Queensland Consolidated Acts

WORKERS' COMPENSATION AND REHABILITATION ACT 2003 - SECT 232P

232P Deciding service requests

(1) An insurer may approve a written request (a
"service request" ) to pay for particular treatment, care or support (the
"requested service" ) to be provided to an eligible worker in a particular period.

(2) A service request may be made for an eligible worker—

(a) before or after a support plan is made for the worker; and

(b) by the worker or the person providing the requested service.

(3) An insurer must decide whether to approve, with or without conditions, or refuse a service request within—

(a) 20 business days after the request is received; or

(b) if, within the period mentioned in paragraph (a) , the insurer asks for further information to help the insurer make the decision—20 business days after the information is received.

(4) In deciding whether to approve or refuse a service request, an insurer must consider the matters prescribed by regulation.

(5) An insurer must give written notice of the insurer’s decision under subsection (3) to—

(a) the person who made the request; and

(b) if the person who made the request is not the eligible worker—the worker.

(6) If an insurer makes a decision about a service request relating to an eligible worker for whom a support plan has been made, the insurer must—

(a) if the insurer approves the service request, with or without conditions—amend the worker’s support plan to reflect the approval; or

(b) if the insurer refuses the service request—ensure a copy of the written notice of the decision is attached to the worker’s support plan.