Football NSW Sports Injury claims examples
Claim 1.
Player who is a member of a private Health Fund, suffers a knee injury involving an anterior cruciate ligament tear which requires surgery.
General Practitioner’s Fees. |
No benefit (Medicare service) |
Specialist’s/Surgeon’s Fees. |
No benefit (Medicare service) |
Hospital Accommodation & Theatre Fee. |
$500 excess that he had paid to his Private Health Fund |
Physiotherapy Fees. |
20 treatments @ $60 per treatment =$1200 Policy cover pays 85% of the incurred fees Total payable = $1020 |
Loss of Income. |
10 weeks @ $250 per week = $2500, less 7 days excess = $250 Total Payable to $2250 |
TOTAL Payable |
$3770.00 |
Claim 2.
A 15 year old player who is not in a private Health Fund suffers an ankle injury during a Club training session.
The Benefit payable is as follows :-
General Practitioner’s Fees. |
No benefit (Medicare service) |
Physiotherapy Fees. |
6 treatments @ $70 per treatment = $420 Policy cover pays 85% of incurred Fees = $357 Policy Limit is $350 per injury if no surgery is involved, minus $50 excess |
TOTAL Payable |
$300.00 |