--- title: "Complaint to the Independent Review Office about a workers compensation or CTP insurer" url: "https://ailawframework.com/precedents/personal-injury-and-compensation/nsw-iro-insurer-complaint" type: "precedent" site: "AI Law Framework" id: "a21-nsw-iro-insurer-complaint" area_id: "A21" kind: "letter" ai_level: "yellow" version: 1 task_ids: ["A21-B5-6", "A21-T1-R13", "A21-WC20261023-12"] law_stated_as_at: "2026-10-23" --- # Complaint to the Independent Review Office about a workers compensation or CTP insurer > Letter for a complaint to the New South Wales Independent Review Office about a workers compensation insurer or a CTP insurer, with the two pathways kept apart. Canonical page: https://ailawframework.com/precedents/personal-injury-and-compensation/nsw-iro-insurer-complaint Law stated as at: 2026-10-23 Site index for agents: https://ailawframework.com/llms.txt ## Key facts - Kind: Letter. A letter or email you adapt and send. - Practice area: [Personal Injury & Compensation](https://ailawframework.com/precedents/personal-injury-and-compensation.md) - Jurisdictions: New South Wales - AI level: Yellow. You and the tool draft together, with you directing. You check every statement you rely on. - Law stated as at: 2026-10-23 - Status: Maintained. Checked on 2026-10-23 against the 3 authorities it cites, for New South Wales. ## When to use it Use when a problem with a New South Wales workers compensation insurer or CTP insurer has not been resolved directly with the insurer, and the firm tells the Independent Review Office what is wrong. Do not use it for the insurer's own internal review, the SIRA review form, or an application to the Personal Injury Commission. ## Used for these tasks - [Prepare a CTP or workers compensation dispute submission from the scheme file](https://ailawframework.com/practice/personal-injury-and-compensation/prepare-a-ctp-or-workers-compensation-dispute-submission-from-the-scheme.md) - [Draft correspondence to the insurer or scheme agent](https://ailawframework.com/practice/personal-injury-and-compensation/draft-correspondence-to-the-insurer-or-scheme-agent.md) - [Check which forum can review a refusal to fund treatment](https://ailawframework.com/practice/personal-injury-and-compensation/check-which-forum-can-review-a-refusal-to-fund-treatment.md) ## How AI may be used The tool may prepare this letter from the claim file and list what was already asked of the insurer, and the lawyer decides whether the Office is the right path and sends it. **AI may:** - State whether the claim is workers compensation or CTP, and what was already raised with the insurer - List delays, a declined claim, treatment not approved, poor communication, or an entitlements dispute, using events already on the file - Index the insurer's letters that are being complained about **AI must not:** - Must not fill in the Office's web form. Its fields did not render on the page that was opened, and they are not invented here - Must not say this complaint is the insurer's internal review, a SIRA review, or a Personal Injury Commission application - Must not say the complaint stops time, or that the Office can change a decision, beyond the outcomes the workers page lists - Must not state what the CTP page says the Office cannot do. That part of the page was not read. The complaints-about-insurers policy was not opened **The lawyer checks:** - Lodge the complaint on the Office's form where a workers compensation or CTP claim has been made and the problem cannot be resolved with the insurer. If no claim has been made, the page points elsewhere. The complaint page prints 139 476 - Workers complaints on the page include delays, a declined claim, treatment not approved, poor communication, and disputes about entitlements. The steps are contact online or by phone, contact with the insurer, review against the scheme rules, and resolution - Workers outcomes the page lists are to progress delayed payments or decisions, clarify how a decision was made, address claim management, resolve insurer disputes, and improve communication - For more complex workers compensation disputes the page says the Office manages ILARS, can arrange approved lawyers, and can fund advice and representation for eligible matters. Who is eligible is not set out beyond those words - Some disputes can be referred to the Personal Injury Commission. The Office can explain the process and the options. It says it does not represent either party - CTP: try the insurer first, by a complaint and a response, or by asking for a review of the decision. The Office looks at delays in determining the claim and at weekly benefits or medical treatment - If the CTP outcome sought is not achieved, the page says the Office can explain how guidelines or legislation may have applied and whether a formal dispute path exists. It reviews a complaint usually within 2 business days. The can and cannot lists were not read - Health, wage and scheme records stay in the firm's approved tool. ASCR r 9 and APP 11 apply. A breach may be notifiable under the Privacy Act 1988 (Cth). ## Authorities - [Independent Review Office, Submit a complaint about your insurer (a workers compensation or CTP claim in NSW, where the problem cannot be resolved directly with the insurer)](https://www.iro.nsw.gov.au/contact-us-about-your-insurer/) - [Independent Review Office, Services for injured workers, insurer complaints (what the Office does, outcomes it lists, ILARS, and referral to the Personal Injury Commission)](https://www.iro.nsw.gov.au/injured-at-work/services-for-injured-workers-insurer-complaints/) - [Independent Review Office, Complaints about CTP insurers (try the insurer first, delays and weekly benefits or medical treatment, and the stated process)](https://www.iro.nsw.gov.au/injured-in-a-motor-vehicle-crash/complaints-about-ctp-insurers/) ## Full text and drafting notes The full text and the drafting notes are not part of this public page. Signed-in firm accounts can read them at https://ailawframework.com/precedents/personal-injury-and-compensation/nsw-iro-insurer-complaint and through the signed-in MCP connector https://ailawframework.com/mcp/firm. *Practice guidance for planning and review. Confirm current primary sources and the requirements of the actual matter. This is general information, not legal advice.*