Death claims require proactive and sensitive management to ensure families and others are provided with appropriate support.
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
S31.1
If an insurer becomes aware of a death that may be work-related, the insurer is to 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 is to 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 are to 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 (unless not reasonably practicable to do so, with reasons clearly recorded on the claim file)
S31.4
In circumstance where more than one dependant or potential dependant is identified, insurers are to:
make an application to the Commission to apportion the lump sum death benefit,
seek the details of all persons who may 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
write to all persons who may have an entitlement to advise that they may be able to claim in relation to the lump sum death benefit, of the need to lodge an application to the Commission for apportionment of the lump sum, the nature of proceedings in the Commission and the availability of funding for independent legal advice through ILARS.
Evidence that the insurer has written to all potential dependants no later than 10 working days after accepting liability, to advise of their potential entitlement
S31.5
Insurers are to 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 are to commence weekly payments for dependent children as soon as possible after liability is accepted.
Commencement of weekly payments within 10 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 are to advise the surviving parent or guardian (or legal representative) to seek advice regarding the tax implications of such payments.
Evidence on claim file
If a worker dies because of a work-related injury or disease, compensation is payable.
Death claims require proactive and sensitive management to ensure families and others are provided with appropriate support.
If a work injury results in the worker’s death, his/her dependant(s) or estate is entitled to be paid the compensation. Entitlements can include:
a lump sum death benefit apportioned among dependants (or if no dependants, to the deceased’s estate)
weekly compensation for dependent children
reasonable funeral expenses, and
compensation for the expense of transporting the body to the deceased’s usual place of residence or an appropriate place for its burial or cremation.
Some death claims are clearly work-related while for others, the nexus between death and work may not be clear. Insurers are to review all deaths that may be work-related that they become aware of (whether or not a claim has been made).
Death claims require proactive and sensitive management to ensure dependants are provided with appropriate support, and delays are minimised. Insurers can help the Workers Compensation Commission (the Commission) and families to reduce delay and legal costs.
