Once the application for review is lodged it will be assessed by the Office of Industrial Relations. If the application for review is deemed valid, the insurer will be instructed to provide their claim file and it will be sent to the Review Unit.
Both the applicant and the other party will be sent correspondence to advise the application is deemed valid. This correspondence will include an information sheet to provide some further information regarding the process.
A Review Officer will then be assigned the application. The role of a Review Officer is to conduct an impartial administrative review of the decision 'on the papers'. This means that the Review Officer cannot give advice on what information to provide and they cannot conduct investigations or make enquiries into obtaining information.
A Review Officer will only be able to consider the information contained within the insurer file and any additional written information provided by the applicant or other party as part of the review application.
Procedural fairness obligations
Any new information provided during the review process may be disclosed to other parties under procedural fairness if the information is new, significant, relevant and adverse. This ensures the party is aware of the information and provides them with the opportunity to respond to the material.
If the information does not meet this criteria, it will not be released. This includes the information contained on the application for review.
Right of Appearance
If an applicant has elected to have a Right of Appearance on the application, the Review Officer will contact the applicant to organise a suitable date and time.
If an applicant chooses to have a Right of Appearance in person, they may bring a support person with them. An applicant is asked to please advise the Review Officer of this to ensure adequate facilities for the meeting are available.
Depending upon the matters the applicant would like to discuss, a Right of Appearance can vary between ten minutes up to an hour.
The Office of Industrial Relations undertakes the Right of Appearance in a professional and non-adversarial manner and as such expects that attendees behave accordingly. Aggressive behaviour, threats or abusive language may lead to early termination of the Right of Appearance.
What happens next?
A Review Officer will consider the written information, and make an impartial evidence-based decision.
The Review Officer will endeavour to make the decision within 25 business days of the application for review being lodged. The process may take longer if an extension has been granted, or if information is being exchanged between the parties through procedural fairness obligations.
If a Review Officer doesn't make a review decision within 25 business days, or the agreed extension timeframe, an applicant can:
- appeal to an Industrial Magistrate
- wait for the review decision to be made.