Year 2008/2009 Sports Insurance Program
Diving Australia has chosen the following cover with OAMPS Insurance Brokers:
- Tragedy cover up to $70,000
- Legal liability up to $20 million
- Professional indemnity up to $5 million
- Non-Medicare medical cover up to $2,500
- Loss of income benefits up to $300 per week for up to 52 weeks
Medicare pays all eligible costs. Diving Australia's policy then covers such expenses as private hospital accommodation, ambulance, physiotherapy and dental fees up to a combined $2,500 in total for each medical claim.
The level of cover under the program is not 'comprehensive' and, as such, we encourage all participants to review their own individual needs. Where appropriate, we advise participants to take out private health, life and income protection insurance. It is an individual’s responsibility to ensure that he/she has adequate insurance cover for his/her needs.
Coverage detail:
Please refer to the capital benefits detail schedule in the download box at right and have a look at a sample OAMPS covere here.
Period of insurance
From: 4.00pm 30 June 2008
To: 4.00pm 30 June 2009
Both Local Standard Time at the insured’s Australian head office or other commencement date as required to fit in with due date of current policy.
Legal liability
Limit of indemnity $20,000,000 - Provides protection for the organisation, first aid officials, coaches, players and others officially involved with the club. Excess $500.
Professional indemnity
Limit of indemnity $5,000,000 - cover applies to coaches, officials and team managers. Excess $500.
Loss of income
If you're a wage earner, temporary total disablement of $300 per week is payable up to a maximum of 52 weeks or 100% of total 'net income lost'. There is a waiting period excess of 7 days.
Modification Expenses
The cover under this section provides for costs necessary up to a maximum of $10,000 to modify the member’s home and/or motor vehicle, or relocating to a suitable home if they are entitled to 100% of the capital benefit.
Funeral expenses
The cover under this section reimburses funeral costs up to a maximum of $5,000.
In memoriam benefit
The cover under this section provides for reasonable costs associated with observance of the death of a member up to a maximum amount of $1,000.
Student Help
The cover under this section reimburses 100% of the cost of home tutorial by a qualified tutor, up to a maximum of $300 per week and subject to a 7 day deferral period. The benefit will be paid for the period of the disablement as certified by a registered medical practitioner or 52 weeks whichever is the lesser.
Home Help
The cover under this section reimburses 100% of the actual costs incurred for home help from a recognised and licensed domestic help agency, up to a maximum of $300 per week and subject to a 7 day deferral period. The benefit will be paid for the period of the disablement as certified by a registered medical practitioner or 52 weeks whichever is the lesser.
Parents' allowance
The cover under this section reimburses $25 per day in-patient benefit to a full time student under 25 years of age for continuous confinement in hospital because of an accident. The benefit is limited to $2,000.
Dependent children's allowance
The cover under this section provides for reasonable costs incurred by the dependent children of a member whilst the member is undergoing medical treatment. The benefit is limited to $500.
Medical and dental costs
The cover under this section reimburses 85% of non-Medicare medical treatment including ambulance, hospital accommodation / theatre fees, orthotics, splints, prosthesis, treatments given by a dentist, chiropractor, masseur, naturopath, osteopath or physiotherapist. The maximum benefit for this section is $2,500. All treatment must be certified by a registered medical practitioner and not subject to any Medicare rebate. All claims are subject to a $50 excess if no private health cover. Any expenses must be incurred within 12 months of the insured person sustaining the injury.
Home nursing care
The cover under this section provides for nursing care provided by a registered nurse (not related to the member) where they are confined to bed for a period of not less than 7 days if certified medically necessary. The maximum weekly benefit payable is $300 per week, and is subject to a 7 day deferral period. The benefit will be paid for the period of the disablement as certified by a registered medical practitioner or 52 weeks whichever is the lesser.
Ancillary non-medical expenses
The cover under this section provides for ancillary non medical expenses (expenses related to medical treatment if certified as necessary. i.e. expenses include items such as travel to receive treatment, but does not include wages lost by any person). The maximum payable under this benefit is $1,500.
Rehabilitation benefits
The cover under this section provides for reimbursement of:
- Tuition or advice fees from a vocational college if certified as necessary and agreed to the maximum payable under this benefit is $3,000
- Rehabilitation expenses (eg gym membership) certified as necessary and agreed to the maximum payable under this benefit is $500
Unexpired membership reimbursement benefits
The cover under this section provides for pro-rata refund of your club’s or association’s membership/registration fee from the date of injury if the member can’t play for the rest of the season. The maximum payable under this benefit is $500.
Double capital sum insured
The cover under this section provides for double the capital sum insured to be paid for a person under 12 years of age who suffers: permanent total disablement or permanent paralysis of all limbs.
Miscarriage and premature childbirth
The cover under this section provides for $2,500 compensation for miscarriage and premature childbirth as a direct result of an accident whilst participating.
HIV
The cover under this section provides for 10% of the permanent total disability benefit 1 as listed in the schedule of capital benefits if contracted as a result of an accident.
Kidnapping
The cover under this section provides for 10% of the permanent disability benefit 1as listed in the schedule of capital benefits.
A typical example of OAMPS cover <top>
A common sport injury in one which requires a knee reconstruction. The following figures apply to such an injury.
