What to Do If Your CTP Insurer Changes the Assessor
If your CTP insurer replaces the assessor handling your claim without notice, you have legal rights under NSW law. The Motor Accident Injuries Act 2017 and SIRA guidelines require insurers to follow specific procedures when changing assessors. This includes informing claimants and providing reasons for the change. If your assessor is replaced without proper notice, you may need to challenge the decision.
Legal Rules for CTP Assessor Changes
Under the Motor Accident Injuries Act 2017, CTP insurers must ensure assessments are fair and transparent. SIRA guidelines state that any change to the assessor must be documented and communicated to the claimant. Insurers cannot unilaterally replace assessors without justification, such as a conflict of interest or new evidence affecting the claim.
Key principles include:
- Notice requirement: Insurers must notify claimants of any assessor change in writing.
- Reasonable cause: Changes must be based on legitimate grounds, such as an assessor’s conflict of interest.
- Right to respond: Claimants must be given an opportunity to provide evidence or challenge the change.
Practical Steps to Take
If your assessor is changed, take these steps:
- Request written notice: Ask the insurer to provide a detailed explanation for the change.
- Review medical records: Ensure your injury documentation is complete and up-to-date.
- Document communication: Keep copies of all correspondence with the insurer.
- Seek independent assessment: If you believe the change is unfair, request a second opinion from a qualified medical practitioner.
Critical evidence includes:
- Your original assessor’s report
- Copies of all insurer communications
- Medical records showing the injury’s progression
- Witness statements if applicable
Dispute Options and Time Limits
CTP insurers must act within specific timeframes. If your claim is delayed or the assessor change is not justified, you may need to:
- File a dispute with SIRA: The NSW Motor Accident Claims Authority can review the insurer’s decision.
- Apply for a review: Under the Motor Accident Injuries Act 2017 s 4.4, you can request a reassessment of your claim.
- Seek legal advice: A solicitor can help you challenge the change through the NSW Civil and Administrative Tribunal (NCAT).
When to Seek Legal Advice
Contact a legal professional if:
- The insurer refuses to provide reasons for the change
- You believe the new assessor is biased
- Your claim is delayed beyond the 52-week statutory benefit period
- You need help challenging the change through NCAT
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.