Sports Insurance in Australia – how personal accident insurance works

What is person accident insurance?

Sports accident insurance is a specific type of cover for athletes and sports players. This type of insurance is specifically designed to help offset sports risks so you can enjoy an active life. In the event of you being injured while competing you may claim benefits including:

What does sports personal accident insurance cover?

• Medicare gap cover. These are the medical expenses that aren't covered by Medicare. This can include elective surgeries, additional diagnostic scans, physiotherapy and other treatments that could make the difference between a partial and a full recovery. Where you are able to claim benefits from a private health insurance policy this type of cover can still pay out, although the benefits may be reduced by the amount already paid.
• Inability to work. In the event of an injury that leaves you unable to work, either temporarily or permanently, you can claim income replacement benefits for a specified period of time.
• Lump sum benefits. If you suffer a specific type of injury you may be awarded lump sum benefits. The size of the payout depends on the type of injury, generally expressed as a percentage of the total lump sum.

The combination of benefits makes it a versatile and practical type of policy. It can work hand-in-hand with existing insurance to specifically cover gaps and deliver an important level of cover for sports participation.

If you're a sports player or athlete, sports accident insurance can help counter injuries and accidents that can occur during training and competitions. See which insurers could cover you.

Compare sports personal accident insurance in Australia

Fund	Monthly Maximum Benefit	Maximum % of Income Covered	Maximum Benefit Period	Waiting Period	Apply
	$30,000	70%	Up to 5 years	4, 8, 13 or 26 weeks	Get quote
	$10,000	75%	Up to 5 years	14, 28, 60 or 90 days	Get quote
	$10,000	75%	Up to 5 years	14, 28, 60 or 90 days	More info
	$10,000	75%	Up to 5 years	14, 28, 60 or 90 days	Get quote
	$25,000	75%	Up to age 65	30 or 90 days	More info
Zurich	$12,000	75%	Up to 5 years	30, 60 or 90 days	Get quote
MLC	$60,000	75%	Up to 5 years	14, 30, 90 days, 1 year or 2 years	More info
OnePath	$60,000	75%	Up to age 70	14, 30, 60, 90, 180 days, 1 Year or 2 Year	More info

What types of sporting injuries can I get covered for?

Some plans can provide you with a lump sum payment to cover for injuries. Depending on the policy, you may be covered for:

You may also be able to claim lump sum benefits for specific types of injury or loss. More serious events will pay larger portions of the sum insured, while less serious ones will pay out partial amounts. In the event of multiple injuries you may be able to claim more than one partial benefit, not exceeding 100% all up.

Full vs partial benefits

Accident cover will protect you from various types of injuries, however the amount you receive will vary based on the type of injury.

Situations where you'll receive a 100% payout of your sum insured

The most serious types of injuries can pay out the full sum insured. These can include:

• Death
• Paraplegia or paralysis
• Total permanent disability
• Total permanent blindness
• Permanent loss of multiple limb
• Permanent and incurable insanity

Situations where you'll receive a 50-75% payout of your sum insured

Partial benefits of these percentages may be paid for injuries such as:

• Permanent total loss of hearing
• Total loss of a hand or single limb
• Loss of an eye

Situations where you'll receive less than 50% payout of your sum insured

These may be as benefits such as 1% per toe lost, or as much as 40% for losing four fingers on one hand. Other injuries covered in this range can be:

• Fractured or broken bones
• Loss of use of limbs or joints
• Shortening of a leg
• Partial loss of hearing or partial blindness

In addition to these benefits, a policy may also provide specific cover for "non-Medicare expenses"

_{Note: These percentages are given as a general guide. For payout details in regards to your policy, make sure you consult the product disclosure statement (PDS) of your policy.}

What are non-Medicare expenses?

These are costs that cannot be claimed through Medicare. Medicare is specifically designed to cover only essential treatments and costs, but these might not be enough for you to make a full recovery.

For example, a doctor might recommend knee surgery following an accident to prevent you from having a limp, but it might not be necessary. This could qualify as elective surgery, and might not be covered by Medicare. Even if it is, there could be a long waiting list until you can get the treatments done in a public hospital.

Some of the specific non-Medicare expense cover that athletes may benefit from can include:

• Private hospital treatment
• Physiotherapy
• Dental treatment
• Elective surgeries
• Specialists and alternative treatments, such as osteopathy, naturopathy, physical therapy and more.

Generally, you will need to have been referred to a specialist by a medical practitioner in order to claim those treatment costs, and any medical expenses claimed will usually need to have been at the recommendation of a registered practitioner.

What should I look for when I select cover?

When looking at sports personal accident insurance cover, it's worth comparing policies by both price and cover. Things to look out for include:

• The level of coverage: This specifically refers to the amount you are insured for, and how much the policy can pay out in the event of a sporting accident. If your life insurance or income protection policy doesn't cover you while playing sports, and you are using a sports personal accident policy to fill in, then your sum insured might need to be roughly equivalent. To your Medicare gap cover needs, consider the limits of any current health insurance policy, as well as the specific extras and hospital coverage it affords.
• What you are covered for: Naturally you need to know what exactly you are covered for. Policies may vary, and it's essential to compare both the payout conditions and any exclusions which may apply.
• Exclusions and restrictions: These can indicate how suitable a policy is for you. For example, "no professional sports cover" may be a specific exclusion that greatly affects its suitability.
• The cost of the cover: Policies need to be within your budget, so you need to make sure you check and compare the price of any personal accident insurance plans you are considering. The cost of cover can vary based on a number of factors, including the insurance provider you choose, so it can be worth knowing about the factors affecting costs.

What is not covered by sports accident insurance?

A range of policy exclusions may apply. Sometimes these can be very specific, such as not covering heart attacks after the age of 35, while others can be more general and commonly found. Some of the more common exclusions can be:

• Riots or other civil commotion, or acts of war
• Taking part in any aerial activities other than as a passenger on commercial flights
• Any deliberately self inflicted injuries
• Any sexually transmitted disease
• Any criminal acts
• While under the influence of drugs, alcohol or any medication other than those prescribed by and taken in accordance with the advice of a medical practitioner
• Pre-existing medical conditions
• Directly or indirectly resulting from loss or damage to health aids or prosthetic devices. For example, the cost of damage to false teeth or injuries resulting from damage to false teeth.
• Any psychological disorders
• Any act of terrorism

Frequently asked questions

• Does Medicare cover sports injuries?

  It depends. Your sport-related surgeries may be deemed a non-emergency by Medicare which could mean that if you require surgery it will be considered elective. The wait time for elective surgeries can span months and, in some cases, over a year.

  Medicare also doesn't cover you when travelling overseas. You may be eligible for some cover through a Reciprocal Health Care Agreement or you'll need to make sure your sports insurance includes overseas cover.

• Are sports injuries covered by insurance?

  Private health insurance can help you pay for in-hospital rehabilitation and out-of-hospital services like physiotherapy and remedial massages. If you're an amateur sports player, you can also consider income protection insurance which replaces part of your income if you're unable to work due to an injury or illness. Professionals or players of more extreme sports may need personal accident insurance for sports instead.

• What is considered a personal accident?

  A personal accident includes bodily injury resulting from an accident that is not an illness. For insurance purposes, personal accident cover may include broken bones or dislocations, permanent disability or even death.

Written by

James Martin

Journalist

James Martin was the insurance editor at Finder. He has written on a range of insurance and finance topics for over 7 years. James often shares his insurance expertise as a media spokesperson and has appeared on Prime 7 News, Insurance News, 7NEWS and The Guardian. An experienced journalist, James' work has featured in publications including The Irish Times, Companies100 and In Business. He holds a Tier 1 General Insurance (General Advice) certification and a Tier 1 Generic Knowledge certification, both of which meet the requirements of ASIC Regulatory Guide 146 (RG146). See full bio

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