Asbestos-Related Diseases (Occupational Exposure) Compensation Act 2011

Within 10 business days of receiving a claim under section 121(1) for expenses, the Commissioner – must, under section 123, if the expenses have not been paid, pay the expenses or, if the expenses have been paid by a person, reimburse to the person the amount of the expenses; or must – serve the person who lodged the claim with notice in writing disputing the claim; and if the expense has not been paid, notify in writing the person who provided the compensable service, if any, to which the claim relates that liability for the expenses is disputed and outline the reasons for disputing the liability; and if the refusal of the Commissioner to pay the expenses relates to a medical question, refer the matter to a medical panel.

A notice under subsection (1)(b) to a person who lodged a claim for expenses is to – state that the Commissioner disputes liability to pay the expenses; and state the reasons why the Commissioner disputes liability to pay the expenses; and attach or identify the medical or other evidence that the Commissioner relies on for disputing liability to pay the expenses; and if the refusal of the Commissioner to pay the expenses relates to a medical question, advise the person that the matter has been referred to a medical panel.

A notice under subsection (1)(b) to a person who lodged a claim for expenses is also to state whether the Commissioner disputes – only the expenses to which the claim for expenses relates; or all – expenses of a specified kind; or expenses incurred with a particular person who supplies medical, hospital, nursing, constant attendance, rehabilitation or ambulance services; or travelling and maintenance expenses related to the provision of medical, hospital, nursing, constant attendance, rehabilitation or ambulance services; or liability to pay expenses of any kind whatsoever claimed by the person under this Part.

If the Commissioner has served on a person a notice for the purposes of subsection (1)(b) disputing expenses of a kind referred to in subsection (3)(b), the Commissioner is not required to comply with this section in respect of any other claim subsequently received from the person – for payment of an expense of the same kind; or incurred with the same particular person, referred to in the notice, who provides the service to which the expenses relate – until a relevant determination is made in relation to the expenses.

For the purposes of subsection (4), a relevant determination in relation to the expenses is – a determination by the Tribunal that the Commissioner is liable to pay the expenses; or a determination by a medical panel that in the opinion of the medical panel the expenses are reasonable, necessarily incurred and required by the person as a result of the person having an asbestos-related disease.

If the Commissioner has served on a person a notice for the purposes of subsection (1)(b) disputing expenses of a kind referred to in subsection (3)(c), the Commissioner is not required to comply with this section in respect of any other claim subsequently received from the person until – the Tribunal has determined that the Commissioner is liable to pay the expenses to which the notice relates; or a medical panel has advised the Commissioner that in the opinion of the medical panel the expenses are reasonable, necessarily incurred and required by the person as a result of the person having an asbestos-related disease.

If the Commissioner fails to serve on a person a notice for the purposes of subsection (1)(b) as required by this section, the Commissioner is to be taken to have accepted liability to pay the expenses to which the notice relates.