We could never anticipate the mishap or accidents that could transpire once we hit the road. This brings New South Wales to require mandatory greenslips, otherwise known as Compulsory Third Party (CTP) insurance for all road users.
Different insurance providers have their own terms when it comes to the coverage of “at-fault” drivers. For some providers, all their greenslips have automatic “at-fault” coverage. However, it is likely to incur higher premiums.
To maximise your compensation, you’ll need to be familiar with the processes of claiming for damages and benefits of NSW greenslip refund.
Basic Terms
A Compulsory Third Party plan covers the third party for motor vehicle accidents as stated in New South Wales law. Third Parties can best be described as other road users, pedestrians as well as passengers in the vehicle. It is important to note that CTP does not generally cover the “at-fault” driver, i.e. the first party. If you are not at fault driver injured in a road accident, then you are the third party and is therefore covered by the “at-fault” drivers’ CTP policy.
Let’s address the focus terms that are most useful in this article.
Benefits
This term pertains to the monetary benefits that will be received by approved claimants. This includes expenses for administering treatment and medical care, income loss and funeral expenses in the event of possible death.
Damages
This term is sub-categorised as economic and non-economic damages. Future working disability which leads to any loss of income is referred to as economic damages. Aspects such as pain and suffering contributing to the degradation of one’s quality of life should be referred to as non-economic damages.
Both sub-categories provide comparatively higher financial benefits because of the serious nature of detriment afflicted to the aggrieved party such as income loss, emotional suffering or physical pain.
How to Claim Benefits
To immediately receive weekly income payments, parties must accomplish the claims process within 28 days beginning from the date of the accident. Submitting claims after 28 days but within 3 months allows you to get your weekly income payments in line with the recovery plan of the insurance company.
Needed Forms
To start your claims process, you’ll need some specific forms as required by the insurer. It is worth pointing out that vital information needed by the at-fault driver’s insurer must be collected first before completing these forms. The following forms should be submitted three months from the date of the accident.
- Fit for Work Certification
- Personal Injury Benefits Application Form
- Funeral Expenses Application Form
Secure a Certificate of Fitness
After recuperating from your injuries, it’s vital to immediately secure a health exam. The investigating law enforcer should assist the aggrieved party to receive an examination from a nearby GP. It is important to have this exam within the first 28 days from the day of the accident to get the most out of your claims.
A comprehensive report of your health status must be included by your GP as well as provide you with proper medical care. This report should apply to your Certificate of Fitness. To structure it as legal evidence, it should include a complete description of injuries incurred by the at-fault driver.
Registering the Accident at the Police
At the earliest possible time, book the accident at the nearest police post and secure your event number. In doing so, you provide the legal fact as to how the at-fault driver caused the accident as well as establish the date and events surrounding the incident. It’s also significant to add photographs, medical receipts, dashboard camera recordings, and other documentation of the accident in your report.
Notify the At-Fault Party Insurer
Contacting the at-fault party insurer in NSW is facilitated through the State Insurance Regulatory Authority (SIRA) Online Claim Notification Tool. The registration plate number of the at-fault vehicle should be duly entered in the aforementioned tool. Thus, it is very important to make sure to remember or take note of the registration numbers of the vehicles involved before leaving the scene of the accident.
Insurer Decision
It is estimated that most insurers process claims and take around 4 weeks to arrive with a decision after submitting your claim within the 28-day cutoff. Under other conditions, the soonest possible date they would arrive with a decision should be within three months from the day of the accident.
Post-Claim
Your recovery plan will be handled directly by your insurer. After contacting you, insurers will draft a schedule of itemised weekly income for you to receive as well as enumerate the required documents to be submitted. Insurers may include specific documentation for physical retraining, signed clearances for return to work rehabilitation programs, and progress reviews.
SIRA may also classify minor injuries formally as Minor Motor Vehicle Accident Injuries. Demand for these claims may be facilitated after 26 weeks of payments.
Damage Claims Procedure
Claims for damages should allow the injured parties to submit their claims within 20 to up to 36 months for accidents involving motor vehicles where they were not at fault.
If the claim involves the death of the insured party, their representatives can process claims at any given time.
Required Forms
Submit the following required documents to the insurer of the at-fault party’s to start your claim:
- Personal Injury Benefits Application Form
- Damages Application Form
- Evidence of Income
Medical and Clinical Exams
Prompt treatment from qualified GP’s should immediately be given to the injured parties. After recuperating, claimants can go through other clinical examinations for injuries incurred from a motor vehicle accident. A Certificate of Impairment will be provided by the assessor who will review the submitted medical reports and other records from the attending hospital.
This impairment certificate aids insurers to itemise all injuries and damages caused by the accident. This information, which is needed in their final decision, allows insurers to determine a markup figure for the party’s compensation.
Expected Period of Decision
A party is given 3 months to provide a proper response to the damage claimant. Insurers should address in their decision both economic and non-economic damages sustained by the victims as well as a full itemisation of the course of their decision. Hereafter, the aggrieved or injured parties will be given a chance to challenge the decision made by the insurer and file an appropriate request for internal review. In this instance, the challenged insurers will closely cooperate with arbitrary reviewers until making a full decision within two weeks.
Post-Claim
Akin to post-claim for benefits, claimants will cooperate with at-fault party insurers to develop a recovery plan to ensure receipt of their weekly payments as well as submitting the required progress reports.
At the significant improvement of the claimant’s’ condition, insurers will provide a final claim for the respective damages. This amount is usually given in lump-sum. By legal limitations, only the SIRA Dispute Resolution Service or lawyers of the claimant have the authority to settle disputes with the insurer to provide the required transparency and impartiality.
