Understanding CTP Assessor Changes in NSW
After the 2017 reforms to the motor accident compensation system in New South Wales, the process for changing a claims assessor or case manager under Compulsory Third Party (CTP) insurance has become more structured and transparent. The Motor Accident Injuries Act 2017 (MAIA) and the associated Motor Accident Injuries Regulation 2017 introduced clearer rules about who can request a change, when it may be granted, and what must be considered by the insurer. These changes were designed to improve fairness, consistency, and accountability in how claims are managed.
How the 2017 Reforms Changed the Process
Before the 2017 reforms, insurers had broader discretion to change assessors at their own direction, often without formal explanation or opportunity for the claimant to object. Under the current framework, insurers must now follow a formal process when considering a change. The claimant may request a change, and the insurer must assess whether it is reasonable and in the best interests of the claim. The insurer must also provide written reasons if a change is made or refused.
The reforms established that an assessor change may be made only if it is in the best interests of the claimant and does not cause unreasonable delay or disruption to the claim. Insurers must consider factors such as the claimant’s ongoing treatment needs, communication preferences, and the continuity of care. A change may not be made simply because the insurer wishes to assign a different case manager, nor can it be used to delay or frustrate a claim.
What You Can Do If Your Assessor Is Changed
If your insurer proposes to change your assessor, you have the right to request a review of that decision. You should write to the insurer in writing, stating your reasons for objecting to the change. Common reasons include ongoing treatment with a known medical team, established communication patterns, or concerns about the new assessor’s experience or responsiveness.
The insurer must respond within 14 days of receiving your objection. If the insurer refuses your objection, they must provide a written explanation that includes how they assessed the best interests of the claimant. You may then request a review by the State Insurance Regulatory Authority (SIRA). SIRA has the authority to investigate and, if necessary, direct the insurer to reinstate the original assessor or take other corrective action.
Evidence That Matters in a Request to Change or Object to a Change
To support a request to change or object to a change in assessor, you should gather and retain the following evidence:
- A copy of any correspondence from the insurer about the proposed change
- A record of your communication with the current assessor, including emails, letters, or notes from phone calls
- Medical reports or treatment plans that show the importance of continuity with your current assessor
- A statement from your medical practitioner or allied health provider explaining why a change could disrupt your recovery
- Details of any delays or complications that have occurred since the proposed change was announced
These materials help demonstrate whether the change would cause harm to your claim, treatment, or recovery. SIRA will consider this evidence when reviewing a dispute.
Time Limits and Dispute Options
There is no fixed statutory deadline for objecting to a proposed change of assessor. However, it is critical to act promptly. Delays may affect your ability to challenge the change, particularly if the new assessor has already begun managing your claim and made decisions that impact your entitlements.
If you believe the insurer has made an unreasonable change, you may apply to SIRA for a review. SIRA will assess whether the insurer followed the rules under the MAIA and the Motor Accident Injuries Regulation 2017. If SIRA finds the change was not in the best interests of the claimant, it may order the insurer to reverse the change or compensate for any resulting harm.
A Hypothetical Example
A 42-year-old woman was injured in a motor vehicle accident in Sydney in June 2024. She was assigned a case manager who worked closely with her physiotherapist and psychologist. In February 2025, her insurer notified her of a change to a new case manager without explanation. She had not requested a change. The new assessor failed to follow up on her treatment plan, and her weekly income payments were delayed for three weeks. She wrote to the insurer, citing the disruption to her recovery and the lack of prior notice. The insurer refused her objection. She then applied to SIRA, which found the change was not in her best interests and directed the insurer to reinstate the original assessor.
When to Seek Independent Advice
While the law provides clear rights to object to a change of assessor, the process can be complex. Insurers may use technical language or procedural delays to discourage objections. If you are unsure whether a proposed change is valid, or if the insurer has not responded to your objection, it is advisable to seek independent advice. A legal or claims professional can help you assess whether the insurer has met its obligations under the MAIA and SIRA guidelines.
Next Steps
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