Page 1417 - Week 04 - Thursday, 4 April 2019
Next page . . . . Previous page . . . . Speeches . . . . Contents . . . . Debates(HTML) . . . . PDF . . . . Video
costs whilst they assess the application. Once an application that was lodged on time has been accepted, insurers must immediately back pay any reasonable and necessary treatment and care not already reimbursed, as well as lost income for the period since the accident happened, ensuring that injured people are not left out of pocket for long.
Any injured person who cannot return to work or their normal activities will be then put on a treatment plan which steps out what treatment and care benefits they will receive via their insurer. This plan is developed in consultation with the injured person and their treating doctor.
Under the existing scheme, payment for treatment, care and lost wages is often delayed by months or even years while liability for the accident is determined. We know from the scheme review, and I tabled it in the Assembly earlier this week, that the average time taken to finalise small claims is 1½ years. It is 3.7 years for larger claims. The new scheme will deliver benefits for injured people sooner so that they can start their recovery right away.
Another common misunderstanding is that defined benefit payments will be provided at the discretion of insurers, who can knock back claims without oversight. In fact, the government sets the rules for how insurers must assess claims, and will oversee how these rules are implemented. Individual decisions made by insurers will be subject to external review through the Civil and Administrative Tribunal.
To provide motor accident injuries insurance, each insurer must be licensed by the motor accident injuries commission. It is a condition of this licence that they follow the rules of the scheme as stepped out in the act and the government regulations and guidelines.
These regulations and guidelines state that insurers must provide injured people with reasonable and necessary treatment and care to help them recover after an accident. These documents also provide a significant level of detail on what this means in practice.
If insurers fail to follow the scheme’s regulations and guidelines, the motor accident injuries commission can use different sanctions against them, ranging from financial penalties to the cancellation of a licence to provide insurance in the ACT.
If an injured person is not happy with the decision made by their insurer, they can first seek an internal review. If an internal review does not resolve the matter, the injured person can seek an external review through the ACAT. The ACAT is a far more approachable body than the Magistrates Court, because of its use of alternative dispute resolution and less adversarial processes. The tribunal also has access to medical tribunal members, so it can deal with medical issues more quickly. People who are seeking external review of insurer decisions through the ACAT can be legally represented if they chose to do so, but they do not have to be in order to have their complaint heard.
Through this debate there has been a lot of focus on the use of a 10 per cent whole person impairment threshold in the new scheme, with it being suggested that this is
Next page . . . . Previous page . . . . Speeches . . . . Contents . . . . Debates(HTML) . . . . PDF . . . . Video