When Can a CTP Insurer Change an Assessor?
In New South Wales, a Compulsory Third Party (CTP) insurer may request a change of assessor if they believe the current one lacks independence, expertise or conflicts of interest. This is governed by the Motor Accident Injuries Act 2017 and SIRA guidelines. While the insurer must justify the change, claimants should prepare documentation to support their case.
What Documentation is Required for Assessor Changes?
When a CTP insurer requests a new assessor, claimants must provide evidence to demonstrate the necessity of their current assessment. Key documentation includes:
- Medical records showing the injury's progression and treatment
- Accident reports from police or witnesses
- Correspondence with the insurer about the assessment process
- Expert opinions from medical practitioners confirming the injury's nature
- Proof of income loss if claiming weekly benefits
Claimants should ensure all records are complete and up-to-date. SIRA guidelines require evidence to support all claims, and incomplete documentation may delay or reduce compensation.
How to Respond to an Assessor Change Request
- Request a written justification from the insurer explaining why they want a new assessor
- Provide all relevant medical evidence to show the current assessor's findings are valid
- Seek independent medical opinion if the insurer's request appears unreasonable
- Document all communication with the insurer about the change
If the insurer's request appears motivated by cost-saving rather than genuine concerns, claimants may need to escalate the matter to SIRA or seek legal advice.
Time Limits and Dispute Options
CTP claims must be submitted within 52 weeks of the accident under the Motor Accident Injuries Act 2017 s 4.4. If an insurer's change of assessor request delays the process beyond this period, claimants may need to apply for an extension.
Disputes over assessor changes should be resolved through SIRA's dispute resolution process. Claimants can also seek legal advice if they believe the insurer is acting in bad faith.
Example Scenario
A cyclist in Western Sydney sustains a soft-tissue injury and submits a claim. The insurer requests a new assessor, claiming the initial report was 'incomplete'. The claimant must provide:
- Medical records showing the injury's progression
- Police reports confirming the accident details
- Correspondence with the insurer about the initial assessment
This example illustrates how thorough documentation can prevent unnecessary assessor changes and protect the claimant's interests.
Next Steps
CTP insurers may change assessors for legitimate reasons, but claimants have the right to challenge such decisions with proper evidence. Ensure all documentation meets SIRA standards and seek legal advice if disputes arise.
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