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Presented by Gow-Gates Insurance Brokers

Presented by Gow-Gates Insurance Brokers

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Presented by Gow-Gates Insurance Brokers

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  1. AUSTRALIAN RUGBY UNION National Insurance Scheme Presented by Gow-Gates Insurance Brokers

  2. Important • The following information is only a Overview/Summary of the covers and other aspects of the ARU Sports Injury and Liability coverage. Before acting on any information contained in this presentation you should refer to the full Policy Disclosure Statement and Policy Documents contained in the “2006 ARU Club Administrators Sports Insurance Manual”.

  3. Background • Is designed to provide cover for Personal Accident, Public and • Products Liability and Professional Indemnity for all players • officials, unions and clubs that are under ARU control • The ARU Funded Deductible was established in 1999 • QBE have been the Insurer since 2001. The actual underwriter has insured the scheme since 1996 • Gow-Gates have acted as brokers for the scheme since 1996 • Renewal Date is 1st March

  4. ARU National Insurance Scheme • Consists of three Coverages – • Sports Injury (Capital, Weekly and Non Medicare Benefits) • - Funded Deductible plus Insurance (the Insurance policy • covers claims when/if the Funded Deductible is exhausted) • Public and Products Liability Insurance • - Insurance Policy • Professional Indemnity Insurance • - Insurance Policy

  5. ARU National Insurance Scheme • Covers all players and officials involved in Rugby Union throughout Australia, when registered with the ARU • The plan is held by the ARU and extends to include various affiliated unions, clubs, players and officials

  6. The ARU Funded Deductible • This Fund is similar to a self insurance and has been designed to pay the majority of Personal Injury claims (currently the first $1,600,000 per year) • Achieves reduced administration and normal insurance costs (such as Stamp Duty and GST) • It does not cover Public and Products Liability or Professional Indemnity claims. • QBE Insurance administer fund and it has been approved by APRA • Claims are paid on the same basis as the insurance policy.

  7. Insurance Levy Payments • All clubs affiliated with the ARU and/or various state unions are automatically covered • An insurance Levy based on team numbers is payable by all clubs • The method of invoicing will be as follows: • Premium funding options are available (contact Gow-Gates).

  8. Who Is Covered? • Australian Rugby Union Limited and its members and affiliate members, including member clubs and associations of the various State members • All players, coaches, trainers, managers, administrators, voluntary workers, selectors, referees, touch judges, ball boys, medical officers, physiotherapists and ambulance workers, and all directors, officers, employees, executive officers, office bearers, members and committees of the Insured (when registered)

  9. Those Not Covered • School teams not playing in ARU Junior competitions • (including schools players in Representative teams). • Golden Oldies • Social Teams not playing in ARU or underlying Union sanctioned competition • Age limitation for the Personal Accident Policy • 4-65 years increased to 75 for Administrators

  10. When Is Cover Provided? • Engaging/playing in official club matches/activities • Engaging in organised training or practice • Traveling directly between matches/activities and the Person’s residence or place of employment • Staying away from the Insured’s home during a tour • Engaging in administrative or organised social activities of the Insured • (Note: Includes both Club & Representative Rugby.)

  11. Liability Coverage • Liabilities arising out of the Insured’s Sporting Activities • Definition of Sporting Activities: • A club, association, or other entity playing or administrating Rugby Union and includes all official activities connected with the Sport including club social and fund raising activities. • A clubhouse or Sports pavilion with a liquor license used by members and guests will be covered • Presentation nights, annual balls, dinners, fund raising are covered if organised by the club for the benefit of the club

  12. Liabilities Excluded • Activities relating to a Licensed Club • Property Owners liability where premises are hired out for non-rugby functions or activities

  13. What Benefits are Covered? Sports Injury – provides coverage for injuries incurred accidentally whilst playing, training, officiating and administering rugby Section A: Death and Permanent Disability Section B: Weekly Benefits (Loss of Income) Section C: Non-Medicare Medical Expenses

  14. Section A – Death and Permanent Disability This section provides a lump sum benefit to insured’s who suffer permanent injury or death Maximum sum insured is $300,000 Death cover is limited to $100,000 Death cover is limited to $10,000 if under 18 There are percentages payable for various levels of disability

  15. Section B – Weekly Benefits (Loss of Income) • Income Earner - 80% of average weekly income, max.$250 per week. 28 day excess, 52 week benefit period • Non-Income Earner - 80% of domestic help which has been certified as necessary by a medical practitioner, max. $250 per week. 14 day excess, 52 week benefit period • Full Time Student - 80% of the actual cost of a home tutor which has been certified as necessary by a medical practitioner, max. $250 per week. 14 day excess, 52 week benefit period • Parents Inconvenience Allowance – Reimbursement of parents expenses incurred visiting a hospitalised injured person who is a fulltime student or <25 yrs; Max benefit $100 per day and $2,000 total (2 day excess).

  16. Section C – Non Medicare Medical Expenses Limit $3,000, with a $250 excess This section provides payment of 80% of non-Medicare medical expenses after any reimbursement from a health fund. Non-Medicare medical expenses are those medical expenses that are not subject to any full or partial Medicare Rebate. The ARU strongly recommend that separate Private Health Insurance be taken out. The Australian Health Act prevents insurers (other than Private Health Insurers) to provide cover for any medical expense covered or partly covered by Medicare (Doctors and X-rays).

  17. Not Claimable • Doctors Fees • Surgeon and Anesthetists fees • X-ray costs • The Australian Health Act prevents insurers (other than Private Health Insurers) to provide cover for any medical expense covered or partly covered by Medicare (Doctors and X-rays).

  18. Claimable • Private hospital accommodation fees, theatre costs, including drips and pins • Physiotherapy and chiropractic (referred by doctor) • Pharmacy • Ambulance • Dental • Hiring of artificial aids such as crutches

  19. Conditions to Non-Medicare Expenses • Expenses incurred after 12 months from the date of the injury are not covered • Expenses covered under this section must be certified necessary by a legally qualified medical practitioner • Reimbursement must first be sought from any applicable Health Fund provider and/or other insurance scheme/plan • Expenses incurred after the injured person resumes playing rugby are not claimable – including physio. • Expenses relating to injuries which did not occur during the policy period of insurance are not covered.

  20. What Injuries Are Not Insured? • Injuries arising out of pre-existing injuries • Injuries arising out of AIDS, HIV, childbirth or pregnancy • Injuries arising out of the insured person engaging in air travel except as passenger in any properly licensed aircraft • Deliberately self-inflicted injury or suicide • Injuries arising out of War, invasion, acts of foreign enemies • Injury caused as a result of any Heat-stroke, sickness or disease and/or Cardiac or Pulmonary or Cerebrovascular incident notwithstanding that such incident may have been caused by or induced by or accelerated by Injury

  21. Sports Public and Products Liability Limit of Liability $20,000,000 Excess: $1,000 Certificates of Currency are available for all clubs. - the interest of owners or licencees of grounds is automatically included on the policy, the insurer will not note the interest of other parties other than these. Excludes claims arising from actual participation by a person in Rugby or training for Rugby where the injury or damage is caused or allegedly caused by another participant.

  22. Sports Professional Indemnity Limit of Liability $10,000,000 Excess $1,000 This section provides coverage for the Insured’s legal liability for breach of professional duty in sport by reason of an act, error or omission committed by or on behalf of the Insured. This policy excludes claims arising from a Player against a Player, however, persons coaching, refereeing, officiating or supervising Rugby or training for Rugby are afforded cover under this section for actions taken against them by Players.

  23. Claims Procedures • As a loss control procedure, clubs/players are required to phone our office to request claim forms. We can either post or email these directly. • Claims are administered by GAB Robins and all claim forms are to be sent directly to them. • GAB Robins • PO Box 1438 • PARRAMATTA NSW 2150 • Claim forms are to be sent to GAB Robins within 30 Days of the injury occurring.

  24. Claims Cont. • Club Secretary to obtain original ARU Sports injury report form • The player is to fully complete the claim form and return to Secretary • Club Secretary is to sign and verify details of claim and ensure full completion • Club Secretary to send the claim form to GAB Robins • Player to submit paid accounts and Health Fund rebate statements • Loss of Income claims to include: • Employee completing section of the form • Doctors certificate certifying the period of disability • Fully completed Attending Physician Statement • If player self employed, proof of earnings such as tax return

  25. Are Overseas players covered by insurance? • Yes … all registered players are eligible for insurance • However, Medicare eligibility is restricted to persons living permanently in Australia who are: Australian citizens; permanent Australian residents; New Zealand residents and citizens of countries with reciprocal health care agreements • There have been instances of non-Medicare recipients being refused treatment at a public hospital, unless a financial guarantee was given by their Club or Union to cover their expenses • To avoid this, clubs should ensure players hold a current Australian Medicare Card or a passport from a Reciprocal Health Care country • If not, the player should have appropriate travel insurance or take-out private health insurance whilst in Australia tailored for non-residents • For more info visit: www.medicare.gov.au/

  26. Overseas Rugby Tours ? • The ARU Sports Injury covers anywhere in the World • Public Liability and Professional Indemnity covers anywhere in the World except USA and Canada. • As the ARU Injury cover is limited to $3,000 and does not cover illness it is recommended that additional Travel Insurance is effected. Travel Insurance policies generally provide high limits of medical expense coverage as well as other covers such as baggage, money, loss of deposits, cancellation of travel, emergency assistance and repatriation, etc. • If effecting travel insurance separately it is important the policy does not exclude injuries arising from playing rugby. • Generally Travel Insurance can be arranged with the ARU Sports Insurer, QBE Insurance Australia, which compliments the existing Sports Injury coverage and does not exclude injuries resulting from rugby. Please contact Gow-Gates Insurance Brokers for further information

  27. Levy Cost Per Team • Category2006 • Seniors (Men/Women’s) $1,960 • Under 19’s / U19 Laws $1,060 • Women’s (10-aside) $ 870 • Juniors (<18’s) $ 170

  28. One-Off Covers • A request for a one-off match, carnival or short competition • Cover is available subject to: • The event is sanctioned by the ARU or State Union • Applications on Special Event Application & approved by State Union • Agreement from the Insurers is required prior to event being covered

  29. Top-Up Cover • Top-up Cover can be arranged on a team or individual basis for weekly benefits and medical expenses cover. • Capital benefits cannot be topped up • Excesses cannot be varied

  30. Resources Available • Club Administrators “Sports Insurance Manual” • Rugby Insurance Brochure • ARU website www.rugby.com.au/communityrugby

  31. ARU Contacts at Gow-Gates Telephone: 02 8267 9999 Fax: 02 8267 9998 Toll Free – 1800 811 371 Robert Lawson rlawson@gowgates.com.au Dianne Morris dmorris@gowgates.com.au Rebecca Fleming rfleming@gowgates.com.au Vicki Baker vbaker@gowgates.com.au