Serpentine Jarrahdale Shire. Community Groups Insurance Program

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1 Serpentine Jarrahdale Shire Community Groups Insurance Program

2 Serpentine Jarrahdale Shire Community Groups Insurance Program Public Liability Public Liability Insurance provides you with insurance cover for your legal liability to third parties for bodily injury and/or property damage arising from your group s activities. Should a third party be injured or have their property damaged due to your group s negligence (or perceived negligence) then the third party will more than likely want to seek compensation from your group. Public liability insurance will protect the group for its legal defence costs and any subsequent award for damages should the group be found to have been negligent in causing the bodily injury or property damage Additional policy benefits Property whilst in the physical or legal control of the Insured (Limit $100,000); Voluntary workers; Tenants Liability; Car Parking Liability; Interest of Landlords; Cross Liability; Professional Liability in respect of: Medical Persons employed to provide first aid or other medical services on premises; Professional advice or service where no fee is charged; Coaches, Instructors, Trainers (both paid and unpaid). Exclusions to cover Employment Liability; Property in Custody and Control (beyond $100,000); Product Defect; Loss of Use; Product Recall; Aircraft, Aircraft Products and Watercraft; Vehicles; Contractual Liability;

3 Professional Liability (except as detailed above); Libel and Slander; Pollution (sudden and unintended not excluded); Territorial Limits excludes actions brought in USA/Canada; Exports to USA/Canada; Asbestos; Faulty Workmanship; Fines, Penalties; Punitive Damages; Assault and Battery; Defect in Design; Inefficacy of Computers, Software and Computer Consulting; Treatment and Dispensing; Child Molestation; Amusement devices; Security Personnel Terrorism LIMITS OF LIABILITY General Liability $10,000,000 any one occurrence. Products Liability aggregate any one Period of Insurance. $10,000,000 any one occurrence and in the DEDUCTIBLE The Insured shall bear the first $250 of each and every claim or series of claims arising out of one Occurrence. All indemnifiable liability attributable to one source or original cause shall be deemed one Occurrence for the purpose of the application of the above deductible. POLICY WORDING AND CONDITIONS As per QBE Commercial Broadform Liability Insurance Policy QM wording and Endorsements (available from our website at or by request).

4 Voluntary Workers Insurance Voluntary Workers Insurance protects the most important asset of your organisation, your volunteers. The policy will provide Volunteer Workers, Committee Persons, Board Members and all other elected officials with financial compensation should such persons sustain personal injury whilst working for and on behalf of a club or community group. The policy allows specific payments for death, loss of limbs and permanent and partial disablement. Policy Section D Injury Assistance: i. Out of Pocket Expenses reimbursement of 100% of all non-medical related expenses incurred as a result of personal injury (eg. Home Help, travelling costs and the like); ii. Non-Medicare Medical related Expenses Benefit reimbursement of 100% of all non- Medicare expenses incurred as a result of personal injury. The maximum amount payable for Policy Extensions (i) and (ii) resulting from any one claim is $10,000. PLEASE NOTE SECTION D (ii) IS ONLY PAYABLE AS PERMITTED BY SECTION 67 OF THE NATIONAL HEALTH ACT 1954 AND THE REGULATIONS ATTACHING TO THE ACT. This policy covers volunteers up to 89 years of age anywhere in Australia There is no waiting period in respect claims for loss of wages Policy Exclusions War; Terrorism; Driving vehicle under the influence of liquor; Whilst training or competing in any organised sport; Flying other than as a fare paying customer of a recognised airline; Suicide; Driving or riding in any race; Motor cycling; Childbirth, pregnancy. SCHEDULE OF BENEFITS Insured Events (as per Policy) Each Insured Person Capital Benefits - Ages 12 to 89 only (Death, Loss of Limbs or Injury thereof, Partial

5 Disablement caused by Injury, Paraplegia/Quadriplegia) $20,000 Broken Bones Additional Capital Benefit $3,000 Lifestyle Modification Additional Capital Benefit $10,000 Weekly Benefits Ages 12 to 89 only $200 per week Excluded Period of Claim 7 days Benefit Period 52 weeks Injury Assistance Benefits 75% of non medical expenses INSURED PERSON(S) DEDUCTIBLE/EXCESSES Any person aged between twelve (12) and eighty nine (89) years inclusive, who is at the time of sustaining the bodily injury carrying out unpaid voluntary work for the direct benefit of the named insured. The Insured shall bear the first 7 days of each and every accident claim or series of claims arising out of the one Event. All indemnifiable liability attributable to one source or original cause shall be deemed one Event for the purpose of the application of the above deductible. ENDORSEMENTS Non-Medicare Medical Expenses With respect to the Non-Medicare Medical Expenses endorsement the maximum we will pay is $1,000. Excess $50. Funeral Expenses It is hereby noted and agreed that where an Insured Person suffers death as a result of an accident this Policy extends to cover the expenses of burial or cremation OR the cost of returning the Insured Person s body or ashes to his/her country of residence up to a maximum of $3,000. POLICY WORDING AND CONDITIONS As per QBE Commercial Voluntary Workers Accident & Health Insurance Policy QM (available from our website at or by request).

6 Serpentine Jarrahdale Shire Community Groups Declaration Name(s) in full Postal Address Postcode Contact Numbers Phone No. (H) (08) Phone No. (W) (08) Fax No (08). Other Interested Parties Please advise the exact description and aim of the organisation Please describe in detail the activities and/or events likely to be undertaken during the policy period Public Liability Limit of Liability $10,000,000 $20,000,000 OTHER Home Premises Location: Number of Members: Are Club Activities conducted away from the Home Premises you have nominated above? If yes, please detail:

7 Voluntary Workers Insurance Total Number of Voluntary Workers Please indicate the nature of Voluntary Work performed: Fetes Yes No Working Bees Yes No Canteen Duties Yes No Cleaning Yes No Child Supervision Yes No Gardening Yes No Barbecue / Picnics Yes No Maintenance Yes No Building Projects Yes No Collection Days/Button Days Yes No Other (please describe in detail) DUTY OF DISCLOSURE The law requires you to tell us everything you know (or could reasonably be expected to know in the circumstances) which is relevant to our decision to insure you and the terms on which we insure you. This duty applies before you enter into a contract with us, that is, before we accept your proposal and also each time before you alter or renew the policy. PENALTY FOR NON-DISCLOSURE If you do not tell us everything necessary, we may: reduce or refuse to pay a claim, or cancel your Policy. If you act dishonestly, we may invalidate the Policy from its beginning and not be bound by it. You don t need to tell us anything which: reduces the risk, is common knowledge; we already know in the ordinary course of our business; or we indicate we do not want to know. If you are not sure that something is relevant, it is best to disclose it anyway. INADEQUATE SPACE TO ANSWER If there is inadequate space to answer our General Information or other questions or you need to disclose something to us because of your Duty of Disclosure, please attach a separate piece of paper to this application giving full details of additional information. DECLARATION AND SIGNATURE The Duty of Disclosure, Non Disclosure and Inadequate Space to Answer notices set out above and have been read by me/us. All answers and statements made in this application are true and accurate in every respect and no information has been withheld which is likely to affect your decision about accepting this insurance. Applicant s Signature X Date Applicant s Title X

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