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Why did my Insurer accept this claim?

As Consultants we are often asked why an Insurer has accepted a WorkCover claim.

Here are some summarized considerations that may explain the process:

  • All WorkCover Insurers are authorized Agents of WorkSafe/ WorkCover.

  • Your Insurer/Agent must follow strict legislative guidelines and be audited regularly to ensure compliance. Fines may apply to your Agent should they fail to meet guidelines and any breach places them at risk of losing their license as an authorized Agent of WorkSafe.

  • The legislation covers most employees for most injuries that occur on your watch and within your workplace. These injuries may include, however, are not limited to, the following:

  • Aggravation of a pre-existing condition.

  • Acceleration of a pre-existing condition.

  • New injuries that allegedly occurred in the workplace and that substantial proof to the contrary is not available.

  • An injury has occurred whereby employment has been a contributing factor.

  • A work-related mental injury.

  • Work-related death.

  • Exacerbation of a pre-existing injury.

An employee that meets the definition of a “Worker” may have an entitlement to many areas of compensation if they meet legislative criteria. Some include:

  • Payment of weekly benefits.

  • Payment of medical expenses.

  • Payment of a lump sum for permanent disability (separate and not impacting on weekly wages).

  • A Common Law payment


  • Choose your staff carefully matching skills to duties.

  • Carry out thorough reference checks.

  • Train your staff well

  • Eliminate/minimize risk

  • Manage each case proactively and seek advice as needed


  • Corporate Spectrum Pty Ltd employs Consultants with between 15-30 years of WorkCover experience to assist you in minimizing the duration of your claims where possible.

  • Our Consultants have sound practical and commercial knowledge.

  • Please contact Trish Cappola on 0404 014821 should you require any assistance.

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