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Standard 24 - factual investigations

Factual investigations play an important role in the workers compensation scheme; however, they can erode worker trust and must therefore be used judiciously.

Factual investigations

Principle: Factual investigations will only be used when necessary and will always be undertaken in a fair and ethical manner.

 ExpectationsBenchmarks
S24.1 Insurers must only undertake factual investigations when required information cannot be obtained by another less intrusive means and insurers must clearly document the purpose for undertaking any factual investigation. Evidence on claim file.
S24.2 If the worker is requested to participate in a factual investigation, the insurer must advise the worker in writing and provide the following information:
  • the purpose of the factual investigation and the contact details of the investigator;
  • the anticipated duration of the factual interview, which must not exceed two hours;
  • that the worker can nominate the place of the interview and may have a support person (including union representative) present;
  • that the worker may request an interpreter if required, who does not count as a support person
  • that the worker will receive a copy of their statement or transcript within ten working days of the interview;
  • that the worker can identify witnesses to be considered to assist the investigation; and
  • advice to the worker that they are not obligated to participate in the factual investigation, however the factual investigation will be used to help determine liability for their claim.
Complete advice provided to the worker at least five working days prior to the proposed factual interview.