As the Risk and Insurance Advisor for Equestrian Australia (EA), Marsh has developed a National Insurance Program to help protect members, coaches, clubs and officials across the EA community.
When it comes to reimbursement of Personal Injury claims, some people get confused about Medicare, the Medicare Gap and what is covered through the National Risk Protection Program.
Medicare is a Commonwealth Government programme that provides eligible Australian residents with free or low-cost medical and hospital care.
Medicare provides access to:
The medical benefits schedule (MBS) lists all treatments and Associated MBR relating to Medicare.
You can access the MBS at any time by Medicare’s website. Items commonly used by sports participants that are Medicare listed can include General Practitioners, surgeons and an anaesthetists.
The MBS lists a rebate amount for each Medicare Item.
Example: A short consultation with a Doctor = Medicare rebate of $15.36
However, doctors or specialists may charge more than the listed MBS amount.
The difference between was is charged and the MBS rebate is call the “Medicare Gap”
The Health Insurance Act 1973 (Cth) strictly prohibits any general insurer from insuring any item that is listed on the Medicare Benefits Schedule.
This also means that regardless of your out of pocket expenses, it is against the law for the insurer to cover the Medicare Gap.
So what does that mean?
If your medical or other treatment has a Medicare Item number, such as the doctor fee above, it is claimable on Medicare by is uninsurable and you may not claim for reimbursement.
In the example you cannot claim the $29.65.
If your medical or other treatment does not have a Medicare Item Number, you may claim for reimbursement through Marsh . For specific insurance and Risk Protection information please visit the making a claim section of this website.
Yes, if the damage was caused during non-income earning Equestrian Activities, your policy will likely cover the cost to repair associated damages to the vehicle.
Public Liability can help provide financial protection should your equestrian activities seriously injure a third party or cause damage to third party property. It is important to note that the excess on a claim under this policy is $2,500. The excess is set at $2,500 to protect the program from a high number of claims in order to keep premiums affordable for members.
The Public Liability policy does provide limited cover to property owners, in circumstances where their involvement is required for legal action brought against you, due to agisting activities conducted on their property.
A property owner is NOT covered under your public liability policy for claims where they are found liable for injuries or damage to a third party or their property.
The Personal Injury Policy provides 24/7 injury protection for any of your non-income earning Equestrian Activities. This may include riding at home, competing, feeding or grooming your horse – as long as you are not being paid to do so.
The benefits listed above are for all EA State Branch Members. If you are not a current EA member, you can register online through your State Branch. Please contact your State Branch directly for any questions on this process.
For a copy of the EA program policy documents please contact us.
Marsh Advantage Insurance Pty Ltd (ABN 31 081 358 303, AFSL 238369) arranges the insurance and is not the insurer. This page contains general information and does not take into account your individual objectives, financial situation or needs. For full details of the terms, conditions and limitations of the covers, refer to the specific policy wordings and/or Product Disclosure Statements available from Marsh Advantage Insurance (MAI) on request. MAI makes no representation or warranty concerning the application of policy wordings or the financial condition or solvency of insurers or re-insurers. MAI makes no assurances regarding the availability, cost, or terms of insurance coverage.
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