Player Insurance Requirements

Player Insurance Scheme
The Player Injury Scheme is not an insurance policy but rather a benefit scheme where a pool of funds maintained from registration fees is used to pay claims that result from GAA injuries.

All registered members of the GAA are members of the Scheme. Please make sure you are registered for the relevant calendar year.

Please find attached a copy of the current claim form, policy brochure and guidelines on submitting a claim.

You will notice that these documents are dated 2010 however the only change since 2010 is that youth footballers must wear a gum shield since 2013 and all footballers must wear a gum shield from 2014 onwards and permanent partial disability has been removed from the Scheme.

The main changes between the 2009 Scheme and the current Scheme are:

Willis must receive at least the first 2 pages of the claim form into their offices within 60 days of the date of injury. Otherwise the claim will be automatically declined. Claim forms can be posted, emailed or faxed. The notification process will be online shortly.

The excess on the Scheme is now € 100.00.

The maximum amount claimable for medical expenses is € 4,500.00.

A referees report is required if the injury occurred during an official match.

A club letter is required if the injury occurred during club/county training or a challenge match.

There is no cover for pre-operative physiotherapy. The only physiotherapy expenses that may be claimed are for treatments that are post-operative i.e. after a surgical procedure. They are then limited to € 320.00 in total. A doctors letter will be required referring the claimant for physiotherapy treatments. In the absence of surgery there is no cover for physiotherapy. While the brochure does not define surgery it can be taken as ….. Treatment administered by a surgeon by the act of incision on an anaesthetised patient (whether conscious or unconscious) to investigate and/or treat a condition to help improve bodily function that has been damaged or injured as a result of GAA activity. This does not include treatments using a local anaesthetic for injections or manipulation used in treating dislocations.

MRI scans can be claimed maxed at € 300.00 per scan. However there are a number of medical centres offering MRI’s for below this price. You do not require a doctor to refer you for an MRI, for the purposes of the Scheme.

If the claimant has private health insurance (VHI, Laya, Aviva, etc) then they must claim from them first. The GAA Scheme is NOT an insurance scheme. It is a benefit scheme for the purpose of giving an injured player a “dig out” if they have no other recourse for their medical expenses. Payments from the Scheme come directly from GAA funds, there is no insurer involved with the Scheme. Willis act as claims assessors and administrators ONLY.

Any treatment being claimed must have been paid prior to claiming with the Scheme. This does not mean that you must wait for your treatment to be completed before submitting a claim. It means the Scheme will only assess receipts and not invoices or unpaid bills.

Loss of wages can be claimed for up to 52 weeks provided the claimant is declared medically unfit to work by doctor/consultant or surgeon. The claimant must be in full-time employment (16 hours or more per week) at the time of the injury.

The excess for a loss of wages claim is the first week.

Payment is calculated by taking the claimants average weekly net wage minus social welfare payment (illness benefit which the claimant must make a claim for and provide written evidence from his local social welfare office stating how much he is receiving or why he is not entitled to receive any payment) or sick pay entitlements from his employer etc.

The Scheme then follows the below limits on the remainder:

Week 1 – excess (no payment)
Week 2 – 4 up to € 200.00
Week 5- 52 up to € 400.00
A claimant can claim for a stay in hospital provided they are an in-patient for a minimum of 10 consecutive days and they can claim for a maximum of 15 days. € 400.00 per day is claimable. This is separate to any hospital charges as these can be claimed under medical expenses.

There is also provisions made under the Scheme in the unfortunate event that a player should suffer death while involved in GAA activity. Such cases will be dealt with individually.

 

 

Posted in Administration