The Philadelphia Indemnity Insurance policy will provide $2,000,000 coverage for the following participants:
*Third party contractors involved should provide their own insurance coverage
Below are the following exlusions which are not covered:
All requests for Certificates of Insurance must be directed to the Mercer Service Team. Contact information provided below:
Service Phone Number: 1-866-838-9536
Service Fax Number: 515-365-3005
Please print and complete the following registration form to be submitted to the Mercer Service Team.
Form more information view the University of California Accident Medical Insurance Policy Summary.
Philadelphia Process (Liability Claims)
When reporting a notice of loss (injury, property damage to third parties, auto accidents, etc.; related to a registered event), please provide as much detail as possible. This should include, but not be limited to, Insured Name (The Regents of the University of California plus student organization/club name), Contact Name (student organization/club), Policy Number, Claimant Name, Claimant Contact Information, Date of Loss, Location of Loss, Cause of Loss, Your Policy or Reference Number, Initial Steps Taken to Mitigate the Loss, Type (s) and Description of Damage and Estimated Amount of Loss.
The claims customer service department will immediately process your first notice of loss and you will be contacted by your servicing representative.
For information on how to report a University of California Accident Medical claim, view the instructions below for the ACE Process. You must report the accident to ACE prior to reporting to Philadelphia.
ACE Process (Accident Medical Claims)
When reporting a notice of an injury to a member and/or participant, please provide as much detail as possible about the circumstances of how the injury occurred. The information you gather will be needed on the claim form, see below, and the servicing representative will obtain further information when needed. Details should include, but not be limited to, Insured Name (UC Campus and full name of the student organization/club), student organization/club Contact Name, Policy Number (provided on form), Injured Member/Participant Name, Date of Loss, Description of the Injury, Description of the Event where the Injury Occurred, Physical Location where Injury Occurred, Cause of Injury, Your Reference Number (if applicable), Initial Steps Taken to assist the injured participant, any medical reports or invoices received from or on behalf of the injured participant.
The claims customer service department will immediately process your report and you and the injured participant will be contacted by your servicing representative.