ECU's Personal Accident insurance includes "out of pocket" non-Medicare medical expenses cover. An excess of $50 applies to all claims made and the policy limit is capped at $10,000. Students, volunteers or research participants who submit a claim MUST claim from any other source before submitting their claim for consideration. In the event of injury, the following process applies:
- Follow advice for "When an Incident Occurs"
- ECU Staff (including Researchers) provide information to the student, volunteer or research participant on how to make a claim
- Any claims where costs are recoverable through Medicare ARE NOT claimable against the policy
- Medical treatment costs must be paid for by the student, volunteer or research participant
- Once medical treatment costs are paid, reimbursement must then be sought through private health insurer or student health insurance policy first
- Any gap or non-refundable portion of medical treatment costs can then be claimed against the personal accident policy
- If the claim is accepted, insurer refund will be made, less the $50 excess and to a maximum of $10,000
Non-Medicare Medical Expenses definition:
“Non-Medicare Medical Expenses means expenses that are not subject to any full or partial Medicare rebate nor recoverable by You or by an Insured Person from any other source and incurred within twelve (12) calendar months an Insured Person sustaining an Injury and paid by You or the Insured Person, certified necessary by a legally qualified medical practitioner, to a registered Private Hospital, physiotherapist, chiropractor, osteopath, nurse or similar provider of medical services excluding the cost of dental treatment unless such treatment is necessarily incurred to sound and natural teeth, excluding dentures and is caused by injury. Medical expenses does not include any or part of any expenses for which a Medicare benefit is paid or is payable including the balance of monies due or payable by that Insured Person after deduction of any Medicare benefit or rebate from the actual expense incurred (commonly known as the “Medicare Gap”).
Provided that We shall not be liable to make any refund in respect of:
(i) any expense recoverable by that Insured Person from any other source except for the excess of the amount recoverable from such source;
(ii) any expense to which Section 67 of the National Health At 1953 (as amended) or any of the regulations made there under apply;
(iii) Any excess or deductible as shown in the Policy Schedule.”
If you are unsure if the ECU personal accident insurance cover will apply to you and your activities, please contact firstname.lastname@example.org.