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How are disputes resolves under the Motor Accidents Compensation Act NSW

Tuesday, July 07, 2015

 

This information is for accidents before 1 December 2017. For accidents after 1 December 2017 the law has changed please CLICK HERE.


 

HOW ARE DISPUTES RESOLVED UNDER THE MOTOR ACCIDENTS COMPENSATION ACT

If you have a dispute with a CTP motor vehicle insurer then you can request a review through the insurer's own internal dispute resolution procedure. However in our experience this rarely resolves the dispute.

The Motor Accidents Authority has set up two (2) services to deal with disputes:‑

  1. Medical disputes are determined by the Medical Assessment Service(MAS); and
  2. Other disputes are determined by the Claims Assessment & Resolution Service (CARS).
  • MAS – Medical Disputes

The Medical Assessment Service (MAS) assesses medical disputes about:‑

  1. Whether treatment is reasonable and necessary;
  2. Whether treatment is related to the accident;
  3. What injuries are related to the accident and;
  4. Whether your injuries exceed the 10% whole person impairment threshold.

You will be referred by MAS to an independent medical specialist. A Doctor will be appointed who will examine you, review your medical records and make a decision concerning the medical dispute following the Motor Accidents Guidelines on assessing such disputes or impairment.

A detailed report is provided usually 2-3 weeks following the appointment.

The determination of a MAS doctor's assessment is usually final and binding on all parties with only a limited right of appeal.

An appeal can only be made if the Doctor has failed to follow the guidelines or made some other error of law.

 

  • CARS - Arbitration

If you cannot reach an agreement with the insurer about procedural matters or the amount of compensation you are entitled to receive for your claim then the matter can be resolved through the Claims Assessment & Resolution Service (CARS). CARS can decide disputes including:‑

Procedural matters such as;

  • Whether a late claim can be made.
  • Whether an insurer can reject a claim form for being incomplete.
  • Whether the insurer can reject a claim for failing to report the accident to the police.

Compensation disputes such as;

  • The amount of compensation you are entitled to receive under the Act as a result of your injuries. This is known as a General Assessment.

Most cases go to CARS due to an inability to reach agreement with the insurer as to how much compensation your claim is worth.

If you are unable to agree with the insurer we will file a General Assessment Dispute with CARS.

You will need a Lawyer to assist you in obtaining the necessary evidence to determine the full extent of economic and non economic loss you are entitled to receive. This will include medical evidence and financial records.

What is CARS?

CARS is an Arbitration system which is conducted in a conference room not a Court. A senior lawyer is appointed to act like a Judge and reads all the evidence, hears submissions by each party and then makes a formal written decision usually with 21 days of the arbitration.

A determination by CARS is binding on the insurer however an injured person can elect to have the matter re-heard by the District Court of NSW.

When do I commence Court proceedings?

Certain types of claims are unable to be determined by CARS. Those claims can proceed to the District Court of NSW. This includes the following types of claims:‑

•             Where liability has been denied by the insurer.

•             Where there are complex legal or other issues involved.

In these types of matters a claim can be commenced immediately in the District court of NSW and will be determined by a Judge rather than through arbitration at CARS.

A Statement of Claim is filed in the Court which outlines your case and how much compensation is claimed. The judge reads all documentary evidence, listens to all the spoken evidence and then hears the submissions by each party. Usually a written decision is made with 1 - 2 months.

The Judges decision is final however can be appealed by either party if an error of law has been made.

Should you have any questions please do not hesitate to contact us on (02) 8518 1120 or info@garlingandco.com.au.

About Matthew Garling.

Matthew Garling, Founder of Garling & Co is a NSW Law Society Accredited Specialist in Personal Injury Law. He specialises in compensation law and has acted on behalf of thousands of injured people in work accidents, motor vehicle accidents and negligence cases over the last 20 years.

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