INSURANCE
IN ALL CASES THE FIRST POINT OF CALL IS THE QCSA SECRETARY
2022-2023 QCSA Public Liability Certificate of Insurance (Updated 16/01/23)
Tax File Number Declaration From
2022-2023 QCSA Personal Accident Schedule
Contact the QCSA Secretary for information relating to insurance that isn't available above.
Insurance Claim Process
Step 1: Submit an ONLINE Injury Report (Club or Team Official to lodge through MCM)
Step 2: Player/Guardian to contact QCSA for a claim form
Step 3: Player/Guardian to forward completed Insurance Claim form to QCSA
Step 4: QCSA will forward completed Insurance Claim form to AIS, together with the QCSA final approval Declaration.
IMPORTANT
SECTION 1 – Reimbursement of Medical Expenses - Non-Medicare related expenses only. (NMME)
Cover is limited to 12 months from the date of injury - 100% of non-Medicare related expenses up to $2,000.00 Also, note that a one time claim excess of $50 will be applied for each claim for this section. This excess will be deducted from the first payment/reimbursement made.
The benefit is all inclusive of expenses such as casts, brace accounts, ancillary treatments (ie. physiotherapy, chiropractic, naturopathy, massage, ambulance, dental) and hospital accounts - following a doctor's referral.
Under this policy, QBE is unable to reimburse Medicare related costs which includes the Medicare gap due to a Federal Government Legislation. We refer you to the claim form which states that Commonwealth Legislation prevents reimbursement of Medicare costs including the Medicare Gap. ie. Doctor, Surgeon, Anaesthetist, Specialist, X-ray (are all Medicare related expenses and cannot be claimed)
Documents required in order to claim for non-medicare related medical expenses:
- Please forward all itemised accounts and receipts for Non-Medicare Medical expenses in order to receive reimbursement.
ie. Physiotherapy, Chiropractic, Ambulance, Private Hospital, Dental (these items are NOT Medicare related and can be claimed under this policy) - Completion of claim form including the referrals page (attached)
SECTION 2 - Loss of Income
Cover is 100% of gross weekly income up to a maximum of $550.00 per week, less 14 days excluded excess period and paid sick leaves.
The first 14 days that the claimant is unable to work for is unpaid and counts toward the excess period. Cover is limited to 12 months from the date of injury.
Documents required in order to claim for loss of income:
- Medical certificates stating the duration claimant is unable to attend work (including first 14 day excess period) and a description of their injury
- Completed employer declaration (part of claim form)
- Completed medical declaration (part of claim form)
- Completed Tax File Declaration form (attached)
GENERAL NOTE:
We understand that medical treatment is ongoing and that not all of the above documents will be available at the time of lodgement. We wish to advise that receipts and medical certificates can be added to the claim at any time during the 12 month claim period. Payments for income benefits and medical expense reimbursements will be made periodically and once received.
(The above information provided by Australian Insurance Solutions Pty Ltd and Golfpac Underwriting)
We understand that medical treatment is ongoing and that not all of the above documents will be available at the time of lodgement. We wish to advise that receipts and medical certificates can be added to the claim at any time during the 12 month claim period. Payments for income benefits and medical expense reimbursements will be made periodically and once received.
(The above information provided by Australian Insurance Solutions Pty Ltd and Golfpac Underwriting)
