LAustralian Insurance Industry Awards.
GAustralia Banking and Finance Insurance Awards.
Allianz Australia Insurance Limited ABN 15 000 122 850 AFS Licence No. 234708
Copyright © 2013 Allianz Australia Limited ABN 21 000 006 226
The worker may be entitled to compensation for weekly benefits while incapacitated for work, medical expenses, rehabilitation expenses, permanent impairment and, in some instances, damages at common law.
GPO Box K772
City Delivery Centre
Perth WA 6842
The diagram below shows a typical lifecycle of a workers’ compensation claim. This diagram is a simplified description of the claims process, so you know what to expect should you need to make a claim.
|Step 1. (Injured worker step)||A workplace injury is reported to the employer. In the case that a serious incident occurs involving a fatality or permanent injury/ illness, please phone WorkSafe immediately on 1800 678 198. We would also request you notify your Allianz contact as soon as possible.|
|Step 2. (Employer step)||The employer notifies Allianz as soon as practicable of the injury/incident and is issued an incident number which is to be used in all correspondence. If the injured worker wishes to make a claim, the employer is to provide the worker with a claim form.|
|Step 3. (Allianz step)||If the injury is significant, a Case Manager will be assigned and will make contact with the employer, injured worker and, if necessary, the treating doctor to initiate injury management activities as appropriate.|
|Step 4. (Employer step)||The injured worker and employer complete the compensation claim forms and, together with a WorkCover Medical Certificate, forward them to Allianz within 5 working days of the employer receiving the worker’s form. |
Please note that in accordance with the Workers’ Compensation and Injury Management Act 1981, WorkCover may penalise employers $1000.00 for failing to report claims to their insurer within the required timeframe (s57A(2A)).
|Step 5. (Allianz step)||Upon receipt of the claim forms and medical certificate, Allianz will assess the claim and in most cases, advise all parties of liability determination within 3 working days.|
If liability cannot be determined, Allianz has a further 10 days to determine liability, thereafter the claim is considered to be disputed.
|Step 6. (Allianz step)||If liability is accepted |
The Case Manager collaborates with the worker, employer and nominated treating Doctors to return the injured worker to work as soon as possible.
If liability cannot be determined without additional information
The Case Manager will notify the employer and the worker of the delay in determining liability and the reason(s) why. The required additional information will be sought and a decision promptly made on receipt.
If liability is not accepted
The Case Manager will notify the employer and injured worker of the liability decision verbally and offer the worker the opportunity to partake in the Internal Dispute & Resolution Process to discuss the decision made on their claim. All parties will subsequently be advised in writing of Allianz’s decision and the process if the decision is disputed.
|Step 7. (Injured worker & employer step)||If liability is accepted, all relevant accounts and requests for wage reimbursements should be sent promptly to Allianz for payment.|
Please note, the Workers’ Compensation and Injury Management Act 1981 requires an employer to make weekly compensation payments to an injured worker within 14 days of being advised the claim is accepted.
Failure to comply with this requirement may result in a WorkCover penalty of $2,000.00 for each weekly payment not made when due. Subsequent payments are required to be made on the employer’s usual pay day.
|Step 8. (Allianz step)||Allianz will keep in regular contact with the employer and injured worker to facilitate a prompt recovery and return to work of the injured worker. Assistance maybe sought from specialist providers, such as occupational rehabilitation experts or medical professionals.|
|Step 9. (Injured worker & employer step)||Injured worker is certified fit for work with no ongoing treatment. All final accounts / wage reimbursements sent to Allianz for payment.|
|Step 10. (Allianz step)|
Allianz closes the claim