We expect insurers to operate with honesty, due care and diligence and in accordance with the guidelines set out by us.
Selling green slips
Insurers are licensed to sell Green Slips. In general insurers must:
- act in good faith with all customers
- never unfairly discriminate against individual customers or groups of customers
- have clear and practical processes for issuing Green Slips to customers
- make sure their Green Slip insurance is readily accessible and available to all customers
Insurers must comply with guidelines for selling, issuing and administering Green Slips.
The guidelines include:
- Market practice and business plan guidelines (from 1 November 2014)
- Premiums determination guidelines (2015)
- MCIS levy collection and refund guidelines (from 1 May 2014)
- Section 14 guidelines (effective 1 January 2010)
Insurers have specific obligations when managing claims. The objective of these is to optimise claimants' recovery from injury and resolve claims as quickly as possible.
The insurer is obliged to:
- accept or deny the claim
- resolve the claim fairly and in a timely manner
And where the claim is accepted:
- provide access to reasonable and necessary treatment, rehabilitation and care
- make payments, and
- make a reasonable offer of settlement
Insurers managing claims are also required to comply with specific requirements which are contained in the:
- Motor accident guidelines: claims handling and medical (treatment, rehabilitation and care)
(effective 1 January 2017). A single set of guidelines were introduced to promote an integrated approach to claims handling and risk based regulation. The guidelines will be used by all NSW CTP insurers for current and new claims from 1 January 2017. They replace the previous claims handling guidelines and the treatment, rehabilitation and attendant care guidelines. The new guidelines are intended to improve the claims experience, minimise disputes and focus on early treatment and recovery.
- Motor Accidents Compensation Regulation 2015
Good communication and cooperation between you, the injured person and the professionals involved is important to assist in the injured person’s recovery and resolution of their claim.
Injury management and assessment
We have developed guidelines to promote best practice in managing some of the injuries that commonly occur in motor vehicle accidents.
Insurers should use evidenced based guidelines when considering requests for services for people with these injuries.
These can include:
- Whiplash guidelines
- Whiplash quick reference guide
- Neuropsychological assessment guidelines (when arranging the neuropsychological assessment of children and adults with traumatic brain injury)
For other advice see our injury management pages:
Insurers responsible for claimants with treatment, rehabilitation and care needs should be familiar with the nationally endorsed clinical framework for the Delivery of Health Services.
The framework sets out five guiding principles for health professionals to support the delivery of the right care at the right time to people with a compensable injury. You should consider these principles when reviewing treatment plans and requests for services:
- Measure and demonstrate the effectiveness of treatment.
- Adopt a biopsychosocial approach – that is consider the whole person.
- Empower the injured person to manage their injury.
- Implement goals focussed on optimising function, participation and return to work.
- Base treatment on the best available research evidence.