This manual has been compiled to enable the Association to assist players and Worldwide Sports Insurance (WWSI) and Sportscover (the Underwriter) to manage claims as quickly and efficiently as possible.
By following these procedures all claims will be dealt with promptly ensuring that the members will be reimbursed in the shortest possible time.
WWSI and National Touch Rugby Association believe this manual is comprehensive and the procedures are simple and straight forward. Should further information be required, please feel free to contact WWSI on the numbers listed at the rear of this manual.
ALL INFORMATION IN THIS MANUAL IS EFFECTIVE FROM 1ST NOVEMBER 2000.
INDEX
(3) Summary of Policy Benefits - Player Accident Insurance
(4) Public Liability Procedures
(5) Summary of Policy Benefits - Public Liability
(6) Premiums
(7) Memo from NTRA - Disaffiliated Associations
(9) Worldwide Sports Insurance Contact Details
What the Association should do when an injury occurs.
Step (1) As soon as possible after the accident ensure the injury has been reported on the score sheet and/or in the injury "Report Book".
N.B. The player must notify their Association Secretary.Step (2) Advise the player to contact Worldwide Sports Insurance and request that a claim form be sent out.
Email:
info@wwsi.com.auOr
Phone: (07) 3876 3001
Or
Fax: (07) 3876 3009
A claim form will be sent directly to the player with a covering letter detailing exactly what the player needs to do to ensure their claim is dealt with quickly.
What the player should do when an injury occurs.
(Within 30 days) WWSI will dispatch a claim form upon request directly to the injured player enclosing full instructions of how the claim form should be completed.Step (1) Report the Injury. (as above)
Step (2) Obtain a claim form.
Step (3) Fill in and send completed form to WWSI. (Within 90 days)
Upon receipt of the claim form, the player should complete appropriate sections of the claim form.Step (4) Complete all treatment.
Player should complete all prescribed treatment keeping all receipts of treatment received and paid for.Step (5) Get the Medical Practitioner to fill in the statement.
Player must obtain a referral from a Doctor (qualified Medical Practitioner or Surgeon) for Physiotherapy, Chiropractic or paramedical services.Step (6) Claim from Medicare and your Private Health Insurance.
(if applicable)To ensure a speedy processing of claim make sure all steps are followed
PLAYER ACCIDENT INSURANCE
4. Policy Benefits
STANDARD or BUDGETInjury sustained by an Injured Person which within twelve The benefits payable will be the
calendar months results in:- following percentage of the capital
benefits specified in the schedule.
Section 4.1 Capital Benefits
1. Death (Persons aged less than 18 years 20%) 100%
2. Permanent Quadriplegia or Permanent Paraplegia 100%
3. Permanent and incurable total loss or use of all limbs 100%
4. Permanent Total Loss of sight of both eyes 50%
5. Permanent Total Loss of sight in one eye 25%
6. Permanent Total Loss of use of two limbs 75%
7. Permanent Total Loss of use of one limbs 35%
8. Permanent Total Loss of the lens of two eyes 50%
9. Permanent Total Loss of the lens in one eye 25%
10. Permanent Total Loss of hearing in:
(a) both ears 75%
(b) one ear 15%
11. Third degree burns and/or resultant disfiguration received from fire or
chemical reaction extend to cover more than 40% of the entire body 50%
12. Permanent Total Loss of use of four fingers and thumb or either hand 70%
13. Permanent Total Loss of the use of four fingers of either hand 40%
(a) both joints 14%
(b) one joint 6%
14. Permanent Total Loss of use of fingers of either hand
(a) three joints 10%
(b) two joints 7%
(c) one joint 5%
15. Permanent Total Loss of the use of toes either foot
(a) all - one foot 15%
(b) great - both joints 5%
(c) great - one joint 3%
(d) other than great, each toe 1%
16. Fractured leg or arm with estimated TOTAL non union 7%
17. Shortening of a leg by at least 5cm 7%
18. Any permanent total disability or permanent total loss of use of any body part
not shown above will be compensated at a percentage of the capital benefit as
determined at the sole and absolute discretion of the underwriters. Such
determination will not be inconsistent with the benefits provided under
events 4-17 inclusive.
19. You becoming totally and permanently disabled as a result of injury sustained
whilst travelling to or from an event in which you are engaged to play for the
Insured we will pay 20% of the applicable capital benefit listed above.
NOTE: The above is a summary of the Policy Benefits. For further information, please contact WWSI.
Covering up to 50% of the cost of Non Medicare / Health Act medical expenses incurred being Hospital Accommodation, Ambulance, Dental, Chiropractic and 75% of Physiotherapy expenses.
The maximum benefit payable will be $1,200. (an excess of $20 will apply)
IMPORTANT NOTES:
1. A referral must be obtained from a doctor (qualified Medical Practitioner) for physiotherapy or chiropractic treatment.
2. Under the Australian Health Insurance Act we are NOT permitted to contribute to any charges covered by Medicare.
3. All injuries must be reported to WWSI within 30 days after an accident occurs. The claim form must be lodged within 90 days.
4. It is the players responsibility to ensure the injury was recorded on a score sheet or in the "Injury Report Book" before requesting a claim form.
5. Benefit will be payable upon receipts for services rendered being produced and all amounts which are claimable under Private Health Insurance being claimed (if applicable). The insurers will then refund up to 100% of the gap between Private Health Insurance and the total amount of the qualifying medical bills, less an initial $20 excess or up to 50% of Non Medicare Medical bills and 75% Physiotherapy less an initial $20 excess.
6. The insured member must claim benefits from Medicare and Private Health Insurance before submitting to WWSI.
7. All medical Expenses must be incurred within 12 Calendar months of sustaining the injury.
Any entitlement to benefits ceases immediately a claimant resumes training or playing.
8. All services must be obtained from a legally qualified practitioner, Hospital and/or Ambulance Service.
Section 4.3: Loss of Income (not available with "Budget Cover")
(4.3.1) LUMP SUM LOSS OF INCOME
Temporary Total disability - Loss of Income $210 10 day excess
Maximum period of claim 52 weeks
Temporary disablement from engaging in or attending to an Insured persons usual profession business or occupation provided that such professional business or occupation was immediately prior to and at the time of the event a full-time remunerative profession business or occupation for the Insured person. In respect of the total period of total disablement the lesser of the schedule amount 75% of "Net Income Lost" or as defined $210 for every week other than the first ten days.
(4.3.2) INJURY ASSISTANCE AND PARENTS INCONVENIENCE BENEFIT
Injury Assistance Benefit - $150 per week 7 day excess
Maximum period of claim 52 weeks
No compensation shall be payable in respect of this benefit should there by any amount payable under loss of income benefit. We will reimburse an Insured Person with 80% of non-medical expenses directly relating to the injury. There is no claim unless the period of total disablement continues for more than seven days. All claims must be substantiated with receipts from a registered service provider.
Any incident which may give rise to a claim under any contract of Public Liability Insurance should always be referred directly to WWSI at the earliest possible opportunity.
STEPS TO FOLLOW
1. Report the incident to a Senior Representative of the Association
2. Ring WWSI on the numbers listed in the back of this book and report the incident
3. Complete the report section of the claim form for the claimant
WWSI will issue a claim form to the claimant.
All further correspondence with the claimant will be handled directly by the insurer
IMPORTANT
A detailed report to be made of the incident and reported to the relevant association officer or official.
At no time should the centre or any representative of the centre admit any liability what so ever for the incident.
Ensure Witness names and Addresses are included in the claim details.
SUMMARY OF POLICY BENEFITS
PUBLIC LIABILITY INSURANCE
Options available for:
- $2 Million Public Liability
- $5 Million Public Liability
- $10 Million Public Liability
INSURED Committee, officials of the associations / clubs including registered members for their respective rights and liabilities.
SCOPE OF COVER Anywhere in Australia
Member to Member LiabilityPOLICY EXTENSIONS Tenants / Property Owners Liability
Car Parking / Unregistered Vehicles
Goods Sold / Food & Drink
Medical & Welfare
Care Custody & Control
Cross Liabilities
PROFESSIONAL INDEMNITY Cover for all Coaches, Referees and Captains in performance of their duties ( Limit $ 1 Million )
EXCESS NIL
TO OBTAIN A CLAIM FORM
PLEASE REQUEST FROM WORLDWIDE SPORTS INSURANCE: -
EMAIL: info@wwsi.com.au
OR
PHONE: (07) 3876 3001
OR
FAX: (07) 3876 3009
OR
POST: P.O BOX 1165
MILTON QLD 4064
Re: Coverage of Disaffiliated Associations
Players and Officials
When an Association disaffiliates with National Touch Rugby Assoc-
Insurance Coverage for the Association in Public Liability and Professional Indemnity – ceases immediately.
2. Players Insurances and Registration also cease immediately for players and/or officials
Regards,
Mr David Douglas
National Touch Rugby Assoc.
The following premiums are effective for all competitions commencing after 1st November 2000.
Public Liability / Professional Indemnity
$2 Million Public Liability - $15 per team
$5 Million Public Liability - $25 per team
$10 Million Public Liability - $35 per team
The above premiums include $1 Million Professional Indemnity Insurance.
Player Accident Insurance
"Budget" * Accident Insurance - $35 per team
"Standard" Accident Insurance - $45 per team
* Please note that the "Budget" cover does not include a Loss of Income / Injury Assistance and Parents Inconvenience Benefit.
All premiums are inclusive of Stamp Duty and GST and are payable prior to the commencement of each season. Payment can be made in the form of a cheque, money order or credit card and are to be forwarded directly to Worldwide Sports Insurance at P.O Box 1165, MILTON QLD 4064.
A completed Proposal Form is required by WWSI to initiate cover. To obtain a Proposal Form, please call (07) 3876 3001.
A receipt, confirming cover has been initiated, will be forwarded to you on receipt of the completed Proposal Form and payment.
CONTACT DETAILS
PHYSICAL ADDRESS: 8 / 27 Mayneview St.
MILTON QLD 4064
POSTAL ADDRESS: P.O BOX 1165
MILTON QLD 4064
PHONE: (07) 3876 3001
FAX: (07) 3876 3009
EMAIL: info@wwsi.com.au