Insurance

Please make sure you have filled out a Headis Sports Australia Injury Form to submit with your application. The Injury Form must be completed and submitted on the day if practical to do so or at the earliest possible opportunity. Delays in filling out the form may affect your application. If a form is not provided to you on the day of your injury please contact [email protected] immediately to request a form.

Group Personal Accident InsuranceBronze Cover – Loss of Income NOT INSURED

Capital Benefits

The cover under this section provides $50,000 for death resulting

from accident.  All other permanent disabilities are calculated

using a percentage of the death benefit depending on the severity

of the injury.  For full details of these percentages, please refer

to the Schedule of Capital Benefits contained in the policy wording. 

Please Note Death is limited to 20% for Members whose age is less

than 18.

Modification Expenses

The cover under this section provides for costs necessary up to a

maximum of $10,000 to modify the Member’s home and/or motor vehicle,

or relocating to a suitable home if they are entitled to 100% of the

Capital Benefit.

Funeral Expenses

The cover under this section reimburses funeral costs up to a maximum

of $5,000.

In Memoriam Benefit

The cover under this section provides for reasonable costs associated

with observance of the death of a Member up to a maximum amount of

$1,000.

Loss of Earnings – NOT INSURED

Student Help – NOT INSURED

Home Help – NOT INSURED

Parents Allowance

The cover under this section reimburses $25 per day in-patient benefit

to a full time student under 25 years of age for continuous confinement

in hospital because of an accident.  The benefit is limited to $1,500.

Dependent Children’s Allowance

The cover under this section provides for reasonable costs incurred by

the Dependent Children of a Member whilst the Member is undergoing medical

treatment.  The benefit is limited to $500.

Medical and Dental Costs

The cover under this section reimburses 85% of non-Medicare medical

treatment including ambulance, hospital accommodation / theatre fees,

orthotics, splints, prosthesis, treatments given by a dentist, chiropractor,

masseur, naturopath, osteopath or physiotherapist.  The maximum benefit

for this section is $1,500.  All treatment must be certified by a

registered medical practitioner and not subject to any Medicare rebate. 

All claims are subject to a $200 excess

Any expenses must be incurred within 12 months of the insured person

sustaining the injury.

Home Nursing Care

The cover under this section provides for nursing care provided by a

registered nurse (not related to the Member) where they are confined to

bed for a period of not less than 7 days if certified medically necessary. 

The maximum weekly benefit payable is $300 per week, and is subject to a 7

day deferral period.  The benefit will be paid for the period of the

Disablement as certified by a registered medical practitioner or 52 weeks

whichever is the lesser.

Ancillary Non Medical Expenses

The cover under this section provides for ancillary non medical expenses

(expenses related to medical treatment if certified as necessary. i.e.

expenses include items such as travel to receive treatment, but does not

include wages lost by any person). The maximum payable under this benefit

is $1,500.

Rehabilitation Benefits

The cover under this section provides for reimbursement of:

a)  Tuition or advice fees from a vocational college if certified

    as necessary and agreed to.  The maximum payable under this

    benefit is $3,000.

b)  Rehabilitation expenses (eg gym membership) certified as

    necessary and agreed to.  The maximum payable under this

    benefit is $500.

Unexpired Membership Reimbursement Benefit

The cover under this section provides for pro-rata refund of your

club’s or association’s membership/registration fee from the date of

injury if the Member can’t play for the rest of the season.  The maximum

payable under this benefit is $500.

Miscarriage and Premature Childbirth

The cover under this section provides for $2,500 compensation for

Miscarriage and Premature Childbirth as a direct result of an

Accident whilst participating.

HIV

The cover under this section provides for 10% of the Permanent

Total Disability Benefit 1. as listed in the Schedule of Capital

Benefits if contracted as a result of an Accident.

Kidnapping

The cover under this section provides for 10% of the Permanent Disability

Benefit 1 as listed in the Schedule of Capital Benefits.

Notes for claimants:

To ensure your claim is processed quickly and efficiently please follow steps below. Please read thoroughly and keep for your own reference.


Non Medicare medical expenses claim:

1. Please note that due to Federal Government Legislation (Sec126, Health Insurance Act 1973) General Insurers are unable to provide benefits on any Medicare related expenses, including gap payments.
2. Claims for treatment given by a chiropractor, masseur, naturopath, osteopath or physiotherapist must be accompanied by a referral from a registered medical doctor.
3. If you hold private health insurance you are required to claim all expenses from your private health fund first. Once you have claimed from your health fund please forward your ‘Statement of Benefits Paid’, the account and receipt to us.
4. If you have already incurred non-Medicare medical expenses, please attach the original tax invoices along with a receipt confirming the account has been paid.


Please note:

1. Your claim cannot be processed if the claim forms are incomplete or illegible. To ensure your claim is processed without delay please make certain all sections on the Sports Injury Claim Form, Medical Statement, Injury Data Collection questionnaire and any applicable Addendums to Injury Data Collection questionnaires are fully complete
2. Please forward your completed Sports Injury Claim Form to our office within 30 days of your injury. Do no wait for all your medical accounts. Forward them to us as you receive them.
3. Your Personal Accident Sports insurance policy covers medical expenses incurred within 365 days of the date of the event that caused the injury.


Complaints and disputes:

If you are dissatisfied with a product or service provided by your Adviser, please contact the Manager of the Branch in your State. If the Branch Manager is unable to resolve the complaint to your satisfaction, you may ask that the matter be referred to the National Complaints Manager for Gallagher. The National Complaints Manager will acknowledge your complaint in writing and endeavour to resolve your problem within 21 working days.
If an issue has not been resolved to your satisfaction, you can lodge a complaint with the Australian Financial Complaints Authority, or AFCA. AFCA provides fair and independent financial services complaint resolution that is free to consumers.
Website: www.afca.org.au
Email: [email protected]
Telephone: 1800 931 678 (free call)
In writing to: Australian Financial Complaints Authority, GPO Box 3, Melbourne VIC 3001

PLEASE NOTE APPLICATIONS ARE NOT SUBMITTED VIA HEADIS SPORTS AUSTRALIA.

PLEASE CONTACT THE BELOW GALLAGHER ACCOUNT EXECUTIVE TO HELP LODGE YOUR APPLICATION:

Kim Thomson
Account Executive
Sports | Recreation | Entertainment
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Direct: +61 2 8838 5779 | Ext: 25779 | Mobile: +61 429 128 061 | Fax: +61 28838 5701
[email protected] | www.ajg.com.au