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Below is information on how to make a claim under the Sports Injury policy. If you wish to make a claim or notify an incident for General Liability, Professional Indemnity or Management Liability, please contact Gow-Gates immediately.

Sports Injury Claims

Steps to follow:

  1. Obtain a claim form
  2. Complete the Claim Form
  3. Lodge the claim form
  4. Lodge additional documentation as required

Step 1: Obtain a claim form

To obtain a claim form:

Click here to download the NSWJRL Sports Injury claim form, or
contact Gow-Gates to be sent a copy of the form.

Step 2: Complete the Claim Form

The insured person (the person making the claim) is to fully complete all sections of the claim form. In addition, the following people will need to complete their relevant sections:

  • The Attending Physicians Statement on pages 5 and 6 will need to be completed by your treating doctor.
  • If you are claiming for loss of income, you will need to have your employer complete the Employer’s Statement on page 3 of the form.
  • The club secretary or treasurer will need to complete and sign the Official Report on page 2 of the form, having verified all the details completed in the form.
  • The District Administrator will need to sign the acknowledgement on page 2 of the form, having verified all the details completed in the form.

Step 3: Lodge the Claim Form

The claim form needs to be lodged to Fullerton Health, within 30 days of the injury.

Please send your claim form and supporting documentation, preferably via email to

or post (IMPORTANT: Please keep a copy of all documentation you send in the post in case it gets lost) to;

The claim form will be acknowledged within 14 days by Fullerton Health. This acknowledgement will include a unique claim number which can be used when lodging additional documentation.

Step 4: Submit additional paperwork

In order to claim, the following documentation will/may be required by Fullerton Health in addition to the claim form.

  • Receipts for paid Non-Medicare Medical Expenses
  • Health Fund rebate statements
  • Doctors Certificates confirming the period of incapacitation
  • Proof of Earnings documentation
  • Any other documentation requested.

Please forward the above documentation to Fullerton Health upon receipt. You can simply note your claim number in order for it to be assessed if you have already received their acknowledgement letter.

Don’t wait for the above documentation before submitting the claim form to Fullerton Health as this delays the claims process and means that your claim payment will be slower.


Claim Form