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Here are the grounds on which the Commissioner will reject your COID claim

by , 02 October 2014
When your employee has an injury on duty, you must help him claim for compensation from COID to cover his expenses and any lost income during his recovery.

When you submit this claim, the Compensation Commissioner goes through a whole process to determine whether or not he'll approve the claim.

The Commissioner rejects claims more than you think. During his review process he'll use these grounds to reject your claim...


Here's how the Commissioner reviews submitted claims

The Commissioner will use the following grounds to determine he's going to reject your COID claim (COIDA Section 90.1):
  • Your employee hasn't submitted a medical examination;
  • Your employee refuses or fails to submit to medical assistance and it prolongs or aggravates his disablement.
  • Your employee's accident happened because of his own misconduct.
  • His decision to award compensation came from misrepresented facts or incorrect view.
  • The amount he awarded came from evidence that wasn't available when he decided on the amount.
If the Commissioner finds any of these to be true, he'll reject the claim and may force you to cover the compensation. 
Here's what you can do to prevent this and ensure the Commissioner doesn't reject your claim.
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Do this to ensure this claim review process goes smoothly

To ensure the review goes smoothly and the Commissioner doesn't reject your claim you must submit all the supporting documents you can. This means the Commissioner doesn't have to keep asking you for more and more information to make his decision.
Now that you know what grounds the Commissioner will use to decide to reject your claim, do what you can to ensure it doesn't happen.

PS: We strongly recommend you check out the COID Compliance Guide. It has everything you need to fully comply with the COID Act.

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