Personal Injury Claims

How to make a claim

1. Download a Personal Injury Claim Form.
2. Complete all relevant sections of the Claim Form including:
   • Confirmation of “Gross Weekly Earnings” (substantiated by employer); and/or
   • “Statement of operations” for harness earnings; and
   • Medical Practitioner’s Statement;
3. Send your completed form to Corporate Services Network (CSN) as soon as possible.
4. CSN will confirm receipt of your claim and/or make contact with you should they require further information

Please note – If you have Private Medical Insurance you should seek reimbursement from the health fund prior to claiming through this policy.

Important Information

The Health Insurance Act (Cth) 1973 does not permit the Insurer to contribute to any charges covered by Medicare (including the Medicare Gap).

Examples of Non-Medicare Medical items.	Examples of items covered by Medicare.
Claimable as per the Policy Wording.	We can not reimburse you for these costs.
Ambulance Physiotherapist Dental Private Hospital Accommodation Chiropractor MRI Scans*	Doctor Surgeon Surgeon’s assistant Anesthetist X-rays MRI scans* Public Hospitals

*Please note: MRI scans are generally claimable through Medicare, however sometimes the referrer and/or provider is not registered with Medicare. Please check with your treating physician prior to lodging your claim.

In addition:

1. All Non–Medicare Medical Expenses will be assessed in accordance with policy terms & conditions. Appropriate supporting documentation will be required. Upon acceptance, the applicable excess of $50 will be deducted.
2. Calculation of lost wages will be based on 85% of gross weekly earnings up to a maximum of $1,000. Weekly benefits are payable up to a maximum of 104 weeks. The “Excess Period” (Non-Payment/Deferral period) is 7 days and is calculated from the commencement date of injury and will be reduced by any amounts payable through Workers Compensation, sick leave or from any other injury compensation type scheme (you must be able to provide medical evidence of date of injury).
3. Any claims to be declined entirely will be advised to the claimant, with reasons for the declinature. Appropriate Internal Dispute Resolution (IDR) procedures will also be provided in accordance with the Insurer's compliance with the General Insurance Code of Practice.