What to expect from insurers when making a claim
The greenslips.com.au Calculator helps vehicle owners find the cheapest price from all 6 NSW CTP insurers. These are AAMI, Allianz, GIO, NRMA Insurance, QBE and Youi. State Insurance Regulatory Authority (SIRA) provides quarterly data on insurer performance. This helps you make more informed comparisons and know what to expect if you make a CTP claim:
1. What are the chances of having my claim accepted? ›
2. How long will I wait for income support and treatment and care? ›
3. How soon will I be working after my accident? ›
4. What happens if I disagree with the insurer? ›
5. How many complaints and active claims do insurers have? ›
1. What are the chances of having my claim accepted?
The 2017 scheme made benefits available to all injured parties in the first 6 months after a road accident. After 1 April 2023, benefits can be extended for 12 months after the accident. Benefits include payments for loss of income, medical and rehabilitation costs.
Most insurers accept 97% of claims and must explain if they deny any claims. Common reasons are late claims (over 90 days), it was not a road accident, or the vehicle was uninsured or unidentified.
Table 1: Percentage of claims insurers accepted
| September 2024 | |
| AAMI | 98% |
| Allianz | 95% |
| GIO | 99% |
| NRMA Insurance | 97% |
| QBE | 97% |
| Youi | 99% |
| Average | 97% |
2. How long will I wait for income support and treatment and care?
How quickly insurers pay benefits is important for helping injured people make a full recovery after an accident. That is why insurers also pay pre-claim support before someone lodges a formal claim. At September 2024, it took an average of 4.4 weeks to receive first income support and 95% received treatment and care within 4 weeks.
Table 2a: Time in weeks to receive first income support
| September 2024 | ||
| weeks |
||
| AAMI | 4.4 | |
| Allianz | 3.4 | |
| GIO | 4.5 | |
| NRMA Insurance | 4.3 | |
| QBE | 5.0 | |
| Youi | 4.8 | |
| Average | 4.4 |
Table 2b: 3-year average weeks to receive income support
|
3-year average Jul 2021-June 2024 |
|
| 2 weeks | 31% |
| 2-4 weeks | 37% |
| 4-6 weeks | 16% |
| Over 6 weeks | 16% |
| Median weeks | 3 |
Table 2c: Percentage who received treatment and care within 4 weeks
| September 2024 | |
| AAMI | 93.8% |
| Allianz | 96.8% |
| GIO | 94.7% |
| NRMA Insurance | 94.9% |
| QBE | 95.1% |
| Youi | 94.8% |
| Average | 95.0% |
Table 2d: 3-year average weeks to receive treatment and care
|
3-year average Jul 2021-June 2024 |
|
| Pre-claim benefits paid | 70% |
| 2 weeks | 20% |
| 2-4 weeks | 5% |
| 4-6 weeks | 2% |
| Over 6 weeks | 3% |
3. How soon will I be working after my accident?
The percentage of people who are working at 26 weeks after the accident varies among insurers. The rolling 6-month average is:
- 64% return to work at 26 weeks
- 21% stay at work at 26 weeks
- 72% are working at 26 weeks.
Table 3: Percentage of people working at 26 weeks after date of accident.
| September 2024 | ||
| AAMI | 68.4% | |
| Allianz | 77.4% | |
| GIO | 68.8% | |
| NRMA Insurance | 70.3% | |
| QBE | 68.9% | |
| Youi | 76.9% | |
| Average | 71.8% |
4. What happens if I disagree with the insurer?
If you disagree with the insurer’s decision, you can request an internal review by the insurer. Types of decisions include threshold injury, treatment and care, weekly payments, or who was at fault in the accident. Insurers usually carry out internal reviews within 28 days.
Table 4a: Percentage of internal reviews within 28 days
Almost all insurers completed internal reviews within 28 days. Around 77% of reviews were upheld in the past 3 years.
| June 2024 | |
| AAMI | 100% |
| Allianz | 100% |
| GIO | 100% |
| NRMA Insurance | 99% |
| QBE | 99% |
| Youi | 100% |
| Average | 100% |
Table 4b: Percentage of insurer reviews upheld or overturned
The majority of insurer reviews were upheld and 21% of reviews were overturned in favour of the claimant.
| Type of internal review | Upheld | Overturned | New decision |
| Medical assessment | 82% | 17% | 1% |
| Merit review | 64% | 33% | 3% |
| Miscellaneous claims assessment | 77% | 23% | 0 |
| Other | 67% | 31% | 2% |
| Total | 78% | 21% | 1% |
5. How many complaints and active claims do insurers have?
Injured people can complain about insurers to the Independent Review Office (IRO). SIRA continues to manage complaints about all other aspects of the scheme. Complaints volumes do not include those directed to insurers.
In the year to June 2024, there were 1,178 complaints:
- 1,085 to IRO
- 93 to SIRA.
Table 5: Market share of complaints and active claims
| Complaints | Active Claims | |
| Year end 30 Sept 2024 |
Year end 30 Sept 2024 |
|
| AAMI | 12.2% | 10.4% |
| Allianz | 13.4% | 21.3% |
| GIO | 12.0% | 14.5% |
| NRMA Insurance | 36.4% | 29.5% |
| QBE | 24.8% | 22.2% |
| Youi | 1.2% | 2.1% |
Sources: State Insurance Regulatory Authority (SIRA) CTP Insurer Claims Experience and Customer Feedback Comparison, September 2024 and SIRA 2017 CTP Scheme Performance Report to 30 June 2024. Note, SIRA stated in March 2023 that it no longer publishes many metrics quarterly.