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 claim, retaining the right evidence is critical to support your case. Under NSW law, claimants must preserve records that demonstrate the injury's nature, treatment, and ongoing impact. This guide explains what evidence to keep, how the Illawarra and South Coast CTP process handles assessor changes, and the legal risks of losing key documents.
NSW CTP Rules Governing Assessor Changes
The Motor Accident Injuries Act 2017 (MAIA) and SIRA guidelines outline that CTP insurers must provide a fair assessment of claims. If an insurer replaces its assessor, it must notify the claimant in writing and explain the reason. While the MAIA does not explicitly address assessor changes, SIRA's Making a motor accident claim page states that claimants must ensure all evidence is available for any assessment.
Key legal principles include:
- Section 4.4 of the MAIA limits benefits for threshold injuries after 52 weeks, but this does not apply if the injury is not a threshold injury.
- Section 3.11 requires insurers to provide a written statement of their assessment within 28 days of receiving evidence.
- SIRA's
- What you can claim* page confirms that claimants must retain all medical records, accident reports, and correspondence with insurers.
Evidence to Retain During Assessor Changes
When a CTP insurer changes assessors, claimants must ensure the following records are preserved:
- Medical records: Include all diagnostic reports, treatment notes, and specialist opinions. For example, if a doctor documents a spinal nerve-root injury (as defined in the Motor Accident Guidelines), this may qualify as a threshold injury.
- Accident reports: Police reports, witness statements, and photos of the scene are essential to establish the incident's circumstances.
- Insurer correspondence: Save all emails, letters, and forms exchanged with the insurer, including notifications of assessor changes.
- Income and employment records: Proof of lost wages or reduced earning capacity is required to support weekly income payments.
- Treatment and care records: Document all medical expenses, therapy sessions, and equipment costs.
A hypothetical example illustrates this: If a claimant with a soft-tissue injury (confirmed by a doctor) loses their medical records during an assessor change, the insurer may dispute the injury's severity, delaying benefits.
Time Limits and Dispute Options
CTP insurers have 28 days under Section 3.11 to respond to new evidence. If an insurer delays or disputes your claim, you may:
- Request a review: Submit a written request to the insurer for a reassessment.
- Dispute through SIRA: If the insurer refuses to act, you can escalate the matter to SIRA.
- Seek independent advice: A solicitor can help challenge the insurer's decision, especially if evidence is lost or mishandled.
Note that the 52-week rule for threshold injuries does not apply if your injury is not classified as a threshold injury. Always confirm your injury's classification with your treating doctor.
When to Seek Legal Advice
If your insurer changes assessors without proper notice, loses your evidence, or disputes your claim, you should contact a legal professional. While the MAIA does not guarantee compensation, claimants have the right to challenge decisions that affect their benefits.
Next Steps
CTP entitlements depend on the accident date, injury type, and claim history. To request contact about your circumstances, complete the quick, no obligation enquiry form.