How are disputes with an insurer resolved?

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

Usually you need to make an application to the Motor Accidents Authority of NSW to resolve 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).
  2. Other disputes are determined by the Claims Assessment & Resolution Service (CARS).

1. MAS

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

  • Whether treatment is reasonable and necessary
  • Whether treatment is related to the accident
  • Whether your injuries exceed the 10% whole person impairment threshold

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

2. CARS

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:

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

If you are unable to agree with the insurer and you need to file a General Assessment you will need the assistance of your Lawyer. 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.

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.