Wage Reimbursement Agreement by by654321

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									                                                                              Wage Reimbursement
                                                                                       Agreement
   This document represents the Agreement between             Insurer
   the Agent and employer in relation to Wage
                                                              CGU Workers Compensation (NSW) Limited
   Reimbursement Schedules.
   Set out below are the conditions of the
   Agreement.                                                 Name


   1      Time frames for submission of reimbursement
          schedules by employer                               Title
          The employer must submit reimbursement
          schedules within 10 calendar days of the end
          of each month.
                                                              Signed

   2      Overdue reimbursement schedules
          Where two (2) or more reimbursement
          schedules are overdue, the Agent will:              Date
          •	terminate this Agreement with the employer;               /   /
            and
                                                              on behalf of Insurer
            r
          •		 eimburse	any	outstanding	weekly	
            compensation benefits to the employer in
            accordance with information contained in
            medical certificates and available details of
            weekly earnings.                                  Employer


   3      Time frames for payment of reimbursement
          schedules by insurer                                Policy number
          The Insurer will:
            r
          •		 eimburse	the	employer	within	5	business	
            days from receipt of the reimbursement            Name
            schedule; or
            r
          •		 eimburse	the	employer	within	7	days,	
            without submission of a reimbursement
            schedule, for all non-significant claims          Title
            (that is the worker is likely to be off work
            for less than 7 days, even if these days
            include partial incapacity).
                                                              Signed
   4      Claim excess provisions
          Any claims excess will be automatically
          offset against the employer’s claim for
          reimbursement of weekly benefits.                   Date
          Employers who report injuries to CGU Workers                /   /
          Compensation (NSW) Limited – Agent for the
          NSW WorkCover Scheme, within 5 calendar             on behalf of Employer
          days of becoming aware of the injury, will
          have the excess waived.




WOR0096
          CGU Workers Compensation (NSW) Limited – Agent for the NSW WorkCover Scheme ABN 83 564 379 108/007   REV4 11/09

								
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