Issued under section 7.31(4) of the Motor Accident Injuries Act 2017
- Claimant: AEQ
- Insurer: Allianz Australia Insurance Limited
- Claim Number: 37C000915
- Reviewable decision-maker: Sarah Hoy
- Date of Reviewable decision: 26 March 2019
- Nature of Reviewable decision: Whether the insurer is entitled to refuse payment of statutory benefits in accordance with section 3.35 of the Act.
- Our Reference: 10089875
- Merit Reviewer: Tami O'Carroll
- Date of Merit Review Certificate: 13 May 2019
Merit Reviewer’s Determination
This determination relates to a merit review matter, which is a reviewable decision under Schedule 2(1)(s) of the Motor Accident Injuries Act 2017 (the Act) – whether the insurer is entitled to refuse payment of statutory benefits in accordance with section 3.35 of the Act.
My determination of the merit review is as follows:
- The reviewable decision is set aside and the following decision is made in substitution for that decision:
- The Insurer was not entitled to refuse payment of statutory benefits under section 3.35(2)(b) of the Act.
- The Insurer requires AEQ to make a claim for workers compensation for the injury with the relevant workers compensation insurer, in accordance with section 3.35(4) of the Act, within 14 days of the date on which AEQ receives this determination. The reasons given for this merit review determination are the reasons for this substituted decision of the insurer.