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Close, terminate or reopen a claim - Medicare Compensation Recovery 011-15040040



Actions available on closed versus terminated claims

Table 1

Action

Closed claim

Terminated claim

Issue a refusal letter

Yes

No

Issue a Z2797 Not notifiable letter

Yes

Yes

Issue a letter for incomplete documents

Yes

Yes

Update contact details on the claim

Yes

Yes

Resend a copy of previously issued correspondence, including with an address change

Yes

Yes

Attach a document to the claim

Yes

Yes

Record a case note

Yes

Yes

Unlink documents

Yes

Yes

Send stale cheque correspondence

Yes

Yes

Confirmation requirements for terminating a claim due to withdrawal

Table 2

Notification form

Confirmation with other party required

Other party

Injured person or claimant

No

N/A

Injured person’s authorised solicitor

Yes

Injured person

Notifiable person or their solicitor

Yes

Injured person or their authorised solicitor

Close Termination reasons

Table 3

Termination reason

Description

Not proceeding

Claim was withdrawn by the injured person/claimant or decided by a court that it will not proceed

Incorrect inured person

Wrong person was selected for the claim.

NOPB paid

Only use this reason when advised by Program Management. A Notice of past benefits was paid, but the agency did not receive a Notice of judgment or settlement or a Notice of reimbursement arrangement, despite repeated contact attempts. Case notes must detail the Program Management advice given and by whom.

Case inactive

Permanently retired from MCRS. There was no activity or processing on the claim for longer than 2 years. This must be escalated to Program Management to make the decision to terminate.

Other

Miscellaneous, see case notes for detailed information.

Small amount <=$5000

Claim settled for an amount less than $5000

Closed on combined claims

The claim was one of several that were finalised by a single judgment/settlement/reimbursement arrangement under another claim.

Settled in favour of Defendant (Notifiable person)

As the claim settled in favour of the defendant (notifiable person) no compensation amount was paid to the injured person. The claim is not notifiable under the HOSC Act.

Not notifiable

Claim was not reportable to Medicare with respect to an injury suffered by a person. See Notifiable and not notifiable claims - Medicare Compensation Recovery.

Incorrect DOI

Wrong date of injury (DOI) selected for the claim, but the insurer insists on registration of a new claim (and issue of a new work item number (WIN). See Claim management - Medicare Compensation Recovery

Incorrect document linked

Identical document/s appear on two work items resulting in the claim being registered twice by different service officers on same day.