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Home My WebLink About07110085 Certificate of InsuranceYahoo! Mail - blakelewis2002@yahoo.com FIlll:?&MAIL I Classic 1111612007 02:49 Phl OUTSIDE lN, Print - Close Window If 11P. .e",: i American Massage Therapy AssociationAe Certificate of Insurance Enrolled Member ID#: 170431 Blake Lewis 9254 Knights Bridge Blvd Apt A Indianapolis, IN 46240-4491 Administered By: Insurance Company: Enrolled Member Classification: PROF W Certificate Period: 11/01/07 12:01 AM Standard Time to 10131/08 12:01 AM Standard Time Healthcare Providers Service Organization American Casualty Company of Reading, PA Affinity Insurance Services, Inc. 159 East County Line Road Hatboro. PA 19040-1218 Type of Insurance Master Policy Number Master Limits (per enrolled member) Policy Effective Date Professional Liability N 0289955556 1/1/2007 $2,000,000 each claim / $6,000:000 12:01 AM aggregate Subject to the Master Policy Occurrence Coverage Standard Aggregate Time to 1/1/2008 12:01 AM Standard Time Coverage is afforded to Enrolled Members for a period of 12 months concurrent with the Enrolled Member5ET is effective date or until membership is terminated or expires. If the Master Policy is non-renewed or cancelled, the Enrolled Members€TMS coverage under this policy will terminate upon the expiration of the Certificate Period and will not be renewed. The Master Policy Aggregate may be reduced by claims paid on behalf of other insureds. Additional Coverages (included in Professional Liability Li mits specified above): • Personal Injury Liability • Good Samaritan Liability • Malplacement Liability • Workplace Liability • Fire & Water Legal Liability (subject to $250,000 sub l imit) Coverage Extensions Coverage Extension Limits License Protection $10,000 per proceeding / $25,000 aggregate Defendant Expense Benefit $10.000 aggregate Deposition Representation $2,500 per deposition / $5,000 aggregate $10,000 per incident / $25,000 Assault (excluding Texas) aggregate http:l/us.f329.mail.yahoo. com lymi ShowLetter?box=1nbox&Msg1d=485...5 beta =yes&order=down&sort=date&pcs=0&ViewAttac h=l&PRINT=1&Idx=0 Page 1 of 3 Yahool Mail - blakelewis2002@yahoo.com Payments Aid 1111612007 02:49 PM per person 1 $100,000 aggregate aggregate Damage to Property of Others $500 per incident / 510,000 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€T'''s, amounts, conditions and exclusions. Please contact HPSO at 1-888-253- 1474 directly for a coov of the complete policy. 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 AMTA 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 most up-to-date list, go to the Benefits page in the membersa€TM section of www.amtamassage.org. • Acupuncture • ACU-Yoga • Aveda Spa Body Therapy • Body Talk • Breathergy • Chiropractic adjustment • Colon Hydrotherapy, Colonics • CPR • Cupping Therapy • Ear Candling • Detoxification • Exercise • Fasting • Flotation Tank Therapy • Hypnosis • Kundalini Yoga • Moxibustion • Naprapathy • Naturopathics • Nutritional or dietary counseling • Osteopathic Soft Tissue Manipulation • Oxygen Therapy • Phoenix Rising Yoga Massage • Pilates (even if being used in conjunction with massage) • Pointer-Plus locator/ stimulator • Psychosomatic-related care • Rebirthing • Religious Healing • Shen (Physic Emotional Release Therapy) • Steam baths, steam booths, steam showers, saunas • Taoist Abdominal Massage • Tanning beds, tanning tables or tanning booths • Teaching yoga to clients (Instructors) • Yoga (even if being used in conjunction with massage) http:/(us.f329.mail.yahoo.comlym/ShowLetter?box=lnbox&Msg Id=485...5 beta syes&order=down&sort=date&pos=0&VlewAttach=l&PRINT=1&ldx=O Page 2 of 3 Yahoo! Mail - blakelewis2002@yahoo.com Additional Information 11 / 1612007 02:49 PM An AMTA 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 concerning the AMTA 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 AMTA 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, coverages€TMS, amounts, conditions and exclusions. Please contact HPSO at 1-888-253-1474 directly for a copy of the complete policy. Healthcare Providers Service Organization (HPSO) is a division of Affinity Insurance Services, Inc,; in NY and NH, AIS Affinity Insurance Agency; in MN and OK, AIS Affinity Insurance Agency, Inc; and in CA; .AIS Affinity Insurance Agency, Inc. dba Aon Direct Insurance Administrators License #0795465. http:llus.f329.mail.yahoo.mmfym,ShowLeuer7hox=lnbox&Msgld=485... 5beta=yes&order=down&sort=date&pos=0&ViewAttach=1&PRINT=1&ldx=0 Page 3 of 3