s 163

Final offer WPI 10% or more—injured person not entitled to make motor accident claim

In force

(1)

This section applies if—

(a)

the relevant insurer for a motor accident decides an injured person’s final offer WPI is at least 10%; but

(b)

the injured person is not entitled to make a motor accident claim in relation to the motor accident.

(2)

The relevant insurer must, within the stated time, give the person a written notice—

(a)

if the insurer requested the IME provider to arrange a review of the first WPI report under section 159—including a copy of the IME provider’s notice of affirmation or increase; and

(b)

telling the injured person—

(i)

their final offer WPI; and

(ii)

how they may apply to the ACAT for review of the final offer WPI decision; and

(iii)

if separate WPI reports assess an injured person’s physical injuries and psychological injuries—how the final offer WPI was determined; and

(c)

offering the person the amount of quality of life benefits payable for their final offer WPI under division 2.6.4 (Quality of life benefits—amount payable); and

(d)

telling the person that the person must, within 28 days after receiving the notice, notify the insurer, in writing, whether they—

(i)

accept the offer; or

(ii)

have applied to the ACAT for review of the final offer WPI decision.

(3)

If the injured person does not notify the relevant insurer within the 28 days, the person is taken to have accepted the offer.

(4)

The relevant insurer must take all reasonable steps to notify the injured person about the consequences of failing to notify the insurer as stated in the notice under subsection (2) within the 28 days.

Examples—reasonable steps

1 including information in the written notice under s (2) about the consequences of failing to notify the insurer within the 28 days

2 sending the injured person a reminder notice before the 28 days

(5)

If the injured person accepts (or is taken to accept) the offer—

(a)

the person’s application for quality of life benefits is taken to have been finally dealt with; and

(b)

the relevant insurer must pay to the injured person the amount of quality of life benefits payable for their final offer WPI under division 2.6.4.

(6)

In this section:

stated time means—

(a)

if separate first WPI reports are provided for the injured person’s physical injuries and psychological injuries and the insurer requests the IME provider arrange a review of only 1 report under section 159—14 days after receiving the IME provider’s notice of affirmation or increase; or

(b)

if separate first WPI reports are provided for the injured person’s physical injuries and psychological injuries and the insurer requests the IME provider arrange a review of both reports under section 159—14 days after receiving the IME provider’s notice of affirmation or increase for both reports; or

(c)

if only 1 first WPI report is provided and the insurer requests the IME provider arrange a review under section 159—14 days after receiving the IME provider’s notice of affirmation or increase; or

(d)

if separate first WPI reports are provided for the injured person’s physical injuries and psychological injuries and the insurer did not request the IME provider arrange a review of either report under section 159—28 days after receiving the later of the second WPI reports; or

(e)

if only 1 first WPI report is provided and the insurer did not request the IME provider arrange a review under section 159—28 days after receiving the second WPI report.

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