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Fill out the form below to find out how much you can claim. If you've already submitted a claim we'll tell you if you're entitled to additional benefits or a lump sum.
Fill out the form below to find out how much you can claim. If you've already submitted a claim we'll tell you if you're entitled to additional benefits or a lump sum. Call 1800 888 529.
The first step in the dispute process is to request an “Insurer Internal Review” (IIR). If you’re not satisfied with the outcome of the IIR, you can apply to SIRA’s Dispute Resolution Service (DRS) to help resolve the dispute.
If you’ve requested an IIR, it means you disagree with the insurer’s assessment or decision to reduce or cut off your benefits
- Minor / non-minor injury definition
- Treatment expenses denied
- Travel expenses to see treatment provider denied
Minor / non-minor injury definition.
This dispute arises if your injuries have been assessed as minor, but you believe they should have been assessed as non-minor. This could mean that your benefits have been cut off before you’re fully recovered or able to return to work, leaving you unable to support yourself financially or get the treatment and care that you need.
It would also mean you’re unable to make a claim for a lump sum to compensate you for future lost earnings or pain and suffering.
Please refer to our articles on how to get a head-to-toe assessment and minor and non-minor injuries explained for more information.
- You’ll need a certificate of capacity from a GP to support your position.
- It’s very important to make sure all your injuries are noted in your certificate of capacity.
- Include any new injuries, psychological injuries, side effects from medication or pre-existing conditions that have worsened.
- Remember, even though most of your injuries may be classified as minor, you only need to have one injury that falls into the non-minor category to successfully dispute the insurer’s position.
Treatment expenses denied.
If treatment expenses are denied by the insurer, it will usually be on the basis that the treatment is not “reasonable and necessary”. This is a subjective definition, open to interpretation, and even medical professionals may disagree on whether your treatment is reasonable and necessary.
What you need to understand is that the insurers employ medical and legal experts in this area, who have dealt with many claims and argued their opinion in many disputes. But don’t let that stop you from disputing the insurer’s decision –
call 1800 888 529 for free legal advice on how to succeed with your dispute.
Travel expenses to see treatment provider denied.
You may find yourself in a position where the insurer refuses to pay for travel expenses to and from treatment providers. This refusal is usually made on the basis that the insurer believes you’re physically able to travel on your own, on public transport or by driving. However, if your injuries are making it difficult for you to travel, you should dispute their decision.
- You’ll need to show medical evidence that supports your position.
- For example, a medical report that shows why you can’t drive, or why it’s hard for you to use public transport.
- If you plan to lodge a dispute, you’ll have a much better chance of success with legal experts on your side.
- SIRA does allow you to engage a lawyer for what’s known as a “paid dispute”, and the lawyer’s fees are covered by the insurer.
- If you’ve had travel expenses denied, call 1800 888 529 for free legal advice on where you stand.
What do I do next?
Be clear on your reasons for your dispute.
Read our article on getting help with your dispute.
Call our advice line if you need further assistance.
“What you need to understand is that the insurers employ medical and legal experts in this area, who have dealt with many claims and argued their opinion in many disputes. But don’t let that stop you from disputing the insurer’s decision.
