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Athletic Insurance Information & Forms - Cleveland State Community College - Cleveland State Community College

Athletic Insurance Information & Forms

Injury Information

To ensure quality care for our athletes, Cleveland State will employ a Certified Athletic Trainer. All athletic injuries must be evaluated and referred to our physicians or your physician by our Athletic Trainer. Athletes are highly encouraged to go through the proper channels when an injury occurs. The exception to this policy is when the team is traveling and a medical emergency occurs. 

All Cleveland State student-athletes must have a physical before they will be allowed to practice.  Physicals will be offered to all Cleveland State student-athletes.  The physicals will be administered by Benchmark Physical Therapy. Each respective coach will let student-athletes know the date and time that physicals will be given. Student-athletes are free to have a physical completed by your family physician. If they choose to do so, they must complete the enclosed Medical History Form and have the doctor complete the physical examination section and return it to their coach when they arrive on campus. All student-athletes will be responsible for having a physical prior to the beginning of school. They will not be able to participate in practices until they have a physical.                             

All injuries will initially be evaluated by our trainer, through Benchmark Physical Therapy. Student-athletes have the option of having injuries evaluated by a physician. Student-athletes will be referred to by our trainer or their own physician.  If they have the injuries evaluated by their own physician, Cleveland State will need to have a copy of the exam report for insurance purposes in their athlete file.

 

Insurance Information

Cleveland State Community College provides secondary athletic accident insurance for the benefit of our student-athletes.  This coverage is provided by Bob McCloskey Insurance and is offered on an excess basis only.  Under the terms of the policy, this coverage is considered to be excess to all other valid and collectible medical insurance policies. Per college policy, there will be a $2000.00 deductible per athlete per injury.  All claims must be filed with the student-athlete’s primary insurance company prior to being submitted through the College’s insurance. All student-athletes must have primary coverage that will include coverage for athletic-related injuries.  If a student does not have primary coverage, the college’s insurance will cover the injury once the $2,000.00 has been met by the athlete. 

In the event that a student-athlete is injured while participating in a covered sport, it is important for us to know about any medical coverage they may have to avoid delays in claim processing.  It should be noted the person responsible for the primary insurance plan is also responsible to insure the claim is filed properly with their insurance company.  Be aware that claim filing does take a considerable amount of time, especially those with more than one insurance plan, so please be patient until the claim is completed. After the bill is filed with their insurance, if a student-athlete still receives a bill for the excess, please mail the bill, copy of your explanation of benefits and an itemized copy of the bill to the College to: Mike Policastro, Director of Athletics at the following address: Cleveland State Community College, P.O. Box 3570, Cleveland, TN 37320-3570. If you have any questions concerning the billing process and/or health related questions, please feel free to contact Mike Policastro, Director of Athletics at (423) 478-6219.

 

Forms

Athlete Physical Examination Form
 
Sports Medicine - Insurance Information