(Injuries to non-employee students)
Work Experience Students use Work Comp, Not This Page
It's rare, but sometimes people get hurt. Our first concern is that they get the medical care they need. Following that, there are reporting and insurance matters as described below. Report all potentially hazardous conditions to reduce the liklihood of someone (or someone else) getting injured to Campus Police, our Risk Manager, or with a work order. Thank you.
City College has an excess policy for injuries incurred by students and student athletes while participating in City College of San Francisco classroom and other supervised/sponsored activities. All other valid and collectible medical insurance policies must be utilized prior to the consideration of this policy.
The summary description of coverage in this brochure is for informational purposes only. In the event of any conflict between this brochure and any other description of the services provided and any insurance policies, the actual insurance policy will control.
Step 1: Confidential Accident Report
Complete even if no medical treatment is provided/sought.
The confidential student incident report must be completed by the INSTRUCTOR, COACH, ATHLETIC TRAINER, or Student Health Center representative. Please scan and e-mail to firstname.lastname@example.org. If you must fax, call Risk Services for the fax number.
Step 2: Claim Form - optional
Students may submit a claim by using this form.
The injured student may complete and submit the following claim form with itemized medical bills to Risk Services for processing. This is an excess policy, so include an explanation of your primary insurance benefits (if you have your own insurance). For questions, call Risk Services at (415) 239-3239.
FRAUD WARNING: Any person who, knowingly and with intent to defraud, or helps commit a fraud against, any insurance company or other person: (1) files an application for insurance or statement of claim containing any materially false information; or (2) conceals for the purpose of misleading, information concerning any material fact thereto, commits or may be committing a fraudulent insurance act, which is a crime and subjects such person to criminal and/or civil penalties. For residents of California, please note: Any person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.