Queensland Consolidated Acts

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WORKERS' COMPENSATION AND REHABILITATION ACT 2003 - SECT 216

Extent of liability for hospitalisation at private hospital

216 Extent of liability for hospitalisation at private hospital

(1) An insurer’s liability for the cost of hospitalisation of a worker at a private hospital extends only to the cost of hospitalisation of the worker as an in-patient at a private hospital—
(a) for non-elective hospitalisation—for not more than 4 days; or
(b) for non-elective hospitalisation for more than 4 days—to the extent agreed to by the insurer under arrangements entered into between the insurer and the worker or someone for the worker before the hospitalisation or any extension of the hospitalisation; or
(c) for elective hospitalisation—to the extent agreed to by the insurer under arrangements entered into between the insurer and the worker or someone for the worker before the hospitalisation.
(2) Before agreeing to arrangements under subsection (1) (b) or (c) , the insurer must be satisfied that—
(a) a public hospital is not reasonably available to the worker or a public hospital that is reasonably available can not admit the worker as an in-patient to a public ward within a reasonable time; or
(b) admission of the worker to a private hospital—
(i) would relieve prolonged pain and suffering to the worker; or
(ii) would result in saving of costs.



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