group personal accident policy schedule · qbe insurance (australia) limited abn 78 003 191 035 an...

QBE INSURANCE (AUSTRALIA) LIMITED ABN 78 003 191 035

AN A045655 PAD – Netball Australia 2017-2018 of 5

GROUP PERSONAL ACCIDENT POLICY SCHEDULE

Policy Number: AN A045655 PAD

Policy Wording: QBE QM 360-1215 Sports Injury Insurance Policy Wording

The Insured: Australian Netball Association (Netball Australia), including

their affiliated Leagues, Associations, Centres and Clubs

The Business: The principal activities are to administer, coordinate, promote

and develop the sport of netball, Risk Management and

governance of sanctioned events, games, tournaments and

training sessions and any other activity incidental thereto.

Period of Insurance: From: 1st February 2017 at 4:00 pm

To: 1st February 2018 at 4:00 pm

Insured Persons: All registered members and all non-participating officials of the

insured, all coaches, umpires, committee members, employees

of the insured including apprentices, voluntary workers and

work experience students, prospective members for up to four

weeks from initial participation.

Time of operation of cover: Whilst participating in sanctioned Netball Australia activities

including:

a) Engaging / Playing in official club matches including club,

championship or representative matches,

b) Organised training or practice sessions for activities as

described in (a) above,

c) Travelling directly between matches / activities in a) or b)

above, and residence or place of employment or the premises

of the insured or its affiliated Associations, Leagues or Clubs,

d) Staying away from your home district during a tour for the

purpose of participating in representative matches / activities,

e) Engaging in administrative or organised social activities or

fundraising activities of the insured or its affiliated Associations,

Leagues or Clubs.

Age Limits: 2-100 years old

Geographical Limits; Worldwide

Aggregate Limit of Liability; $2,000,000



Benefits & Sums Insured:

Benefit Maximum individual compensation

– each insured person

Section A – Capital Benefits

Event 1 Death persons aged 18-75 years $250,000

persons under 18 and over 75 years $25,000

Capital Benefits Events 2 and 6-30 $100,000

Event 4 Paraplegia & Event 5 Quadriplegia $500,000

Section B – Weekly benefits - Injury

We will pay 100% of your pre-disability earnings to a maximum of

Members/Players $250 per week

Officials and Voluntary Workers $700 per week

Maximum benefit period 104 weeks

Excess period 14 days

Section D – Injury assistance benefits

If you are not in receipt of pre-disability earnings we will pay expenses for

Home assistance $400 per week

Student assistance $400 per week



Parents inconvenience allowance $50 per day up to a maximum of $2,500

Section E - Non Medicare Medical Expenses

If you have private health insurance:

100% of Expenses to a maximum of

Members/Players $2,500

Volunteers/Officials $5,000

$0 excess applies if you have private health insurance

If you do not have private health insurance:




$75 excess applies each and every claim if you do not have private health insurance

Ambulance expenses:




$0 excess

For full details of cover provided under this policy, please refer to the Policy booklet



ENDORSEMENTS ATTACHING TO AND FORMING PART OF THIS POLICY

Section A - Capital benefits - Funeral expense additional capital benefit – Policy amendment

What we will pay is amended to a maximum sum of $10,000.

Section A - Capital benefits – Modification benefit additional capital benefit – Policy

amendment


In memoriam benefit is added to Section A – Capital benefits

If a death benefit has been paid under capital benefits we will also pay for reasonable

costs associated with observance of the death up to a maximum of $1,000.

Counselling support benefit is added to Section A – Capital benefits

We will pay up to $1,000 per week, subject to a maximum sum of $10,000, for counselling

support to you or your immediate family, provided by a registered medical practitioner, if you

witness the death of an athlete, or if you suffer death, quadriplegia or paraplegia.

Chauffeur services is added to Section B – Weekly benefits - Injury

If we pay you weekly benefits, we also agree to reimburse expenses incurred for a chauffeur

or taxi service to and from your usual place of work and your usual place of residence, if you

recover sufficiently to return to work but are certified by a doctor as being unable to drive a

vehicle or travel on public transport.

You must provide receipts to support your claim. We will pay up to $200 per week up to a

maximum sum of $5,000.

Unexpired membership benefit is added to Section D – Injury assistance benefits

We will reimburse you a pro rata refund of your membership/registration fee from the date

of injury should you be deemed by a registered medical practitioner to be unable to

participate in the playing of the sport for the remainder of the season and this is as a result of an

injury covered by this policy.

Benefit: Up to a maximum of $500.



Bed care benefit is added to Section D - Injury assistance benefits

What we will pay

• If you are confined to a bed for a period of not less than 7 days, under the continuous

care of a registered nurse, as a result of injury covered by this policy we will pay $400

per week for a period of 52 weeks whilst you are confined. Your confinement must be

certified as necessary by a legally qualified medical practitioner.

What we will not pay

• If the medical practitioner or registered nurse is your relative,

• If you are confined to a bed in a nursing home, a place of rest, a rehabilitation facility,

mental institution, geriatric ward or any alcohol or drug treatment facility.

Section E – Non Medicare medical expenses– ‘What we will not pay’

What we will not pay is amended as follows:

• for costs associated with MRI scans, unless not covered under Medicare or Private

Health Insurance,

• for costs incurred which are associated with the prevention of injury. For example,

knee braces, mouth guards and ankle braces,

• for costs related to breakage of dentures, optical lenses or spectacles,

• expenses incurred for which a Medicare benefit is payable,

• expenses incurred more than 12 months after the date of injury,

• accounts covered by private health insurance unless you have claimed a private health

benefit. If that is the case we will pay the difference between any private health

insurance rebate to which you receive and the actual cost you incur, less any excess

applicable.

Section E – Non Medicare medical expenses - Non Australian residents

Benefits will be paid to you on the same basis as though Medicare applied, therefore benefits

that would normally attract Medicare for permanent residents will not be claimable. All

benefits will cease if you leave Australia.

Rehabilitation expenses is added to Section E – Non Medicare medical expenses

We will reimburse you up to $500 for rehabilitation expenses certified as necessary by a

registered medical practitioner and agreed to in writing by us and incurred as a result of an

injury covered by this policy. Rehabilitation expenses includes but is not limited to gymnasium

fees or personal physical trainer fees.



General exclusions, Additional exclusions applying to this Policy – Policy amendment

The following additional exclusions are amended as follows:

8. social matches unless sanctioned by the insured

9. end of season trips for social purposes unless sanctioned by the insured

10. activities involving parent/child competition unless sanctioned by the insured

“Sanctioned” is defined as any event organised or under the control of the insured.

The following additional exclusions are added:

14. your participation in activities organised or sanctioned by the national netball league;

15. your participation in activities organised or sanctioned by Netball Australia if you are a

Diamonds squad member.

‘What we will not pay’ – Policy amendment

Under Section A – Capital benefits, Section B - Weekly benefits – Injury and Section D – Injury

assistance benefits the following is removed:

• any condition that is caused by repetitive movements or actions of your sport.


AN A045655 PAD – Netball ACT 2017-2018 Page 1 of 5




The Insured: ACT Netball Association Inc (Netball ACT), including their

affiliated Leagues, Associations, Centres and Clubs












Time of operation of cover: Whilst participating in sanctioned Netball ACT activities

including:












Leagues or Clubs.






































Ambulance expenses:




$0 excess





Aggregate deductible

This policy is subject to an aggregate deductible of $31,200

“Aggregate Deductible” means the total amount of any one claim or series of claims (less the

applicable excess/s) which be first borne by the insured during any one period of insurance.

We will not be liable to make any payment under this policy until the paid losses exceed the

aggregate deductible during any one period of insurance.

Once the aggregate deductible is exceeded the standard excesses will apply thereafter.




amendment



If a death benefit has been paid under capital benefits we will also pay for reasonable costs

associated with observance of the death up to a maximum of $1,000.






If we pay you weekly benefits, we also agree to reimburse expenses incurred for a chauffeur or

taxi service to and from your usual place of work and your usual place of residence, if you






We will reimburse you a pro rata refund of your membership/registration fee from the date of

injury should you be deemed by a registered medical practitioner to be unable to participate in

the playing of the sport for the remainder of the season and this is as a result of an injury covered

by this policy.
