How do I submit a claim?
You can submit your claim form in the following ways:
- Hand-deliver it to Human Resources (Mt Helen);
- Post it: Attention - Co-ordinator, Workplace Support, Federation University Australia, PO Box 663, Ballarat VIC 3353; or
- In special circumstances you can submit your claim form to the insurance agent or the VWA.
Some claims may be accepted by the University straight away, others may be forwarded to our insurer for investigation before deciding to accept or reject the claim.
If your claim is not accepted immediately and you are off work, you will receive payments from your leave entitlements (usually sick leave). If your claim is later accepted, any leave you have used as part of your workers compensation claim will be re-credited to you.
Any medical expenses incurred will be held by the University until your claim has been accepted or rejected. If the claim is accepted UB and the Insurer will pay the reasonable medical expenses incurred.
Regardless of the status of the claim, you will receive written notification from the University advising that we have received your claim form and what action we are taking ie. accepting the claim or asking the insurance company to make the decision.
If the claim is for time off work the insurer has 28 days from the day they receive the claim form from the University to make a decision. If the claim is for medical expenses only, the insurer has up to 28 days to make a decision.
If the University has asked the insurance company to make a determination of liability, you will receive written notification from the insurer advising you of their decision and the reasons for it.
*source: UB Occupational Rehabilitation Program
What if my claim is investigated?
There are many reasons why the insurer may investigate your workers compensation claim. Quite often they simply need to have more information on the claim than provided in the claim form.
If your claim is investigated you will be advised and, in most cases, you will be required to attend a medical appointment with a doctor of the insurer's choice.
You may also be asked to speak to an investigator appointed by the Insurance company to explore the background circumstances of your claim. The investigator may interview you, your supervisors, co-workers and any witnesses named on your claim form.
It is advisable you participate fully in any investigation that may take place as your participation means that the insurer has all the facts surrounding your claim and can make a balanced decision.
What if my claim is rejected?
If your claim is rejected, the insurer will notify you in writing, listing the reason/reasons for rejecting your claim.
If you disagree with the decision staff members may:
- Discuss your concerns with the Co-ordinator, Workplace Support, and/or talk to your union representative, as they can advise you on what further actions can be taken to have the decision reviewed. Alternatively:
- Contact the WorkCover Advisory Service for advice. Information is provided free of charge. Ph: 1800 136 089 or email: firstname.lastname@example.org
- Use the Accident Compensation Conciliation Service. This is a free service that can assist you in resolving your dispute without a solicitor or going to court. Ph: 1800 635 960 or visit www.conciliation.vic.gov.au. To have your dispute referred to conciliation you must lodge a request for conciliation within 60 days of receiving a rejection notice from the insurer.
- Discuss your concerns with the University's insurer and request a review of the decision by a Senior Officer. If you request an internal review you must still apply to have the matter heard in conciliation.