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Not proceeding	Claim was withdrawn by the injured person/claimant or decided by a court that it will not proceed.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