- Workers Compensation Act 1987
- Workplace Injury Management and Workers Compensation Act 1998
- Workers' Compensation (Dust Diseases) Act 1942
- Workers Compensation (Bush Fire, Emergency and Rescue Services) Act 1987
- Workers Compensation Regulation 2016
- Workers Compensation (Dust Diseases) Regulation 2018
- Workers Compensation (Bush Fire, Emergency and Rescue Services) Regulation 2017
- Workers compensation guidelines
- NSW workers compensation guidelines for the evaluation of permanent impairment
- Workers compensation medical dispute assessment guidelines
- Guidelines for workplace return to work programs
- Workers compensation market practice and premiums guidelines
- Guidelines for the approval of treating allied health practitioners 2016 No 2
- Workers compensation licensed insurer business plan guidelines
Standards of practice
- Overarching claims management principles
- Standard of practice principles
- S1. Worker consent
- S2. Worker access to personal information
- S3. Initial liability decisions – general, provisional, reasonable excuse or full liability
- S4. Liability for medical or related treatment
- S5. Recurrence or aggravation of a previous workplace injury
- S6. Recoveries
- S7. Interim pre-injury average weekly earnings calculation
- S8. Insurer making weekly payments
- S9. Reduction in payments of compensation
- S10. Payment of invoices and reimbursements
- S11. Changes in capacity
- S12. Injury management plans
- S13. Additional or consequential medical conditions
- S14. Referral to an injury management consultant
- S15. Approval and payment of medical, hospital and rehabilitation services
- S16. Case conferencing
- S17. Section 39 Notification
- S18. Retiring age notification
- S19. Section 59A notification
- S20. Permanent impairment assessment reports
- S21. Negotiation on degree of permanent impairment
- S22. Insurer participation in disputes and mediations
- S23. Recovery of overpayments due to insurer error
- S24. Factual investigations
- S25. Surveillance
- S26. Arrangement for payments to Medicare Australia
- S27. Notification and recovery of Centrelink benefits from lump sum payments
- S28. Interpreter services
- S29. Cross-border provisions
- S30. Closing a claim
- S31. Death claims
- S32. Managing claims during the COVID-19 pandemic
- Workers compensation benefits guide
- Fees and rates orders
- Standards of practice
S23. Recovery of overpayments due to insurer error
Managing overpayments to workers in a fair and transparent manner contributes to the viability of the system and helps to preserve the relationship between the insurer and the worker.
Risks relating to overpayment or duplication of payments to workers will be mitigated where practicable while ensuring efficient management of claims, and overpayments will be managed in a fair and transparent manner.
Where an insurer identifies an overpayment to a worker due to an error and wishes to seek recovery, the insurer is to advise the worker of the details of the payment(s) and clearly describe the error and the potential impact to the worker.
Evidence on claim file
Where the insurer negotiates a repayment arrangement with the worker, the insurer is to demonstrate they have considered the individual circumstances of the worker and potential financial hardship.
Evidence on claim file
The insurer is to obtain informed consent from the worker before commencement of any repayment arrangement.
Evidence on claim file
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.