GAA Players Injury Scheme and Physio
GAA Players Injury Scheme
Important points to note in relation to the scheme include:
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 excess on the Scheme is €100.
The maximum amount claimable for medical expenses is €4,500.
A referees report is required if the injury occurred during an official or challenge match.
A club letter is required if the injury occurred during club/county training.
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 in total maxed at €40 for any one treatment. (8 treatments at €40 each). A doctors letter will be required referring the claimant for physiotherapy treatments.
MRI scans can be claimed maxed at €300 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, Quinn, 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).
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
Week 5- 52 up to € 400
There is scope in the Scheme to claim if the claimant has suffered a Permanent total or partial disability (loss of finger etc). However each case is taken on its own merits and the medical information is assessed by an independent medical advisor. The decision is made directly by CLG and they will agree the relevant claim figure.
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 per day is claimable. This is separate to any hospital charges as these can be claimed under medical expenses.
If you have any questions or comments regarding any of the above please do not hesitate to contact either the club secretary or club insurance officer.