2012-2013
Dear UDM Student-Athletes:
Enclosed you will find important forms and information regarding your athletic participation at the University of Detroit Mercy. Also, you will come across the scheduled dates and times for physicals and appraisals for the upcoming 2012-2013 school year. Please print all forms legibly. All of the information must be completed in full so that in the event you are injured, we can deliver the best treatment, make the proper referral, and provide the medical provider with necessary information. In addition, it is an athletic department requirement that we have on file a photocopy of your insurance card(s) both front and back before the beginning of the school year. If you have previously provided the sports medicine staff with a photocopy both front and back of your current primary insurance card, please disregard this notice. If there are any changes to any information during the school year with regards to your insurance, address, or parents’ and/or legal guardians’ employer information, please let us know immediately. Student-athletes who fail to provide a valid insurance card will be automatically enrolled in the student health center insurance and be charged according. It is the student-athletes responsibility to maintain primary health insurance coverage during the academic year. If the primary insurance lapses and you fail to notify or pick up primary coverage, you will be held accountable for any accumulated cost for any athletic related injury or illness.
The University of Detroit Mercy has a secondary athletic accident insurance policy. This policy provides secondary insurance coverage for injuries you may incur while participating in an intercollegiate sport. Our policy does not cover the following situations and/or circumstances:
- Athletic injuries or illnesses that are pre-existing in nature
- Chronic or Overuse athletic injuries
- Medical Illnesses such as Mononucleosis, Strep Throat, Influenza, etc.
- Athletic injuries that are not directly related to UDMintercollegiate sport participation
- Athletic injuries that are not directly reported to the UDM Sports Medicine Staff in a timely manner
- Second medical opinions not authorized by the UDM the Director of Sports Medicine
In addition, the University of Detroit Mercy will not be held responsible for any medical bills above and beyond the usual and customary cost as dictated by the insurance industry. Please understand that most universities operate under the same regulations.
In the event you sustain an injury which is eligible for secondary insurance coverage under the UDM policy, the following steps will occur:
1)We file an injury report with our insurance company indicating a legitimate claim may be forthcoming.
2)You or your parents/legal guardians are responsible for submitting bills to your primary insurance plan if the medical provider does not do so.
3)Once the bills have been submitted, your insurance carrier will send you or your parents an Explanation of Benefits (EOB) showing what has been paid to the medical provider. Please forward a copy of this EOB and any bills to:
Michael Miller, MS, ATC
Assistant Athletic Director for Sports Medicine
4001 W. McNichols Road
CalihanHall- Athletic Department
Detroit, Michigan48221-3038
Telephone Number: (313) 993-1740
Fax Number: (313) 993-1741
Email:
4)The insurance agency will make requests directly to you or your parents/legal guardians for any information needed to process the
claim. If the insurance agency does not receive the requested information within 60 days of the claim date, your claim is considered
inactive. At this point, any unpaid bills may go on your credit rating. At no time will the school be responsible for securing
the needed information.
Please note that if your primary insurance coverage is through an HMO or PPO, you must see a physician within your network or follow proper procedures required by your plan in order for your insurance and the university’s insurance to satisfactorily complete its portion of the claim. Failure to follow the proper procedures may nullify benefits.Also, Canadian as well as International student-athletes may have to, in certain circumstances, return to Canada or back to their native country to receive medical care for their athletic injuries due to the Canadian Health Care or International Health Care plan.
Finally, pleaseBRING ALL enclosed information to your scheduled physical/appraisal in August or September, or MAILALL enclosed information to the UDM Sports Medicine Department before August 2012. You can also access our required medical forms through the Detroit Titans Athletics website at and click on the sports medicine icon. If you or your parents/legal guardians have any questions, please call the UDM Training Room at your earliest convenience. Thank you for your time and consideration in this matter.