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s 154

WPI less than 5%—insurer may make offer

In force
Chapter 2Motor accident injuries—defined benefits
Part 2.6Defined benefits—quality of life benefits
Division 2.6.3Quality of life benefits—WPI assessment

154 WPI less than 5%—insurer may make offer

(1)

This section applies if—

(a)

if separate WPI reports from an independent medical examiner assess an injured person’s physical injuries and psychological injuries—the higher WPI assessment assesses the person’s WPI as less than 5%; or

(b)

if only 1 WPI report from an independent medical examiner assesses an injured person’s WPI—the person’s WPI is assessed as less than 5%.

(2)

The relevant insurer for the motor accident must give the injured person a written notice—

(a)

including a copy of each report; and

(b)

if there are separate WPI reports for the person’s physical and psychological injuries, and the insurer considers that it is appropriate to make an offer to the person—offering the person the amount of quality of life benefits payable for their WPI under division 2.6.4 (Quality of life benefits—amount payable); and

(c)

telling the person that the person must, within 26 weeks after receiving the notice—

(i)

notify the insurer, in writing, whether they accept or disagree with each report; and

(ii)

if the person disagrees with a report and wishes to have a second WPI assessment carried out—

(A)

arrange a second WPI assessment at their own expense; and

(B)

give the insurer the second WPI report.

(3)

The relevant insurer for the motor accident must give the notice to the injured person—

(a)

if there are separate WPI reports for the person’s physical and psychological injuries—within 14 days after receiving the later report; or

(b)

if there is only 1 WPI report—within 14 days after receiving the report.

(4)

If the injured person does not notify the insurer, and give the insurer the second WPI report, within the 26 weeks, the person is taken to have accepted—

(a)

if the relevant insurer has made an offer—the offer; and

(b)

if the relevant insurer has not made an offer—each report stated in the notice under subsection (2).

(5)

The relevant insurer must take all reasonable steps to notify the injured person about the consequences of failing to notify the insurer, and failing to give the insurer the second WPI report, as stated in the notice under subsection (2) within the 26 weeks.

Examples—reasonable steps

1 including information in the written notice under s (2) about the consequences of failing to notify the insurer, and failing to give the insurer the second WPI report, within the 26 weeks

2 sending the injured person a reminder notice before the end of the 26 weeks

(6)

If the injured person accepts (or is taken to accept) the offer or the report, the person’s application for quality of life benefits is taken to have been finally dealt with.

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