Where a person's only injuries resulting from the accident are threshold injuries, weekly benefits and treatment and care generally cease after 52 weeks (ss 3.11 and 3.28).
A threshold injury under the Motor Accident Injuries Act 2017 (NSW) includes a soft tissue injury and a psychological or psychiatric injury that is not a recognised psychiatric illness (adjustment disorder and acute stress disorder are the usual examples; s 1.6 and Motor Accident Guidelines Part 5).
If a CTP insurer changes assessors during your motor accident claim in Bathurst, it's essential to retain all evidence supporting your case. Under NSW law, claimants must document medical records, accident details, and communication with insurers to ensure their claim isn't undervalued or delayed. This guide explains the legal requirements, practical steps, and time limits relevant to assessor changes under the Motor Accident Injuries Act 2017.
Legal Rules Behind Evidence Retention
The Motor Accident Injuries Act 2017 (MAIA) governs CTP claims in NSW. SIRA’s guidance confirms that claimants must preserve all records that demonstrate the nature, extent, and impact of their injuries. This includes medical reports, treatment records, and evidence of how the accident affected your daily life. If an insurer replaces its assessor, the new assessor must review all available evidence to determine the claim’s validity. Failure to retain critical documents could lead to disputes over the accuracy of the new assessment.
Practical Evidence to Keep
When a CTP insurer changes assessors, you should retain the following:
- Medical records showing the injury’s progression, including specialist reports and imaging
- Accident reports from police or witnesses, including dates, times, and vehicle details
- Witness statements and contact information
- Photos of the accident scene, vehicle damage, and personal injuries
- Correspondence with the insurer, including claims forms and assessment requests
- Income records to support claims for lost wages or care costs
These documents help the new assessor understand the full context of your claim. For example, if your injury requires ongoing treatment, medical records prove the necessity of care payments.
Time Limits and Dispute Options
Under the MAIA, insurers must respond to claims within specific timeframes. If an assessor change delays your claim, you may need to request a review of the insurer’s process. SIRA’s guidelines state that claimants can dispute an assessor’s findings by providing additional evidence or seeking an independent review. However, time limits for disputing assessments are strict, claims must typically be resolved within 52 weeks of the accident if only threshold injuries are involved.
When to Seek Legal Advice
If the insurer’s new assessor refuses to consider key evidence or disputes the severity of your injuries, it’s important to consult a legal professional. A lawyer can help you challenge the assessment, request a second opinion, or ensure the insurer follows the correct process under the MAIA. This is particularly important if the assessor’s decision impacts your long-term compensation or access to treatment.
Example Scenario
Consider a claimant who suffered a soft-tissue injury after a collision in Bathurst. The insurer initially assigned an assessor who downgraded the injury to a threshold injury. When the claimant provided additional medical evidence showing ongoing pain and mobility issues, the insurer changed assessors. The new assessor reviewed the updated records and adjusted the claim to reflect the full extent of the injury. This highlights the importance of retaining all evidence to support your case.
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