Comcover's claims management services ensure that a co-ordinated and uniform approach is taken to the management of claims against the Australian Government. In order to provide these services, Comcover has a number of outsourced arrangements with service providers including legal, motor vehicle repairers, assessors and claims management specialists.
Claims are managed by 'sector' specialists within the Comcover team, for example, motor vehicle, property and travel. All details are tracked in Comcover's online claims management system, accessible via the Comcover Launchpad.
Reporting a Claim
Early notification of a claim or an event or loss that is likely to give rise to a claim is crucial to the ability of Comcover to protect the Fund Member's interest and minimise any subsequent loss.
What is a claim?
Comcover's Statement of Cover defines a claim as:
- any demand by a third party against a Fund Member for compensation; or
- a request by you for indemnity in accordance with your Schedule of Cover and the Statement of Cover
Importantly, it is the Fund Member's responsibility to contact Comcover to advise of any loss or event that has occurred even if at the time of notification there has been no demand from a third party.
What if the claim or incident is below our agency's excess?
- All incidents of a liability nature should be recorded by Fund Members for their own risk management purposes and be notified to Comcover.
- For non-liability incidents that are clearly below the excess, Fund Members should record these as part of their own risk management program.
- For non-liability related incidents that are approaching the excess, Fund Members should record these as part of their own risk management program and report them to Comcover as they may exceed the excess and become a claim.
- For non-liability related incidents that exceed the excess, Fund Members should record these as part of their own risk management program and report them to Comcover for processing as a claim.
How do I make a claim?
Fund Members are required to notify Comcover of an incident occurring, a claim being made against the Fund Member; or where the Fund Member becomes aware of circumstances that are likely to give rise to a claim against it as soon as reasonably practicable. To do so, Fund Members must:
- Notify Comcover
- Locate and preserve any evidence
- Download and complete all relevant claim form documentation and forward it to Comcover
- Provide all supporting documentation and evidence to Comcover
- Refer all future correspondence concerning the matter to Comcover
What information will I need to provide to Comcover?
At the minimum, you should provide:
- the name and contact details of your Fund Member's Insurance Contact Officer
- a full description of the incident including the time, date and location of the incident
- the name of the Fund Member employee or other persons involved
- details of the claim made, or likely to be made, against the Fund Member
- the name and address, if known, of the third party(s) involved in the incident
- the names and addresses of witnesses.
Where possible, you should also provide (and keep on your own file):
- any originating application, writ, summons, demand or other correspondence from third party(s) and file notes of any telephone conversations with third party(s).
- employee statements. The statement should be confined to the facts and not express an opinion on negligence/liability.
- witness statements.
- photographs of the incident site (if relevant).
- details of any other party(s) (not employees or affected third parties) who may have contributed to the incident.
- any other relevant information.
To assist in the collation of this information, we recommend you either complete the incident notification form on the Comcover Gateway or complete the relevant claim form.
Tips for reporting a claim
- Refrain from making any statement to possible claimants or witnesses to an incident, or taking any action, that could be construed as an admission of liability. Refer all communication to Comcover.
- Where possible and appropriate, take all necessary steps to prevent further public access to the site where the incident took place (or any other actions to prevent further loss) until it can be visited by an assessor and made safe.
- Request all staff (or other persons associated with you such as contractors) who witnessed the incident to prepare written notes, or better still statements, dealing with the facts of the incident as observed by them. No attempt should be made to attribute blame.
- Where property is lost or stolen take all reasonable steps to recover the property. If the loss is caused by theft, report the loss to the police immediately.
For motor vehicle claims:
Report details of a motor vehicle accident to the Police that:
- damages the motor vehicle or property belonging to another party
- injures people.
Report the theft of a motor vehicle or its contents to the Police. If the vehicle is damaged, leave the vehicle at the premises of a repairer of your choice where it can be examined by an assessor (minor repairs will be attended to immediately).
For travel claims:
- medical claims should be reported to Comcare in the first instance. Comcare is responsible for managing workers' compensation claims and rehabilitation under the Safety Rehabilitation and Compensation Act 1988 for Australian Government employees.
Management of claims - Comcover
Once Comcover has accepted a claim, we assume responsibility for managing the claim, including managing any litigation that may arise as a consequence of that claim. All claims are managed in accordance with the Legal Services Directions 2017, which can be found at the Attorney-General's Department website.
Comcover develops its strategies for the defence and settlement of claims against the Commonwealth, in association with the Office of Legal Services Coordination, Attorney-General's Department.
Whole-of-Government Legal Services Panel
Management of liability claims typically involves management of litigation. Where appropriate, appointment of a legal provider will be from the Whole-of-Government Legal Services Panel (Legal Services Panel).
Comcover is responsible for appointing the most appropriate legal services provider from the Legal Services Panel, in consultation with the Fund Member and Comcover. Fund Members who appoint legal advisers before reporting a claim to Comcover, and without consulting Comcover, will not be reimbursed for the costs incurred.