Queensland Consolidated Acts

[Index] [Table] [Search] [Search this Act] [Notes] [Noteup] [Previous] [Next] [Download] [Help]

WORKERS' COMPENSATION AND REHABILITATION ACT 2003 - SECT 538

Internal review by insurer

538 Internal review by insurer

(1) Before an insurer makes any of the following decisions, the insurer must undertake an internal review of the proposed decision—
(a) a decision to reject an application for compensation;
(aa) a decision not to provide a service under section 232AB ;
(b) a decision under section 232M that a worker is not entitled to treatment, care and support payments;
(c) a decision to refuse a service request, or approve a service request on conditions, under section 232P ;
(d) a decision to refuse a payment request under section 232R ;
(e) a decision under section 232S that the insurer is not satisfied that a worker’s serious personal injury is likely to continue to meet the chapter 4A eligibility criteria for the injury after the interim period ends;
(f) a decision under section 232S that a worker’s entitlement to treatment, care and support payments ends before the end of the interim period;
(g) a decision to not accept liability to make treatment, care and support payments under section 232ZD ;
(h) a decision to amend approved services for an eligible worker under section 232ZG ;
(i) a decision to suspend, under section 232ZH , a worker’s entitlement to treatment, care and support payments for all or part of a period the worker is absent from Australia;
(j) a decision to terminate compensation;
(k) a decision under section 325C to refuse an examination application.
(2) The review must be made by a person who is in a more senior position than the person who proposes to make the decision.



AustLII: Copyright Policy | Disclaimers | Privacy Policy | Feedback