ guardian(s) of the student-athlete must complete an annual insurance verification from declaring the primary insurance company which provides coverage for the student-athlete. Please note it is vital that all requested information be competed in its entirety. The student –athlete will not be able to participate until this information is completed, signed and submitted to the UNH AT Department.
Procedure Regarding Injury and Referral:
Should an athlete be injured while practicing or participating in a supervised UNH intercollegiate varsity sport, he/ she must, regardless of how minor, report this to the AT staff in a timely manner (Claims must be submitted within 90 days from the date of injury; and treatment must be initiated within 90 days from the date of injury). Under no circumstances should an individual seek other care without reporting information to the AT staff prior to seeking other care. If an athlete seeks such un-reported care, he / she should be prepared to pay for such services. No liability on the part of UNH exists or may be assumed to exist for off-campus medical treatment or hospitalization of any kind for athletic injuries without prior report to the AT staff.
- Submit all bills incurred to the primary insurance. This will result in one or more of the following:
- The primary insurance may ask for more information. It is the student-athlete or parent/ guardian responsibility to provide that information to the primary insurance.
- The primary insurance may honor the claim and pay all or a portion of the bills incurred.
- The primary insurance may not honor the claim and will send a denial of benefits letter.
- If a balance remains after the primary insurance has paid its portion of the claim, the student-athlete or parent/ guardian need to submit a copy of all the bills and the corresponding explanation of benefits (EOB - a letter from the primary insurance explaining what was paid and why) to the Athletic Training Department.
- UNH AT will submit those bills and EOBs to the Athletic Department Insurance Company.
- Only claims and bills incurred within two years from the date of injury will be covered.
- Injury sustained in an activity that is not associated with a required intercollegiate practice or competition supervised by a coach.
- Pre-existing conditions: A chronic or recurrent injury that was sustained prior to participation at UNH; includes any injury or illness for which treatment has been provided during a specific time period prior to subsequent injury or illness, or any injury that has not been deemed completely rehabilitated by the appropriate professional
- Unauthorized consultations or treatments.
- Medical Illnesses (not limited to: colds, intestinal viruses, flu, tonsillitis, mono, appendicitis, heart irregularities, wart removal, asthma, etc.) or any other conditions not directly related to an intercollegiate athletic accident. NOTE: Arrangements may be made through the athletic training staff for the care and treatment of any illness or injury condition, but they are made only for the convenience and quality of health care of the athlete. These arrangements do not constitute Athletic Department responsibility for payment.
- New injuries that occur after the student-athlete’s eligibility is exhausted.
- Conditions as a result of non-compliance with the school’s policies, team rules, or the advice of the team physician, attending physicians, the athletic trainers or coach.
- Other dental injuries that are not a result of athletic competition (i.e. wisdom teeth, toothache) CANNOT be paid for by the Athletic Department Insurance. Any structural repair or cosmetic work done in addition to emergency care is the financial responsibility of the student athlete. UNH strongly recommends personal insurance for other medical expenses.
- Bills incurred AFTER TWO CALENDAR YEARS from the date of injury noted on the incident report.
The student-athlete and/ or the parent/guardian responsibilities:
- Do NOT pay bills prior to submitting to UNH’s insurance.
- To ensure that any special procedures required by their insurance policy are followed and to comply with the requests for information, etc. from the insurance company;
- Prior to services: contact their insurance company for pre-authorization of services;
- Prior to services: contact their primary care physician for referral to services ;
- Post services: forwarding EOB (explanations of benefits) from primary insurance and remaining balances/ bills to UNH AT for processing;
- Any delinquent bills resulting in bad credit due to non-compliance with insurance companies requests may be the responsibility of the student-athlete and/ or his/her parent(s) / guardian(s).
- Any other communication with primary insurance company or providers required.
- To inform UNH AT of any changes to the primary insurance status and understand that incorrect or undisclosed information could result in delayed claims processing.
The UNH Athletic Department Insurance coverage expires 2 years (104 weeks) from the date of the injury.
The UNH Athletics Department does not assume any responsibility for action taken by collection agencies for non-payment of medical bills. The individual athlete is responsible by law for all services rendered to him/her.
Student-athletes or parent/ guardian should submit any bills for an athletic injury to their athletic trainer or the Athletic Training Department at 145 Main St. Durham, NH 03824 or fax to 603-862-4198. The process will be expedited if the Explanation of Benefits (EOB) from the primary insurance for the corresponding dates of service is included.
Contact your team’s athletic trainer or Cindy Michaud at 603-862-3892 with questions/ concerns.