Emergency Procedures

							This directory provides phone numbers for emergencies.

Name                      Office                  Home                   Cell
Risk Manager/Legal Counsel
Mike Anderson             608-443-3749            608-277-1627           608-444-5318
Human Resources Director
Pamela Oldham             608-443-3744            608-277-1405           608-217-9668
Vice President
Karon Morton              608-443-3711            608-273-8334           608-217-7600

REPORTING AN EMERGENCY

Follow these procedures in case of an emergency, accident or crisis (such as death, serious
injury, fire, crime, assault, missing/overdue person/s) involving anyone attending or en route
to/from an official InterVarsity event, including camps, conferences, and global/urban projects.

Step 1: Speak to a member of InterVarsity’s Risk Management team at the phone numbers
above, immediately after first contacting local emergency resources (police, fire, ambulance,
911).

Step 2: Contact your supervisor / project leader / project director (within 2 hours).

Step 3: Submit a completed Accident Report Form to the Legal Department at the NSC in
Madison (within 24 hours).

If the individual is someone other than an employee, employee’s spouse, or employee’s child
(e.g. they’re a student) and professional medical care is provided (e.g. ambulance, EMT,
emergency room, urgent/immediate care center, hospital, clinic, physician, nurse, etc):

      Complete the appropriate Camper Insurance Claim Form for the home state of the
       individual(s) as soon as possible. Forms should be available at all official InterVarsity
       events. The top of the Camper Insurance Claim Form is labeled “Special Risk Accident
       and Sickness Claim Form.” The Claim Form should be sent by the individual(s) or health
       care provider directly to AIG at the address on the form (within 48 hours).
      Contact InterVarsity at 608.443.3699 with the name of each individual involved (within
       one week).

Visit the Risk Management section of the Staff Handbook for more information.
REPORTING NON- EMERGENCY ILLNESSES / ACCIDENTS

In case of accident or illness requiring professional medical care at or en route to/from an
official InterVarsity event:

   1. Notify health care provider of InterVarsity medical coverage through AIG Life Insurance
      Company (limits are $2500/sickness, $5000/accident).
   2. Complete the appropriate Camper Insurance Claim Form for the home state of the
      individual(s) at the hospital/clinic where health care is provided. Forms should be kept on
      hand at all events where Camper Insurance has been purchased. The top of the Camper
      Insurance Claim Form is labeled “Special Risk Accident and Sickness Claim Form.”
          o The staff member supervising the event should sign the form in Section A as the
              “Policyholder Representative” and write InterVarsity and the location of the event
              on the first line. The form should then be given to the claimant for completion of
              sections A and B. The staff member must not view the form after giving it to the
              camper/individual.
          o ”Supervisor” = the staff member in charge of the event.
          o ”Dates of Coverage” = the dates of the event.
          o If payment is required or made at the time of service, check “No” regarding
              “payment to the physician or supplier” (section B) and send in a bill showing
              proof of payment.
          o Section C will be filled out by the hospital or a similar form may be submitted to
              AIG by the hospital at their discretion.
          o If a claim form is not available at the time of treatment, give the health care
              provider InterVarsity’s AIG group policy number (#8047336) and AIG’s phone
              number (1.800.551.0824) and submit a completed claim form as soon as possible.
   3. Claimant or health care provider should send the completed claim form directly to AIG,
      making sure the form includes all necessary supporting documents (see address and
      instructions at the top of the claim form).
          o If the claimant has further questions, this person should speak with AIG directly,
              not through InterVarsity (see AIG phone number above).
   4. Staff must contact the Camper Insurance Administrator (608.443.3699) within one week
      of the accident/illness with the name of each claimant for verification purposes.