Special Risk Program (Enhanced)
- Availability
- Eligibility
- Who is Covered?
- Covered Activities
- Description of Coverages
- Plans
- Excess Coverage
- General Exclusions, Limitations and Definitions
- Underwriting
- Premiums
- When Coverage Begins
- Examples of Eligible Groups
- Additional Information Pertaining to Special Risk Accident Program Supplement
- Print this Page
Availability
This program is available in the following states: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, North Dakota, New Jersey, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming. State exceptions may apply.
Our Enhanced Special Risk Program is not available in all states. See our Special Risk Countrywide Program for:
- Connecticut
- Florida
- Kansas
- Maine
- Maryland
- Montana
- South Carolina
- Vermont
- Washington
For New York only, see our Special Risk New York Program.
This is an explanation of the general purposes of the coverage described, but in no way changes or affects the policy as actually issued.
Eligibility
The program is ideal for:
- Fashion Show
- Fairs
- Parades or Parade Units
- Outings
- Picnics
- Seminars
- Conventions
- Fund Drives
- Beauty Contests
- Pageants
- Theatrical Performances
- Hayrides
- Concerts
- Volunteer Workers for Churches
- Schools
- Hospitals
- Community Celebrations
For actual eligibility requirements, please see the Underwriting section and the Special Risk Accident Program Supplement below.
Who is Covered?
All members of the group or organization and in some instances all instructors/supervisors are covered, subject to the terms of the policy.
Covered Activities
Coverage under the Special Risk policy is tailored to meet the needs of the organization involved. Generally, members and supervisors are covered while participating in or supervising activities sponsored by the organization. In many cases business travel accident and individual travel coverage to and from the activities may also be included.
Description of Coverages
Accidental Death and Dismemberment (AD&D) - pays the following to the Insured Person or his/her beneficiary for losses that occur within 180 days of an accident:
| Loss | Benefit |
|---|---|
| Life | Principal Sum |
| Both Hands or Both Feet or Sight of Both Eyes | Principal Sum |
| One Hand and One Foot | Principal Sum |
| Either Hand and Sight of One Eye | Principal Sum |
| Either Foot and Sight of One Eye | Principal Sum |
| Speech and Hearing in Both Ears | Principal Sum |
| Either Hand or Foot | One-half the Principal Sum |
| Sight of One Eye | One-half the Principal Sum |
| Speech or Hearing in Both Ears | One-half the Principal Sum |
| Thumb and Index Finger on the Same Hand | One-quarter the Principal Sum |
Loss of hand or foot means severance through or above wrist or ankle joint. Loss of sight, speech and hearing means entire and irrecoverable loss. Loss of thumb and index finger means actual severance through or above metacarpophalangeal joints.
We will not pay more than the largest amount shown for all losses due to the same accident.
Accident Medical Expense - pays the Reasonable Expenses incurred by an Insured Person, in excess of the Deductible Amount, for Medical Care due to Injury, if the first expense is incurred within 26 weeks after the accident and the expense is incurred within 2 years of the accident. The benefit will not pay more than the Maximum Benefit for all expenses incurred as the result of any one accident. In addition, the benefit will not pay more than the Maximum Dental Limit for all expenses incurred for dental treatment, services and supplies; or more than the Maximum Benefit for all Medical Care and dental treatment, services and supplies, as the result of any one accident. The Deductible Amount will be applied separately to each accident.
Accident Total Disability - This benefit is available only to organizations whose members (and instructors/ supervisors, if covered) are otherwise gainfully employed. Pays the weekly benefit selected if an insured person is totally disabled and unable to work as the result of a covered accident. Total disability must commence within 30 days of such accident. Pays a benefit for up to two years while the insured is unable to work at his usual occupation. It can be purchased with a cost-saving waiting period. This benefit will be written only in conjunction with the Accidental Death and Dismemberment or Accident Medical Expense benefit.
Plans
Benefit plans may be selected to meet the needs of each individual organization. The minimum and maximum benefit amounts which may be written under this program read as follows:
| Benefit | Minimum | Maximum | |
|---|---|---|---|
| Accidental Death Principal Sum | $500 | $100,000 | |
| Accidental Dismemberment Principal Sum | $500 | $100,000 | |
| Accidental Medical Expense | $500 | $1,000,000 | |
| Accident Total Disability | $10/week | $500/week | |
| Period Payable | 13 weeks | 2 years | |
| Waiting Period | none | 180 days | |
In many cases, an underwriting restriction will not permit offering the above maximums. An attempt should always be made to keep benefits at a reasonable level in accordance with actual needs of the group.
Plans and rates for eligible groups for this program may be obtained from our Accident Underwriting Department. Each case submitted will be underwritten and rated in accordance with the nature of the group.
Excess Coverage
In certain states, lower rates are available if the Medical Expense portion of The Hartford's Special Risk Insurance is purchased on an "excess basis". This means that after the Insured Person has been reimbursed for medical expenses by other insurance programs, The Hartford will pay up to the maximum Medical Expense benefit provided by any other Plan. Other Plans include such health insurance coverage as group hospital or medical plans, or no-fault automobile coverage. Any amounts paid by another insurance plan cannot be used to satisfy any deductible under The Hartford's policy.
General Exclusions, Limitations and Definitions
The Policy does not cover loss resulting from or for:
- (1) intentionally self-inflicted Injury, suicide, or attempted suicide, whether sane or insane;
- (2) war or act of war, whether declared or undeclared;
- (3) Injury sustained while in the armed forces (land, water or air) of any country or international authority;
- (4) Injury sustained while in or on, boarding or alighting from, being struck or run down by, any aircraft except as an airline passenger on an aircraft: (a) operated by a passenger airline on a regularly scheduled trip over its established route or that is chartered by that airline; or (b) any transport type aircraft operated by the Military Airlift Command (MAC) of the United States or any national government recognized by the United States;
- (5) repair, replacement, examination for prescriptions, or fitting of: (a) eyeglasses; (b) contact lenses; or (c) hearing aids;
- (6) dental work or treatment on natural teeth which is not necessary for the repair or relief of Injury;
- (7) repair or replacement of existing dentures, partial dentures, braces, fixed or removable bridges, or other artificial dental restoration;
- (8) repair or replacement of artificial limbs or orthopedic braces;
- (9) Injury sustained while the Insured Person is voluntarily taking drugs which federal law prohibits dispensing without a prescription, including sedatives, narcotics, barbiturates, amphetamines or hallucinogens, unless the drug is taken as prescribed or administered by a licensed Physician; or
- (10) Injury sustained by an Insured Person during or as a result of his or her commission of a felony or while incarcerated for a felony, except that this exclusion will not be applicable upon acquittal or dismissal of the felony charges;
- (11) Injury sustained as a result of the Insured Person's being legally intoxicated from the use of alcohol while operating a motor vehicle;
- (12) Injury sustained as a Member of a Team while practicing for or participating in any athletic game, event or tournament sponsored by or under the direction of any professional, semi-professional, intercollegiate, interscholastic or organized amateur league, conference or association; or traveling to or from such practice or participation;
- (13) expenses covered under any automobile reparations insurance (no-fault) or automobile insurance medical payments benefit; or
- (14) injury sustained by an Insured Person as a result of participation in a riot or insurrection.
Injury means bodily injury of an insured person that results directly and independently of all other causes from an accident that occurs while he or she is participating in a Covered Activity. Sickness or disease (except pus-forming infection which shall occur through an accidental cut or wound) or hernia of any kind will not be considered as bodily injury.
Underwriting
All quotations for organizations to be covered under the Special Risk Accident program will be processed through our Accident Underwriting Department.
Complete and return the applicable request form along with any other information you feel may be helpful in underwriting the case. Pay particular attention to the following factors:
- Confirm that the group is eligible under applicable state
laws. If in doubt, contact our Accident Underwriting Department.
- Coverage is compulsory for all eligible members of a group to be insured.
- Experience of participants and supervisors as well as type and frequency of activity will affect the rate.
- Individual travel coverage to and from activities is available to many eligible groups and it will affect the rate.
- If coverage has been provided previously by another carrier, you must provide premium and loss information for the past 3 years with the Request for Insurance.
All members (and all instructors/supervisors if eligible) of a group must be included in the policy. No name lists are required, but a premium must be paid for each person to be insured. New members joining the group while the policy is in effect will be covered automatically until the policy expiration date - WITHOUT ADDITIONAL CHARGE. The total premium for the policy is payable when insurance becomes effective. No refunds will be made for members who leave the group before the policy period expires.
Premiums
The minimum premium for the Special Risk program is $310. The minimum premium is non-refundable in the event the policy is canceled after the effective date.
When Coverage Begins
If the Request for Insurance is received and approved before the starting date of the group activity or program, coverage will begin on the first day of the activity or program. Otherwise, coverage will begin on the date the Request for Insurance is approved following its receipt by The Hartford.
Examples of Eligible Groups
Eligible Groups and Scope of Coverage
| Group No | Eligible Groups | Who is Covered | When They Are Covered |
|---|---|---|---|
| 1 | Adult Church Groups (See Additional Information section), Amateur Chorus, Choir and Concert Groups, Amateur Glee Clubs | All members of the policyholder. | While participating in activities sponsored and supervised by the policyholder, including traveling with a group in connection with such activities. |
| 2 | Chamber of Commerce, Exchange, Jaycee, Kiwanis, Lions, Optomists, Rotary, Sertoma | All members of the policyholder. | While participating in activities sponsored and supervised by the policyholder, including traveling with a group in connection with such activities. |
| 3 | Amateur Theater (adult or children) | All participants in the activities sponsored by the policyholder. | While participating in activities sponsored and supervised by the policyholder, including traveling with a group in connection with such activities. |
| 4 | Baton Twirlers, Drill Team,Drum and Bugle Corps, Marching Band, Marching Groups | All members of the policyholder. | While participating in activities sponsored and supervised by the policyholder, including traveling with a group in connection with such activities. |
| 5 | Volunteer Hospital Workers (Candy Stripers, Gray Ladies and Red Cross) | All members of the policyholder. | While participating in volunteer activities sponsored and supervised by the policyholder, on the premises of the hospital to which the insured person is assigned. |
| 6 | Civil Defense | All members of the policyholder. | While on duty under the supervision of the policyholder or while participating in fund-raising drives, training classes, test, drills, or trials of a piece of apparatus directly connected with such activities. |
| 7 | Vacation Bible School. Teachers may be insured, but if so, must all be included. | All registered full-time students(and teachers) of the policyholder. | While participating in activities sponsored and supervised by the policyholder or while traveling with a group in connection with such activities. |
| 8 | Soapbox Derbies. Adult supervisors may be insured, but if so, all must be included. | All participants in (and adult supervisors of ) the Soapbox Derby sponsored by the policyholder. | While participating in (or supervising) the Soapbox Derby sponsored by the policyholder, on the premises designated by the policyholder. |
| 9 | Adult Study Seminar, Beauty Contest, Fashion Show, Hay Ride, Outing, Parade, Picnic. | All participants in the activities (bystanders, spectators, and onlookers will not be included). | While participating in the activities sponsored and supervised by the policyholder and on the premises designated by the policyholder. Travel to and from the activity will not be included. |
| 10 | Athletic Officials. (Baseball, Basketball, Football, Hockey, Lacrosse, Soccer, Softball, Wrestling and Track) | All members of the policyholder. | While officiating on the premises to which the insured person is assigned by the policyholder; while attending a meeting of the policyholder or while traveling to and from such meeting or premises and home. |
| 11 | Senior Citizen (See Additional Information section) | All members of the policyholder. | While participating in activities sponsored and supervised by the policyholder; or while traveling with a group in connection with such activities. |
| 12 | Institutions of Higher Learning. (Community Colleges, Business Schools and other Specialty Schools); see Additional Information section | All registered full-time non-dormitory students of the policyholder. Registered part-time students and/or instructors may be insured at the option of the policyholder, but if so, all must be insured. | While participating in school activities sponsored by the policyholder on the premises designated by and under the supervision of the policyholder or while traveling with a group in connection with such activities. |
| 13 | Ski groups and other employee, religious, educational and recreational groups taking ski trips. | All participants on the ski trip (including supervisors). | While participating in non-competitive downhill or cross-country ski trip activities sponsored by and under the direct supervision of the policyholder; or while traveling with the group in connection with such activities under the direct supervision of the policyholder on the premises designated by the policyholder. |
Additional Information Pertaining to the Special Risk Accident Program
It is not the purpose of the Special Risk Accident Program to cover heavily concentrated air travel exposure. However, the rates shown in this section do include air travel as long as the aggregate limit of the group does not exceed $1,000,000 on any one aircraft. To determine the aggregate limit for the group, multiply the selected death benefit by the number of group members traveling together on a single aircraft. If the aggregate limit is over $1,000,000, contact your reporting office.
The Special Risk Accident Program outlined in this section is not available to any group organized for the practice or play of competition team sports.
The Adult Church Group category under Group No. 1 does not include groups engaged in volunteer construction activities.
The Senior Citizen category (Group 11) is written only on an excess basis over and above other group blanket or franchise health insurance coverage; other group hospital or medical service plans and pre-payment coverage; any coverage under labor-management trustee plans, union welfare plans, employer organization plans, or employee benefit organization plans; coverage under any governmental programs, coverage required or provided by any statute and automobile reparations insurance (no-fault) coverage. In addition, a mandatory minimum deductible of at least $25 is required.
The program for Institutions of Higher Learning (Group 12) is not available to schools with activities of a hazardous nature, and is not available in some states. This program is primarily designed for use in community colleges, business schools, computer science and other specialty type schools. Examples of hazardous activities include skydiving, demolitions/explosives, or stunt-flying. Please contact the Accident Underwriting department with questions regarding eligibility.
Coverage for ski exposure is available only to Group 13. This program is not available to any group organized only for the purpose of engaging in competitive skiing. If the group does both recreational and competitive skiing, only recreational skiing will be covered. The Hartford can provide coverage for competitive skiing events under a Sports Accident Program. It is not the intent of the Ski Trip Accident Program to provide coverage for ski jumping. If your group is planning more than one ski trip throughout the year, all of these trips may be insured under one policy. Be certain to indicate whether the skiing is downhill or cross-country; if both, please so indicate when computing the policy premium.