Eligibility for and lodging of a workers compensation claim Q9 
How soon must the insurer make a decision on the claim?

An insurer can commence provisional payments of weekly benefits and medical expenses up to $7,500 withing seven days of initial notification of the injury. These weekly benefits can be paid for a maximum period of 12 weeks, if required.

These 'provisional' payments are designed to reduce the impact of injury and illness, but do not mean an admission of liability by the insurer or employer.

In many cases, an injured worker will not need to lodge a claim form if they are only going to be away from their normal duties for a short period. However, a claim form can still be lodged if an injured worker wants to. Sometimes the insurer will require that a claim form be lodged.

If a claim form has been lodged, the insurer must make a decision whether to accept liability or dispute the claim, within 21 days of receiving the claim.

However, if 'provisional' weekly payments have already commenced, the timeframe in which the claim must be determined may be extended to the end of the period approved for the 'provisional' payments.

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