A COMO man says an Insurance Commission of WA (ICWA) decision not to pay out 100 per cent of his claims after a no-fault crash this year was not acceptable.
Graham Armstrong suffered lower back whiplash and extreme pain, rendering him temporarily unable to walk, after a car slammed into the side of his car in the city on March 6.
Mr Armstrong, who was not at fault, applied to the State Government’s Compulsory Third Party Division at the ICWA after commencing chiropractic treatments; six weeks worth that eventually cost $1250.
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READ NOWICWA reimbursed him $1018.00, an amount Mr Armstrong called unacceptable and called on the ICWA to refund his money in full.
“I have been paying third party insurance for years, in the past five I have paid the Government 100 per cent of what my treatment cost,” he said.
Commission Secretary Kane Blackman said WorkCover WA set the Schedule of Fees for Allied Health providers, and ICWA paid in accordance to the fees set.
“The Insurance Commission pays the reasonable cost of treatment in accordance with the WorkCover fees,” he said.
He said some providers charged beyond what ICWA would reimburse, and prospective patients should seek pricing before starting treatment.
“Some Allied Health providers seek to charge in excess of the WorkCover fees, and claimants are advised to consult the treatment provider before commencing treatment to confirm they invoice WorkCover fees,” he said.
Mr Armstrong said he did not accept the explanation.
“They say to go and find a provider that will charge the amount (ICWA) pays out… but I had just had an accident I was in pain, it was not a good time,” he said.
“(The insurance) says you are covered when you’re not, are you supposed to be a lawyer before you have an accident? It’s nonsense.”