IMPORTANT NOTICE

JLT Sport is no longer the insurance broker for the Football Federation Victoria insurance programme. Please see the FFV Website for further details.

If you wish to lodge a Liability claim for incidents that incurred prior to 1st January 2012 please use the claim form below or contact JLT Sport on 1300 130 373.

2011 General Liability Claim Form

If you wish to lodge a Personal Injury claim for injuries incurred prior to 1st January 2012 please use the claim form below and forward directly to SUA Claims Department or contact them on 1300 363 413.

Personal Injury Claim Form – if the injury occurs between 1st November 2010 and 1st January 2012.

How to lodge a Personal Injury Claim

• Step 1:
  • Download – if the injury occurs between 1^st November 2011 and 1^st January 2012.
  • Download – if the injury occurs between 1^st November 2009 and 1^st November 2010.
• Step 2: Complete each section of the claim form. Please note: Incomplete claim forms may cause delays in processing your claim. For assistance, please contact SUA Claims Department on 1300 363 413.
• Step 3: Send your claim form (via post or fax) to SUA Claims Department – PO Box 2717 Taren Point, NSW 2229 or FAX: 02 9524 9003 Important: Claims should be lodged within 180 days from the date of injury. You do not need to wait for all treatments to be completed before sending your claim form. Treatment is permitted even after you have submitted your claim.
• Step 4: SUA will confirm receipt of your claim form or contact you should they require further information.

Important Information

SPORTS UNDERWRITING AUSTRALIA PTY LTD (SUA) is the administrator of the Personal Accident Policy (arranged by JLT Sport) for the Football Federation Victoria Insurance Programme. SUA administers all claims associated with this policy for the 2010/2011 period.

The Health Insurance Act (Cth) 1973 does not permit the Insurer to reimburse any costs for medical treatments that are registered with Medicare (this includes the Medicare Gap).

As SUA is a NON MEDICARE MEDICAL INSURER, they are prevented by government legislation from covering the MEDICARE GAP. This means that in most cases, a service that is performed by a registered Medical Practitioner will not be covered by the policy.

Some examples of expenses NOT claimable through this section include:

• The Gap between the registered Medical Practitioner’s fee and the amount you receive back from medicare for the following medical services: Doctors, Surgeons, Anaesthetists, Pathologists & Radiologists. And;
• Other items where a Medicare refund (in any part) is recoverable.