Does my CTP insurer have to act in my best interest?

The short answer is no.

At the start of the claim your case manager may seem like they are doing everything they can to help you and they probably are.

Arranging treatment is the primary factor at this early stage. As time goes on you may find that treatment funding will no longer be approved. If you disagree with that decision you should seek the advice of a lawyer. Most lawyers offer no obligation or free advice at this stage.

Unlike a workers compensation claim, there is no requirement to pay any loss of income on a week to week basis and it is usually paid as a lump sum at the end. Interim payments of compensation can be paid if you can show financial hardship but otherwise you bear the cost of your lost income. Lawyers can assist with financial hardship applications as well as ensuring you preserve the evidence you will need to make your claim for lost income at settlement of your claim.

Your injuries may prevent you from performing tasks around your home or garden. The insurer may fund some assistance at the start of the claim but withdraw it at a later time. A lawyer can assist you in obtaining evidence from an expert that the need for such services still exists.

If liability for your claim is in dispute, including that you are being held partly liable for the accident, you should obtain legal advice because even small liability reductions can have a significant impact on your overall settlement.

The insurer is likely to refer you to an independent doctor for a one-off assessment of your injuries. Some doctors perform most of their assessments for insurers and very few for injured people. If the insurer is referring you to a doctor, this is an important time to speak to a lawyer and obtain advice. Engaging a lawyer at this time and having their input into selection of the doctor may result in you being able to see a more sympathetic doctor.

The insurer may make an offer to resolve your claim for a sum of money. They have no obligation to offer you fair or reasonable compensation. They do have an obligation to make profits for their shareholders. If an offer is made, it is highly recommended that you contact a lawyer for advice. There are numerous examples of injured persons achieving much higher compensation amounts after instructing a lawyer, following an offer from an insurer. Don’t rely on an insurer to advise you whether you should instruct a lawyer. Make the call.

You must issue proceedings in Court within 3 years of the motor vehicle accident or your claim will be out of time. If you miss that 3-year time limit, an insurer will rely on your claim being out of time and won’t pay compensation. You can seek an extension of time from the Court but there are numerous cases in which Courts have not granted extensions, and only some in which they do.

Issuing proceedings in Court yourself is very difficult and we recommend you consult with a lawyer if your claim is beyond the 2-year mark from the date of the accident so that you can be properly prepared.

At MKF Lawyers we can advise you at any stage of your motor vehicle accident claim. We are also available for out of hours appointments and discussions. Contact us for a free, no obligation discussion about your motor vehicle accident claim on 08 7093 2998 or by email at info@mkflawyers.com.au.  

For more information about motor vehicle accident claims, visit our web page here.

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