Introduction

Claim Procedure

1. Please fully complete all sections of the claim form and ensure you sign the privacy declaration (Section 6).  Please provide answers to all of the information required in order to avoid delays with your claim as we cannot proceed with the claim without this information.
2. Pay all medical and other accounts as the insurer will not pay those on your behalf.
3. Make your Medicare Claim.
4. The Scouts Insurance includes coverage for non-Medicare medical expenses.
5. Any portion of any expense for which a Medicare benefit is paid or payable, including the balance of monies you have to bear after deduction of any Medicare benefit or rebate from the actual expense incurred (commonly known as the ‘Medicare gap’) and any invoices listed under Medicare Benefits Scheme, is unable to be reimbursed under this or any other general insurance due to Australian Federal Legislation.  It is in fact a breach of the Health Insurance Act to reimburse such costs.
6. Make Private Health Insurance claims, as the insurer’s obligation is only for any portion not fully covered by Private Health – please provide a copy of your Health Fund Benefit Statement (if applicable).
7. YOUR EMPLOYER fully completes Section 8 of the claim form.
8. YOUR DOCTOR fully completes the two page “Medical Practitioners Statement” (Section 7).
9. Attach a copy of your most recent Payslip to your claim submission.
10. Scan and email all completed documents along with any accounts and receipts in support of our of pocket expenses claimed back to risk@scoutsqld.com.au