Appropriate consultation should occur with relevant stakeholders prior to the closure of a claim, to ensure that the reasons for and implications of the closure are clearly understood.
Principle
All relevant stakeholders will be notified prior to the closure of a claim.
Expectations
Benchmarks
S30.1
Before closing a claim, the insurer is to contact the worker, the employer and any relevant service providers to advise of the intention to close the claim, including the reasons for doing so, and provide an opportunity for any outstanding invoices or reimbursements to be paid.
Evidence on claim file
S30.2
The insurer is to finalise all outstanding invoices before closing the claim.
Evidence on claim file
S30.3
The insurer is to confirm in writing the closure of a claim to the worker and the employer, including:
the date the claim was closed
the date on which medical benefits will cease (not applicable to exempt workers), and
what to do if the worker or employer believes the claim needs to be re-opened.
Notification within two working days after the claim is closed
Before closing a claim, insurers should ensure that all activities have been completed and relevant stakeholders (including service providers) have been notified that the claim is to be closed.
Appropriate consultation should occur with relevant stakeholders prior to the closure of a claim.
The reasons and implications of the closure are to be clearly communicated to all relevant stakeholders. Clear communication is required to ensure fairness and transparency and that stakeholders are not disadvantaged during the process.
