UCLA Office of Insurance & Risk Management

Insurance Coverage for UCLA Volunteers

Who Qualifies as a UCLA Volunteer for Self-Insurance Program Coverage?
An individual qualifies for coverage under UCLA's volunteer insurance programs, if all of the following requirements are met:

The service is performed by the individual for the primary benefit of the University of California.
The individual is not paid to perform the service (expenses may be reimbursed).
The service is not performed for academic credit or to receive or qualify for some type of certification or accreditation.
The service is not performed as an alternative to a civil or criminal fine or penalty or serving a jail sentence.
The service is provided under the supervision of UCLA faculty and/or staff.
The service does not involve participation in athletic activities.
Unless prior written approval is obtained from OIRM, the service must be performed on University premises or in the greater Los Angeles area by persons eighteen (18) years of age or older, and can not involve over-night travel.

IMPORTANT NOTE
Departments are responsible for keeping records of dates,
periods of service and duties of authorized volunteers.
Departments must provide appropriate volunteer supervision and safety
training in order to reduce the risk of injuries.

What Coverage is Provided UCLA Volunteers?

Workers Compensation - Qualified volunteers who complete the UCLA Volunteer Workers' Compensation Election Form prior to injury are covered by the University's self-insured workers' compensation program for injuries they receive in the course and scope of performing University volunteer service. The original Volunteer WC Election Form must be retained in the department for whom the volunteer performs services for not less than eighteen months after the service end. A copy of the election form must be filed with the Workers' Compensation Manager in the Office of Insurance and Risk Management (OIRM).

When a volunteer reports an injury:
- If he is able to transport himself and it is a weekday during business hours, refer the volunteer to the Occupational Health Facility (OHF) located in 200 Medical Plaza. Complete an "Employee's Referral Slip for Industrial Injury and Report of Accident" form for the employee to take to OHF. Click here for a copy of the "Employee's Referral Slip for Industrial Injury and Report of Accident" form.
- If the volunteer is not able to transport herself to OHF, call a campus ambulance and have the volunteer taken to the Emergency Medicine Center. Injured volunteers should be referred to the Emergency Medicine Center when OHF is not open.
- Injured volunteers must be given a "Workers' Compensation Claim Form" within one business day of the volunteer's report of the injury. The department must complete items 11, 12, 13, 17, and 18 on the Claim Form and sign the Claim Form at item 16. Click here for detailed instructions on completing the Claim Form. Click here for a copy of the Employee's Claim For Workers' Compensation Benefits form (Claim Form). A copy of the completed Claim Form for each volunteer injury must be faxed to the Office of Insurance and Risk Management, 46957 as soon as completed.
Note: To reduce a department's Workers' Compensation costs due to volunteers claims, departments may prefer to enroll qualified volunteers in the optional Medical/Accident Insurance program. The annual cost of this insurance is $5.00 per volunteer with a $45 minimum per department per year. The department is responsible for maintaining a log of covered volunteers which must submitted to the Office of Insurance and Risk Management no later than June 30 of the fiscal year in which the service was provided. Some persons who may not qualify for coverage as University volunteers may be covered under this program. Contact the Workers' Compensation Manager for additional information and applications.
General Liability - Qualified volunteers may be covered by the University's self-insured General Liability Program, BUS 75 (www.ucop.edu/ucophome/policies/bfb/bus75.html) when the volunteer is acting within the course and scope of his duties as such, but only insofar as The Regents elect to have them included with respect to a particular claim or suit. This means that the determination about whether a volunteer is covered under BUS 75 is made only after a claim is made or a lawsuit is filed.

Note: Because of the uncertainty of this coverage, departments may wish to enroll their qualified volunteers in an optional Volunteer Liability Program. This program provides personal liability insurance protection for a bodily injury, personal injury or property damage liability claim arising out of the performance of the volunteer's duties. This program provides $1,000,000 of coverage per occurrence subject to an annual aggregate. There is an annual departmental registration cost of $125.00 plus a fee of $1.40 per volunteer with a $100 minimum. Contact the Liability Program Manager for brochures, applications and additional information.

|VOLUNTEER ELECTION OF WORKERS' COMPENSATION COVERAGE FORM|

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