Australian Football – National Risk Protection Programme

Personal Injury Claims

How to make a personal injury claim?

1. Obtain a copy of JLT Sport’s Personal Injury Claim Form.
   1. Download - choose the correct claim form for you:
      • JLT Sport Personal Injury Claim Form – for injuries sustained prior to 1 January 2009
      • JLT Sport Personal Injury Claim Form – for injuries sustained after 1 January 2009
   2. Phone Echelon on 1800 640 009 who will post a copy to you.
2. Complete all relevant sections of the Claim Form
3. Send your completed form to Echelon within 180 days from the date of injury (earlier is preferable).
4. Echelon will confirm receipt of your claim and/or make contact with you should they require further information.

Important Information

The Health Insurance Act (Cth) 1973 does not permit the Trustee or Insurer to contribute to any charges covered by Medicare (including the Medicare Gap).

Examples of Non-Medicare Medical items.	Examples of items covered by Medicare.
Claimable as per the Policy Wording.	We can not reimburse you for these costs.
Ambulance Physiotherapist Dental Private Hospital Accommodation Chiropractor MRI Scans*	Doctor Surgeon Surgeon’s assistant Anesthetist X-rays MRI scans* Public Hospitals

* Please note – MRI scans are generally claimable through Medicare, however please check with your referrer and/or provider to confirm if this is the case prior to lodging your claim.

In addition, there will be no refund in respect of:

1. Any expenses recoverable by You from any other insurance scheme or plan providing medical or similar coverage or from any other source except for the excess of the amount recoverable from such other policies/plans.
2. Any expense to which the National Health Act (Cth) 1953 or any of the regulations made there under apply.