Journey Accident insurance

Some of the benefits available under this policy are:

• Accidental death – $100,000
• Permanent disablement – up to $100,000
• Weekly Injury Benefit – up to 85% of average gross weekly income for a period of up to 104 weeks for temporary disablement.  Maximum benefit limits and a 14-day waiting period applies.
• Fractured Bones and Loss or Damage to Teeth benefits
• Tuition or advice expenses – up to a maximum of $9,000 by a licensed vocational provider to support retraining if required.
• Chauffeur or taxi services – up to $2,500 per claim for necessary transport to and from place of residence and normal place of work
• Return to work assistance – up to $20,000 per claim for professional assistance with returning to work, including special equipment and modifications to the usual workplace if required.
• Domestic Help Benefit – up to $500 per week to hire necessary domestic help, for a maximum of 26 weeks.
• Modification Benefit – up to $20,000 for required modifications to the member’s home and/or motor vehicle, or relocation expenses following Permanent Total Disablement, paraplegia or quadriplegia.

* For full details of the benefits, limits, terms, conditions, and exclusions applicable to this policy, please refer to the policy wording and policy schedule which can be obtained, by request, from the Association. Age limits apply.

Please note that benefits apply only to claims resulting from bodily injury following an accident. The policy does not provide cover for psychological injuries, sickness or pre-existing medical conditions.

You must have been a financial member of the NSWNMA at the time of the accident to be eligible for cover. Further restrictions may apply, including for members aged 75 and over. Please refer to the policy wording and policy schedule for full details.

Cover applies:

• Whilst travelling directly between the boundaries of your usual place of residence and your usual place of work (whilst working as a nurse or midwife only) for the purposes of starting or ending your day’s work; and
• During activities undertaken during lunch time and meal breaks.

A 14-day waiting period applies to the Weekly Injury Benefit for Temporary Total or Partial Disablement only. This means that if you are off work for less than 14 days as a result of your accident, you are not entitled to these benefits. If you are off work for 14 days or more, please note no benefit will be payable in respect of Weekly Injury Benefit for Temporary Total or Partial Disablement for the first 14 days.

No. The Journey Accident Insurance policy is underwritten by a general insurer who, per government legislation, is prevented from reimbursing the cost of any kind of medical expense. However, if the accident involves a motor vehicle, Compulsory Third Party (CTP) insurance may provide a medical benefit.

If you are involved in a motor vehicle accident, you should lodge a claim on your Compulsory Third Party (CTP) insurance first. This is because your CTP insurance may be able to provide you with benefits you are not entitled to under this cover.

1. If your accident involved a motor vehicle, lodge a claim on Compulsory Third Party (CTP) insurance
   This is an important first step for you to address as soon as possible after your accident. Here is the link to access claim information: https://www.sira.nsw.gov.au/claiming-compensation/motor-accidents-injury-claims
2. Contact the Association to register your request to claim under the Association’s Journey Accident Insurance policy and to receive more information and claim forms
   We will guide you through how to lodge a claim and advise as to any documentation required to process your claim. This could include, but is not limited to:

• A completed Claim Form;
• Provision of payslips (to evidence your salary)
• Medical certificates and supporting medical documentation (e.g. hospital discharge letters, x-ray reports).

The Association will lodge the claim and liaise with the insurer on your behalf. The insurer will assess and respond to the claim within ten (10) business days and may require additional information.

The time needed for the insurer to assess a claim and provide a decision varies with each individual claim. In some cases, the insurer may require additional reports, medical evidence, information or investigation before they can approve a claim and process payment. However, as a general guide:

• If the claim involves a motor vehicle accident, the insurer will likely seek a police report which can take 6-8 weeks. Therefore a claim decision may take at least 6-8 weeks.
• If the claim does not involve a motor accident, and there are no other extenuating circumstances that require additional reports or investigation, the claim decision may take around 10 days.

For longer term weekly injury claims, it is likely you will be required to provide the insurer with ongoing and updated information including, but not limited to:

• Regular medical certificates from your treating doctor or specialist, stating the medical condition and period of incapacity (payments cannot be paid unless there is medical evidence of incapacity)
• Depending on the nature of your injury, a rehabilitation assessor or other provider may be appointed to assist with return to work. This is to provide our insurer with a clear understanding of your condition, the progress of your recovery and the outlook of your return to work
• Throughout the life of the claim, an independent medical review may be requested by the insurer to assess the progress of your recovery and capacity to return to work.