What is a ‘reasonable excuse’ notice not to commence provisional liability payments?

Where an injury has been notified to the insurer and there is insufficient information to determine the claim or there has been a significant delay between the injury and the notice of injury, the insurer will have a ‘reasonable excuse’ not to commence provisional liability payments. A ‘reasonable excuse’ may include the following:

  • Insufficient medical information
  • The injured person is unlikely to be an employee
  • The insurer is unable to contact the worker
  • The worker refuses to release information about the injury
  • The injury is not work related
  • The injury is notified two months after occurring
  • The injury is not a significant injury

If a reasonable excuse notice is provided the insurer has a further 21 days to make a decision as to whether they will accept or decline the claim.