Where a person's only injuries resulting from the accident are threshold injuries, weekly benefits and treatment and care generally cease after 52 weeks (ss 3.11 and 3.28).
If you're involved in a motor accident in Newcastle or the Hunter region and believe an insurer mishandled evidence or records, you may need to contact the NSW Motor Accident Claims Authority (SIRA). This article explains what evidence to preserve, how to formally complain to SIRA, and the procedures for reviewing claims. It also covers time limits and when to seek legal advice.
What Evidence to Keep for CTP Claims
When dealing with insurers, claimants must retain specific documents to support their case. Key records include:
- Medical reports detailing injuries and treatment
- Accident reports from police or witnesses
- Photographs of the scene, vehicle damage, and injuries
- Copies of all correspondence with the insurer
- Income records to support claims for lost wages
- Evidence of ongoing treatment or rehabilitation
SIRA emphasizes that incomplete or lost records can weaken a claim. For example, if a claimant fails to document a doctor's advice about long-term care, it may affect eligibility for weekly income payments.
Filing a SIRA Complaint About Insurer Evidence
To complain about an insurer's handling of evidence, follow these steps:
- Review the insurer's response to ensure it addresses all claims in your claim form
- Gather evidence of the insurer's alleged misconduct, such as delayed responses or refusal to provide records
- Submit a written complaint to SIRA via their online portal or by mail
- Include supporting documents like emails, medical records, and witness statements
SIRA will assess whether the insurer breached its obligations under the Motor Accident Injuries Act 2017. For instance, if an insurer refuses to provide a copy of a medical report requested under section 3.11, this could constitute a breach of duty.
SIRA's Procedures for Reviewing Evidence Complaints
SIRA reviews complaints within 28 days of receipt. During this period, the insurer must respond to the complaint. If SIRA finds the insurer acted unreasonably, it may:
- Order the insurer to provide missing records
- Reassess the claim's value
- Issue a formal reprimand to the insurer
Claimants should note that SIRA does not provide legal advice, so it's important to understand that complaints are about evidence handling, not the merits of the claim itself.
Time Limits and When to Seek Advice
CTP claimants must submit their claim to SIRA within 52 weeks of the accident. If the claim is submitted late, SIRA may refuse it under section 4.4 of the Motor Accident Injuries Act 2017. However, if the delay is due to circumstances beyond the claimant's control, such as a medical condition preventing timely action, SIRA may still consider the claim.
If you're unsure whether your complaint meets SIRA's criteria, or if your insurer has refused to provide records, it's advisable to consult a solicitor. Legal professionals can help determine whether your case involves a breach of duty or if you need to pursue a separate legal action.
Next Steps for Claimants
Preserving evidence, understanding SIRA's complaint process, and knowing when to seek legal advice are critical for claimants in Newcastle and the Hunter region. If you're unsure about your next steps, complete the quick, no obligation enquiry form to request contact about your circumstances.