Football Insurance

Making a Personal Injury Claim

If an injury occurs to one of the clubs (football) players or volunteers, please provide the following instructions:

1. Visit Marsh AFL web site to read the Summary information.
2. Download the Personal Injury Claim Form from the “Making a Claim” section.
3. Complete the Claim Form and submit it to Echelon Australia within 180 days from the date of injury (sooner rather than later).
4. Do not wait for treatment to cease before making a claim.

Medicare vs Personal Injury Coverage

When it comes to reimbursement of Personal Injury claims, some people get confused about Medicare, the Medicare Gap and what is covered through the National Risk Protection Programme.

What is Medicare?

Medicare is a Commonwealth Government programme that provides eligible Australian residents with free or low-cost medical and hospital care.

Medicare provides access to:

• Free treatment as a public (Medicare) patient in a public hospital.
• Free or subsidised treatment by practitioners such as Doctors and Specialists.

What’s covered by Medicare?

The Medicare Benefits Schedule (MBS) lists all treatments and associated rebates relating to Medicare. You can access the MBS at any time via Medicare’s web site. Items commonly used by sports participants that are Medicare listed include general practitioners, surgeons and anesthetists.

What is the Medicare Gap?

The MBS lists a rebate amount for each Medicare Item.

Example: A short consultation with a Doctor = Medicare rebate of $15.35

However, doctors or specialists may charge more than the listed MBS amount.

The difference between what is charged and the MBS rebate is called the “Medicare Gap”.

• The Doctor charges $45.00.
• Medicare provides a rebate of $15.35.
• Medicare Gap = $29.65 (out of pocket expense).

What’s the difference between Medicare and the AFL National Risk Protection Programme?

The Health Insurance Act 1973 (Cth) strictly prohibits any general insurer (and the programmes Trustee) from insuring any item that is listed on the Medicare Benefits Schedule.

This also means that regardless of a persons out of pocket expenses, it is against the law for the Insurer or Trustee to cover the Medicare Gap.

So what does that mean?

If the medical treatment has a Medicare Item Number it is uninsurable through the AFL National Risk Protection Programme and may not be claimed for reimbursement through Marsh.

If the medical treatment does not have a Medicare Item Number, a claim may be made for reimbursement Marsh.

For specific Insurance and Risk Protection information please visit the Making a Claim section of this web site.

Personal Injury coverage through your club is limited by the Health Insurance Act. As such, Marsh encourage participants of AFL football to investigate the benefits of private health insurance.

To assist clubs ensure players are aware of the benefits of private health insurance, there is a Private Health Insurance Audit available from the Downloads section of this website.

Clubs can be proactive in their care for players by encouraging private health insurance coverage. Conducting an audit of the private health insurance status of their playing list is one method to draw attention to this issue.