Horizon Solsolutions Australia Pty Ltd v National Disability Insurance Agency

Horizon Solsolutions Australia Pty Ltd, trading as Cocoon SDA Care, ran a large disability services business. The judgment says it supported more than 190 people with disabilities, employed about 1,200 staff and operated across about 185 specialist disability homes. It also had major monthly employee-related expenses, said to exceed $5 million from July 2024.

Like many providers in government-funded systems, Horizon depended on regular claims processing. In the ordinary course, claims submitted through the NDIA portal were processed within two or three business days. There had been some isolated reviews and requests for more information, but those were usually resolved within about four weeks and had not significantly affected cashflow.

In early March 2025, the NDIA changed course and moved Horizon’s claims into manual review. That meant the provider was no longer receiving the usual quick turnaround. According to the judgment, the manual review process took weeks and was still ongoing when the case was heard. Horizon said more than 9,300 claims worth about $6.4 million were under manual review. Although substantial payments had been made, substantial sums remained unpaid.

Horizon responded by going to the Federal Court. It brought two proceedings, one filed on 27 March 2025 and a second on 28 April 2025, and they were heard together. The company argued that the NDIA had unreasonably delayed making decisions on its claims for payment under s 45 of the NDIS Act. It wanted declarations to that effect and orders requiring the agency to decide the outstanding claims forthwith.

The judgment sets out a range of matters that formed part of the NDIA’s risk picture. One important part of the background was action by the NDIS Quality and Safeguards Commission. On 10 March 2025, a delegate of the Commissioner sent Horizon a notice proposing refusal of its application for registration. Separate notices proposed permanent banning orders against Horizon and its director, Mr Latif.

Those notices referred to three main categories of concern. First, they alleged that Horizon had submitted claims for services to three people while they were incarcerated, and said those services were not provided. Secondly, they alleged claims had been submitted for supports said to have been provided to three people after their dates of death. Thirdly, they referred to a video uploaded to YouTube by an employee that allegedly disclosed the personal details of 30 NDIS participants.

The video had been taken down by the time of the notice.

Horizon and Mr Latif disputed those allegations. Their response said some issues were administrative failures and honest mistakes in a small subset of claims, not systemic fraud. They said services could in some circumstances be provided while a participant was incarcerated, that some claims should have been marked as short notice cancellations, and that some post-death claims may have been made under the NDIS Bereavement Addendum.

Mr Latif also deposed that some incorrect claims had been identified and would be refunded.

The legal issue was whether the NDIA had unreasonably delayed making decisions on Horizon’s claims for payment, so that relief should be granted under s 7(1) and s 16(3) of the Administrative Decisions (Judicial Review) Act 1977 (Cth). The judgment says that whether delay is unreasonable must be assessed objectively, having regard to all the circumstances. It also refers to the usually high threshold for proving unreasonable delay.

Horizon’s argument was straightforward. It said claims were usually processed within two or three business days. It argued that the NDIS Act did not envisage a highly complex or inherently time-consuming process for deciding claims under s 45, that any manual payment integrity review should be determined quickly, and that the NDIA had not given a clear time by which the claims would be accepted or rejected.

The NDIA’s answer was that the court had to look at the whole statutory setting, not just the ordinary portal turnaround. The judgment refers to the objects and functions of the NDIS Act, including the need to ensure the financial sustainability of the scheme and the agency’s function of preventing, detecting, investigating and responding to misuse or abuse of the scheme.

It also refers to the Public Governance, Performance and Accountability Act 2013 (Cth), which imposes duties about proper use and management of public resources, risk and control systems, and fraud prevention.

The result was clear. Both applications were dismissed with costs. The catchwords state that the court was not satisfied there had been unreasonable delay by the NDIA in deciding Horizon’s claims for payment. The judgment also states that it is not the court’s role to supervise the administration of the agency unless there is an issue involving the legality of the agency’s conduct.

That framing is important. The court did not say that delay can never be challenged. It did not say that agencies have unlimited time. What it did say, in effect, was that this applicant had not shown the level of legal unreasonableness required on the facts and statutory context before the court.

The decision should therefore be read carefully. It was not a merits ruling on the underlying allegations against Horizon. It was not a finding that the alleged privacy incident occurred as described. It was not a finding that the NDIA was right about every concern it had. The court’s conclusion was narrower: given the agency’s statutory functions and the surrounding circumstances, it was not persuaded that the delay had become unreasonable in the legal sense required by the ADJR Act.

There are several practical points in this case for businesses, especially those in regulated sectors or those that rely on government claims systems.

First, normal processing times are not a guarantee. A business may become used to claims being processed in days and may build staffing, payroll and supplier commitments around that assumption. This case shows that once an agency identifies integrity concerns and shifts to manual review, the timetable can change dramatically. The fact that the old system was fast does not mean a court will force the agency to keep operating at that speed.

Secondly, agencies and regulators often look at risk holistically. In the background here were disputed allegations about claims conduct, prior notices, audit concerns and an alleged privacy incident. The privacy issue was not the legal issue before the court, but it still formed part of the broader context. For businesses, that means privacy compliance should not be treated as a silo. A data handling problem can affect regulator confidence, payment scrutiny and operational continuity.

Thirdly, records and controls matter. The judgment refers to concerns about inadequate documentation, unsupported entries and weak internal controls. Whether or not those concerns are ultimately upheld in another forum, they can still influence how an agency assesses risk in the meantime. Businesses that submit claims into regulated funding systems should expect record quality, staff training and internal controls to be tested if concerns arise.

The judgment was delivered by Wheelahan J on 20 May 2025 in the Federal Court of Australia. The hearing took place on 6 May 2025. The two proceedings were QUD 171 of 2025 and QUD 231 of 2025. The first proceeding was commenced on 27 March 2025 and the second on 28 April 2025.

The published reasons clearly show that both applications were dismissed with costs. They also clearly show the court’s central conclusion that it was not satisfied there had been unreasonable delay by the NDIA in deciding Horizon’s claims for payment.

The available judgment text used for this page ends before the full reasons conclude. The core outcome and the main legal framing are clear, but this page does not attempt to reconstruct any further detailed reasoning beyond what is plainly supported.