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Medical Coverage Campus Resources Student Participants Risk Management Services Cal Poly Pomona In the event of an injury resulting from an accident Workers’ Compensation claim forms. Field Trip during a field trip, the student’s personal health care Claims Coordinator plan is primary. If the student’s health care benefits Phone: (909) 869-3725 are exhausted, the CSU Student Travel Accident Fax: (909) 869-2926 Insurance may help pay for additional related injury expenses. Enrolled students without a private health E-Mail: email@example.com Guidelines plan may seek medical attention from the campus Student Health Services. Authorization to Drive on University/State Business, Authorization to Use a Private Vehicle Please note that the CSU Student Travel Insurance Form, Accident Information Card, Defensive policy covers accidental injury only. The policy Driver Training requirements, and DMV DOES NOT provide coverage for any illness or Clearance. disease unless an accident is the direct cause of the illness. Loretta Roth Training & Development Coordinator Workers’ Compensation Benefits Organizational Development & Training Phone: (909) 869-2705 If you are an employee with Cal Poly Pomona, Fax: (909) 869-3779 participating in a field trip (i.e., staff, faculty, student E-Mail: firstname.lastname@example.org working on a field trip as a student assistant, including college work study funded student assistants, or as an approved volunteer employee), University Police Services you may be eligible for Workers’ Compensation benefits that may assist in paying for medical Emergencies and other assistance. expenses related to your accident. Call the campus Phone: (909) 869-3070 Workers’ Compensation Coordinator to obtain a Fax: (909) 869-4909 claim form at (909) 869-3725. Rev. May25, 2009 What is a Field Trip? Field Trip Guidelines (Continued) What to Do in Case of a Vehicle Accident A field trip is an out-of-classroom, off-campus trip relating Faculty/staff field trip participants shall complete all 1. Determine whether immediate medical attention to an academic course or university sponsored program paperwork and obtain the necessary management is needed for anyone involved in the accident. where the date, time and location (usually for a group) is approvals, required for traveling on University business, Obtain necessary medical assistance. selected by a faculty or staff member. in advance of the field trip. For example, if a course requires students to meet the No alcoholic beverages or controlled substances shall be 2. Use the STD 269 (Accident Information Card), faculty member at a museum on a specific date/time, and transported in a State or private vehicle (on State if driving a State vehicle, and share information this meeting is considered part of the course’s required business) at ANY TIME. with the other driver. content, then this would be considered a field trip. However, if the faculty member asks students to visit a 3. Do not admit any fault or make promises. museum sometime during the academic term, and they do it Authorized Participants & Drivers on their own without any involvement of faculty/staff, then Authorized Participants of a Cal Poly Pomona (CPP) 4. Report any accident to the State Office of Risk the student's visit to the museum would not be considered a Field Trip are CPP: and Insurance Management (ORIM) that field trip. involves any State-owned vehicle or any vehicle Faculty (personal, rental, leased, etc.) used for State Field Trip Guidelines Staff (academic) business within 48 hours. Complete and submit Approved volunteer employees* the form STD 270 (Vehicle Accident Report) to To ensure that all field trips have the least potential liability your supervisor and Risk Management Services. Enrolled students and promote the greatest amount of safety possible, the Enrolled College of the Extended University following guidelines are recommended and are intended to 5. If a police report was completed, provide the students supplement any existing college/departmental procedures: report number with the STD 270. Your supervisor must complete and submit form STD All field trips shall begin and end at 274 (State Driver Accident Review). the field trip site. *For non-academic staff and student To be a University-covered field trip, it needs to be a volunteers, the completion of a CSU 6. Immediately report any bodily injury or course requirement. Volunteer Identification Form is significant property damage to the State required. This form is to be held in Office of Risk Insurance and Management Students should be advised of any hazardous, (ORIM) by telephone at (916) 376-5302 or by extraordinary, or strenuous activity anticipated during the academic office. FAX (916) 376-5277. Weekend voicemail the field trip. messages may be left at (800) 900-3634. All All field trip participants must complete and submit Authorized Vehicle Drivers on a Field Trip Must calls will be returned on the next business the appropriate liability waiver (including the Possess: day. designation of an emergency contact person), before A valid California driver’s license departing on the trip. The waivers are to be retained in A good driving record (DMV pull notice) the academic department office. If driving a private vehicle**, a completed Authorization to Use Privately Owned A list of all persons participating in the Vehicle on State Business (Form STD 261) is field trip should be retained in the academic to be submitted to be submitted. department office (with a designated faculty/ staff contact person in charge of safety), in the event of **Please note that personal liability insurance is a major accident or emergency. primary when driving a privately owned vehicle.
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