Commonwealth Consolidated Acts

[Index] [Table] [Search] [Search this Act] [Notes] [Noteup] [Previous] [Next] [Download] [Help]

HEALTH AND OTHER SERVICES (COMPENSATION) ACT 1995 - SECT 21

Notice of past benefits

  (1)   If, in relation to each notice given to the claimant under section   17 in respect of the claim for compensation, either:

  (a)   the claimant has given to the Chief Executive Medicare a statement under section   18; or

  (b)   the period for giving the statement has expired;

the Chief Executive Medicare may give to the notifiable person a notice under this section.

  (2)   The notice must set out:

  (a)   the period covered by the notice; and

  (b)   the total amount of eligible benefits paid by the Commonwealth, during that period, in respect of services and care rendered or provided in the course of treatment of, or as a result of, the injury the claimant claims to have suffered.

  (3)   If the claimant had given to the Chief Executive Medicare a statement under section   18 prior to the Chief Executive Medicare giving the notice, the notice must not, in relation to the period covered by the statement, take account of any eligible benefits that were paid in respect of services or care not specified in the statement.

  (4)   Without limiting the matters that the notice may include, it may include information about amounts that may become payable to the Commonwealth under this Act or the Charges Act in respect of the amount of compensation in question.

  (5)   Without limiting the matters that the notice may include, it may include a statement to the effect that, if an amount of compensation is fixed under a judgment or settlement made in respect of the claim within 6 months after the notice was given, the notice is taken to be a notice of charge under section   24, given by the Chief Executive Medicare on the day on which the compensation is fixed.

  (6)   If a notice contains a statement of a kind referred to in subsection   (5), it must also contain a statement to the effect that, subject to subsection   (7), if:

  (a)   the notice is taken to be a notice of charge under section   24; and

  (b)   the judgment or settlement fixes the amount of compensation on the basis that liability for the injury should be apportioned between the compensable person and the compensation payer; and

  (c)   as a result, the amount of compensation is less than it would have been if liability had not been so apportioned;

the amount specified in the notice as payable to the Commonwealth is reduced by the proportion corresponding to the proportion of liability for the injury that is apportioned to the compensable person by the judgment or settlement.

  (7)   If a notice contains a statement of a kind referred to in subsection   (5), it must also contain a statement to the effect that, if:

  (a)   the notice is taken to be a notice of charge under section   24; and

  (b)   the amount of compensation is fixed by a judgment that specifies an amount (the past expenses component ), being a portion of the amount of compensation, to be a component for either or both of the following:

  (i)   the medical expenses already incurred relating to the injury;

  (ii)   the expenses in respect of nursing home care, residential care or home care already incurred relating to the injury;

the past expenses component is taken to be the amount specified in the notice as payable to the Commonwealth.

  (8)   Without limiting the matters that the notice may include, it may include a statement to the effect that if a reimbursement arrangement is made in respect of the claim, the notice is taken to be a notice of charge under section   25, given by the Chief Executive Medicare on:

  (a)   if the reimbursement arrangement was made before the Chief Executive Medicare gives the notice to the notifiable person--the day on which the Chief Executive Medicare gives the notice to the notifiable person; or

  (b)   in any other case--the day on which the reimbursement arrangement is made.

  (9)   The Chief Executive Medicare must give a copy of any such notice to the claimant.

  (10)   The Chief Executive Medicare may give more than one notice to the notifiable person in respect of the same claim for compensation.

  (11)   Subject to subsection   (13), the claimant or the notifiable person may request the Chief Executive Medicare to give the notifiable person a notice.

  (12)   The Chief Executive Medicare must comply with such a request:

  (a)   if, at the time the request was made, the claimant had been given a notice under section   17 with which he or she had not yet complied but the period for compliance had not expired--within 28 days after he or she complies or within 28 days after the period for compliance expires, whichever happens first; or

  (b)   if the Chief Executive Medicare gives to the claimant a notice under section   17 within 28 days after the request was made--within 28 days after the claimant complies with the notice, or within 28 days after the period for compliance expires, whichever happens first; or

  (c)   in any other case--within 28 days after the request was made.

  (13)   Subsection   (11) does not apply if:

  (a)   the Chief Executive Medicare had given the notifiable person a notice within the period of 6 months prior to the request; or

  (b)   a judgment has been made in respect of the claim for compensation.



AustLII: Copyright Policy | Disclaimers | Privacy Policy | Feedback