The Christmas – New Year period has historically proven to be a busy period for workers compensation. Due to a variety of reasons, we see a higher frequency of claims during this period. Last December and just before Christmas break / public holidays, one of our clients had a psychological claim lodged against them. The worker had been terminated two weeks prior to the claim being lodged.

The insurer was on skeleton staff, getting a claim number took three business days. A factual investigation was requested immediately through our preferred provider. The claim was initially provisionally accepted based on the medical certificate despite our documented notes and clear CCTV footage proving the injured worker was at fault.

The worker suddenly became entitled to wages they would not normally earn during this period, needless to say, this was very upsetting for our client.

ABILITY GROUP was able to turn around the factual in a very short time frame which assisted in reducing the wages loss component that impacts premium.  Once the factual report was received legal advice was sought in regards to a claim declinature. The solicitors supported a claim declinature. To ensure the claim declinature was strong enough an IME was arranged in the interim. This further supported the case and a section 74 notice was issued shortly after.

This was an excellent result for the client as psychological claims can be quite lengthy in time and extremely costly. Despite the initial unfit certificate, prompt action and a strategic approach overcame the barriers to result in minimal impact for the client and a great outcome.  ABILITY GROUP was able to save significant impact to premium and ensure minimisation of the financial impacts of this situation as well as close out the claim.