SIRA Logo

Standard 30 - closing a claim

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.

Closing a claim

Principle: All relevant stakeholders will be notified prior to the closure of a claim.

ExpectationsBenchmarks
S30.1 Before closing a claim, the insurer must 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 must finalise all outstanding invoices prior to closing the claim. Evidence on claim file.
S30.3 The insurer must 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 2 working days after the claim is closed.