Motor accidents disputes – 2017 scheme

Disputes are assigned to the most appropriate dispute resolution pathway.

Miscellaneous claims assessment

Disputes are assigned to the most appropriate dispute resolution pathway.

The following matters are dealt with through the miscellaneous assessment dispute resolution pathway:

  • whether there has been due enquiry and search to establish the identity of a motor vehicle where there is a claim against the Nominal Defendant
  • whether a person with a claim against the Nominal Defendant was a trespasser on land that is a road related area open to the public for driving, riding or parking vehicles
  • whether the Nominal Defendant has lost the right to reject a claim because of a failure to make due inquiry and search to establish the identity of a vehicle
  • whether the death or injury of a person has resulted from an accident in NSW
  • determining the insurer of the at-fault motor vehicle in an accident
  • determining whether the motor accident was caused by a person other than the claimant
  • whether the accident was mostly caused by the claimant
  • whether the insurer is entitled to refuse payment of statutory benefits because the claimant committed a serious driving offence
  • whether the insurer is entitled to reduce the statutory benefits payable after twelve months  because of the claimant was contributory negligent
  • whether for a motor accident is a no-fault motor accident
  • whether the claimant has given a full and satisfactory explanation for non-compliance with a duty or for delay
  • whether the motor accident verification requirements have been complied with
  • whether notice of a claim has been given in accordance with the requirements of the Motor Accidents Injuries Act 2017 (the Act)
  • whether the insurer is entitled to refuse payment of statutory benefits because of a failure to make a claim within the required time
  • whether a late claim may be made for damages
  • whether a claim may be rejected for non-compliance with section 6.15 (‘How notice of claims given’) of the Act
  • any issue of liability for a claim, or part of a claim, for statutory benefits not otherwise specified in Schedule 6 of the Motor Accident Injuries Act 2017
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Lodgment
Lodgment Assessment

Lodgment

When to lodge a dispute resolution application

A miscellaneous claims dispute may be lodged with the Commission when:

  • the decision has been the subject of an internal review by the insurer
  • the insurer has declined to conduct an internal review
  • the insurer has failed to complete an internal review and notify the claimant of the decision within the required timeframe, or
  • the Motor Accident Injuries Regulation 2017 provides that an internal review is not required.

How to lodge an application

Applications to resolve a miscellaneous claims dispute should be lodged via the Commission’s online portal.

If a self-represented claimant is unable to use the portal to lodge their application, they may contact the Commission to obtain a PDF copy of the form or have an application mailed to them. These applications may be lodged via email or post, or in person at the Commission.

An application for miscellaneous claims assessment must include:

  • the decision that is referred for a miscellaneous claims assessment
  • the alternative decision sought
  • the reasons the decision should be changed
  • any regulated costs sought (if applicable).

All relevant information must be attached to the application. An application should not be lodged until all relevant material is available. Additional information may be provided in limited circumstances where an application is made on an approved form and it is considered to be in the interests of justice that the information be included in the application.

How to respond to an application

The respondent will receive a sealed copy of the application from the applicant and must respond within 14 days from the date on which the application was registered with the Commission in relation to:

  • death or injury
  • serious driving offence exclusion
  • time for making a statutory benefits claim.

For all other miscellaneous claims the time for lodging a reply is 21 days from the date on which the application was registered with the Commission.

The response must be lodged through the Commission’s online lodgement portal.

If a self-represented respondent is unable to use the portal to lodge their response, they may contact the Commission to obtain a PDF copy of the form or have a copy mailed to them. These forms and the accompanying documents may be lodged via email or post, or in person at the Commission.

All relevant information that has not been included by the applicant should be attached by the respondent at the time the response is lodged. Respondents may not be able to submit further information at a later time.

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Assessment

Assessment process

The Commission will allocate the matter to a member, who will determine the most appropriate way to conduct the assessment. This may include conducting the assessment on the basis of the documents and information lodged in the application and reply only or via teleconference, videoconference or face-to-face meeting.

Decision

The Member will issue the parties with a Certificate of Determination following the miscellaneous claims assessment and attach a brief statement of reasons for the determination.

What is the status of the decision? 

The decision of the Member about a miscellaneous claims assessment matter relating to a claim for statutory benefits is binding on the parties to the dispute.

How long does resolving a dispute take?

The time taken to resolve a dispute depends on:

  • the issues in dispute
  • the standard of preparation by the parties
  • the willingness of parties to genuinely attempt resolution
  • whether a decision is appealed.

The Commission aims to resolve disputes as quickly as possible and will encourage the parties to resolve their dispute at the earliest opportunity.

Relevant resources

Procedural Direction PIC 2 – Determination of matters ‘on the papers’

Procedural Direction PIC 3 – Documents and late documents

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