Authority to access a claim - Medicare Compensation Recovery 011-15040120

This party can

Injured person

Parent

Legal representative (not solicitor – see note)

Authorised third party

Government regulatory authority

Compensation agent

be the compensable person

Yes

No

No

No

No

No

be the claimant

Yes - if 14 or over and mentally capable of managing their own affairs

Yes - if injured person is under 14 or not mentally capable of managing their own affairs

Yes

Yes

No

No

be the compensation payer

No

No

No

No

Yes

Yes

be the insurer

No

No

No

No

Yes

Yes

be the notifiable person

No

No

No

No

Yes

Yes

be the representative organisation

No

No

No

No

Yes

Yes

pay notice of charge to the agency

Yes - conditions apply

Yes - conditions apply

Yes - conditions apply

Yes - conditions apply

Yes

Yes

pay advance payment to the agency

No

No

No

No

Yes

Yes

receive updates on case processing from the agency

Yes - if claimant

Yes - if claimant

Yes - if claimant

Yes - if a valid Third party authority (MO021) form is held on theclaim

Yes - if no advance payment

Yes - if no advance payment

receive advance payment refund from the agency

Yes - if claimant

Yes - if claimant

Yes - if claimant

Yes - If MO024 form is provided with a trust account

No

No

receive notice of charge refund from the agency

Yes - conditions apply

Yes - conditions apply

Yes - conditions apply

No

Yes

Yes

receive ad hoc refund from the agency

Yes - conditions apply

Yes - conditions apply

Yes - conditions apply

No

Yes

Yes

Scenario

Authorised person/s

Evidence & action required (if applicable)

Minor under 14 years of age on the same Medicare card as the parent or guardian and on no other cards

Parent or guardian

Linked on Medicare card

• Medicare card

Minor under 14 years on the same Medicare card as the parent or guardian as well as their own Medicare card

State appointed authority/legal guardian

• Guardianship or court order

Note: do not use Medicare card as evidence, minor could be under Child Protection.

Minor under 14 years on a different Medicare card as the parent or guardian

State appointed authority/legal guardian

Parent/guardian (with relevant evidence provided)

• Guardianship or court order

Supporting documentation fromstate appointed authority/legal guardian, or

• Commonwealth of Australia Statutory Declaration (in consultation with programme management)

Minor under 14 years of age where a Power of Attorney, Executor, Public Trustee or other trustee is acting on their behalf

State appointed authority/legal guardian

• Guardianship or court order
• Probate or Letters of Administration, or
• Documentation from the Public Trustee

Minor under 14 years of age on their own Medicare card and no claimant is named

Minor - acting as an independent

• None required

Minor is under 14 years of age and no claimant is named

Claimant

• Details of the person making the claim on behalf of the minor must be given
• Reject – request details of the claimant be provided
• No provisional WIN to be registered.
• Courtesy call made to sender to advise that form cannot be actioned until a completed form with claimant/supporting evidence is provided
• NCRI notes to be left on minor’s record stating actions taken
• Issue We are unable to process (Z2802) letter, only if appropriate to issue to notifiable person

Minor over 14 years of age on the same Medicare card as the parent or guardian where the authority was signed when the minor was under 14 years of age

Parent/guardian

Accept – implied authority until the minor:

• turns 18 years of age, or

revokes the authority verbally or in writing or submits a new Medicare Compensation Recovery Third Party authority (MO021) form

Minor over 14 years of age on the same Medicare card as the parent or guardian where the authority was signed after the minor turned 14 years

Parent/guardian

• Signed authority from minor requesting parent/guardian act on their behalf

Minor over 14 years of age on the same Medicare card as the parent or guardian where there is no signed authority

Injured person

Parent/guardian or authorised third party if requested and MO021 signed by injured person

• Signed authority from minor requesting parent/guardian or solicitor to act on their behalf

Minor over 14 years of age on their own Medicare Card

Injured person

Authorised third party if requested and MO021 signed by injured person

• Signed authority from minor requesting authorised third party to act on their behalf

Minor is over 14 years of age and is not mentally or physically capable of handling their own affairs. A parent or guardian, Power of Attorney, Executor, Public Trustee or other trustee has been appointed

Parent/guardian, Power of Attorney, Executor, or trustee

• Supporting document from parent/guardian, Power of Attorney, Executor, or trustee
• Guardianship or court order
• Probate or Letters of Administration
• Documentation from the Public Trustee, or
• Commonwealth of Australia Statutory Declaration

Minor is over 14 years of age who is not physically or mentally capable of handling their affairs and has a claimant under 18 years

Claimant under 18 years

• Accept if supporting documents are received, or
• Reject if no supporting documents received – request documents be provided Guardianship or court order
• Documents from Public Trustee, or
• Commonwealth of Australia Statutory Declaration (in consultation with Program Management)