Kingsway Junior Football Club subscribes to the AFL National Risk Protection Program through JLT Insurance Brokers, and whilst this costs the club a couple of thousand dollars each year, the cover is quite limited in its benefits. The cover we have arranged reimburses 50% of Non – Medicare Medical Expenses with a $2,000.00 limit per claim and a $100.00 excess per claim.
Basically it reimburses expenses that are not standard Medicare items, which are incurred within 12 calendar months of the injury, and which are paid for treatment certified by a legally qualified medical physician, including the cost of medical supplies and ambulance service.
The Health Insurance Act 1973 does not permit the Insurer to contribute to any charges covered by Medicare ( including the Medicare Gap ). This means that any charges for treatment from a Doctor, Surgeon, Anaesthetist or Surgeon’s Assistant are not covered. It also means that charges for X-ray, some MRI scans and Public Hospitals are not covered.
In addition, there is no refund for any expenses recoverable from any other insurance scheme or plan providing medical or similar coverage ( except for the excess of the amount not recovered from that scheme or plan ).
In the event of injury, if the player / parents have private health insurance, it is a requirement of the policy ( after notifying the Club’s Committee of the injury ) that expenses are claimed from the private health fund first. A statement of payment should be obtained from the insurer. All non – Medicare accounts should then be collated and I would suggest that at that stage , the parents should contact the club committee to see about lodging a claim. The completed claim form must be submitted to the Insurer ( Via the Club ) within 180 days of the injury.