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Administration    

Q: I need to provide evidence that the agency is covered by the Fund for public liability / property / workers’ compensation / personal accident. What do I do?

A: A contact person at each agency has been supplied with a copy of a “Certificate of Currency” for the current financial year. You need to contact your agency contact for a copy. See Certificates of Currency for information on who to contact.


Q: Who is Marsh Pty Ltd and what is its role?

A: Marsh is the Tasmanian Risk Management Fund’s Fund Administration Agent. Its responsibilities include:
  • administering claims in accordance with agencies’ directions;
  • reviewing all claim and payment documentation to make sure that it is complete, accurate and appropriate;
  • providing claims management advice to agencies; and
  • providing regular reports to agencies on the progress, and actual and outstanding costs associated with each claim.


Q: Who is the underwriter for the Fund?

A: The Crown in Right of Tasmania is the underwriter of the Fund. The Fund is not a separate legal entity, but part of the Crown. A liability of the Fund is a liability of the Crown.


Q: Will the Fund meet agencies' pre-Fund liabilities?

A: No. Liabilities arising from events that occurred before the introduction of the Fund are the responsibility of agencies. Medical liabilities are an exception. The Government is making a special annual contribution to the Fund to meet pre-Fund medical liabilities.


Q: Why does the Fund accumulate reserves?

A: The Fund follows conventional insurance practice and quarantines all losses for a particular year against the contributions received for that year. Therefore, the Fund needs to set aside each year an amount to meet liabilities arising from claims made in that year (claims, particularly in the liability classes of insurance, sometimes take a number of years to settle). The level of reserves required to meet outstanding liabilities remains a matter for periodic actuarial estimation until they are actually settled.


Q: How are agency contributions established?

A: The level of agencies’ contributions reflects their risk exposure, claims experience and nominated excess amounts. See contributions for a detailed explanation of how contributions are calculated.

Contract works    

Q. Are contract works covered by the Tasmanian Risk Management Fund?

A: No, contract works are not insured through the Tasmanian Risk Management Fund. Contract works let by inner-Budget agencies are separately insured through Marsh Pty Ltd. Cover for a contractor under that policy is automatic upon acceptance of each contractor’s tender. The contractor is then responsible for the payment of the premium due under the policy to Marsh Pty Ltd. The contract works policy consists of two components – one component to meet potential property damage claims and another component to meet potential liability claims ie claims made by third parties arising from the works.
Contact Marsh Pty Ltd for further information.

Housing    

Q: Is glass breakage covered by insurance?

A: Only when broken by fire or storm. All other causes are handled by Housing Tasmania.


Q: Why haven’t stolen or damaged fittings been replaced yet in an untenanted property?

A: They will be replaced on the day that the property is re-tenanted.


Q: Who is responsible for removing/storing tenants’ contents if vacation is required after a fire?

A: The tenant.


Q: In the event of a total loss, who decides if a property is to be rebuilt or demolished?

A: After assessment and valuation, Housing’s Strategic Management section in conjunction with the Area Manager.

Liability    

Q: What is the difference between “directors and officers liability” and “professional indemnity” cover?


A: “Directors and officers liability” covers individual officers, and others who are involved in the management of an agency, against claims alleging a breach of their managerial duties, or an act or omission in relation to the discharge of their functions as an officer of the agency. “Professional indemnity” covers an organisation (including the Crown) and its employees against claims alleging a breach of professional duty to a third party, for example an error in the provision of a specialised service, or negligent performance of a specialised obligation or function.


Q: A lease contract requires the agency to indemnify the lessor for “all claims whatsoever” which may arise during the period of the tenancy. What should we do?


A: The Fund will, subject to the payment of any excess, cover public liability claims relating to the agency’s own legal liability in tort or statute. The Fund will not, however, cover other parties (such as the lessor) purely against their own legal liability. Therefore, before agreeing to any “hold harmless” provisions in a lease contract, the agency should consider whether the lessor is requiring the agency to indemnify them only for the agency’s negligence or for the lessor’s negligence as well – the latter will not be automatically covered by the Fund. By negotiation, the agency should try to have the lessor contractually accept the risks that they are in the best position to control (eg inherent building defects). The Fund Administration Agent, Marsh Pty Ltd or Crown Law can provide assistance with any such complex insurance requirements.


Motor Vehicles    

Q: Who do I get motor vehicle repair quotes from and how many quotes do I need?

A: Contact Marsh Pty Ltd for a list of preferred repairers in your area. Two quotes are required and these should be forwarded to Marsh for assessment. Please note that only Marsh has the authority to authorise repairs.


Q: Do I need to advise the Fleet Manager if I have an accident?

A: The Fleet Manager must be advised of all accidents/incidents involving vehicles leased through sgfleet.


Q: I was at fault in the accident and have received a request from the other party involved to have their vehicle repaired. What do I do?

A: If you have already lodged your claim form with Marsh, please refer the other party to them and they will attend to their request. If you have not lodged a claim form, please do so as soon as possible.


Q: Who authorises repair of my vehicle after I send Marsh Pty Ltd the claim form and quotes?

A: Marsh will assess the claim and will authorise repairs on behalf of the agency. You will be notified of the successful repairer.


Q: Does Marsh arrange a replacement vehicle whilst mine is being repaired?

A: No. Cover provided by the Fund does not include the cost of a temporary replacement vehicle.


Q: Who has responsibility for handling under-excess claims?

A: Agencies are responsible for handling under-excess claims. However, Marsh will administer under-excess claims where agencies request this service (this service is offered for motor vehicle, property and liability claims). Under-excess claim administration fees and claim costs are paid to Marsh directly by agencies and not the Fund. See motor vehicle claims for advice on managing under-excess claims, including pro-forma letters to third parties.


Q: The third party has enquired about access to a hire car while their vehicle is being repaired. What do I do?

A: Refer them to Marsh Pty Ltd.


Q: Are private vehicles, used for work purposes, covered by the TRMF?

A: No. Agencies should advise employees that it is their responsibility to have the vehicle comprehensively insured. (refer to Ministerial Direction No. 1.1 2002 – Administration)


Public Liability    

Q: Members of the community will be participating in an agency training session. Are they covered by the Fund if they are injured whilst participating?

A: The Fund's public liability cover will respond if the person is injured in circumstances where the agency is found to have been negligent. See incident management – liability.

Volunteers    

Q: If an agency volunteer is injured while carrying out an authorised agency activity, what benefits are they entitled to?

A: The TRMF provides no-fault personal accident cover to agencies for authorised agency volunteers. See incident management – personal accident for information about benefits.


Q: If a volunteer is injured as a result of assisting an officer as described in section 86 of the National Parks and Reserves Management Act 2002 or section 71 of the Nature Conservation Act 2002, is the volunteer entitled to receive the full equivalent provisions of the Workers Rehabilitation and Compensation Act 1988?

A: Yes, and the agency’s excess for workers’ compensation claims will apply. See incident management – workers’ compensation.


Q: Is there any age limit on the personal accident cover provided by the TRMF?

A: There is no age restriction in relation to this cover.


Q: Does the TRMF’s personal accident cover extend to cover the gap between the actual costs of medical services and any amount which a person is able to recover in respect of those services from Medicare or a private health fund?

A: Yes. See incident management – personal accident for more information.


Q: Are agency volunteers covered for personal accident when travelling from their place of residence to the authorised agency activity?

A: No. Volunteers who are injured in a motor accident may be entitled to claim from the Motor Accidents Insurance Board (MAIB).

Workers’ Compensation    

Q: Are agency employees covered for workers’ compensation whilst working interstate?

A: Yes, section 31A of the Workers Rehabilitation and Compensation Act 1988 provides the appropriate protection for Tasmanian employees working interstate. See incident management – workers’ compensation.

Under the Act, workers’ compensation premiums are payable to the State or Territory determined to be the worker’s “State of connection.” The payment of such premiums is facilitated through Marsh Pty Ltd.

Determination of a worker’s State of connection is based on the following tests (as set out in Section 31A of the Act):
  • the State where the worker usually works in the employment; or
  • if no State, or no single State is identified, the State where the worker is usually based for the purposes of the employment; or
  • if no State, or no single State is identified, the State where the employer’s principal place of business in Australia is located.

The following issues are taken into account in deciding whether a worker usually works in a particular State:
  • the worker’s work history with the employer over the preceding 12 months;
  • the worker’s proposed future working arrangements;
  • the intentions of the worker and the employer and;
  • any period during which the worker worked in a State, or was in a State for the purposes of employment whether or not the worker is regarded as working or employed in that State under its workers’ compensation law.

It should be noted that any temporary arrangement, under which the worker works in a State for a period of not longer than six months, is not taken into account.


Q: Who can claim for workers’ compensation?

A: All State Service employees are eligible for workers’ compensation if they suffer or aggravate an injury at work, or contract a disease for which work was the major contributor. This includes injuries incurred:
  • whilst working interstate or overseas (for a Tasmanian Government agency);
  • whilst the employee is on loan or has been hired out to another employer; or
  • from a motor vehicle accident whilst the employee was on official business.


    Q: How is the entitlement to weekly benefits calculated?

    A: Weekly benefits paid are the greater of:
    • the “ordinary time rate of pay” which the worker was earning immediately prior to the injury; or
    • the average of the workers normal weekly earnings over the previous year. This includes any regular allowances except for travel or accommodation allowances. Overtime is excluded unless it is a part of the regular pattern of employment.


    Q: How long do weekly payments continue?

    A: Provided that the worker continues to produce a Workers Compensation Medical Certificate, weekly payments can continue for up to 9 years (or until the worker reaches 65 years of age) but reduce over time in accordance with the following “step down” provisions:
      • 100% of the normal weekly payment for 13 weeks:
      • 85% of the normal weekly payment for weeks 14 to 78, inclusive: and
      • 80% of the normal weekly payment thereafter.
          Note that injuries incurred prior to 1 July 2001 are subject to different rates.

        Q: What else is the worker entitled to claim for?

        A: The employer is responsible for all reasonable expenses necessarily incurred by a worker as the result of an injury, including:
        • medical services, eg medical practitioners, hospital and rehabilitation services; and
        • travel to and from these services.


        Q: How much can be claimed for travelling expenses?

        A: The type of vehicle that the worker drives determines the amount that can be claimed for travelling expenses. From 5 January 2007, the applicable rates were $0.3887 per kilometre for vehicles under two litres and $0.452 per kilometre for vehicles over two litres. To make a claim, use a travel reimbursment form.

          Q: When can we settle a claim?

          A: Claims may be settled by agreement between the parties after 12 months if the injury is stable.


          Q: Is the worker entitled to a lump sum?

          A: A worker suffering a permanent impairment may be entitled to receive a lump sum payment in addition to their normal weekly payments. The amount paid is based on an assessment of the level of impairment.


          Q: When can a claim be made for common law damages?

          A: A worker may only sue an employer for damages under common law when the injury or disease results in a 30% or greater whole-person impairment.


          Q: Why do we need a rehabilitation provider?

          A: The employer may choose to appoint a rehabilitation provider to assist in the management of certain workers’ compensation cases. The role of the rehabilitation provider is to, in consultation with the employer, medical practitioner and injured worker:
          • assess the needs of the injured worker and the workplace requirements;
          • identify and coordinate any health and vocational services, and workplace modifications, needed to return the injured worker to work; and
          • monitor the return-to-work process and ensure that goals remain appropriate and achievable.


          Q: My agency has received a medical certificate from an employee and we think he should have recovered from the injury by now. Can we dispute the certificate?

          A: You cannot dispute a certificate if there has been no break in certification or no change in diagnosis. If you think the employee’s case is suspicious, you should refer the employee for an independent review.


          Q: When is it appropriate to seek a GP report? For injuries such as sprains and strains (particularly to the back) should we request a report as a precautionary measure?

          A: Generally for claims that look like they could become costly it is wise to request a report when the claim is first received. A good indication can be obtained from this as to what treatment will be required and the costs that may be involved.


          Q: How long should treatment such as physiotherapy be approved for without being reviewed?

          A: This depends upon the nature of the injury. As a general rule, soft tissue injuries should be resolved within six weeks. Treatment after this date should be reviewed by requesting a report from the treating specialist and/or the treating GP. If you believe the treatment is excessive, an Independent Medical Assessment should be arranged.


          Q: If an employee requests a copy of their Independent Medical Assessment report, can we give it to them?

          A: Yes.
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