Changes to CTP Assessor Processes After 2017 Reforms
The 2017 reforms to New South Wales’ Compulsory Third Party (CTP) motor accident compensation scheme introduced significant changes to how insurers manage claims assessments. Claimants in Bathurst and across NSW now have clearer legal boundaries around when and how insurers can replace an assessor. Under the Motor Accident Injuries Act 2017, insurers must provide a valid reason for changing an assessor, such as a conflict of interest or failure to meet professional standards. This replaces the previous system where insurers had broader discretion.
How SIRA Handles Assessor Disputes
The State Insurance Regulatory Authority (SIRA) oversees compliance with the reforms. If a claimant believes an insurer has unreasonably changed an assessor, they can request a review through SIRA. SIRA evaluates whether the insurer’s actions align with the Act’s requirements, including whether the new assessor has the necessary qualifications and impartiality. Claimants should document the insurer’s reasons for the change and seek SIRA’s intervention if they suspect procedural unfairness.
Steps for Claimants Facing Assessor Changes
- Review the insurer’s notice: Insurers must provide written reasons for replacing an assessor. If the reasons are unclear or insufficient, this may indicate a breach of the reforms.
- Contact SIRA directly: Claimants can submit a formal request for a review via SIRA’s claims portal. This process is free and does not require legal representation.
- Seek independent medical advice: If the new assessor’s report conflicts with medical records, claimants should consult their treating physician to clarify the injury’s severity.
- Monitor time limits: The 2017 reforms do not alter the 52-week statutory limit for weekly benefits if only threshold injuries are involved. However, disputes over assessor changes must be resolved before this period expires to avoid losing entitlements.
Practical Evidence to Gather
Claimants should preserve records such as:
- The insurer’s notice of assessor change (including dates and reasons)
- Copies of all assessor reports and correspondence
- Medical records confirming the injury’s nature and treatment
- Witness statements or incident reports if available
When to Seek Legal Advice
While SIRA provides a free dispute resolution pathway, claimants should consult a solicitor if:
- The insurer refuses to provide a valid reason for the change
- The new assessor’s report contradicts medical evidence
- The claimant is unsure how to navigate SIRA’s process
Example Scenario
A claimant in Bathurst receives a notice that their assessor has been replaced due to ‘inadequate experience.’ If the new assessor lacks the required qualifications under the Motor Accident Guidelines, the claimant can request SIRA to review the decision. This highlights how the 2017 reforms now require insurers to justify such changes more rigorously.
Next Steps
Time limits and procedural requirements may apply. To request contact about your circumstances, complete the quick, no obligation enquiry form.