What Is The Claims Process

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WHAT IS THE CLAIMS PROCESS
  1. Treatment and Rehabilitation

Once you have lodged your Personal Injury Claim Form you will be allocated a Claim Reference Number which you should quote to any treatment providers. The CTP Insurer will arrange for a rehabilitation officer to contact you directly to discuss your treatment needs with you. This is because the CTP Insurer had a duty under the law to ensure you receive reasonable and necessary treatment.


  1. What if the CTP Insurer denies payment for my treatment?

The CTP Insurer may deny liability for payment of your treatment if they do not believe it is reasonable and necessary. This then creates a “medical dispute”. All medical disputes need to be determined by the Motor Accident Assessment Service (MAS).   Your lawyer will discuss your options in the case of the CTP Insurer denying payment for treatment.

The Motor Accident Assessment Service is also responsible for determining any disputes concerning entitlements to compensation for Non Economic Loss (Pain and Suffering) and Domestic assistance.


  1. What happens when my claim is ready to resolve?

If your matter can not be settled by way of an agreement with the CTP Insurer, your claim will need to be referred to the Claims Assessment Resolution Service (CARS) where an “Assessor” who is likely to be a very experienced Lawyer or Barrister will assess your claim and make a determination as to the value of your claim.

Before your matter can be referred for a formal assessment of compensation by the Claims Assessment Resolution Service there are procedures in place to ensure that the parties to the dispute attempt to reach a settlement of the matter. Most matters do in fact resolve at settlement conferences.

Determinations by the Claims Assessment Resolution Services are generally binding on the CTP Insurer (exceptions apply) but are not binding on the injured claimant. An injured claimant has the right of review to a Judge of the District Court. It is essential you seek legal advice before seeking a review of a decision by a CARS assessment by a Judge in the District Court as there can be legal costs ramifications.