Principally promoters, organisers and operators of Mini Trotting events including all associated activities.

Transcription

1 Personal Accident INSURED BENEFICIARIES BUSINESS GEOGRAPHICAL SCOPE PERIOD OF INSURANCE SCOPE OF COVER Voluntary Workers of Mini Trotting Clubs and Associations as detailed below including all members, instructors, officials and the like (excluding New South Wales) Queensland Mini Trotting Clubs Queensland Junior Harness Racing Assoc Inc Queensland Mini Trotting Sporting Assoc Inc Western Australia Mini Trotting Clubs WATA Be Active Pony Trots Albany Pony Trots Bunbury Pony Trots Busselton Pony Trots Narrogin Pony Trots Total Pony Trots Victoria Mini Trotting Clubs Pony Trots Victoria Tasmania - Mini Trotting Club Tasmanian Pacing Club Carrick Park Pacing Club South Australia - Mini Trotting Club SA Pony Association Voluntary Workers of the Insured. Principally promoters, organisers and operators of Mini Trotting events including all associated activities. Australia From: 1 September 2014 at 4 PM Local Standard Time To: 1 September 2015 at 4 PM Local Standard Time and any further period for which the Insurer agrees to provide cover. Whilst engaged on the authorised voluntary work of the Insured including direct travel to and from such voluntary work. 1

2 Schedule of Benefits PART A LUMP SUM BENEFITS FOR INJURY Insured Persons Aged up to 70 Years EVENTS 1-19 Maximum benefit is $100,000 Insured Persons Aged Years EVENT 1 is reduced to $10,000 where there are no dependents EVENT 2 is DELETED PART B WEEKLY BENEFITS FOR INJURY Income Earners EVENT 20 85% of average weekly earnings up to a maximum of $1,000 payable on the 8 th day but not exceeding 104 weeks Non-income Earners out of Pocket Expenses Cover under Part B is limited to $500 per week / max $5,000 payable on receipts for such expenses that are directly attributable to the disablement up to a maximum of 52 Weeks TABLE OF EVENTS THE EVENTS Injury resulting directly in the following Event(s), which occur within twelve (12) months of the date of the Injury: PART A LUMP SUM BENEFITS THE BENEFIT Being a percentage of the amount shown in the Schedule against Part A or B for each Insured Person. 1) Accidental Death 100% 2) Permanent Total Disablement 100% 3) Permanent and Incurable paralysis of all limbs 100% 4) Permanent Total Loss of sight of both eyes 100% 5) Permanent Total Loss of sight of one eye 100% 6) Permanent Total Loss of use of two limbs 100% 7) Permanent Total loss of use of one limb 100% 8) Permanent and incurable insanity 100% 9) Permanent Total Loss of hearing in: a) both ears b) one ear 10) Permanent Total Loss of four fingers and thumb of either hand 100% 20% 11) Permanent Total Loss of the lens of one eye 60% 12) Third degree burns and/or resultant disfigurement which covers more than 40% of the entire external body 50% 13) Permanent Total Loss of use of four fingers of either hand 40% 14) Permanent Total Loss of use of one thumb of either hand: a) both joints b) one joint 15) Permanent Total Loss of use of fingers of either hand: 75% 30% 15% 2

3 a) three joints b) two joints c) one joint 16) Permanent Total Loss of use of toes either foot: a) all - one foot b) great both joints c) great one joint d) other than great - each toe 17) Fractured leg or patella with established non-union 10% 18) Shortening of leg by at least 5cm 7.5% 19) Permanent Disability not otherwise provided for under insured Events 5 to 18 inclusive. Such percentage of the Sum Insured as the Insurers shall in their absolute discretion determine and being in their opinion not inconsistent with the benefits provided under Events 5 to 18 inclusive. ADDITIONAL BENEFITS 15% 10% 5% 15% 5% 3% 1% Limited to a maximum amount of 75% of the amount shown in the Schedule against Part A Lump Sum Benefits. Funeral Expenses Up to a maximum of $5,000. Non-Medicare Medical Expenses ($50 excess applies) Out of Pocket Expenses (Non-income earner) Emergency Home Help Clause Student Tutorial Cost AGGREGATE LIMIT OF LIABILITY $2,000,000 Up to a maximum of $5,000. The benefit under Part B Weekly Benefits Injury is limited to $500 per week up to a maximum of $5,000. Up to a maximum of $350 per week payable on the 8 th day of treatment by a Doctor for an aggregate period not exceeding 52 weeks. Up to a maximum of $250 per week payable on the 8 th day of treatment by a Doctor for an aggregate period not exceeding 52 weeks. 3

4 ENDORSEMENTS: EMERGENCY HOME HELP If during the Period of Insurance and whilst the person is a Covered Person and engaging in voluntary work on behalf of the Policyholder, a Covered Person who is retired, unemployed or not in receipt of a Salary suffers from Event 25 and/or 26 described in Part B of the Table of Events and is unable to carry out Domestic Duties, We will pay for the cost of reasonably and necessarily incurred Domestic Duties expenses as a result of that Bodily Injury up to the $350 per week payable from the 8th day of treatment by a Doctor for a maximum of fifty-two (52) weeks. Definitions Under Emergency Home Help Domestic Duties means the usual and ordinary domestic duties undertaken by someone as a homemaker and could include child-minding and home help services. Conditions Applying to Emergency Home Help 1. Child-minding and home help services must be carried out by persons other than the Covered Person's Close relatives or persons permanently living with the Covered Person. 2. Child-minding and home help services must be certified by a Doctor as being necessary for the recovery of the Covered Person. FUNERAL EXPENSES If during the Period of Insurance and whilst the person is a Covered Person, the Covered Person suffers an Accidental Death the Policy extends to cover the expenses of burial or cremation OR the cost of returning the Covered Person's body or ashes to a place nominated by the legal representative of the Covered Person s estate, up to a maximum of $5,000. NON-MEDICARE MEDICAL EXPENSES If during the Period of Insurance and whilst on the voluntary work of the Policyholder, a Covered Person suffers from a Bodily Injury, We will pay the Non-Medicare Medical Expenses incurred up to a maximum of $5,000. An Excess of $50 applies to each and every claim under Non-Medicare Medical Expenses. Definitions Under Non-Medicare Medical Expenses Non-Medicare Medical Expenses means expenses: (a) incurred within twelve (12) months of sustaining a Bodily Injury; and (b) paid by a Covered Person or by the Policyholder for Doctor, Physician, Surgeon, Nurse, Physiotherapist, Chiropractor, Osteopath, Hospital and/or Ambulance Services for the following treatments: Medical Surgical X-ray Chiropractor Osteopathic Physiotherapy Hospital Nursing Treatment But does not include: Dental Treatment, unless such treatment is necessarily required, to teeth other than dentures and is caused by the Bodily Injury referred to in (a) above. Conditions Applying to Non-Medicare Medical Expenses 1. The benefit payable is less recovery made from any Private Health Insurance Fund with respect to the expense. 4

5 2. No benefit is payable in respect of the Medicare gap, being the difference between the payment made by Medicare and the Medicare Benefits Schedule fee for the expense. OUT OF POCKET EXPENSES NON INCOME EARNER If a Covered Person does not earn a Salary and is eligible for a benefit under Section 1 Event 25 and/or 26, the sum insured is limited to $500 per week payable upon receipts furnished by the Covered Person for such expenses attributable directly to such disablement to a maximum of $5,000. STUDENT TUTORIAL COSTS If during the Period of Insurance and whilst the person is a Covered Person on behalf of the Policyholder, a Covered Person who is a student, suffers from Event 25 and/or 26 described in Part B of the Table of Events and is unable to attend registered classes, We will pay the cost of reasonably and necessarily incurred home tutorial services as a result of that Bodily Injury up to $250 per week for a maximum of fifty-two (52) weeks. CONDITIONS APPLYING TO STUDENT TUTORIAL COSTS 1. The Covered Person must be registered as a full time student. 2. Home tutorial services must be carried out by persons other than the Covered Person s Close Relatives or persons permanently living with the Covered Person. DIFFERENCE IN CONDITIONS ENDORSEMENTS To the extent of cover that Your previous Group Personal Accident insurance policy a benefit existed which does not exist under this policy or was a larger benefit than the similar benefit which exists under this policy (the difference in conditions benefit), We will pay You the amount that represents the difference in conditions benefit as if that benefit existed under this policy. AGE LIMIT EXTENSION The maximum age limit of Covered Persons under the Policy is extended to eighty (80) years of age. Notwithstanding anything contained in the Policy to the contrary the following conditions shall apply to this extension: There is no cover under the Policy with respect to any Covered Person who is aged eighty (80) years or more and all cover with respect to a Covered Person shall cease upon their attaining that age. This will not prejudice any entitlement to claim benefits which have arisen before a Covered Person has attained the age of eighty (80) years. The maximum amount We will pay under Section 1 Part A Lump Sum Benefits - Event 1 Accidental Death with respect to any Covered Person aged between seventy (70) and eighty (80) years of age that has no dependents is $10,000. There is no cover under the Policy for Part A Lump Sum Benefits - Event 2 Permanent Total Disablement with respect to any Covered Person aged between seventy (70) and eighty (80) years of age. NON-MEDICARE MEDICAL EXPENSES With respect to the Non-Medicare medical Expenses endorsement the maximum We will pay is $5,000. Excess $50. OUT OF POCKET EXPENSES It is hereby declared and agreed that should an Insured Person be a 5

6 non-income earner, the benefit under Section 1 Part B, Weekly Benefits Injury is limited to $500 per week payable upon receipts furnished by the Insured for such expenses attributable directly to such disablement to a maximum of $5,000. EMERGENCY HOME HELP CLAUSE With respect to Emergency Home help the maximum amount We will pay is $350 per week payable from the 8 th day of treatment by a Doctor for an aggregate period not exceeding 52 weeks. STUDENT TUTORIAL COST With respect to the Student Tutorial Cost endorsement the maximum amount We will pay is $250 per week payable from the 8 th day of treatment by a Doctor for an aggregate period not exceeding 52 week. PREMIUM BREAKDOWN Premium $1, Premium GST $ Stamp Duty $ Total Premium $1, IN WITNESS WHEREOF, this Policy has been countersigned by an authorised officer of A & H International on behalf of the Company at MELBOURNE this 9th DAY OF DECEMBER GPAS PDS/WRD 01/14 ST 6

7 Sydney Melbourne Brisbane Perth ABN Level 4, 33 York Street Suite 1507 Exchange Tower Level 20 Level 7, AFS Licence No: SYDNEY NSW Lt Collins Street 260 Queen Street 189 St Georges Terrace GPO Box 4213, SYDNEY MELBOURNE VIC 3000 BRISBANE QLD 4000 PERTH WA 6000 Website: NSW 2001 T: T: T: T: Freecall F: Freefax