Page 1904 - Week 05 - Thursday, 16 May 2019

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item

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section

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decision

10

66 (1)

not pay funeral benefits because applicant not entitled to funeral expenses under s 175

11

96

decision about amount of income replacement benefits injured person entitled to for first payment period

12

97

decision about amount of income replacement benefits injured person entitled to for second payment period

13

100 (1)

decision about injured person’s post-injury earning capacity

14

101 (3) (b) (ii), (4) (b) (ii) or (5) (b) (ii)

refuse to make earlier payment of income replacement benefits to injured person who makes late application for defined benefits because not satisfied there are exceptional circumstances justifying earlier payment

15

103 (2)

refuse to pay injured person interim weekly payment

16

103 (4)

refuse to pay injured person lower interim weekly payment

17

105 (2)

suspend injured person’s benefit payments

18

107 (1) (b)

reduce or stop paying income replacement benefit payments

19

121 (1)

make reasonable request to injured person to attend health practitioner for assessment of treatment and care needs

20

121 (3)

suspend payment of treatment and care benefits and income replacement benefits because injured person fails to comply with reasonable request to attend health practitioner

21

126 (2)

refuse to approve treatment and care not mentioned in injured person’s recovery plan because treatment and care not reasonable and necessary in the circumstances and will not assist with injured person’s recovery or management of person’s injury

22

128 (2) (a) (i) (B)

refuse to make earlier payment of treatment and care expenses, domestic services expenses and travel expenses in relation to late application for period starting on date that is 13 weeks before date of application because insurer not satisfied that there are exceptional circumstances justifying earlier payment

23

129 (1)

not pay treatment and care expenses, domestic services expenses and travel expenses because of 1 or more of the following reasons:

(a) the expenses cannot be verified;

(b) the expenses have not been incurred;

(c) the insurer has previously paid the expenses;

(d) for treatment and care expenses—the expenses were—

(i) not approved by the insurer; or

(ii) not set out in the injured person’s recovery plan