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Group personal
accident insurance
Adult and youth football teams | Summary of benefits
Basic and Superior policy summary
Valid from 1 July 2013
Appointed by The FA
Protection for your most
valuable assets
As The FAs appointed broker to deliver the
National Game Insurance Scheme, we have worked
in conjunction with The FA and County Football
Associations to create personal accident products
for adult and youth football teams.
Why have personal accident
insurance?
If you become injured whilst participating in a club
activity, you can incur significant financial losses as
a result. Personal accident insurance can help offset
some of these unexpected expenses. This insurance
can pay out a set amount if someone is injured in an
accident and the payout can be a lump sum or a
weekly amount.
About Bluefin Sport
We are a national provider of insurance and risk
management solutions to the world of sport and
our approach has helped to make us one of the UK’s
leading sport insurance brokers.
We are currently the number one provider of football
insurance in the UK with clients ranging from grassroots
through to the professional levels of the game.
“Working alongside Bluefin Sport,
The FA hopes to significantly
improve the insurance available
to the national game”
Kelly Simmons,
Director of National Game and Women’s Football
It ensures all participants have protection in the event
of an injury and because this is a non negligence cover
it can help reduce litigation in the game. For example,
unlike a liability policy you do not have to find someone
to be at fault for an injury to receive compensation.
When does cover apply?
Although you can purchase insurance at any time, your
cover will not start until the 1 July 2013 (or later if you
apply after 1 July). All policies whenever bought will
expire on 30 June of each given year and will renew
annually. This is to fall in line with County FA affiliation
processes.
NOTE: If you purchase your policy after 1 October 2013 your premium will be
calculated on a pro rata basis to reflect the time on cover to the 30 June. This will be
calculated automatically online and return premiums are issued if applying by post).
The policies operate whilst at any ground or premises
worldwide (please see exclusions) where there is an
agreed fixture or training and includes travelling directly
to and from such activities. In addition the policy cover
has been extended to include all club social events
(please see exclusions).
The life cover is included and operative whilst training
and playing football matches only.
Our partnership with The FA
Who is covered?
Testament to our success in football was our
appointment by The FA as the approved insurance
broker to deliver the National Game Insurance Scheme
(NGIS). Alongside other products, the provision of
personal accident insurance forms a major part of the
NGIS. Together with The FA, we want to encourage this
additional protection for all those involved in the game.
The policy automatically includes:
• players.
• trainers.
• committee members.
• club officials.
• managers.
If you require cover for a veterans team contact us at
[email protected] or 0845 872 5060.
Appointed by The FA
Cover designed to suit your
requirements
We offer a ‘Basic’ or ‘Superior’ package for both adult
and youth teams. This means you can pick and choose
the levels of benefits you need and what you can afford.
Basic or Superior?
Basic
Basic cover is our minimum benefit level entry policy to
provide a cost effective solution for those operating on a
low end budget. It does not include any weekly benefits.
The cover provides:
Supporting grassroots football
• Cover for serious and long term injuries.
By joining the many thousands of clubs already insured
via the NGIS you are helping to provide grassroots
football with lower costs. By purchasing these products
and supporting the NGIS you are helping to secure a
sustainable future for the national game.
• Options to upgrade to Basic Extra to include a broken bones benefit (adult team option only).
Why choose us?
Superior
Superior cover options are for those looking to increase
benefit levels and tailor the cover to suit their needs.
The cover provides:
• All the Basic cover benefits plus a vast range of additional benefits covering both long term and short term injuries.
• We’re The FAs appointed broker and provide the
official National Game Insurance Scheme products.
• 60% of County Football Associations and The FA
recommend us.
• Ability to buy online or apply by post.
• Supporting The FAs new Whole Game System (WGS).
• Choice of a weekly benefit amount for adult teams.
• No pre-existing condition exclusions in respect of
accidental bodily injury (with exception of dislocations).
• Ability to include a range of optional extra benefits.
• No limit to number of players/club officials in a team.
What are the main exclusions?
• Wide policy wording definitions.
• lnfluence of alcohol, solvents, drugs or medication
unless prescribed.
• Being a professional footballer.
• Member of the armed forces.
• Engaging in a criminal act, riot or civil commotion.
• Motorcycling other than mopeds or scooters up to 50cc.
• Club social events that include fireworks, bonfires,
driving events, bouncy castles, water sports or any
activity above 3 metres off the ground.
• Travel to Afghanistan, Iraq, Ivory Coast, Somalia,
Nigeria, Pakistan, Venezuela, Columbia, Mexico, Yemen
or Chechnya.
Please see the policy for full details of exclusions.
• Permanent total disablement from usual occupation.
(This means the benefit is paid out if you are unable to
continue your current (usual) job due to disablement.
Many policies only pay this benefit if you are unable to
undertake any job again).
• Long benefit periods. and range of options to tailor the
policy cover.
• Legal and counselling advice helplines included at
no additional cost providing support when you need
it most.
• BACS claims payment (optional).
• Monthly instalments available for premiums of £80
and over. Online only over 5 months at 6% (APR
Typical 21.7%).
‘A&E departments in England have seen a 14% rise in sports injury
cases in a year. Just over 388,500 cases were treated in the 12
months to February 2012’
Source: NHS
The policy benefits
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Helping to spread the costs
We understand that the current economic climate
provides many financial challenges for grassroots clubs
and their members.
If you purchase your cover online, we can provide a
competitive monthly instalment facility enabling you to
spread the cost of your insurance over 5 months at 6%
charge (APR Typical 21.7%) for premiums of £80
and over. For example:
Adult team covers
Basic
Option to include:
£26per team
Basic Extra
Superior 30 = £82 per team. 5 x payment of £17.38 a
month per team, which includes the 6% charge of £4.92).
• Accidental death
£30,000
• Life cover
£7,000
Visit bluefinsport.co.uk/ngis to get a quote today.
• Permanent total
disablement1
Up to
£50,000
Clubs will experience additional claims payment
efficiency with the insurers optional BACS payment
facility ensuring injured persons receive benefit
payments direct to their bank account.
This statement does not constitute advice or a personal
recommendation for our personal accident insurance
products. Should you require advice please contact us.
The next step
Details of the premiums and covers can be found in
this document. For instant quotations and cover visit
our website where you will also find useful information
relating to the NGIS.
Please contact our dedicated team if you require any
advice or assistance.
0845 872 5060
[email protected]
bluefinsport.co.uk/ngis
per team
•Broken bones benefit £50
(legs, collar arms &/or cheek)
• Loss of sight in one
or both eyes
£30,000
• Loss of one or more
limbs
£30,000
1
Many personal accident policies will only pay under this benefit if you are
100% disabled but our policy will pay a percentage relative to your level of
disability - this is known as permanent partial disablement.
Your demands and needs
The level of cover you choose will dictate whether
cover includes a weekly benefit for temporary disability
in addition to the one-off lump sums for permanent
disability. The levels of cover are explained more fully
on the following pages.
£20
(including permanent
partial disablement)
Efficient claims service
This product is designed to meet the demands and
needs of football clubs that wish to protect their
members against consequences of accidents whilst
playing in, training for or travelling to a club fixture
resulting in accidental; injury, death or disability.
Additional
Policy notes:
(TTD = Temporary Total Disablement)
The maximum age limit for players is 55 and club officials 75 years of
age. If you have any players and officials above this age please refer
to Bluefin sport as cover may be arranged for them. Life Cover will
commence at attainment of 6 years of age and will cease at attainment
of 50 years of age.
•
2
Cover excludes the first 14 days of incapacity. If insured persons
are not in paid employment but is a student then a maximum benefit
of £25 per week is payable with a 6 week benefit period. The TTD
benefit only applies to an insured person who are in paid employment
of 16 hours per week or more.
• The TTD benefit does not apply to those individuals without paid
employment or who are employed less than 16 hours per week or
whose sole employment is football
• There is no cover for professional footballers.
• Aggregate limit £2,000,000. (This is the maximum amount that the insurer, ACE, will pay per event in total under this and any other policies issued by ACE)
Which policy should I get?
Sadly we experienced a claim for the accidental death benefit in
the 2012/13 season which highlights why it remains so vital to have
at least the Basic level of cover in place for your team(s).
Thankfully incidents of this nature aren’t a common occurance but
the short term injuries, such as a broken arm or leg can be. This
can lead to time off work if you are an adult in employment or
additional costs if you need to take time out to care for an injured
youth player.
To ensure you provide wider protection for your players and
officials you should consider purchasing the ‘Superior’ range of
benefits. You still receive all the Basic benefits but you can include
many more meaningful benefits for the more common incidents.
The premiums shown are inclusive of Insurance Premium Tax of 6%. Exclusions and limitations apply. For full terms and conditions please contact Bluefin Sport.
© Copyright 2013 Bluefin Insurance Services Limited. All Rights Reserved.
By purchasing these products you are helping to provide grassroots
football with lower costs. With your support of NGIS you are
helping to secure a sustainable future for the national game.
Instalments - pay over 5 months for premiums of £80 or more.
Available for online purchases only.
Superior
Choose a weekly benefit:
Includes all ‘Basic’ benefits:
• Accidental death
£30,000
• Life cover
£7,000
• Permanent total
disablement1
Up to
£50,000
(including permanent
partial disablement)
Superior 30
£82per team to include:
• TTD weekly benefit2 £30 per wk
Superior 50
• Loss of one or more
limbs
£30,000
£140per team to include:
£30, £50, £75,
£100 or £150
Benefit period 104 weeks
£100
(legs, collar arms &/or cheek )
£100
AS STANDARD FOR 2013/14
• Loss of speech
£30,000
• Loss of hearing both
ears
£30,000
• Loss of hearing one ear
£6,250
NEW for 2013/14
• Loss of internal organ
£30,000
• Emergency dental (pain
relief)
Up to £100
• Emergency medical
expenses
£500
• Rehabilitation and
retraining
Up to £2,500
• Home/car adaptation
expenses
Up to £10,000
• Extra travel expenses
Up to
£25 per week
Benefit period 4 weeks
• Coma benefit
• Physiotherapy. 50% of costs up to
max £25per week/6 sessions
average £
per person
Superior 75
£170per team to include:
• TTD weekly benefit2 £75 per wk
Superior 100
£220per team to include:
• TTD weekly benefit2 £100 per wk
Superior 150
£290per team to include:
• TTD weekly benefit2 £150 per wk
TTD = Temporary Total Disablement
This product is sold per team not per
person. The amounts below are purely
to illustrate the average cost per person
for a year based on an average sized 11
a side team of 15 members:
Basic
£1.73 per person
Basic Plus
£3.07 per person
Superior 30
£5.47 per person
Superior 50
£9.33 per person
Superior 75
£11.33 per person
Superior 100
£14.33 per person
Superior 150
£19.33 per person
Please note: Our policies do not
have a restriction on numbers within
a team so even greater savings per
person can be achieved if you have
more than 15 members in each team.
Do you have players over 55? No problem.
Call us on 0845 872 5060
£25 per day
Benefit period 365 days
• Hospitalisation
per team
• TTD weekly benefit2 £50 per wk
Plus the following:
• Primary dislocation
of kneecap, elbow,
shoulder or hip INCLUDED
£35
• Increase broken bones benefit
from £100 to £250
• Include dental expenses following
an accident up to £250
£30,000
• Broken bones
Superior Extra
Additional
• Loss of sight in one or
both eyes
• Choice of weekly
TTD benefit2 level
Option to include:
£25 per day
Benefit period - 30 days
• Legal advice and
counselling helplines
24/7
• Home help
(TTD extension)
Includes being a
f/t housewife or
househusband as
an occupation
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bluefinsport.co.uk/ngis
Please note: £5 administration fee will need to be added to the total premium for all postal applications
The policy benefits
Youth team covers
1. Choose Basic or Superior cover
2. Decide if you wish to
Please note that steps 2 and 3 only apply if Superior cover selected
Superior Silver
Superior Gold
£14 per U13’s team & above
£23 per U13’s team & above
£10 per U12’s team & below
or £16 per U12’s team & below
£31 per U13’s team & above
• Accidental death
£10,000
• Accidental death
£10,000
• Accidental death
• Life cover
£7,000
• Life cover
£7,000
• Life cover
£7,000
Up to £30,000
• Permanent total
disablement1
Up to £50,000
Basic
• Permanent total
disablement1
Up to £25,000
(including permanent
partial disablement)
• Loss of sight in
one or both eyes
• Permanent total
disablement1
• Loss of sight in one
or both eyes
£10,000
(including permanent
partial disablement)
(including permanent
partial disablement)
£25,000
or £23 per U12’s team & below
£25,000
• Loss of sight in one
or both eyes
£50,000
• Loss of one or
more limbs
• Loss of one or more
limbs
£25,000
• Loss of one or more
limbs
£50,000
£25,000
• Loss of speech
£25,000
• Loss of speech
£25,000
• Loss of speech
£50,000
• Loss of hearing (both ears)
£25,000
• Loss of hearing (both ears)
£50,000
• Loss of hearing (one ear)
£6,250
• Loss of hearing (one ear)
£12,500
• Loss of internal organ
£6,250
• Loss of internal organ
£12,500
• Emergency medical
expenses
£100
• Emergency medical
expenses
£200
• Emergency dental
£100
• Emergency dental
£200
1
any personal accident policies will
only pay under this benefit if you are
100% disabled but our policy will pay
a percentage relative to your level of
disability - this is known as permanent
partial disablement.
(pain relief)
(pain relief)
It does happen!
A ball hit a young boy direct in the face
causing a detatched retina. The policy
paid out £50,000 under the loss of sight
benefit and the club paid just £26 for the
insurance.
£200
£100
• Broken bones
£50
• Broken bones
• Rehabilitation and
retraining
Up to £2,500
• Rehabilitation and
retraining
up to £2,500
• Home/car adaptation
expenses
Up to £10,000
• Home/car adaptation
expenses
Up to £10,000
• Weekly benefit2
for club officials
(Temporary Total
Disablement -TTD)
£50 per week
• Weekly benefit2
for club officials
(Temporary Total
Disablement -TTD)
£50 per week
• Broken bones
(legs, collar, arms &/or cheek)
• Broken bones
(fingers and toes)
£15 per day
• Hospitalisation
£25 per day
• Coma benefit
24/7
• Legal advice and
counselling helplines
Benefit period -30 days
• Coma benefit
Benefit period - 365 days
• Legal advice and
counselling helplines
£50
(fingers and toes)
Benefit period 52 weeks
3
14 day deferment period
Benefit period 52 weeks
3
14 day deferment period
• Hospitalisation
(legs, collar, arms &/or cheek)
£15 per day
Benefit period -30 days
£25 per day
Benefit period - 365 days
24/7
The premiums shown are inclusive of Insurance Premium Tax of 6%. Exclusions and limitations apply. For full terms and conditions please contact Bluefin Sport.
© Copyright 2013 Bluefin Insurance Services Limited. All Rights Reserved.
To ensure you are buying the official NGIS
products make sure you look out for this logo...
Instalments - pay over 5 months for premiums of £80 or more.
Available for online purchases only.
3. Choose any optional extras
increase benefit levels
(not available if Basic cover only selected.)
Youth Weekly 16-18yr olds
Superior Platinum
£16 per team of
or £27 per U12’s team & below
£10,000
• Life cover
£7,000
• Permanent total
disablement1
Up to £75,000
Additional
£10
per U13’s & above
team or £8 per U12’s team & below
• Expenses relating to home
tuition or necessary additional
expenses to attend school
following an injury.
• Weekly benefit (temporary
total disablement) £35 per
week for 16 to 18 year olds
employed for at least 16 hours
or more. (Benefit period 52
weeks. 14 day deferment period 3).
(including permanent
partial disablement)
• Loss of sight in one
or both eyes
£75,000
• Loss of one or more
limbs
£75,000
Parent / Legal Guardian
Inconvenience Benefit
• Loss of speech
£75,000
• Loss of hearing (both ears)
£75,000
per U13’s & above
Additional
team or £3 per U12’s team & below
• Loss of hearing (one ear)
£18,750
• Loss of internal organ
£18,750
• Emergency medical
expenses
£250
• Emergency dental
£250
(pain relief)
Student Tutorial
Additional
16 to 18 yr olds
£36 per U13’s team & above
• Accidental death
• Up to £35 per week after 7
days, 26 week period.
Physiotherapy
£6
£4
per U13’s & above
Additional
team or £5 per U12’s team & below
• Up to £100 in the event of
unforeseen travel costs in the
event of an accident.
• 50% of costs up to max £25 per
week/6 sessions.
Policy notes:
£50
• The maximum age limit for players is 18 and club officials 75 years of age. If you have
any players and officials above this age please refer to Bluefin Sport as cover may be
arranged for them. Life cover will commence at attainment of 6 years of age and will
ceases at attainment of 50 years of age.
• Rehabilitation and
retraining
up to £2,500
•
• Home/car adaptation
expenses
Up to £10,000
• Weekly benefit2
for club officials
(Temporary Total
Disablement -TTD)
£50 per week
• Broken bones
£250
(legs, collar, arms &/or cheek)
• Broken bones
(fingers and toes)
£15 per day
£25 per day
Benefit period - 365 days
• Legal advice and
counselling helplines
• 3 Deferment period refers to the period at the beginning of a period of temporary
total disablement during which benefits are not payable.
• There is no cover for professional footballers.
Benefit period -30 days
• Coma benefit
If insured persons are not in paid employment but is a student then a maximum
benefit of £25 per week is payable with a 6 week benefit period. The TTD benefit only
applies to club officials who are in paid employment of 16 hours per week or more.
• The TTD benefit does not apply to those individuals without paid employment or who
are employed less than 16 hours per week or whose sole employment is football.
Benefit period 52 weeks
3
14 day deferment period
• Hospitalisation
2
24/7
• Aggregate limit £2,000,000. (This is the maximum amount that the insurer, ACE, will
pay per event in total under this and any other policies issued by ACE).
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Or visit
bluefinsport.co.uk/ngis
Please note: £5 administration fee will need to be added to the total premium for all postal applications
At a glance glossary...
Accident & accidental
Means a single, sudden, unusual, and unexpected event, which
occurs at an identifiable time and place during the period of
insurance and which causes bodily injury.
Accidental death
Death caused by accidental bodily injury.
Effective time
Whilst at any ground or premises worldwide where there is an
agreed fixture or organised training including travelling directly to
and from such activities. Cover has been extended to include club
social events but excluding hazardous events such as, fireworks,
bonfires, driving events, bouncy castles, water sports or anything at
a height above 3 metres from ground level e.g. bungee jumping.
Aggregate limit
The maximum amount that the insurer will pay per event in total
under this and any other policies issued by the insurer to the insured.
The life cover is operative whilst training and playing football
matches only.
Basic
The name of our range of products designed to provide the
minimum basic levels of insurance.
Emergency dental (pain relief expenses)
External oral impact which results in damage to the insured person’s
teeth which necessitates immediate emergency pain relief. This
does not cover any other procedure other than the relief of pain.
Benefit period
Means the maximum (but not necessarily consecutive) period for
which benefits are payable in respect of any insured person for
any one accident. The benefit period commences at the end of the
deferment period, if any.
Emergency medical expenses
If an insured person incurs any additional reasonable emergency
medical expenses for immediate and urgent treatment, the insurer
will reimburse the insured person up to the amount shown in the
policy.
Bodily injury
Injury which is caused solely by accidental means and which
independently of illness or any other cause occurs within 12 months
from the date of the accident.
Excess
An amount you pay towards a claim or that is deducted from the
settlement.
Broken bones (adult policies)
A lump sum benefit is paid if an accident occurs causing bodily
injury and the insured person fractures one or more of the bones
listed below:
i) Leg (femur, tibia, fibula), ankle (tarsals) or kneecap (patella)
ii) Arm (humerus, radius, ulna) or wrist (carpals)
iii) Cheek bone (malar)
iv) Collar bone (clavicle)
Broken bones top up (optional superior extra adult policies)
The insurer will pay the insured person an additional amount on top
of the Broken Bones benefit specified above.
Broken bones (youth policies)
A lump sum benefit is paid if an accident occurs causing bodily
injury and the insured person fractures one or more of the bones
listed below:
i) Leg (femur, tibia, fibula), ankle (tarsals) or kneecap (patella)
ii) Arm (humerus, radius, ulna) or wrist (carpals)
iii) Cheek bone (malar)
iv) Collar bone (clavicle)
v) Finger or toe
Coma benefit
Where bodily injury results in coma, insurers will pay the insured
person the amount shown in the schedule for each day the insured
person remains in a coma up to 365 days.
Club officials
Includes managers, trainers, referees, committee members and
assistant referees.
Deferment period
A period at the beginning of a period of temporary total
disablement during which benefits are not payable
Dental injury
If an accident occurs during the period of insurance and effective
time and causes bodily injury to an insured person and directly
results in the loss of permanent natural teeth, insurers will pay up
to the amount in the policy for all teeth lost or partially lost. Claims
for partial loss of tooth or teeth shall be calculated by assessing
the percentage of tooth lost in relation to the maximum benefit
payable. This cover does not apply to deciduous (milk) teeth, dental
implants, crowns, veneers, dentures, bridges or intra orally wear
and tear of teeth.
Extra travel expenses (adult policies)
Additional reasonable travel expenses incurred up to an amount
provided per week for a maximum period of time as shown in the
policy.
Home / car Adaptation and home relocation expenses
Where bodily injury results in quadriplegia or paraplegia, and the
benefit for permanent total disablement becomes payable, insurers
will also indemnify the policyholder for expenses incurred, up to the
amount shown in the policy, for adapting the insured person’s home
or car or for relocating to another home to cater for the practical
changes involved in living with the disablement.
Home help (adult policies)
Temporary total disablement cover includes insured persons whose
occupations are as full time house wives or house husbands.
Home tuition (youth policies)
Up to the amount shown in the policy for expenses which relate to
providing a home tutor or necessary additional expenses required
to attend school where the insured person is a student.
Hospitalisation
Payable for injuries independent of illness or any other cause,
results in their hospital confinement, within twelve calendar months
from the date of the accident, insurers will pay the insured person
for each complete twenty-four hour period of such hospital
confinement up to a maximum benefit as shown in the policy.
Inconvenience benefit (youth policies)
In the event of unforeseen travel expenses for parents/legal
guardians due to an accident the insurers can pay up to the amount
shown in the policy.
Insurance Premium Tax (IPT)
A levy that is a percentage of your premium (currently 6%) applied
by the government. This excludes life insurance where there is
0% insurance premium tax applicable. The tax payable is shown
as a separate charge on your documentation (Isle of Man and the
Channel Islands are exempt from this tax). These insurance policies
are exempt from VAT (Valued Added Tax).
Legal advice helpline
During the period of insurance the insured person may obtain
personal legal advice over the telephone. The advice may include
but is not limited to:
a) Advice where injury has been caused by the negligence of a third party.
b) Advice on employment issues including redundancy, bullying,
harassment, unfair discrimination and retirement.
Life cover
A specific sum payable to the insured person’s beneficiaries after
the insured person’s death (whilst playing and training only), the
benefit is payable provided the insured person’s death was not an
accidental death. Life cover will commence at attainment of 6 years
of age and will cease at attainment of 50 years of age.
Loss of hearing
Total and irrecoverable deafness confirmed by audiometer and
sound threshold tests.
Loss of internal organ
Total and permanent:
a) loss by removal: or
b) effective loss of use of one lung or one kidney, the spleen or the liver.
Loss of limb
In respect of:
a) an arm – amputation or complete and permanent loss of use at or above the wrist;
b) a leg – amputation or complete and permanent loss of use at or above the ankle (talo-tibial joint).
Loss of sight
To be deemed to have occurred:
a) in both eyes when the insured person’s name has been added to the register of blind persons maintained by the government on the authority of a qualified ophthalmic specialist; or
b) in one eye when the degree of sight remaining after correction is 3/60 or less on the Snellen Scale (which means the insured Person is only able to see at 3 feet that which they should normally be able to see at 60 feet) and ACE is satisfied that the condition is permanent and without expectation of recovery.
Loss of speech
Total and permanent loss of speech.
Material Fact
You must ensure that all of the information provided to the
insurer in the application form, by correspondence, over
the telephone, on claim forms and other documents is true,
complete and accurate. You should note that providing
incomplete, false or misleading information could affect the
validity of the ACE insurance policy and may mean that all or
part of a claim may not be paid.
Physiotherapy cover
If an accident occurs during the period of insurance and effective
time that causes bodily injury to an insured person and directly
results in a valid:
1. Temporary total disablement claim
or
2. Broken bones claim
Insurers will pay the insured person 50% of the costs for each
session of necessary physiotherapy incurred within 12 months
of bodily injury, up to a maximum of £25 per visit, for total of 6
sessions provided that the insured person has a written referral from
their General Practitioner for physiotherapy arising from such bodily
injury.
Primary dislocation benefit
Primary dislocation means the first time an insured person has
suffered a dislocation of the following joints;
i) Kneecap
ii) Elbow
iii) Hip
The insurer will pay the Insured Person up to the amount shown.
Rehabilitation and retraining
Where bodily injury results in the permanent total disablement
benefit becoming payable for an insured person, insurers will
indemnify the insured person up to £2,500 for reasonable costs
incurred to rehabilitate and/or retrain the insured person for an
alternative occupation, subject to insurers prior written approval
being obtained.
Student
An insured person who is in full time education and enrolled or
attends classes at a school, college, or university.
Permanent disabling injury
Means loss of sight, loss of hearing, loss of speech or loss of limb.
Permanent partial disablement
A percentage of the permanent total disablement benefit will be
paid relative to the level of disability:
1. Permanent total disablement 100%
2. Total loss of use of:
a. back or spine (excluding cervical) without cord involvement
40%
b. neck or cervical spine without cord involvement 30%
c. shoulder, elbow or wrist 25%
d. hip, knee or ankle 20%
3. Loss of or total loss of use of:
a. foot below the level of the ankle(talo tibular joint) 50%
b. thumb 20%
c. one forefinger or big toe 15%
d. any other finger 10%
e. any other toe 4%
Permanent total disablement
Disablement other than any permanent disabling injury which has
lasted for at least 12 months and which in the insurers opinion is
beyond hope of recovery and will in all probability continue for
the remainder of the insured person’s life will prevent the insured
person from engaging in or giving attention to:
a) their usual occupation if in gainful employment;
b) business profession or occupation of any and every kind if the insured person:
i) is not in gainful employment
ii) is employed solely as a footballer
iii) has football as their main employment;
c) business schooling profession or occupation of any and every kind if the insured person is under 16 years of age or under 18 years of age and in full time education for the remainder of their life.
Superior
The name of our product range that provides upgrade options
from our Basic cover range.
Temporary total disablement (TTD)
Temporary disablement which entirely prevents the insured
person from engaging in their usual occupation.
Usual occupation
The tasks, duties and other functions, which the insured person
normally performs in connection with their paid employment
for which they are engaged in 16 hours or more per week.
permanent temporary disablement (PTD) is paid when an injury
prevents you from continuing your usual occupation.
Worldwide
The policy operates worldwide excluding travel to Afghanistan,
Iraq, Ivory Coast, Somalia, Nigeria, Pakistan, Venezuela,
Columbia, Mexico, Yemen or Chechnya.
The full policy wording can be found on our website bluefinsport.co.uk/ngis
About our insurance services
1. The Financial Services Authority (FSA)
The FSA is the independent watchdog that regulates financial
services. It requires us to give you this document. Use this
information to decide if our services are right for you.
2. Whose products do we offer?
We offer products from a range of insurers.
We only offer products from a limited range
of insurers a We only offer a product from ACE European Group Limited to satisfy the Personal Accident insurance requirements of the applicable clubs that are
affiliated to their County Football Association.
3. What will you have to pay us for our services?
a A £5 fee for postal applications only
a No fee for arranging the ACE European Group
Limited Personal Accident insurance policy on line.
You are entitled, at any time, to request information regarding
any commission which we may have received as a result of
placing your insurance business
4. Who regulates us?
Bluefin Insurance Services Limited, 5 Old Broad Street,
London, EC2N 1AD is authorised and regulated by The
Financial Services Authority. Our FSA Reference Number is
307899
Bluefin Insurance Services Limited permitted business is
advising, arranging and administering (including handling
claims) general insurance contracts.
You can check this on the FSA’s Register by visiting the FSA’s
website www.fsa.gov.uk/register or by contacting the FSA on
0845 606 1234
5. Ownership
Bluefin Insurance Services Limited is an insurance
intermediary ultimately controlled by AXA UK Plc through our
parent, Bluefin Insurance Group Limited.
6. What to do if you have a complaint?
If you wish to register a complaint, please contact us:
in writing:
Complaints Officer
Bluefin Insurance Services Limited
CI Tower
St George’s Square
New Malden
Surrey KT3 4TP
by phone:
020 8336 2000
by fax:
020 8949 6226
by email:
[email protected]
If you cannot settle your complaint with us, you may be
entitled to refer it to the Financial Ombudsman Service.
7. Client and Insurer Money
When we receive premium payment from you or premium
refund from your insurer, ACE European Group Limited,
(“ACE”) we hold these on behalf of ACE as determined by the
Terms of Business Agreement we have in place with them.
This protects you against the risk of our insolvency as the
money is deemed to have been immediately received by ACE.
However, ACE will not have fulfilled their obligation to pay
a premium refund to you until we pay those monies to you.
Equally, once we have received a premium payment from you,
we shall be unable to refund that premium to you without the
consent of ACE.
Insurer Money and/or Client Money (that is money held on
your behalf or as deemed to be Client Money by the FSA
Client Money Rules) will be held in a Non-Statutory Trust
Account and in accordance with such rules. A copy of these
rules is available at the FSA website www.fsa.gov.uk Under
the terms of a Non-Statutory Trust, general creditors are
not able to make claims on such money. We are entitled
to use Client Money held on behalf of one customer to pay
another customer’s premium before the premium is received
from that other customer and to pay premium refunds
before we receive payment from the insurer. However, we
are not entitled to use Client Money to take our commission
payments before we receive the relevant premium payment
from the customer.
We may hold both Insurer and Client Money in the same bank
account but when this happens insurers will have previously
agreed that any claim by you on monies that are Client Money
will come before their claim.
Unless we receive your written instruction to the contrary,
we shall treat receipt of payment from you and refund of
premium which fall due to you, as being within your informed
consent to the payment of those monies into a Non-statutory
Trust Account. Interest earned on Client and Insurer Money
held by us is retained by us.
8. Are we covered by the Financial Services Compensation
Scheme (FSCS)?
We are covered by the FSCS. You may be entitled to compensation
from the scheme if we cannot meet our obligations. This
depends on the type of business and the circumstances of the
claim.
Further information about compensation scheme arrangements
is available from the FSCS.
9. The capacity in which we are acting
As an insurance intermediary we usually act as your agent
and are therefore subject to the law of agency which imposes
various duties on us. In the case of this personal accident
insurance we act for and owe duties of care to insurers and the
following table is provided to advise you when and how this
arises so you will be aware of any possible conflicts of interest.
Sourcing a suitable policy (i.e.
when we get quotes for you)
We act as your agent
Placing the insurance (i.e. when
we arrange for your cover to
start)
We act as your agent
In the event of a claim
We act as agent of the insurer
We will act as your agent
a
a
a
We will act as agent of the insurer
Delegated Authority - The terms for this policy have been
provided using an authority delegated to Bluefin by the insurer.
[email protected]
bluefinsport.co.uk/ngis
Bluefin Sport is a trading name of Bluefin Insurance Services Limited which is authorised and regulated by the Financial
Services Authority. Registered Office: 5 Old Broad Street, London, EC2N 1AD. Registered in England No: 931954.
1357-0213
We act as agent of the insurer
Sport
Group personal accident
Application
1) Club details
(Please complete sections 1 to 7, ensuring you sign the declaration on the back)
Tear out
Club name
Contact name
Contact address
Postcode
Phone
Email*
Affiliated County FA
Affiliated League
*By providing your e-mail address you consent to receiving policy documentation, renewal invitations and correspondence electronically only.
2) Number of teams
Number of adult 11 a side teams
Number of youth U13’s teams & above
Number of adult 5/7 a side teams
Number of youth U12’s teams and below
3) Adult team cover
(Please refer to summary of the benefits)
Please select level of cover required
Please
multiply your number of adult
teams by the premium selected
Basic
Superior
30
Superior
50
Superior
75
Superior
100
Superior
150
(Please tick)
o
o
o
o
o
o
£ per 11 a
side team
£26
£82
£140
£170
£220
£290
£
A
£ per 5/7 a
side team
£13
£41
£70
£85
£110
£145
£
B

Would you like any optional extras?
NB: ‘Basic Extra’ additional option is only
available if ‘Basic’ cover purchased and
‘Superior Extra’ is only available if
‘Superior’ cover is purchased.
4) Youth team cover
Basic
Extra
Superior
Extra
(Please tick)
o
o
£ per 11 a
side team
£20
£35
£
£ per 5/7 a
side team
£10
£17.50
£

Please multiply your number of adult teams
by the premium selected
D
(Please refer to summary of the benefits)
Please select level of cover required
Please multiply your number of youth
teams by the premium selected
Basic
Superior
Silver
Superior
Gold
Superior
Platinum
(Please tick)
o
o
o
o
£ per U13’s
team & above
£14
£23
£31
£36
£ per U12’s
team & below
£10
£16
£23
£27

Please multiply your number of youth
teams by the premium selected

(Please tick)
Parent/
legal
guardian
benefit
Student
Tutorial
o
o
Physio

o
E
£
F
Youth
Weekly
16-18 yr olds
o
(Please tick)
£ per U13’s
team & above
£4
£10
£6
£
£ per U12’s
team & below
£3
£8
£5
£
Tear out
5) Inception date
£
NB: The benefit below only applies to teams
consisting of 16 to 18 yr olds so please specify
the number of teams you require cover for and
multiply by £16.
Would you like any optional extras?
G
H
£ per 16-18yr
old teams
£16
I
£
Number of teams
6) Total premium
Please confirm the date you wish the cover to start
/
C
/20
Please note, your cover must operate from 1st July, or later
to 30th June each year.
Please add the total premium due for
all your teams (add boxes A to J)
Administration fee
(No fee online)
£15
£5.00
£
Add A to J
J
Please turn over
Please note that cover cannot commence until payment has been received and the proposal form accepted by Bluefin Sport
(Please read, sign and date)
IMPORTANT: Please read the information below. Your application will not be accepted unless the declaration is signed.
Definitions
Some words in this application form are in bold and have particular meaning. Wherever they appear their particular meaning
is given below:
We/Us/Our/Ourselves: ACE Europe Life Ltd and ACE European Group Ltd.
You/Your: Club Official, Club Secretary, Committee Member.
Insured Person: Person(s) specified in the Schedule as being insured person(s).
Tear out
7) Declaration
Material Facts Disclosure
You must ensure that all of the information provided to the insurer in the Application Form, by correspondence, over the
telephone, on claim forms and other documents is true, complete and accurate. You should note that providing incomplete,
false or misleading information could affect the validity of the ACE insurance policy and may mean that all or part of a claim
may not be paid.
Data Protection Statement
PLEASE READ this notice as it explains the purposes for which We will use the personal and sensitive personal data (information) which We hold.
We accept fully Our responsibility to protect the privacy of customers and the confidentiality and security of information
entrusted to Us.
Where You have provided information about another person in connection with the purchase and/or performance of this
insurance Policy You confirm that they have appointed You to act for them, that they have consented to the processing of
their personal data, including sensitive personal data and they have consented to any possible future transfer of their information abroad. You also agree to receive on their behalf any data protection notices from Us.
We will use the information You have provided for;
• customer service
• handling claims
in connection with this accident insurance policy.
We may disclose information to Our service providers and agents for these purposes. The information You have provided
may also be used for the purpose of fraud prevention including passing details to other insurers and regulatory bodies.
In the event that an Insured Person makes an injury related claim, We may need to obtain further Sensitive Personal information such as medical history in order to assess the claim. The claim form will explain in more detail how this Sensitive
Personal data is handled.
If an Insured Person asks We will provide details of the information We hold in accordance with the applicable law.
Any information which is found to be incorrect will be corrected promptly. We may monitor and/or record Your communication with Us either Ourselves or by reputable organisations selected by Us, to ensure consistent servicing levels and account
operation. We will keep information about Insured Person(s) only for so long as it is appropriate.
Contact Details for Us
The Customer Service Manager,
200 Broomielaw, Glasgow G1 4RU
Telephone: 0800 389 8425 (Within UK only)
E-mail:
A&[email protected]
Statement of Fact
Neither You or any manager, Club Official(s) or committee member(s) of the club now applying for this insurance have:• been convicted of or charged (but not yet tried) with a criminal offence other than (road traffic) motor offences
• received an official caution for a criminal offence within the last three years other than a (road traffic) motoring offence.
In respect of the club which is the subject of this insurance contract, or any other business which You, Your managers, Club
Officials or committee members have been involved with, no insurer has ever:• declined, cancelled or refused any proposal of insurance;
• cancelled or declined to renew any insurance;
• imposed special terms or conditions.
If You are unable to confirm these statements, You must contact Bluefin immediately. These are all considered to be Material
Facts.
• I declare that I have the authority of the club players and Club Officials to supply any personal details.
• I declare to the best of my knowledge:
i In respect of the persons to be insured no insurer has declined to provide accident insurance or cancelled or refused to
renew such insurance;
ii The above statements and particulars, whether written by me or by others on my behalf, are true and complete;
iii I have not withheld any Material Fact.
• I agree that this application and declaration shall be the basis of the contract between ACE European Group Ltd and ourselves, and I agree to accept the company’s standard form of policy for this class of insurance.
Signature ________________________Position within club____________________________________Date ______________
Payment method and where to send
For postal applications we can only accept payment in the form of a cheque made payable to ‘Bluefin Insurance Services’
[email protected]
bluefinsport.co.uk/ngis
Bluefin Sport is a trading name of Bluefin Insurance Services Limited which is authorised and regulated by the Financial
Services Authority. Registered Office: 5 Old Broad Street, London, EC2N 1AD. Registered in England No: 931954.
1357-0213 © Copyright 2013 Bluefin Insurance Services Limited. All Rights Reserved.
Sport
Tear out
Please return this form and payment to Bluefin Sport, Castlemead, Lower Castle Street, Bristol BS1 3AG