Sports Medicine: Injury & Insurance Policies
Table of Contents
- Policies for reporting injuries
- Insurance information
- Policy exclusions
- Submitting secondary claims to Calvin College
If you sustain an injury, it should be reported to the athletic training staff as soon as possible. This can be done in person, by phone, or by email. The athletic training staff will evaluate the injury and take action as deemed appropriate. If an illness occurs and you seek treatment from Calvin College Student Health Services, you should notify the athletic training staff as soon as is reasonably possible. This is to simplify communication between the sports medicine staff and the medical personnel at Student Health Services, should your illness impact participation status.
Calvin College provides secondary insurance coverage for injuries resulting from injuries that occur during competition or supervised practice. You must report these injures to the athletic training staff to retain this secondary coverage. Seeking medical treatment without prior approval from the sports medicine staff, except in an emergency situation, will result in a loss of insurance benefits. Please see the insurance section below for more information regarding the secondary insurance policy.
You are not required to check with the athletic training staff prior to receiving treatment for an injury or illness; however the sports medicine staff is available during the entire academic year. If you do sustain an injury that may impact your participation status, reporting the injury to the athletic training staff will help to facilitate the gathering of medical information necessary to clear you to return to full participation in intercollegiate athletics. The student-athlete is responsible for any and all costs incurred for the treatment of injuries or illnesses during out-of-season competition or training.
The NCAA requires that all participating student-athletes be covered by a valid primary health insurance policy. Thus, Calvin College requires proof of insurance coverage. Submitting this information is part of your initial athletic physical process. If your insurance information or coverage changes, it is your responsibility to provide this information the Calvin College.
If you are not a Michigan resident, please contact your insurance company prior to reporting to campus to ensure that you will maintain all coverage benefits while you are away from home at college. This is due to the fact that many insurance companies provide different levels of coverage while you are “traveling” outside of your home region. By contacting your insurance company and alerting them to the fact that you will be living in a different area of the country, you may be able to maintain all of your insurance benefits.
Please note that KnightCare does NOT provide coverage for "athletic injuries." As there are several exclusions to Calvin’s secondary insurance policy which will potentially be encountered by many student-athletes, it must be understood that any bills incurred for injuries that fall under these exclusions will be the sole responsibility of the student-athlete. As such, it is recommended that student-athletes look into other types of insurance which will provide coverage for “athletic injuries” to avoid being held completely responsible for potentially large medical expenses.
Secondary athletic insurance
Calvin College provides secondary athletic accident coverage for all student-athletes participating in varsity and junior varsity intercollegiate athletics. This policy provides coverage for outstanding medical bills incurred as a direct result of an athletic accident after your primary insurance coverage has been exceeded. An athletic accident is defined as an unexpected, sudden, and definable event which is the direct cause of bodily injury independent of any illness, prior injury, or congenital predisposition.
Coverage is not provided for medical expenses that are not a direct result of a referral from a member of the Calvin College Sports Medicine Staff. Coverage is also not provided for medical expenses resulting from illness, disease, or conditions unrelated to an athletic accident. These conditions include, but are not limited to, pre-existing conditions, out-of-season injuries, injuries that occur in-season which are not directly related to supervised practice or competition (i.e. classes, intramurals, etc), or routine medical care (i.e. vision, dental, etc). This policy does not provide benefits for:
Treatment, services, or supplies which:
- are not Medically Necessary;
- are not prescribed by a Doctor as necessary to treat an Injury;
- are determined to be Experimental/Investigative in nature;
- are received without charge or legal obligation to pay;
- are received from persons employed or retained by the School or any Family Member, unless otherwise specified; or
- are not specifically listed as Covered Charges in this Policy.
Intentionally self-inflicted Injury, violating or attempting to violate any duly enacted law. Injury by acts of war, whether declared or not.
Injury received while traveling or flying by air, except as a fare-paying passenger on a regularly-scheduled commercial airline.
Injury covered by Worker’s Compensation or the Occupational Disease Law.
Treatment of illness, disease or infections, except pyogenic infections or bacterial infections, which result from the accidental ingestion of contaminated substances.
Treatment of Osgood-Schlatter’s disease; appendicitis; osteomyelitis; pathological fractures; congenital weakness; TMJ; fainting; headaches; boils; detached retina unless directly caused by Injury; or mental or Nervous Disorders whether or not caused by Injury.
Injury contributed to by the use of alcohol or drugs no prescribed by a Doctor.
Injury caused by or contributed to aggravation or reinjury of a Pre-existing Condition.
Suicide or attempted suicide while sane; or self-destruction or an attempt to self-destroy while insane.
Fighting, except as an innocent victim.
Expense incurred for the use of orthotics unless used exclusively to promote healing.
Heart and/or circulatory malfunction resulting from participation in a Covered Activity such as stroke, heat exhaustion (except as specifically stated), heart attack, and brain circulatory malfunctions.
Repetitive motion Injuries, strains, hernia, tendinitis, bursitis, spondylolysis, osteochondritis dissecans, and heat exhaustion (except as specifically stated) not related to a specific Injury.
Any penalty imposed by Other Valid and Collectible Insurance or Plan for failure to follow plan procedures.
If you suffer an athletic accident during in-season competition or supervised practice and generate medical expenses that are associated with that accident, you must first file claims with your own personal insurance company.
If a balance remains after the personal insurance company has paid its maximum, that balance can then be submitted to the Calvin College secondary insurance company.
If the expense is covered, Calvin College’s insurance company will pay the balance of the eligible medical expenses up to the maximum of the policy.
If your primary insurance coverage is through a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO), the proper procedures required by the plan must be followed in order for Calvin College’s insurance to complete its portion of the claim. This is especially important if your insurance plan requires pre-authorization to have treatment out of your plan’s network or service area.
To pay the balance of the bill, you must submit all outstanding bills to the head athletic trainer along with a copy of the explanation of benefits (EOB) which you should receive from your insurance company showing that they have already paid their maximum. Submit bills to:
Joe Dykstra, ATC
Head Athletic Trainer
3195 Knight Way SE
Grand Rapids, MI 49546
Phone: (616) 526-7630