Disputes
If you or someone you know does not agree with a decision that is made, we encourage you to reach out to your care services coordinator to discuss this. The dispute could be about:
- whether the crash was a motor vehicle crash
- whether an injury resulted from a motor vehicle crash or was attributable to some other condition, event, incident or factor
- whether a motor vehicle injury meets the catastrophic injury criteria
- a decision made by the Insurance Commission to suspend the participation of a person in the scheme
- a decision not to approve an amount or type of treatment, care and support service.
If the matter cannot be resolved informally, you can apply to have the issue addressed through formal dispute resolution. The dispute resolution process allows for review of decisions for:
- CIS scheme eligibility; and
- amount or type of treatment, care and support services to be provided to people with catastrophic injuries.
You can apply for a review of the decision by a medical expert review panel:
- Current list of CIS scheme dispute resolution medical experts and convenors.
The panel is independent and made up of up to three health professionals. The application must be made in writing within 28 days after the person is given written notice of the written eligibility decision or the treatment/care assessment decision and should include:
- applicant’s name, address and contact details
- statement that there is disagreement with the decision (eligibility or assessment)
- detailed reasons why there is disagreement with the decision
- for assessment disputes, reasons why the request is necessary and reasonable in the event a service has not been approved by the Insurance Commission and is the subject of the dispute
- any other relevant information or reports.
If you would like to submit a formal request for dispute resolution, please send us an email via drpsupport@icwa.wa.gov.au.
The Motor Vehicle (Catastrophic Injuries) Regulations 2016 provides further information.