PERSONAL ACCIDENT INSURANCE
Non-Medicare Medical Expenses
What does this section cover?
This cover provides you with reimbursement of certain medical expenses and the cost of other specified treatment incurred as a result of an injury for which a Medicare benefit is not payable. These expenses must be incurred within 12 calendar months from the date you sustained the injury. For full details please consult the Policy Wording or contact JLT Sport.
Important Information
The Health Insurance Act (Cth) 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 charges for X-Ray, some MRI Scans (if Medicare registered) and Public Hospitals are not covered. In addition, there will be no refund in respect of:
- 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.
- any expense to which the National Health Act (Cth) 1953 or any of the regulations made there under apply.
What The Insurer Will Not Pay
The insurer will not pay for any claim under this section of the Policy if the claim arises directly or indirectly out of any of the following:
- Any injury, medical condition, infirmity or weakness known to the insured person or which would have been known to a reasonable person in the circumstances to have existed prior to the commencement of this Policy;
- Illness;
- Costs incurred which are associated with the prevention of injury. For example knee braces, mouth guards, ankle braces;
- Costs related to breakage of dentures, optical lenses or spectacles;
- Expenses incurred for which a Medicare benefit is payable;
- Expenses incurred more than 12 months after the date of injury.
- Accounts covered by private health insurance whether claimed or not.
- The compensation paid will be reduced by amounts paid or payable from any statutory transport accident scheme or statutory workers compensation scheme or private health insurance.
What are the benefits payable?
The table of benefits below must be read in conjunction with the policy wording.
| Benefit | Description | Cover |
|---|---|---|
| Non-Medicare Medical | Reimbursement of Non-Medicare Medical expenses incurred within 12 calendar months. |
|
This is a summary of cover only and does not purport to contain all policy terms, conditions and exclusions. Please refer to the policy wording and PDS for full details.
Please note that in some cases the cover available is broader than the cover outlined in the Standard Policy Wording and PDS. Please contact JLT Sport for further details.
