Who can make a claim?
A claim can be made by:
- Any person who is a registered player, coach, trainer, manager, administrator, voluntary worker, selector, referee, touch judge or ball boy of a club that is part of the NSW Junior Rugby League Districts scheme who has been injured whilst playing or engaging in Rugby League, training for, or travelling to and from a club match or function.
- Players must be registered before taking part in a game.
What benefits am I entitled to?
Payment of 80% of non-Medicare medical expenses after any reimbursement from your health fund. You are not privately insured through this policy. These expenses include private hospital accommodation, physiotherapy, pharmacy, ambulance and dentistry.
The maximum benefit payable is $2,500
An Excess of $100 applies to each claim (excess is $50 if you belong to a Private Health Fund and for Ambulance costs).
All medical treatment must be certified necessary by a medical practitioner.
Due to the National Health Act 1958 no coverage is provided under this insurance for medical expenses which are payable (whether fully or partly) by Medicare.It is strongly recommended that separate Private Health Insurance be taken out.
Wekly Benefits are payable as below whilst you are temporarily totally disabled and wholly and continuously prevented from engaging in any occupation and/or attending school and/or studies.
- Income Earners – 80% of gross income (net of business expenses) up to a maximum of $300 per week for 52 weeks. 14 day excess applies.
- Non Income Earners – 80% of authorised domestic help up to a maximum of $300 per week for 52 weeks. 14 day excess applies.
- Full-time Students – 80% of authorised tutorial costs up to a maximum of $300 per week for 52 weeks. 14 day excess applies.
Top up cover is strongly recommended. Please refer to your Club Secretary for an application form.
Parents Inconvenience Expenses -Reimbursement of necessary additional expenses incurred in visiting a hospitalised injured person up to a maximum of $100 per day. Maximum benefit is $2,000 (2 day excess).
Funeral Expenses – expenses incurred in burial or cremation within 12 months of injury.The maximum benefit payable is $2,000
Coverage for Death and some Permanent Disabilities is provided under the NSW Sports Injury Scheme arranged by your Junior League. Refer to your club for details.
Public & Products Liability
Legal liability up to $ 10,000,000.($20 million if elected by your District) Includes Errors and Omission (Professional Indemnity) up to $5,000,000. Excess $500 each and every loss.
How do I make a claim?
When making a claim for an injury, you must:
- Advise your Club Secretary that you wish to make a claim.
- Obtain from your Club Secretary:
- “Sports Injury Report Form” to be completed by you, and
- Attending Physician’s Statement to be completed by your doctor.
- Return both fully completed claim forms to your Club Secretary.After your Club Secretary verifies the claim he/she will forward these to the District Administrator who forwards them to the Insurer’s Claims Administrators.
- Claims must be lodged with the District Administrator within 30 days of injury.
- When completing the claim form, ensure that you provide as much information as possible. This may include documents, records or even photographs for identification.
- You must attend any medical examinations or other assessment organised by QBE Insurance or GAB Robins Australia Pty Ltd.
- You must take all reasonable steps to recover from any injuries.
- If you require an update on the status of your claim, you may contact GAB Robins Australia Pty Ltd as above or phone 02 9633 3533.
Who can I talk to about an issue or complaint?
Talk to QBE Insurance staff first, ask for Corporate Property underwriting or claims staff.
If the matter cannot be resolved, it will be referred to QBE’s Internal Dispute resolution (IDR) representative.
If the mater cannot be resolved internally, QBE will provide you with details of an independant external dsipute body called Insurance Enquiries and Complaints Ltd (IEC).
Points to Remember
- Only injuries which occur during the policy period are covered.
- No coverage is provided for injuries arising from pre-existing injuries or physical or congenital conditions. Injuries arising from AIDS, HIV, childbirth or pregnancy are not covered.
- Full details of the Policy are available from your Club Secretary.
- Claims forms are available from your Club Secretary.
- Your District Junior League Administrator will submit your claim form.
- All claims must be advised to your District Administrator within 30 days of injury.
- It is recommended that all players and officials take out separate Top Up insurance and Private Health Insurance,
- This brochure is a summary only of the main points of coverage. Please refer to the policy document held by your club for complete policy terms and conditions.
This plan is underwritten by:
QBE Insurance (Australia) Limited,
ABN78003 191 035
82 Pitt Street, Sydney NSW 2000
DUTY OF CARE STATEMENT
When you register and play with a Junior Rugby League club, you are reminded that Rugby League is a body contact sport. Potential, notwithstanding all safeguards, exists for a player to sustain an injury. Players must therefore prepare themselves for the game by having a commitment to training and a high level of fitness. As a measure of your Club and Junior League’s support to players and officials, insurance cover has been arranged as set out in this document for your benefit and risk protection. In addition to these polices all players and officials may, and are encouraged to take out private health insurance and “Top Up” over and above the insurance cover specifications defined in this brochure, particularly in relation to “Loss of Income”. Any advice or additional insurance cover that any member or your club or association may require can be arranged by making enquiries at either Gow-Gates Insurance Brokers Pty Ltd, your club or your association. Under the policy in place, as set out in this brochure, no death or permanent injury benefit is available. Death and permanent injury are covered under a separate policy through the NSW Sporting Injuries Scheme which is arranged by your Junior League.