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Journey Personal Injury Cover – Frequently Asked Questions

1.    Is every PSA member covered/insured?

Every financial member from 16 years of age up to 70 years of age (excluding retired, retrenched and associate member status) is covered by this policy.

2.    When did the insurance policy start?

The policy started at 4pm on 6 February 2013 AEDST.

3.    What does the journey insurance cover pay me?

The policy can provide salary compensation with weekly injury benefits – 85% of salary up to $1,500 for up to 104 weeks (up to 26 weeks for members 66-70 years of age).

4.    Is there an excess?

The excess is fourteen days before the cover takes effect.  This means that the insurance policy will not pay you for the first 14 days post injury where you will need to access sick or other leave.

5.    Does this policy cover me for medical expenses?

No.

6.    Does this policy provide me with a capital sum benefit in case of a permanent
injury/impairment?

No.  This policy does not provide a lump sum for permanent injuries.  The other PSA Personal Injury Insurance Policy details what members are eligible to receive if they receive a permanent injury.

7.    Why does the insurance policy cut off at 70?

People ask why 70 years of age is the cut off despite workers’ compensation generally covering members in full until 65.  This limit was placed by the insurance company.  The PSA is reviewing the coverage age limitation, looking to extending the coverage up to 75 or 80 by the end of this policy year, if viable.

8.    Do you have to be a PSA member for a period of time to be eligible?

You need to be a financial member at the time of the incident.  

9.    What does the policy cover?

The policy generally covers financial members for incidents that cause injury on a journey from your normal place of abode to your work (and return) without significantly increasing the risk of the journey by significant deviations or activities.

10.   Am I excluded from claiming if an injury occurs whilst I am picking up a loaf of bread,
picking up the children from childcare, or if I go to TAFE after work?

If you do not significantly increase the risk of injury or undertake a significant deviation for a non-work purpose you may still be covered, depending on the circumstances of the case.

11.   Can I cover my family under this policy?

No.  Nor does this policy include an option of enabling members to take up an additional cover for their children or partner.

12.   Am I covered for death and funeral costs under this policy?

No.  This policy does not cover you for death and funeral costs.  The PSA has an internal Provident Fund which contributes towards your funeral costs and a Personal Accident Insurance policy which may provide cover within the terms of its policy.

13.   Am I required to undertake a medical examination prior to the insurance covering me?

Unlike personal insurance, this is a group insurance that covers a particular cohort of the population (public sector workers).  Amongst this group there will be people with pre- dispositions to certain injuries and people with natural tolerance.  The only requirements are that, when you make a claim, be honest, and submit a medical opinion by arranging for your treating doctor to complete the Attending Physician’s Statement.

14.   Does the policy cover previous injuries?

No. The policy covers injuries which occur within the scope of the policy.

15.   Who is the insurer?

The insurer is AIG Group, the biggest insurer in the world.

16.   How does Journey Insurance interact with Workers’ Compensation or Motor Accident
Insurance (CTP)?

The PSA journey insurance policy is aimed at providing members with income support after a journey accident.  If you make a workers’ compensation claim or a motor accident claim (settlement has been known to occur several years later), and are later paid for this incident, you will be expected to repay from the settlement any funds paid under this insurance policy.

17.   How does the insurance interact with other insurances that I may have?

This insurance policy will be in addition to other insurance policies you may have, PROVIDED that the combined total compensation you receive under all policies, including AIG Journey cover, does not exceed 85% of your pre-disability income.

18.   What will be the process if I have a claim?

You must contact AIG directly.  The PSA will be unable to fill out the form for you or advise whether your claim will be accepted.  The following covers the various methods you can use to lodge a claim.

Email: Send the claim form, Attending Physician’s Statement and any supporting documentation to austclaims@aig.com.  The email box will confirm receipt and allocate a claim number.  Using email provides you with a record.

Online: visit www.aig.com.au/lodge-a-claim_920_213350.html and follow the instructions.

Phone: Contact AIG claims on 1800 339 663.  You will need to provide a written claim form and Attending Physician’s Statement.  As AIG is a large insurance company and has multiple types of policies, you will need to tell the AIG staff member answering your telephone call that the policy is a “Group Personal Accident Journey Cover”.

Members are reminded that when making a claim they should submit a completed claim form and supporting documentation.

19.   What is the Policy number and name?

Quote the PSA’s policy number 2200103082 for the Group Personal Accident Journey Cover.

20.   What are the timeframes for assessment of claims?

The timeframe is that payments should be commenced within a fortnight, once all the details/documents are provided to the insurance company.  A common reason for delay is that claimants do not provide all the relevant documentation.

21.   How is the claim paid?

The claim is paid fortnightly in arrears.

22.   Can I dispute a decision about my claim?

Yes.  AIG are committed to handling any complaints about their products or services efficiently and fairly.

If you have a complaint:

    1. Contact AIG on their dedicated complaints line: 1800 339 669.
    2. If your complaint is not satisfactorily resolved you may request that the matter be reviewed by AIG management by writing to:
       The Compliance Manager
      AIG
      Level 12, 717 Bourke Street
      Docklands VIC 3008
    3. If you are still unhappy, you may request that the matter be reviewed by AIG’s Internal Dispute Resolution Committee (“Committee”).  AIG will respond to you with the Committee’s findings within 15 working days.
    4. If you are not satisfied with the finding of the Committee, you may be able to take your matter to an independent dispute resolution body, Financial Ombudsman Service (FOS).  This external dispute resolution body can make decisions with which the AIG are obliged to comply.

     Contact Details are:

     Financial Ombudsman Service
     Phone 1300 780 808 (local fee applies)
     Email info@fos.org.au
     Internet: http://www.fos.org.au
     GPO Box 3, Melbourne, VIC 3001

23.   Where can I find more information on the PSA’s journey insurance and other insurance
policies?

The PSA’s Journey Insurance Policy

The other PSA insurance policy documents are on the PSA website.

The above information is subject to the relevant policy wording.  The advice is of general nature.  Each and every incident &/or scenario would be handled on a case by case basis and subject to its own merits and the terms and conditions of the policy wording.
Last Revised 20 May 2013

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