74   Insurers to give notice and reasons when liability disputed

(cf former s 94A)

(1)  If an insurer disputes liability in respect of a claim or any aspect of a claim, the insurer must give notice of the dispute to the claimant.

(2)  The notice must contain the following:

(a)  a statement of the reason the insurer disputes liability and of the issues relevant to the decision,

(a1)  a statement to the effect that the worker can request a review of the claim by the insurer,

(b)  unless paragraph (c) applies, a statement to the effect that the worker can refer the dispute for determination by the Commission,

(c)  if the insurer has referred or proposes to refer the dispute for determination by the Commission, a statement to that effect specifying the date of referral or proposed referral,

(c1)  a statement to the effect that the matters that may be referred to the Commission are limited to matters notified in the notice, or in a notice after a further review or in correspondence prior to any such referral concerning an offer of settlement or in a request for a further review,

(d)  a statement to the effect that the worker can also seek advice or assistance from the worker’s trade union organisation or from a lawyer,

(e)  such other information as the regulations may prescribe or, subject to the regulations, as the Authority may from time to time approve and notify to insurers and self-insurers.

(2A)  In the case of a claim for compensation under this Act, a statement of reasons in a notice under this section is to indicate the provision of the workers compensation legislation on which the insurer relies to dispute liability.

(2B)  A notice under this section must be expressed in plain language.

(3)  The regulations may make provision for the form of and for other information to be included in or to accompany a notice under this section.

The regulations may require an insurer to give a copy of a notice under this section to the claimant’s employer.

(3A)  The regulations may create offences in connection with any failure to comply with this section.

Note. A dispute as to liability to commence weekly payments within the requisite period after a claim for compensation is made must be notified in accordance with this section (See section 93 and the offence arising under section 94).

(4)  Notice is not required to be given under this section with respect to a dispute if notice has been given under section 54 of the 1987 Act with respect to the dispute and that notice contained the statements and information that a notice under this section is required to contain.

(5)  Before giving a notice under this section, an insurer must carry out an internal review of the decision to dispute liability in respect of the claim or an aspect of the claim.