When Can a CTP Insurer Change the Medical Assessor?
Under NSW CTP rules, insurers may request a new assessor if they believe the original assessment was inadequate or if there are concerns about the claimant’s recovery progress. This is governed by the Motor Accident Injuries Act 2017 and SIRA guidelines. Insurers must provide a valid reason for the change, such as discrepancies in medical records or the need for a second opinion. Claimants should be notified in writing and given time to prepare.
Practical Steps for Claimants Preparing for Assessments
If your insurer changes the assessor, take these steps:
- Review the new assessor’s credentials - Ensure they are registered with SIRA and have relevant experience.
- Gather all medical records - Include pre-accident health history, treatment notes, and specialist reports.
- Prepare a list of questions - Address any gaps in the assessment, such as the relevance of past injuries.
- Attend the assessment with support - Bring a carer or advocate if needed, especially for complex cases.
- Document the process - Record the date, time, and details of the assessment for future reference.
SIRA’s Role in Regulating Assessor Changes
SIRA oversees CTP claims and ensures assessments comply with the Motor Accident Guidelines. Insurers must follow strict procedures when requesting a new assessor, including:
- Submitting a written request with specific reasons.
- Allowing claimants time to respond to the new assessment.
- Ensuring the new assessor follows the same evidence standards as the original.
If you believe the assessor change is unjustified or impacts your claim, contact SIRA directly. They can review the insurer’s decision and ensure your rights are protected.
Time Limits and Dispute Options
CTP insurers have 28 days to request a new assessment after the initial report. If you disagree with the change, you may:
- Request a review from SIRA - They can investigate the insurer’s reasoning.
- Dispute the change formally - This requires written evidence of the insurer’s failure to follow guidelines.
- Seek legal advice - A solicitor can help challenge the change if it affects your entitlements.
When to Seek Independent Advice
If the assessor change delays your claim, affects your benefits, or creates confusion about your injury, contact a legal professional. SIRA provides free information sessions, but only a solicitor can assess whether your claim is being handled fairly.
Next Steps
CTP entitlements depend on the accident date, injury type, and claim history. If you’re in the Illawarra or South Coast, regional SIRA offices may have additional procedures. General information cannot determine whether a claim is available in your case. Complete the quick, no obligation enquiry form to request contact about your circumstances.