Recovery plan—suspension of benefits
124A Recovery plan—suspension of benefits
If an injured person fails, without reasonable excuse, to undergo the treatment and care stated in the person’s recovery plan, the relevant insurer may suspend either or both of the following until the person undergoes the treatment and care:
the person’s treatment and care benefits;
the person’s income replacement benefit payments.
If the relevant insurer decides to suspend the injured person’s benefit or payment, the insurer must give the injured person written notice (a suspension notice) stating—
the reasons for the suspension; and
the actions the injured person may take to avoid the benefits or payments being suspended; and
the date the suspension takes effect; and
that the injured person may seek internal review of the suspension under part 2.10 (Defined benefits—dispute resolution).
A suspension notice must be given to the injured person at least 2 weeks before the date the suspension takes effect.
The MAI guidelines may provide for the matters that must be taken into consideration by an insurer in deciding to suspend an injured person’s benefits or payments.
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