After a claim is lodged
The insurer may ask you (the claimant) to provide additional information about the claim and the circumstances out of which it arises. If so, the insurer will send you an Additional Information Form (PDF 205 K).
Additional Information
This form should be completed and returned within 1 month after the date the information is requested or 9 months after the accident or date of first appearance of symptoms, whichever is the later.
If the claim has been made against the Nominal Defendant in respect of an unidentified vehicle, the form must be returned within 1 month after the date of request or 3 months of the accident, or whichever is the later date.
You must co-operate with the insurer and give information reasonably requested.
Who decides if liability for a claim is accepted
A claims manager from the insurance company will decide whether liability for your claim is accepted. For liability to be accepted, negligence must be established against another person. The insurer may need to investigate the accident to determine liability. The insurer has six months after receipt of the claim form in which to make a determination on liability. By admitting liability the insurer agrees that the vehicle insured by them was at fault for the accident. If liability is denied, and the matters in dispute cannot be resolved at a compulsory conference you will have to take the matter to Court for resolution.
The CTP insurer's obligations
On receipt of your claim, the insurer must:
- Contact you within 14 days of receiving the Notice of Accident Claim Form (PDF 255 K) with a decision on whether or not your claim form is a satisfactory notice and whether or not the insurer is prepared to meet any reasonable and appropriate rehabilitation expenses you may require.
- Determine liability within six months of receiving a satisfactorily completed Notice of Accident Claim Form.
- Attempt to settle the claim as soon as practicable.
Once liability has been admitted or a decision made on rehabilitation, the insurer must:
- Take steps to ensure reasonable and appropriate rehabilitation services are provided.
- Meet the reasonable costs of medical, hospital and pharmaceutical expense based on the extent of liability, which is measured as a percentage.
The insurer may be prepared to pay for treatment and rehabilitation services without accepting liability. In these instances the insurer must first give approval.
Claimant's obligations
As a claimant, you must be prepared to help the insurer with its investigation of the accident. You may be required to give specific information, photographs, documents or records, and you may be required to have a medical examination or assessment. You must also take all reasonable steps to recover from your injury. Reasonable steps may include:
- Having recommended medical treatment;
- Undergoing recommended rehabilitation therapy or rehabilitation programs; and
- Returning to work or taking specified steps to obtain employment.
Last reviewed 9 July 2009
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