New South Wales Consolidated Acts

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Claims administration manual

192A Claims administration manual

(cf former s 93B)

(1) The Authority may prepare and publish a claims manual for use by licensed insurers under this Division.
(2) In preparing the claims manual, the Authority is required to promote, as far as practicable--
(a) the prompt processing of claims and payment of amounts duly claimed, and
(b) the giving of information about workers' entitlements and about procedures for the making of claims and the resolution of disputes, and
(c) the minimisation of the effect of injuries to workers by the making of prompt arrangements for rehabilitation, and
(d) the proper investigation of liability for claims, and
(e) the recovery of proper contributions in connection with claims from other insurers or persons.
(3) The claims manual may make provision (not inconsistent with this Act, the 1998 Act or the regulations under those Acts) in connection with all matters relating to the administration of claims, including--
(a) liaison between insurers and employers concerning rehabilitation assessment of injured workers, and
(b) the provision or arrangement of suitable employment or rehabilitation training for partially incapacitated workers, and
(c) the monitoring of employment-seeking activities or rehabilitation training by partially incapacitated workers, and
(d) arrangements for the settlement of claims for damages, and
(e) procedures to be followed before a claim is made, such as procedures in connection with early notification of injury and provisional acceptance of liability.
(3A) The Workers Compensation Guidelines under the 1998 Act can make provision in connection with any matter in connection with which the claims manual can make provision.
(4) The Authority may give an insurer directions as to the procedure to be followed in the administration of any claim or class of claims in order to comply with the claims manual, the Workers Compensation Guidelines, the 1998 Act and this Act.
(4A) An insurer who fails to comply with a direction under subsection (4) is guilty of an offence.
: Maximum penalty--50 penalty units.
(5) It is a condition of the licence of an insurer under this Division that the insurer comply with any direction given to the insurer under this section.
(6) Any claims manual in force under section 93B, immediately before its repeal, is taken to have been prepared and published under this section.

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