The Sports Personal Injury policy has three main sections:

• Non-Medicare Medical Benefits
• Weekly Loss of Income Benefits
• Capital Benefits
  

Non-Medicare Medical Benefits

The section provides payment of 100% of Non-Medicare Medical Expenses after any reimbursement from your Private Health fund.  A $100 excess applies to each and every claim and the maximum benefit payable is $3,000. If claiming for Ambulance ONLY, then no excess is payable.

This benefit covers only expenses that are not covered by the Medicare Act 1973. i.e. expenses for which there is no full or partial Medicare rebate. Commonwealth Legislation prevents insurers, other than a registered private health insurer (BUPA, HCF, Medibank Private etc.) from insuring the Medicare Gap.

Examples of expenses that are generally claimable under this section are -

• Private hospital accommodation
• Physiotherapy and chiropractic treatment
• Pharmacy
• Ambulance
• Dental
• Hire of artificial aids such as orthotics, splints, crutches

Examples of expenses that are not claimable under this section include -

• Doctors fees
• Surgeon and anaesthetists fees
• X-Ray costs

Weekly Loss of Income Benefit

This section provides an income replacement to insured persons that suffer an injury and are temporarily totally disabled from performing an occupation.

Your average weekly income which can be claimed under the policy is net of business expenses and excluding bonuses, commissions, overtime payments and other allowances.

It should be noted that proof of consistent work and pay entitlements will be requested.

Note: Tax may be withheld by the insurer from your Weekly Benefit.  Please speak with your Accountant about your obligations to the ATO.

Capital Benefits

This section provides a lump sum benefit to insureds that suffer permanent injury or death.

The maximum benefit under this section is $750,000 for Paraplegia / Quadrilplegia.

There are benefits payable for various levels of disability for example;

A detailed list of the benefits is contained in the policy wording, available from Gow-Gates.

Additional Benefits

There are other additional benefits available under the Sports Personal Injury policy including:

• Student Assistance benefit
• Domestic Home Help Expenses
• Parents Inconvenience Allowance
• Travel and Accommodation Expenses
• Funeral Expenses Benefit
• Overseas Medical / Repatriation Expenses

For details of these additional benefits, please refer to the policy document or contact Gow-Gates.

What injuries are not covered

The Sports Injury section is designed to provide coverage for injuries incurred accidentally whilst playing, training, officiating and administering rugby.  In keeping with this philosophy the policy contains some exclusions that clarify this intention.

Claims are excluded under the policy for injuries arising out of:

• Pre-existing injuries or physical or congenital conditions
• a sexually transmitted disease, AIDS, HIV, childbirth or pregnancy
• engaging in air travel except as a passenger in any properly licensed aircraft
• effects of alcohol and/or drugs not prescribed by a medical practitioner
• Deliberately self-inflicted injury or suicide
• war, invasion or acts of foreign enemies etc.
• any heat-stroke, sickness or disease and/or cardiac or pulmonary or cerebrovascular incident notwithstanding that such incident may have been caused by or induced by or accelerated by Injury
• any act of Terrorism
• Claims will be proportionally reduced where an Injured Person continues to engage in training or practice or playing rugby whilst injured or not fully recovered from an injury, causing another injury, reoccurrence of an injury or aggravation of an injury.