Making A Claim
Personal Injury Claims
Important Information
QBE Insurance Australia Ltd is the insurer for the Personal Accident Policy (arranged by JLT Sport) for the Football Queensland Risk Protection Programme. QBE administers all claims associated with this policy for 2010. Please consider the following important information prior to submitting a personal accident claim.
- The Health Insurance Act (Cth) 1973 does not permit the Insurer to reimburse any costs for medical treatments that are registered with Medicare. This also prevents reimbursement of the Medicare Gap.
- Claims must be lodged within 90 days of the date of injury
- Treatment must occur within 12 months of the date of injury
- All treatment must be certified as ‘necessary’ by your treating physician.
- The Physician’s Declaration of the claim form must be completed by a medical practitioner. Your claim will not be accepted if this section is completed by a physiotherapist, chiropractor etc.
- Send original paid receipts with your claim form (unless retained by your Private – Health Fund). If retained by your Health Fund, forward a Statement of Account with your completed documentation.
- Keep a copy of all documents relating to your claim as a personal reference
- Do not wait for treatment to be completed before sending your claim form. You can contribute further receipts for up to 12 months from the date of injury.
| Examples of Non-Medicare Medical items. | Examples of items covered by Medicare. |
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| Claimable as per the Policy Wording. | We can not reimburse you for these costs. |
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* MRI scans are generally claimable through Medicare, however please check with your referring physician and/or the MRI service provider to confirm if this is the case prior to lodging your claim.
Submitting Your Claim
Non Medicare Medical Claims
- Access a current claim form or call JLT Sport and a claim form will be sent to you via fax or mail.
- Claim from your Private Health Fund (if applicable) in the first instance
- Complete all relevant sections of the claim form
- Your claim form may be returned if there is important information missing
- Send your claim form to QBE Insurance Australia Ltd as soon as possible (must be within 90 days of the date of injury)
- QBE will confirm receipt of your claim form or contact you should they require more information.
Claims must be submitted by post. Completed claim forms and accompanying receipts can be sent to:
QBE Insurance (Australia) Ltd.
GPO Box 4108
Sydney NSW 2001
Please contact QBE on (02) 8275 9192 or (02) 8275 9622 if you do not receive confirmation of your claim within four weeks.
Loss of Income Claims
Report the claim to QBE by completing the Loss of Income section of the Personal Accident Claim Form. Please refer to the above steps for instructions on how to submit your claim.
IMPORTANT INFORMATION FOR LOSS OF INCOME CLAIMS
- The excess period is 14 days
- You must be in full-time employment at the time of injury.
- Other benefits do not need to be exhausted prior to claiming on this section.
- The Attending Physicians Report must be completed by the medical practitioner who attended to you. If a fee is charged for completing this section, that fee will be borne by the claimant.
- Your loss of income claims must be covered by a Medical Certificate for the full period of disability.
- For tax implications we recommend that you seek the advice of a qualified tax consultant. You may be required to pay tax on any Loss of Income benefit received.
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 QBE immediately by phone on (02) 8275 9192 or (02) 8275 9622. Claims staff will advise you on what you need to do next.