JLT Sport Personal Injury Claim Form

Hawthorn Cricket Club’s Insurance Policy Overview JLT Australian Cricket National Club Risk Protection Program

This is a general introductory guide to our members on what this policy covers, to assist you in making personal decisions regarding medical treatment and other personal health insurance choices, prior to and after incurring an injury, whilst involved in the activities of the Hawthorn Cricket Club.

For more detailed information you may request a copy of the Personal Accident Insurance Policy and refer to the JLT Sport Personal Injury Claim Form available from our Administration Officer, Debbie Elliot, or download these documents from http://www.jltsport.com.au/cricketaustralia

What is Covered? The Australian Cricket National Club Risk Protection Programme’s Personal Accident cover provides some reimbursement for Non-Medicare Medical Costs and/or Loss of Income cover incurred within 12 months from the date of injury. The policy covers personal injury claims for physical and bodily damage by accident, occurring during any activity connected with Hawthorn Cricket Club.

General Limits of Cover Non‐Medicare Medical Costs Loss of Income 85% Reimbursement 85% Reimbursement $5,000 maximum per claim $500 maximum per week $50 excess per claim 14 day elimination period

What are Non-Medicare Medical Costs? These are costs of additional health services that are not covered by the Medicare Benefits Scheme such as: Ambulance, Physiotherapist, Dental Care, Private Hospital Accommodation, Chiropractor etc. N.B. – Out of pocket Medicare related expenses (i.e. the Medicare Gap) are not covered by this policy.

Loss of Income cover This is based on the claimant’s average weekly salary or income, (net of business expenses), excluding overtime and bonuses and after tax. Cover is calculated weekly, 14 days from the date the injury occurred (the elimination period) up to a maximum of 12 months after the injury. It covers full loss of income or partial loss of income if working at a reduced capacity, up to a maximum of $500 per week.

In the event that any accidental, permanent injuries or death occurs, the policy provides compensation payments (as listed in the policy). The policy can also provide assistance for reasonable expenses incurred for permanent or temporary periods of Total Disablement including: home help, student assistance and parents allowances, if children are hospitalised for periods over 24 hours.

Who is Covered? The policy covers: registered players, committee members, coaches, training assistants and any volunteer workers of the Hawthorn Cricket Club.

Scope of cover The policy covers any cricket match, practice or training session, social, administrative or fund-raising event arranged by Hawthorn Cricket Club. It also includes travel directly to or from any such event (with specified limitations). Important Provisos and Exclusions that can effect your claim: 1. You must seek professional medical advice as soon as possible after the injury and follow that advice. 2. You are not covered if you play or return to training against medical advice. 3. Medicare related expenses such as: doctors, public hospital expenses, surgeons, anaesthetists, x-rays are not covered. 4. Pre-existing injuries, weaknesses or medical conditions before cover commenced are not covered. 5. Future related injuries to the original injury claim are not permitted. 6. Any benefits available from existing personal health insurance or government compensation act will be used to reduce the liability under this policy. 7. You are not covered if the accident occurs under the influence of intoxicating drugs or alcohol. 8. You are not covered if the accident occurs whilst involved in a criminal act. 9. Claims must be lodged with the JLT Trustee within 180 days of the injury occurring using the appropriate claim form, provide copies of invoices and any assist with any requests made by the insurer.

The Australian Cricket National Club Risk Protection Programme is an automatic benefit for financial members of Hawthorn Cricket Club. We hope this general advice will assist you in determining the adequacy of this cover for you or your child’s needs.

We also hope this advice will help you avoid any insurance claim problems if you or your child unfortunately sustains a personal injury whilst involved at our club.

Wishing you a safe and successful season.

Regards

Hawthorn Cricket Club.