Understanding Insurer-Ordered IME Examinations in NSW CTP Claims
If you have been involved in a motor accident in Western Sydney and your CTP insurer has requested an independent medical examination (IME), you may be concerned about time limits. Under NSW law, there are no fixed statutory deadlines for when an insurer must arrange an IME. However, the Motor Accident Injuries Act 2017 and the Motor Accident Injuries Regulation 2017 require that any medical assessment must be conducted in a timely and reasonable manner. Insurers must not unreasonably delay or withhold an IME, and any request must be made in good faith to assess injury status, treatment needs or capacity for work.
What the Law Says About IME Time Limits
There is no specific time limit set out in NSW legislation that defines when an IME must occur after a claim is made. The law does not prescribe a fixed number of days within which an insurer must schedule an IME. Instead, the focus is on reasonableness and good faith. The insurer must act within a timeframe that is appropriate to the claim’s progress, the nature of the injury, and the need for medical evidence to determine entitlements to treatment and care benefits, weekly income payments, or damages.
SIRA’s guidance confirms that insurers must not delay an IME without justification. If an insurer delays an IME for an unreasonable period, such as more than 12 weeks after a claim is formally made or after a treatment plan has been established, the claimant may have grounds to challenge the delay. Delays that interfere with access to treatment, medical management, or the ability to return to work may be considered unreasonable under the Motor Accident Injuries Act 2017.
What Happens If an IME Is Conducted Outside Reasonable Time
If an insurer requests an IME after a period that a reasonable person would consider unacceptably long, the claimant may be able to argue that the insurer has failed to act in good faith. This could affect the insurer’s ability to rely on the IME report if it is submitted late or if the delay has caused harm, such as a delay in receiving treatment, a worsening of symptoms, or a loss of capacity to return to work.
An IME conducted more than 12 months after the accident may be challenged on grounds of relevance and reliability, particularly if the injury has resolved or if the claimant has already received a final medical assessment. The report may not be accepted as evidence if it is not contemporaneous with the claimant’s current condition.
Practical Steps to Protect Your Rights
If you are asked to attend an IME, you should:
- Confirm in writing that the request is from your insurer and not a third party.
- Request a copy of the insurer’s written justification for the IME, including the purpose and the expected outcome.
- Keep a record of all correspondence, including emails, letters, and text messages, regarding the IME.
- Note the date the IME was requested and the date it was scheduled.
- If the IME is delayed beyond 12 weeks from the date of request, document the delay and notify the insurer in writing that you consider the delay unreasonable.
- If the IME is more than 12 months after the accident, ask the insurer to explain why it is still necessary.
Evidence That Matters in IME Time Limit Disputes
The following records may support a claim that an IME was delayed unreasonably:
- Medical records showing ongoing treatment or symptoms at the time the IME was requested.
- Correspondence between you and your insurer showing the date the IME was first requested.
- A letter from your treating medical practitioner confirming that a delay in the IME has affected your treatment or recovery.
- Evidence that you were unable to return to work because of a delayed IME.
When to Seek Advice
If you believe your insurer has unreasonably delayed an IME, or if you have been asked to attend an IME more than 12 months after the accident, you should seek advice. Delays can impact your ability to access treatment, receive income support, or pursue a damages claim. In Western Sydney, where access to medical services may vary, delays in medical assessments can have a significant effect on recovery and claim outcomes.
A claimant who has been asked to attend an IME more than 12 months after the accident should ask the insurer to justify the delay and request a written explanation. If the insurer cannot provide a reasonable explanation, the claimant may have grounds to dispute the IME or seek a review through SIRA.
Hypothetical Example
A pedestrian in Liverpool, Western Sydney, was struck by a car in May 2024. The claim was reported in June 2024. The insurer did not request an IME until November 2025, more than 17 months after the accident. The claimant had been under ongoing treatment for a back injury and had not returned to work. The insurer’s IME report was submitted in January 2026. The claimant’s treating doctor wrote that the delay had prevented timely intervention and worsened the condition. In this case, the claimant may argue that the insurer’s failure to act in a timely manner contributed to the injury’s persistence. The insurer may not be able to rely on the IME report if it is not contemporaneous with the claimant’s current condition.
Next Steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.