Compo Delay Keeps Victim In Limbo
Sydney Morning Herald
Wednesday April 24, 1996
Solicitors acting for a man who was brain damaged in a motorcycle accident are threatening to sue the Health Insurance Commission (HIC) over bureaucratic delays that are costing accident victims thousands of dollars in lost interest.
Mr Graham Holstein, who has been unable to work since the accident in 1987, has waited nine years for the courts to award him $750,000.
However, his payout is in limbo - he cannot even get interest while the commission collates information on what is expected to be a Medicare bill of no more than $10,000.
Speaking from near Forster yesterday, Mr Holstein, 31, said he desperately needed the settlement. He owed the bank $72,000 and had his eye on a house he wanted to buy.
"I've got so sick and tired of living on a pension," he said. "I used to work on the railways, you know, and it was $1,100 a fortnight." Now, with rent assistance, he was living on just over $400 a fortnight.
The Law Society of NSW says the commission has consistently been unable to prepare a statement of past benefits to victims within the legislated 28 days.
The statement is used to calculate the amount Medicare is to be reimbursed from a damages payout. Although the Health and Other Services Compensation Act came into force only on February 1, the society says it has a backlog of 7,000 applications.
The society's former president, Mr Maurie Stack, whose firm is representing Mr Holstein, said unless the commission agreed to meet the interest payments, Mr Holstein would sue the commission for breach of statutory duty.
"It defies logic. Here is a big payment, $750,000, and a tiny payment to Medicare. They have put no cap on it, every cent is frozen. It's bureaucracy gone mad," he said.
Mr Stack said the legislation allowed for a three-month hold-up, from the time a statement was requested until the certificate was issued to the insurer, who then released the funds. In most cases, pensions were cut off after the court settled a case and people had to reapply for a pension under other provisions, he said.
A spokesman for the Office of the Protective Commissioner, which manages many cases of personal litigation, said disabled people were being further disadvantaged by the new act. It was difficult for the accident victims to go back over hundreds of items on a Medicare list and determine which treatments related to the injury, he said. This is required before the commission will issue a clearance certificate to the insurer.
A spokeswoman for the HIC confirmed that it had missed the 28-day deadline in some cases. There was a backlog in NSW and Queensland, which had an "astonishingly" high number of personal injury cases, she said.
However, she believed it was an interim problem.
The Federal Minister for Health, Dr Wooldridge, could not be contacted yesterday.
© 1996 Sydney Morning Herald
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