External review—decision
197 External review—decision
In deciding an application for external review of an ACAT reviewable decision, the ACAT must, by order—
affirm the decision; or
amend the decision; or
set aside the decision and—
make a substitute decision; or
remit the matter for reconsideration by the insurer that made the decision (the decision-maker) in accordance with any direction of the ACAT.
In deciding the application for external review, the ACAT must only consider the information that was available to the decision-maker when the decision was made.
However, the ACAT may, on application by a party, give the party leave to present information or evidence that was not reasonably available to the decision-maker when the decision was made.
Example a medical report for an examination undertaken, but not reported on, when the decision was made
A regulation may prescribe conditions for allowing additional information or evidence to be presented under subsection (3).
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