Travel Claim - Check-list
- Please complete & return with Claim Form ► To Corporate Services Network (“ISN”)
Send
DIRECT To: / 1. / EMAIL – ALL Documents – DIRECT to Corporate Services Network (CSN)”
/ 3. POST ORIGINAL Documents to:
Corporate Services Network (“CSN”)
L2, 280 George St, SYDNEY. NSW. 2000.
Ph: 02 8256 1780 Fax: 02 8256 1775
2. / EMAIL – ALL Documents – To UoM Insurance Office at: / Policy No:
02.PP.015907
Your Name (as the Claimant): / Student - No: / Email :
Payment To Be Sent to? / ►Yourself ?
– Please Advise Bank Account Details on Claim Form / ►YourSchool/ Department (if UoM Property)?
– Please Advise Name & Address Details for Cheque
Is this a NEW CLAIM Notification? / Is this an EXISTING [ACE Insurance Ltd.] CLAIM ?
▼ If YES- please provide your Confirmation of Cover▼ / If YES – Please advise the current ACE CLAIM NO?
______
1. / / Attach a copy of your University Travel Insurance – CONFIRMATION EMAIL. / OR 2. / Attach a copy of your ONLINE Student Registration CONFIRMATION LETTER
Required Claim Documentation / Per Policy Section / Yes / No / N/A / Comment
1. / Cancellation charges [Section 4.], Loss of Deposit Claim [Section 6.].
▬ ORIGINAL Tickets/Vouchers if a refund is not obtainable
▬ Doctors/Hospitals Certificate specifying exact nature of condition of Injured / Sick person
▬Letter from Travel agent verifying Total Cost of Journey, value of unused portion of journey, Cancellation Charges incurred and Total Amount of Refund received.
2. / Overseas Medical, Dental and / or Hospitalisation Claim[Section 4.]
▬ ORIGINAL Doctor’s / Hospital accounts and receipts
▬ Details relating to Medical Benefit refunds
3. / Emergency Expenses Claim[Section 4.]
▬ Receipts and/ or Tickets relating to Additional Expenses incurred
▬ Doctors/Hospitals Certificate specifying exact nature of condition of Injured / Sick person
▬ Letter from Travel Agent / Carrier verifying reason for Additional Expenses and / or any Refund applicable
4. / Luggage, Personal Effects Claim[Section7.]
▬ Report/ Letter from authority(Police, Airline) confirming the loss occurred and the amount of compensation provided
▬ Receipts, Guarantee certificates, Instruction Manuals, Valuation Certificates, bank Card or Credit card Vouchers or other proof of purchase for items claimed
▬ Bank statements, transaction receipts or other proof of cash claimed
▬ Quotations for replacement items claimed for repair or replacement
5. / Accidental Death Claim[Section1.]
▬ Death Certificate, Coroner’s Deposition & Findings and Birth Certificate
6. / Personal Liability[Section9.]
▬ Letters or Demands of a Claim made against you
7. / Rental Vehicle Collision & Theft Excess Cover Claim[Section10.]
▬ Rental Agreement & Documentation to confirm excess payment and vehicle repair invoice
Note: General Requirements **
1. For liability claims, do not make any admission or offer. Request the claim against you to be put in writing.
2. All losses under luggage and travel documents must be reported to local authorities within 24 hours and written acknowledgement obtained.
3. For medical claims, please submit claims to your private health provider prior to lodgement with ACE.
4. Immediately report any luggage loss or damage to the airline or carrier involved and submit a claim to them. In some instances they may be responsible for damage and or loss. [** Claims should be submitted through the University within 30 days after completion of the journey. ]
Student –Travel Insurance – Fact Sheet /
1. Schedule of Benefits 2. How to Claim 3. Frequently Asked Questions
1. Schedule of Benefits Policy No: 02.PP.015907
The University of Melbourne (UoM) holds a Business Travel Insurance Policy 02.PP.015907, (the Policy) with insurer, ACE Insurance Limited, (ABN 23 001 642 020, AFS Licence No. 239687) of 28-34 O’Connell Street, Sydney, NSW, 2000 (ACE). This Benefits Summary, provided for general information only, may change marginally when renewed each year at the 31st October. It is not a substitute for the complete record of insurance cover. Please refer to the ACE Policy Wording & Product Disclosure Statement, available from the University Insurance Office web-site link, for full details.
An extension to the Period of Cover can be purchased direct with ACE, via a separate ACE Policy:
► UniversityInsurance Office
E
Contact: Insurance Officer
Phone: + 61 3 8344 3444 / * Category 1: Students who University accepts as Eligible. (NO cover for Spouse/Partner or Child.) / Policy Benefits
* Category 2: Affiliated Members of MU Sport who the University of Melbourne accepts as Eligible. / Specific Categories of “Insured Persons”
* Category 3: MU Sportparticipants & others who the University of Melbourne accepts as Eligible. / 1. / 2 + 3.
Section 1: Personal Accident & Sickness
– Lump Sum Benefits or Weekly Benefits if an
Insured Person suffers from a Covered Event
asa result of Defined Injury. / Part A / Lump Sum Benefits / Table of Events 1 - 19 / $100,000 / $100,000
Part B / Weekly Benefits (Injury) / 104 Weeks / 85% Salary / 7 Days Excess / $ 250 / $ 250
Part D / Lump Sum Benefit / Injury Resulting in Fractured Bones / $ 3,000 / $ 1,000
Part E / Lump Sum Benefit / Injury Resulting in Loss of Teeth or Dental Procedures / $ 1,000 / $ 1,000
►Access to International Assistance is available, if an Insured Person during their travel has been threatened, attacked or forcibly detained. If an Event occurs - or is believed to have occurred - the Melb. Uni. representative must phone the University’s, Melbourne 24 hour - emergency number: + 61 3 8344 6666, for contact details.
Section 4: Medical Additional Expenses
Cancellation & Curtailment Expenses
– Medical and AdditionalExpensesforan Accidental Death
or Injury suffered during Journey; Additional orForfeited Travel, Out-of-Pocket Expenses from Unexpected Death, Serious Injury or Sickness of a Specified Person assoc. with Insured Person or Other Unforeseen Circumstances outside their control. / Medical Expenses
(Outside Australia.) / – Limit of Cover / Unlimited Cover
– Excess Per Person / $ 100 / $ 100
Cancellation &
Curtailment
Expenses / – Limit of Cover: / – For Claims – Up To 31 October, 2013 / $100,000 / $100,000
– For Claims – From 1 November, 2013 / Unlimited Cover
– Excess Per Person / $ 200 / $ 200
Continuous Bed Confinement / – Limit of Cover [Over 48 Consecutive Hrs. - Max.100 Hrs.] days.) / $50 /Day / $ 50 /Day
– Excess Per Person / NIL / NIL
Section 5: ACE ( 24 Hour ) Travel Advice / Assistance
(Outside Australia.) Line: ( 61 2 ) 8907 5995 Reverse Charges
– OR– Visit Website: / Emergency Assistance, during a journey, for services such as replacing lost or stolen passports, emergency evacuation, interpreter access or referral, tracing delayed luggage or medically supervised repatriation. / Included
Section 6: Loss of Deposits / Cover for pre-paid Travel, Accommodation costs if a trip is cancelled
due to Unforseen Circumstances outside of the Insured Person’s control. / Excess: $ 200 /Person / $ 6,000 / $ 3,000
Section 7: Baggage/ Business Property, Electronic-Equipment, Deprivation of Baggage & Money/ Travel Documents:
– Baggage / Business Property: Baggagemeans Personal Property Owned By Insured Person or for which they are
legally responsible for, taken on or acquired during Journey, excluding household effects unless acquired during Journey
(includes Digital Cameras.) Business Propertyis office equipment & replacement value /plans, business papers, etc. / – Total Limit of Cover / $ 4,000 / $ 4,000
– Limit Any One Item / $ 1,000 / $ 1,000
– Excess Per Person / $ 200 / $ 200
– Electronic Equipment means personal / business
computers, palm pilots, mobile phones & other items of a
similar nature deemed by Insurer to be electronic. Note:
Digital Cameras are covered as Business Property.
[ Coverwhilst carried in or on any aircraft, aerial device, bus, waterborne vessel or craft, unless theyaccompany the Insured Person as personal cabin baggage unless placed in the hold under specific instructionprior to checking in.A written report from either Police or Carrier is requiredfor theft related claims. ] / [ Insured Person Owned ] – Electronic Equipment Items – Total Limit of Cover / $ 1,500 / $ 1,000
Limit Any OneItem: / ▪ Palm Pilots, PDAs, I-Pads, Tablets & other mobileinternet devices / $ 300 / No Cover
▪ Mobile Phones / – For Claims– Up To 31 October, 2013 / $ 300 / No Cover
– For Claims –From the 1 November, 2013 / No Cover / No Cover
▪ Personal / Business Computers / $ 1,000 / $ 800
▪ ALL OTHER Electronic Equipment Items / $ 500 / $ 500
[ Insured Person Owned ] – Excess Per Person / $ 200 / $ 200
[ University Owned ] / – Electronic Equipment Items – Total Limit of Cover / $ 15,000 / $ 15,000
(From 22.04.13) / – ( University ) Excess Per Claim / $ 500 / $ 500
–
– Money and
Travel Documents / Cover for coins, bank notes, postal money orders, traveler’scheques, letters of credit, passports,
automatic teller machine cards, travel tickets, visas, entry permits, credit cards, petrol, other papers. / – Limit of Cover / $ 500 / $ 300
– Excess Per Person / $ 200 / $ 200
– Deprivation of
Baggage / Cover for delayed, misdirected or mislaid by any transport carrier more than 8 consecutive hours, provided for Insured Person’s reasonable expenses to buy essential replacement clothing, toiletries. / – Limit of Cover / $ 500 / $ 500
– Excess Per Person / NIL / NIL
Section 8: Alternative Employee / Resumption of Assignment Expenses Cover for Employee or Resumption Expenses due to injury / illness. / No Cover / No Cover
Section 9: Personal Liability / Access to cover if an Insured Persons becomes legally liable to pay damages in respect of either bodily injury to any person or loss of or damage to property And such injury or damage is caused by an accident. / $10 Million / $10 Million
Section 10: Rental Vehicle
Excess Waiver / Cover for Vehicle Insurance EXCESS - of Insured Person’s Rental Vehicle damaged in collision or stolen. Insured Person is required to purchase the Comprehensive Insurance provided by the rental company. / $ 2,000 / $ 1,000
Section 11: Extra Territorial
Workers Compensation / Cover is provided for certain non-statutory, Workers Compensation Benefits. [Weekly Benefit.] / No Cover / No Cover
Section 12: Missed Transport
Connection(NIL XS.) / Reasonable expenses incurred to assist use of alternative scheduled public transport services to arrive at a University activity on time if transport connection is missed due to Unforeseen Circumstances outside their control. / $ 3,000 / $ 2,000
Section 13: Overbooked Flight
Evacuation(NIL XS.) / Cover for certain costs & expenses incurred, whilst on a Journey, if denied boarding on a confirmed scheduled flight due to overbooking and no alternative transport is made available within (8) hours of scheduled departure. / $ 2,500 / $ 1,500
Section 14: Political & Natural
Disaster Evacuation / Cover for the cost of returning Insured Person to their country of residence or the nearest safe place due to need to leave a country after being expelled or officials advising they leave. / Annual Aggregate
$ Max.PerPerson. / $100,000 20,000 / $100,000
$ 20,000
Section 15: Search & Rescue
Expenses / Cover for costs of a recognized rescue provider or police whilst travelling outside Australia, if Insured Person is reported missing, necessitating a search and rescue to be undertaken. / Annual Aggregate
$ Max Per Person. / $100,000
$ 20,000 / $100,000
$ 20,000