Common Mistakes When Lodging a SIRA Complaint
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).
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 you're in Bega NSW and have a complaint about your motor accident insurer, understanding how to proceed correctly is critical. One of the most frequent errors people make is failing to provide sufficient evidence to support their claim. SIRA requires detailed documentation, including medical records, accident reports, and correspondence with the insurer. Without this, complaints may be dismissed or delayed.
NSW CTP Rules Behind SIRA Complaints
SIRA complaints are governed by the Motor Accident Injuries Act 2017 and the Motor Accident Guidelines. These laws outline what claims are available and how insurers must handle them. For example, if your insurer refuses to pay for treatment or disputes the severity of your injury, you must demonstrate that the injury meets the 'threshold injury' criteria under the guidelines. Failing to prove this can weaken your case.
Practical Steps and Evidence to Gather
When lodging a complaint with SIRA, ensure you:
- Collect all medical records, including reports from doctors and specialists
- Obtain a copy of the accident report from the police or relevant authority
- Note any communication with your insurer, including dates and details of denied claims
- Gather witness statements if available
- Keep records of any financial impact, such as lost income or medical expenses
These documents help SIRA assess whether your insurer has acted fairly under the CTP scheme.
Time Limits and Dispute Options
You must lodge a complaint with SIRA within 52 weeks of the accident if you're seeking benefits under the Motor Accident Injuries Act. However, this timeframe doesn't apply to complaints about the insurer's conduct. If your complaint is rejected, you can request a review or escalate the matter to the NSW Civil and Administrative Tribunal (NCAT). Always act promptly to avoid procedural issues.
When to Seek Legal Advice
If your complaint is denied or delayed, consider consulting a solicitor specialising in CTP claims. They can help you understand your options, including whether to pursue a dispute through NCAT or seek compensation for breach of duty. Remember, each case is unique, and the outcome depends on the specific facts and evidence.
Final Steps
Avoid common errors like incomplete documentation or missing deadlines. If you're unsure about your options, complete the quick, no obligation enquiry form to request contact about your circumstances. Every claim depends on its own facts.