If your CTP claim was denied or reduced in Armidale, you may be able to request an internal review before escalating to the Personal Injury Commission (PIC) or SIRA. This guide explains how to challenge insurer decisions under NSW CTP laws, what evidence matters, and time limits to watch.
How to Request an Internal Review
Insurers must provide a written explanation for claim decisions under the Motor Accident Injuries Act 2017. If you disagree, you can ask for a reconsideration within 28 days of receiving the decision. SIRA's guidelines state that claims must be reviewed 'in the light of all relevant evidence' including medical reports, accident details, and witness statements.
To request a review, write to the insurer's claims manager with:
- A clear statement of your disagreement
- Specific reasons why you believe the decision is incorrect
- Supporting evidence such as medical records, accident reports, or expert opinions
Evidence to Support a Dispute
Insurers often deny claims based on perceived 'threshold injuries' or 'no fault' claims. To challenge this, you must prove:
- Medical evidence of injury (e.g., scans, specialist reports)
- Evidence of fault (e.g., police reports, witness accounts)
- Financial impact (e.g., wage loss records, medical bills)
In rural areas like Armidale, local doctors and accident reconstruction experts may be critical to proving your case. SIRA advises that 'clinical evidence must clearly show injury severity' to qualify for benefits.
Time Limits and Dispute Options
You must request an internal review within 28 days of the insurer's decision. If the review outcome is unsatisfactory, you can escalate to the PIC within 28 days of the review decision. Claims must be submitted to SIRA within 28 days of the PIC's final decision.
Note: Time limits apply strictly. For example, if an insurer denies a claim on 1 May 2026, you must request a review by 29 May 2026. Delays may prejudice your right to challenge the decision.
Example: Challenging a 'No Fault' Claim
A cyclist in Armidale was denied a claim because the insurer claimed the accident was 'no fault'. The injured person requested a review, providing:
- A doctor's report confirming soft tissue injury
- A police report showing the other driver ran a stop sign
- Witness statements from local residents
The insurer reconsidered and agreed to pay benefits. This shows how evidence of fault and injury can change insurer decisions.
When to Seek Advice
If your insurer refuses to review your claim, or if you're unsure about your options, contact a solicitor specialising in CTP claims. They can help you:
- Prepare a strong internal review request
- Navigate SIRA's dispute resolution process
- Understand your rights under the Motor Accident Injuries Act 2017
Next Steps
CTP claims depend on strict time limits and evidence requirements. If you're in Armidale and need help challenging an insurer's decision, complete the quick, no obligation enquiry form to request contact about your circumstances.