19 APRIL

NEW ZEALAND GAZETTE

903

13.2 The Accredited Employer must agree that, during the Claim Management Period, the Accredited Employer must provide all statutory entitlements in relation to work-related personal injuries suffered by that Accredited Employer’s employees and pay all the costs in relation to every claim by an employee for work-related personal injury (including administration costs). This is other than:

(a) To the extent expressly agreed in the Contract for Partnership Discount (if a member of the Partnership Discount Plan); and

(b) To the extent that the Accredited Employer and the Manager from time to time agree that the Manager will, in exchange for a payment agreed with the Accredited Employer, take over the management of the case of any particular employee; and

(c) Those health related costs which are bulk funded by the Manager (being public health acute services costs and ambulance expenses); and

(d) As provided for in paragraph 16 (if applicable).

13.3 For the avoidance of doubt:

(a) Such statutory entitlements are, during the Claim Management Period for that injury, to be met by the Accredited Employer except to the extent expressly stated in paragraph 13.2;

(b) The Accredited Employer must agree to pay (or reimburse to the Manager if required by the Manager) all obligations which have accrued at the date of expiry of the Claim Management Period;

(c) Weekly compensation is to be deemed to accrue from day to day;

(d) An Accredited Employer must agree that if an employee of that Accredited Employer suffers a work-related personal injury and incurs primary health costs in respect of such injury the costs of which are borne by the Manager, the Accredited Employer must reimburse those costs to the Manager.

(e) The Accredited Employer must agree to be liable to the Manager for any expenses incurred in respect of the claim by the Manager after the end of the relevant Claim Management Period or on termination or cancellation of an Accreditation Agreement being expenses unreasonably deferred or not met by the Accredited Employer;

(f) Nothing in this paragraph precludes the Accredited Employer from providing more assistance to the employee than the statutory minimum. However, the Accredited Employer must agree to inform the employee that:

(i) More than the statutory minimum is being paid; and

(ii) The Manager will not be liable to continue to pay more than the statutory minimum should responsibility for the claim pass to the Manager.

(g) To the extent that:

(i) The Manager has responsibilities and obligations as the “insurer” under sections 54 to 74 of the Act; and

(ii) Those responsibilities and obligations arise as a result of a work-related personal injury to an employee of the Accredited Employer,

the Accredited Employer must agree to accept such responsibilities and obligations. This is unless the Act or this Framework or the context requires otherwise.\n
13.4 The Accredited Employer must agree that where the injury concerned is either:

(a) Of the type defined in section 33 of the Act (being a work-related gradual process, disease or infection); or

(b) A subsequent injury (as defined in section 112 of the Act),

Such that, if the Accredited Employer were the “managing insurer” (as defined in section 109 or 112 of the Act), it would be entitled to recover a proportion of the costs of providing entitlements to the employee (and associated costs) under sections 111(2) or 113 (as the case may be) of the Act then:

(c) The Accredited Employer must manage the claim and make the same payments of statutory entitlements as it would be required to do if it were the Accredited Employer of the injured employee for the whole period of the work-related gradual process, disease or infection or when the “previous personal injury” (as defined in section 112) occurred (as the case may be);

(d) The Accredited Employer may notify the Manager of the circumstances of the claim and the basis for contending that, if it had been the “managing insurer”, it would have been entitled to recover a proportion of the costs of providing the statutory entitlements referred to in subparagraph (c) (and associated costs);

(e) On notice under subparagraph (d) the Manager must:

(i) Take all appropriate steps in a timely manner to check the validity of the claim;

(ii) If the claim is valid and the Manager was the “contributing insurer” (as defined in sections 109 or 112 as the case requires) and the previous employer was not an Accredited Employer at the relevant time, the Manager must pay to the Accredited Employer the appropriate amount (calculated under sections 108 or 113(2) as the case requires);

(iii) If the claim is valid and if the Manager was not the “contributing insurer” or if the previous employer at the relevant time was an Accredited Employer, the Manager must take reasonable steps to recover the appropriate amount (calculated under sections 108 or 113(2) as the case requires) on behalf of the Accredited Employer and account to the Accredited Employer for all recoveries (after deductions of reasonable collection expenses);

(iv) If the Manager considers the claim not to be valid the Manager must promptly notify the Accredited Employer.