2015 INSURANCE GUIDE PERSONAL ACCIDENT (Students) This guide is provided to assist University of Adelaide students in understanding the Personal Accident insurance cover available to them and how to make a claim in the event of an injury arising from activities associated with their University studies. Legal & Risk Division of Services & Resources
Named Insured: The University of Adelaide Policy Number: 03PO005475 Expiry Date: 31 December 2015 Scope of Cover The policy provides a level of Personal Accident cover for: Full-time enrolled students of the University who suffer an injury during the period of their enrolment on a 24 hour, 7 day basis INSURANCE COVER THROUGH THE UNIVERSITY S INSURANCE PROGRAM IS AVAILABLE FOR DECLARED AND DISCLOSED ACTIVITIES AND IS PROVIDED TO THE UNIVERSITY AND ITS PERSONNEL, PROVIDED THE TERMS OF THE PARTICULAR POLICIES ARE COMPLIED WITH. Part-time enrolled students of the University who suffer an injury while participating in a University activity. Non-Medicare expenses incurred within 12 months of sustaining a bodily injury may be claimed for under the policy, including the following treatments: Medical Chiropractor Surgical Osteopathic X-Ray Physiotherapy Hospital Nursing Treatment Key Policy Points The policy does not cover dental treatment, unless such treatment is necessarily required to teeth other than dentures, and is cause by the bodily injury. This insurance does not provide for any disability arising from illness and is for injury only. All claims must be supported by a medical certificate provided by a registered medical practitioner who is not a family member. Non-Medicare medical expenses will be paid for up to a maximum of $5,000 Medicare-related expenses (including the Medicare gap) cannot be claimed for under this policy. General Exclusions The policy will not provide an insurance payment for an injury or disability arising from: Illness Pre-existing medical conditions Participating in or training for any professional sport
Travelling in an unlicensed aircraft or flying/engaging in any aerial activity as part of the aircraft s crew Being exposed to radiation or radioactivity from any nuclear fuel or nuclear waste Pregnancy or childbirth, except for unexpected medical complications or emergencies arising therefrom Contracting a sexually transmitted disease Complications of infection with the Human Immunodeficiency Virus (HIV) or any variance including Acquired Immune Deficiency Syndrome (AIDS) and AIDS Related Complex (ARC) Intentional self-injury, suicide, criminal act or intentional illegal act Medicare-related expenses (including the Medicare gap) cannot be claimed for under this policy. Claiming against this policy 1. Contact Tom Pontt by phone (08) 8313 3878 or by email (thomas.pontt@adelaide.edu.au) and request a claim form. 2. Provide a detailed description of the events that resulted in the claim. 3. Attach all supporting documentation, (photographs, emails, receipts etc.) to the claim form including a medical certificate provided by a registered medical practitioner who is not a family member. THOMAS PONTT INSURANCE OFFICER LEGAL & RISK OFFICE G07 MITCHELL BUILDING THE UNIVERSITY OF ADELAIDE ADELAIDE SA 5005 4. Send the completed claim form and supporting documentation to the Insurance Officer. 5. When your claim has been finalised you will receive notification from the Legal & Risk Office. Deductible In the event of a claim against the policy, the insurer may apply a deductible of $50 for non-medicare expenses (restricted to University activities). For more information contact Legal & Risk Tom Pontt (Insurance Officer) thomas.pontt@adelaide.edu.au 08 8313 3878 Insurance Office G12 Mitchell Building 08 8313 4539
A.B.N. 33 061 063 303 Attention: Ms A Hill 155 Fullarton Road Tel. +61 8 8309 3060 Fax. +61 8 8309 3065 www.ajg.com To Whom It May Concern, MEMORANDUM OF INSURANCE This Memorandum is to confirm that, as the appointed insurance broker to The University of Adelaide, the following contract of insurance has been arranged as at the date of this Memorandum. CLASS OF INSURANCE: INSURED: Group Personal Accident Undergraduate Accident Plan The University of Adelaide and its Controlled Entities, Associated Entities and Businesses PERIOD OF INSURANCE: From: 31 December 2014 to: 4:00pm 31 December 2015 INTEREST INSURED: SITUATION INSURER: POLICY NO: INTERESTED PARTY: Bodily Injury (as defined) as a result of an accident and medical costs able to be indemnified at law based on schedule of benefits as per policy subject to Death and Capital Benefits of $10,000 death benefit and commencing at $100,000 for other capital benefits Anywhere in Australia Ace Insurance Limited 03PO005475 Various parties as declared from time to time **IMPORTANT NOTICE** This Memorandum is issued as a matter of information only and does not confer any rights upon the Memorandum holder. This Memorandum does not alter or override the terms and conditions of the contract of insurance. You must consult the policy wording for the terms, conditions and exclusions of the contract of insurance. Issued on 31 December 2014 By ARTHUR J. GALLAGHER A Division of Arthur J. Gallagher (Aus) Pty Ltd David Clarke Client Manager Corporate