What is a genuine dispute certificate (Vic)?
If you have a WorkCover matter on foot, it is possible that the WorkCover insurer will at some point make a decision that you do not agree with.
Whether that be rejecting your WorkCover claim, not accepting a particular injury, refusing to pay for a particular type of medical treatment or something else.
If they do, you’re able to dispute that decision to conciliation.
You can read about what conciliation is as well as the conciliation process here.
One possible outcome of the conciliation process is that the conciliator from the ACCS issues what’s called a Genuine Dispute Certificate (sometimes referred to as a “GD”).
A Genuine Dispute Certificate is a document that certifies that a matter has gone to conciliation but could not resolve by way of the conciliation process.
The certificate confirms that the conciliator believes that both parties involved in the dispute (you and the insurance company) have arguable cases.
That is, that there is a ‘genuine dispute.’
Here’s an example of a matter where a Genuine Dispute Certificate might be provided:
Let’s say that you have a shoulder injury and that your treating specialist has suggested that you would benefit from shoulder surgery.
As you’re on WorkCover, your specialist submits a request to the WorkCover Insurer requesting that they pay for the cost of the surgery, and any associated costs.
After considering the medical material, the WorkCover insurer then sends you a letter (referred to as a notice) letting you know that they don’t agree to pay for the cost of the surgery.
The letter should outline the reasons as to why they won’t pay for surgery.
For example purposes, lets say that they believe that you could better treat and manage your shoulder injury with conservative treatment (eg: physiotherapy) as opposed to having surgery.
You disagree with this and pursue the matter to conciliation.
At conciliation you and the insurer both put forward your respective arguments.
The conciliator believes that both parties have valid arguments, and the matter fails to resolve by way of agreement between the parties.
The conciliator then provides the parties with the genuine dispute certificate.
What’s next after a genuine dispute certificate has been issued?
A genuine dispute certificate gives a person the option of pursuing the matter to the WorkCover division of the Magistrates court to be determined.
It doesn’t necessarily mean that a person has to do so however. It just gives someone the option to do so.
The other thing to keep in mind is that you don’t need to pursue the matter to court right away.
You could wait months or even years before doing so.
There is no time period in which you need to pursue a matter to the Magistrates’ court.
Are there any other options?
If you have gone through the conciliation process and obtained a genuine dispute certificate, there is nothing stopping you from continuing to negotiate with the insurance company.
You could for example call them up and have further discussions.
It is possible that in some cases they will change their decision.
Particularly if the dispute is a medical related dispute and further medical material is obtained that supports your position.
A genuine dispute certificate, sometimes referred to as a GD is a certificate that is provided by the conciliator at the end of a WorkCover conciliation.
It certifies that the matter could not resolve at the conciliation process, but that both parties have an arguable case.