Martial Arts & Self Defense Instructor Insurance Plan
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NOTE TO ALL AGENTS AND BROKERS: This program does not pay a commission to agents and brokers
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This program has been designed for U.S.-based martial arts and/or self defense instructors who work on an independent contractor basis training individuals in martial arts and/or self defense. This could include self defense instructors, law enforcement/security defense tactic instructors or martial arts instructors. Coverage provided under this program includes commercial general liability protection for the instructor for liability claims arising out of their operations while training.
This program does not provide coverage for the operation, ownership or maintenance of a fitness, sports or dance facility. If I do own, operate or maintain a fitness, sports or dance facility, this coverage will not extend to the facility. I must purchase a general liability policy for the facility itself. Click Here to be redirected to our Martial Arts Schools Insurance
Download Full Application for Full Coverage Limits, Exclusions, Ineligible Activities, Fraud Statements, etc.
I agree that I have reviewed and acknowledge the General Fraud Statement and Electronic Disclosure and Consent. The email used during this application is the email I wish to use for all correspondence.
Costs are fully earned and non-refundable once coverage begins.
I agree to the following:
Application for this plan may be made 01/01/2020 through 12/31/2020. After this date, new applications will be subject to changes in rates and coverages.
Completion of this enrollment form confirms your desire to obtain insurance through the Sports, Leisure and Entertainment Risk Purchasing Group. An RPG provides group purchasing power for similar risks resulting in potential advantageous coverage terms, competitive rates, risk management bulletins, and rewards for favorable group loss experience. An RPG Administration fee may be charged. The submission of this enrollment form and/or acceptance of payment does not guarantee coverage. Certain operations are not eligible for coverage by this program. We reserve the right to decline any request for coverage.
Coverage Effective Dates:
Annual Coverage: Coverage begins on the date after the enrollment form is received and approved concurrent with the payment of the entire premium or, a later effective date can be requested. Coverage will expire on year from the effective date.
Single Event Coverage: Coverage begins on the first day of the event listed on the enrollment form assuming the form is received and approved concurrent with the payment of the entire premium and will expire 12:01 a.m. the date following the last date of the event. Coverage is only provided for the dates listed on the enrollment form.
The premium computation section must be completed as applicable. Please note that all rates are per instructor. I understand that I must be over the age of 18 to qualify for this coverage.
I understand that this coverage is for U.S.-based martial arts and/or self defense instructors who work on an independent contractor basis training individuals in martial arts and/or self defense. This could include self defense instructors, law enforcement/security defense tactic instructors or martial arts instructors.
An instructor age 18 or older conducting private or group instruction in any of the following is eligible to enroll in this program:
- Self Defense Instruction Or Law Enforcement / Security Defense Tactic Instruction
- Martial Arts instruction of:
- jiu jitsu
- Kung fu
- Sayoc kali
- Brazilian jiu jitsu
- Mixed martial arts or ultimate fighting
- Tai chi
- Chi kun
- Muay thai
- Tang soo do
- Dim mak
- Jeet kune do
- Krav maga
- Thai boxing
Coverage will only be provided for the types of instruction listed on the application.
I understand that the following are Ineligible Operations under this policy-
Operations not eligible for this program include but are not limited to the following:
- Boxing (contact/sparring)
- Firearms Training
- Tournaments or competitions
- Certified athletic trainers
- Instructors under the age of 18
- Coaching of organized competitive athletic teams
- Military/paramilitary combat training
- Your employment as an exempt or nonexempt employee of a school, college or university.
Exclusions: The following exclusions are contained in the commercial general liability coverage provided by this program. Abuse, molestation, harassment or sexual conduct; Aircraft/hot air balloon; Airport; Amusement devices (the ownership, operation, maintenance or use of: any mechanical or non-mechanical ride, slide, or water slide, any inflatable recreational device, any bungee operation or equipment, any vertical device or equipment used for climbing - either permanently affixed or temporarily erected, or dunk tank. Amusement devices do not include any video or computer games or any device that is specifically designed for the training or instruction of the activity for which you are enrolled.); Animals (injury or death to, or injury, death or property damage caused by any animal owned, rented or hired by you); Asbestos; Commercial general liability standard exclusions (CG0001 04/13 edition); Cryogenic Chambers/therapy; Cycling (other than stationary); Instruction/activity held on or in open water (e.g. lakes, ponds, ocean); Employment-related practices; Fireworks; Fungi or bacteria; Haunted attractions; Lead; Medical, therapy or health care services; Nuclear energy liability; Operation, ownership or management of any facility; Performers (injury or death to any performer or entertainer during any activity, event or exhibition including but not limited to any stunt, concert, show or theatrical event. This exclusion does not apply to participants in any activity, event or exhibition that are part of the designated operations for which you are enrolled); Physicals/stress testing; Physical therapy, massage or salon services; Rodeos; Saddle animals; Sale or distribution of herbal, medicinal and/or nutritional products; Snowmobile; Use of sharpened/bladed weapons; Use of projectile weapons including, but not limited to, firearms and tasers, and defense sprays; Violation of statutes that govern e-mails, faxes, phone-calls or other methods of sending material or information; Those operations listed as ineligible: the sport of boxing (contact/sparring); the sport of wrestling Certified athletic trainers; Coaching of organized competitive athletic teams; Firearms training; Instructors under the age of 18; Military/Paramilitary combat training; Tournaments or competitions; Your operations related, in whole or in part, to your employment as an exempt or non-exempt employee of a public or private school, college or university.
Applicable in AL - Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or who knowingly presents false information in an application for insurance is guilty of a crime and may be subject to restitution fines or confinement in prison, or any combination thereof.
Applicable in AR, LA, MD, RI and WV - Any person who knowingly (or willfully)* presents a false or fraudulent claim for payment of a loss or benefit or knowingly (or willfully)* presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. *Applies in MD Only.
Applicable in CO - It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies.
Applicable in DC - It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant.
Applicable in FL - Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree.
Applicable in KY - Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime.
Applicable in ME, TN, and WA - It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties (may)* include imprisonment, fines and denial of insurance benefits. *Applies in ME Only.
Applicable in MN - Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to civil fines and criminal penalties.
Applicable in NJ - Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties.
Applicable in NY - Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation.
Applicable in OH - Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.
Applicable in OK - WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty off a felony.
Applicable PA - Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.
Applicable in OR - Any person who knowingly and with intent to defraud or solicit another to defraud the insurer by submitting an application containing a false statement as to any material fact may be violating state law.
Applicable in VA - It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines and denial of benefits.
I understand that the insurance company, in determining whether to provide insurance coverage, will rely on the information contained in this form and all other information being submitted. I hereby warrant, represent and confirm that, to the best of my knowledge, all information provided is complete, true and correct.
I am aware that the insurance company expects accurate reporting for my premium calculation. I understand that my books and records may be examined or audited by the insurance company at any time during the coverage period and up to three years afterwards. Intentional misrepresentation or misreporting may jeopardize coverage.
I further acknowledge that I have reviewed all information provided with this enrollment form and understand the exclusions that apply, as well as the activities and operation for which coverage is not provided.
I understand that this online enrollment provides the option for the insured to select General Liability. However, Sadler offers other types of insurance policies that are not available on this online enrollment such as Medical Expense, Workers' Compensation, Excess Liability, Property (building and contents), Equipment, Event Cancellation, Cyber Risk, Business Auto, Professional Liability, etc. If I am interested in a quote for these other types of policies, I will need to inform Sadler in writing, firstname.lastname@example.org.
I understand that I will only receive electronic copies of insurance documents and will not receive paper copies.
I understand that the files contained in my proof of coverage email are important documents. Once these documents are received, I will review and make sure the documents contain the coverages requested and further agree to notify Sadler & Co., Inc. if the documents have any mistakes in coverages and/or limits. I am aware that because this coverage is written on a master policy, only the certificate of insurance and the verification of coverage will be provided. However, a copy of the master policy is available at any time by emailing a request to email@example.com.
If I do not get email containing my proof of coverage documents within 24 hours, I will follow-up with Sadler & Company immediately.
I acknowledge that my address below is correct and will update Sadler & Co., Inc. of any changes to this email in the future. I grant permission to Sadler & Co., Inc. to utilize this email address to send all documents electronically, including but not limited to, certificates of insurance, verification of coverage, underwriting questions, coverage changes, quarterly newsletters and important messages.
If you've already purchased insurance with Sadler & Company and need to access to your verification of coverage documents or add an Additional Certificate click here to recover your information. The email address attached to your account will need to be supplied.
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