Motor accidents
This section contains essential information for insurers that are licensed (or want to apply for a licence) to operate in the NSW Motor Accidents CTP Scheme.
Compulsory Third Party (CTP) insurance, also known as Green Slip insurance, is compulsory in all Australian states and territories and a requirement of motor vehicle registration.
Licensed insurers in the NSW CTP Scheme protect vehicle owners from liability if their vehicle causes injury or death to other road users.
The scheme protects:
- pedestrians, passengers, cyclists, motorcyclists
- drivers of other vehicles and
- to a limited extent, the driver at fault
- the close relatives of people killed in a crash.
We have licensed six insurers to operate in the NSW CTP Scheme. For more information about licensing, refer to Part 9, Division 9.1, Section 9.2 of the Motor Accident Injuries Act 2017. Business plan requirements are detailed in Part 3 of the Motor Accident Guidelines.
The role of licensed insurers
Insurers are responsible for:
1. 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.
For all policies issued on or after 1 December 2017, the Motor accident guidelines (issued under the Motor Accidents Injuries Act 2017) apply.
2. Managing claims made under the Motor Accident Injuries Act 2017
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 liability for the claim within a prescribed timeframe under the Act.
Where liability is accepted, the insurer must:
- commence payment of statutory benefits without delay
- provide access to reasonable and necessary treatment, rehabilitation and care
- make a reasonable offer of settlement of a damages claim as soon as practicable.
Insurers managing claims are also required to comply with specific requirements which are contained in the:
Joint Assessments
Under the Motor accident guidelines, both parties to a claim must use their best endeavours to agree to a joint medical or other health-related assessment.
The Guidance to Joint Medical or Other Health-Related Assessments in the CTP Scheme sets out an approach to support insurers and legal representatives of injured people reach agreement to a joint assessment during a damages claim. An editable template joint letter of instruction is also available.
The Guidance has been developed through consultation with key stakeholders including insurers, legal representatives and health practitioners working in the scheme, and aims to improve the claim experience for injured people by encouraging the use of joint assessments and minimising the number of assessments an injured person is required to undergo.
Parties are encouraged to use the information contained within the Guidance material to assist in meeting the requirements outlined in the Motor accident guidelines and in reaching agreement to a joint assessment.
3. Managing claims under the Motor Accidents Compensation Act 1999
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 liability for the claim, and where the claim is accepted:
- provide access to reasonable and necessary treatment, rehabilitation and care
- make relevant payments
- make a reasonable offer of settlement.
4. Guidance notes for insurers
Guidance notes are sometimes developed by SIRA to assist insurers in understanding how to apply certain parts of the legislation, regulations or Guidelines. They do not constitute legal advice and should not be relied upon by people in determining individual claims. They are guidance for insurers only and are not legislative instruments. SIRA publishes these notes so stakeholders can understand guidance provided to insurers.
- Threshold Injury Guidance Note
- Contributory Negligence Guidance Note
- Earner Guidance Note
- Internal Review Guidance Note
- Weekly Benefits and Sick Leave Guidance Note.
- Seeking Centrelink clearance for lump sum payments
Notifying SIRA about a significant matter
SIRA is the independent regulator of the CTP insurance scheme in NSW.
To fulfil its objectives and functions under the State Insurance and Care Governance Act 2015 and relevant scheme legislation, SIRA requires the timely and transparent notification of significant matters from licensed insurers and providers. These notifications enable SIRA to respond to significant matters related to policies of insurance, claims and other related matters under the scheme legislation.
For more information, please see the Notification of significant matters page.
Forms
Here are the forms you might need.
Publications
- Motor accident guidelines: claims handling and medical (treatment, rehabilitation and care) apply to current and new claims from 1 January 2017. The guidelines are intended to improve the claims experience, minimise disputes and focus on early treatment and recovery. They replace the previous claims handling guidelines and the treatment, rehabilitation and attendant care guidelines.
- The Motor Accidents Compensation Regulation 2015 sets out the costs that may be covered by the insurer under the scheme for certain services.
- Evidence-based guidelines should be used when considering requests for services for people with these injuries. These can include:
- Whiplash guidelines (2014)
- Whiplash quick reference guide (2015)
- Neuropsychological assessment guidelines (when arranging the neuropsychological assessment of children and adults with traumatic brain injury)
- Neuropsychological assessment fact sheet for solicitors, CTP insurers and LTCS staff
- our Treatment Advice Centre pages
- the nationally endorsed Clinical framework for the Delivery of Health Services
- Scheme reports
- The Guidance to Joint Medical or Other Health-Related Assessments in the CTP Scheme may be used by Insurers to assist in meeting their obligations under the Motor accident guidelines and to reach agreement to joint assessments for damages claims made in respect to accidents which occurred on or after 1 December 2017.
- The joint assessment template letter of instruction may be modified and used by parties where a joint assessment has been agreed to.