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Accident victims hit medicare snag

Phil Dickie, The Australian, 28 April 1996

Industrial and motor vehicle accident victims, many of whom have waited years for their claims to be settled, now have to wait further months while payment is cleared by Medicare.

Medicare may be owed nothing in some cases and in others only a few hundred dollars out of settlements of more than $100,000.

But settlements can be delayed for up to five months.

Steve Rush, of Wellington Point, was badly injured in November 1993, when a wall in a partly built townhouse fell on him.

The Workers Compensation Board settled his claim for $125,000, after court proceedings began in early March.

Mr Rush still hasn'tt received his payment and does not know when it will finally clear the Medicare merry-go-round.

"They are not owed much - a couple of hundred dollars at the most," Mr Rush said.

"But I can't do anything - I'm bludging off friends, I can't work, I can't get on with my life."

Federal legislation enabling Medicare to place a charge on settlements became operational in February.

Since then, according to the Australian Lawyers Alliance, dozens of cases have become snagged in Medicare red tape.

The association's Queensland President, Mr Peter Carter, said there was no dispute over Medicare's right to be repaid and "our members and have always done this on the settlement of claims".

But Medicare's new ability to hold up the payment of settlements coupled with new and highly complex procedures have introduced long delays.

Mr Carter said Medicare officers did not seem to understand the new system with each officer telephoned "telling a different story from the last person".

"Insurance companies are sitting back delighted with the situation, because they get the benefit of holding on to what must be tens of millions of dollars in compensation Australia-wide," Mr Carter said.

In one case, a 70 year old man who was made a paraplegic in a car accident has been waiting an additional six weeks for payment of a settlement of several hundred thousand dollars.

"This person needs the money urgently to repay loans and to modify his house with such items as an electric hoist for his wheelchair," Mr Carter said.

"Medicare is owed nothing, but continues to refuse to pay despite numerous requests to have the matter resolved speedily."

The Health Insurance Commission, which administers Medicare, has told the association that payment can be expedited by both parties obtaining a certificate of benefit before settling claims.

But most claims are settled virtually at the door of the court. The insurance companies involved also often have little incentive to expedite payment.

Mr Rush said he would be happy to be paid only half of his payment while the remainder goes through the Medicare red tape.

"If you owe the Government money, they fine you extra and hit you with interest," Mr Rush said.

"But it doesn't work the other way round, when they owe you money," he said.