I NSURANCE
CatholicMutualPARTICIPANT ACCIDENTINSURANCE CLAIM FORM
(NOTETotheParticipant/Parent/Guardian: ReportandClaimFormwillbereturnedifnotfullycompletedandsigned.)
BasicProceduresforSubmittingtheIncidentReportandParticipantAccidentInsuranceClaimForm
1.TheParish/SchoolAdministratororPastorwillcompletetheincidentreport,signanddatewhereindicated.
2.Theparticipantorparticipant'sparents/guardianwillcompletetheAccidentMedical/InsuranceClaimform.
3.ForwardthecompletedIncidentReportandAccident Medical/InsuranceClaimformstoK&KInsuranceGroup.BOTHreportsshouldbesubmittedtoK&Katthesametime.
PLEASENOTE:ProcessingmaybedelayediftheReportandAccidentMedical/InsuranceClaimformsarenotfullycompleted,signedandsenttogether.
TotheParticipant/Parent/Guardian:
Attachcurrentitemizedphysician,hospital,orotherprovider'sbillsforaccidentmedicalexpensesbeingclaimedaswellastheprimarycarrier'sExplanationofBenefitsshowingtheirpaymentsanddenials.Thesebillsmustshowthepatient'sname,condition(diagnosis),typeoftreatmentgiven,datetheexpensewasincurredandthechargesmade.
MAILTO:
K&KINSURANCEGROUP,INC.
ClaimsDepartment
P.O.Box2338
FortWayne,Indiana 46801-2338(800)237-2917
Forgeneralclaimsquestionsorstatusofaclaimcall:
800-237-2917,option1.orefax:312-381-9077
Departmentemail:(tobeusedwhenforwardingnewclaimsandattachmentsforexistingclaims)
KI N S
U R A KN C E
1712MagnavoxWay P.O.Box2338FortWayne,Indiana46801
CatholicMutual
ph(800)237-2917
Fax(260)459-5915forParticipantAccidentUnit
OnbehalfofNationwideInsurance(PLEASE PRINT)
INCIDENTREPORT
INSUREDNAMEOFINSURED:DioceseofBaker(SludenlAccidenl/CAT)POLICY#:FPX0000025473200FPX0000025472600
PARISH/SCHOOL:CITY/STATE:
TIMEPLACEDATE:TIME:DAM0PM
OFINCIDENTACTIVITY: EVENT TYPE: LOCATION:
HAPPENEDTONAME:SSN:
DATEOFBIRTH:SEX:0Male OFemalePHONE:!\ADDRESS: CITY: STATE: ZIP:
FUNCTIONAS: 0PARTICIPANT0VOLUNTEER0STUDENT
0OTHER:
APPARENTBODYPART:
INJURYCONDITION:(Laceration,Concussion,Sprain,Fracture,Etc.):ORDAMAGE 0ON-SITECAREONLY,BY(PHYSICIAN)(EMn(TRAINER)OTHER: 0AMBULANCE,TAKENTO: CITY:
0FATALITY
OCCASIONWHATWASTHESITUATIONAND EXACTLOCATIONATTHETIMEOFTHE INCIDENT?
INCIDENTDESCRIBEWHAT HAPPENED:
DESCRIPTION
WITNESSES / NAME: / NAME:(Ifknown) / ADDRESS: / ADDRESS:
PHONE:I \PHONE:I\
PASTOR/PARISH/NAME:PHONE:I\
SCHOOLTITLE:ORGANIZATION:
ADMINISTRATORSIGNATURE:DATE:
COMPLETEALLSECTIONSANDFAXORMAILIMMEDIATELYTO:
K&KINSURANCEGROUP,INC.,P.O.BOX2338,FORTWAYNE,IN46801-2338
THISFORMMUSTINCLUDETHEINSUREDNAME,POLICYNUMBER,ANDSIGNATUREOFTHEINSURED/REPRESENTATIVEBEFORERETURNINGORPROCESSINGMAYBEDELAYED
1029_5_10CATHMUT
KI N S U R A KN C E
OnbehalfofNationwideInsurance
1712MagnavoxWay P.O.Box2338FortWayne,Indiana46801
(800)237-2917Fax(260)459-5915
email:
CatholicMutual
ACCIDENT MEDICAL INSURANCE
CLAIMFORM
InsuredName:DioceseofBaker(StudentAccidenUCAT)
PolicyNumber:FPX0000025473200FPX0000025472600
ITISIMPORTANTTHATALLINFORMATIONREQUESTEDONTHISCLAIMFORMBEFURNISHED.OMISSIONOFVITALINFORMATIONWILLCAUSEDELAYINCLAIMPROCESSING.
TOBECOMPLETEDBYINJUREDPERSONORPARENT
PARTII
MEDICALBENEFITS UNDERTHISPOLICYMAYPROVIDEPRIMARY,EXCESSORACOMBINATIONOFBOTHCOVERAGES.UPONRECEIPTOF THISCLAIMFORM,ANACKNOWLEDGEMENT LETTERWILLBESENTTOYOUADVISINGWHATSPECIFICBENEFITSYOUAREENTITLEDTO.
IFTHEMEDICALBENEFITISEXCESS,YOURCLAIMSHOULDBESUBMITIEDTOTHEINSURANCECOMPANYPROVIDINGCOVERAGETOYOUTHROUGHYOUROWNORYOURPARENT'SPERSONALHEALTHPLAN,YOUREMPLOYERORGOVERNMENTALHEALTHPLAN.AFTEROTHERINSURANCEBENEFITSHAVEBEENSUBMITTED,YOUSHOULDFORWARDACOPYOFTHEOTHERINSURANCECOMPANY'SEXPLANATIONOFBENEFITSANDTHECORRESPONDINGITEMIZEDMEDICALSTATEMENTS.IFYOURINSURANCECOMPANYDENIESBENEFITS,SENDACOPYOFTHEIRDENIAL.
WEWILLNOTPROCESSYOURCLAIMWITHOUTEMPLOYERINFORMATION.ITISIMPERATIVETHATWERECEIVEALLDATAREQUESTED.TIMELYRECEIPTOFREQUESTEDINFORMATIONWILLHELPEXPEDITEPROCESSINGOFYOURCLAIM.
INJUREDPERSON:
SPOUSE'SNAME(ifapplicable):_
FATHER·sNAME(ifinjuredisaminor)
MOTHER'SNAME(ifinjuredisaminor)_
EMPLOYER NAME:
EMPLOYERNAME:._
EMPLOYER ADDRESS:
EMPLOYERADDRESS:_
CITY:._
STATE:ZIP:
CITY:___STATE:ZIP:_
PHONE:'\
PHONE:_..______
GROUPINSURANCE COMPANY:
GROUPINSURANCECOMPANY.______
POLICYNUMBER:
POLICYNUMBER:__
INSURANCE COMPANYADDRESS:
INSURANCECOMPANYADDRESS:_
CITY.:_
STATE:ZIP:
CITY:___STATE:ZIP:__
SOCIALSECURllYNUMBER:
SOCIALSECURITYNUMBER:__
SIGNATURE:
SIGNATURE:._
IWAIVEANYPROVISIONOFLAWTOTHECONTRARYANDHEREBYAUTHORIZEK&KORITSREPRESENTATIVESTOFURNISHTOANYHOSPITAL,PHYSICIANOROTHERPERSONWHOHASATIENDEDME,AND MYINSURANCECARRIER,ANYANDALLINFORMATIONWITH RESPECTTOTHEACCIDENTALINJURYFORWHICHlAMCLAIMINGINSURANCEBENEFITS.
IWAIVEANYPROVISIONOFLAWTOTHECONTRARYANDHEREBYAUTHORIZEANYHOSPITAL,PHYSICIANOROTHERPERSONWHOHASATIENDEDME,ANDMYINSURANCECARRIEROREMPLOYER,TOFURNISHTOK&KORITSREPRESENTATIVESANYANDALLINFORMATION WITHRESPECTTOANYSICKNESSORINJURY,MEDICALHISTORY,CONSULTATION,PRESCRIPTIONS,ORTREATMENT,ANDCOPIESOFALLHOSPITAL,MEDICAL,ORINSURANCERECORDSINCLUDING,BUTNOTLIMITEDTO,INFORMATIONREGARDINGOTHERINSURANCECOVERAGES.IAGREETHATAPHOTOCOPYOFTHISAUTHORIZATION SHALLBECONSIDEREDASEFFECTIVEASTHEORIGINAL.
IUNDERSTANDTHISAUTHORIZATIONISNECESSARYTOFACILITATETHEOBTAININGANDPROVIDINGOFINFORMATIONNEEDEDTOQUICKLYPROCESSMYCLAIM.
SIGNED:_____
PleaseNote:Ifinjuredpersonisaminor,signaturemustbeofparentorlegalguardian.
DATE:_
1029_5_10CATHMUT
APPLICABLEINALASKA
Apersonwhoknowinglyandwithintenttoinjure,defraud,ordeceiveaninsurancecompanyfilesaclaimcontainingfalse,incomplete,ormisleadinginformationmaybeprosecutedunderstatelaw.APPLICABLE IN ARIZONA
Foryourprotection,Arizonalawrequiresthefollowingstatementtoappearonthisform.Anypersonwhoknowinglypresentsafalseorfraudulentclaimforpaymentofalossissubjecttocriminal andcivilpenalties.
APPLICABLEINARKANSAS,DELAWARE,KENTUCKY,LOUISIANA,MAINE,MICHIGAN,NEWJERSEY,
NEWMEXICO,NEWYORK,NORTHDAKOTA,PENNSYLVANIA,SOUTHDAKOTA,TENNESSEE,TEXAS,VIRGINIA,ANDWESTVIRGINIA
Anypersonwhoknowinglyandwithintenttodefraudanyinsurancecompanyoranotherperson,filesastatementofclaimcontaininganymateriallyfalseinformation,orconcealsforthepurposeofmisleading,informationconcerninganytact,materialthereto,commitsafraudulentinsuranceact,whichisa crime,subjecttocriminalprosecutionand[NY:substantial]civilpenalties.InLA,ME,TN,andVA,insurancebenefitsmayalsobedenied.
APPLICABLEINCALIFORNIA
For your protection, California law requires thefollowing toappearonthisform:Any personwho
knowinglypresentsafalseorfraudulentclaimforpaymentofalossisguiltyofacrimeandmaybesubjecttofinesandconfinementinstateprison.APPLICABLE IN COLORADO
It is unlawful to knowingly provide false,incomplete,ormisleadingfactsorinformationtoaninsurancecompanyforthepurposeofdefraudingorattemptingtodefraudthecompany.Penaltiesmayinclude imprisonment,fines, denial of insurance,andcivildamages.Anyinsurancecompanyoragentofaninsurancecompanywhoknowinglyprovidesfalse,incomplete,ormisleadingfactsorinformationtoapolicyholderorclaimantforthe purposeofdefrauding or attempting to defraud the policy
holderorclaimantwithregardtoasettlementorawardpayablefrominsuranceproceedsshallbereportedtotheColoradoDivisionofInsurancewithintheDepartmentofRegulatoryAgencies.APPLICABLE IN THE DISTRICT OFCOLUMBIA
Warning:Itisacrimetoprovidefalseormisleadinginformationtoaninsurertorthepurposeofdefraudingtheinsureroranyotherperson.Penaltiesincludeimprisonmentand/orfines.APPLICABLE IN FLORIDA
PursuanttoS.817.234,FloridaStatutes,anypersonwho,withtheintenttoinjure,defraud,ordeceiveanyinsurerorinsured,prepares,presents,orcausestobepresentedaproofoflossorestimate
ofcostorrepairofdamagedpropertyinsupportofaclaimunderaninsurancepolicyknowingthattheproofoflossorestimateofclaimorrepairscontainsanyfalse,incomplete,ormisleadinginformationconcerninganyfactorthingmaterialtotheclaimcommitsafelonyofthethirddegree,punishableas
providedinS.775.082,s.775.083,orS.775.084,
FloridaStatutes.
APPLICABLEINHAWAII
Foryourprotection,Hawaiilawrequiresyoutobeinformedthatpresentingafraudulentclaimforpaymentofalossorbenefitisacrimepunishablebyfinesorimprisonment,orboth.
APPLICABLEINIDAHO
Anypersonwhoknowinglyandwiththeintenttoinjure,defraud,ordeceiveanyinsurancecompany
filesastatementofclaimcontaininganyfalse,incompleteormisleadinginformationisguiltyofafelony.
APPLICABLEININDIANA
Apersonwhoknowinglyandwithintenttodefraudaninsurerfilesastatementofclaimcontaininganyfalse,incomplete,ormisleadinginformationcommitsafelony.
APPLICABLEINMARYLAND
Anypersonwhoknowinglyandwillfullypresentsa
falseorfraudulentclaimforpaymentofalossorbenefitorwhoknowinglyandwillfullypresentsfalseinformationinanapplicationforinsuranceis
guiltyofacrimeandmaybesubjecttofinesandconfinementinprison.
APPLICABLEINMINNESOTA
Apersonwhofilesaclaimwithintenttodefraudorhelpscommitafraudagainstaninsurerisguiltyofacrime.
APPLICABLEINNEVADA
PursuanttoNRS686A.291,anypersonwhoknowinglyandwillfullyfilesastatementofclaimthatcontainsanyfalse,incompleteormisleadinginformationconcerningamaterialfactisguiltyofafelony.
APPLICABLEINNEWHAMPSHIRE
Anypersonwho,withpurposetoinjure,defraudordeceiveanyinsurancecompany,filesastatement
ofclaimcontaininganyfalse,incompleteormisleadinginformationissubjecttoprosecutionandpunishmentforinsurancefraud,asprovidedinRSA638:20.
APPLICABLEINOHIOAnypersonwho,withintenttodefraudorknowingthathe/sheisfacilitatingafraudagainstaninsurer,submitsanapplicationorfilesaclaimcontainingafalseordeceptivestatementisguiltyofinsurancefraud.
APPLICABLEINOKLAHOMA
WARNING:Anypersonwhoknowinglyandwithintenttoinjure,defraudordeceiveanyinsurer,makesanyclaimfortheproceedsofaninsurancepolicycontaininganyfalse,incompleteormisleadinginformationisguiltyofafelony.
APPLICABLEINRHODEISLAND
Anypersonwhoknowinglypresentsafalseorfraudulentclaimforpaymentofalossorbenefitorknowinglypresentsfalseinformationinanapplicationfor insurance isguiltyofacrimeand
maybesubjecttofinesandconfinementinprison.
APPLICABLEINWASHINGTON
Itisacrimetoknowinglyprovidefalse,incomplete,
ormisleadinginformationtoaninsurancecompanyforthepurposeofdefraudingthecompany.Penaltiesincludeimprisonment,finesanddenialofinsurancebenefits.
FRAUDCIAIMS(2010102)
DearParticipant: Ifyouhaveanappointmentwithadoctorastheresultofasportrelatedinjury,pleaseshowthisdocumenttothedoctor'sinsurancesecretary.Youshouldbeidentifiedasamemberofthefollowing preferredprovidernetworksand/ortheiraffiliates.
DearDoctororProvider:Thisdocumentindicatesthatthispatientisaparticipantinthefollowingpreferredprovidernetworksand/ortheiraffiliates:
FtTrhestHealth
Network
--
HYGEIA
INSTRUCTIONS FOR COMPLETING THEACCIDENT INSURANCE FORMTO THE INJURED PERSON/PARENT /GUARDIAN
Totheinjuredperson/parenVguardian:
CompletepartIIofthisclaimform.Attachcurrentitemizedphysician,hospital,orotherprovider'sbillsforaccidentmedicalexpensesaswellaslheprimarycarrier'sexplanationofbenefitshowingtheirpaymentanddenial.Thesebillsmustshowthepatient'sname,condition(diagnosis),typeoftreatmentgiven,datetheexpensewasincurred,andthechargesmade.ReturnthisformtoK&KInsuranceGroup,Inc.Pleasenote:Claimformswillbereturnedifnotfullycompletedandsigned.Omissionofvitalinformationwillcauseadelayinclaimprocessing.
1029_5_10CATHMUT
1712MagnavoxWayP.O.Box2338FortWayne,Indiana46801-2338(800)637-.4757Fax(?60)459-5866
IMPORTANTINFORMATION
PLEASEREADCAREFULLY
OneofthespecializedbenefitsK&Kprovidesisourprofessionalclaimsservice. Wearepleased
tohaveyouasourclientandtoextendthisservicetoyou.
EnclosedisasupplyofCaseReportFormsforyouruseinreportingaccidentsonyourpremisesthat result in bodily injury and/or property damage. Early, accurate informationisusedbyK&KClaimspersonneltodeterminewhetheritshouldbetreatedasapotentialclaimagainstyourinsuran·ce,orasan"incident"tobefiledawayforfutureuseifneeded.
K&K'sCaseReportFormsaredesignedtohelpyoureportinformationpromptly andaccurq.tely.Theyalsopermitustogatherlosshistoryinformationforanalysisandprovidefurtheropportunitytominimizethecostofclaims.Usetheseformstoreportanyinjurytoapatronthatrequiredemergencyn:iedicalattentionand/orreferralformedicalcare.Also,includeanyinjurytoeitherthepersonorafamilymember.
Ifaseriousaccidentshouldoccur,particularlyonewithcriticalorfatalinjuries,callK&Kimmediately.Ourclaimsnumberisoperational24hoursaday,sevendaysaweekat1-800-237-2917.Thiswillenableustobecomeinvolvedimmediately,providingguidanceandadvice.
As indicated, complete the form by choosing the correct opt.ions and adding information
todescribetheoccurrence.
Itisourgoaltoworkcloselywithyoutoprovidethebestclaimserviceavailabletoday.P'leasecontactusifyouhaveanyquestions.
K&KInsuranceGroup,Inc.
114810/03
1712MagnavoxWay
P.O.Box2338
FortWayne,Indiana 46801-2338
(800)237-2917Fax(260)459-5910
CA#0334819
INCIDENT REPORTINGINSTRUCTIONS EMERGENCY PROCEDURES
EMERGENCYPROCEDURES
1.ACTION:Followyourwrittenplanandtakeappro
priatecareofalllnjuiedpersons.
2.NOTICE:Incidentscanhappenanywhere.AdvisingK&Kassoonaspracticalafteranincidentoccurssurroundingyourevent,regardlessofthelocationoftheincidentorwhetherornotyoufeelyouareresponsibleforthebodilyinjuryorpropertydamage,isessential.Ifappropriate,anadjusterwillbeassigned Immediately.
3.STATEMENT:Donotmakeanystatementsregardingthecauseoftheaccident.Givenoopinionsorconjecturestoanyoneotherthanyourinsurancecompanyrepresentative.
DONOTADMITTOLJABILiTY. DONOT
INFERORPROMISETOPAY.
Useonlytheacceptablestatement:"Theacci
dentisunderinvestigation,"NOTHINGMOREi
4.INVESTIGATION:Cooperatewithyourinsurancecompanyrepresentative.Letthispersonmakeanyandallconclusiveinvestigations.
5.WITNESSES:Securenames,addressesandphone
numbers(homeandwork)ofwitnessesassoonas
possibleaftertheaccident.NOTHINGMORE!
6.PHOTOS:Takephotosofallaccidentscenesassoonaspossible.
WAIVERRELEASE:(Ifrequired)Ifinsuredpersonwasinrestrictedarea,locate signedWaiverandReleaseimmediatelyandstoreinsafeplace.Sendtotheinsurancecompanyonlybyrequestandbyregisteredmail.RetainphotocopyofWaiverandReleaseforyourfile.
LOCALAUTHORITIES:Iftheincidentisinvestigatedbylocalauthorities,identifytoK&K,I.e.police,fromwhattown,countyandstate.
CASEREPORTFORM:Completeallinformationrequiredandavailablewlthln24hours.Minimuminformationshouldincludefacilitynameandaddress,dateofaccident,victim'sname,addrBssandphonenumber;familynameandphonenumberiffatality;andthesignatureofthepersonthatcompleted form.
MailASAP-nothingcanbehandledbytheinsuringcompanywithoutthisinformation.
REMEMBER:NOTIFY K&KOFALLINCIDENTS,NOT.JUSTTHOSECATASTROPHICINNATURE.
PREPAREFOREMERGENCIES
1.HaveaqualifiedpersondesignatedtomakeALLprivate,publicormediastatements.Makeallpersonnelawarethatonlythedesignatedstatementpersoninquiresaboutaloss.
2.Makeaseparatequalifiedpersondesignated forallemergencymedical,fireandsecurityoperations.
3.Haveadequatepersonnelonsite:security,medical,andfire protectionservicesandequipment."Adequate"meansproperandprudentforyouranticipatedattendanceandeventactivity.
4.Havebackuppersonnelandequipment,includingbackuppowersources,inplacetomaintaineventintegrity.
. 5. Haveawrittencrisismanagementplanthataddressesall"worstscenario"situations,includingevacuation.
6.Trainandpracticeallemergencyprocedures.
7.Ifpolicywordingrequiresit,haveadequatesuppliesofWaiverandReleaseforms.Haveadequateaccidentreportingformsonsite.ThosewhomustsignaWaiverandReleaseformarethosepersonspracticingand/orparticipatinginanyathletlceventsponsoredbyyou,aswellasanyoneenteringarestrictedarea,whichisgenerallydefinedasanyareawhereadmittancetothegeneralpublicisprohibtted.
8.HavethenameandnumberofyourInsuranceContactpostedprominently..Incaseofamajorspecta1orlossorfatality,K&K's24-hournumberis260-45S-5000.Haveonepersonresponsibleforthiscall.CallK&Kdirect; donotrelyonaBroker,etc.torelaythecall.
SD-10 (1010) 1/03