When a CTP insurer changes assessors during a motor accident claim in Auburn, claimants must avoid specific errors to protect their entitlements. Under NSW law, claimants have the right to request a new assessor if they believe the current one is biased or unqualified, but procedural missteps can derail the process. This article explains the legal framework, practical steps, and common mistakes to avoid when dealing with assessor changes under the Motor Accident Injuries Act 2017.
Why Assessor Changes Matter in CTP Claims
NSW CTP insurers must follow strict rules when changing assessors. The Motor Accident Guidelines outline that an assessor must be independent and qualified to evaluate claims. If a claimant suspects bias, they can request a new assessor, but this must be done within 28 days of receiving the initial report, as per SIRA guidelines. Failing to act within this timeframe may result in the insurer refusing the request, even if the claimant has valid concerns.
Common Mistakes Claimants Make
- Not Documenting Concerns: Claimants often fail to clearly explain why they believe the assessor is unsuitable. Without specific evidence of bias or unfitness, insurers may dismiss the request. For example, a claimant might mention general dissatisfaction without citing specific breaches of the assessor’s qualifications.
- Missing the 28-Day Deadline: The 28-day window to request a new assessor is strict. If a claimant delays beyond this period, the insurer may argue the request is untimely, even if the assessor’s impartiality is questionable.
- a Ignoring SIRA’s Role: SIRA oversees CTP claims and can intervene if a claimant disputes an assessor’s decision. However, claimants must first exhaust internal insurer processes before escalating to SIRA. Failing to follow this path can lead to unnecessary delays.
- Failing to Provide Evidence: When requesting a new assessor, claimants must support their concerns with evidence. This could include documentation of the assessor’s past decisions, conflicts of interest, or failure to follow SIRA guidelines. Without such evidence, the insurer may reject the request.
Practical Steps to Avoid Issues
- Submit a Written Request: Clearly state your reasons for requesting a new assessor in writing. Reference specific sections of the Motor Accident Guidelines or SIRA’s rules to justify your concerns.
- Keep Records of Communication: Document all interactions with the insurer, including dates and details of any correspondence. This helps prove compliance with deadlines and procedures.
- Seek SIRA Intervention if Needed: If the insurer refuses a legitimate request, contact SIRA directly. They can review the case and ensure the insurer follows the correct process.
Time Limits and Dispute Options
Under the Motor Accident Injuries Act 2017, claimants must notify the insurer of any changes to their medical condition or treatment within 28 days. If an assessor change is delayed beyond this period, the insurer may argue the claim is out of time. Additionally, claimants can dispute an assessor’s findings by submitting a formal objection to the insurer, supported by medical evidence.
When to Seek Legal Advice
If a claimant is unsure whether their assessor change request is valid, or if the insurer is refusing to comply with SIRA guidelines, they should consult a solicitor. Legal advice can help ensure all procedural requirements are met and that the claimant’s rights are protected.
Final Steps for Claimants
If you’re in Auburn and facing an assessor change, act promptly and follow the correct procedures. Avoid common errors like missing deadlines or failing to provide evidence. For personalized guidance, complete the quick, no obligation enquiry form to request contact about your circumstances.