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Are You Unrepresented in a CTP Claim?

Claiming compensation after a motor vehicle accident can be a very complex process.

The introduction of the Motor Accident Injuries Act 2017 (‘MAI Act’) in December 2017 (which replaced the former Motor Accident Compensation Act 1999) introduced a no-fault statutory compensation scheme covering medical treatment expenses and lost wages for a period of up to six months.

Further statutory benefits are possible after that six months but the claimant needs to prove that someone else was at fault for the accident.

In New South Wales an injured person is allowed to make a compulsory third party (‘CTP’) insurance claim on their own as an ‘unrepresented claimant’. But while taking this course might appear at first to be a more economical option, you also take on a very heavy load of time-consuming and stressful administrative work. In all compensation claims, strict time limits apply to making the claim and filing documentation in support of it, including police reports, medical assessments, payslips and more.

Perhaps the most challenging part of making a compensation claim on your own is dealing with the CTP insurer. The imbalance in resources between an insurance company and an unrepresented claimant means that people will sometimes feel intimidated into accepting a settlement offer that is neither in their best interests nor reflective of the loss they have suffered.

For these reasons, engaging an expert Sydney Workers compensation lawyer to guide you through the claims process is worth every cent. The ‘Report of the Independent Review of Insurer Profit within the NSW Compulsory Third Party Scheme’ to the State Insurance Regulatory Authority (‘SIRA’) in 2015 found that claimants with legal representation received a gross pay-out figure on average eight times greater than for claimants who were unrepresented.

Three-year time limit

December 2020 will mark the three-year anniversary of the introduction of the MAI Act.

If you are eligible, you have a period of three years from the date of the car accident in which to start a claim for damages. This time limit is likely to see numerous unrepresented claimants commencing claims in the coming months.

Many of these claimants will receive offers from insurers that may not accurately reflect the amount they are entitled to. Without a solid understanding of the complexity involved in how claims are assessed, it can be very difficult for an unrepresented claimant to work out whether they are being offered a reasonable settlement amount or not. It is tempting to accept an offer and be done with it, but this is not always wise.

Additionally, some settlement agreements proposed by insurance companies extinguish your right to make any further claim in relation to the injuries you’ve suffered, depriving you of the possibility of greater compensation from a common law claim, for example.

The insurer may also deny the claim on the basis of a technicality in the legislation or claim you contributed to the accident which caused the injury. In both situations, the services of an experienced compensation lawyer in answering the insurance company’s claims can prove invaluable.

Unrepresented claimants and disputes

When there is a dispute or disagreement about a CTP insurer’s settlement offer for a personal injury claim that occurred after 1 December 2017, a claimant can request an Insurer Internal Review within 28 days after receiving the insurer’s decision.

If a claimant remains dissatisfied after this review process, they may apply to SIRA’s Dispute Resolution Service (DRS) to try and resolve the issues or receive an independent determination of the dispute.

Some commentators have described this process as almost impossible to navigate for an unrepresented claimant. Not only does it impose a heavy administrative burden on a claimant, but there are also time limits for both processes which add stress and worry to the life of a person who is usually still recovering from an injury.

Contact us to see how we can help

While SIRA has introduced a CTP Legal Advisory Service for those injured in motor vehicle accidents after 1 December 2017, it can only provide limited advice on the statutory benefits available and some other matters. Nor can it file any applications or documents on your behalf to a court or the DRS.

Our personal injury lawyers at BPC Lawyers can advise you on all aspects of making a personal injury CTP claim and fully represent you in seeing it through to a satisfactory resolution. We have award-winning experts who will take the stress out of making a claim if you are seeking to do so within the three-year time limit since the introduction of the MIA Act. Call us today for an initial appointment on (02) 8280 6900.