Understanding the Role of the CTP Insurer and the PIC in Assessor Disputes
If you are involved in a motor accident in Greater Sydney and your CTP insurer proposes a change of claims assessor or case manager, you may be concerned about how the process will unfold. The Personal Injury Commission (PIC) oversees the resolution of disputes in the NSW CTP scheme, including those involving changes to assessors. The PIC does not appoint assessors, but it provides guidance and oversight when disputes arise. Under the Motor Accident Injuries Act 2017, the CTP insurer is responsible for appointing and managing the claims assessor. However, if you believe the change is not in your best interest, you have the right to raise a dispute with the insurer and, if unresolved, to seek review through the PIC.
What the PIC Expects When a Dispute Arises Over a Change of Assessor
The PIC expects claimants to provide clear and factual reasons for objecting to a change of assessor. Common grounds include a lack of communication, perceived bias, delays in processing claims, or a breakdown in trust. The PIC does not automatically overturn a change of assessor. Instead, it assesses whether the insurer followed the correct procedures under the Motor Accident Injuries Regulation 2017 and whether the change was reasonable in the circumstances. The insurer must notify you in writing of any proposed change and provide a rationale. The PIC will consider whether the insurer gave you adequate opportunity to respond before the change was made.
Practical Steps to Take if Your CTP Insurer Proposes a Change of Assessor
If your CTP insurer notifies you of a proposed change of assessor, you should act promptly. First, confirm in writing that you have received the notice and request a copy of the insurer’s rationale for the change. Retain all correspondence, including emails, letters, and call records. If you believe the change is not justified, you may request a review from the insurer’s internal dispute resolution process. This must be done within 28 days of receiving the notice, or the PIC may not accept your complaint.
Next, gather evidence that supports your objection. This may include:
- A record of all communications with your current assessor, including dates, times, and content.
- Evidence of delays, unresponsiveness, or mismanagement by the current assessor.
- Medical reports or treatment notes that demonstrate continuity of care is important to your recovery.
- A statement from your medical practitioner explaining why a change may disrupt your treatment or recovery.
How the PIC Handles Disputes Involving Assessor Changes
The PIC does not have the authority to appoint a new assessor. Its role is to review whether the insurer followed the correct process and whether the decision to change the assessor was reasonable. If you dispute the change, you may lodge a complaint with the PIC under the Motor Accident Injuries Act 2017. The PIC will assess whether the insurer:
- Provided you with written notice of the change.
- Gave you a reasonable opportunity to respond.
- Had a valid reason for the change, such as a conflict of interest, performance issues, or a change in the insurer’s internal processes.
The PIC may also consider whether the change would impact your access to treatment, income support, or compensation. However, the PIC cannot override a decision made by the insurer unless it finds a procedural or legal error. The PIC’s decision is not binding on the insurer, but it may influence the insurer’s willingness to reconsider.
Time Limits and the Importance of Acting Promptly
There are time limits that apply when disputing a change of assessor. You must raise your objection with the insurer within 28 days of receiving notice of the change. If the insurer does not resolve your dispute, you may then apply to the PIC for review. The PIC must decide on your complaint within 30 days of receiving it, unless an extension is granted. Failure to act within these timeframes may result in your complaint being dismissed.
What You Should Know About the Medical Dispute Pathway
If the change of assessor affects your medical treatment or care, you may also consider using the PIC’s medical dispute pathway. This allows you to challenge decisions about treatment, care, or medical assessments. You must provide a written request to the PIC, supported by medical evidence, including reports from your treating medical practitioner. The PIC will assess whether the proposed change of assessor would interfere with the medical management of your injury. However, a medical dispute does not guarantee a change of assessor. The PIC will assess whether the change is in your best interests, based on the evidence provided.
Hypothetical Example: A Claimant’s Experience in Greater Sydney
A pedestrian in Sydney’s Inner West was injured in a motor accident in June 2026. Her current claims assessor had been managing her claim for 10 months, coordinating her medical treatment and weekly income payments. In August 2026, she received a letter from her CTP insurer stating that her assessor would be replaced due to a restructure. She believed the change would disrupt her recovery and submitted a written objection, attaching her medical reports and a letter from her physiotherapist. The insurer rejected her objection, citing internal policy. She then lodged a complaint with the PIC, which reviewed the insurer’s process and found that the insurer had not given her a reasonable opportunity to respond. The PIC recommended the insurer reconsider, and the insurer reinstated her original assessor.
When to Seek Independent Advice
A change of assessor can affect your access to compensation, treatment, and support. If you are unsure about your rights or how to respond, it is advisable to seek independent advice. The PIC does not provide legal representation, and you are not required to have a lawyer to make a complaint. However, legal advice can help you understand whether the insurer followed the correct procedures and whether your objection has a reasonable basis. You may also contact a community legal centre or a solicitor with experience in CTP claims.
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