How is liability determined?
CGU will work in consultation with you to determine liability quickly and then assess the injured worker’s compensation entitlement for weekly benefits, medical and other expenses. CGU will undertake a thorough review of all information prior to determining initial liability and then work to establish an appropriate claims management strategy.
On receipt of a valid claim, CGU will contact you within three working days to discuss the circumstances of your employee’s injury including:
- how the injury occurred and whether their employment was a contributing factor to the claimed injury
- whether your employee has lost time from work as a result of their injury
- any return to work opportunities
- whether the worker is a ‘worker’ (or deemed worker) for the purposes of Accident Compensation Act 1985 or Workers Injury Compensation and Rehabilitation Act (for injuries sustained on or after 1 July 2014)
- any other grounds for rejecting liability, for example the worker’s injury was due to serious and wilful misconduct
- whether you need any assistance during the claims management process.
CGU will review and consider all treating medical practitioner reports, forms and accident circumstance reports and any other documentation submitted by the worker.
To assist in determining liability of a worker’s claim, CGU may arrange for the worker to be assessed by an independent medical examiner to assist in determining liability.