PVP Claim Decision Review Process

Claimants whose claim for PVP compensation was denied or who were not awarded the full amount claimed may request a review of the PVP Program’s decision.

Simplified Route

Under the Simplified Route, claimants may request reconsideration (please see below for explanation) of their claim decision by the PVP Program if there are reasonable grounds to believe that an error was made by the PVP Program Claim Examiner.

Request for Reconsideration

For claims processed under the Simplified Route, claimants who believe that the outcome of their claim decision is not correct have the right to request reconsideration of the claim decision by the PHAI. The request must be in writing and specifically identify which points in the claim decision are to be reconsidered. The Request for Reconsideration must be received by the PHAI within 20 business days of the date of the mailing of the claim decision.

For more information, please click below:
•    Request for Reconsideration form


Standard Route

Under the Standard Route, claimants may request that the claim decision be reviewed if there are reasonable grounds to believe that an error was made by the PVP Program Claim Examiner. Mediation and/or arbitration are also available for claims filed under this route.

Mediation

Mediation is an informal, voluntary, agreement-reaching process in which a qualified mediator will assist the parties to attempt to reach an agreement in a collaborative and consensual manner. Mediation will attempt to identify, to the satisfaction of the claimant and the PHAI, if there was an error in the claim decision.  Mediation may be bypassed if both parties agree to go directly to Arbitration.

For more information, please click below:
•    Request for Review - Mediation
•    PVP Program Mediation Agreement

 

Arbitration

Arbitration is available to claimants who have filed a claim under the Standard Route. It is a final and binding independent decision-making process that will determine if any errors were made by the Claim Examiner in making the claim decision. The arbitration will be conducted in writing and will based on the material already contained in the claim file. There will be no oral hearing and no new evidence can be filed by either party in connection with the arbitration.

For more information, please click below:
•    Request for Review - Arbitration
•    PVP Program Arbitration Agreement

November 29, 2016