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Medical disputes

The Medical Assessment Service (MAS) can help if there’s been a claim for compensation following a motor vehicle accident but the injured person and the insurer can’t agree on something to do with permanent impairment or medical treatment.

SIRA’s Dispute Resolution Service (DRS) delivers independent dispute  resolution services for disputes between insurers and injured people in the CTP Green Slip Scheme. This includes disputes related to injuries sustained in accidents that occurred on or before 30 November 2017  assessed at the Medical Assessment Service (MAS) and the Claims Assessment and Resolution Service (CARS).

Either the injured person (or their legal representative) or the insurer can make an application to DRS for resolution of a medical dispute. Then the other party will have a chance to reply to that application.

How injured people can lodge a dispute application with DRS to resolve a Medical Dispute or submit a reply

  • You can apply online or by completing a form
  • Lodging a dispute application is free

Need help submitting your application?

If you have any enquiries before submitting, you can call DRS on 1800 34 77 88.

How to lodge a dispute application with DRS or submit a reply

Online

The fastest way to lodge your application or reply is online using the SIRA DRS Portal. If you use the Portal, DRS will receive your application immediately. You can also view documents related to your application and follow the progress of your application in the Portal.

Learn more about the SIRA DRS Portal.

Your lawyer can also lodge an application or reply on your behalf using the DRS Legal Portal.

Using a form

If you prefer to fill in a form and send it to DRS, you must use one of the following forms.

Application forms:

If you need more space to list extra documents on your form, use this extra document information form.  Continue the numbering and attach it to your application.

Reply forms:

You must send a copy of your completed dispute application or reply form and all supporting information to DRS as well as the other party.

Please email your form and supporting information to DRS at: drsenquiries@sira.nsw.gov.au

Or alternatively mail it to:

Dispute Resolution Service (DRS)
State Insurance Regulatory Authority
Level 19, 1 Oxford St,
Darlinghurst NSW 2010
Or DX 10 Sydney

How insurers must lodge a dispute application with DRS to resolve a Medical Dispute or lodge a reply

Insurers must use the DRS Insurer Portal to lodge all dispute applications and replies.

Learn more about the DRS Insurer Portal

Access the DRS Insurer Portal

What happens next?

The medical dispute resolution process

After we receive your application or reply form we will review it and in most cases, allocate it to a DRS medical assessor so they can carry out a medical assessment and possibly an examination.

A medical decision maker is an independent health practitioner with expertise in conducting medical assessments and determining matters  relating to motor accident claims.

Depending on your injuries, you may need to attend more than one medical examination.

We will advise you  of all the medical assessment details (eg medical decision maker’s name, location of any examination, date and time).

If you can’t attend, contact us immediately (if you don’t turn up, or you make a late cancellation, you might be charged a cancellation  fee).

After the examination is finished, the medical decision maker will consider all the available documentation and make a decision about your dispute.

They will provide a certificate setting out their decision and the supporting reasons.  In most cases the certificate and reasons will be sent within three weeks of the appointment.

Everyone’s situation is different.  We encourage you to contact us so we can talk you through the process and answer any questions you might have. You can also read these fact sheets:

Expenses

The insurer must pay a claimant's reasonable expenses (including travel expenses) to attend a medical assessment examination.

If you don’t turn up  or make a cancellation with less than 1 weeks’ notice, you may be required to pay a cancellation fee. Please contact us as soon as possible if you need to cancel.

Further information

Medical decision makers and assessment venues

Medical decision makers are independent DRS decision makers, appointed to make impartial determinations of medical disputes.

Medical assessments are held at a number of locations in the Sydney metropolitan area, rural and regional NSW, as well as outside NSW.

There are more than 150 medical decision makers with their own professional medical rooms  and medical specialties. You can also read our venue policy for more information about the location of medical assessment examinations.

Details of the appointed DRS medical decision makers can be found here:

Administrative law challenges to medical assessments

Decisions made by the medical decision makers may be subject to judicial review in the NSW Supreme Court. See our decisions page for more information.