If your NSW Compulsory Third Party (CTP) insurer is delaying a decision on your motor accident claim, retaining the right evidence is critical. Under NSW law, claimants must preserve records that demonstrate the injury, accident circumstances, and insurer obligations. This guide explains what evidence to keep, how SIRA guidelines apply, and the legal boundaries insurers must follow.
Legal Framework for CTP Claims in NSW
NSW CTP claims are governed by the Motor Accident Injuries Act 2017 and administered by SIRA (State Insurance Regulatory Authority). Insurers must act within legal timeframes to assess claims. Section 4.4 of the Act specifies that weekly benefits and treatment payments are limited after 52 weeks if injuries are classified as 'threshold injuries', a term defined in the Motor Accident Guidelines.
Insurers are legally required to provide a written decision within 28 days of receiving all necessary evidence. If they fail to act within this period, claimants may need to escalate the matter through SIRA or seek legal advice. The 52-week rule applies only if the injury does not meet the threshold injury criteria under the guidelines.
Practical Evidence to Retain During Delays
When insurers delay decisions, claimants must retain records that prove the injury's severity and the accident's circumstances. Key evidence includes:
- Medical records: Detailed reports from GPs, specialists, and physiotherapists, including imaging and treatment plans.
- Accident details: Police reports, witness statements, and photographs of the scene.
- Insurer correspondence: Emails, letters, or forms showing the insurer's failure to act within deadlines.
- Income records: Proof of lost wages or reduced earning capacity.
- SIRA claim forms: Completed and submitted documents showing the claim's progress.
For example, a pedestrian with soft tissue injuries (including a spinal nerve-root injury with neurological signs) must retain medical evidence to prove the injury meets the threshold injury definition under the guidelines.
Time Limits and Dispute Options
Insurers must respond to claims within 28 days of receiving all evidence. If they delay beyond this period, claimants may need to:
- Request a written explanation of the delay.
- Escalate the matter to SIRA via the CTP dispute process.
- Seek legal advice if the insurer refuses to act within the 52-week limit for threshold injuries.
Note: The 52-week rule does not apply if the injury involves whole-person impairment (WPI) or requires long-term care. Always verify your injury's classification using the Motor Accident Guidelines.
When to Seek Legal Advice
If your insurer delays decisions beyond 28 days, or if you believe your claim is being undervalued, contact a legal professional. SIRA provides free dispute resolution services, but complex cases may require a solicitor to challenge the insurer's interpretation of the law.
Next Steps
CTP claims depend on accurate record-keeping and timely action. If your insurer is unresponsive, start by requesting a written decision within 28 days. For guidance on preserving evidence or escalating disputes, complete the quick, no obligation enquiry form.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.