Page 1903 - Week 05 - Thursday, 16 May 2019

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item

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section

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decision

1

59 (2)

refuse late application because applicant does not have full and satisfactory explanation

2

62

refuse to pay applicant’s expenses because not allowable expenses under MAI guidelines

3

65 (1)

reject liability for defined benefits

4

65 (1)

reject liability for defined benefits because applicant not a person mentioned in s 55 (1)

5

65 (1)

reject liability for defined benefits because application made on behalf of applicant by someone other than a person mentioned in s 55 (2)

6

66 (1)

not pay income replacement benefits because applicant not entitled to those benefits under s 89

7

66 (1)

not pay treatment and care benefits for expenses incurred for stated treatment and care because of 1 or more of the following reasons:

(a) treatment and care not reasonable and necessary;

(b) treatment and care did not relate to personal injury sustained in motor accident;

(c) injured person has not paid for the treatment and care and is not liable to pay for the treatment and care

8

66 (1)

not pay treatment and care benefits for domestic services expenses incurred by injured person in employing someone to provide domestic services to injured person’s dependants because of 1 or more of the following reasons:

(a) expenses not reasonable and necessary;

(b) injured person did not provide those services to dependants before the motor accident;

(c) dependants are able to undertake those services

9

66 (1)

not pay treatment and care benefits for travel expenses incurred by injured person and a parent or other carer accompanying injured person because of 1 or both of the following reasons:

(a) expenses for travel and accommodation not reasonable and necessary;

(b) travel not undertaken to undergo treatment and care