s 191

Internal review—decision

In force

(1)

An insurer must, within 10 business days after receiving an application for internal review of an internally reviewable decision—

(a)

decide to—

(i)

affirm the decision; or

(ii)

amend the decision; or

(iii)

set aside the decision and make a substitute decision; and

(b)

give the applicant written notice of the decision (an internal review notice) that includes the following:

(i)

the reasons for the decision;

(ii)

information about how the applicant may apply for external review of the decision.

(2)

However, the MAI guidelines may provide for particular circumstances in which the 10 business days may be extended.

(3)

A decision by the insurer under subsection (1) takes effect on the day the internally reviewable decision was made.

(4)

A regulation may prescribe—

(a)

additional information an internal review notice may or must contain; and

(b)

any document or thing that must accompany a notice; and

(c)

anything else in relation to a notice.

Division 2.10.3 ACAT review of insurer’s decisions

Research tools for this sectionPro

The statute text is free to read above. View Pro plans to unlock the case-law research tools for each provision.