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Claim was withdrawn by the injured person/claimant or decided by a court that it will not proceed |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