A threshold injury under the Motor Accident Injuries Act 2017 (NSW) includes a soft tissue injury and a psychological or psychiatric injury that is not a recognised psychiatric illness (adjustment disorder and acute stress disorder are the usual examples; s 1.6 and Motor Accident Guidelines Part 5).
If an insurer is taking longer than expected to decide on your CTP claim in regional NSW, you should take immediate steps to protect your rights and ensure your claim progresses. Delays can occur for various reasons, including incomplete documentation, complex injury assessments, or internal processing backlogs. However, under the Motor Accident Injuries Act 2017, insurers are required to assess claims within a reasonable timeframe. You are not required to wait indefinitely. The first practical steps include confirming the insurer has received your claim, verifying the completeness of your supporting evidence, and formally requesting a progress update. In regional NSW, where access to legal and medical services may be more limited, early action is critical to avoid delays that could affect your entitlement to benefits.
The Motor Accident Injuries Act 2017 establishes the framework for CTP claims in NSW. It provides for statutory benefits such as treatment and care, weekly income payments, and, where applicable, damages for non-economic loss. These benefits are not automatically granted and depend on the nature of your injuries, the circumstances of the accident, and whether you meet the threshold for damages. If your insurer has not responded within a reasonable period, you may not be able to rely on informal delays. Instead, you should follow a structured approach to escalate the matter through official channels.
Key evidence that supports your claim and helps prevent unnecessary delays includes medical records detailing your injuries and treatment, a completed accident report (if available), photographs of the scene or vehicle damage, witness contact details, and proof of income loss. In regional areas, it is especially important to obtain a medical practitioner’s report confirming the nature and extent of your injuries. This report must be issued under the Motor Accident Guidelines and may be required to assess whether you have a threshold injury. Failure to provide timely and complete evidence may result in a delayed or denied decision.
If your insurer has not responded within 28 days of receiving your claim, you may contact the Motor Accident Commission (SIRA) for assistance. SIRA is the independent body responsible for overseeing CTP claims in NSW. It does not make decisions on claims but can help resolve disputes, clarify procedural requirements, and ensure insurers comply with their obligations under the Act. You can contact SIRA’s claims team via phone or online to report a delay. SIRA may then issue a formal notice to the insurer to respond within a specified timeframe. This step is particularly useful in regional NSW, where direct access to insurer representatives may be limited.
In some cases, a claim may be delayed because the insurer is awaiting a medical assessment or because a dispute arises over fault or injury severity. If the insurer has not responded within 60 days, you may consider lodging a formal complaint with SIRA. SIRA can investigate the delay and, if warranted, direct the insurer to act. You may also seek independent legal advice at this stage to understand your rights and options. However, you are not required to have a solicitor to make a claim or to report a delay.
A hypothetical example: A cyclist in Wagga Wagga was struck by a car in a regional car park on 15 August 2026. The cyclist sustained a whiplash injury and was unable to work for three weeks. The claim was submitted to the insurer on 20 August. By 10 October, no decision had been received. The cyclist obtained a medical report confirming a soft-tissue injury and submitted it to the insurer on 15 October. The insurer still had not responded by 1 November. At this point, the cyclist contacted SIRA to report the delay. SIRA issued a notice to the insurer, which responded within 10 days. The claim was then assessed and approved for treatment and care benefits and weekly income payments.
Time limits and procedural requirements may apply. For example, if you are seeking damages, you must generally commence proceedings within three years of the accident date. However, the timeframe for notifying an insurer of a claim is not strictly defined by law, but prompt notification is essential to preserve your rights. Delays in notifying an insurer may affect the amount of benefits you receive, particularly if the insurer argues that you failed to act with reasonable diligence.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.