Tournament Insurance

The 2010 Gold Coast Champions Cup Insurance Program

Below is a “Plain English” version of the 2010 Gold Coast Champions Cup Insurance Program. This minimum level of cover means this Program is not "comprehensive" and as such we encourage all participants to review their own individual needs and circumstances and where appropriate take out Private Health, Life and Income Protection Insurance. It is an Individual's responsibility to ensure that he/she has adequate insurance cover for his/her needs.

PERSONAL ACCIDENT INSURANCE

Personal Accident cover is designed to reimburse for related expenses and costs of an injury. Where a registered member sustains an injury, and there are costs and expenses associated with the treatment and recovery of that injury, the cover will reimburse such costs and expenses, according to the benefits outlined hereunder. Please note that there is no coverage for any Medicare related expenses, including gap payments. This is due to Government Legislation (Section 126, Health Insurance Act 1973)

Who is covered?
All registered participating teams & players, coaches, officials, first aid personnel, administrators and voluntary workers of the Gold Coast Champions Cup and registered participating teams.

When & where is cover provided?
The policy runs for the duration of the tournament, 25 September 2010 – 2 October 2010, and provides coverage whilst:

Competing in official activities, such as competitions/tournaments;
Travelling to or from official competitions, meetings or official functions.
Engaging in administrative or organised social activities of the Insured;
Engaged in activities connected with the sport whilst staying away from home during a tour for the purpose of participating.
Engaged in authorised voluntary work / committee meetings.

What are you covered for?
The Personal Accident policy covers items such as death, disablement, non-Medicare medical expenses, loss of income, student tutorial costs, domestic home help costs and parental assistance. You are covered for injuries even if the accident was your fault.

What is the cover?

Capital Benefits
The cover under this section provides $50,000 for death resulting from accident. All other permanent disabilities are calculated using a percentage of the death benefit depending on the severity of the injury. For full details of these percentages, please refer to the Schedule of Capital Benefits contained in the policy wording. Please Note Death is limited to 20% for Members whose age is less than 18.

Loss of Income / Student Allowance / Domestic Home Help
The cover under this section pays 75% of the insured person’s actual weekly income, up to a maximum of $210 per week, subject to a 14 day deferral period. Please note that income earned from participating in the sport is not covered. The benefit will be paid for the period of the Total Disablement as certified by a registered medical practitioner or 52 weeks whichever is the lesser.

Non-Medicare Medical Expenses
The cover under this section reimburses 85% of non-Medicare medical treatment. The maximum benefit for this section is $1,500. All treatment must be certified by a registered medical practitioner and not subject to any Medicare rebate. All claims are subject to a $50 excess. Any expenses must be incurred within 12 months of the insured person sustaining the injury.

Funeral Benefit
Covering funeral expenses incurred up to the sum insured per funeral. The benefit is limited to $5,000.

How to make a claim?

Obtain a claim form from the administrator of the tournament.
Make sure you return your completed claim form within 30 days from the date of injury, otherwise your claim may be affected, to the administrator of the tournament.

Medical Expenses Claim

Complete ALL sections on the front of the Sports Injury Claim Form.
Claims for treatment given by a chiropractor, masseur, naturopath, osteopath or physiotherapist must be accompanied by a referral from a registered medical doctor.
When you are satisfied everything is completed correctly, please sign and date the Claim Form at the bottom of the second page.
Have your attending doctor complete the Medical Statement including period of your incapacity.
If you are a member of a Private Health Fund, please claim from them first and then forward your rebate statement, account and receipt to us when you completely finish treatment.

Important

Please note that this is a reimbursement policy and all medical bills must be paid prior to lodging the claim. Periodic payment can be arranged by the Insurer, so the claim form can be provided without any receipts. Receipts can then be provided once treatment has started.
Please note that it is a policy condition that we only pay for treatment that takes place within 365 days of the date of the event that caused the injury unless the delay is on the advice of a registered medical doctor or dentist.
If claiming ongoing loss of income it is necessary to provide medical certificates at least every 2 weeks.

Here is an example of a Medical Claim
Barry is a 32 year electrician who has injured his leg whilst competing in the tournament. He has been advised by his local doctor that he has to undertake physiotherapy treatment, as well as have some x-rays. He is advised that he requires surgery. Barry has a weekly earning of $500 net per week. As a result of his injuries, he has 8 weeks off work. Paying the claim for Medical Expenses (Government legislation does not allow General insurers to cover any costs subject to a Medicare rebate)

Private practitioner visit, Surgeon, X-Ray/MRI, Anesthetist, Public Hospital Accommodation	Covered by Medicare
Private Hospital Accommodation (1day @ $500)	$500
Benefit Selected – 85%	$425
Sub Total	$425
Physiotherapy @ $50 per visit (4 visits)	$200
Benefit Selected – 85%	$170
Sub Total	$595
Less Excess	$50
Total	$545
Loss of Income - 8 weeks @ $210 per week (less 10 day excess)	$1,365
Total Claim Payment	$1,910