My WorkCover insurer won’t pay for my surgery. What can I do?
When a WorkCover Insurer won’t pay for the surgery you need as a result of your workplace accident or injury, you may be preparing yourself for a conciliation meeting.
We know dealing with a large insurance company can be a daunting and frustrating experience. As challenging as this process may be, one of the best things you can do is arm yourself with knowledge about the claims process.
Depending on your dispute, you may be feeling nervous or unsure about what to expect or how you should get ready.
We’ve prepared some easy tips explaining the conciliation process, so you can feel confident you’re giving yourself the best chance at the right outcome.
The Conciliation process explained:
Conciliation is designed to be a fair, neutral dispute resolution process to help an agreement be reached outside of court. Both you and your WorkCover insurer will have the chance to provide information and raise issues related to the dispute, and have the opportunity to reach a mutual agreement by the end of the meeting.
There are a few simple steps you can take to make sure that you’re feeling ready for conciliation.
1. Think about the outcome you want
Be clear what you want to get out of conciliation. It helps to write down some clear talking notes about anything you want to be raised beforehand, so you have something to refer to during the meeting. Having this goal in mind will help you feel able to participate in the process.
Remember, the conciliation conference will only be able to deal with the particular insurer decision that you disagree with.
2. Be organised
Make sure you have all the relevant documentation ready to go.
Up-to-date records and easy to follow information that supports your position is the best thing to have for conciliation.
Your WorkCover claim form
Your medical documents (including medical reports from your doctors)
Any non-medical documents relevant to your case, such as the incident report or statements from your co-workers
Before you head in have all of these ready in an order that makes sense to you, so you can present your case with confidence.
3. Be aware
It’s useful for you to hang on to the letter from the WorkCover insurer responding to your request and make sure you understand what their position is clearly, even though you might disagree with it. The process will be made easier for you when you know what the other side of the table is going to say.
What’s Conciliation like?
A conciliation meeting is designed to be a fair, informal service for reaching an agreement. An independent officer will guide the process. These officers understand the nature of these disputes, and will ask enough questions to ensure that everyone has a chance to speak. They will speak to you separately and privately and also mediate discussions between both parties.
Conciliation meetings are scheduled at 90 minutes, but depending on the nature of the dispute they can finish up earlier or require more time.
If you need assistance after conciliation, or would like assistance arranging for an advocate to attend conciliation with you, our team of friendly lawyers are experienced in workers compensation issues. Give us a call on 1800 21 22 23