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.

What does upgrading cover mean?

From 1^st November 2010, all clubs receive the basic level of cover for Non-Medicare Medical and Loss of Income benefits. Clubs can choose to upgrade from the standard level of cover to a higher level of cover to provide their players with increased benefits and reimbursements of Non-Medicare Medical Expenses and to provide a higher weekly benefit in respect to lost earnings.

Upgrading cover is OPTIONAL. Clubs should consider the costs to players and inform members of all decisions made by the club in regard to Upgrading Cover.

How to Upgrade Cover:

1. Step 1 Download and print the appropriate form.
   • Currently unavailable please Contact Us for further information.
2. Step 2 Complete all relevant sections of the form and calculate the total premium.
   • Section A = Club Details
   • Section B = Non-Medicare Medical
   • Section C = Loss of Income Cover
3. Step 3 Sign the form, attach payment and send to JLT Sport.
4. Step 4 Upgraded cover will commence from the date JLT Sport receives the completed form and payment.

To download and view the above documents, you will need a PDF viewer such as Adobe Reader installed on your computer.