The URL can be used to link to this page

Home My WebLink About07050038 Certificate of Insurance American Massage Therapy Association@ Certificate of Insurance Member ID: 177172 Marie Planck 56 Granite Dr Carmel, IN 46032-5205 Member Classification: PROF W Member Effective Date: 05/01/2007 to 04/3012008 Administered By: Healthcare Providers Service Organization Affinity Insurance Services. fne. 159 East County Line Road Hatborn. P A 19040-12 1 8 Insurance Company: American Casualty Company of Reading, PA ?1'l' eofInsurance . Professional Liability Occurrence Coverage Master Policy Effective Date Limits'iper eniolled'mcmber)' 1/112007 12:0[ AM Standard Time $2.000.000 each claim / to 1/1 /200S 12:0 I AM Standard $6,000.000 aggregate Subject to Time the Master Policy Aggrc rate Coverage is afforded to Enrolled Members for a period of 12 months conCUITcnl \/,/ith the Enrolled Member's effective date ur until memhership is tenninated or expires. if the Master Policy is non-renewed or cancelled, the Enrolled Member's coverage under [his policy will terminate upon the expiration of the Certificate Period and will not be renewed. The Master Policy' A reoatc mav be reduced b claims aid on behalf of other insureds. Additional Coverages (included in Professional Liahility Limits .specified anove): . Personal Injury Liability . Good Samaritan Liability . Malplacement Liability . Workplace Liability . ."'ire & ',Vater Legal Liahility (subject to $250,000 sub liiniO Master Policy Number N 0289955556 Coverage Extensions License Protection Defendant Expense Benefit Deposition Representation Assault (excluding Texas) Medical Payments First AiJ Damage to Property of Others Coverage Extension Limits $1 U,OOO per proceeding I $25,000 aggregate $10,000 aggregate $2.500 per deposition / $5,000 aggregate $IO.O{)O per ;ncideol / $25.000 aggregale $2000 per person / SIOO,OO(J aggregate $2.500 aggregate $500 per incident / $10.000 aggregate This material is intended to provide II general overview of the prodll(.~ts and services offered. Only the policy cun provide (he aCiUal terms, coverage's, amOllnlS. conditions and exclusions. Please contact upsa at ! -S8S-253-1474 directly for a copy of the complete policy. ~HPSO Ilcallhc""r.. PrP,'id~,., S~,,'ic~ Ol"!:'Joi,-Miu". K#05-00312 AMTA Coverage and Modality Exclusions Named Insureds are covered for professional services for which the named insured is licensed, certified, accredited, trained or qualifIed to perform within the scope of practice recognized by the regulatory agency responsible for maintaining the standards of the massage therapy profession. As an AMT A enrolled member covered by our insurance program. enrolled members are responsible for and expected at all times to be familiar and current with all laws. regulations, etc. in their state of practice that govern their profession as a massage therapist. Modality Exclusions The following list of modalities is excluded under this insurance program. This list is subject to review and change by AMTA. For the 1I10st up-to-date list, go to the Benefits page in the members' section of www.amtamassage.org. 0 Acupuncture 0 Hypnosis 0 Psychosomatic-related care 0 ACU-Yoga 0 Kundalini Yoga 0 Rebirthing 0 A veda Spa Body Therapy 0 Moxibustion 0 Religious Healing 0 Body Talk 0 Naprapathy 0 Shen (Physio Emotional 0 Breathcrgy 0 Naturopathics Release Therapy) 0 Chiropractic adjustment 0 Nutritional or dietary 0 Steam baths, steam booths, 0 Colon Hydrotherapy. counseling steam showers. saunas Colonies 0 Osteopathic Soft Tissue 0 Taoist Abdominal Massage 0 CPR Manipulation 0 Tanning beds. tanning tables 0 Cupping Therapy 0 Oxygen Therapy or tanning booths 0 Ear Candling 0 Phoenix Rising Yoga Massage 0 Teaching yoga to clients 0 Detoxification 0 Pilatcs (even if being used in (Instructors) 0 Exercise conjullction with massage) 0 Yoga (even if being used in 0 Fasting 0 Pointer-Plus locator/ conjunction with massage) 0 Flotation Tank Therapy stimulator Additional Information An AMT A membership card in conjunction with this notice should serve as acceptable evidence of insurance to anyone requesting proof of your professional liability coverage. If you have any additional questions conceming the AMT A Professional Liability Insurance Plan, please call our insurance administrator, HPSO, toll free at 1-888-253-1474. We are dedicated to giving you the best service possible and thank you for the opportunity to provide this insurance and membership to you. Please also feel free to call AMT A with questions or comments. Reporting Claims Please call HPSO toll free at 1-888-253-1474 for claim reporting procedures or refer to the AMTA Professional Liability Benefits Guide. Additional Insured Requests Please call HPSO toll free at 1-888-253-1474 for additional insured requests. This program is underwritten by American Casualty Company of Reading, PA a CNA company and is offered through the Healthcare Providers Service Organization Risk Purchasing Group. This material is intended to provide a general overview of the products and services offered. Only the policy can provide the actual terms, covemge's, amounts, conditions and exclusions. Please contact HPSO at 1-888-253-1474 directly for a copy of the complete policy. Hcaltht.:are Providers Service Organization (HPSQ) is a division of Affinity Insurance Services. Inc,; in NY "od Nt!. AIS Affinity Insurance Agcllcy~ in MN and OK. AIS Affinity Insurance Agency, Int.:; and in CA. AIS Affinity Inwrance Agency, Inc. dbu Aon Direct Insurance Administrators License #0795465. DlHPSO "~I )5M0107 Health,;att I'n,,'iokn; Sort"i,'" O'l:"niUltl"". "/~--~,,:.,,, .f '~.t f ~l ,,',$,j .\ t..-,", -'''fl ""-::'~_r(!/ AMTA m~~ Name Member 10# Member C1assificllioll Expiration Dale M,lrie Planck 177172 PROF; W 04/30/2008 1