Personal Accident Cover

Making a Claim

Insurance Broker

Football Queensland is proud to announce the engagement of Marsh Pty Ltd as our Insurance Broker for the 2008 season.

Contact details are as follows:

Marsh Pty Ltd

555 Lonsdale Street

MELBOURNE 3000

Telephone: 03 9936 2627 or 03 9936 2630

In the event that a potential claim, please advise Football Hervey Bay as soon as practical.

2008 Sports Injury Claims Procedure

STEP 1

All claims must be notified to Sportscover within 30 days of the accident, injury or damage occurring. Please notify us by obtaining the relevant claim form via:

Calling Marsh Pty Ltd; or

Complete an online claim form request.

STEP 2

Complete the claim form, providing as much information as possible including supplying original receipts, and submit this to the Sportscover office nearest to you via fax or post.

STEP 3

You will then receive a claim number and Internet Access PIN.

STEP 4

Visit the Sportscover Website to monitor the progress of your claim by entering your claim number and Internet Access PIN.

The contact number for Sportscover is 1300 134 956

Example of a Personal Accident Claim

An example is as follows:

Player A is injured playing football and suffers a serious knee injury. The injury is an anterior cruciate ligament rupture and requires surgery. No private health insurance is held.
He spends two days in a private hospital and incurs hospital costs as follows:
Room charge two nights at $450 per night	$900.00
Theatre fee	$500.00
Total	$1,400.00

Player A also requires 9 months of physiotherapy to assist in the rehabilitation. $45 per visit. He attended 18 times. Total $810.00.
The physiotherapist also recommended a two month gym program based on increasing the strength in the knee. Cost $200.00.

The claim was settled as follows:
Hospital cost	$1,400.00	@	80%	=	$1,120
Physiotherapy	$810.00	@	80%	=	$648
Gym program	$200.00	@	80%	=	$160
Sub Total				=	$1,928
Less Excess					$50.00

Total payable by Sportscover for medical benefits is:					$1,878.00

The fees of the surgeon and the anaesthetist were also incurred. Due to the provisions of the Health Insurance Act, these items are not claimable under the Sportscover policy, but they may be claimable via Medicare. Please refer to Medicare for further information.

IMPORTANT INFORMATION

After $200 worth of treatment from an ancillary provider a referral from a legally qualified medical practitioner must be obtained.
Forward only original receipts (retaining a copy for your own records).
Claim on your Private Health Insurance FIRST if you have Private Health cover, and send their statement of payment with your claim.
Please do not send doctors', surgeons', anaesthetists', x-ray or MRI scan accounts as they are covered by Medicare. The Health Insurance Act (Cth) 1973 does not permit the trustee or the insurer to pay any part of these accounts. Refer to Non Medicare Medical Expenses

PUBLIC LIABILITY & PROFESSIONAL INDEMNITY

Claims made against you by members of the general public for personal injury or damage to their property arising from the conduct of your business are regarded by insurance companies as extremely serious.

It is essential that under no circumstances should any admission of liability or offer to pay an amount be given to the person concerned, and you should notify Marsh immediately on 1300 306 383 to ensure that your interests are fully protected.

Class of Insurance:	Group Personal Accident

Insured:	Football Queensland Limited
	Definition of Insured includes:
	Affiliated federations/leagues, affiliated clubs, registered players, referees, officials, administrators and voluntary workers.

Period of Insurance:	5 February 2008 - 31 December 2008

Insured Persons:	Registered players and/or non-playing officials and/or playing members, life members, any director, committee member, executive officer, office holder, manager, administrator, coach, trainer, officials and voluntary workers including co-opted volunteers of Football Queensland Limited and/or affiliated leagues and clubs.

Scope of Cover:	Whilst playing, practising and training under the auspices, control, or direction of relevant sports association and/or club;

Operative Time:	You would be covered when you are:
	a) Playing in official Football Queensland and affiliated league competition matches
	b) Engaged in organised training or practice (including practice matches) for activities described in (a) above
	c) travelling to or form directly between activities described in (a) or (b) above and the Insured persons residence or place of employment or Football Queensland premises or affiliated league premises and/or club premises. (Subject to event 13 of the Insurers schedule).

Interest Insured:	Capital Benefits
	Sum Insured - $75,000 subject to
	percentage scale.

	Non-Medicare Medical Expenses
	Injury sustained by an Insured person which, within twelve calendar months, results in:
	Private hospital accommodation Ambulance transport costs Physiotheraphy and Chiropractic Dental services (to sound whole teeth only) Ancillary medical procedures
	The Percentage of Medical Benefits covered under this section is 80%
	The Percentage of Physiotherapy expenses covered under this section is 80%
	The Excess Payable for each claim under this section is $50
	The maximum amount payable per claim under this section is $2,000

	Funeral Expenses
	Injury resulting in the accidental death of an Insured person covered under Event 1 of Section A - Death. 100% of actual costs of funeral of an Insured, OR $2,000 whichever is the lesser.

Additional Benefits relating to Junior Participants and Senior Female Participants:	Loss of Income for wage earners
	The amount payable is the lesser of 80% Net Income lost or $300 per week
	The Maximum Benefit Period is 52 Weeks
	Excess period is 14 days of sick leave entitlement - whichever is the greater.

	Injury Assistance Benefits
	Where the Insured person is not entitled to compensation under Accident Weekly Benefits section (Temporary Total Disablement) being not in receipt of income.
	Household Help - $300 per week OR Student Assistance Benefit Period - $300 per week (Benefit period - 52 weeks) OR Parent Inconvenience Allowance - $25 per day for each full time student under 18 years of age (Benefit period - 52 weeks)

	Injury Assistance and Parents Inconvenience Benefit limited to $1,500 per claim. Excess period - 14 days.