sec.281Parties to attempt to resolve claim

### sec.281 Parties to attempt to resolve claim The parties must endeavour to resolve a claim as quickly as possible. The insurer must give the claimant a written notice under subsection (4) within 6 months after— the insurer receives a complying notice of claim or waives the claimant’s noncompliance with the requirements of section 275 ; or the court makes an order under section 297 ; or the court makes an order under section 298 . For subsection (2) , for a worker with a terminal condition, the insurer must give the claimant the written notice within 3 months. The written notice must— state whether liability in connection with the event to which the claim relates is admitted or denied and— if liability is admitted— state whether contributory liability is claimed from the worker or another party; and state the extent, expressed as a percentage, to which liability is admitted; and if liability is denied, completely or partly—give particulars of the basis on which liability is denied; and state whether the insurer accepts or rejects any offer of settlement that may be made by the claimant; and if the claimant did not make an offer of settlement in the notice of claim or the insurer is rejecting the offer—contain a genuine offer or counter-offer of settlement, or a statement of the reasons why an offer or counter-offer of settlement can not yet be made; and be accompanied by copies of all medical reports, assessments of cognitive, functional or vocational capacity, or other material in the insurer’s possession not previously given to the claimant that may help the claimant to make a proper assessment of the offer. The insurer must, within 5 business days after giving the claimant the written notice, give a copy of the notice to any contributor. If the insurer is WorkCover, WorkCover must also, within 5 business days after giving the claimant the written notice, give a copy of the notice to the worker’s employer. The insurer or the claimant to whom a written offer or counter-offer of settlement is made must respond in writing to the offer within 10 business days after receiving it, indicating acceptance or rejection of the offer, unless a response to the offer is to be made under subsection (4) (b) . The offer or counter-offer of settlement is made on a without prejudice basis and must not be disclosed to a court except on the issue of costs. An admission of liability by an insurer under this section— is not binding on the insurer at all if it is later shown at the trial in the proceeding for damages that the claimant has been relevantly guilty of fraud or attempted fraud; and is not binding on the insurer at all if it is later shown that liability was admitted because of misrepresentation by any person; and is not an admission about the nature and extent of the claimant’s loss or damage or that the claimant has sustained loss or damage, unless it specifically states otherwise; and does not entitle the claimant to apply for judgment, summary or otherwise, in a court of competent jurisdiction; and is confined to damages under the claim. In calculating the period of 6 months mentioned in subsection (2) , any period during which a decision of the insurer relevant to the claim is subject to a review or appeal is not counted. In this section— decision , for subsection (9) , includes failure to make a decision. review or appeal means a review or appeal under chapter 13 that has been started. s 281 amd 2004 No. 45 ss 45 , 3 sch (sec.281-ssec.1) The parties must endeavour to resolve a claim as quickly as possible. (sec.281-ssec.2) The insurer must give the claimant a written notice under subsection (4) within 6 months after— the insurer receives a complying notice of claim or waives the claimant’s noncompliance with the requirements of section 275 ; or the court makes an order under section 297 ; or the court makes an order under section 298 . (sec.281-ssec.3) For subsection (2) , for a worker with a terminal condition, the insurer must give the claimant the written notice within 3 months. (sec.281-ssec.4) The written notice must— state whether liability in connection with the event to which the claim relates is admitted or denied and— if liability is admitted— state whether contributory liability is claimed from the worker or another party; and state the extent, expressed as a percentage, to which liability is admitted; and if liability is denied, completely or partly—give particulars of the basis on which liability is denied; and state whether the insurer accepts or rejects any offer of settlement that may be made by the claimant; and if the claimant did not make an offer of settlement in the notice of claim or the insurer is rejecting the offer—contain a genuine offer or counter-offer of settlement, or a statement of the reasons why an offer or counter-offer of settlement can not yet be made; and be accompanied by copies of all medical reports, assessments of cognitive, functional or vocational capacity, or other material in the insurer’s possession not previously given to the claimant that may help the claimant to make a proper assessment of the offer. (sec.281-ssec.4A) The insurer must, within 5 business days after giving the claimant the written notice, give a copy of the notice to any contributor. (sec.281-ssec.5) If the insurer is WorkCover, WorkCover must also, within 5 business days after giving the claimant the written notice, give a copy of the notice to the worker’s employer. (sec.281-ssec.6) The insurer or the claimant to whom a written offer or counter-offer of settlement is made must respond in writing to the offer within 10 business days after receiving it, indicating acceptance or rejection of the offer, unless a response to the offer is to be made under subsection (4) (b) . (sec.281-ssec.7) The offer or counter-offer of settlement is made on a without prejudice basis and must not be disclosed to a court except on the issue of costs. (sec.281-ssec.8) An admission of liability by an insurer under this section— is not binding on the insurer at all if it is later shown at the trial in the proceeding for damages that the claimant has been relevantly guilty of fraud or attempted fraud; and is not binding on the insurer at all if it is later shown that liability was admitted because of misrepresentation by any person; and is not an admission about the nature and extent of the claimant’s loss or damage or that the claimant has sustained loss or damage, unless it specifically states otherwise; and does not entitle the claimant to apply for judgment, summary or otherwise, in a court of competent jurisdiction; and is confined to damages under the claim. (sec.281-ssec.9) In calculating the period of 6 months mentioned in subsection (2) , any period during which a decision of the insurer relevant to the claim is subject to a review or appeal is not counted. (sec.281-ssec.10) In this section— decision , for subsection (9) , includes failure to make a decision. review or appeal means a review or appeal under chapter 13 that has been started. - (a) the insurer receives a complying notice of claim or waives the claimant’s noncompliance with the requirements of section 275 ; or - (b) the court makes an order under section 297 ; or - (c) the court makes an order under section 298 . - (a) state whether liability in connection with the event to which the claim relates is admitted or denied and— (i) if liability is admitted— (A) state whether contributory liability is claimed from the worker or another party; and (B) state the extent, expressed as a percentage, to which liability is admitted; and (ii) if liability is denied, completely or partly—give particulars of the basis on which liability is denied; and - (i) if liability is admitted— (A) state whether contributory liability is claimed from the worker or another party; and (B) state the extent, expressed as a percentage, to which liability is admitted; and - (A) state whether contributory liability is claimed from the worker or another party; and - (B) state the extent, expressed as a percentage, to which liability is admitted; and - (ii) if liability is denied, completely or partly—give particulars of the basis on which liability is denied; and - (b) state whether the insurer accepts or rejects any offer of settlement that may be made by the claimant; and - (c) if the claimant did not make an offer of settlement in the notice of claim or the insurer is rejecting the offer—contain a genuine offer or counter-offer of settlement, or a statement of the reasons why an offer or counter-offer of settlement can not yet be made; and - (d) be accompanied by copies of all medical reports, assessments of cognitive, functional or vocational capacity, or other material in the insurer’s possession not previously given to the claimant that may help the claimant to make a proper assessment of the offer. - (i) if liability is admitted— (A) state whether contributory liability is claimed from the worker or another party; and (B) state the extent, expressed as a percentage, to which liability is admitted; and - (A) state whether contributory liability is claimed from the worker or another party; and - (B) state the extent, expressed as a percentage, to which liability is admitted; and - (ii) if liability is denied, completely or partly—give particulars of the basis on which liability is denied; and - (A) state whether contributory liability is claimed from the worker or another party; and - (B) state the extent, expressed as a percentage, to which liability is admitted; and - (a) is not binding on the insurer at all if it is later shown at the trial in the proceeding for damages that the claimant has been relevantly guilty of fraud or attempted fraud; and - (b) is not binding on the insurer at all if it is later shown that liability was admitted because of misrepresentation by any person; and - (c) is not an admission about the nature and extent of the claimant’s loss or damage or that the claimant has sustained loss or damage, unless it specifically states otherwise; and - (d) does not entitle the claimant to apply for judgment, summary or otherwise, in a court of competent jurisdiction; and - (e) is confined to damages under the claim.