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Standard 4 - Liability for medical or related treatment

Making  medical or treatment liability decisions promptly, in consultation with key stakeholders and based on all available evidence will reduce the likelihood of disputes and ensure workers can focus on recovery and return to work.

Liability for medical or related treatment

Principle: Liability decisions will be informed by careful consideration of all available information and proactive consultation with relevant stakeholders.

 ExpectationsBenchmarks
S4.1When determining liability for medical or related treatment, insurers must obtain and consider all relevant information, consult with the worker and relevant parties as required, and make a decision at the earliest possible opportunity.Evidence on claim file.
S4.2When a claim for medical or related treatment is received, the insurer must acknowledge the request and keep the worker informed of the status of their claim.Request acknowledged within ten working days.
S4.3The insurer must advise the relevant parties of the outcome and reasons for a decision regarding liability for medical or related treatment.Advice provided within two working days after decision.