sec.172Deciding service request— Act , s 232P

sec.172 Deciding service request— Act , s 232P

For section 232P (4) of the Act , this section prescribes the matters an insurer must consider in deciding a service request relating to an eligible worker. The insurer must consider the following matters— whether or not the requested service relates to— the worker’s treatment, care and support needs resulting from the worker’s serious personal injury; or the worker’s need for treatment, care or support resulting from another injury resulting from the same event as the worker’s serious personal injury; if the requested service relates to the treatment, care and support needs mentioned in paragraph (a) (i) —whether or not the needs are necessary and reasonable in the circumstances; if the requested service relates to the treatment, care or support mentioned in paragraph (a) (ii) —whether or not the treatment, care or support is necessary and reasonable in the circumstances; if the requested service does not relate to treatment, care and support needs or treatment, care or support mentioned in paragraph (a) (ii) , or the insurer does not consider the needs or the treatment, care or support mentioned in paragraph (a) (ii) are necessary and reasonable in the circumstances—whether or not the insurer should, wholly or partly, pay for the requested service under chapter 4A of the Act , having regard to the matters mentioned in section 170 (2) (f) . (sec.172-ssec.1) For section 232P (4) of the Act , this section prescribes the matters an insurer must consider in deciding a service request relating to an eligible worker. (sec.172-ssec.2) The insurer must consider the following matters— whether or not the requested service relates to— the worker’s treatment, care and support needs resulting from the worker’s serious personal injury; or the worker’s need for treatment, care or support resulting from another injury resulting from the same event as the worker’s serious personal injury; if the requested service relates to the treatment, care and support needs mentioned in paragraph (a) (i) —whether or not the needs are necessary and reasonable in the circumstances; if the requested service relates to the treatment, care or support mentioned in paragraph (a) (ii) —whether or not the treatment, care or support is necessary and reasonable in the circumstances; if the requested service does not relate to treatment, care and support needs or treatment, care or support mentioned in paragraph (a) (ii) , or the insurer does not consider the needs or the treatment, care or support mentioned in paragraph (a) (ii) are necessary and reasonable in the circumstances—whether or not the insurer should, wholly or partly, pay for the requested service under chapter 4A of the Act , having regard to the matters mentioned in section 170 (2) (f) .

• (a) whether or not the requested service relates to— (i) the worker’s treatment, care and support needs resulting from the worker’s serious personal injury; or (ii) the worker’s need for treatment, care or support resulting from another injury resulting from the same event as the worker’s serious personal injury;