HomeMy WebLinkAbout07040096 Certificate of Insurance
American Massage Ther~py Association@
Certificate of Insurance
Member ID: 79900
Teresa Marie Hultz
140 1/2 1st 5t NE
Carmel, IN 46032-1802
Member Classification: PROF W
Member Effective Date: 03/01/2007 to 02129/2008
Administered By:
Healthcare Providers Service Organization
Affinity Insurance Services, Inc.
159 East County Line Road
Hatboro, PA 19040-1218
Insurance Company:
American Casualty Company of Reading, PA
cMai>tei'.POlic .Number MaSterPolicEffectivld)atii" LiIiiits ( er eiu'olledfuember)
N 0289955556 1/1/2007 12:01 AM Standard Time $2,000,000 each claim f
to 1/1/2008 12:0 I AM Standard $6,000,000 aggregate Subject to
Time the Master Polic A e ate
Coverage is afforded to Enrolled Members for a period of 12 months concurrent with the Enrolled Member's effective date or
until membership is terminated or expires. If the Master Policy is non-renewed or cancelled, the Enrolled Member's coverage
under this policy will terminate upon the expiration of the Certificate Period and will not be renewed. The Master Policy
A re ate ma be reduced b claims aid on behalf of other insnreds.
Additional Coverages (included in Professional Liability Lintits specified above):
. Personal Injury Liability
. Good Samaritan Liability
. M81placement Liability
. Workplace Liability
. Fire & Water Leg81 Liability (subject to $250,000 sub lintit)
.... of IrisUrifuce; .
Profession81 Liability
Occurrence Coverage
Coverage Extensions
License Protection
Defendant Expense Benefit
Deposition Representation
Assault (excluding Texas)
Medical Payments
First Aid
Damage to Property of Others
Coverage Extension Limits
$10,000 per proceeding f $25,000 aggregate
$10,000 aggregate
$2,500 per deposition f $5,000 aggregate
$10,000 per incident f $25,000 aggregate
$2,000 per person f $100,000 aggregate
$2,500 aggregate
$500 per incident f $10,000 aggregate
This material is intended to provide a general overview of the products and services offered. Only the policy can provide the actual terms,
coverage's, amounts. conditions and exclusions. Please contact HPSO at 1-888-253-1474 directly for a copy of the complete policy.
II HPSO
Heahhcare Providers Service Orpni=at:k>nR
K#05-00312