Injury Claim

:: How to make a Claim (WRFL)
:: VAFA Claims Procedure

How to make a Claim (WRFL)

Policy Reference B0901LK0406981

Public and products liability, professional indemnity and associations liability claims
It is essential that you notify JLT Sport immediately of any potential claim. It is also extremely important not to admit liability or discuss the matter with a third party person. JLT Sport will then guide you as to the next step in the process.

Personal accident capital benefit claims
If there appears to be a potential for a capital benefit for permanent or partial impairment please notify JLT Sport immediately. Claims personnel will advise you on what will need to do next.

Non-Medical medical claims Firstly report the claim to JLT Sport.

This can be done one of two ways:

A) By phoning the JLT Sport Claims team on 1800 640 009. This is a toll free number in Australia. Claims staff will help with your claim and send a claim form to you for completion. You will be required to complete the form and return with any medical accounts for reimbursement.

B) By accessing the JLT Sport website (www.jltsport.com.au) and completing an online claim form. This will automatically be lodged electronically, but you will need to send in any medical accounts for reimbursement.

In both cases you will be allocated a claim number which should be detailed on any future accounts or correspondence relating to the same injury.

Make sure you advise your club name. It is in your interest to notify your club of the injury and report your claim as soon physiotherapy, dental, chiropractic and all ancillary benefits, including ambulance (providing you are not a member)

Please do not send doctors’, surgeons’, anaesthetists’, x-ray of MRI Scan accounts as they are covered by Medicare. The Australian Health Insurance Act does not permit us to pay any part of these accounts.

Loss of income claims
This is a non-compulsory cover which clubs have to take out on behalf of the but any players at a team level.

Please note we do not hold this cover at this time
If there appears to be a potential for a loss of income claim please notify JLT Sport immediately. Claims personnel will advise you on what you need to do next.

Important information for loss of income claims

1. You must be a permanent or regular casual employment at the time of injury.
   
   
2. The benefit is for up to 80% of your weekly sum insured whichever is the lesser.
   
   
3. Other insurance benefits do not need to be exhausted prior to claiming on this section.
   
   
4. The attending physician’s report must be completed by the practitioner who attended to you I.e. doctor/ physiotherapist/chiropractor: if a fee is charged for completing this section, that fee will be borne by the claimant.
   
   
5. Your loss of income claims must be covered by a medical certificate for your full period of disability.

WE DO NOT PAY FOR THE FIRST 14 DAYS OF DISABILITY.
Note: Subject to the Insurance Contracts Act 1984 any treatment rendered necessary any injury must be completed within 12 calendar months from the date of such injury occurring.

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VAFA Claims Procedure

WHAT THE ASSOCIATION SHOULD DO WHEN AN INJURY OCCURS!
Advise the player to contact Sportscover and request a claim form to be sent out.

Sportscover: (03) 9721 4700 or
Claims Hotline: (03) 9721 4747
Website: www.sportscover.com.au

A claim form will be sent out 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 A PLAYER SHOULD DO WHEN AN INJURY OCCURS!

1. Obtain a claim form or complete application online Sportscover will despatch a claim form upon request directly to the injured player enclosing full instructions of how the claim form should be completed. (Within 30 days)
   
   
2. Fill in the claim form and send it to Sportscover as soon as possible. Upon receipt of the claim form, the player should complete appropriate sections of the claim form.
   
   
3. Have a medical Practitioner fill in the physician statement.
   
   
4. Complete all treatment. Player should complete all prescribed treatment keeping all receipts of treatments received and paid for.
   
   
5. Claim from medicare and private Health Insurance.
   
   
6. Send all receipts and private health Insurance Statements to Sportscover.

To ensure a speedy processing of claim make sure all steps are followed.

IMPORTANT NOTES:

1. Under the Australian Health Insurance Act we are NOT permitted to contribute to any charges covered by Medicare.
   
   
2. All claims must be notified within 30 days after an accident occurs. The claim for must be lodged within 90 days with Sportscover.
   
   
3. It is the players’ responsibility to ensure the injury was reported on a score sheet or in the “Injury report Book” before requesting a claim form.
   
   
4. Benefit will be payable upon receipts for services rendered being produced and being 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 $50 excess or up to 50% of Non medicare bills, 50% of physiotherapy bills - less an initial $50 excess.
   
   
5. The insured member must claim benefits from Medicare and private Health Insurance before submitting to Sportscover.The insured member must claim benefits from Medicare and private Health Insurance before submitting to Sportscover.
   
   
6. All medical expenses must be incurred within 12 Calendar months of sustaining the injury.
   
   
7. All services must be obtained from a legally qualified practitioner, Hospital and/or Ambulance Service.

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