Questions and Answers

Following are Questions and Answers about the Fort Smith student accident insurance policy terms and coverage.

Question:

Do students have to go a particular doctor or hospital to obtain benefits from the school’s accident insurance policy?

Answer: NO.  Students can obtain medical treatment from any licensed doctor or hospital to be eligible for policy benefits.  The school policy pays the same benefits to all licensed doctors and other medical service providers.  To be eligible for policy benefits, a student must be seen and treated by a licensed doctor of medicine within 90 days from the original verified school accident date.

 

Question:

How can parents obtain an Accident Insurance I.D. Card to present to doctors or hospitals?

Answer:

Individual student medical insurance I.D. cards are not issued or available.  If a student is injured during a covered school activity, you can provide the doctor or hospital with the address of this website to obtain more details regarding the student insurance program. www.fortsmithstudentinsurance.com

 

Question:

Will the school accident insurance policy pay for all medical bills in full if a student is injured during a school activity?

Answer:

NO. The school accident insurance policy does not guarantee to pay 100 percent for all medical bills. Doctors, hospitals and other medical service providers are free to establish their own fees and charges resulting in a wide range of charges. The benefits paid by the student insurance policy will be paid based on the terms and specific benefit levels stated in the policy.  CLICK HERE for a summary of policy terms and benefits. In some cases, doctors, hospitals or other medical service providers may ‘write off ‘ the amounts not paid by insurance.  However, any expense that is not covered by the school insurance plan must be paid by parents.  The school does not accept financial responsibility for paying any expenses due to school related student injuries. 

 

Question:

What if parents have family insurance through work or other sources of coverage such as an HMO or PPO?  Can parents collect from both the school policy and other policies?

Answer:

NO. If students are covered by other insurance, the school accident policy could help cover some of the parent’s insurance deductibles, co-pays and other expenses that may not be covered by another insurance plan.  The school accident insurance policy is a ‘supplemental’ policy and is not intended to allow double coverage or profiting as a result of a school accident.  To be eligible for coverage under the school policy, parents must first file a claim for benefits with any other collectible coverage source.  The school policy will then consider payment of covered medical expenses that are not collectible from any other primary coverage source.

 

Question:  

What does the school policy cover and when is coverage effective?

Answer:

The school policy is effective for covered accidents that occur during school sponsored, school scheduled, school funded and school employee supervised classes, sports and activities.  For a detailed summary of the policy benefits, terms and exclusions, please CLICK HERE.

 

Question:

What if a student is ‘home schooled’.  Will students be covered at home?

Answer:

NO.  The school accident policy only covers accidental injury occurring during school classes and activities that are directly supervised by a paid school employee.

 

Question:

If a student needs ongoing treatment due to an injury that did not originally happen during a school activity, will the school policy pay for ongoing medical treatment or surgery?

Answer:

No.  The school policy is designed to cover eligible medical treatment expenses that are due solely to accidental injuries that originally occurred while participating in covered school activities. The policy does not cover any medical expenses for the treatment of conditions that originated prior to the policy effective date or when the student was not a participant in a covered school activity.  The policy will not cover treatment expense due to the reoccurrence of, complications of, aggravation of or reinjury of medical conditions that originated while the school policy was not in force. For example, if a student had a knee injury during the summer or on the weekend at home and the knee continues to cause pain and discomfort while in gym class or sports, the school policy is not going to cover medical expenses attributed to or associated with the aggravation, reoccurrence of or reinjury of the knee condition.  Medical bills for the treatment of ‘pre-existing’ conditions are not covered by the policy.

 

Question:

What if a student has on-going medical treatment expenses after a school related injury?

Answer:

The school accident insurance policy will cover medical treatment expenses that are necessary and directly due to a covered school injury for up to one year from the date of the school accident date that originally caused the injury.  If a student subsequently reinjures or aggravates the original injury, the school policy may not cover on-going expenses.

 

Question:

What if a student becomes ill or sick during a school class or activity?  Will the school policy pay for treatment of conditions such as the flu, sore throat, fainting, asthma or other types of illnesses or medical conditions?

Answer:

No.  The school policy will not pay for any treatment due to an illness or disease, regardless of whether or not the illness or disease was contracted at school.

The school accident insurance policy only considers claims that are as a direct result of a sudden, unexpected, identifiable accident that occurs during a covered school activity.

 

Question:

Are students covered if injured on school premises when they are not participating in a school sponsored and school supervised activity, such as playing on the school fields without school supervision during the summer months or while on vacations?

Answer:

NO.  Students injured during activities that are not exclusively Fort Smith School District school sponsored, scheduled and directly supervised by a paid school employee are not covered by the school accident insurance policy.

 

Question:

What if a student is involved and injured during a fight at school? 

Answer:

School fights are not considered a ‘covered school sponsored activity’.  Therefore, students injured during a fight would not be eligible for school accident insurance policy benefits.  Parents would be financially responsible for their child’s injury expenses due to fighting at school.

 

Question:

Does the school policy provide policy benefits if a student is injured while walking to or from home and school or while a student is riding a bike or traveling in a personally owned vehicle?

Answer:

NO.  The school policy only covers students while actually riding in a school bus or school van that is operated by a school designated and licensed adult driver.  Injuries that may occur while waiting for the bus or on home premises before or after school are not covered by the policy.

 

FOR ADDITIONAL INFORMATION regarding the school policy, please view the various sections of this website for more descriptive details.  If you have additional policy or claim questions after reviewing this website, please CLICK HERE.

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