CTP Insurer Late Payment Interest During Medical Assessments
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).
If your NSW CTP insurer delays payment of statutory benefits during medical assessments, you may be entitled to interest under the Motor Accident Injuries Act 2017. This article explains your legal rights, how the CTP scheme handles delayed payments, and steps to take if your claim is affected.
Legal Basis for Payment Interest
NSW CTP insurers must pay interest when statutory benefits are delayed. Section 3.11 of the Motor Accident Injuries Act 2017 requires insurers to pay interest on unpaid benefits, including weekly income payments and treatment benefits. This applies even if the delay occurs during medical assessments. The exact rate of interest is determined by the Motor Accident Injuries Regulation 2017, which typically aligns with the current Bank of Australia rate.
How the CTP Scheme Handles Delayed Payments
CTP insurers must pay interest for each day a benefit is unpaid. This includes situations where medical assessments are pending or delayed. For example, if your insurer delays payment of weekly income benefits while waiting for a medical report, you may claim interest for the period of delay. The SIRA guidelines (https://www.sira.nsw.gov.au/claims/motor-accidents) confirm that interest applies to all unpaid statutory benefits, including those related to medical assessments.
Steps for Claimants on the Central Coast
- Document the delay: Keep records of all communication with your insurer, including dates of correspondence and details of any delayed payments.
- Request written confirmation: Ask your insurer to confirm the payment date and interest rate being applied.
- Seek medical evidence: Ensure your medical assessments are completed promptly to avoid further delays in benefit payments.
- Contact SIRA: If your insurer refuses to pay interest, contact the State Insurance Regulatory Authority (SIRA) for assistance. SIRA can investigate complaints about delayed payments and interest calculations.
Time Limits and When to Seek Advice
NSW CTP insurers must pay interest within 52 weeks of the accident date for threshold injuries. If your claim involves injuries exceeding the threshold, interest applies for the full duration of your benefits. However, time limits exist for disputing payment delays. If your insurer refuses to pay interest, you should seek legal advice within 6 months of the delay being identified. This ensures you can challenge the insurer’s decision under the Motor Accident Injuries Act 2017.
Example Scenario
Consider a claimant who sustained a soft-tissue injury (threshold injury) on the Central Coast. Their insurer delayed payment of weekly income benefits for 12 weeks while awaiting a medical assessment. Under the CTP scheme, the insurer must pay interest for the 12-week period. The claimant could claim interest calculated at the Bank of Australia rate, which would typically be around 5% annually.
When to Seek Legal Advice
If your insurer refuses to pay interest or disputes your claim, consult a solicitor specialising in NSW CTP claims. Legal advice is particularly important if your injury involves a whole person impairment rating or if the insurer claims contributory fault. A lawyer can help you understand your rights and ensure the insurer complies with the law.
Next Steps
CTP insurers must pay interest for delayed payments, but the process can be complex. If your claim involves medical assessments on the Central Coast, ensure you document all delays and seek legal advice if necessary. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.