Appendix 1: Context and relevant provisions - Standard 23 - Recovery of overpayments due to insurer error

Standard 23 - Recovery of overpayments due to insurer error

Insurers should have processes in place to minimise any risk of overpayment or duplication of payments to workers. In instances where there may be an overpayment, this is to be managed in a fair and transparent manner.

Managing overpayments to workers in a fair and transparent manner, and in accordance with the law contributes to the viability of the system and minimises the likelihood of the relationship between the insurer and the worker being placed at risk.

If the overpayment is due to a return to work impacting the worker’s earnings, the insurer can seek an order for recovery from the Workers Compensation Commission (the Commission).

The Commission may also make such orders as it thinks fit for the adjustment of weekly payments to a worker to take account of any overpayments in respect of any previous period. When the overpayment has arisen from fraud, SIRA may issue the order for recovery.

Overpayments to a worker resulting from insurer error are only to be recovered with informed and written consent of the worker.