Insured Person means each of:
in respect of cover under PAI, the Renter and an Authorised Driver; and
in respect of cover under PEB, the Renter, an Authorised Driver and any person travelling with the Renter and Authorised Driver, but excluding any hitchhiker.
Limb means the entire limb between the shoulder and the wrist or between the hip and the ankle. Non-Medicare Medical Expenses means:
Expenses that are not subject to any full or partial Medicare rebate nor are they recoverable by the Insured Person from any other source and are incurred within 12 calendar months of the Insured Person sustaining Injury;
They must be paid by the Insured Person and be for treatment certified necessary by a legally qualified medical practitioner, to a registered Private Hospital, physiotherapist, chiropractor, osteopath, nurse or similar provider of medical services;
They include the cost of medical supplies or ambulance hire;
They do not include the cost of dental treatment unless it is necessarily incurred to sound and natural teeth, other than first teeth or dentures, and is caused by Injury. Note: Non-Medicare Medical Expenses does not include any or part of any expenses for which a Medicare benefit is paid or is payable, nor does it include the balance of monies due or payable by the Insured Person after deduction of any Medicare benefit or rebate. (Commonly known as the “Medicare Gap”).
Refund Not Available: We shall not be liable to make any refund in respect of:
Any expense recoverable by the Insured Person from any other insurance scheme or any plan providing medical/physiotherapy or similar coverage or from any other source except for the excess of the amount recoverable from such other insurance plan or source;
Any expense to which Section 67 of the National Health Act 1953 (as amended) or any of the regulations made under it apply;
More than the specified percentage of each claim less all deductions and the Excess shown in Part C of the Table of Events;
Any expense which We are prohibited by Law from paying.
Our Total Liability shall not exceed in the amount specified in Part C of the Table of Events, in respect of any one Injury. PAI means the cover provided under Section 1 of this Policy. PEB means the cover provided under Section 2 of this Policy. Permanent means lasting 12 consecutive months and at the end of that period being beyond hope of improvement. Permanent Total Disablement means total disablement which continues for 12 consecutive months and at that time is certified by a registered and legally qualified medical practitioner (who is not the Insured Person or a family member) as being beyond hope of improvement and entirely preventing the Insured Person forever from engaging in any business, profession, occupation or employment for which he or she is reasonably qualified by training, education or experience. Policy Period means in relation to You, the period specified in the Policy Schedule and in relation to a Renter, it means the period of hire of a Avis Australia vehicle for the Avis Rental Period specified in the Rental Agreement. Renter means the person with whom You have made the Rental Agreement. Rental Agreement means the Avis Standard Rental Agreement or Avis Worldwide Master Rental Agreement that is in force when the Injury, loss or damage that gives rise to a claim under this Policy occurs. Temporary Total Disablement means that as a result of Injury the Insured Person is wholly and continuously prevented from engaging in his or her usual occupation and is under the regular care of and acting in accordance with the instructions or professional advice of a registered and legally qualified medical practitioner who is not the Insured Person or a family member. Terrorist Act – means any actual or threatened use of force or violence directed at or causing damage, injury, harm or disruption, or committing of an act dangerous to human life or property, against any individual, property or government, with the stated or unstated objective of pursuing economic, ethnic, nationalistic, political, racial or religious interests, whether such interests are declared or not. Robberies or other criminal acts, primarily committed for personal gain and acts arising primarily from prior personal relationships between perpetrator(s) and victim(s) shall not be considered Terrorist Acts. Terrorism shall also include any act which is verified or recognised by the (relevant) Government as an act of terrorism.
Total and Permanent Loss means the Permanent and total physical loss of the body part referenced in the Table of Events. Where that body part is a Limb, Total and Permanent Loss means the Permanent and total physical loss or loss of use of that body part referenced in the Table of Events in Section 1 of this Policy, or for an eye entire and irrecoverable loss of sight in that eye. War – means war, whether declared or not, or any warlike activities, including use of military force by any sovereign nation to achieve economic, geographic, nationalistic, political, racial, religious or other ends. We/Our/Us/Insurer means Chartis Australia Insurance Limited (Chartis) ABN 93 004 727 753, AFSL 381686. You/Your means W.T.H. Pty Limited ABN 15 000 165 855 trading as “Avis Australia”. Words in the singular include the plural and vice versa.
SECTION 1 – PERSONAL ACCIDENT INSURANCE (PAI) Cover under this Section is provided only if the Renter has signed the Rental Agreement accepting cover for PAI.
SCOPE OF COVER This Section of the Policy covers the Insured Person whilst he or she is:
the driver of an Avis Australia vehicle, or
entering through the driver’s door of an Avis Australia vehicle for the purpose of driving the vehicle, or
alighting through the driver’s door of an Avis Australia vehicle immediately after having driven the vehicle.
EXPOSURE If an Insured Person suffers an Event as a direct result of exposure to the elements, We will pay the Compensation shown for that Event.
DISAPPEARANCE If an Insured Person disappears and after twelve calendar months it is reasonable for Us to believe they have died due to an insured Injury, We will pay the Compensation shown for Event 1 (Death) subject to receipt of a signed undertaking given by the legal personal representative of the Insured Person that any such Compensation shall be refunded if it is later demonstrated that the Insured Person did not die as a result of an Injury.
SPECIAL PROVISIONS FOR PAI
Compensation payable under Event 1 (Death) is payable to the Insured Person’s legal personal representative. All other compensation is payable to the Insured Person(s).
In respect to the Capital Benefits in Part A of the Table of Events:
In the event of multiple Injuries sustained in the same accident and more than one Event can be claimed, only one Event will be compensated.
If an Insured Person suffers an Injury resulting in any one of the Events 2 to 9 We will not be liable under this Policy for any subsequent Injury to that Insured Person.
Any Compensation payable for Events 2 to 19 listed in Part A of the Table of Events shall be reduced by any Compensation already paid under Event 20 in Part B of the Table of Events in respect of the same Injury.
Compensation is not payable:
For more than one of the Events under Part B of the Table of Events [Weekly Injury Benefit] in respect of the same period of time.
To more than one Insured Person in the event an accident causes Injuries to more than one Insured Person.
For longer than 52 weeks in respect of the Events in Part B of the Table of Events - [Weekly Injury Benefit] as regards any one Injury.
Unless as soon as possible after the happening of any Injury giving or likely to give rise to a claim, the Insured Person obtains and follows proper medical advice from a registered and legally qualified medical practitioner who is not the Insured Person or a family member.
WEEKLY BENEFITS LIMITATION For each Insured Person, the Compensation payable under Part B of the Table of Events [Weekly Injury Benefit] is limited to the amount stated in Part B of the Table of Events or the Insured Person’s weekly Income, whichever is the lesser. If the Insured Person is entitled to receive:
Weekly or periodical disability benefits under any other policy of insurance; and/or