Football Federation Victoria

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Making A Claim

Non Medicare Medical Claims

Important Information

SPORTSCOVER AUSTRALIA PTY LTD (Sportscover) is the administrator of the Personal Accident Policy (arranged by JLT Sport) for the Football Federation Victoria Insurance Programme. Sportscover administers all claims associated with this policy for 2008.

The Health Insurance Act (Cth) 1973 does not permit the Insurer to reimburse any costs for medical treatments that are registered with Medicare (this includes the Medicare Gap).

As Sportscover Australia Pty Ltd is a NON MEDICARE MEDICAL INSURER, they are prevented by government legislation from covering the MEDICARE GAP. This means that in most cases, a service that is performed by a registered Medical Practitioner will not be covered by the policy.

Some examples of expenses NOT claimable through this section include:

  1. The Gap between the registered Medical Practitioner’s fee and the amount you receive back from medicare for the following medical services: Doctors, Surgeons, Anaethetists, Pathologists & Radiologists. And;
  2. Other items where a Medicare refund (in any part) is recoverable.

Examples of items covered by Medicare. We can not reimburse you for these costs.

Examples of Non-Medicare items. Claimable as per the Policy Schedule.

* Some MRI machines are not registered with Medicare. Please check with your treating physician before lodging your claim.

Loss of Income Claims:

Firstly report the claim to Sportscover by completing the Loss of Income section of the Personal Accident Claim Form. The claim form can be accessed via any one of the three options outlined above.

IMPORTANT INFORMATION FOR LOSS OF INCOME CLAIMS

Capital Benefits Claims

If you wish to make a capital benefit claim against this policy or there is a potential for such a claim relating to permanent or partial disablement please notify Sportscover immediately by phone. Claims staff will advise you on what you need to do next.

Liability Claims

If an incident occurs that may give rise to a liability claim (General Liability or Club Management Liability), it is essential that you notify JLT Sport immediately on 1300 130 373.

It is also extremely important not to admit liability or discuss the matter with a third party. JLT Sport staff will guide you as to the next step in the process.

© 2008 Jardine Lloyd Thompson Pty Limited – ABN 69 009 098 864 AFS Licence No: 226827