CLAIMS PROCEDURES REQUIREMENTS

In the event of a claim /injury or potential claim the club must notify Kiely Gaule Financial Services in writing within 30 days of the incident with full details of injury.  Any claim notified after 30 days would not be covered unless exceptional circumstances applied.  The claim will be registered and a claim form will be sent to the club for completion.  Please also note that the medical certificate section on the claim form must be completed by the insured person’s doctor or consultant.

Confirmation of the details of any injury must come from an independent witness statement such as the referee or an A&E doctors report confirming that the injury occurred in a match or training. A letter from club committee member if injury was sustained in a friendly match or training session.

Before Underwriters can confirm if an injury/claim is covered they must have a fully completed claim form and any other documentation requested by them. When the claim is confirmed all medical expenses must be vouched for with original receipts.

Please note that medical expenses recoverable under health insurance underwriters such as Aviva, VHI, Laya  or any other source must be claimed for first.  If not recoverable or only partly covered then you can claim under this policy.

It is important to note the following:

Medical Expenses/Treatment must be paid for the by the insured person and these expenses will be reimbursed once receipts have been submitted less the Policy Excess and expenses recoverable from any other health insurance policy. Regarding Physio treatment, it must be provided by a Chartered Physiotherapist.

However, if elective surgery is required, we can accept a Pro Forma invoice showing a breakdown of the costs involved and have the monies transferred to the Club’s bank account to enable the player provide an upfront payment to the hospital

Any medical expenses must be claimed for within 52 weeks from the date of injury,

Pre existing conditions/injuries are excluded from the cover.  For full details of cover and endorsements and exclusions please refer to the policy documents.

Excesses: € 150 for schoolboy/girl personal accident cover

€ 175 for adult                   “             “         “

 

Loss of Income Cover:

Documentation Required-

13 weekly payslips, dated prior to the injury/absence from work.

Confirmation of any Sick Pay Entitlements.

Confirmation that player is entitled to social welfare benefit.

For Self Employed confirmation of weekly income from his accountant.

Loss of income is payable for a maximum of 104 weeks, less the excess period of 2 weeks/4 weeks.

Loss of income would be paid less any payments such as social welfare/sick pay to bring the player to his average net weekly wage.

 

 

PLEASE  REFER TO THE POLICY DOCUMENT FOR FULLER DETAILS