1.3 Recoveries
1.3.1 Recovery roles | 1.3.2 TAC recoveries | 1.3.3 National Disability Insurance Agency (NDIA) Compensation Recoveries | 1.3.4 Negligent third parties | 1.3.5 Payments made in error| 1.3.6 Calculate GST recovery amounts
In certain circumstances, WorkSafe can:
- recover monies for claims costs paid
- ensure that other negligent parties contribute to the costs of WorkSafe claims.
WorkSafe is committed to ensuring Agents provide timely and efficient identification, investigation and referral processes for TAC and negligent third party recovery claims.
Types of recoveries
Recoveries can be claimed under the legislation from:
- the TAC, in accidents:
- directly caused by the driving Means there is a direct or close relationship of cause and effect, even if not the sole cause. There does not have to be collision or direct contact with the vehicle to cause injury. However, an injured claimant must have sufficient connection between the injury, the incident and the driving to prove that the driving directly caused the injury and the incident. of a motor vehicle, tram or train or arising from the use of a motor vehicle, tram or train
- negligent third parties in workplace accidents
- self-insurers, for contribution to the worker's injury subject to the period of self-insurer/WorkSafe policy coverage and terms of entry/exit from the scheme.
In dual insurance cases with motor vehicle/tram/train/other vehicle involvement, where the liability is usually split 50/50 between the TAC and WorkSafe
Compensation under the legislation is not payable for an injury to the extent that compensation has been received in respect of the same injury under the laws of a place other than this State (whether within or outside Australia).
When conducting recoveries, Agents must:
- practice appropriate conduct for recovery claims arising from the death of a worker, including when obtaining information from dependants
- adhere to the requirements of the Information Privacy Act 2000 and legislation that governs the use of personal and health information that they hold
- avoid potential conflict of interest between the investigation of a claim and the occupation health and safety investigations that can lead to prosecution.
See: Access to Information & Privacy | Death claims | Investigations & Compliance
1.3.1 Recovery roles
Recoveries are identified and managed by the following parties:
Recovery type | Identified by | Managed by |
---|---|---|
Overpayment |
Agent |
Agent |
Negligent third parties |
Agent / Panel firm / WorkSafe |
WorkSafe |
Prior insurer contribution injury |
WorkSafe |
WorkSafe |
Dual insurance |
Agent / Panel firm / WorkSafe |
WorkSafe (damages) |
Motor vehicle accidents | Agent / WorkSafe | WorkSafe |
Compensation paid twice |
Agent / Panel firm / WorkSafe |
WorkSafe |
The Case Manager is responsible for:
- entering information into ACCtion
- forwarding documents/files to WorkSafe’s Recoveries Team and/or WorkSafe's Legal Panel
- instructing investigations on WorkSafe's request
- after allocation, forwarding information requested by WorkSafe’s Recoveries Legal Panel
- authorising payment of recovery investigation and legal costs.
A suitably qualified person (technical) has responsibility for the overall management of the recovery aspect of the claim. This responsibility can be to:
- identify, clarify and confirm recovery potential
- instruct recovery investigations
- refer recovery potential claims to WorkSafe’s Recoveries Team
- approve payment of recovery investigation and legal costs.
WorkSafe’s Recoveries Team has the overall responsibility for policy, training and monitoring of the recovery function. It also:
- manages claims with the TAC
- allocates all claims to the panel firm
- receives third party and TAC recovery payments and banks monies recovered
- authorises refund of employer excess
- provides support to Agents
- instructs the panel firm on the conduct of recovery litigation
- authorises the panel firm to pursue recovery litigation.
The panel firm is responsible for:
- reviewing the recovery claim and determining recovery viability
- advising WorkSafe of recovery and legal costs estimates
- negotiating/litigating a recovery claim
- finalising settlement A lump sum payment that replaces an injured worker's right to ongoing weekly compensation.
- receiving and forwarding recovery monies
- billing Agents
- recovering legal costs paid
- recovering employer excess.