QBE Insurance (Australia) Limited ABN 78 003 191 035 Corporate Travel Policy Schedule Insured Name: Cycling Australia., BMX Australia Inc, (CA upgrade licence only) Mountain Bike Australia Inc including all clubs, financial members, temporary members (for events) officials, accredited coaches, event promoters and race directors when working for and on behalf of Cycling Australia Inc and Mountain Bike Australia Inc Period of Insurance: From 30/11/2014 to 30/11/2015 at 4:00 PM Policy Number: AN A042332 PAD Policy Wording: QM184-0612 - Corporate Travel Insured Person: Insured Persons Category 1: All members who have been issued with an international license or travelling with the approval of Cycling Australia (International Licence Holders) or to a sanctioned event approved by Cycling Australia. The cover includes training and competitive cycling and any associated holiday travel. All registered members, nonparticipating officials, Judges, Committee members and all other Employees of the insured not covered by Category 2 including apprentices, voluntary workers and work experience students. Insured Persons Category 2: Directors, Executives, Managers, Coaches, Authorised members and their accompanying spouses and/or partners and dependent children, whilst engaged on authorised business travel as declared. The cover includes training and competitive cycling and any associated holiday travel or overseas leisure travel. Time of Operation of Cover: Authorised Business Travel shall mean a Journey to an overseas or interstate destination and shall start from the time of leaving home or normal place of business (whichever is left last) and continue until arrival back home or normal place of business (whichever is reached first) in Australia. Everyday commuting shall not be regarded as a Journey. The Journey(s) must commence during the Period of Insurance, must be undertaken on Your behalf for a business purpose, must be less than 180 consecutive days in duration, must be authorised by You, and must involve an overnight accommodation or travelling a distance greater than 100 kilometres. A journey includes associated holiday travel or overseas leisure travel, for all Insured Person(s) provided it forms part of authorised business travel. Coverage is extended to include pure leisure travel for Directors (not otherwise associated with business travel), including the Director’s accompanying spouses or partners and dependent children Territorial Limits: Worldwide Aggregate Limit of Liability: Any one accident or series of accidents arising out of the the one event. The limit applies to Sections A, B, C, H, I, M and Additional Covers $ Overseas Medical and Additional Expenses 5,000,000 Unlimited Personal Liability $ 10,000,000 Loss of Deposits 10,000 Additional Covers - 1. Extra Territorial Workers $ 500,000 Additional Covers - 2. Environmental and Natural Disaster $ 500,000 Additional Covers - 3. Political Evacuation cover $ 500,000 We will not pay more than the amount stated for all claims under Section A arising out of or in connection with a charter aircraft, a light aircraft and or a helicopter $ 500,000 QBE Insurance (Australia) Limited ABN 78 003 191 035 Schedule of Benefits AN A042332 PAD PAD Maximum Individual Compensation (Each Insured Person) A B Capital Benefits (Payable conditions 1-30) Category 2 Only 7 Times Salary up to a maximum of $ 500,000 $ 3,000 Weekly Benefits -Benefits - Injury Category 2 Only Weekly Benefits - 85% of earnings up to a maximum of: Excluded period of claim is 7 days each and every period of disablement We will continue to pay weekly benefits up to a maximum of 104 weeks C Weekly Benefits -Benefits - Illness Not Insured F Overseas Medical and Additional Expenses Medical expenses Unlimited Emergency dental expenses up to $5,000 Emergency optical expenses up to $5,000 Additional expenses as per policy wording G Emergency Travel Assistance as per policy wording H Baggage and Personal Effects $ 5,000 Limit any one item $1,250 except for Sunglasses / Glasses where the limit is $1,000 Excess NIL Deprivation of Baggage $3,000 I Personal Money Travellers Cheques and Credit Cards $ 5,000 J Personal Liability $ 10,000,000 K Kidnap & Ransom & Personal extortion $ 500,000 L Loss of Deposits and Additional Expenses $ 10,000 Cancellation/interruption expenses Excess of $200 for each and every claim applies $ Additional expenses M 100,000 as per policy wording Refund of Excess following Collision Damage or Theft $ 5,000 Additional Covers under Policy Wording 1 Extra Territorial Cover Weekly Amount $ 1,000 Maximum limit for any one person $ 500,000 Common Law Limit $ 500,000 Aggregate Limit $ 1,000,000 2 Environmental and Natural Disaster Evacuation cover Any one Event $ 500,000 3 Political Evacuation cover Any one Event $ 500,000 QBE Insurance (Australia) Limited ABN 78 003 191 035 Additional Benefits contained within QM184-0612 - Corporate Travel: This applies to Category 2 Insured Persons Only Broken Bones Additional Capital Benefit - up to $10,000 Disappearance Additional Capital Benefit - aligned to Death Benefit within Section A Lifestyle Modification Additional Capital Benefit - up to $20,000 Surgical Procedures Additional Benefit (resulting form injury or illness) - up to $20,000 Rehabilitation Additional Benefit (resulting from injury or illness) - up to $10,000 Claims Escalation Additional Benefit (resulting from injury of illness) - index benefit by 7% or CPI which ever is the lesser after 52 weeks of benefits For full details of terms, conditions and limits applicable to these benefits, please refer to the policy wording. Endorsements attaching to and forming part of this Policy Schedule: 1. Section A:- Death and Capital Benefits cover for dependent children. The maximum benefit we will pay under this section of the policy in the event of Death of an accompanying dependent child as a result of an injury under 18 years of age will be $10,000 No benefits are payable under Section B or C to accompanying spouses or travelling companion and/ or dependant children. These benefits are subject to the policy aggregate limit of liability. 2 3 Definition Professional / Elite Athletes It is hereby agreed and declared that the following Definition will apply to this policy: Individual(s) who represent Australia at Olympic Games and/or Commonwealth Games; and/or when representing a listed UCI World Tour Team (including but not limited to the Tour de France, the Giro d’Italia, the Vuelta a España - as well as prestigious international one-day classics). For those members there are no benefits in respect to Medical Expenses under Section F whilst competing only. All other benefits are covered. Definition Sanctioned Event A sanctioned event is a 'Race', 'Ride' or 'Training' activity conducted under endorsed protocols of an affiliated entity of Cycling Australia and when all the participants in that event are members of CA or MTBA. An affiliated entity includes a State, Association, Club or registered promoter who has satisfied their terms of affiliation. A race is a competitive cycling event where placings and times may be awarded. 4 Difference in condition (DIC) / Difference in limits (DIL) It is hereby declared and agreed that we guarantee to provide as a minimum no less cover in conditions and limits than the coverage that exists under the expiring Cycling Australia Inc. Sports Injury and Business Travel policy through Savannah Insurance Agency Pty Ltd on behalf of certain Underwriters at Lloyd’s which expired 30th November 2014. 5 Section M Refund of Excess following Collision Damage or Theft This section is extended to include a trailer. 6 Special Note It is hereby declared and agreed that with respect to Category 1 Insured Persons who are travelling beyond 180 days the definition of Journey is amended as follows "Journey shall mean any trip involving an overseas destination and shall start from the time of leaving home or normal place of business". The maximum duration of any one trip shall be 365 days. For any trip exceeding 180 days, coverage we will provide ongoing Medical Expenses incurred after the Insured Person(s) returns to Australia provided they relate to the condition which first manifests itself during the journey and subject to not contravening the Health Insurance Act 1973 (Cth), the Private Health Insurance Act 2007 (Cth) or the National Health Act 1953 (Cth). If the Insured Person does not immediately return to Australia as soon as they are medically cleared to do so, medical expenses will be capped at a maximum of $20,000 if the member remains in the USA and $50,000 as per policy wording if they remain anywhere else in the world. 7 Additional benefit - travel expenses and accomodation. If an Insured Person sustains an injury and is admitted as an inpatient of a hospital, which is more than 100 kilometres from the Insured Person's normal place of residence, we will pay reasonable accommodation and transport expenses incurred by their spouse or partner and / or dependent children to travel to or remain with the Insured Person. In the event the Insured Person is a dependent child, this endorsement will extend to cover the Insured Person's parents or legal guardian. 8 Participation Exclusion General Exclusion 5 participating in or training for any professional sport is deleted. Privacy QBE includes information about how we manage your personal information in our Product Disclosure Statement and Policy booklets. You can obtain a copy of the QBE Privacy Policy Statement from our website www.qbe.com or contact the Compliance Manager via email: compliance.manager@qbe.com for further information. Duty of Disclosure - What you must tell us Under the Insurance Contracts Act 1984 (the Act), you have a Duty of Disclosure. The Act requires that before a policy is entered into, you must give us certain information we need to decide whether to insure you and anyone else to be insured under the policy, and on what terms. Your Duty of Disclosure is different, depending on whether this is a new Policy or not. Renewals, variations, extensions and reinstatements QBE Insurance (Australia) Limited ABN 78 003 191 035 3 Once your Policy is entered into and is no longer new business then your duty to us changes. You are required before you renew, vary, extend or reinstate your Policy, to tell us everything you know and that a reasonable person in the circumstances could be expected to know, is a matter that is relevant to our decision whether to insure you, and anyone else to be insured under the Policy, and if so, on what terms. • You do not have to tell us about any matter – that diminishes the risk – that is of common knowledge – that we know or should know in the ordinary course of our business as an insurer, or – which we indicate we do not want to know. • If you do not tell us If you do not comply with your Duty of Disclosure we may reduce or refuse to pay a claim or cancel your Policy. If your non-disclosure is fraudulent we may treat this Policy as never having worked. This Policy is underwritten by QBE Insurance (Australia) Limited ABN 78 003 191 035 of 2 Park Street, Sydney 2000 QBE Insurance (Australia) Limited ABN 78 003 191 035
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