Can the insurer decline my claim?

Yes. An insurer can dispute any part or your entire claim.

When disputing your claim the insurer under Section 74 of the Workers Compensation Act must provide you a written notice of the reasons why the claim is declined and provide a copy of all medical evidence and other documents that they rely upon in declining your claim.

A claim could be declined for the following reasons:

  • The insurer does not believe you are injured at work
  • The insurer does not believe the injury is any longer work related
  • The insurer believes you have recovered from your injury and can return to work
  • The insurer does not believe the medical treatment you have requested is reasonable or necessary
  • The insurer has medical evidence which states that your injury is not work related

The insurer cannot stop payments of weekly compensation until they have provided you with a written notice of the reasons the claim is declined.