When Insurers Delay CTP Claims in NSW
If you're injured in a motor accident in NSW and your insurer is taking too long to respond, you're not alone. Insurers are legally required to make decisions within specific timeframes, but delays are common. This article explains your rights, what to do if your claim is delayed, and how to challenge slow decisions.
Legal Timeframes for CTP Claims
Under the Motor Accident Injuries Act 2017, insurers must respond to claims within 21 days of receiving all required documentation. If they need more time, they must notify you in writing and provide a reason. Delays beyond this period may breach your legal rights.
The 21-day rule applies to all CTP claims, including those involving soft tissue injuries, permanent impairments, or lifetime care needs. If your insurer fails to meet this deadline, you may have grounds to escalate the matter.
What to Do if Your Claim is Delayed
- Request a written timeline from your insurer. They must explain why they're delaying and when they expect to make a decision.
- Keep records of all communication. Save copies of emails, letters, and phone records showing the delay.
- Escalate to SIRA if the insurer doesn't respond within 21 days. The NSW Motor Accident Claims Authority (SIRA) oversees insurer compliance with timeframes.
- Seek independent advice if your claim is delayed beyond 60 days. Legal experts can help you challenge the insurer's decision.
Consequences of Delayed Decisions
Delays can harm your claim in two ways:
- Statutory benefits like weekly income payments may be cut off after 52 weeks if your injuries are classified as 'threshold injuries' (per s 4.4 of the Motor Accident Injuries Act 2017).
- Evidence timelines may expire. For example, if you wait too long to seek medical treatment, your claim could be rejected.
How to Challenge a Delayed Decision
If your insurer's delay causes harm, you may need to:
- Submit a formal complaint to SIRA using their online form.
- Request a review of your claim if the insurer refuses to pay.
- Seek legal assistance if your claim is delayed beyond 90 days. A solicitor can help you apply for an injunction or other remedies.
Example: A Delayed Claim in Auburn
Imagine you were injured in a car accident in Auburn and submitted your claim to the at-fault driver's insurer. After 25 days, you receive a letter stating the insurer needs more time to assess your claim. This delay may breach your legal rights, especially if your injuries require ongoing treatment.
Next Steps
If your insurer is not responding in a timely way, act quickly. SIRA has specific rules about insurer timelines, and delays can affect your ability to claim benefits. For personalized advice, complete the quick, no obligation enquiry form to request contact about your circumstances.