Non Medicare Medical Expenses, Loss of Income and other benefits

What is covered under this section?

The following benefits are offered under the Personal Accident Policy;

• Non Medicare Medical Expenses

• Loss of Income

• Home Help Benefit

• Student Assistant Benefit

• Parents Inconvenience Benefit

• Funeral Benefit

• Rehabilitation Benefit

• Bed Care Benefit

• In Memoriam Benefit

• Kidnapping Benefit

• Membership Benefit

• Counselling Benefit

What are the benefits payable?

The most commonly claimed benefits via the Netball Australia Personal Accident Policy are;

Non Medicare Medical Expenses

Loss of Income

Please refer below for details of the benefits payable for Non Medicare Medical Expenses and Loss of Income. For further information on what is payable via other policy benefits, such as Rehabilitation and Student Assistance etc, please refer to the Policy Schedule and Wording.

1) Non-Medicare Medical Expenses

This covers insured persons for NON-MEDICARE MEDICAL Expenses. The policy is for reimbursement only. That is, the member must pay the account and then claim reimbursement under this insurance cover.

NOTE: Only NON-MEDICARE items are claimable (i.e The “Medicare gap” is not claimable due to government legislation).

The most common “Non Medicare” expenses include:

Private Hospital
Dental
Ambulance
Chiropractic
Physiotherapy
Osteopathy

Medical expenses that are covered by Medicare (i.e. not covered by this sports injury policy) include:

Doctors Fees
Surgeons
Anesthetists Fees
X-rays

Benefit

Members with Private Health Insurance

Reimbursement up to 100% of Non-Medicare medical costs, up to a maximum of $2,500 per injury for Members/Players ($5,000 for officials and voluntary workers (i.e. non-participants).

Members without Private Health Insurance

Reimbursement up to 80% of Non-Medicare medical costs, up to a maximum of $2,500 per injury for Members/Players ($5,000 for officials and voluntary workers (i.e. all non-participants).

Excess

A $75 excess applies to each injury ($Nil if a member of a Private Health Fund).

$Nil excess for ambulance only.

Conditions

If a member belongs to a private health fund, they must claim from that fund first.
Non Medicare Medical costs are only reimbursed by this policy if incurred within 52 weeks from the date of injury.

2) Loss of Income

This benefit provides cover for insured persons who are disabled from an injury relating to events covered and are unable to work.

The benefits payable are 100% of net weekly income up to a maximum of $250 per week ($300 per week for Netball WA members),

$700 per week for officials and voluntary workers (i.e. all non-participants).

Note: Claimant must being engaged in Full Time Employment. Full Time employment means physically performing or undertaking permanent work in the Insured Person’s Occupation, for a minimum of 80 hours over the 8 week period immediately prior to the Injury. Periods of unpaid leave of any kind are not included in the assessment of the minimum hours per week required to meet the definition of Full Time Employment.

What is the policy excess?

The first 14 days income from the date of injury is excluded.

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