If your NSW Compulsory Third Party (CTP) insurer is delaying a decision on your motor accident claim, you have options to resolve the dispute. Under NSW law, insurers must respond within set timeframes, and claimants can escalate matters through SIRA processes, mediation, or legal action. This article explains how to address delays, what evidence matters, and when to seek legal advice.
How SIRA Handles Delayed Decisions
SIRA (State Insurance Regulatory Authority) oversees CTP claims in NSW. If an insurer fails to respond within 28 days of receiving a claim form, the claim is automatically referred to SIRA for review. This applies even if the insurer claims it needs more time to assess the case. SIRA will then evaluate whether the insurer’s delay violates its obligations under the Motor Accident Injuries Act 2017.
Practical Steps for Claimants
- Confirm the insurer’s response timeframe: Insurers must acknowledge claims within 14 days and provide a decision within 28 days. If they fail to meet these deadlines, you can escalate the matter.
- Request written confirmation: Always ask the insurer in writing for a timeline and reasons for delays. Keep copies of all correspondence.
- Submit a formal complaint: Use SIRA’s online complaint form or contact them directly. Include details of the delay, your claim form number, and any evidence of the insurer’s inaction.
- Escalate to SIRA: If the insurer ignores your complaint, SIRA will intervene. They may order the insurer to pay your claim, issue a penalty, or refer the matter to mediation.
- a Hypothetical Example: Imagine a claimant in Albury who submitted a claim form on 1 July 2025. The insurer acknowledged it on 15 July but delayed a decision until 10 August. Under NSW law, this 28-day deadline was breached, triggering an automatic SIRA review. The claimant could then request a formal complaint and seek mediation if the insurer refused to pay.
Time Limits and Dispute Options
CTP insurers must respond to claims within 28 days. If they fail to do so, SIRA will review the claim, and the claimant may be entitled to payment of their claim, including treatment and care benefits, weekly income payments, or lump sum damages. If the insurer disputes the claim, you can:
- Request a review by SIRA: SIRA will assess whether the insurer’s decision is lawful.
- Seek mediation: SIRA offers mediation to resolve disputes without court.
- Take legal action: If mediation fails, you may need to file a claim in the NSW Civil and Administrative Tribunal (NCAT) or the District Court. Legal advice is essential here, as courts will examine whether the insurer’s delay or refusal to pay was justified.
When to Seek Legal Advice
Consult a solicitor if:
- The insurer refuses to pay your claim outright.
- You receive a letter of disagreement or a ‘no claim’ decision.
- You need help drafting a formal complaint or preparing evidence.
- You want to challenge the insurer’s assessment of your injuries.
A lawyer can help you understand your rights, prepare a case, and ensure you meet all procedural deadlines.
Next Steps
CTP claims depend on the date of the accident, the insurer’s actions, and the evidence you provide. If your insurer is delaying a decision, act quickly to protect your rights. Complete the quick, no obligation enquiry form to request contact about your circumstances.