What is an internal review
An internal review is when an insurer re-evaluates a decision they previously made about your claim. A skilled and experienced person, who did not have a role in the original decision, will conduct the review. The decision can be changed or remain the same.
The reviewer will consider the information used in the initial decision, as well as any further information you provide.
Application time limits
You need to apply for an internal review within 28 days of receiving the insurer’s decision. Late applications may be declined.
If the insurer accepts your application, they will provide the outcome within 14 to 21 days, which may extend to 28 days if further information is needed.
How to apply for a review
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#1 How to apply for a review
The insurer may ask you to complete a form and/or provide supporting information. Ensure you include:
- why you want an internal review
- what outcome you are seeking
- the part of the decision you want reconsidered (for example, amount of weekly benefits)
- any additional documents or material relevant to the review.
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#2 Insurer will carry out review
- The insurer will acknowledge receipt of your application and explain their internal review process within two working days, either in writing or via post or email.
- The insurer will complete the review and notify you of the outcome within 14 or 21 days.
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#3 Completion of review and decision made
- You will receive a written notification detailing the outcome and how the decision was reached.
- You can contact the insurer or SIRA for clarification.
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#4 Refer to the Personal Injury Commision
If you’re not happy with the internal review decision, or if it’s not provided within 28 days, you can lodge a further dispute with the independent Personal Injury Commission (PIC).
Contact the PIC on 1800 742 679 between 8:30am – 5:00pm, Monday to Friday (except public holidays).
Where to get more help
Contact CTP Assist
CTP Assist is an information service provided by SIRA. Call them on 1300 656 919 between 8.30am - 5pm weekdays, or email ctpassist@sira.nsw.gov.au.
Contact the insurer's internal review team
Contact your insurer’s customer relations team. Contact details can be found on the insurer's website.
Contact the Independent Review Office
Contact the Independent Review Office (IRO) on 13 94 76 between 8:30am-5:30pm weekdays, or email complaints@iro.nsw.gov.au
Legal advice
If you would like to seek legal advice you can contact the Law Society of NSW
Updated 19 December 2024