Parents, Students and School Administrators

Hillsborough County Public Schools (Tampa)

How to File a Claim/ Where to Seek Treatment?/ Q&A

Immediately following a student accident, report the accident to a school official so they can complete a student accident report.  Notify your primary insurance immediately so they many start the claims process.  If you do not notify your primary insurance first this could delay your claims.

The Parent/Legal Guardian is required to submit the following items to School Insurance of Florida. 

1. A completed School Insurance of Florida claim form. 

2.  A copy of the school’s student accident report.  

3.  Itemized bills and any primary insurance information and explanation of benefits.

Parents should submit the completed claim form and copy of the accident report to the School Insurance of Florida claim office no later than 90 days after the date of the student’s accident. The school insurance policy will not pay for 100% of all medical expenses due to the limits of the school sports policy as described in the student enrollment application and in this website. Parents must file with their primary insurance first and then School Insurance of Florida. The parent must mail the claim form, copy of the student accident report from the school, copies of medical bills and information from your primary insurance to School Insurance of Florida.  If you have primary insurance and pay for any out-of-pocket copays or deductibles you must ask for an itemized bill in order to be reimbursed by this policy. Valid claims are paid within 7 business days after receipt of completed claim information and records.

The Enrollment Application and Summary of Insurance is provided with the claim form so you will see the benefits you may be eligible to receive. It is the responsibility of the student/student’s parents to file claims. The school district is not responsible for filing claims or payment of any expenses not covered by the school sports insurance policy or any other insurance policy "Listing of Doctors and Providers of Service"

You can download a claim form from this website. However, the school will have to provide you with the student accident report copy. WE CANNOT ACCEPT CLAIMS SUBMITTED ON-LINE because a student accident report is needed and we need copies of original medical bills. 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. The schools do not keep records or have information regarding claims. Contact: School Insurance of Florida if you need answers to claim or coverage issues. The school does not keep records regarding claims. All claims are processed by School Insurance of Florida's claim office.

IMPORTANT: When contacting School Insurance of Florida's office about a claim, please state the full name of your injured son or daughter and the COUNTY 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 7-10 business days after receipt of completed claim information. Completed Claim Information means a complete claim form, accident report, itemized bills, explanation of primary insurance benefits, medical records and any other information requested by the insurance company.

FLORIDA LAW requires us to inform you that: "Any person who knowingly and with intent to injure, defraud or deceive any insurance company, files a statement of claim containing any false, incomplete or misleading information is guilty of a felony of the third degree."

WHERE TO SEEK MEDICAL TREATMENT  -   "Listing of Doctors and Providers of Service" 

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. Please refer to the top part of the enrollment application for a summary listing of policy benefits, limitations and exclusions.  Parents should ask the Doctor or facility what out of pocket expenses they may be responsible for paying, if any.  School Insurance of Florida is developing a "Listing of Doctors and Providers of Service" that have agreed in most cases, not all, to accept the School Insurance benefits.  Please check with the provider of service to see if they are participating and what out-of-pocket expenses you may be responsible for paying, if any.

The Insurance Company cannot regulate how much Doctors or other providers of service charge.  Doctors and Hospitals are allowed to charge their own fees for their services. Doctors and hospitals may charge more than what the school sports policy pays. The insurance company will pay benefits in accordance with the school sports policy provisions. Please download a summary of insurance for a listing of policy benefits terms and provisions. If you have any questions about coverage please contact School Insurance of Florida.

FREQUENTLY ASKED QUESTIONS

 Do all Hillsborough County School students that want to participate in school sports have to pay a Sports Activity fee?

 YES. All Hillsborough County high school and middle school students that want to participate in interscholastic sports must pay the Sports Activity Fee before they will be allowed to participate in practices and competition.  The fee includes coverage for basic accident insurance.  Please download and review the insurance coverage available to you.  Students may obtain enrollment forms from the school coach, this website or Purchase Online Now.

 How do I upgrade coverage from one plan to another? You can either take a money order to the school for the difference or mail in the difference to School Insurance of Florida.  If you mail the additional premium in please allow 5-7 business days and be sure to indicate this is to upgrade your coverage. If you have questions please contact School Insurance of Florida. 

 What if my child is already covered by insurance through a family or employer group insurance policy?  Do we still have to pay the Fee?

YES. All students will be required to pay the Sports Insurance Fee regardless of whether or not you have other primary insurance. The school cannot accurately monitor the insurance status of all students.  Parents may become suddenly and un-expectedly uninsured leaving student athletes unprotected.  In order to keep the cost of the Insurance Fee low, the school policy is secondary to all other insurance.  Therefore, if you do have other insurance the school sports policy might be able to assist in payment of eligible bills not payable by your primary insurance plan, HMO or PPO.  You must first file a claim with all other primary sources of coverage before processing a claim for benefits under the school sports insurance policy. If you do have other insurance or coverage through a HMO or PPO, the school policy may help pay some of your out-of-pocket costs for deductibles or co-pays due to a student’s sports injury. If an athlete is not covered by any other insurance plan, the school sports policy will pay up to the specified limits listed in the school sports insurance policy as summarized in this website. 

 When does the Sports Accident Insurance go into effect and when does coverage end? 

If a student has paid the required Sports Fee before the first day of a school sponsored, school supervised athletic practice, the coverage goes into effect on the first day of practice in August, as sanctioned by the FHSAA, or on the date paid at 11:59 PM, whichever is later.  If the insurance fee is paid after the first day of practice, coverage starts the day after the enrollment and payment of the fee. Coverage cannot be backdated.  Coverage under the school sports insurance plan is effective only while Hillsborough County School students are participating in FHSAA interscholastic sports practices and competition that are exclusively school sponsored, school scheduled, school supervised and school funded during the regular school term. Injuries during other non-sports related activities and regular classes are not covered. This plan will provide coverage for summer cardio conditioning (conditioning is defined as cardiovascular exercise, this does not include practice of any kind) and weighlifting excercises while under the direct supervision of a HCPS coach. 

All coverage under the school sports insurance policy terminates on the last interscholastic sports game scheduled during the regular school term or on the last day of school whichever is first.  Coverage does NOT continue during the summer months for any practices, games, drills, camps or leagues.

 If my son or daughter is injured in a Hillsborough County school sport, do I have to take them to a specific hospital or doctor to receive benefits under the school sports insurance policy? 

"Listing of Doctors and Providers of Service"

NO. Student athletes may obtain medical treatment from any licensed hospital or licensed physician to be eligible to receive school sports insurance medical benefits.  All medical expense benefits are listed in the policy.  All licensed medical providers will receive the same listed policy benefits.

 Will the school sports insurance policy pay for all medical expenses due to a school related sports injury?

NO!  Florida schools are not responsible for school accidents and are not required by law to purchase medical insurance for students. Accidents that happen during school sports are not the fault of the school. Payment for student’s medical expenses is the responsibility of parents. However, since student athletes are subject to some level of risk during practices and competition, the Hillsborough County School District’s, limited sports accident insurance policy, may help parents pay some of the medical expenses due to sports injuries. The school sports insurance plan pays benefits based on the policy schedule of benefit limits and terms. Specific policy limitations and specified payment amounts are listed in the school sports policy.  The school sports policy will not pay for 100% of all medical expenses. Doctors and hospitals are free to set and charge their own fees. However, their fees may be more than the benefits available from the school sports policy. The school cannot accept responsibility for paying any medical bills for students injured during sports or for any expenses not covered by personal insurance or the school sports policy.

 What does the school sports insurance plan cover? 

A detailed description of the school policy benefits, limitations, and exclusions can be viewed and downloaded from this website. An outline of coverage can also be obtained from the school Athletic Office. The Enrollment Application/Summary of Insurance outlines specific sports insurance policy benefits, terms and limitations. The school sports insurance policy benefits are available only for accidental injuries occurring during interscholastic sports practices and competitions that are scheduled and supervised by the Hillsborough County School Board during the regular school term. 

IMPORTANT NOTE: Injuries that may occur during regular school classroom activities are not covered.  Club sports, summer camp sports, summer sports leagues and any sports that are not exclusively sponsored and funded by the Hillsborough County School District and sanctioned by the Florida High School Athletic Association are not covered by the school sports policy. No coverage is available for summer camps, summer practices or drills, summer games or league programs even though these summer programs may be held on school property.

♦ Does this coverage include off-season or summer activities?

 NO!  The insurance coverage only applies for summer conditioning and for regular FHSAA (Florida High School Athletic Association)season practices and games, as sanctioned by the FHSAA.  When the season ends, the insurance coverage will terminate after the last game.  The coverage will extend for off-season conditioning during the regular school term.  Conditioning is defined as weight training and cardiovascular exercise.  These insurance plans do not provide coverage for practices, drills, games, or camps during the summer months or during the offseason.  Only weightlifting and cardiovascular exercise are considered eligible conditioning activities. 'Conditioning' is defined as: 'Weight training'meaning the use of free weights and stationary apparatus. 'Cardiovascular Conditioning' meaning distance and interval training. 'Plyometrics' meaning the use of pre-set conditioning programs. 'Conditioning' IS NOT teaching sport specific skills and drills, and DOES NOT involve the use of sport specific equipment (i.e. starting blocks, hurdles, rebounders, ball machines, bats, footballs, rackets, etc).

 After I enroll and pay the Sports Fee, will my son or daughter get a Sports Insurance I.D. Card?

YES.  I.D. Cards are available.  If you enrolled on-line using a credit card, you will receive an I.D. card on-line once your purchase is complete. Email requests for I.D. Cards will be answered within 2-3 business days (please check your email and be sure we are listed as an email contact).  If you prefer to mail a written request for an I.D. card, please provide a self-addressed stamped envelope with your request.                                                                

 How do I File a Claim?  

You can obtain a claim form from the school coach’s office or download a claim from this website. A completed claim form and the school accident report should be forwarded to School Insurance of Florida within 90 days from the date of accident to be considered eligible for school sports policy benefits.  If you have other insurance through a family or employment policy, you must first file a claim with your other insurance, HMO or PPO before receiving benefit consideration from the school sports insurance policy.  (Please refer to the question above “What if my child is already covered by insurance through a family or employer group insurance policy?  Do we still have to pay the Sports Insurance Fee?”)

 Who do we contact for Answers regarding Claims or Coverage?

Contact School Insurance of Florida to obtain prompt answers to all claim or coverage questions at 1-800-432-6915; Fax: 407-798-0296; Direct Claims: 407-798-0290 or email info@schoolinsuranceofflorida.com. All claims are processed by School Insurance of Florida claims office. Note: The school does not process claims or keep records regarding sports insurance claims. Therefore, do not call the school about claims or coverage questions. The school will not be able to answer claim or coverage questions. Contact School Insurance of Florida's office.

The questions and answers stated above are intended to provide a general, brief explanation and summary of the Hillsborough County School District sports accident insurance policy.  The Hillsborough County School District will receive a master policy that contains all terms and provisions from which all claims benefits will be determined.  The master insurance policy contains specific definitions and terms that may not be included in this website and are not fully explained by the school.  For answers to more specific questions, please contact School Insurance of Florida, P.O. Box 784268, Winter Garden, Florida 34778-4268.

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