Ask an NSW insurer to review a motor-accident benefits decision
MaintainedLast reviewed
Key facts
- Human involvement
- YellowClose supervision
- How AI is used
- From the decision and the date it was received, set out the 28-day request, what the request must identify, and the notification period in section 7.9(4) and guideline 7.25. Do not send the request, and do not treat the review as staying the decision.
- What the lawyer must review
- Decide whether to request the review, and settle anything sent.
- A request after 28 days may be accepted or declined in writing.
- The review does not stay the decision. Count the insurer's time from receipt of the request.
- Keep medical details in the firm's system. Apply ASCR rule 9, APP 11, and the Privacy Act notifiable-breach test.
Rules that apply
The document starts from the task name. Change it if this piece of work is different.
The work product
Forum. Personal Injury Commission motor-accident stream, after an insurer internal review, for an accident on or after 1 December 2017
Produce. A review request ready for the lawyer to send, with the 28-day and 14-day dates.
Have ready. Decision notice and the date it was received; The alternative decision sought; The issues the lawyer marks.
Example of the limit. Illustrative example: Weekly payments are refused and the notice is received on 1 April. The tool dates a request by 29 April and states that the review will not stay the refusal. The insurer's notice period is 14 days, or 21 days if guideline 7.25 applies, and not more than 28 days after the request. It does not send the request.
Stop and hand it back when
- The accident date is before 1 December 2017.
- The date the decision was received is not known.
Sources for this task were checked on 2026-10-23.
Who does what
| Role | What they do |
|---|---|
| Assistance | Do not begin AI assistance until the responsible lawyer has defined and confirmed its permitted scope. |
| Lawyer | Set the scope, supervise the work closely, verify every part relied on, resolve omissions and exceptions, and approve the exact output. |
Checklist
- For an accident on or after 1 December 2017, guideline 7.1 says the dispute process begins with an internal review, and a Commission application follows if that review does not resolve the matter. Section 7.19(2A) does not require an internal review before a medical dispute about the degree of permanent impairment is referred for assessment.
- The request is made within 28 days of receiving the decision, by the approved form, the online process, a letter or telephone. It identifies the decision, the alternative decision sought and the issues.
- The insurer notifies the result within 14 days of receiving the request, unless guideline 7.25 gives longer: 21 days for permanent impairment, a threshold injury, fault, mostly at fault, a serious driving offence, or contributory negligence. New information is 14 days after that information is provided. The maximum is 28 days after the request. The review may consider information that was not before the original decision.
- Section 7.9(7) says the review does not stay the decision. A late request may be declined, and the decline must say the claimant may refer the dispute to the Personal Injury Commission.
Sources
- SIRA Motor Accident Guidelines Part 7 · 2026-10-23
- Motor Accident Injuries Act 2017 (NSW) section 7.9 · 2026-10-23
This is the motor-accident internal review. It is not the workers compensation dispute path and it is not the Independent Review Office.