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Standard 31 - death claims

Death claims require proactive and sensitive management to ensure families and others are provided with appropriate support.

Death claims

Principle: Death claims will be managed with empathy and respect, and liability decisions and payment of entitlements in relation to death claims will be prioritised and not unnecessarily delayed.

ExpectationsBenchmarks
S31.1 If an insurer becomes aware of a death that may be work-related, the insurer must proactively investigate the circumstances of the death, including in cases where the death occurred some time after a work-related injury. Proactive investigation to commence within five working days after becoming aware of the death.
S31.2 When an insurer is notified of a death that may be work-related, the insurer must contact the worker’s family, the family’s legal representative or another appropriate party without delay to advise them of the insurer’s role. Contact within five working days after being notified of a death.
S31.3 Insurers must determine liability for death claims as soon as practicable; and where a liability decision is likely to be delayed, insurers must document the steps taken to obtain information relevant to determining liability. Liability determined within 21 days after becoming aware of the death.
S31.4 In circumstance where more than one dependant or potential dependant is identified, insurers must:
  • make an application to the Commission to apportion the lump sum death benefit;
  • seek the details of all persons who conceivably have an entitlement, including potential dependants who may be eligible for the lump sum death benefit and potential dependent children who may be eligible for weekly payments; and
  • advise all persons who conceivably have an entitlement of their potential entitlement.
Application to the Commission for apportionment made within ten working days after accepting liability.
S31.5Insurers must advise the family or legal representatives of the deceased as soon as possible after a liability decision is made.Written confirmation of the liability decision within two working days after the decision is made.
S31.6Insurers must commence weekly payments for dependent children as soon as possible after liability is accepted.Commencement of weekly payments within ten working days after accepting liability.
S31.7If weekly payments are payable to an adult dependent child (18-21 years in full-time education), insurers must advise the surviving parent or guardian (or legal representative) to seek advice regarding the tax implications of such payments.Evidence on claim file.