Conciliation - challenging decisions of WorkCover insurers

Conciliation - challenging decisions of WorkCover insurers

If your WorkCover insurer makes a decision in writing that you disagree with or fails to respond to a request within 28 days, you can ask to meet with a representative from the insurance company to try and resolve the dispute. This meeting is referred to as Conciliation.

In order to arrange a Conciliation meeting, you must lodge a Request for Conciliation with the Accident Compensation Conciliation Service (ACCS). The form must be lodged within 60 days of the date of the insurer's decision, although extensions are possible in some circumstances.

The ACCS will request information from your treating doctors in preparation for the Conciliation meeting. They will also arrange a time for you to meet with one of their representatives, together with a representative from the insurer, yourself and occasionally a representative from the employer. You can also arrange for assistance from your Union, Union Assist or WorkCover Assist.

At the Conciliation, there are five possible outcomes:

  • The matter could be adjourned;
  • The insurer could withdrawn their decision and reinstate your entitlements;
  • The insurer could make you an offer to settle the dispute for a limited amount of benefits;
  • Your case could be referred to the Medical Panel if there are medical questions in dispute; or
  • If you are unable to reach any of the above outcomes, the Conciliator will issue a Genuine Dispute Certificate, enabling you to issue Magistrates Court proceedings if you wish.

If you are required to take a day off work to attend the conciliation, you are entitled to be compensated by the Victorian WorkCover Authority for your reasonable transport costs up to $50, and your loss of income up to $350. You are only entitled to compensation for loss of income if you take a day of leave without pay, rather than paid sick leave, annual leave or weekly payments.

If you or someone you know have been injured at work, we invite you to contact one of our WorkCover experts on (03) 9321 9988 to get some advice on your potential entitlements.

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