Your CTP insurer tells you they are arranging an ISV assessment in your car accident claim. What does this mean?

In South Australia, car accident injury compensation claims are assessed by reference to the Civil Liability Act (SA) and the Civil Liability Regulations 2013 (SA), and with the use of an Injury Scale Value (ISV) assessment. The ISV that is assessed will then assist with determining the compensation you are entitled to claim.  

Once your injuries are stable, an ISV medical assessment will be arranged to assist in assessing your injuries. If you do not have a lawyer involved in your claim, the CTP insurer will choose the assessor and arrange the assessment.   An accredited doctor needs to perform the assessment, and it is important that an appropriate assessor is selected for the ISV assessment in your claim.  While doctors are required to be independent, insurers tend to use selected doctors rather than the next person on the list. As a result, it is important to speak to a lawyer as soon as possible if the CTP insurer raises the topic of arranging an ISV assessment. Lawyers tend to recommend different Doctors to those that the insurers usually select.

The doctor performing the ISV assessment is required to address the following topics in their assessment report:

1. The doctor’s opinion as to the diagnosis of each of the injuries assessed.
2. The likely prognosis. That is, the likely course/outcome of the injuries.
3. Whether the injuries are stable. That is, whether the injuries have reached a point that they are unlikely to get better or worse.
4. Whether the injuries have been caused by the motor vehicle accident.
5. The effect of the motor vehicle accident on any pre-existing injury and the extent to which those injuries have been made worse by the injuries sustained in the motor vehicle accident.
6. The effect of the motor vehicle accident on any injury sustained after the motor vehicle accident occurred, and the extent to which it has been made worse by the injuries sustained in the motor vehicle accident.
7. The assessment method used. That is, whether the doctor has used AMA5, GEPIC or some other assessment method with detailed reasons provided for the assessment method and application.
8. If relevant, the Whole Person Impairment for each injury, which is a percentage impairment rating.
9. The Injury Scale Value item number. Schedule 1 of the Civil Liability Regulations 2013 sets out item numbers for injuries as well as a guide for the assessment of the ISV item number.

Additional questions can be asked of the doctor performing the ISV assessment but need to be agreed with the CTP insurer prior to the assessment.  A lawyer will recommend appropriate additional questions to you, covering things like:

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1. Treatment needs including any future surgery;
2. Your future ability to do housework and gardening; and
3. The effect of your injuries on your long term ability to work.

While the ISV assessment is used as a tool to assess the ISV rating it is not determinative, and it is not a once and for all assessment. It is however important to ensure the most appropriate doctor is chosen to perform the ISV assessment so that the ISV assessment report provides you with the best chance of maximising the compensation you are entitled to. It is therefore important that you speak to motor vehicle accident lawyers in Adelaide who understand the ISV system.

At MKF Lawyers we provide legal advice and assistance to clients injured in motor vehicle accidents across South Australia. We can provide you with legal advice regarding managing a request by a CTP insurer to arrange an ISV assessment and the best way to secure the compensation you are entitled to.

Contact us by telephone on 08 7093 2998, by text to 0482 075 591 or by submitting a free claim check here to speak to one of our Adelaide based motor vehicle accident lawyers today about your claim. We work on a no win no fee basis and we offer a first free discussion about your claim so there’s no up front cost to obtain the information and assistance you need for your motor vehicle accident claim.

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