MSA PERSONAL ACCIDENT INSURANCE & MEDICAL EXPENSES COVER
Below is an important newsletter from MSA.
Please take note of the following :-
Three things to look out for. (1) They won’t cover you unless it’s an official MSA practise. (2) It must be a MSA sanctioned event.(3) If you suffer from any pre existing condition such as heart problems then they won’t cover you for an on track heart attack.
We recommend that people still pursue their own medical schemes in conjunction with the compulsory MSA medical insurance. Simply put if you crash at the Thursday practice you won’t be covered by the insurance even though the ambulance is there.
Your race entry is only VALID if paid in full BEFORE you go out on the circuit. You are NOT covered by MSA during an incident say during official practice if you have completed an entry form BUT not yet paid your full race fees
David Bolding
MSA PERSONAL ACCIDENT INSURANCE & MEDICAL EXPENSES COVER This document has been compiled to provide an overview on the cover in place for all MSA motorsport competitors. This is by no means the policy wording (which can be found on the MSA website) and hence will not have any bearing on any claims, but rather an explanation of the coverage available and a summary of important aspects relevant to you, including information relating to some of the common queries we have received in this regard.
For ease of reference, the current Group Personal Accident Insurance Policy will be referred to as “Policy” hereinafter and the minimum coverage available (R150,000) will be used as an example where relevant.
SUMMARY OF COVERAGE PROVIDED: As motorsport is known to be a hazardous sport, it is MSA’s duty to ensure that relevant safety aspects are provide for and adhered to in order to minimize the risk, and that appropriate measures and protocols are in place should the need arise. One aspect of this duty of care is to ensure that immediate medical treatment is available at the event and suitable medical transportation is readily accessible to enable further treatment and stabilization in an appropriate medical facility without any untoward delays.
Primary Coverage The Group Personal Accident Insurance Policy includes coverage of medical and other specified expenses incurred whilst attending any MSA sanctioned or approved event on a global basis. This Policy can be used as the primary source of coverage, hence indemnifying you against appropriate medical expenses until the cover limit is reached. In other words, should you belong to a medical aid, your medical savings funds do not need to be utilized in the first instance.
Cover Limits Each competitor is covered up to a certain limit as chosen by themselves when applying for their annual license. There are currently three cover options available, viz. R150,000, R250,000 and R500,000. Should you choose to take the minimum coverage available, this means that your medical expenses will be covered up to R150,000 should you have an accident at an MSA event. This cover limit is applicable to each and every claim, meaning that should you have an accident six weeks later, another R150,000 is available and so forth. The maximum amount one competitor can claim is R1,500,000 per annum.
Covered Events The Policy covers ‘accidental’ costs – costs incurred due to an accident at an MSA event. The costs incurred in respect of medical expenses, disability or death will be covered up to the limit chosen. The Policy also covers other specified ‘accidental’ costs, in addition to the basic cover limit chosen:Emergency rescue and transportation costs – additional R100,000 available to cover costs incurred by medical transportation, including a medical helicopter or aeroplane. This ensures that competitors injured in remote locations can be transferred to appropriate facilities and still have the benefit of the entire chosen cover limit towards medical expenses. Repatriation – an additional R100,000 towards returning an injured competitor to their home if ready to be discharged, or to a suitable facility for ongoing care. Wheelchairs and related costs – an additional R100,000 available to purchase a wheelchair and necessary motor vehicle modifications, and another R10,000 towards retraining in a suitable occupation. Temporary driver benefit – an additional R10,000 if unable to drive to and from work.. Child care benefit – a daily benefit paid out to a parent should they not be able to take care of their children. Trauma counseling – an additional R10,000 benefit. Death – an additional R20,000 benefit.
Exclusions
A few important exclusions to be highlighted:Expenses incurred due to a known medical condition. This means that if you are known with a heart problem and have a heart attack whilst racing, you will not be covered. Costs incurred at events not held under the auspices of MSA. Refusal to be treated by or follow the advice of the onsite medical staff. Injuries sustained whilst not at an MSA event – i.e. practicing for an event the following weekend. As with all insurance policies or medical aids, any costs incurred over and above the chosen limit will be for your own account.
CLAIMS PROCEDURE: Please refer to the full claims procedure as found on the MSA website. A few important points to note however: A competitor’s name must appear on the MSA Accident Report Form completed by the medics at the event for any claim to be considered. This confirms that a competitor was injured at a specific MSA event and not at any other time (see exclusions above). The importance of this is that if you are involved in an accident, no matter how trivial you think it may be, please make sure that you see the medic so that you can be included in this register. All aeromedical evacuation costs must be pre-authorized by MSA. The medic in attendance at the event is to contact the MSA Medical Panel President (Dr. Debbie van Niekerk – contact number on the back of every licence card) for authorization prior to activating any aeromedical provider. This is to ensure that the most appropriate medical provider is utilized and that the competitor is taken to the most appropriate medical facility based on probable injuries sustained. MSA must be notified of all claims within thirty days of the incident – the relevant claims notification form can be downloaded from the website, completed and emailed through. Each claim has an excess of R1,000 meaning that you are liable to pay the first R1,000 of each and every claim. As casualty fees are usually around this ball-park figure, we normally ask that the competitor settles the casualty and related bills and submits a claim for anything over and above the excess R1,000.BENEFITS OF THE POLICY: Medical Aid There are medical aid schemes that will cover costs incurred due to competitive motorsport, and hence we have had enquiries as to the benefits of this Policy over the coverage already in place.
A large proportion of costs are incurred on an outpatient basis, meaning that competitors are seen in casualty, have x-rays done and are generally treated in casualty then sent home – they are not often admitted into the hospital. As most casualty, radiology (x-ray) and pathology (blood tests) practices as well as Specialist surgeons and Physicians are either not contracted to medical aids or do not charge medical aid rates, they request that you pay them upfront and then claim back from your medical aid.
Whilst medical aid schemes will reimburse you for the costs paid, this will be from your medical savings funds and at their own predetermined rates. This means that in effect you are paying for all the costs yourself, and unfortunately depleting your savings fund at the same time, leaving little available for day-to-day medical expenses. MSA’s Policy ensures that your costs will be covered – the underwriter will pay for costs incurred on an outpatient basis and will reimburse you for the same amount that was paid (less the excess) and not at a pre-determined, lower rate; and that you retain your medical savings funds for expenses incurred due to non-motorsport injuries or illnesses.
Medical aid schemes do not offer any additional benefits apart from medical expenses coverage. This Policy has numerous additional benefits as listed above – death, disability, rehabilitation & retraining costs, childcare, driver services to name a few - an extra ±R350,000 on top of the medical expenses coverage. Certain medical aid schemes also have rigorous criteria and approval processes that need to be adhered to prior to the activation of aeromedical transportation. We had a case recently where an injured competitor required to be airlifted to hospital. It was thought that he held coverage through MSA’s policy and hence pre-authorization was sought and obtained. It then became apparent that he had elected not to take out MSA’s coverage as he was on a medical aid – who declined the request for an aeromedical transportation.
This Policy will cover you at both local and international events. Few medical aid schemes will cover you outside the borders of RSA should you have the opportunity of participating in international events.
Monthly premiums paid to medical aid companies are far in excess of the averaged R100 per month for medical expenses coverage under this Policy. To add to this, the medical savings that the schemes allocate per annum (approx. R4,000-R10,000 per adult member) is also far less than the minimum R150,000 offered per claim to each competitor with a maximum of R1,500,000 per annum. Hence, the averaged amount of R100 per month (a fraction of the costs of racing) for a R1,500,000 benefit is certainly a very competitive premium.
Insurance has been in place through MSA for over ten years, and hence well-defined relationships and policies exist. Provided the correct claims procedures are followed, MSA’s reimbursement is on average after two weeks of claim submittal. This is prompt in comparison with most medical aid schemes.
SUMMARY:
Given all the above, please ensure that you select the appropriate level of coverage when you apply for your licence. Although we all hope for an injury-free year, the inevitable does happen. Enjoy your racing, and above all, keep safe!
Regards, Dr Debbie van Niekerk President: Medical Panel
