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Definitions

Severe & Moderate Brain Injury Definitions

Severe Traumatic Brain Injury means a traumatically-induced structural injury to the brain with physiological disruption of brain function resulting directly and independently of all other causes from a Covered Accident:

  1. Indicated by the presence of the following clinical signs:

    • a Glasgow Coma Scale (GCS) score of eight (8) or less or an equivalent result on another coma severity scale as approved by Us; and either:

    • loss of consciousness for a period of twenty-four (24) hours or more; or

    • Post Traumatic Amnesia (PTA) persisting for seven (7) days or more as measured by the Galveston Orientation and Amnesia Test (GOAT); PTA is considered to have ended when a GOAT score of seventy-five (75) or more is achieved on three (3) consecutive administrations.

  2. Directly and independently resulting in:

    • physical, cognitive, emotional or behavioral functional impairment requiring admission to a Long Term Acute Care Hospital; and

    • subsequent rehabilitative treatment by any or all of the following: Physicians, psychologists, physical therapists, occupational therapists, speech language pathologists.

Moderate Traumatic Brain Injury means a traumatically-induced structural injury to the brain with physiological disruption of brain function resulting directly and independently of all other causes from a Covered Accident:

  1. Indicated by the presence of the following clinical signs:

    • a Glasgow Coma Scale (GCS) score of nine (9) to twelve (12) or an equivalent result on another coma severity scale as approved by Us; and

    • loss of consciousness for a period of at least thirty (30) minutes.

  2. Directly and independently resulting in:

    • physical, cognitive, emotional, or behavioral functional impairment requiring admission to a Hospital; and

    • subsequent rehabilitative treatment by any or all of the following: Physicians, psychologist, physical therapist, occupational therapists, speech language pathologists.

 

Paralysis Definition

Paralysis means total loss of use. A physician must determine the loss of use to be complete and not reversible.

  • Hemiplegia means total paralysis of upper and lower limbs on one side of the body.

  • Paraplegia means total paralysis of both lower limbs or both upper limbs.

  • Quadriplegia means total paralysis of both upper and lower limbs.

  • Uniplegia means total paralysis of one lower limb or one upper limb.

 

Dismemberment Definition

Dismemberment means the loss of:

  • Two or More Members - 100% of benefit amount selected.

  • One Member - 50% of benefit amount selected.

  • Thumb and Index Finger of the Same Hand - 25% of benefit amount selected.

"Member" means loss of hand or foot, loss of arm or leg, loss of sight, loss of speech and loss of hearing.

"Loss of Hand or Foot" means complete severance through or above the wrist or ankle joint.

"Loss of Arm or Leg" means complete severance through or above the elbow or knee joint.

"Loss of Sight" means total and permanent loss of sight of one eye that is irrecoverable, including by surgical and artificial means.

"Loss of Speech" means total and permanent loss of audible communication that is irrecoverable by natural, surgical or artificial means.

"Loss of Hearing" means permanent total deafness in both ears such that it cannot be corrected by any aid or device.

"Loss of Thumb and Index Finger of the Same Hand" means complete severance of each through or above the metacarpophalangeal joint of both digits of the same hand.

"Severance" means the complete separation and dismemberment of the part from the body.

 

Covered Accident Definition

Depending on the type of policy issued, Covered Accident means one of the following:

for Individual or Group Policies:

Covered Accident means an Accident that occurs while:

  • coverage is in force for a Covered Person; and

  • riding a Bicycle for pleasure or training purposes or participating in a Cycling Event; and

  • results in an Injury for which benefits are payable.  Riding a Bicycle includes getting on and off the Bicycle and riding as a passenger only on a Bicycle specifically built or adapted to carry a passenger.

for Event/Tour Policies:

Covered Accident means an Accident that occurs while:

  • coverage is in force for a Covered Person; and

  • participating in a Cycling Event while wearing a helmet; and

  • results in an Injury for which benefits are payable. Riding a Bicycle includes getting on and off the Bicycle and riding as a passenger only on a Bicycle specifically built or adapted to carry a passenger. Verification of proper use of a Helmet at the time of the Covered Accident must be part of an official police report of the Covered Accident or be certified, in writing, by a Physician. 

for Bikeshare/ Bike Rental Policies:

Covered Accident means an Accident that occurs while:

  • coverage is in force for a Covered Person; and

  • riding a Bicycle; and

  • results in an Injury for which benefits are payable.  Riding a Bicycle includes getting on and off the Bicycle and riding as a passenger only on a Bicycle specifically built or adapted to carry a passenger.

 

Covered Person Definition

Covered Person means an eligible person who is within the covered class(es) listed in this Policy and for whom the required premium is paid when due.

 

Bicycle Definition

Bicycle means a two or three wheeled vehicle designed for transport by pedaling including a Pedelec (Pedal Electric Cycle) or E-Bike which is a bicycle with electrically motorized assistance not exceeding a maximum of 1200 watts and that does not require a motor vehicle, moped or motorcycle license to operate. It includes bicycles specifically built or adapted to carry a passenger.

 

Helmet Definition

Helmet means protective headgear which meets or exceeds the impact standards for bicycle helmets set by the United States Consumer Product Safety Commission or such successor organization or standard as designated by the insurer.

 

Professional Bicycle Racer Definition

Professional Bicycle Racer means a person who, in the previous 12 months prior to enrollment, has received any form of remuneration totaling more than $1,000 for bicycle racing and/or is a registered rider on a Union Cycliste Internationale (UCI) team.

 

Gravity Events Definition

Gravity Events means riding a Bicycle while participating in a cycling discipline that is primarily characterized by the starting line of the activity being at a higher altitude than the finish line. These disciplines include, but are not limited to, Downhill, Enduro, Dual Slalom, Mountain Cross (Four Cross or 4x) and Super D as defined by the 2017 USA Cycling Rulebook.

 

Stunt or Acrobatic Act Definition

 Stunts or Acrobatic Act means a difficult or dangerous feat or trick requiring extreme agility and characterized by one or more of the following:

  • Freeriding or BMX-style Riding;

  • Rotations purposefully conducted while in the air.

 

Bicycle Park Definition

Bicycle Park means a purpose-built recreational environment made for Freeriding, BMX-style Riding, skiing, snowboarding, skateboarding, scooter, wheelchair, and aggressive inline skating.

 

Freeriding Definition

Freeriding means a discipline of mountain biking closely related to Downhill with a focus on dirt jumping, tricks, style, and technical terrain features without a set course, goals, or rules.

 

BMX-Style Riding Definition

BMX-style Riding means riding a Bicycle while engaging in, training for, or participating in any sub-discipline of BMX-style Riding, including but not limited to:

  • Park - Characterized by riding a Bicycle on a series of wooden or cement ramps designed specifically for BMX bicycles or skateboards.

  • Street - Characterized by riding a Bicycle on natural or man-made terrains within cities, such as ledges, curbs, broken glass, and burns, or anything on-street not made specifically to be ridden on.

  • Dirt - Characterized by riding a Bicycle on jumps formed from packed dirt, rollers, berms, and doubles.

  • Flatland - Characterized by riding a Bicycle on flat ground and including various balancing and spinning techniques while standing in awkward positions on various parts of the bike, including the pegs, handlebars, and seat.

  • Racing - Characterized by riding a Bicycle in formally or informally organized heats, also called motos.


Eligibility

Individuals are eligible to enroll in Balance for Cyclists if you are:

  • An amateur or recreational cyclist or a Professional Bicycle Racer

  • U.S. resident

  • Between the ages of 18 and 74

  • Living in a state where Balance for Cyclists is available.

We retain the right to investigate eligibility status to verify eligibility requirements are met. If we discover the eligibility requirements are not met, our only obligation is to refund any premium paid.

Events & Tours are eligible to enroll if the event location is in a state where Balance for Cyclists is available. No residency requirements.

Bikeshare programs are eligible to enroll if the program is in a state where Balance for Cyclists is available. No residency requirements.


Availability & Coverage Area

State Availability

 

Arizona

Arkansas

California

Connecticut

District of Columbia

Florida

Georgia

Hawaii

Idaho

Indiana

Iowa

Kentucky

Louisiana

Michigan

Minnesota

Mississippi

Montana

Nevada

New Mexico

North Dakota

Ohio

Oklahoma

Texas

Utah

Virginia

West Virginia

Wyoming

 

Coverage Area

Coverage is worldwide, 24/7/365.


Exclusions

To help protect from the financial consequences of an accident at an affordable price, there are some things we can't cover:

  1. Suicide, self-destruction, attempted self-destruction or intentional self-inflicted injury while sane or insane.

  2. War or any act of war, declared or undeclared.

  3. Sickness, disease or any bacterial infection, except one that results from an accidental cut or wound or pyogenic infections that result from accidental ingestion of contaminated substances.

  4. Violation or in violation or attempt to violate any duly-enacted law or regulation, or commission or attempt to commit an assault or felony, or that occurs while engaged in an illegal occupation.

  5. Voluntarily taking any drug or narcotic unless the drug or narcotic is prescribed by a physician.

  6. Intoxication or being under the influence of any drug or narcotic.

  7. Performing any bicycle Stunt or Acrobatic Act.

  8. Riding a Bicycle while engaging in, training for, or participating in Gravity Events, Freeriding, or BMX-style Riding.

  9. Riding a Bicycle within a Bicycle Park.

  10. Riding as a passenger on a bicycle not specifically built or adapted to carry a passenger.

  11. Individual Coverage only: Riding a bicycle for compensation of any kind, except as a Professional Bicycle Racer*, regardless of whether or not Workers' Compensation applies.

  12. Any loss or claim for benefits that should otherwise be the subject of any compulsory insurance legislation relating to the activities covered under the Policy.

  13. The actual or threatened use of pathogenic or poisonous biological or chemical materials by any person(s), committed for political, religious, ideological or similar purposes with the intention to influence any government and/or to put the public or any section of the public in fear.

  14. Nuclear reaction, nuclear radiation or radioactive contamination.

    *View our definitions in the Info Center section of the website.


Customer Interaction Standards

Affinity Group Underwriters (AGU) is committed to a performance management policy of constantly striving to ensure that our relationships with customers and business partners are guided by five key principles:

  • Fairness - we will always treat customers and business partners fairly

  • Honesty - we will always be truthful and not mislead anyone about our products or services

  • Transparency - we will always fully disclose all pertinent facts and information

  • Respect - we will always demonstrate the utmost respect and courtesy in our dealings with others

  • Care - we will always be mindful of and act in the best interests, not only of ourselves, but of our customers and business partners as well.

We recognize that customers are people first and we resolve to interact with them on a person-to-person basis even when using electronic and telephonic communication.

It is our policy to fully comply with all applicable and relevant laws and regulations regarding customer service, disclosure, advertising standards, unfair, deceptive or misleading sales practices and the equitable treatment of customers. In addition, we will abide by rules and standards promulgated by our business partners as they may apply to us.

It is imperative at all times that we do everything possible to protect the privacy of our customers' personal information whether stored electronically or on paper.

Management is committed to monitoring customer service and conducting ongoing training for current and new staff with regard to these principles and best customer services practices.

We are proud of our record. Since the founding of the company in 1997, AGU has never been fined, sued, censured or otherwise been the subject of any legal or regulatory action in respect of our dealings with customers. We resolve to do all that we can to continue that record.

Our goal is to be known as a company that delivers the highest standards of customer care. As an example, our motto is "we answer the phone." During business hours, our customers can expect to talk to a person without having to first endure a series of impersonal telephone prompts.


Privacy Statement

We believe you have the right to know the privacy policies of the sites you visit. We are committed to the security of all data and information that is transmitted to us through any medium (electronic submission, e-mail, phone, fax or regular mail), and the protection of your personally identifiable information. 

Any information submitted is retained for the exclusive use of Affinity Group Underwriters and/or our partner companies who provide services. We do not sell, trade, lease or rent any information obtained from this website. Your personal information will only be shared with our insurance company partners when you make a formal application for insurance.

We use standard internet technology to detect the type of operating system, internet browser and e-mail client that anyone accessing the website is using. This allows us to notify the user of potential problems with our applications and certain operating system/internet browser combinations. Determining the e-mail client in use allows us to send communications that are compatible with the user's system.

If you have questions about our privacy policy, please contact Lori Mills at (804) 273-9797 or send an email to LMills@agu.net.


Complaints

If you have any concerns about this website or our response to any inquiry made in reference to the insurance coverages offered, please contact Lori Mills at (804) 273-9797 or send an email to LMills@agu.net.  We will address any concerns in a timely manner.