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40.1.1 Timely Approach to Claims Processing
It is the duty of all delegates to determine all claims for compensation in an accurate and timely manner. The accuracy of determinations is not negotiable. No compromise can be accepted in the degree of care and diligence in deciding any entitlement under the Act. Claims assessors should always aim to meet the targets for time taken to process of 75 days for the VEA and 120 days for the SRCA and MRCA. Where possible, the assessment of claims should commence as soon as possible after receipt and the regular ongoing management of those claims conducted in a reasonable timeframe. To achieve this it is important that both the claims assessors and their managers closely monitor the claims that are received and on hand to ensure a good awareness of the status of claims and circumstances of the clients. The principles to be applied to claims processing to assist in achieving this goal are as follows;
- Start the investigation of all claims within 7 days of assignment;
- Complete all follow up actions on the day they become due;
- Refuse to get stuck, ask for help the day a problem becomes evident.
In some cases however, the urgency associated with the matter means that a claim must be dealt with ahead of older claims and significant attention needs to be given to obtaining the necessary information to make a determination. This is a judgement call for the delegate and/or the manager based on the degree of personal distress, financial hardship and medical or rehabilitation concerns of the client.
Priorities need to be attributed by the claims assessor and their manager, and based on the circumstances of the claim at the time of receipt and allocation. These priorities will need to be regularly reviewed during the progress of the claim where changes to the claimant's circumstances may provide a greater urgency. This regular review can be conducted as part of the case conferencing process between claims assessors and their team leader or Director/Manager.