Understanding CTP Claims When the At-Fault Driver Has No Insurance
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).
In New South Wales, if you are injured in a motor accident caused by a driver who does not hold valid Compulsory Third Party (CTP) insurance, your claim is still governed by the Motor Accident Injuries Act 2017 and administered by the Personal Injury Commission (PIC). The PIC expects claimants to provide clear evidence that the at-fault driver was operating a vehicle without valid CTP cover at the time of the accident. This is not a defence to liability but a critical factor in determining whether a claim can proceed under the CTP scheme. The PIC will assess whether the driver was uninsured at the time of the accident, and if so, the claim may be processed under the standard CTP framework, subject to the same eligibility and evidence requirements as any other claim.
What the PIC Requires to Assess Uninsured Driver Claims
The PIC expects claimants to provide specific evidence to establish that the at-fault driver had no valid CTP insurance. This includes:
- A police report confirming the driver was not insured at the time of the accident.
- A copy of the vehicle registration record showing no CTP insurance was listed on the vehicle at the time of the accident.
- A statement from the driver admitting they were not insured, or a sworn affidavit from a witness who observed the driver operating the vehicle without insurance.
- Evidence that the driver was not covered under any other CTP policy, including a policy held by a third party such as a family member or employer.
The PIC will not accept a claim based solely on a claimant’s assertion that the driver was uninsured. The burden of proof lies with the claimant to demonstrate, on reasonable grounds, that the driver was not insured at the time of the accident. Without this evidence, the claim may be rejected or referred to the Motor Accident Commission for further review.
How SIRA’s Guidance Applies to Disputes in Ballina
The State Insurance Regulatory Authority (SIRA) provides clear guidance on how disputes involving uninsured drivers are handled under the CTP scheme. SIRA’s position is that a claim may proceed even if the at-fault driver was uninsured, provided the claimant has met the statutory requirements for a CTP claim, including:
- The injury occurred in a motor accident involving a motor vehicle.
- The claimant was not at fault or was not more than 50% at fault.
- The claimant has provided medical evidence of injury and, where applicable, a whole person impairment (WPI) assessment.
In Ballina, as in the rest of NSW, the PIC follows SIRA’s published guidelines when assessing disputes. If a claim is disputed on the grounds that the at-fault driver was uninsured, the PIC will review all submitted evidence and may request additional documentation. The PIC will not automatically accept a claim based on an uninsured driver status alone. The claim must still meet the threshold injury and damages eligibility criteria under the Motor Accident Injuries Act 2017.
Expectations for Resolving Disputes in CTP Claims
The PIC expects claimants to engage in good faith dispute resolution. If a claim is disputed, the PIC will issue a written decision outlining the reasons for the decision. The claimant may then request an internal review within 28 days of receiving the decision. The internal review will be conducted by a different PIC officer, and the claimant must submit any new evidence that was not previously provided.
If the internal review upholds the original decision, the claimant may apply to the Personal Injury Commission (PIC) for a review of the decision. The review process is not a re-hearing but a review of the evidence and legal reasoning. The claimant must provide a written submission explaining why the decision should be changed. The PIC may request additional medical evidence, including a second opinion from an independent medical practitioner, if the original assessment is considered incomplete or inconsistent.
Practical Steps and Evidence That Matter
To strengthen a claim involving an uninsured driver in Ballina, you should:
- Seek medical treatment immediately and keep all records, including diagnosis, treatment notes, and any referrals.
- Take photographs of the accident scene, vehicle damage, and any visible injuries.
- Collect contact details of witnesses and obtain written statements if possible.
- Request a copy of the vehicle’s registration history from the Roads and Maritime Services (RMS) to confirm no CTP insurance was listed at the time of the accident.
- Notify your insurer or the PIC as soon as possible, ideally within 30 days of the accident, to preserve your rights.
Time Limits and the Importance of Acting Promptly
There is no statutory time limit for making a CTP claim in NSW, but delays may affect the availability of evidence. The PIC may reject a claim if evidence is not provided within a reasonable time, particularly if the accident occurred more than 12 months ago. The PIC may also require a claimant to explain any delay in reporting the accident or seeking treatment.
A Realistic Example
A pedestrian in Ballina was struck by a car on 15 May 2026. The driver fled the scene and was later identified as not having CTP insurance. The pedestrian reported the incident to police, who confirmed the driver had no valid CTP policy. The pedestrian submitted a claim to the PIC with a police report, medical records, and a WPI assessment. The PIC initially declined the claim on the grounds that the injury was not severe enough to meet the threshold for damages. The pedestrian requested an internal review, submitted a new medical report from a specialist, and the review was upheld. The claim was then referred to the Personal Injury Commission for a damages determination.
When to Seek Independent Advice
The PIC’s expectations in disputes involving uninsured drivers are based on statutory law and SIRA’s published guidelines. However, the outcome of a claim depends on the facts, evidence, and legal interpretation. If you are facing a dispute, it is advisable to seek independent legal advice to understand your rights and options, particularly if you are seeking damages or have a complex injury.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.