What is a Section 74 Notice?
A Section 74 Notice is a written decision made by the insurer outlining the reasons to decline your claim and/or medical expenses. A Section 74 Notice will include documents that the insurer has relied on to arrive at their decision.
It is important to note that if you are told over the phone by the insurer that they are declining your claim and/or medical expenses the insurer must put their decision in writing in the form of a Section 74 Notice.
It is vital that the insurer provides you with a Section 74 Notice as you need it to challenge the insurers decision. Often, insurers will delay sending out Section 74 Notices, which means that the injured worker cannot challenge the decision and will not receive their weekly payments or have treatment expenses paid.
If you have not received a Section 74 Notice and you have been informed that the insurer has declined your claim and/or medical expenses you should ask the insurer to provide you with a written Section 74 Notice.
Can I challenge the insurers decision?
Yes…it is suggested that you seek the expertise of a lawyer when challenging the decision of a Section 74 Notice. The first option to get the decision changed is to apply for an internal review. However, we find that this is generally a pointless process as we have rarely, in all our years of practice seen an insurer change their decision after an internal review.
The second option is to have the insurers decision reviewed by the Workers’ Compensation Commission. This is the most effective method of review, and your lawyer will assist you with this process. Often, insurers decline your claim on the smallest bit of information that is beneficial to the insurer, even though it is quite clear that your injury is work related, or your treatment is reasonably necessary.
It is also important to remember that insurers are companies designed to make a profit. So, if they can decline your claim at the first instance, they will. Often the decision to decline a claim is largely unfounded, which is why we look at challenging the insurers decisions.
At Garling & Co we have challenge hundreds of decisions to stop weekly payments or refuse medical treatment and our success rate is almost 100%.
If you would like to discuss your claim please do not hesitate to call us on 8518 1120 or email firstname.lastname@example.org
GARLING AND CO LAWYERS