What is MAPP?
The member accident protection program of the fraternity is
a benefit of membership. The program is intended to compliment the health
insurance program of every undergraduate member of the fraternity for injuries
as a result of an accident. The premium for this program is paid by the
fraternity and the program may be cancelled or changed at the sole discretion
of the fraternity at any time. The information provided is for informational
purposes only and is not intended to replace the insurance contract. For specific information regarding any
claim, or to determine if your organization purchases this coverage, please
contact Willis.
MAPP
informational brochure 
(pdf format)
What you need to submit when reporting a
claim?
1. Complete
an accidental injury claim form. The link below will allow you to download the
necessary form.
Accidental Injury Claim Form 
(Word format)
2. For an accidental
death benefit claim, you will need to submit an accidental injury claim form
(above) and an accidental death benefit claim form (below) as well as a
Certificate of Death and a copy of the investigating police report, if
applicable.
Additionally, you will need to submit
any medical expenses related to the accident with itemized billing and the
Explanation of Benefits (EOB) received from the primary health insurance
carrier. The link below will allow you to download the necessary death benefit
claim form.
Accidental Death Benefit
Claim Form 
(Word format)
3. If medical
treatment and resulting expenses occur, you will need to submit Itemized bills
showing the name of the provider, diagnosis code for the injury sustained and
procedure codes for the treatment rendered.
4. For each itemized
bill, a copy of the corresponding Explanation of Benefits (EOB) from the
primary health insurer showing what was paid and what is the covered person's responsibility.
If expenses are paid, submit a paid receipt and benefits will be reimbursed
directly to the insured party or guardian.
Who is an Insured Person under the Member Accident
Protection Program?
§
All eligible undergraduate members, associate
members\pledges of the fraternity are insured for covered accidental injuries
which are incurred while the policy is in force and occur while:
§
In good standing with the fraternity. Membership will
be verified with the (inter)national administrative office of the fraternity so
be certain your membership has been reported and all pledge, initiation,
undergraduate dues and risk management\insurance fees have been paid.
§
Enrolled as a student at an institution of higher
learning where there is an undergraduate chapter of the fraternity, except
during appropriate holiday or summer breaks. If a covered injury occurs during
a holiday or summer break, the eligible member will have had to have been an
enrolled student during the prior school term and continuing at an institution
of higher learning the following term.
What Protection is provided?
The following limits of protection are provided:
§
*Accident Medical Expense and/or Dental Injury
§
$5,000 Accidental Dismemberment and/or Accidental Death
Benefit
§
52 Week Benefit Period
§
$0 Deductible
*Note: Specific limits of Accidental
Medical Expense and/or Dental Injury within any program may differ, please contact
Willis to discuss specifics.
How are benefits paid?
§
Additional benefits will be paid only when eligible
medical expense is not recoverable from any other insurance policy, service
contract or workers' compensation policy. This policy will reimburse deductibles
and co-pays of health insurance programs.
§
Benefits for any one accident shall not exceed, in the
aggregate, the Medical Expense Maximum.
§
In the absence of any other applicable coverage, the
coverage provided is primary.
What is Accidental Dismemberment?
When, because of covered injuries, the Insured sustains any
of the following losses within 52 weeks after the date of the accident, the
Company will pay benefits for loss of:
§
Paraplegic or Greater 100%
§
Two or more members 100%
§
One member 50%
Member is defined as hand, foot or sight of eye. The
percentage shown is applied to the Accidental Dismemberment Principal Sum. Loss means severance of the limb at or above
the joint and total and irrecoverable loss of the entire sight. Loss must occur
within 52 weeks after the date of the accident. Only one of the amounts (the largest applicable) will be paid for
any one accident.
What is Accidental Death?
The Company will pay the Accidental Death Principal Sum when
a covered accidental injury results in the Insured's death. Death must occur within 52 weeks of the
covered accident. If Accidental
Dismemberment Benefits have been paid for a loss resulting from the same
accident, the Accident Death Benefit will not be payable. To receive benefits,
loss must be independent of sickness and all other causes.
What is excluded under this coverage?
The Policy does not cover Loss nor provide benefits
for:
- Expenses
for treatment on or to the teeth, except for treatment resulting from
Injury to natural teeth;
- Eyeglasses,
hearing aids, and examination for the prescription or fitting there of;
- Suicide,
attempted suicide or intentionally self-inflicted Injury;
- Injury
due to participation in a riot;
- Cosmetic surgery;
- Loss
resulting from air travel, except as a fare-paying passenger on a
commercial airline;
- Injury
resulting from any declared or undeclared
war;
- Injury
while in the armed forces of any country;
- Injury
covered by any worker's compensation or occupational disease law;
- Treatment provided in a government Hospital unless the Insured is
legally obligated to pay such
charges;
- Infections
except pyogenic or bacterial infections caused wholly by a covered Injury;
- Claims
occurring while parachuting or hand-gliding;
- Expense
covered by any other policy;
- Hernia
in any form;
- Sickness
or disease, in any form;
- Fighting
(unless an innocent victim);
- Injuries
due to intramural tackle football, hockey or rugby. All other intramural
activities are covered;
- All
intercollegiate sport participation including off season conditioning:
- Injuries
resulting from the use of any illicit drug and/or narcotic unless
administered on the advice of a physician.
Note: The listed exclusions are for illustration
and does not list all exclusionary terms of the policy.
To whom are claims reported?
Willis
Claim Department
10707 Pacific Street, Suite 200
Omaha, NE 68114
) (800) 736-4327
2 (800) 328-0522
* fraternityclaims@willis.com
: www.WillisFraternity.com
When you call to report
a claim you will need to reference that you are reporting this claim as a member
of the fraternity program and provide the name of the fraternity and the
university/college at which you are a member.
Important Notes:
§
The Member Accident Protection Program is NOT a
substitute for health insurance. It provides NO protection for sickness or
illness. Every member of the fraternity must be certain that they obtain health
insurance coverage from their parents or other source.
§
Coverage applies to students enrolled at
universities/college within the United States only. Coverage will not apply in
Canadian provinces.
§
The policy requires reporting a covered accidental
injury within 180 days of the original injury. A delay in reporting can cause
your claim to be denied or have your benefit payments delayed.
A premium indication for coverage can be obtained by contacting:
Marketing
Department
Willis
10707
Pacific Street, Suite 200
Omaha, NE 68114
) (800) 736-4327, extension 4191
2 (800) 328-0522
fraternalinsuranceapp@willis.com
