Delays in CTP insurer decisions can significantly impact an injured person's ability to return to daily activities. Under NSW law, insurers must act promptly to assess claims, but delays can hinder recovery timelines. This article explains how delayed decisions affect rehabilitation, what SIRA guidelines say about claim timelines, and practical steps to take if your insurer is slow.
How Delayed CTP Decisions Affect Daily Activity Recovery
CTP insurers are legally required to evaluate claims within set timeframes. Delays in decisions can prevent injured road users from accessing necessary treatment, rehabilitation support, or income benefits. For example, if an insurer postpones approving a claim for soft tissue injuries, the injured person may not receive timely access to physiotherapy or medical equipment needed to return to work or daily routines.
SIRA guidelines state that claims must be resolved within 28 days of being referred to a claims assessor. If delays occur, claimants should escalate the issue through formal channels. Delays can also affect the calculation of weekly income benefits or treatment and care payments, as these depend on a clear timeline of recovery.
Practical Steps for Claimants Facing Delays
If your insurer is slow to decide on daily activity recovery, take these steps:
- Request a written timeline from the insurer detailing when they expect to make a decision.
- Document all communication with the insurer, including dates of correspondence.
- Seek independent medical advice if you believe your recovery is being undervalued.
- Escalate to SIRA if the insurer fails to meet its 28-day assessment deadline.
Evidence such as medical records, accident reports, and witness statements can support your case. SIRA also provides templates for disputing delays, which can be accessed through their official website.
Time Limits and When to Seek Legal Advice
NSW law imposes strict time limits for CTP claims. For example, weekly income benefits are generally limited to 52 weeks if only threshold injuries are involved. Delays in insurer decisions can push these deadlines, reducing the window for claimants to access support.
If your insurer refuses to acknowledge delays or disputes your ability to return to daily activities, it may be time to seek legal advice. A solicitor can help challenge unreasonable delays or ensure your claim aligns with SIRA's rehabilitation expectations.
Example: How Delays Impact Recovery
Consider a cyclist with a soft tissue injury who is delayed in receiving treatment approval. While the insurer reviews the claim, the cyclist may struggle to manage household responsibilities or work, worsening their recovery. SIRA guidelines emphasize that insurers must act swiftly to avoid such outcomes.
Next Steps
CTP claims depend on timely decisions from insurers. If your case is delayed, act quickly to protect your rights. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.