Internal Payout Limitations

Accident insurance policies that cover sports and recreation organizations such as teams, leagues, camps or recreation departments should not include internal payout limitations which are also known as allocated benefits or sublimits.
Examples of these unacceptable internal payout limitations, allocated benefits, or sublimits include:
  • Limiting surgeons’ fees to $2500
  • Limiting daily hospital room and board to $100
  • Limiting doctors’ visits to $20
  • Limiting physiotherapy to $10
These internal payout limitations effectively reduce the payout for moderate to serious injuries to 50%  of total medical bills in many cases.  A reduced payout leads to unpaid medical bills which can result in a lawsuit against a sports organization and its administrators, employees, and volunteers in an effort to find a deep pocket.
These internal payout limitations should always be avoided for normal sports and recreation activities.  However, in the case of high risk adult sports and activities, it may not be possible to negotiate affordable terms with an Accident carrier without such provisions.