Page 2533 - Week 08 - Thursday, 5 August 2021
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6. All applications include treatment and care, with the number of applications per month outlined above. Of the 498 applications:
a. 437 have been accepted by an MAI insurer and benefits paid.
b. 22 have been rejected.
c. 39 remain to be determined.
d. Data on whether treatment and care has been suspended is not readily available. The information would have to be requested from insurers and requires manual review and collation. Producing this data would be an unreasonable diversion of the resources of the MAI Commission.
7. Where a treatment and care decision was identified as the reason for review, there have been 16 decisions taken on internal review.
8. Of the 16 internal reviews involving a review of a treatment and care decision: (a) 11 were affirmed; (b) one was amended; (c) two set aside and substituted; and (d) one remains in progress.
9. Of the 11 affirmed internal review decisions that related to specific treatment and care decisions, five were taken to external review by the ACAT.
10. The Defined Benefits Information Service is an information and limited advice service provided by CARE Inc on a pilot basis. The number of services is reported per quarter:
|
Feb-Mar 20 |
Apr-Jun 20 |
Jul-Sept 20 |
Oct-Dec 20 |
Jan-Mar 21 |
|
20 |
14 |
32 |
25 |
34 |
11. The total value of benefits for treatment and care and income replacement paid to applicants for each month to the end of May 2021 is:
|
Month |
Treatment and Care |
Income Replacement |
|
February 20 |
$1,032.08 |
$0.00 |
|
March 20 |
$16,298.31 |
$27,928.48 |
|
April 20 |
$37,402.45 |
$26,984.29 |
|
May 20 |
$128,701.20 |
$122,383.36 |
|
June 20 |
$151,274.19 |
$68,716.14 |
|
July 20 |
$153,482.93 |
$89,832.70 |
|
August 20 |
$145,317.02 |
$123,835.87 |
|
September 20 |
$224,196.12 |
$175,103.21 |
|
October 20 |
$534,243.19 |
$135,988.26 |
|
November 20 |
$296,875.82 |
$151,426.68 |
|
December 20 |
$220,079.10 |
$209,532.90 |
|
January 21 |
$260,449.95 |
$163,814.82 |
|
February 21 |
$474,812.22 |
$146,241.32 |
|
March 21 |
$364,855.24 |
$221,665.99 |
|
April 21 |
$344,369.68 |
$166,801.43 |
|
May 21 |
$249,272.08 |
$184,031.85 |
|
Total |
$3,602,661.58 |
$2,014,287.30 |
12. Seventeen matters have been listed by the ACAT for external review relating to the Motor Accident Injuries Scheme; nine relating to treatment and care and none relating
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