In an ideal world making a claim for workers’ compensation or compulsory third party (CTP) motor vehicle accident compensation ends with the claimant being paid an amount they are satisfied and happy with.
But for around 17,000 people each year, such claims for compensation end up in dispute resolution because the person making the claim is unhappy with the response of the insurance company handling the claim. This may be because their claim is refused or they consider the amount offered as compensation – and the reasons for it – to be inadequate.
As anyone whose compensation claim has resulted in dispute resolution would know, this process is not exactly straightforward.
Depending on the type of claim, dispute resolution in NSW is handled by one of a number of bodies, including the Workers Compensation Commission (WCC), as well as the Dispute Resolution Service (DRS), Motor Accidents Claims Assessment and Resolution Service (CARS) and Motor Accidents Medical Assessment Service (MAS) offered under the auspice of the State Insurance Regulatory Authority (SIRA).
From March 2021 – in an important simplification of the dispute resolution process – all personal injury-related claims will come before the newly legislated Personal Injury Commission (PIC). The PIC merges the dispute resolution schemes of both the workers’ compensation and CTP schemes so that the one, independent tribunal will manage applications for dispute resolution in these types of claim.
“Making a compensation claim is already stressful enough, and this new Commission will put the claimant at the centre of the dispute resolution process,” said the relevant NSW Minister, Victor Dominello, once the legislation was passed.
How will the PIC work?
The motivation for the introduction of the PIC is to provide a ‘one-stop shop that will resolve compensation disputes justly, quickly and as cost-efficiently as possible.
To that end, the new tribunal will be constituted by two specialist divisions to deal with workers’ compensation and motor accidents, presided over by an independent judicial head (President).
The PIC President can appoint medical assessors for workers’ compensation and motor accident matters, and merit reviewers for motor accident matters. The new Act also enables the Commission to appoint mediators for work injury damages claims under the Workplace Injury Management and Workers Compensation Act 1998.
A person whose claim comes before the Commission is entitled to be represented by a lawyer, or by an agent (such as a union rep). The Commission may refuse to permit a party to be represented by an agent if it is of the opinion that the agent does not have sufficient authority to make binding decisions on behalf of the party.
In workers’ compensation claims where the claimant is unrepresented, the Commission must refuse to permit an insurer to be represented by an Australian legal practitioner unless leave is granted by the Commission.
The PIC is designed to resolve claims in a less formal way than court proceedings. To this end, proceedings may be by way of video or telephone conference between the parties, rather than a formal hearing.
Decisions of the Commission in workers’ compensation claims are final and binding on the parties, and not subject to appeal or review. The NSW Supreme Court retains the power to provide, however, relief for jurisdictional error in proceedings as part of a judicial review of a decision of the Commission.
The importance of legal representation
It’s important to note that while the PIC has been created to streamline the dispute resolution process, there is no change to the underlying substantive law in relation to entitlements of injured persons to damages or other compensation, or assistance in either workers’ compensation or motor accident compensation claims.
For this reason, it is important to avail yourself of an experienced compensation lawyer should you need to make a claim for compensation. In the event your claim requires dispute resolution, a legal professional with expertise in negotiating satisfactory outcomes with insurers is vital to ensure you get what you’re entitled to.
At BPC Lawyers we are personal injury specialists, with years of experience handling workers’ compensation and motor vehicle accident claims. We have helped you navigate the new PIC should your claim require a dispute resolution process with the insurer.