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.
Expectations | Benchmarks | |
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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:
| Application to the Commission for apportionment made within ten working days after accepting liability. |
S31.5 | Insurers 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. |
S31.6 | Insurers 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. |
S31.7 | If 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. |