Delayed insurer decisions, early steps for injured road users
If your CTP claim is delayed, you're not alone. Insurers in NSW have legal obligations to process claims within set timeframes, but delays are common. This guide explains your rights, practical steps to take, and how SIRA's guidance applies to regional areas like Illawarra and South Coast.
Legal obligations of insurers under NSW CTP laws
Under the Motor Accident Injuries Act 2017, insurers must act promptly to assess claims. While there's no fixed deadline for all claims, the law requires insurers to:
- Acknowledge your claim within 14 days of receiving it (s 4.3 of the Act)
- Provide a written decision within 28 days of the claim being accepted (s 4.4)
- Notify you of any delays and explain the reason for the delay
If an insurer fails to meet these timelines, it may be breaching its legal duties. SIRA confirms that insurers must act 'reasonably and promptly' in all cases, including regional areas.
Practical steps for injured road users
If your claim is delayed, take these steps:
- Document the delay, Keep a record of dates, correspondence, and any communication with the insurer.
- Contact the insurer in writing, Request a written explanation for the delay and a timeline for resolution.
- Escalate through SIRA, If the insurer doesn't respond, use SIRA's dispute resolution process. SIRA's regional offices in Wollongong and Nowra can assist with claims in Illawarra and South Coast.
- Seek medical evidence, Ensure your medical records clearly show the injury's impact, as this supports your claim.
Time limits and disputes
CTP claims must be made within three years of the accident (s 4.1 of the Act). If the insurer delays processing, you may need to:
- Request a review of the insurer's decision
- Lodge a complaint with SIRA
- Consider mediation or legal action if the insurer refuses to pay
SIRA's guidance (https://www.sira.nsw.gov.au/claims/motor-accidents) states that delays in processing can affect your ability to claim weekly payments or treatment benefits. For example, if a claim is delayed beyond 52 weeks, benefits may be limited under the Act.
When to seek advice
If the insurer refuses to pay, disputes the claim, or fails to meet processing deadlines, you should consult a solicitor. While SIRA provides free information, legal advice is needed to:
- Challenge an insurer's refusal
- Navigate complex disputes
- Ensure you meet all claim deadlines
Example: A regional claim delay
A cyclist in Kiama suffered a soft-tissue injury in 2023. The insurer delayed processing the claim for over 30 days, during which the cyclist missed work. SIRA advised that the insurer's delay breached its duty of care, and the claimant was entitled to weekly payments for the period of delay. This shows how regional claims can be handled under the same legal framework as metropolitan areas.
Next steps
CTP claims depend on the accident date, injury type, and insurer actions. If you're facing a delayed decision, take action now to protect your rights. Complete the quick, no obligation enquiry form to request contact about your circumstances.