Definitions:
Covered Accident, with respect to all benefits under this policy, except death benefits, means an accident which directly results in bodily Injury (not excluded from coverage by the policy Exclusions and Limitations) to the Insured Person as a result of which the Insured Person incurs a Covered Loss in excess of the Covered Accident Deductible, and which occurs to an Insured Person while this policy is in effect and between the dates shown in the Plan of Insurance and while he or she is participating in a Covered Event or performing directly assigned duties in connection with the Covered Event; and

• which occurs during Covered Travel to and from the location of a Covered Event;
• which occurs during a temporary stay at the location of a Covered Event held away from the location of the Insured Person’s Participating School while the Insured Person is engaged in an activity or travel authorized by the Insured Person’s Participating School; or
• which occurs by a cardiovascular accident or stroke or other similar traumatic event caused by exertion while participating in a Covered Event.

Covered Accident Deductible means the amount of Medical Expenses and/or Dental Expenses and/or Rehabilitation Expenses and/or Custodial Care Expenses, as shown in the Plan of Insurance:

• Incurred by the Insured Person as a result of a Covered Accident within the Deductible Establishment Period;
• that qualify as a Covered Loss under the policy; and for which no benefits are payable under the policy.

Covered Loss means Reasonable and Customary: (a) Medical Expense; (b) Dental Expense; (c) Rehabilitation Expense; and (d) Custodial Care Expense. An expense will be a Covered Loss under the policy after all adjustments (including but not limited to discounts, write-offs and negotiated fees), only to the extent that it is for Medically Necessary services, and not excluded under the Exclusions and Limitations section in the policy. Further, for those Insured Persons who have satisfied the Covered Accident Deductible, Covered Loss shall not include any expenses Incurred after the respective Date of Recovery. Covered Loss also means Disability Benefits as described in the Benefits section of the policy payable as a result of a Covered Accident.

Covered Travel means team or individual travel, for purposes of representing the Sponsoring Organization that is to or from the location of a Covered Event and is authorized by the Insured Person’s Sponsoring Organization. Individual Covered Travel is subject to a requirement that the travel be paid for or subject to reimbursement by the Sponsoring Organization. Covered Travel to a Covered Event will commence upon embarkation from an authorized departure point and terminate upon arrival at the location of the Covered Event.

Covered Travel from a Covered Event will commence upon departing from the location of the Covered Event and terminate upon return to the authorized place from which such Covered Travel to the Covered Event began.

Hospital means an institution which meets all of the following requirements: (a) It is licensed (if required) as a Hospital by applicable licensing authorities; (b) It is open at all times; (c) It is operated mainly to diagnose and treat illnesses and Injuries on an inpatient basis; (d) It has a staff of one (1) or more Doctors on call at all times; (e) It has twenty-four (24) hour nursing services by registered nurses on duty or call; (f) It is not mainly a skilled nursing facility, clinic, nursing home, rest home, convalescence home, or like place; and (g) it has organized facilities for surgery or provides for such facilities for its patients through formal written agreement with other Hospitals.

Injury or Injuries means bodily Injury which results directly from an accident and which is independent from disease, sickness or other bodily functions.

Medical Expense means the Reasonable and Customary charges:

• of a professional ambulance service for Medically Necessary transportation to and from a Hospital;
• of a Doctor for Medically Necessary care and treatment;
• of a Hospital for Medically Necessary inpatient services, including room and board (not exceeding the semi-private room rate for each day of confinement unless a private room is Medically Necessary);
• for Medically Necessary Hospital inpatient services and supplies, including intensive care services, and daily Hospital charges for personal Hospital services (including television, radio, telephone, barber, and beauty services to a maximum payment as shown in the Plan of Insurance);
• for Medically Necessary out -patient and emergency room care and treatment;
• for confinement in an Extended Care Facility;
• for Home Health Care; and
• for medical or surgical services, prescription drugs, and other medical supplies commonly used for herapeutic or diagnostic services, which are Medically Necessary and prescribed by a Doctor operating within the scope of his or her license.

Medically Necessary means recommended by a Doctor and commonly recognized in the Doctor’s medical profession as proper care or treatment of the patient’s condition. In the case of Hospital or Extended Care Facility confinement, Home Health Care treatment, or Custodial Care, the length of confinement or treatment and the services or supplies furnished by the Hospital or Extended Care Facility, Home Health Care, or Custodial Care plan will be Medically Necessary only if it is reasonably determined by the Company that they are related to the care or treatment of the patient’s condition. The care, treatment, services, or supplies must not be experimental in nature. The fact that any particular Doctor may prescribe, order, recommend, or approve a service or supply does not, in and of itself, make the service or supply Medically Necessary.

Rehabilitation Expense means the Reasonable and Customary charges for Medically Necessary physical and occupational rehabilitation provided by licensed medical practitioners or under the supervision of a duly licensed Rehabilitation Facility.

For questions call:
Mutual of Omaha Insurance Company
Phone: 800-524-2324

This document is a summary of the U.S. All Star Federation (USASF) Catastrophic Injury Insurance Program. The
Memorandum of Coverage on file with USASF contains all of the provisions, exclusions, limitations and qualifications of the insurance benefits. If there is any conflict between the Memorandum of Coverage and this piece, Memorandum of Coverage provisions will prevail.