How SIRA Handles Disputes Over Vehicle Modifications in CTP Claims
If your CTP claim involves vehicle modifications like hand controls or mobility aids, disputes may arise over their necessity or cost. Under NSW law, the State Insurance Regulatory Authority (SIRA) oversees these claims. SIRA assesses whether modifications meet the 'reasonable and necessary' threshold under the Motor Accident Injuries Act 2017. Medical evidence from a specialist is critical to support your case.
Available Dispute Resolution Pathways
- Internal SIRA Review: You can request a review of your claim's assessment. SIRA will consider new evidence or re-evaluate existing documentation.
- Personal Injury Commission (PIC) Mediation: For disputes involving medical assessments, the PIC can mediate. This pathway is particularly relevant if your claimant's condition or treatment is contested.
- Independent Medical Examination (IME): SIRA may require an independent specialist to reassess your claimant's condition. This is common in cases where the original medical opinion is disputed.
Evidence Required for Vehicle Modifications Claims
To support your claim, you must provide:
- Medical records confirming the injury's impact on mobility
- Documentation of the modification's cost and installation
- Evidence of the modification's necessity (e.g., doctor's report)
- Any correspondence with SIRA or insurers
Practical Steps for Claimants
If your claim is disputed:
- Gather all medical and financial records
- Submit a formal request for internal review within 28 days of receiving SIRA's decision
- Consider PIC mediation if the dispute involves medical assessments
- Seek legal advice if your claim is rejected or if you need to challenge a decision
Time Limits and Next Steps
You have 28 days from receiving SIRA's decision to request a review. If the dispute involves medical evidence, the PIC may take up to 90 days to resolve. Claims must be submitted within 52 weeks of the accident for weekly benefits, though this timeline does not apply to vehicle modifications.
When to Seek Legal Advice
Consult a solicitor if:
- Your claim is rejected without explanation
- You need to challenge SIRA's medical opinion
- You face a dispute over the cost or necessity of modifications
- You want to explore alternative dispute resolution options
Example Scenario
A cyclist in Bankstown suffered a spinal injury requiring hand controls. SIRA disputed the modification's cost, arguing it exceeded the 'reasonable and necessary' threshold. The claimant submitted a specialist report confirming the modification's medical necessity, leading to a revised assessment.
Next Steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.