Common Law Damages Pathway in NSW CTP Claims, What to Do If the Insurer Says No
If you've been injured in a motor vehicle accident in New South Wales and the insurer has refused to pay your claim, you may be wondering what options are available to you. This article explains the common law damages pathway in NSW CTP claims, what you need to consider, and the dispute options available to you.
What Is a Common Law Damages Claim in NSW CTP?
In New South Wales, motor accident claims are governed by the Motor Accident Injuries Act 2017 and the Motor Accident Injuries Regulation 2017. These laws outline the statutory benefits available to injured parties, such as weekly income payments and treatment and care benefits. However, they do not cover all types of injuries or losses.
If your injuries fall outside the statutory benefits, such as if they are not classified as 'threshold injuries', you may be able to pursue a common law damages claim. This type of claim allows you to seek compensation for pain, suffering, loss of enjoyment of life, and other non-economic losses.
What Happens If the Insurer Says No?
If the insurer has refused to pay your claim, they may have determined that your injuries do not meet the criteria for statutory benefits or that your claim is not covered under the CTP scheme. In such cases, you may need to explore other options.
One option is to challenge the insurer's decision. This can be done through a formal internal review with the insurer, or by seeking a review from the Personal Injury Commission (PIC). The PIC is an independent body that can review claims and provide a decision on whether a claim should be accepted.
What Evidence Do You Need for a Common Law Claim?
To support a common law damages claim, you will need to provide evidence of your injuries and the impact they have had on your life. This may include:
- Medical records showing the nature and extent of your injuries
- Medical opinions from a qualified medical practitioner
- Witness statements from people who have seen your injuries or know about your condition
- Accident reports and photographs of the scene
- Income records to show the impact of your injuries on your earnings
- Correspondence with the insurer and any other relevant parties
What Are the Dispute Options Available?
If the insurer has refused to pay your claim, you may have several options to challenge their decision:
- Internal review: Most insurers have a process for reviewing claims internally. You can request a review in writing and provide any new evidence or information.
- Personal Injury Commission (PIC) review: If the internal review does not resolve the issue, you can apply to the PIC for a review. The PIC will assess your claim and may issue a decision that is binding on the insurer.
- Legal action: If you believe the insurer has acted unfairly or in bad faith, you may be able to take legal action. This would typically involve a solicitor and may require a court hearing.
What Are the Time Limits for a Common Law Claim?
In New South Wales, there are time limits for bringing a common law damages claim. Generally, you must start your claim within three years of the date of the accident. However, this time limit may be extended in certain circumstances, such as if you were a minor at the time of the accident or if you were injured as a result of a long-term condition.
What Should You Do Next?
If the insurer has refused to pay your claim, it is important to act quickly. You should:
- Gather all relevant evidence to support your claim
- Seek legal advice to understand your options and how to proceed
- Consider a review by the Personal Injury Commission or legal action if necessary
When Should You Seek Legal Advice?
If you are unsure whether your claim is valid or how to proceed, it is important to seek legal advice. A solicitor can help you understand your rights, assess the strength of your claim, and guide you through the process of challenging the insurer's decision.
Final Thoughts
If the insurer has refused to pay your claim, you are not without options. You may be able to pursue a common law damages claim and challenge the insurer's decision through internal review, the Personal Injury Commission, or legal action. However, it is important to act quickly and seek legal advice to ensure your claim is handled properly.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.