Ambulance Reimbursement
Overview
Accidents happen without notice or warning and you never know where you might be when they happen. Most people don't have ambulance coverage included in their current insurance policy. This benefit will help you recover the cost of ambulence transportation and can put up to $1000 back in your pocket from the expense.
- In the event that You or a Family Member require ambulance transportation services and/or paramedic treatment as the result of an Injury caused by an Auto Related Accident
- You or a Family Member will be entitled to reimbursement of actual expenses incurred for ambulance transportation services and/or paramedic treatment
- up to a maximum of $1,000 per occurrence.
Description
Description of Coverage: In the event that You or a Family Member require ambulance transportation services and/or paramedic treatment as the result of an Injury caused by an Auto Related Accident, You or a Family Member will be entitled to reimbursement of actual expenses incurred for ambulance transportation services and/or paramedic treatment, up to a maximum of $1,000 per occurrence. To qualify for benefits: (1) the Injury must have occurred during the Coverage Period , (2) ambulance transportations must have been provided by a licensed ambulance service and (3) paramedic treatment must have been for urgent medical attention that is provided by a certified emergency medical technician.
EXCLUSIONS:
We shall not be responsible for:
- A Reimbursement if the qualifications for benefit (numbers 1 through 3 under “Description of Coverage”) are not met;
- Any loss caused by suicide or self-destruction, or any attempt threat, while sane or insane;
- Any loss covered by any other applicable insurance or indemnity available to You or a Family Member.
- Any loss caused by declared or undeclared war, or any act thereof;
- Any loss caused by operating, riding in, entering or exiting any vehicle which is (a) being tested or time tested, or (b) participating in races, speed contests or exhibitions of any kind;
- Any loss caused by being struck as a pedestrian by operating farm equipment or any other vehicle which is not designed or licensed for use on public roads;
- Any loss caused by bacterial infection, except pus-forming infections resulting from Injury;
- Any loss caused by participating in or attempting to commit a felony;
- Any loss caused by illness or disease or allergic reaction;
- Any loss caused by ingestion of a poisonous substance (except accidental ingestion of a poisonous substance which causes Injury);
- Any loss caused by driving under the influence of narcotics, unless taken in accordance with the advice of a Physician;
- Any loss caused by driving under the influence of any intoxicating liquor. (An intoxicating liquor is that which is defined as or determined to be such by the laws of the jurisdiction where the loss or cause of loss occurred.)
Definitions:
You, Your, or Member means the person who is a member in good standing as defined by the membership terms and conditions and whose membership has not expired or been cancelled by the member or Administrator
Family Member (family membership must be purchased for coverage to apply) means the spouse or Domestic Partner1 of the Member, but only if the spouse or Domestic Partner of the Member resides at the Principal Residence of the Member, and each unmarried child of the Member, who is less than twenty-one (21) years of age (or less than twenty-three (23) years of age if a full-time student at an accredited college or university), but only if the unmarried child resides at the Principal Residence of the Member; or any dependent with documented disabilities who has the same Principal Residence as the Member and who relies on the Member for maintenance and support; or any unmarried dependent under the Member’s legal guardianship who is under twenty-one (21) years of age (or less than twenty-three (23) years of age if a full-time student at an accredited college or university). Any spouse, Domestic Partner or child of the Member who does not reside at the Principal Residence of the Member is not eligible for coverage under this Evidence of Coverage. 1Domestic Partner means an unmarried person in an intimate, committed relationship of mutual caring who shares responsibility for basic living expenses with the Member and also resides in the Principal Residence and is at least eighteen (18) years old and is not currently married and/or committed to another person.
How To File a Claim
HOW TO FILE A CLAIM:
To submit a claim, You or a Family Member should call the Administrator at 1-800-711-4280 within forty-five (45) days of the date that the Auto Related Accident occurred. Failure to give notice within forty-five (45) days of the Auto Related Accident may result in a denial of the claim.
The Administrator will send a claim form, which should be completed and mailed back to the Administrator with all of the following:
- A copy of the explanation of the diagnosis, along with copies of the itemized bills and receipts for the ambulance transportation and/or paramedic service expenses incurred by You or a Family Member;
- A copy of the Declaration Page from any available insurance (e.g. home, auto, health) for this claim;
- A copy of the claim form(s) submitted to an insurance company (e.g. home, auto, health) for the ambulance transportation and/or paramedic treatment expenses incurred by You or a Family Member:
- A copy of the police report (if applicable);
- A copy of the payment(s) for ambulance transportation service and/or paramedic treatment service by Your or an Family Member’s insurance company and/or by any other available insurance;
- Any other documentation that the Administrator may reasonably request.
All these required items, including the claim form, must be postmarked within ninety (90) days of the date of Auto Related Accident, or the claim may be denied.