Disability Insurance for Professional Athletes-Individual Sports
Professional athletes participating in an individual sport who are highly ranked may insure themselves in the event of a career ending injury or illness. Below is the contract language explaining the way the policy works.
Here is a partial list of the individual sports covered:
- Olympic Athletes
- UFC Ultimate Fighting Champion
- Tae Kwon Do
- Auto Racing
- Horseback Riding
- Horse Racing
- Body Building
- Martial Arts
- Auto Racing
- Speed Skating
- Ice Skating
- Snow Boarding
- Track and Field
PART ONE-INSURING AGREEMENT
In the event that the Insured sustains Bodily Injury caused in and of itself by an Accident
occurring during the Certificate period and which, solely and independently of any other
cause, results in the Total Disablement directly culminating in the Permanent Total
Disablement of the Insured and providing the Total Disablement commenced within
twelve (12) months of the date of such Accident, then the Insurers agree to pay the benefits
stated in the Schedule to the Insured.
In the event that the Insured sustains any Sickness or Disease which first manifests itself
during the Certificate period and which solely and independently of any other cause results in
the Total Disablement directly culminating in the Permanent Total Disablement of the
Insured and providing the Total Disablement commenced within twelve (12) months of the
date of such first manifestation, then the Insurers agree to pay the benefits stated in the
Schedule to the Insured.
PART TWO – DEFINITIONS
For the purposes of this Insurance:
1. Insured shall mean the person identified in the Schedule as such.
2. Bodily Injury shall mean a specific physical injury caused by an Accident, which
occurs while this Certificate is in force.
3. Accident shall mean a single sudden and unexpected event, which occurs at an
identifiable time and place and which causes unexpected Bodily Injury at the time it
4. Total Disablement shall mean the Insured’s complete and total physical inability to
Participate in his occupation as stated in the Schedule.
5. Permanent Total Disablement shall mean that the Insured has suffered continuous
Total Disablement for the Waiting Period stated in the Schedule, and that as a result
of the Accidental Bodily Injury or Sickness or Disease giving rise to the Total
Disablement, the Insured has no likely hope of improvement, sufficient to
Participate ever again in his occupation as stated in the Schedule.
6. Waiting Period shall mean the continuous period of time stated in the Schedule
during which the Insured must be Totally Disabled before any claim for Permanent
Total Disablement will be considered. No covered claim shall exist and no benefit
shall be due or payable under this Certificate unless and until the Insured has suffered
Total Disablement for the continuous period as stated in the Schedule, culminating in
Permanent Total Disablement.
7. Sickness or Disease shall mean physical illness or malady.
8. Manifest, or Manifestation shall mean the date when a Sickness or Disease is
reasonably capable of diagnosis by a Physician.
9. Participate, Participation or Participating shall mean that the Insured is available
and/or physically able to practice or perform in his occupation as stated in the
10. Physician shall mean a health care practitioner (other than the Insured or a member
of the Insured’s immediate family) licensed to practice medicine, prescribe or
administer drugs and perform surgery.
PART THREE – EXCLUSIONS
This Certificate does not cover disability wholly or partially, directly or indirectly caused by,
contributed to by or aggravated by:
1. war or any act of war, whether war is declared or not;
2. suicide, self-destruction, attempted suicide or self destruction, or intentionally self inflicted
injury, while sane or insane;
3. the Insured’s own criminal or felonious act as defined by the laws of the jurisdiction
where the crime takes place, which results in a conviction of the Insured;
4. the death of the Insured, howsoever caused. No covered claim shall exist and no
benefit shall be due or payable under this Certificate in the event of the death of the
Insured whether or not such death is caused directly or indirectly by the Accidental
Bodily Injury or Sickness or Disease and whether or not such death occurs during
the Waiting Period. No claim shall be assumed nor payable under this Certificate in
the event of the disappearance of the Insured;
5. the Insured;
(a) being under the influence of drugs or narcotics that are not lawfully available,
unless prescribed for the Insured by a qualified Physician;
(b) using any drugs or substances in violation of the rules or regulations of the
governing body of the sport in which the Insured performs;
(c) using any performance enhancing anabolic steroids, stimulants and
corticosteroids, unless prescribed for the Insured by a qualified Physician;
6. conditions of psychotic, psychoneurotic or epileptic origin;
PART FOUR – CONDITIONS AND OTHER PROVISIONS
1. CONDITIONS PRECEDENT TO RECOVERY: The conditions and provisions set
forth herein are conditions precedent to the obligation of the Insurers to pay any
benefits hereunder. Any exclusions, terms or conditions of coverage under this
Certificate do not preclude the Insurers from imposing other exclusions, terms or
conditions on any other Temporary or Permanent Total Disablement Certificate or
any other Certificate issued by the Insurers on the same Insured.
2. NOTICE OF ACCIDENTAL BODILY INJURY or SICKNESS or DISEASE:
Notice of any Accidental Bodily Injury or Sickness or Disease which may give rise
to a claim under this Certificate, together with full particulars, shall be given to the
Insurers, through their representatives as stated in the Schedule, within twenty (20)
days after its occurrence.
3. SUBMISSION OF INCIDENT REPORT FORM: An Incident Report Form shall be
submitted to the Insurers, through their representatives as stated in the Schedule,
within ninety (90) days after the commencement of Total Disablement. The
completed Incident Report Form shall be accompanied by an executed general
medical record release signed by the Insured. Such forms shall be available through
the Insurers’ representatives as stated in the Schedule.
4. SUBMISSION OF PROOF OF PERMANENT TOTAL DISABLEMENT FORM:
Within twenty (20) days after the commencement of Permanent Total Disablement,
the Insured shall submit a Proof of Permanent Total Disablement Form, certifying
that the Insured has suffered Permanent Total Disablement as defined within this
Certificate. Such Form shall be available through the Insurers’ representatives as
stated in the Schedule. Such Form shall not be submitted until after the
commencement of Permanent Total Disablement, it being understood that no
covered claim shall exist and no benefits shall be due or payable hereunder until after
the completion of the Waiting Period as stated in the Schedule and satisfaction of all
Certificate terms and conditions.
5. INSURERS’ ACCESS TO ADDITIONAL MATERIALS: The Insured shall provide,
assist and cooperate with the Insurers, or their representatives as stated in the
Schedule, in obtaining any other records the Insurers deem necessary to evaluate the
incident or claim.
6. CLAIMS COOPERATION: In no event shall the Insurers be liable to pay any
benefits hereunder unless the Insured cooperates with the Insurers and their
representatives as stated in the Schedule in the investigation of the incident or claim.
7. RIGHT TO MEDICAL EXAMINATION: After initial notice of Accidental Bodily
Injury or Sickness or Disease the Insurers shall be allowed to secure the Insured’s
medical records, to monitor treatment and/or to send any medical examiner selected
by the Insurers to examine the Insured and every facility shall be given for such
PART FOUR – CONDITIONS AND OTHER PROVISIONS (continued)
8. INSURERS’ DUTY TO PAY: Payment may be made under this Certificate only after
the Insured has submitted, through the Insurers’ representatives as stated in the
Schedule, the completed Incident Report Form, a general medical release signed by
the Insured, any other materials requested by the Insurers, or their representatives as
stated in the Schedule, and the Proof of Permanent Total Disablement Form, and only
after the Insurers and their representatives as stated in the Schedule have completed
an investigation of such incident or claim.
No benefits shall be payable under this Certificate if the Insured refuses to undergo
any reasonable and not inherently dangerous medical treatment to improve the
condition giving rise to the claimed inability to perform.
9. REHABILITATION: If, after a period of Total Disablement, the Insured
Participates in their occupation as shown in the Schedule and performs the duties
thereof on a full-time basis for a period of at least an aggregate of the number of
regular season or post season games/events and/or play-off or championship
games/events as shown in the Schedule, the Insured shall be deemed conclusively to
have been fully rehabilitated and no claim shall be payable hereunder.
10. CHANGE IN CONTRACT STATUS OF INSURED: No benefits shall be payable
hereunder if the Insured’s contract for their services in the occupation stated in the
Schedule is terminated prior to Total Disablement directly culminating in the
Permanent Total Disablement.
11. NO ASSIGNMENT OF CERTIFICATE: No assignment of this Certificate, or any
rights hereunder, shall be binding upon the Insurers unless the Insurers assent thereto
12. NON DISCLOSURE: Any material misstatement, non-disclosure or concealment,
whether or not such are innocent or fraudulent, in relation to any matter affecting this
Insurance shall render this Certificate voidable at the option of the Insurers.
13. FRAUDULENT CLAIMS: The making by the Insured of any fraudulent claims
shall render this Certificate null and void as from the inception date, and all claims
hereunder shall be forfeited.
14. PAYMENT OF PREMIUM: In the event that the premium(s) as stated in the
Schedule, other than the initial payment, is (are) not paid within thirty-one (31) days
of its (their) due date then this Certificate shall automatically lapse from the date such
unpaid premium was due. The total premium is under all circumstances always fully
due in the event of any claim being paid hereunder.
PART FOUR – CONDITIONS AND OTHER PROVISIONS (continued)
15. LIMITATION OF ACTIONS: No action at law or in equity shall be brought to
recover under this Certificate prior to ninety (90) days from the submission, through
the Insurers’ representatives as stated in the Schedule, of a completed Proof of
Permanent Total Disablement Form, nor shall such action be brought unless the
Insured has complied with all of the terms and conditions of this Certificate, and in
no event after the expiration of two (2) years from the commencement of Permanent
16. ENTIRE CONTRACT: This Certificate, including any Schedule, Endorsement,
Rider, Contract Details between the Insured and the organization stated in the
Schedule, or Proposal, attached hereto, constitutes the entire contract of insurance. No
change in this Certificate shall be valid until approved by the Insurers in writing and
unless such approval be endorsed hereon or attached hereto. No agent has authority to
change this Certificate or to waive any of its provisions.
17. CONFORMITY WITH LAW: Any provision of this Certificate which, on its
effective date is in conflict with the laws or statutes of the state/province/country
governing this Certificate, is hereby amended to conform to the minimum
requirements of such laws or statutes.
18. CONSTRUCTION OF WORDS REGARDING GENDER: All aforesaid words which
are used in the masculine gender shall be understood to be feminine where applicable.
19. REFUND OF BENEFITS: In the event that the Insurers pay a claim under this
Certificate and the Insured subsequently recovers sufficiently to resume the
occupation stated in the Schedule, the Insured agrees to immediately refund all
monies paid to him hereunder by the Insurers.