If your insurer delays a decision on your NSW CTP claim for returning to daily activities, it could affect your entitlements. Under the Motor Accident Injuries Act 2017, insurers must assess claims within set timeframes. Delays may require you to escalate the issue or seek legal advice. This article explains how delayed decisions impact your claim, what evidence matters, and steps to take if your insurer is unresponsive.
How Delayed Decisions Affect Your Claim
NSW CTP insurers must assess claims within 52 weeks of the accident for certain benefits, per SIRA guidelines. If your insurer delays decisions about daily activity recovery, it may risk breaching these time limits. Delays can also hinder access to treatment and care benefits, which are crucial for rehabilitation. For example, if your insurer takes longer than 52 weeks to decide on weekly income payments, you may lose entitlement to those benefits.
Practical Steps for Claimants
If your insurer is slow to act, gather evidence showing the delay. This includes:
- Medical records proving your injury and recovery progress
- Accident reports and witness statements
- Correspondence with the insurer showing unresponsiveness
- Evidence of how the delay impacts your daily activities
You should also document any attempts to escalate the issue, such as phone calls, emails, or written complaints. SIRA recommends contacting the insurer in writing to request a timeline for their decision.
SIRA's Guidance on Timeframes
SIRA's Motor Accident Claims page states insurers must respond to claims within 52 weeks for certain benefits. If your claim involves weekly income payments or treatment benefits, delays beyond this period may mean you lose entitlement to those payments. SIRA also advises claimants to seek independent legal advice if the insurer refuses to provide a decision within the timeframe.
When to Seek Legal Advice
If your insurer delays decisions for more than 52 weeks, or if you believe the assessment is unfair, you should consult a legal professional. A lawyer can help you understand your options, including disputing the insurer's decision or applying for a review. In Bega, injured road users should note that delays in CTP claims can have serious financial and health consequences.
Next Steps
NSW CTP claims depend on the accident date, injury type, and insurer actions. If you're facing delays in decisions about daily activity recovery, time limits may apply. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.