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s 105

Suspension of benefit payments—failure to comply with request for assessment

In force
Chapter 2Motor accident injuries—defined benefits
Part 2.4Defined benefits—income replacement benefits
Division 2.4.4Income replacement benefits—injured person’s obligations

105 Suspension of benefit payments—failure to comply with request for assessment

(1)

This section applies if the relevant insurer for a motor accident makes a reasonable request that an injured person undergo a medical or other examination to assess the person’s fitness for work.

(2)

If the injured person fails without reasonable excuse to comply with the request, the relevant insurer may suspend the injured person’s benefit payments for the period that the failure to comply continues.

Note An injured person’s entitlement to income replacement benefits may also be suspended if the person fails to undergo treatment and care stated in the person’s recovery plan (see s 124).

(3)

If the relevant insurer decides to suspend the injured person’s benefit payments, the insurer must give the injured person written notice (a suspension notice) stating—

(a)

the reasons for the suspension; and

(b)

the actions the injured person may take to avoid the benefit payments being suspended; and

(c)

the date the suspension takes effect; and

(d)

that the injured person may seek internal review of the suspension under part 2.10 (Defined benefits—dispute resolution).

(4)

A suspension notice must be given at least 2 weeks before the date the suspension takes effect.

(5)

The MAI guidelines may make provision in relation to the following:

(a)

the conduct of medical and other examinations under this section;

(b)

the information a health practitioner may ask a person injured in a motor accident for in relation to a medical or other examination of the person by the health practitioner under this section;

(c)

the information a health practitioner may ask the relevant insurer for a motor accident in relation to a medical or other examination of a person injured in the motor accident by the health practitioner under this section;

(d)

the circumstances in which the relevant insurer for a motor accident may ask for a medical or other examination of a person injured in the motor accident under this section.

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