Answer
Must an insurer tell the NDIS Agency within 7 days?
Yes, where the insurer has received a section 109(2) notice. It must write to the CEO about the liability no later than 7 days after it becomes liable to indemnify, or within 7 days after receiving the notice, whichever is later. The civil penalty is 60 penalty units.
What starts the clock?
Two events can start it: becoming liable to indemnify the compensation payer, in whole or in part, and receiving the section 109(2) notice. The later of the two is the start. The duty is to give written notice of the liability, so the notice has to say that liability exists, not only that a claim is open.
Is a compensation payer treated the same way?
No. Subsection 110(3) puts a parallel duty on a potential compensation payer given a notice under section 109(1). An insurer's own duty is subsection 110(4). A delegated authority that handles the claim does not move the duty away from the insurer.
What happens if the payment is made anyway?
Subsection 114(7) makes it a contravention for an insurer to make a payment in relation to the liability while a notice under section 109(2) or 111(2) is in force. The exceptions are a written revocation for a section 109 notice, payment to the Agency of the amount in a section 111 notice, or written permission from the CEO. Each contravention is 60 penalty units.
What evidence should be kept?
Keep the notice and its receipt date, the date the insurer became liable and the source of that knowledge, the written notice sent to the CEO, and the diary entry that created the 7 day deadline. Where a third party handles the claim, keep the reporting schedule that carried the duty to them.
The duties behind this answer
Not legal advice; does not certify. Read the provision at https://www.legislation.gov.au/C2026A00066/latest/text. Last updated .