2026-2027 SCHOOL YEAR

Following is information outlining the benefits and exclusions of the accident insurance program.  Please note that the insurance is “secondary” to any other insurance coverage the family may have and will pay only on eligible medical expenses not payable by other sources of coverage.

If accidental bodily injury occurs during a school sponsored and school supervised activity and requires treatment within 35 days from the original date of injury by a licensed physician or treatment in a legally constituted hospital, the insurance company will pay the reasonable and customary expenses for necessary medical, dental or hospital care provided within one year from the date of the injury up to the policy maximum amount for any one injury, which are not paid by other collectible insurance plans.  The insured shall have free choice of a physician or hospital for treatment.  If, however, an insured has other valid coverage through another insurance plan(s) and does not chose a physician or hospital through the other plan, we will pay benefits as if the other plan’s guidelines had been followed.

• Click Here to Download a Summary of Insurance

POLICY MAXIMUM BENEFITS

TREATMENT MUST COMMENCE WITHIN 35 DAYS. ** NOTE **  SUBMIT A CLAIM TO COMPANY WITHIN 90 DAYS FROM THE DATE OF ACCIDENT ** NOTE **
BENEFITS AVAILABLE FOR ONE YEAR FROM DATE OF INJURY.

POLICY EXCLUSIONS

1. Suicide, self-destruction, attempted self-destruction, or intentional self-inflicted Injury while sane or insane.
2. War or any act of war, declared or undeclared.
3. An Accident which occurs while the Covered Person is on Active Duty in any Armed Forces, National Guard, military, naval or air service or organized reserve corps.
4. Injury sustained while in the service of the armed forces of any country. When the Covered Person enters the armed forces of any country, We will refund the unearned pro-rata premium upon request.
5. Participation in a riot or insurrection.
6. Any Injury requiring treatment which arises out of, or in the course of fighting, brawling, assault, or battery.
7. Sickness, disease, bodily or mental infirmity or medical or surgical treatment thereof, bacterial, or viral infection, regardless of how contracted. This does not include bacterial infection that is the natural foreseeable result of an Accidental external bodily injury or accidental food poisoning.
8. Disease or disorder of the body or mind.
9. Mental or Nervous disorders, except as specifically provided in the Policy.
10. Asphyxiation from voluntarily or involuntarily inhaling gas and not the result of the Covered Person’s job.
11. Voluntarily taking any drug or narcotic unless the drug or narcotic is prescribed by a Physician and not taken in the dosage or for the purpose as prescribed by the Covered Person’s Physician.
12. Intoxication or being under the influence of any drug or narcotic.
13. Injury caused by, contributed to, or resulting from the Covered Person’s use of alcohol, illegal drugs or medicines that are not taken in the dosage or for the purpose as prescribed by the Covered Person’s Physician.
14. Driving under the influence of a controlled substance unless administered on the advice of a Physician.
15. Driving while Intoxicated. Intoxicated will have the meaning determined by the laws in the jurisdiction of the geographical area where the loss occurs.
16. Violation or in violation or attempt to violate any duly enacted law or regulation, or commission or attempt to commit an assault or felony, or that occurs while engaged in an illegal occupation.
17. Conditions that are not caused by a Covered Accident.
18. Charges which are in excess of Usual and Customary charges.
19. Expenses incurred for an Accident after the Benefit Period shown in the Schedule of Benefits.
20. Regular health checkups.
21. Any Accident where the Covered Person is the operator of a motor vehicle and does not possess a current and valid motor vehicle operator’s license.
22. Travel in or upon: A snowmobile; A water jet ski; Any two or three wheeled motor vehicle, other than a motorcycle registered for on-road travel;
    Any off-road motorized vehicle not requiring licensing as a motor vehicle;
23. Travel or flight in or on any vehicle for aerial navigation, including boarding or alighting from:
    While riding as a passenger in any Aircraft not intended or licensed for the transportation of passengers; or
    While being used for any test or experimental purpose; or
    While piloting, operation, learning to operate or serving as a member of the crew thereof; or
    While traveling in any such Aircraft or device which is owned or leased by or on behalf of the Policyholder of any subsidiary or affiliate of the Policyholder, or by the Covered Person or any member of His household.
    A space craft or any craft designed for navigation above or beyond the earth’s atmosphere; or an ultralight hang-gliding, parachuting, or bungee-cord jumping
    Except as a fare paying passenger on a regularly scheduled commercial airline. 
24. Treatment for an Injury that is caused by or results from a nuclear reaction or the release of nuclear energy. However, this exclusion will not apply if the loss is sustained within 365 days of the initial incident and:
    The loss was caused by fire, heat, explosion, or other physical trauma which was a result of the release of nuclear energy and The Covered Person was within a 100-mile radius of the site of release either:
    At the time of the release; or
    Within 24 hours of the start of the release; or
    Occurs while the Covered Person is in
25. Elective or Cosmetic surgery, except for reconstructive surgery on an injured part of the body.
26. Services rendered for detection and correction by manual or mechanical means (including x-rays incidental thereto of structural imbalance, distortion, or subluxation in the human body for purposes of removing nerve interference where such interference is the result of or related to distortion, misalignment, or subluxation of or in the vertebral column.
27. Pregnancy; childbirth; miscarriage; abortion; or any complications of any of these conditions. This does not apply if treatment is required as a result of a Covered Accident.

HOW TO FILE A CLAIM

PLEASE SUBMIT A CLAIM TO COMPANY WITHIN 90 DAYS FROM THE DATE OF ACCIDENT. Medical Bills must be submitted within one year from the date of service.  Late bills cannot be processed.

1)  Present a claim to your own insurance company FIRST.  After a settlement has been made with your insurance company, make certain all questions on the claim form are completed. This coverage is secondary, EXCESS insurance. You must file a claim with your primary family insurance first. If your son or daughter has an accident at school and you have purchased the student insurance program, please obtain a claim form from the school principal's office or the athletic office where your son or daughter attends school.

2) Part B of the claim form will need to be filled out by the school official. The Parent is required to complete Part A and mail to KidGuard Insurance's claim office. Please follow the instructions printed on the claim form.

• Download Claim Form

3) You will need to attach copies of all itemized medical bills. If you have other primary insurance you will need to file a claim with your primary insurance carrier and include a copy of the letter or statement from your primary insurance indicating the payments provided by them or their reasons for refusal to pay benefits to you. Email: Claims@KidGuardinsurance.com (for submitting claim forms, EOB's and itemized bills)

4) It is the Parent/Legal Guardian’s responsibility to file a claim within 90 days from the date of accident. The school is not responsible for filing claims. However, they will provide you with a claim form or you can download one from this website or contact KidGuard Insurance (a division of Doxa Programs, LLC) to obtain a claim form. Please forward the completed claim form no later than 90 days after the date of accident to be eligible to receive any available policy benefits. You must file a claim with any other primary insurance, even if you have a deductible. This includes HSA, HMO or PPO plans. 

WE CANNOT ACCEPT CLAIMS SUBMITTED ON-LINE because a school official’s signature and the parent/legal guardian signature are needed on the form. You only need to submit ONE completed claim form for each accident. You do not have to send another claim form if you are submitting additional bills that come in later. PLEASE DO NOT CALL THE SCHOOL ABOUT THE STATUS OF A CLAIM PAYMENT OR TO ASK QUESTIONS ABOUT COVERAGE. Contact: KIDGUARD INSURANCE if you need answers to claim or coverage issues. The school does not keep records regarding claims. All claims are processed by KIDGUARD INSURANCE'S claim office.

When contacting the office about a claim, please state the full name of your injured son or daughter and the SCHOOL DISTRICT where he or she attends school. We need the school name to reference the claim information for you. Generally, valid claims are processed within 15-20 working days after receipt of completed claim information.

WHERE TO SEEK MEDICAL TREATMENT

If a student has primary insurance they should stay in that primary insurance network even if they have a deductible. They must file a claim with any primary insurance coverage first to be eligible for the student accident insurance even if they have a deductible. 

If there is no primary insurance coverage, students may seek medical treatment from any licensed hospital or licensed physician and be eligible to receive the stated school policy benefits that are outlined in the enrollment application.  It is the parent or student's responsibility to ask the Doctor or provider of service if they are participating in the network and what out of pocket expense they may be held accountable for paying. Please refer to the summary of insurance benefits above for a summary listing of policy benefits, limitations and exclusions.

The Insurance Company cannot regulate how much doctors or other providers of service charge. Doctors and Hospitals are allowed to establish and charge their own fee levels. Doctors and Hospitals may charge more than what the School Insurance accident insurance policy pays. The insurance benefits will be paid based upon the stated policy provisions.

ADDRESS INQUIRIES AND CLAIMS TO ADMINISTRATOR:
KIDGUARD INSURANCE
P. O. BOX 140926
ORLANDO FL. 32814
Phone Number: 407-798-0290

PLEASE READ CAREFULLY:
You must indicate on the claim form the name of your personal insurance company and your policy number before benefits can be paid by the insurance plan.  Failure to provide complete claim information will prolong payment of allowable benefits. 

KidGuard is a division of DOXA Programs, LLC, an Indiana limited liability company. All claims activities and services are performed and provided by DOXA Claims, LLC, a Florida limited liability company licensed as an insurance claims administrator in all jurisdictions in which services are provided. For more information regarding DOXA Programs, LLC, or DOXA Claims, LLC please visit our website at www.doxa.com/compliance.

LAW STATES: Any person who knowingly and with intent to injure, defraud or deceive any insurance company, files a statement of claim or an enrollment form containing any false or incomplete, or misleading information is guilty of a felony of the third degree.