Student Accident (Education Training)

Palm Beach State College students who are enrolled in classes that may result in injury during training or clinical experience situations (e.g., in certain Criminal Justice, Health Sciences, Public Safety and Trade & Industry programs) are responsible for all medical and/or personal expenses resulting from treatment of any such injury. However, to assist with this expense, all students in covered programs are covered by Student Accident (Education Training) Insurance coordinated by the College and paid for by the student as part of the course registration fee. This insurance coverage is in excess of any private insurance the student may have and is in effect only during classwork and/or training. If the student has their own private health insurance coverage, the College's policy will pay for any out-of-pocket expenses not covered by the student's own insurance, e.g., any deductible or co-payment. If the student has no private health insurance, the College's policy will cover an accident fully up to its limit of $25,000. However, students returning to the College for agility tests, re-certifications, etc. are not eligible for this insurance.

If you are a student in a covered program who becomes injured while participating in classwork or training under that program, you should immediately inform your class supervisor or instructor of the accident. Your supervisor/instructor will then contact Security in order for them to complete a formal Accident – Incident Report. If you need any medical treatment for your injury, our policy allows for the first expense for treatment of the injury to be incurred up to 26 weeks after the accident. Upon deciding that you need medical treatment, or as soon as possible thereafter, you must inform your supervisor/instructor, who is responsible for obtaining the claim form, which you must complete, sign and submit. The completed and signed claim form must be submitted within 30 days of your first treatment to the claims administrator, AG Specialty Insurance, at www.agspecialtyinsurance.com or by email to claims@agadm.com. The Claim Form MUST be signed by you, the student, as well as by your Instructor, or Risk Management. Be sure that you keep a copy of the completed claim form for your records and send a copy to the Risk Manager at MS#66, Building SEC 103.

Following any medical treatment, your medical insurance carrier (if you have one) will send you an Explanation of Benefits (EOB) outlining what they have paid or will pay and what they will not pay. You must send the EOB and any bills you may receive from your medical provider with your claim form, or as soon as possible thereafter. Once your claim has been submitted to AG Administrators, they will contact you directly regarding the status.  Please feel free to contact the PBSC Risk Manager at riskmanagement@palmbeachstate.edu or 561-868-4015 if you need any assistance.

The Claim Form can also be accessed at the link below. If you have any questions or comments regarding the Student Accident (Education Training) Insurance program, please contact the PBSC Risk Manager at riskmanagement@palmbeachstate.edu or 561-868-4015. If you have any questions regarding the status of a claim, please contact AG Specialty Insurance at 610-935-0800 or www.agspecialtyinsurance.com. 

 

Accident Claim Form

Programs Covered

Student Accident Program Guide

Summary of Coverage

Brochure