Dear ocal Associations (LAs),
Below is some general information on how rider claims are processed by USAC and K&K insurance. I will add this as an agenda item for our June phone call as well:
When a Report of Occurrence is received by the internal membership coordinator; it is scanned to our insurance company (K&K)
At that time K&K enters it into their system but the claim is pended until the injured rider submits a claim form. K&K does not generate a claim form and send it to the rider. Riders can receive a claim form by calling K&K at 1-800-237-2917 and choosing Option 1. The rider will need to request a USA Cycling Claim Form, fill it out and mail it back to the insurance company.
Our K&K representative will be sending an insurance claim form so it can be added to our insurance information online. The information "choose Option 1 and ask for a USA Cycling Claim Form" will also be added to our online instructions.
Riders may also call the number listed above if they have questions (1-800-237-2917).
Different companies have different processes and with the switch of insurance carriers comes a switch in how claims are handled. Because the insurance company does not officially start a claim until they receive a claim form from the rider, they are then not left with a lot of open claims with no action.
Please let me know if you have any questions. Below is more detailed information for your convenience.
FILING ACCIDENT FORMS
1. Anyone injured at an event must have his or her accident reported to a race official the day of the race.
2. If an injured rider wishes to file a claim, he or she must call 800-237-2917. A claim form must be filed with the insurance company within 30 days of the accident.
3. If an injured rider has primary insurance coverage:
a. They need to file a claim with their primary insurance carrier.
b. They need to call Specialty Benefits, Inc. at the number listed above.
c. They need to submit copies of their medical invoices and an Explanation of Benefits from their primary carrier to:
c/o K & K Insurance Group - Claim Department
1712 Magnovox Way
PO Box 2338
Fort Wayne, IN 46801-2338
4. Once the primary carrier has paid their portion of the medical expenses, the USA Cycling carrier will pay 70% of the Reasonable and Customary remaining expenses ABOVE the deductible, up to a limit of $25,000.
5. If an injured rider has no other medical insurance coverage:
a. Rider must do 1, 2, and 3b as outlined above.
b. Rider must submit their medical invoices directly to the USA Cycling insurance carrier.
c. The USA Cycling carrier will pay 70% of the Reasonable and Customary medical expenses after the $5,000 out-of-pocket deductible up to a limit of $25,000.
Local Association Program Manager
210 USA Cycling Point
Colordo Springs, CO 80919