2014 INSURANCE SUMMARY USA Swimming
2014 Insurance Summary
Table of Contents Page
MembershipProtection .................................................................................................2
Excess Accident Medical Insurance .................................................................................2
Liability Insurance Program ...........................................................................................3
A. General Liability .............................................................................................3
Coverage & Limits of Liability.....................................................................3
B. Excess Liability...............................................................................................3
Coverage & Limits of Liability.....................................................................3
Exclusions.........................................................................................................4
InsuredActivities ..............................................................................................5
Certificates (requesting).......................................................................................5
Reporting Requirements/Online Report of Occurrence Form ...............................................6
Liability Provisions in Club Contracts...............................................................................6
Liability/Medical Release Form ......................................................................................7
OptionalInsurance .......................................................................................................8
Certificates Now (additional insured endorsements)..........................................................9
USA Swimming
1 Olympic Plaza
Colorado Springs, CO 80909-5770
Phone: 719/866-4578
FAX: 719/866-4050
The following is a narrative summary of coverage provided by the various policies and is not
intended to change, modify or negate any policy terms, provisions, conditions and/or exclusions.
Revised January, 2014
Membership Protection
USA Swimming's policy for membership protection is:
• To provide safety education for its membership;
• To provide excess accident medical protection for USA Swimming members who may suffer injuries
while participating in insured activities;
• To provide evidence of financial responsibility so that USA Swimming clubs can conduct insured
activities.
To implement this policy, USA Swimming has adopted two major programs:
• Excess Accident Medical Protection
• General Liability Insurance
These two programs are intended to provide reasonable protection for USA Swimming athletes, non-
athlete members and clubs.
EXCESS ACCIDENT MEDICAL INSURANCE DESCRIPTION OF COVERAGE
Carrier: Mutual of Omaha Insurance Company
Policy Number; TSMP-SP-35054
Policy Term of Coverage: January 1, 2014 to January 1, 2015
Insureds: Members of USA Swimming
When Coverage Starts: Coverage is a benefit of membership in USA Swimming and begins upon
receipt of the completed membership application form with appropriate fee
and acceptance by the LSC Registration/Membership Chair or its designee.
When Coverage Is In Effect:USA Swimming members are covered while participating in a USA
Swimming supervised, sponsored, sanctioned or approved event including:
• Competitions and meets;
• Organized practice sessions;
• Approved social and fund raising activities;
• Travel to and from competitions, meets, events, organized practice sessions, approved social
and fundraising activities at the direction of a coach or club board of directors;
• OVC events for USA Swimming Officials only
Coverage Outline:
When covered Injuries result in treatment by a Legally Qualified Physician beginning within 90 days of the
accident, the Medical Expense incurred in excess of the Medical Deductible, if any, will be paid. Benefits
will not exceed a maximum of$25,000.00. Benefits must be Medically Necessary and shall not exceed the
Usual and Customary charges in the geographic area where treatment is performed. Only covered Medical
Expenses incurred by the Insured within 52 weeks from the date of the accident are covered.
Benefits:
• $25,000.00 maximum per occurrence for Accident Medical Expenses. Eligible Medical Expenses are: (a)
Treatment by a Legally Qualified Physician; (b) Care or services from a Hospital or Ambulatory Surgical
Center; (c) Services from a registered graduate nurse (RN or LPN) not related to the Insured by blood
or marriage; (d) Professional ambulance service; (e) Orthopedic appliances; (f) Injuries to sound and
natural teeth.
• $1,000.00 maximum per occurrence for Chiropractic or Physical Therapy treatment/expenses
Deductible/Excess:
This program is excess to any other insurance in place through the member's employment, school or
family. Benefits for Medical Expense will be paid only for such expense which is not recoverable from any
other insurance policy, service contract or workers'compensation. The deductible amount is the total of all
other collectible benefits from primary insurance sources applicable to the Injury or$100.00 of medical
expenses when there is no primary insurance available.
Revised January, 2014 2
Exclusions and Limitations:
No coverage is provided for: (a) suicide while sane or intentionally self-inflicted injury while sane; (b)
Injuries caused by an act of declared or undeclared war; (c) Injuries received while in the armed service
(upon notice to us of entry into an armed service, the pro rata premium will be refunded); (d) Injuries
received while acting as a pilot or crew member; (e) Injuries resulting from air travel, except while as a
passenger for transportation only; (f) Injuries resulting from the Insured's engagement in or attempt to
commit a felony or being engaged in an illegal occupation; (g) Injuries received while under the influence
of any controlled substance, unless administered on the advice of a Legally Qualified Physician; (h)
Injuries received while Intoxicated; (I) Injuries sustained while traveling, except as specifically provided;
(j) the cost of eyeglasses, contact lenses or examinations for either; (k) the cost of dental treatment,
except as specifically provided for Injuries to sound, natural teeth; (1) injuries covered by workers'
compensation or employer's liability laws; or (m) any health related expenses; and (n) Elite Athletes.
How to File a Claim:
Claim forms are sent to the injured party upon USA Swimming National Headquarters receipt of a
completed Report of Occurrence form and verification of the injured party's USA Swimming membership.
All bills must first be submitted to any group hospital/medical and/or HMO coverage for which the member
is eligible. Copies of any Explanation of Benefits (paid or denied) documents from an individual or group
hospital/medical and/or HMO coverage must accompany all bills.
Completed claim forms should be submitted to Mutual of Omaha — Special Risk Services as
directed on the claim form. Additional claim forms may be obtained by contacting USA Swimming
National Headquarters.
This description of coverage summarizes the provisions of the Mutual of Omaha Insurance
Company policy issued to USA Swimming. Should there be any discrepancy between the policy
and this description, policy provisions will prevail.
LIABILITY INSURANCE PROGRAM
A. General Liability
Insurance Company: National Casualty
Policy Number: KK00000003948800
Policy Term: January 1, 2014 to January 1, 2015
12:01 a.m. Mountain Standard Time
Coverage & Limits:
Coverages Limits of Liability
Bodily Injury and Property Damage Combined $1,000,000 Each Occurrence
General Aggregate $None
Personal Injury and Advertising Injury $1,000,000
Damage to Rented Premises $1,000,000
Products-Completed Operations $2,000,000 Annual Aggregate
Medical Payments (third party) $5,000 Any One Person
Sexual Abuse/Molestation $1,000,000 Each Occurrence
Sexual Abuse/Molestation $5,000,000 Annual Aggregate
Employee Benefits Liability $1,000,000 Each Claim ($1,000 Deductible)
Employee Benefits $2,000,000 Annual Aggregate
B. Excess Liability
Insurance Company: National Casualty
Policy Number: KKO0000003948900
Policy Term: January 1, 2014 to January 1, 2015
12:01 a.m. Mountain Standard Time
Coverage & Limits:
Coverages Limits of Liability
Bodily Injury and Property Damage Combined $4,000,000
Personal Injury and Advertising Injury $4,000,000
Revised January, 2014 3
Products Completed Operations $4,000,000
General Aggregate $4,000,000
*There is no excess liability coverage provided for Abuse and Molestation
Who is Insured:
• Named Insureds
n I ISA Swimming. Inc. dba USA Swim mina
o USA Swimming Local Swimming Committees
o USA Swimming Foundation
• Other Insureds - Clubs or Group Members but only as respects liability arising from"Covered
Activities":
USA Swimming, Inc. member clubs, in which all athletes or participants and coaches are members of
USA Swimming, Inc., group members and "member coaches"solely as respects to"bodily injury"and
"property damage"arising from "covered activities"for which a group member has received approval
from USA Swimming, Inc. or its authorized representative.
Exclusions-OTHER INSUREDS ONLY: (The following list is not inclusive)
This insurance does not apply to bodily injury and/or property damage, claims or suits arising out of or
related to:
• The use of a diving board or diving platform regardless of when it occurs, how it occurs and/or whether
it is related to Insured Activities. This exclusion does not apply to starting platforms as described by
the technical rules of United States Swimming, Inc. in effect on the date of the occurrence.
• Racing starts in a water depth less than the minimum required in the USA Swimming Inc. (dba USA
Swimming) Technical Rules or by any municipal, local, or state ordinance, regulation, code, or statute in
effect at the date of the occurrence.
• Any occurrence arising out of or related to any sporting activity other than swimming. This exclusion
does not apply to dryland training activities and intra club water polo.
• The ownership, entrustment, maintenance, operation, use, loading or unloading of any automobile or
aircraft owned or operated by or rented or loaned to any insured, or any other automobile or aircraft
operated by any person in the course of his employment by any Insured.
• Any obligation for which the Insured or any carrier as his insurer may be held liable under any workers'
compensation, unemployment compensation or disability benefits law, or under any similar law.
• Damage to property owned or occupied by or rented to the insured, property used by the insured, or
property in the care, custody.
• Empioyment-related practices including but not limited to wrongful termination, discri�,,nation or sexual
harassment.
• Any intentional acts.
• Pollution with Hostile Fire&Water Treatment Chemicals exception.
• Player vs.Player
• Fireworks,Hot Air Balloon,Dunk Tanks,Haunted Houses,Amusement Devices*,Rodeos,Bungee Operations,
Concerts and Climbing Walls.
*Amusement Devices-means any device or equipment a person rides for enjoyment, including but not limited to, any
mechanical ride, slide, water slide (including any ski or tow when used in connection with a water slide), moonwalk or
moon bounce, bungee operation or equipment.Amusement device also includes any vertical device or equipment used
for climbing-either permanently affixed or temporarily erected.Amusement device does not include any video arcade or
computer game.
Revised January, 2014 4
This description of coverage summarizes the provisions of the National Casualty policy issued to
USA Swimming. Should there be any discrepancy between the policy and this description, policy
provisions will prevail.
Insured Activities-OTHER INSUREDS ONLY: (Inclusive)
The insurance afforded by this policy applies to any Other Insured for insured activities. Insured activities
are defined as:
• Swimming meets that have been issued a written meet sanction or a meet approval;
• Swimming practices, dry-land activities and Learn-to-Swim programs where all swimmers are
registered as athlete members of USA Swimming or USMS and which are conducted under the direct
and active supervision of a USA Swimming member coach;
• United States Swimming, Inc. Swim-A-Thons®;
• Approved social events and approved fund raising activities;
• Swimming Tryouts;
• Office Premises;
Meet sanction is defined as a permit that has been issued by a Local Swimming Committee to a USA
Swimming, Inc. group member to conduct a meet in conformance with all USA Swimming rules.
Meet approval is defined as a permit that has been issued by a Local Swimming Committee for meets
conducted in conformance with USA Swimming rules in which both members and non-members compete.
USA Swimming, Inc. member clubs that either host or participate in an approved swimming meet will be
considered an insured provided that all of its athletes or participants and coaches are members of USA
Swimming, Inc.
Member coach is defined as a coach member of USA Swimming who has completed Safety Training for
Swim Coaches and CPR as well as successfully completed a Background Check, and if applicable, Coaches
Education as required by USA Swimming.
Approved social events and approved fund raising activities are events and activities that have been
approved by USA Swimming, Inc. or by Risk Management Services, Inc.
Swimming Tryouts are defined as swimming practices where Swimmer(s), who are not and who have
never been members of USA Swimming, participate with a USA Swimming club or seasonal club, for a
period not to exceed thirty consecutive days in any twelve month period, in order to determine the
Swimmer(s) interest in registering as a member of USA Swimming.
Dryland Training Activities are defined as weight training, running, calisthenics, exercise machine
training and any other activity for which an Other Insured has received approval from USA Swimming,
Inc. or Risk Management Services, Inc.
Certificates(requesting):
• Liability Certificates. Verification of Coverage Certificates for clubs are automatically sent to each
registered USA Swimming member club with the yearly club insurance packet. Additional certificates
are available upon request from USA Swimming National Headquarters.
• Additional Insured Endorsements and Certificates. Additional Insured Certificates and
Endorsements are available on the Internet, by going to the following website:
www.certificatesnow.com. Instructions for issuing the certificates are attached (see page 11). The
Additional Insured Endorsement Certificates are not automatically renewed each year. You may
request Certificates be issued by Risk Management Services, Inc. at a cost of$25.00 per certificate.
EXCEPTION: If there are special requirements requested by the Additional Insured, please contact Risk
Management Services, Inc. at 800-777-4930 x10 for assistance at no additional charge.
Revised January, 2014 5
C. Reporting Requirements: (All liability policies)
All claims or incidents must be reported immediately to the USA Swimming National Headquarters and Risk
Management Services, Inc. To submit an incident please use the USA Swimming Online Report of
Occurrence Form by going to this link on the website to complete the form: www.usaswimming.or /g ROO.
You will receive a confirmation email along with the submitted data which you can save or forward as
directed by your LSC.
it is impemtive. that nn nor nn nrlmitc linhility nr rocnnncihility nr rfiq I sses Any aspect of An Incident with
anyone other than an authorized insurance company claims representative of USA Swimming, law
enforcement authorities or emergency medical personnel.
D. Liability Provisions in Club Contracts:
Almost every USA Swimming Member Club is a party to a contract with an owner of a swimming pool,
public or private. Almost all USA Swimming Members, including LSCs and the national organization itself,
will, at one time or another; enter into contracts for the use of a swimming venue for a meet or other
authorized aquatic activity.
Such contracts will include standard language as to time of use, compensation, maintenance and the like.
Such contracts will also contain language with regard to the tort liability of both parties during the use of
the facility. The owner will usually include indemnification and hold-harmless clauses for itself on liability
for bodily injury and property damage resulting from the negligence of the USA Swimming Member, its
officers, agents and employees.
It will be impossible to avoid such releases or waivers couched in general language. The owners, or their
attorneys, may insist on this.
However, it is extremely important that the USA Swimming Member Club, LSC, etc., does not sign a
contract containing language which indemnifies or exculpates (clears from alleged fault or guilt) the owner
from liability for damages resulting from the sole negligence of the owner, or its agents and
employees. Such language may or may not be valid in your particular state. If it is, it is usually subject to
strict interpretation.
If you are in doubt on this, consult an attorney in your own state and at the same time refer him/her to the
General Counsel for USA Swimming.
If you see the following language, or anything similar to it, consult legal counsel at once before signing the
agreement:
Club (LSC) agrees to indemnify Owner against all liability loss, or other damage claims or obligations
because of or arising out of personal injury or property damage, related to Club's (LSC) use and occupancy
of the premises, including that caused by the negligence of the Owner or its agents or employees.
Revised January, 2014 6
LIABILITY( RELEASE AND INDEMNIFICATION R
I, the undersigned participant and parent, request voluntary participation for minor to participate in the
activity on (date) which begins at (time)
and ends at (time) sponsored by all of which
are hereinafter referred to as the"activity".
I consent to my/minor's participation in the activity and acknowledge that the minor and I fully understand
my/minor's participation may involve risk of serious injury or death, including losses which may result not
only from my/minor's own actions, inactions or negligence, but also from the actions, inactions, or
negligence of others, the condition of the facilities, equipment, or areas where the event or activity is being
conducted, and/or the rules of play of this type of event or activity. I understand that if I have any risk
concerns, I should discuss the risks associated with my participation with the activity coordinators and
event staff, before I sign this document and before the activity begins.
Release — Minor's Rights:
In consideration of allowing Minor Participant to participate in this USA Swimming event, I hereby release
and hold harmless USA Swimming, members of its board of directors, and its officers, employees,
members, volunteers, other participants, and agents (collectively, the "Released Parties"), of and from,
and do discharge and waive, any and all claims, demands, losses, damages, and liabilities that Minor
Participant may have or sustain with respect to any and all damage and/or injury, of any type, arising out
of his or her participating in this USA Swimming event. I also agree that if any portion of this agreement is
held to be invalid the balance, notwithstanding, shall continue in full force and effect.
(Print name of minor) (Signature of minor) (Date)
Release — Parents'/Guardians' Rights:
In consideration of allowing Minor Participant to participate in this USA Swimming event, I hereby release
and hold harmless the Released Parties, of and from, and do discharge and waive, any and all claims,
demands, losses, damages, and liabilities that I may have or sustain with respect to any and all damage
and/or injury, of any type, arising from Minor Participant's participation in this USA Swimming event. I
also agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall
continue in full force and effect.
I certify that my/minor is in good health and have no physical condition that would prevent participation in
this activity. Furthermore, I agree to use my/minor's personal medical insurance as a primary medical
coverage payment if accident or injury occurs. I consent to emergency medical treatment in the event
such care is required.
(Print name of Parent/Guardian) (Signature of parent) (Date)
Indemnification by Parent/Guardian:
The undersigned parent/guardian further agrees to indemnify, save and hold harmless the Released Parties
from any and all claims, demands, losses, damages and liabilities for indemnities, contribution or otherwise
with respect to any damage and/or injury, of any type, arising from Minor Participant's participation in this
USA Swimming event.
(Print name of Parent/Guardian) (Signature of parent) (Date)
Send completed Liability Medical Release form to:
Risk Management Services, Inc.
P.O. Box 32712
Phoenix, AZ 85064-2712
or Fax to: (602) 274-9138
Revised January, 2014 7
Optional Insurance
The following optional insurance coverages may be obtained on an individual basis by LSCs or USA Swimming
clubs. For further information, contact:
Risk Management Services, Inc. Phone: (800) 777-4930 toll free
P.O. Box 32712 or (602) 840-3234
Phoenix, AZ 85064-2712 Fax: (602) 274-9138
Website: www.theriskpeople.com
Directors and Officers & Employment Practices Liability Insurance for USA Swimming Member Clubs
Definition. Provides coverage for defense costs and liabilities incurred by insured directors and officers arising
out of claims alleging that an insured has committed "wrongful acts," which means any error, misstatement,
misleading statement; act, or omission, neglect or breach of duty by policy definition. This coverage
specifically excludes bodily injury or property damage claims which would likely be covered by the general
liability policy. Also proviries coverage for wrongful termination(s), harassment and other employment related
situations.
Limit of Liability. $1,000,000
Deductible. $1,000 for the organization.
Premium. Minimum $375
Requirements. Submission of a signed application; prepaid premium.
Crime Coverage for USA Swimming Member Clubs
Provides coverage for dishonest acts of employees or volunteers
Limit of coverage. $25,000
Deductible. $250
Cost. $175 or $275 depending on number of employees
Special Activities/Events
Provides liability insurance for some activities not insured under the USA Swimming program (e.g., learn to
swim programs for non-members). Contact Risk Management Services, Inc. regarding specific coverage and
premium information.
We strongly recommend the Member Clubs consider purchasing Workers Compensation, Property
Insurance for equipment and a Business Owners Package Policy if the club has an office premises.
Contact Risk Management Services, Inc. or a local agent to purchase these coverages.
Revised January, 2014 8
Owdficates Online
Proofoflnsurance for USA ,S'wimmiW Member Clubs
A club's facility or pool might ask you to add them as "Additional Insured"to your policy. You are responsible for processing
these requests yourself directly over the Internet 24 hours a day, 7 days a week. Please call 1-800-777-4930 x10 or x13 with
any questions or for assistance. Please note there is a $25.00 charge for any certificates processed by Risk Management
Services,Inc. The charge does not apply to certificates you need which require special wording.
Note: ifyour club is neii,and you are not in the Certifr'catesNow system, or-you have updated the club's information recently,
contact Kim Tate at 1-800-777-4930 x10, email ktat.a%theriskpeople.com,for assistance in processing your certificate.
1. Go to www.certificatesnow.com.
2. Enter YOUR CLUB'S User ID&Password in CAPITAL LETTERS: (this will be your "2"digit LSC code and "2
"3"or "4"digit Club code that can be found in your UM S14,imming membership renewal pack) Ex: see below....
USER 1D: Example: CO-XX or VA-XXXX (all caps and the"dash")
PASSWORD: SWIM(DO NOT CHANGF THIS PASSWORD)
3. Click on"Deliver Certificates" in the middle of your screen.
4. Select the"2014 USA Swimming Member Club Certificate"and hit Continue.
Do not add pour own swim club name or any,individual person as recipient.
The certificate must state the.facility or facility°owner that requested this Certificate. Always enter the facility or
facility owner's address, no matter which delivery method}you choose.
5. Now you can either:
a) Select a Recipient(Certificate Holder)and hit"Continue". Add New Recipient if non showing.
b)Change a Recipient(Certificate Holder)by clicking on the blue name. The field will open
and you can edit the information. Make sure to save the information, select the Holder and hit"Continue"
d)Add a new Recipient(Certificate Holder). Click on"New Recipient",a window opens. Enter Name, Address,
City, State,ZIP, Country of the location that asked you for this Certificate.
NOXt choose a delivery method. You have the option to e-mail, fax, US-Mail, or save only. Depending on the
method you choose you need to enter the information in the appropriate field. e.g., if you choose e-mail you will
need to enter the e-mail address.
Click"Save", Select the Recipient and hit"Continue"
6. Review Information and hit continue.
7. Review Delivery Method and hit continue.
8. This is the last screens For a copy of the Certificates for your files, Check®to send yourself an e-mail of this
certificate. A copy will be sent to the main e-mail address that is registered with USA Swimming.
9. Hit"Deliver Now"and Yo u'i- ]one...
You will be directed back to the beginning;this means that your certificate has been sent. The system may take up to 48 hours
to deliver the certificate so plan ahead to allow for this delivery tirne.
Revised January, 2014 9
CERTIFICATE ADDENDUM
"Covered Activities"
With respect to USA Swimming member clubs, group members, member coaches,
volunteers and additional insured owners/lessors of premises, sponsors and co-
promoters, "Covered Activities" are defined as:
1) Swimming meets that have been issued a written sanction or approval. Approval
means a permit issued by one of the USA Swimming, Inc. Local Swimming
Committees for swimming meets conducted in conformance with USA Swimming,
Inc. technical rules in which members and non members may compete. USA
Swimming, Inc. member clubs that either host or participate in a swimming meet that
has been issued an approval will be considered an insured provided that all of its
athletes or participants and coaches are members of USA Swimming, Inc.
2) Swimming practices, dry land training activities and learn to swim programs, where
all swimmers or participants are members of USA Swimming, Inc. and are
conducted under direct and active supervision of a member coach. A Member
Coach is defined as a coach member of USA Swimming, Inc. who has complied with
safety training required by USA Swimming, Inc. Dryland training activities means
weight training, running, calisthenics, exercise machine training, and any other
activity for which an insured has received approval from USA Swimming, Inc. or its
authorized representative.
3) USA Swimming, Inc. Swim-A-Thons, Fund raising activity which clubs can purchase
for lap-a-thons through the USA Swimming Foundation.
4) Approved social events and approved fund raising activities that are social events
and activities for which an insured has received approval from USA Swimming, Inc.
or its authorized representative.
5) Swimming Tryouts. Swimming Tryouts means swimming practices where a
swimmer(s) who is not and who has never been a member of USA Swimming, Inc.
participates with a USA Swimming, Inc. club for a period not to exceed thirty
consecutive days in a twelve month period to determine the swimmer's interest in
becoming a member of USA Swimming, Inc.
6) Office premises liability for Member Clubs