Heise v Employers Mutual Limited [2022] NSWCA 283

Heise v Employers Mutual Limited [2022] NSWCA 283

Employers Mutual Limited, acting as a claims manager for the State, does not fall within the class of persons criminally liable under s 281 and s 283 of the 1998 Act; only employers or insurers with statutory duty and legal power to determine claims can be held liable, not third-party contractors. The appeal...

Source-derived case information.

Jurisdiction
Australia
Judgment Date
21 December 2022
Procedural Posture
Appeal / Court of Appeal, New South Wales, Principal Judgment
Outcome
Leave to appeal granted; appeal dismissed with costs.
Legal Topics
['statutory Interpretation' 'compensation for Permanent Impairment' 'criminal Liability for Failure to Determine Compensation Claims' 'role and Liability of Claims Managers' 'application of Workers Compensation Guidelines']
['workers Compensation' 'administrative Law'] ['statutory Interpretation' 'compensation for Permanent Impairment' 'criminal Liability for Failure to Determine Compensation Claims' 'role and Liability of Claims Managers' 'application of Workers Compensation Guidelines']

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Procedural Posture

Appeal / Court of Appeal, New South Wales, Principal Judgment

Legal Issues

  1. 1 ['Whether criminal liability under s 283 of the 1998 Act applies to private companies acting as claims managers for the State' 'Statutory construction of ss 281 and 283 of the 1998 Act as to who must determine claims' 'Whether a claims management contractor can be prosecuted for failing to determine a claim']

Ratio Decidendi

Employers Mutual Limited, acting as a claims manager for the State, does not fall within the class of persons criminally liable under s 281 and s 283 of the 1998 Act; only employers or insurers with statutory duty and legal power to determine claims can be held liable, not third-party contractors. The appeal challenging Adamson J’s construction was dismissed because the statutory scheme does not extend criminal liability to claims managers like EML.

Court Disposition

Leave to appeal granted; appeal dismissed with costs.

Orders

  • ['Leave to appeal is granted.' 'The appellant is to file a notice of appeal within 28 days in terms consistent with the draft amended notice of appeal.' 'The appeal is dismissed with costs.']