Insurance
Football West in conjunction with Gow Gates, has arranged insurance coverage for all their affiliated associations, clubs, officials, coaches, voluntary workers and players.
Product Disclosure Statement and Policy Wording
Associations Liability
Abuse Extension
Sporting Accident Claim Form
Summary of Insurances
Policy 1. Sports Personal Injury - Recommended
Class of Insurance: Sports Personal Injury Insurance
Period of Insurance: From: 4pm 16th March 2011
To: 4pm 31st December 2011
Insured: Football Federation Australia Limited including all Participating State Associations and Territory Governing Bodies as listed below;
- Football West Limited.
and all affiliated associations, member clubs including non-playing officials, referees and/or registered playing members (non-playing officials include team manager(s), trainer(s), coach(s), masseur(s), committee, office bearers, voluntary workers, co-opted voluntary workers and Officials).
Insured Person(s): All players, coaches, trainers, managers, administrators, voluntary workers, selectors, referees and other match officials, ball boys, medical officers, physiotherapists, masseurs and ambulance officers; and all directors, officers, employees, executive officers, office bearers, members and committees of the Insured.
The Sport: Football
SCOPE OF COVER: Policy 1. continued
Interest Insured: (a) Playing in official matches sanctioned by The Insured
(b) Engaged in organised training or practice (including practice matches)
(c) Travelling directly to or from or between activities described in (a) or (b)
above and the Insured Person's normal place of residence or place of employment.
(d) Staying away from the Insured Person's home district including overseas
travel during a tour for the purpose of participating in representative matches and/or any other games duly authorised by The Insured.
(e) Actually engaged in administrative or organised social activities of The
Insured.
Geographical Limit: Anywhere in Australia and New Zealand
Policy Wording: Sportscover Player Accident Policy Wording April 2008_YOA 2009
Plus the following agreed schedule of benefits and endorsements.
|
Event |
Benefit |
|
Capital Benefits |
$100,000 ($20,000 if under 18 years of age) |
|
Non Medicare Medical Expenses
|
Limited to 85% of Actual Maximum amount payable $3,500 Excess $50 each claim |
|
Loss of Income - Weekly Benefit |
85% of Net Income or $300 per week, whichever is the lesser Benefit Period 52 Weeks Elimination Period 14 Days |
|
Student Assistance |
$300 per week Benefit Period 52 Weeks Elimination Period 7 Days |
|
Domestic Home Help Expenses |
$300 Benefit Period 52 Weeks Elimination Period 7 Days |
|
Parents Inconvenience Allowance |
$1,500 |
|
SCOPE OF COVER: Policy 1. continued |
|
Event |
Benefit |
|
Medical Expenses Incurred Overseas/Medical Evacuation
Sum Insured - $150,000 Intended for any State or Territory, Association or Club representative teams touring overseas
|
Medical Expenses Incurred Overseas means emergency medical, surgical, hospital, ambulance service, dentists, or orthodontic services and other costs of treatment incurred outside Australia, given or prescribed by a legally qualified medical practitioner and which are not recoverable from any other source.
Medical Evacuation means additional travel and accommodation costs incurred for the return of an Insured Person to Australia on the written advice of a legally qualified medical practitioner.
|
|
Travel and Accommodation Benefit 85% of travel expenses / $150 per night for accommodation Limit - Up to $1,500 Benefit Period - 52 Weeks |
Travel and Accommodation Expenses means reasonable travel and accommodation costs incurred as a result of an Injury to an Insured Person
For the purpose of this clause, "Family Member" means: (i) any spouse, domestic partner, or companion; (ii) any parent, or parent of the spouse, domestic partner or companion; (iii) any sibling or child.
|
|
Cover extended to registered participants whilst competing for their school |
|
Sports Injury
- Sporting Accident Claim Forms (including Medical Report) can be obtained from Gow-Gates Insurance Brokers.
- The appointed club officer is to arrange for all sections of the ‘Claim Form' and ‘Medical Report' are to be completed as soon as possible and within 30 days of the injury.
- It is important that a senior officer signs the appropriate sections of the claim form and verifies the details stated on all sections. They must also ensure the section for "Part 2 - Loss of Earnings" is completed if claiming for weekly benefits.
- It is also very important that the injured player signs the ‘Declaration and Authorisation' on page 3.
- When the claim form is completed please send directly to the insurer, Sportscover within 30 days of the injury to.
Claims Department
Sportscover Australia Pty Ltd
Locked Bag 6003
Wheelers Hill, VICTORIA 3150
Important: if the ‘Medical Report' is not completed at this stage do not hold off sending the claim form to Cunningham Lindsey, this can be sent separately when ready.
- If Non Medicare medical expenses are being claimed the paid accounts and Health Fund rebate statements should be forwarded to Sportscover as they come to hand.
Any queries on lodged claims can be directed to;
Claims Hotline 1300 134 956
Email asiapac.claims@sportscover.com
|
Account Manager |
Brett Duprez P (02) 8267 9939 M 0407 213 677 |
|
Account Executive |
Will MacArthur P (02) 8267 9952 |
