What is provisional liability?
Provisional liability is an interim decision made by the insurer to provide financial assistance while a Workers Compensation claim is investigated. It allows the worker to receive support even before the insurer determines full liability.
How long does provisional liability last?
Provisional liability is for a period of 12 weeks and covers loss of income and up to $10,000 for reasonable medical expenses.
Why can the insurer refuse provisional liability?
The insurer may refuse provisional liability and have the claim reasonably excused. The reasons the insurer can reasonably excuse the claim include:
- Insufficient evidence that the injured person is a worker
- Insufficient medical evidence
- The worker cannot be contacted
- The worker refuses to allow the insurer to access personal information such as health records
- The insurer believes the injury is not work related
- There is no requirement for weekly compensation
- The injury was reported more than 2 months after it occurred
When can provisional payments be ceased?
Provisional payments can be stopped if:
- The worker doesn’t provide a certificate of capacity
- The worker doesn’t provide an authority allowing the insurer to obtain information about the injury
- The worker has returned to work and there is no further loss of earnings or need for medical treatment
Liability is determined
