Q: I need to provide evidence that the agency is covered by the Fund for legal liability (including public and products liability and professional indemnity) / 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 Jardine Lloyd Thompson Pty Ltd and what is its role?
A: Jardine Lloyd Thompson (JLT) is the Tasmanian Risk Management Fund's Fund Administration Agent. Its responsibilities include:
- administering claims in accordance with a Fund participant's directions;
- reviewing all claim and payment documentation to make sure that it is complete, accurate and appropriate;
- providing claims management advice to participants; and
- providing regular reports to participants on the progress, and actual and outstanding costs associated with each claim.
See roles and responsibilities for further information.
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 a participant's pre-Fund liabilities?
A: No. Liabilities arising from events that occurred before the introduction of the Fund are the responsibility of participants. 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. 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 the Fund Administration Agent. 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 the Fund Administration Agent. 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 Jardine Lloyd Thompson Pty Ltd for further information.
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.
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, Jardine Lloyd Thompson Pty Ltd or Crown Law can provide assistance with any such complex insurance requirements.
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 legal liability cover will respond if the person is injured in circumstances where the agency is found to have been negligent. See legal liability - incident management.
Q: Who do I get motor vehicle repair quotes from and how many quotes do I need?
A: Contact Jardine Lloyd Thompson Pty Ltd (JLT) for a list of preferred repairers in your area. Two quotes are required and these should be forwarded to JLT for assessment. Please note that only JLT 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 the Government's Fleet Manager.
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 JLT, 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 JLT the claim form and quotes?
A: JLT will assess the claim and will authorise repairs on behalf of the agency. You will be notified of the successful repairer.
Q: Does JLT 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, JLT 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 JLT 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 JLT.
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)
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 personal accident - incident management 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 workers' compensation - incident management.
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 personal accident - incident management 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).
Q: Are employees of a Fund participant covered by the Fund for workers' compensation whilst working interstate?
A: The Fund provides workers' compensation cover for injuries incurred when Tasmania is the 'State of connection' for the injured worker as defined by section 31A of the Workers Rehabilitation and Compensation Act 1988.
Agencies should note that where employees are engaged in circumstances where Tasmania is not the 'State of connection', the agency may need to take out separate workers' compensation cover.
For information and guidance on the 'State of connection' refer to the section on cross-border claims in A Guide to Workers Compensation and Rehabilitation in Tasmania issued by WorkCover Tasmania or contact either the DPP or the Fund Administration Agent, Jardine Lloyd Thompson Pty Ltd (JLT).
The payment of premiums where separate workers' compensation cover is required is facilitated through JLT.
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 Fund participant);
- 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.
Some volunteers are also eligible. See workers' compensation - cover for further information.
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 period of incapacity; or
- the average of the workers weekly earnings over the previous year. This may include some allowances. Overtime is only included in certain circumstances.
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 26 weeks:
- 90% of the normal weekly payment for weeks 27 to 78, inclusive: and
- 80% of the normal weekly payment thereafter.
Note: Injuries incurred prior to 1 July 2001 and between 1 July 2001 and 30 June 2010, are subject to different rates.
Note: The period for payment of weekly payments extends for workers left with a permanent whole person impairment. See workers' compensation - extent of cover for further information.
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 and other 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 23 November 2009, the applicable rates were $0.4117 per kilometre for vehicles under two litres and $0.4787 per kilometre for vehicles over two litres. To make a claim, use a travel reimbursement form.
Q: When can we settle a claim?
A: Claims may be settled by agreement between the parties after two years. Any settlement prior to two years requires the approval of the Tribunal. See settlement of a claim for further information.
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 20% 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: A medical certificate has been received 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: In general yes, but there may be some circumstances where this is not possible.