What Evidence Must NSW CTP Insurers Retain During Internal Reviews?
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).
NSW Compulsory Third Party (CTP) insurers must retain specific evidence during internal reviews of claims to comply with legal and regulatory standards. This includes medical records, accident reports, and all correspondence with claimants. The Central Coast-based insurer must document its assessment process to ensure transparency and fairness, as mandated by the Motor Accident Injuries Act 2017 and SIRA guidelines.
NSW CTP Rules Behind Evidence Retention
Under the Motor Accident Injuries Act 2017, insurers are legally obligated to maintain records that support their decisions. SIRA’s guidelines (https://www.sira.nsw.gov.au/claims/motor-accidents) clarify that insurers must retain evidence for at least five years, including:
- Medical evidence confirming injury severity
- Accident reports detailing the incident
- Correspondence with claimants and witnesses
- Internal review notes and decision rationales
This ensures claimants can challenge decisions and insurers can justify their assessments.
Practical Evidence to Keep During Internal Reviews
Insurers must preserve all documents that could affect a claim’s outcome. Key evidence includes:
- Medical records: Including diagnosis, treatment plans, and impairment assessments
- Accident reports: From police, witnesses, or scene investigators
- Witness statements: Including statements from parties involved
- Photographs: Of the accident scene, vehicle damage, and injuries
- Income records: To assess lost wages or care costs
For example, if an insurer disputes a claim for soft-tissue injuries, it must retain medical records proving the injury meets the threshold injury definition under the Motor Accident Guidelines.
Time Limits and Dispute Resolution
Insurers must complete internal reviews within 28 days of receiving new evidence (per SIRA’s internal review protocol). If a claimant disagrees with the outcome, they can:
- Request a written explanation of the insurer’s decision
- Submit additional evidence to support their claim
- Escalate to the Personal Injury Commission (PIC) for mediation
- Appeal to SIRA if the PIC does not resolve the dispute
Note: A challenge does not guarantee a changed decision. Insurers must demonstrate their review process adhered to legal standards.
When to Seek Legal Advice
Claimants should consult a solicitor if:
- The insurer refuses to provide a written explanation
- Evidence is lost or destroyed
- The internal review process exceeds 28 days
- The claimant believes the insurer has acted unlawfully
Legal professionals can help ensure insurers comply with evidence retention laws and navigate dispute resolution pathways.
Next Steps
CTP insurers on the Central Coast must retain specific evidence during internal reviews to comply with NSW law. If you believe an insurer has failed to keep proper records, seek legal advice to protect your claim. Time limits and procedural requirements mean acting promptly is critical.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.