197External review—decision

197 External review—decision (1) In deciding an application for external review of an ACAT reviewable decision, the ACAT must, by order— (a) affirm the decision; or (b) amend the decision; or (c) set aside the decision and— (i) make a substitute decision; or (ii) remit the matter for reconsideration by the insurer that made the decision (the decision-maker) in accordance with any direction of the ACAT.

(2) In deciding the application for external review, the ACAT must only consider the information that was available to the decision-maker when the decision was made. (3) However, the ACAT may, on application by a party, give the party leave to present information or evidence that was not reasonably available to the decision-maker when the decision was made. a medical report for an examination undertaken, but not reported on, when the decision was made (4) A regulation may prescribe conditions for allowing additional information or evidence to be presented under subsection (3).